1
|
Takazono T, Hosogaya N, Fukushima K, Morio R, Irifune S, Miyamura T, Harada Y, Nagayoshi Y, Kondo A, Mihara T, Fukuda Y, Sasaki E, Sawai T, Imamura Y, Morikawa T, Futsuki Y, Inoue Y, Fukushima K, Suyama N, Tanaka H, Hanaka T, Shimabukuro I, Hata R, Ota K, Morimoto S, Nakada N, Ito Y, Yoshida M, Takeda K, Ide S, Iwanaga N, Nemoto K, Funada M, Izumikawa K, Yatera K, Yanagihara K, Mukae H. Efficacy and safety of lascufloxacin for nursing- and healthcare-associated pneumonia: A single-arm, open-label clinical trial. J Infect Chemother 2024:S1341-321X(24)00005-9. [PMID: 38190963 DOI: 10.1016/j.jiac.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/06/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND Nursing- and healthcare-associated pneumonia (NHCAP) constitutes most of the pneumonia in elderly patients including aspiration pneumonia in Japan. Lascufloxacin (LSFX) possesses broad antibacterial activity against respiratory pathogens, such as Streptococcus spp. And anaerobes inside the oral cavity. However, the efficacy and safety of LSFX in NHCAP treatment remains unknown. We aimed to evaluate the efficacy and safety of LSFX tablets in the treatment of patients with NHCAP. METHODS In this single-arm, open-label, uncontrolled study, LSFX was administered to patients with NHCAP at 24 facilities. The study participants were orally administered 75 mg LSFX once daily for 7 days. The primary endpoint was the clinical efficacy at the time of test of cure (TOC). The secondary endpoints included clinical efficacy at the time of end of treatment (EOT), early clinical efficacy, microbiological efficacy, and safety analysis. RESULT During the study period, 75 patients provided written informed consent to participate and were included. Finally, 56 and 71 patients were eligible for clinical efficacy and safety analyses, respectively. The median age of the patients was significantly high at 86 years. All patients were classified as having moderate disease severity using the A-DROP scoring system. LSFX tablets demonstrated high efficacy rates of 78.6 % at TOC and 89.3 % at EOT. The risk factors for resistant bacteria or aspiration pneumonia did not affect clinical efficacy. No severe adverse events associated with the study drugs were observed. CONCLUSION Oral LSFX is an acceptable treatment option for moderate NHCAP in elderly patients who can take oral medications.
Collapse
Affiliation(s)
- Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoki Hosogaya
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Koki Fukushima
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Internal Medicine, Izumikawa Hospital, Nagasaki, Japan
| | - Ryosuke Morio
- Department of Internal Medicine, Izumikawa Hospital, Nagasaki, Japan; Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Satoshi Irifune
- Department of Internal Medicine, Shimabara Hospital, Nagasaki, Japan
| | - Takuto Miyamura
- Department of Internal Medicine, Shimabara Hospital, Nagasaki, Japan
| | - Yosuke Harada
- Department of Internal Medicine, Nagasaki Kouseikai Hospital, Nagasaki, Japan; Department of Internal Medicine, Nagasaki Saiseikai Hospital, Nagasaki, Japan
| | - Yosuke Nagayoshi
- Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, Japan
| | - Akira Kondo
- Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, Japan
| | - Tomo Mihara
- Department of Internal Medicine, Japan Community Healthcare Organization Isahaya General Hospital, Nagasaki, Japan
| | - Yuichi Fukuda
- Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Eisuke Sasaki
- Department of Respiratory Medicine, Ureshino Medical Center, Saga, Japan
| | - Toyomitsu Sawai
- Department of Respiratory Medicine, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Yoshifumi Imamura
- Department of Internal Medicine, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Toru Morikawa
- Department of Internal Medicine, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Yoji Futsuki
- Department of Internal Medicine, Nagasaki Saiseikai Hospital, Nagasaki, Japan
| | - Yuichi Inoue
- Department of Internal Medicine, Japanese Aino Memorial Hospital, Nagasaki, Japan
| | - Kiyoyasu Fukushima
- Department of Internal Medicine, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital, Nagasaki, Japan
| | - Naofumi Suyama
- Department of Internal Medicine, Izumikawa Hospital, Nagasaki, Japan
| | - Hikaru Tanaka
- Department of Internal Medicine, Senju Hospital, Nagasaki, Japan
| | - Tetsuya Hanaka
- Department of Respiratory Medicine, Kurate Hospital, Fukuoka, Japan
| | | | - Ryosuke Hata
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Fukuoka, Japan
| | - Kenji Ota
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shimpei Morimoto
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Nana Nakada
- Health Center, Nagasaki University, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Internal Medicine, Nagasaki Goto Chuoh Hospital, Nagasaki, Japan
| | - Masataka Yoshida
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Respiratory Medicine, Sasebo City General Hospital, Nagasaki, Japan
| | - Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Midori Funada
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
| |
Collapse
|
2
|
Miyazaki T, Fukushima K, Hashiguchi K, Ide S, Kobayashi T, Sawai T, Yatera K, Kohno Y, Fukuda Y, Futsuki Y, Matsubara Y, Koga H, Mihara T, Sasaki E, Ashizawa N, Hirayama T, Takazono T, Yamamoto K, Imamura Y, Kaku N, Kosai K, Morinaga Y, Yanagihara K, Mukae H. A high α1-antitrypsin/interleukin-10 ratio predicts bacterial pneumonia in adults with community-acquired pneumonia: a prospective cohort study. Pneumonia (Nathan) 2023; 15:16. [PMID: 37876022 PMCID: PMC10599029 DOI: 10.1186/s41479-023-00118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Current microbiological tests fail to identify the causative microorganism in more than half of all pneumonia cases. We explored biomarkers that could be used for differentiating between bacterial and viral pneumonia in patients with community-acquired pneumonia (CAP). METHODS In this prospective cohort study conducted in Japan, data obtained from adult patients with bacterial pneumonia, including bacterial and viral coinfections (bacterial pneumonia [BP] group), and purely viral pneumonia (VP group) at diagnosis were analyzed using multivariate logistic regression analysis to identify predictors of bacterial pneumonia. Furthermore, a decision tree was developed using the predictors. RESULTS A total of 210 patients were analyzed. The BP and VP groups comprised 108 and 18 patients, respectively. The other 84 patients had no identified causative microorganism. The two groups shared similar characteristics, including disease severity; however, a significant difference (p < 0.05) was observed between the two groups regarding sputum type; sputum volume score; neutrophil counts; and serum levels of interleukin (IL)-8, IL-10, and α1-antitrypsin (AAT). Sputum volume score (p < 0.001), IL-10 (p < 0.001), and AAT (p = 0.008) were ultimately identified as predictors of BP. The area under the curve for these three variables on the receiver operating characteristic (ROC) curve was 0.927 (95% confidence interval [CI]: 0.881-0.974). The ROC curve for sputum volume score and an AAT/IL-10 ratio showed a diagnostic cutoff of 1 + and 65, respectively. Logistic regression analysis using dichotomized variables at the cutoff values showed that the odds ratios for the diagnosis of BP were 10.4 (95% CI: 2.2-50.2) for sputum volume score (absence vs. presence) and 19.8 (95% CI: 4.7-83.2) for AAT/IL-10 ratio (< 65 vs. ≥ 65). CONCLUSIONS Considering that obtaining a definitive etiologic diagnosis with the current testing methods is difficult and time consuming, a decision tree with two predictors, namely sputum volume and the AAT/IL-10 ratio, can be useful in predicting BP among patients diagnosed with CAP and facilitating the appropriate use of antibiotics. TRIAL REGISTRATION UMIN000034673 registered on November 29, 2018.
Collapse
Affiliation(s)
- Taiga Miyazaki
- Division of Respirology, Rheumatology, Infectious Diseases, and Neurology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
| | | | | | - Shotaro Ide
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Isahaya General Hospital, Isahaya, Japan
| | | | | | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | | | | | | | | | | | | | | | - Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- First Department of Internal Medicine, Division of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
| | - Yoshifumi Imamura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
- Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Norihito Kaku
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshitomo Morinaga
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| |
Collapse
|
3
|
Ide S, Sakamoto N, Hara S, Hara A, Kakugawa T, Nakamura Y, Futsuki Y, Izumikawa K, Ishimatsu Y, Yanagihara K, Mukae H. Interstitial Lung Disease Induced by Pazopanib Treatment. Intern Med 2017; 56:79-83. [PMID: 28050004 PMCID: PMC5313429 DOI: 10.2169/internalmedicine.56.7380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Although pneumothorax has been reported to be a major pulmonary adverse event in patients treated with pazopanib, a multikinase inhibitor, drug-induced interstitial lung disease (DILD) has not been reported. A 74-year-old Japanese man who received pazopanib for the treatment of femoral leiomyosarcoma and lung metastasis presented with dyspnea and fatigue. He had mild interstitial pneumonia when pazopanib treatment was initiated. Chest computed tomography revealed progressive bilateral ground-glass opacity (GGO) and traction bronchiectasis. We diagnosed DILD due to pazopanib. The patient's pazopanib treatment was interrupted and a steroid was administered. The symptoms and GGO were improved with treatment. Physicians should be aware of DILD due to pazopanib in patients with pre-existing interstitial lung disease.
Collapse
Affiliation(s)
- Shotaro Ide
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Ide S, Nakamura S, Yamamoto Y, Kohno Y, Fukuda Y, Ikeda H, Sasaki E, Yanagihara K, Higashiyama Y, Hashiguchi K, Futsuki Y, Inoue Y, Fukushima K, Suyama N, Kohno S. Epidemiology and clinical features of pulmonary nontuberculous mycobacteriosis in Nagasaki, Japan. PLoS One 2015; 10:e0128304. [PMID: 26020948 PMCID: PMC4447365 DOI: 10.1371/journal.pone.0128304] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 04/27/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Recent reports indicate that the incidence of nontuberculous mycobacterial-lung disease (NTM-LD) is increasing. This study aimed to investigate the epidemiology and clinical features of NTM-LD patients in Nagasaki prefecture, Japan to identify the negative prognostic factors for NTM-LD in Japan. METHODS The medical records of patients newly diagnosed with NTM-LD in eleven hospitals in Nagasaki prefecture between January 2001 and February 2010 were reviewed. Data regarding the annual population of each region and the incidence of all forms of tuberculosis were collected to assess geographic variations in NTM-LD incidence, isolates, and radiological features. RESULTS A total 975 patients were diagnosed with NTM-LD. The incidence increased over the study period and reached 11.0 and 10.1 per 100,000 population in 2008 and 2009, respectively. M. intracellulare was the most common pathogen in the southern region, and M. avium most common in other regions. The most common radiographic pattern was the nodular-bronchiectatic pattern. Age >60 years, body mass index <18.5 kg/m2, underlying lung disease, and cavitary pattern were the negative prognostic factors at the 1-year follow-up. CONCLUSIONS The incidence of NTM-LD has been increasing in Nagasaki prefecture. The isolates and radiographic features of patients vary markedly by region.
Collapse
Affiliation(s)
- Shotaro Ide
- Department of Respiratory Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Unit of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shigeki Nakamura
- Department of Respiratory Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
- * E-mail:
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | | | | | | | - Eisuke Sasaki
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | | | | | | | - Yuichi Inoue
- Isahaya Health Insurance General Hospital, Isahaya, Japan
| | | | | | - Shigeru Kohno
- Department of Respiratory Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
5
|
Yamamoto Y, Narasaki F, Futsuki Y, Fukushima K, Tomono K, Kadota J, Kohno S. Disopyramide-induced pneumonitis, diagnosed by lymphocyte stimulation test using bronchoalveolar lavage fluid. Intern Med 2001; 40:775-8. [PMID: 11518123 DOI: 10.2169/internalmedicine.40.775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 72-year-old man was admitted to our hospital with fever and cough. He had been on disopyramide treatment for nine days to control cardiac arrhythmia. On admission, chest X-ray examination revealed reticulonodular opacities in both lungs, and impending respiratory failure was evident. A differential cell count of the bronchoalveolar lavage fluid (BALF) showed a marked increase of lymphocytes. A lymphocyte stimulation test (LST) for disopyramide using BALF was positive, although the test using peripheral blood was negative. This case suggests that LST using BALF is useful for the diagnosis of drug-induced pneumonitis.
Collapse
Affiliation(s)
- Y Yamamoto
- Department of Internal Medicine, Nagasaki Prefecture Shimabara Onsen Hospital
| | | | | | | | | | | | | |
Collapse
|
6
|
Futsuki Y, Nagashima S, Yamamoto Y, Araki J, Asai S, Sawatari K, Maesaki S, Kohno S. [An imported case of primary pulmonary coccidioidomycosis]. Kansenshogaku Zasshi 2000; 74:580-4. [PMID: 10965661 DOI: 10.11150/kansenshogakuzasshi1970.74.580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Coccidioides immitis is a causative agent of coccidioidomycosis, which is one of the most dreadful mycosis because of its infectious and pathogenic nature. The endemic areas are in the southwestern parts of the United States and other semi-arid regions throughout the Western Hemisphere. During the early 1990s, the incidence of coccidioidomycosis in California increased dramatically, resulting in recognition for this mycosis as a reemerging infectious disease in the United States. The patients included a large number of non-informed visitors from non-endemic countries. Our report is on an imported case of primary pulmonary coccidioidomycosis. A 35-year-old Japanese male, after living in the United States for nine months, suffered from a combination of headache and fever. He was given a serological examination, and a chest radiograph in Phoenix, Arizona in the United States and was diagnosed as coccidioidomycosis. A daily dosage of 400 mg of fluconazole was administered and he returned to Japan. His headache and skin rash persisted and he was admitted to our hospital to evaluate the severity of his disease. There were no fungi cultured from neither bronchoalveolar nor cerebrospinal fluid and he was discharged. The patient had been treated with fluconazole and his symptoms, high-resolution CT and serological antibody titer were monitored. After 18 months, his clinical and radiological evolution was favorable and his serological IgM titer was below its sensitivity medication was stopped and there were no relapses.
Collapse
Affiliation(s)
- Y Futsuki
- Department of Internal Medicine, Sasebo General Hospital, Nagasaki
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Mizokami A, Eguchi K, Moriuchi R, Futsuki Y, Terada K, Nakamura H, Miyamoto T, Katamine S. Low copy numbers of human T-cell lymphotropic virus type I (HTLV-I) tax-like DNA detected in the salivary gland of seronegative patients with Sjögren's syndrome in an HTLV-I endemic area. Scand J Rheumatol 1998; 27:435-40. [PMID: 9855214 DOI: 10.1080/030097498442262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
To evaluate the hypothesis, proposed in previous reports from HTLV-I non-endemic areas, that HTLV-I is involved in a significant proportion, about a quarter, of Sjögren's syndrome patients who lack serum antibodies to the virus, we examined for the presence or absence of HTLV-I in DNA samples isolated from salivary gland tissues of 17 seronegative as well as 7 seropositive patients with Sjögren's syndrome in Nagasaki, Japan, where the virus is highly endemic. The nested two-step polymerase chain reaction (PCR), with a sensitivity capable of detecting a single DNA molecule, failed to amplify the HTLV-I tax sequence from DNA of 14 of the 17 seronegative patients. The tax was only amplifiable from the tissue DNA of the remaining three seronegative patients. The detection rate, 3/17 (18%), was, unexpectedly, less than those previously reported from the HTLV-I non-endemic areas. Moreover, in contrast to high viral loads (10(-1) to 10(-3) per cell) in the salivary gland of the seropositive patients, a semiquantitative PCR revealed that the copy number of the HTLV-I tax in the gland tissue of these seronegative patients was very low, 10(-5) per cell. This level is unlikely to be sufficient to promote an inflammatory reaction in the tissue. Our findings might argue against the involvement of "prototype" HTLV-I in the pathogenesis of Sjögren's syndrome in seronegative patients.
Collapse
Affiliation(s)
- A Mizokami
- Department of Bacteriology, Nagasaki University School of Medicine, Japan
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Asai S, Futsuki Y, Tomari S, Araki J. [Short-course chemotherapy of tuberculosis with pyrazinamide]. Nihon Rinsho 1998; 56:3087-90. [PMID: 9883615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A 6-month regimen consisting of isoniazid (INH. 0.3-0.5 g).rifampicin (RFP. 0.3-0.45 g).pyrazinamide (PZA. 1.2-2.0 g) and streptomycin (SM. 0.75 g) or ethambutol (EB. 0.75-1.0 g) given for 2 month followed by isoniazid and rifampicin for 4 month is the preferred treatment for patients with fully susceptible organism, who adhere to treatment. Consideration should be given to treating all patients with directly observed treatment.
Collapse
Affiliation(s)
- S Asai
- Sasebo City General Hospital
| | | | | | | |
Collapse
|
9
|
Mizukane R, Nakatomi M, Futsuki Y, Araki J, Asai S, Sawatari K, Hirakata Y, Maesaki S, Tomono K, Kohno S. [A study of virulence factors produced by MRSA strains isolated from blood samples]. Kansenshogaku Zasshi 1998; 72:788-93. [PMID: 9780580 DOI: 10.11150/kansenshogakuzasshi1970.72.788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Toxic shock syndrome toxin-1 (TSST-1) and enterotoxins are important virulence factors produced by Staphylococcus aureus. It is reported that these toxins are associated with septic shock and toxic shock syndrome. We investigated the toxin production and coagulase types of 701 MRSA strains isolated in Sasebo City General Hospital between 1994 and 1996 TSST-1 or/and enterotoxins were detected in 67% of all MRSA strains, and those were detected in 88% of MRSA strains isolated from blood samples. 45% of all MRSA strains produced both TSST-1 and enterotoxin C, and 70% of MRSA strains obtained from blood produced those toxins. Frequency of TSST-1 or/and enterotoxin production by MRSA strains isolated from blood samples was significantly higher than that by MRSA strains isolated from urine and pharynx (p < 0.05), and frequency of both TSST-1 and enterotoxin C production by MRSA isolates from blood was significantly higher than that by MRSA strains isolated from pharyngeal sample (p < 0.05). This study indicated that investigation of virulence factors produced by MRSA might give the useful information on prevention and treatment of MRSA infection.
Collapse
Affiliation(s)
- R Mizukane
- Internal Medicine, National Nagasaki Hospital
| | | | | | | | | | | | | | | | | | | |
Collapse
|