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Kobayashi K, Takahashi S, Yasuda M, Miyazaki J, Wada K, Matsumoto M, Hayami H, Yamamoto S, Kiyota H, Sato J, Matsumoto T, Hasegawa N, Kobayashi I, Masumori N, Kimura T, Yamada H, Nakagawa T, Kaneko T, Matsumoto K, Fujimura T, Kamei J, Ishikawa K, Fujimoto K, Nakai Y, Shigemura K, Sadahira T, Hinata N, Kitano H, Yamashita M, Yasufuku T, Komeda H, Hiyama Y, Takahashi Y, Kanamaru S, Murakami M, Arakawa S, Yamada D, Mita K, Hamasuna R, Tanaka K, Matsukawa M, Takaoka E, Shigeta M, Takenaka T, Nishino M, Ishitoya S, Hayakawa S, Okumura K, Ueda M. Fourth national Japanese antimicrobial susceptibility pattern surveillance program: Bacterial isolates from patients with complicated urinary tract infections. J Infect Chemother 2024:S1341-321X(24)00108-9. [PMID: 38588797 DOI: 10.1016/j.jiac.2024.03.024] [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: 03/08/2024] [Accepted: 03/31/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Antimicrobial susceptibility patterns of bacterial pathogens isolated from patients with complicated urinary tract infections were analyzed using the national surveillance data, comprising 793 bacterial strains from eight clinically relevant species. MATERIALS AND METHODS Data were collected for the fourth national surveillance project from July 2020 to December 2021 by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Disease, and the Japanese Society of Clinical Microbiology. Surveillance was supervised with the cooperation of 43 medical institutions throughout Japan. RESULTS Fluoroquinolone required a minimum inhibitory concentration (MIC) of 2-64 mg/L to inhibit the 330 tested Escherichia coli strains. The proportion of levofloxacin-resistant E. coli strains increased from 28.6% in 2008 to 29.6% in 2011, 38.5% in 2015, and 44.5% in 2021. The proportion of levofloxacin-resistant strains of Pseudomonas aeruginosa also increased from previous survey results, showing a continuing downward trend. Conversely, the proportion of levofloxacin-resistant strains of Enterococcus faecalis decreased relative to previous reports. Neither multidrug-resistant P. aeruginosa nor carbapenem-resistant Enterobacteriaceae were detected. For methicillin-resistant Staphylococcus aureus (MRSA), the proportion of vancomycin-susceptible strains (MIC of 2 μg/mL) decreased from 14.7% to 7.7%. DISCUSSION Bacterial strains that produced extended-spectrum β-lactamase included E. coli (82/330 strains, 24.8%), Klebsiella pneumoniae (11/68 strains, 16.2%), and Proteus mirabilis (4/26 strains, 15.4%). As compared to previous surveillance reports, these strains showed an increase in proportion over the years.
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Affiliation(s)
- Kanao Kobayashi
- Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Japan Organization of Occupational Health and Safety, Chugoku Rosai Hospital, Hiroshima, Japan.
| | - Satoshi Takahashi
- Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Mitsuru Yasuda
- Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Jun Miyazaki
- Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, International University of Health and Welfare Ichikawa Hospital, Chiba, Japan
| | - Koichiro Wada
- Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Shimane University Faculty of Medicine, Shimane, Japan
| | - Masahiro Matsumoto
- Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, The University of Occupational and Environmental Health, Fukuoka, Japan
| | - Hiroshi Hayami
- Urogenital Sub-Committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Hanafusa Urology Clinic(former), Miyazaki, Japan
| | - Shingo Yamamoto
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan; Department of Urology, Hyogo College of Medicine, Hyogo, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan; Iguchi Nephrourology and Internal Medicine Clinic Shinkoiwa, Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | | | - Naoki Hasegawa
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Intetsu Kobayashi
- Department of Infection Control and Prevention, Toho University Faculty of Nursing, Tokyo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroki Yamada
- Department of Urology, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tomoyuki Kaneko
- Department of Urology, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazumasa Matsumoto
- Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan
| | | | - Jun Kamei
- Department of Urology, Jichi Medical University, Tochigi, Japan
| | - Kiyohito Ishikawa
- Department of Urology, School of Medicine, Fujita Health University, Aichi, Japan
| | | | - Yasushi Nakai
- Department of Urology, Nara Medical University, Nara, Japan
| | - Katsumi Shigemura
- Division of Urology, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Nobuyuki Hinata
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Kitano
- Department of Urology, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
| | | | | | - Hisao Komeda
- Department of Urology, Gifu Municipal Hospital, Gifu, Japan
| | - Yoshiki Hiyama
- Department of Urology, Hakodate Goryokaku Hospital, Hokkaido, Japan
| | - Yoshito Takahashi
- Department of Urology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Sojun Kanamaru
- Department of Urology, Kobe City Nishi-Kobe Medical Center, Hyogo, Japan
| | - Masaya Murakami
- Department of Urology, Fuji City General Hospital, Shizuoka, Japan
| | - Soichi Arakawa
- Department of Urology, Sanda City Hospital, Hyogo, Japan
| | - Daisuke Yamada
- Department of Urology, Mitoyo General Hospital, Kagawa, Japan
| | - Koji Mita
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital (formerly Hiroshima City Asa Citizens Hospital), Hiroshima, Japan
| | | | - Kazushi Tanaka
- Department of Urology, Kita-Harima Medical Center, Hyogo, Japan
| | | | - Eiichiro Takaoka
- Department of Urology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Masanobu Shigeta
- Department of Urology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Tadasu Takenaka
- Department of Urology, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Masashi Nishino
- Department of Urology, Japanese Red Cross Hamamatsu Hospital, Shizuoka, Japan
| | - Satoshi Ishitoya
- Department of Urology, Japanese Red Cross Otsu Hospital, Shiga, Japan
| | - Shohei Hayakawa
- Department of Urology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
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Hiyama Y. Editorial comment to Lower bleeding volume contributes to decreasing surgical site infection in radical cystectomy: A propensity score-matched comparison of open versus robot-assisted radical cystectomy. Int J Urol 2024; 31:437. [PMID: 38287227 DOI: 10.1111/iju.15407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, NTT Medical Center Sapporo, Hokkaido, Japan
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Shindo T, Hashimoto K, Takahashi A, Miyamoto S, Kunishima Y, Sato S, Fukuta F, Hiyama Y, Takayanagi A, Kato R, Wanifuchi A, Ueki Y, Okada M, Adachi H, Kobayashi KO, Tanaka T, Masumori N. Comparison of Oncological Outcomes of Pembrolizumab as Second-line Therapy and Maintenance Avelumab Therapy in Advanced Urothelial Carcinoma After Platinum-based Chemotherapy. Anticancer Res 2024; 44:1271-1279. [PMID: 38423657 DOI: 10.21873/anticanres.16922] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND/AIM Sequential therapy using chemotherapy and subsequent immune checkpoint inhibitor (ICI) treatment prolongs the survival of patients with advanced urothelial carcinoma (UC). However, no comparison data for oncological outcome between pembrolizumab and avelumab has been reported. Thus, we compared oncological outcomes between pembrolizumab as second-line therapy and maintenance avelumab therapy in patients with advanced UC. PATIENTS AND METHODS We retrospectively evaluated patients with advanced UC treated with pembrolizumab or avelumab between January 2018 and February 2023. We compared oncological outcomes after adjusting for patient characteristics. Immune-related adverse events (AEs) in each group were evaluated using the Common Terminology Criteria for Adverse Events. RESULTS There were 186 and 44 patients in the pembrolizumab- and avelumab-treated cohorts, respectively. After propensity score matching, 43 patients from each group were selected and analyzed. Median progression-free survival from the initiation of pembrolizumab and avelumab treatments was 126 and 139 days, respectively (log-rank test, p=0.625). Median overall survival in the pembrolizumab and avelumab cohorts were 658 days and not reached, respectively (log-rank test, p=0.249). Thirty-eight (20.4%) and 14 (31.8%) all-grade immune-related AEs were observed in 186 pembrolizumab- and 44 avelumab-treated patients, respectively (chi-squared test, p=0.112). Regarding endocrine-related AEs, 12 (6.5%) and none (0%) were observed in pembrolizumab- and avelumab-treated patients, respectively (Fisher's exact probability test, p=0.129). CONCLUSION Pembrolizumab and maintenance avelumab therapy provide equivalent oncological outcomes in patients with advanced UC. Although no significant difference was observed, there might be a potential risk of higher endocrine-related AEs due to pembrolizumab compared to avelumab maintenance therapy.
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Affiliation(s)
- Tetsuya Shindo
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan;
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Takahashi
- Department of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan
| | - Shintaro Miyamoto
- Department of Urology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | | | - Shunsuke Sato
- Department of Urology, Oji General Hospital, Tomakomai, Japan
| | - Fumimasa Fukuta
- Department of Urology, Steel Memorial Muroran Hospital, Muroran, Japan
| | - Yoshiki Hiyama
- Department of Urology, NTT Medical Center Sapporo, Sapporo, Japan
| | - Akio Takayanagi
- Department of Urology, Japan Community Healthcare Organization Hokkaido Hospital, Sapporo, Japan
| | - Ryuichi Kato
- Department of Urology, Muroran City General Hospital, Muroran, Japan
| | - Atsushi Wanifuchi
- Department of Urology, Japanese Red Cross Kushiro Hospital, Kushiro, Japan
| | - Yohei Ueki
- Department of Urology, Takikawa Municipal Hospital, Takikawa, Japan
| | - Manabu Okada
- Department of Urology, Obihiro Kyokai Hospital, Obihiro, Japan
| | - Hideki Adachi
- Department of Urology, Saiseikai Otaru Hospital, Otaru, Japan
| | - K O Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Hiyama Y, Yamamoto S, Sato T, Ogasawara N, Masumori N, Takahashi S, Yokota SI. Affinity of β-Lactam Antibiotics for Neisseria gonorrhoeae Penicillin-Binding Protein 2 Having Wild, Cefixime-Reduced-Susceptible, and Cephalosporin (Ceftriaxone)-Resistant penA Alleles. Microb Drug Resist 2024; 30:141-146. [PMID: 38215246 DOI: 10.1089/mdr.2023.0256] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024] Open
Abstract
Multidrug-resistant Neisseria gonorrhoeae is a serious concern worldwide. Resistance to β-lactam antibiotics occurs through mutations in penicillin-binding proteins (PBPs), acquisition of β-lactamases, and alteration of antibiotic penetration. Mosaic structures of penA, which encodes PBP2, play a major role in resistance to β-lactams, especially cephalosporins. Ceftriaxone (CRO) is recognized as the only satisfiable antibiotic for the treatment of gonococcal infections; however, CRO-resistant isolates have emerged in the community. Here, we examined the affinity of β-lactam antibiotics for recombinant PBP2 in a competition assay using fluorescence-labeled penicillin. We found no or little difference in the affinities of penicillins and meropenem (MEM) for PBP2 from cefixime (CFM)-reduced-susceptible strain and cephalosporin-resistant strain. However, the affinity of cephalosporins, including CRO, for PBP2 from the cephalosporin-resistant strain was markedly lower than that for PBP2 from the CFM-reduced-susceptible-resistant strain. Notably, piperacillin (PIP) showed almost the same affinity for PBP2 from penicillin-susceptible, CFM-reduced-susceptible, and cephalosporin (including CRO)-resistant strains. Thus, PIP/tazobactam and MEM are candidate antibiotics for the treatment of CRO-resistant/multidrug-resistant N. gonorrhoeae.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Urology, NTT Medical Center Sapporo, Sapporo, Japan
| | - Soh Yamamoto
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toyotaka Sato
- Laboratory of Veterinary Hygiene, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
- Graduate School of Infectious Diseases, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Noriko Ogasawara
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Shin-Ichi Yokota
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Hiyama Y. Editorial Comment: Proctoscopy following transrectal prostate biopsy can control rectal bleeding after prostate biopsy. Int J Urol 2024; 31:143. [PMID: 38010075 DOI: 10.1111/iju.15349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, NTT Medical Center Sapporo, Sapporo, Hokkaido, Japan
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Yasuda M, Takahashi S, Miyazaki J, Wada K, Kobayashi K, Matsumoto M, Hayami H, Yamamoto S, Kiyota H, Sato J, Matsumoto T, Yotsuyanagi H, Hanaki H, Masumori N, Hiyama Y, Nishiyama H, Kimura T, Yamada H, Matsumoto K, Ishikawa K, Togo Y, Tanaka K, Sadahira T, Inokuchi J, Hamasuna R, Ito K, Hirayama H, Hayashi K, Kurimura Y, Kadena H, Ito S, Shiono Y, Maruyama T, Ito M, Hatano K, Chokyu H, Ihara H, Uno S, Monden K, Yokoyama T, Kano M, Kaji S, Kawahara M, Sumii T, Tojo T, Hosobe T, Naito K, Kawai S, Nishimura H, Izumitani M, Yoh M, Matsumura M, Fujita R, Takayama K, Hara M, Nishi S. The third nationwide surveillance of antimicrobial susceptibility against Neisseria gonorrhoeae from male urethritis in Japan, 2016-2017. J Infect Chemother 2023; 29:1011-1016. [PMID: 37553046 DOI: 10.1016/j.jiac.2023.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/21/2023] [Accepted: 08/03/2023] [Indexed: 08/10/2023]
Abstract
Neisseria gonorrhoeae is one of the important pathogens of sexually transmitted infections. N. gonorrhoeae is rapidly becoming antimicrobial resistant, and there are few drugs that are effective in the initial treatment of gonorrhea. To understand the trends of antimicrobial susceptibility of N. gonorrhoeae, the Surveillance Committee of the Japanese Society of Infectious Diseases, the Japanese Society for Chemotherapy, and the Japanese Society of Clinical Microbiology conducted the third nationwide antimicrobial susceptibility surveillance of N. gonorrhoeae isolated from male urethritis. The specimens were collected from male patients with urethritis at 30 facilities from May 2016 to July 2017. From the 159 specimens collected, 87 N. gonorrhoeae strains were isolated, and 85 were tested for susceptibility to 21 antimicrobial agents. All strains were non-susceptible to penicillin G. Seven strains (8.2%) were β-lactamase-producing strains. The rates of susceptibility to cefixime and cefpodoxime were 96.5% and 52.9%, respectively. Three strains were non-susceptible with a minimum inhibitory concentration (MIC) of 0.5 mg/L for cefixime. None of the strains were resistant to ceftriaxone or spectinomycin. The susceptibility rate for ciprofloxacin was 23.5% (20 strains), and no strains showed intermediate susceptibility. The susceptibility rate against azithromycin was 81.2%, with one strain isolated with a MIC of 8 mg/L against azithromycin. The results of this surveillance indicate that ceftriaxone and spectinomycin, which are currently recommended for gonococcal infections in Japan, appear to be effective. It will be necessary to further expand the scale of the next surveillance to understand the current status of drug-resistant N. gonorrhoeae in Japan.
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Affiliation(s)
- Mitsuru Yasuda
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Satoshi Takahashi
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Jun Miyazaki
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, International University of Health and Welfare Ichikawa Hospital, Chiba, Japan; Department of Urology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Koichiro Wada
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Faculty of Medicine, Shimane University, Izumo, Japan; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kanao Kobayashi
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Masahiro Matsumoto
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Hiroshi Hayami
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan
| | - Shingo Yamamoto
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan; Department of Urology, School of Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | | | | | - Hideaki Hanaki
- Research Center for Anti-infectious Drugs, Kitasato Institute for Life Science, Kitasato University, Tokyo, Japan
| | - Naoya Masumori
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yoshiki Hiyama
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroki Yamada
- Department of Urology, School of Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Kazumasa Matsumoto
- Department of Urology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kiyohito Ishikawa
- Department of Urology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Yoshikazu Togo
- Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan
| | | | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Junichi Inokuchi
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryoichi Hamasuna
- Department of Urology, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Kenji Ito
- Ito Urology Clinic, Kitakyushu, Japan
| | | | - Kenji Hayashi
- Department of Urology, Tomakomai Urological Clinic, Hokkaido, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | - Motonori Kano
- Department of Urology, Kano Hospital, Kasuya-gun, Japan
| | | | | | | | | | | | | | | | | | | | | | | | - Ryuji Fujita
- Nephrology and Urology Nishigawara Clinic, Okayama, Japan
| | - Kazuo Takayama
- Department of Urology, Takayama Hospital, Chikushino, Japan
| | - Makoto Hara
- Department of Urology, Tsujinaka Hospital, Kashiwa, Japan
| | - Shohei Nishi
- Nishi Urology and Dermatology Clinic, Kitakyushu, Japan
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Hiyama Y. Editorial Comment to Proactive discontinuation of postoperative antibiotic prophylaxis after urethroplasty. Int J Urol 2022; 29:711-712. [PMID: 35477930 DOI: 10.1111/iju.14909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, NTT East Medical Center Sapporo, Sapporo, Hokkaido, Japan
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Hiyama Y, Takahashi S, Yasuda M. AAUS guideline for chlamydial urethritis. J Infect Chemother 2021; 28:142-145. [PMID: 34887176 DOI: 10.1016/j.jiac.2021.11.024] [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: 09/28/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 10/19/2022]
Abstract
Urogenital chlamydial infection is the most common sexually transmitted infection. Many cases of chlamydial infection are reported worldwide every year. Genital chlamydial infection in women can also cause obstetric issues, including infertility and miscarriage. For that purpose, appropriate care should be conducted with the latest knowledge. Only few guidelines come from Asian countries. The Asian Association of Urinary Tract Infection and Sexually Transmitted Infection (AAUS) belonging to the Urological Association of Asia (UAA) had developed the guidelines regarding chlamydial urethritis. We have collected the feedback and updated the guidelines which is now submitted for consideration of publication. In addition to the levels of evidence, the recommendation grades were defined using the modified GRADE methodology. Herein, we present the new edition of the UAA-AAUS guidelines for chlamydial urethritis.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan; Department of Urology, Hakodate Goryoukaku Hospital, Japan.
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Japan
| | - Mitsuru Yasuda
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Japan
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Sadahira T, Maruyama Y, Hiyama Y, Kitano H, Yamada H, Goto T, Kondo T, Shigemura K, Mitsui Y, Iwata T, Edamura K, Araki M, Watanabe M, Takenaka T, Teishima J, Miyata Y, Ishikawa K, Takaoka EI, Miyazaki J, Takahashi S, Masumori N, Kiyota H, Fujisawa M, Yamamoto S, Sakuma T, Kusumi N, Ichikawa T, Watanabe T, Nasu Y, Tsugawa M, Nasu Y, Wada K. A Clinical Trial Evaluating the Usefulness of Tailored Antimicrobial Prophylaxis Using Rectal-culture Screening Media Prior to Transrectal Prostate Biopsy: A Multicenter, Randomized Controlled Trial. Acta Med Okayama 2021; 75:663-667. [PMID: 34703052 DOI: 10.18926/amo/62782] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim of this report is to introduce an on-going, multicenter, randomized controlled trial to evaluate whether tailored antimicrobial prophylaxis guided by rectal culture screening prevents acute bacterial prostatitis following transrectal prostate biopsy (TRPB). Patients will be randomized into an intervention or non-intervention group; tazobactam-piperacillin or levofloxacin will be prophylactically administered according to the results of rectal culture prior to TRPB in the intervention group whereas levofloxacin will be routinely given in the non-intervention group. The primary endpoint is the occurrence rate of acute bacterial prostatitis after TRPB. Recruitment begins in April, 2021 and the target total sample size is 5,100 participants.
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Affiliation(s)
- Takuya Sadahira
- Department of Urology, Okayama University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Yuki Maruyama
- Department of Urology, Okayama University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Yoshiki Hiyama
- Hakodate Goryoukaku Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Hiroyuki Kitano
- Hiroshima University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Hiroki Yamada
- Jikei University Katsushika Medical Center.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Takayuki Goto
- Kyoto University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Tsubasa Kondo
- Nagasaki University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Katsumi Shigemura
- Kobe University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | | | | | | | - Motoo Araki
- Department of Urology, Okayama University Hospital
| | | | | | - Jun Teishima
- Hiroshima University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Yasuyoshi Miyata
- Nagasaki University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Kiyohito Ishikawa
- Fujita Health University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Ei-Ichiro Takaoka
- Internationla University of Health and Welfare Hospital.,International University of Health and Welfare Narita Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Jun Miyazaki
- Internationla University of Health and Welfare Hospital.,International University of Health and Welfare Narita Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Satoshi Takahashi
- Sapporo Medical University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | | | - Hiroshi Kiyota
- Jikei University Katsushika Medical Center.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Masato Fujisawa
- Kobe University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | - Shingo Yamamoto
- Hyogo College of Medicine College Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | | | | | | | - Toyohiko Watanabe
- Department of Urology, Okayama University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
| | | | | | | | - Koichiro Wada
- Department of Urology, Okayama University Hospital.,The Japanese Research Group for Urinary Tract Infection (JRGU)
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10
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Takahashi S, Yasuda M, Wada K, Matsumoto M, Hayami H, Kobayashi K, Miyazaki J, Kiyota H, Matsumoto T, Yotsuyanagi H, Tateda K, Sato J, Hanaki H, Masumori N, Hiyama Y, Egawa S, Yamada H, Matsumoto K, Ishikawa K, Yamamoto S, Togo Y, Tanaka K, Shigemura K, Uehara S, Kitano H, Kiyoshima K, Hamasuna R, Ito K, Hirayama H, Kawai S, Shiono Y, Maruyama T, Ito S, Yoh M, Ito M, Hatano K, Ihara H, Uno S, Monden K, Yokoyama T, Takayama K, Sumii T, Kadena H, Kawahara M, Hosobe T, Izumitani M, Kano M, Nishimura H, Fujita R, Kaji S, Hayashi K, Tojo T, Matumura M. Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan: Comparison with the first surveillance report. J Infect Chemother 2021; 28:1-5. [PMID: 34580009 DOI: 10.1016/j.jiac.2021.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 01/23/2023]
Abstract
The Urogenital Sub-committee and the Surveillance Committee of the Japanese Society of Chemotherapy, The Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology conducted the second nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis. In this second surveillance study, clinical urethral discharge specimens were collected from patients with urethritis in 26 hospitals and clinics from May 2016 to July 2017. Based on serial cultures, the minimum inhibitory concentration (MIC) could be determined for 41 isolates; the MICs (MIC90) of ciprofloxacin, levofloxacin, tosufloxacin, sitafloxacin, doxycycline, minocycline, erythromycin, clarithromycin, azithromycin and solithromycin were 2 μg/ml (2 μg/ml), 1 μg/ml (0.5 μg/ml), 0.25 μg/ml (0.25 μg/ml), 0.125 μg/ml (0.063 μg/ml), 0.125 μg/ml (0.125 μg/ml), 0.25 μg/ml (0.25 μg/ml), 0.031 μg/ml (0.031 μg/ml), 0.25 μg/ml (0.125 μg/ml), and 0.016 μg/ml (0.008 μg/ml), respectively. In summary, this surveillance project did not identify any strains resistant to fluoroquinolone, tetracycline, or macrolide agents in Japan. In addition, the MIC of solithromycin was favorable and lower than that of other antimicrobial agents. However, the MIC of azithromycin had a slightly higher value than that reported in the first surveillance report, though this might be within the acceptable margin of error. Therefore, the susceptibility of azithromycin, especially, should be monitored henceforth.
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Affiliation(s)
- Satoshi Takahashi
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Mitsuru Yasuda
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Koichiro Wada
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masahiro Matsumoto
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Hayami
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan
| | - Kanao Kobayashi
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Jun Miyazaki
- The Urogenital Sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Diseases (JAID) and the Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | | | | | - Kazuhiro Tateda
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of JSC, JAID and JSCM, Tokyo, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, Kitasato University, Tokyo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroki Yamada
- Department of Urology, The Jikei University Katsushika MedicalCenter, Tokyo, Japan
| | - Kazumasa Matsumoto
- Department of Urology, Kitasato University School of Medicine, Kanagawa, Japan
| | | | - Shingo Yamamoto
- Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshikazu Togo
- Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazushi Tanaka
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Katsumi Shigemura
- Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Uehara
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Kitano
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keijiro Kiyoshima
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryoichi Hamasuna
- Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kenji Ito
- Ito Urology Clinic, Kitakyushu, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | - Kazuo Takayama
- Department of Urology, Takayama Hospital, Chikushino, Japan
| | | | | | | | | | | | - Motonori Kano
- Department of Urology, Kano Hospital, Fukuoka, Japan
| | | | - Ryuji Fujita
- Jin-Hinyokika Nishikawahara Clinic, Okaayama, Japan
| | | | - Kenji Hayashi
- Tomakomai Urology and Cardiology Clinic, Tomakomai, Japan
| | - Takanori Tojo
- Department of Urology, Tomeiatsugi Hospital, Atsugi, Japan
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11
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Hiyama Y, Sato T, Takahashi S, Yamamoto S, Ogasawara N, Masumori N, Yokota SI. Reduction of susceptibility to azoles and 5-fluorocytosine and growth acceleration in Candida albicans in glucosuria. Diagn Microbiol Infect Dis 2021; 102:115556. [PMID: 34678714 DOI: 10.1016/j.diagmicrobio.2021.115556] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 11/18/2022]
Abstract
Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia and glucosuria, and is a risk factor for Candida infections. To reveal the potential effects of glucosuria on Candida spp., we investigated their growth and antifungal susceptibilities in normal human urine to which glucose was added. The viable cell numbers of Candida spp. were more than 10 fold higher in the urine added 3000 mg/dL glucose than in plain urine. In antifungal susceptibility, more than 80% of Candida albicans clinical isolates increased minimum inhibitory concentrations of azoles and 5-fluorocytosine with the addition of glucose, and exceeded their breakpoints. In most of the C. albicans clinical isolates, the mRNA expression of the azole resistance genes ERG11, CDR1, CDR2, and MDR1 in the presence of glucose in urine. These observations provide valuable information about the clinical course and therapeutic effects of azoles against C. albicans infections in patients with diabetes mellitus and hyperglucosuria.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toyotaka Sato
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Soh Yamamoto
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noriko Ogasawara
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shin-Ichi Yokota
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
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12
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Takahashi S, Arakawa S, Ishikawa K, Kamei J, Kobayashi K, Shigemura K, Takahashi S, Hiyama Y, Hamasuna R, Hayami H, Yazawa S, Yasuda M, Togo Y, Yamamoto S, Wada K, Watanabe T. Guidelines for Infection Control in the Urological Field, including Urinary Tract Management (revised second edition). Int J Urol 2021; 28:1198-1211. [PMID: 34480379 DOI: 10.1111/iju.14684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/19/2021] [Accepted: 08/17/2021] [Indexed: 01/08/2023]
Abstract
The Committee for the Development of Guidelines for Infection Control in the Urological Field, including Urinary Tract Management of the Japanese Urological Association, together with its systematic review team and external reviewers, have prepared a set of practice guidelines, an abridged version of which is published herein. These guidelines cover the following topics: (i) foundations of infection control, standard precautions, route-specific precautions, and occupational infection control (including vaccines); (ii) the relationship between urologists and infection control; (iii) infection control in urological wards and outpatient clinics; (iv) response to hepatitis B virus reactivation; (v) infection control in urological procedures and examinations; (vi) prevention of infections occurring in conjunction with medical procedures and examinations; (vii) responses to urinary tract tuberculosis and bacillus Calmette-Guérin; (viii) aseptic handling, cleaning, disinfection, and sterilization of urinary tract endoscopes (principles of endoscope manipulation, endoscope lumen cleaning, and disinfection); (ix) infection control in the operating room (principles of hand washing, preoperative rubbing methods, etc.); (x) prevention of needlestick and blood/bodily fluid exposure and response to accidental exposure; (xi) urinary catheter-associated urinary tract infection and purple urinary bag syndrome; and (xii) urinary catheter-associated urinary tract infections in conjunction with home care. In addressing these topics, the relevant medical literature was searched to the extent possible, and content was prepared for the purpose of providing useful information for clinical practice.
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Affiliation(s)
- Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Soichi Arakawa
- Department of Urology, Sanda City Hospital, Sanda, Hyogo, Japan
| | - Kiyohito Ishikawa
- Department of Quality and Safety in Healthcare, Division of Infection Control and Prevention, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Jun Kamei
- Department of Urology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Kanao Kobayashi
- Department of Urology, Japan Organization of Occupational Health and Safety, Chugoku Rosai Hospital, Kure, Hiroshima, Japan
| | | | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryoichi Hamasuna
- Department of Urology, Federation of National Public Service and Affiliated Personal Mutual Aid Association, Shin-Kokura Hospital, Kitakyushu, Fukuoka, Japan
| | - Hiroshi Hayami
- Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan
| | - Satoshi Yazawa
- Yazawa Clinic, Tokyo, Japan.,Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Yasuda
- Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Yoshikazu Togo
- Department of Urology, Kyowakai Medical Corporation Kyoritsu Hospital, Kawanishi, Hyogo, Japan
| | - Shingo Yamamoto
- Urology and Kidney Transplant Center, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Koichiro Wada
- Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Toyohiko Watanabe
- Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
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13
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Hiyama Y. Editorial Comment to Sodium glucose-linked transport protein 2 inhibitors: An overview of genitourinary and perioperative implications. Int J Urol 2021; 28:990-991. [PMID: 34216024 DOI: 10.1111/iju.14639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
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14
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Wada K, Yokoyama T, Uno S, Araki M, Sadahira T, Maruyama Y, Acosta H, Nakajima H, Hiyama Y, Kunishima Y, Togo Y, Nukaya T, Yamada H, Shigemura K, Ito S, Tanimura M, Kobayashi K, Kitano H, Teishima J, Yasuda M, Uehara S, Hamasuna R, Watanabe T, Nakagawa T, Hayami H, Miyazaki J, Takahashi S, Masumori N, Ishikawa K, Kiyota H, Fujisawa M, Arakawa S, Nasu Y, Yamamoto S. Nationwide surveillance of bacterial pathogens isolated from patients with acute uncomplicated cystitis in 2018: Conducted by the Japanese Research Group for Urinary Tract Infections (JRGU). J Infect Chemother 2021; 27:1169-1180. [PMID: 33863634 DOI: 10.1016/j.jiac.2021.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/02/2021] [Revised: 03/03/2021] [Accepted: 03/14/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to monitor the development of drug-resistant bacteria isolated from acute uncomplicated cystitis (AUC) and to evaluate methodology of the survey conducted by collecting only clinical data. METHODS We enrolled female patients at least 16 years of age diagnosed with AUC in 2018. Patient information including age, menopausal status, and results of bacteriological examination were collected and analyzed regardless of bacterial identification, antimicrobial susceptibility testing or extended-spectrum β-lactamase (ESBL) detection method. RESULTS A total of 847 eligible cases were collected. Escherichia coli (E. coli) was the most frequently isolated bacterial species at about 70%, with proportions of fluoroquinolone-resistant E. coli (QREC) and ESBL-producing E. coli isolates at 15.6% and 9.5% of all E. coli isolates, respectively. The proportion of Staphylococcus saprophyticus (S. saprophyticus) was significantly higher in premenopausal women. Regarding the drug susceptibility of E. coli, isolates from Eastern Japan had significantly higher susceptibility to cefazolin, cefotiam and cefpodoxime and lower susceptibility to levofloxacin in postmenopausal women. ESBL-producing E. coli isolates had a high susceptibility to tazobactam-piperacillin, cefmetazole, carbapenems, aminoglycosides, and fosfomycin. In S. saprophyticus, the susceptibility to β-lactams including carbapenems was 40-60%. CONCLUSIONS The proportions of QREC and ESBL-producing E. coli were increasing trends and lower susceptibility to LVFX in postmenopausal women was observed. Such surveillance, consisting of the collecting only clinical data, could be conducted easily and inexpensively. It is expected to be continuously performed as an alternative survey to conventional one collecting bacterial strains.
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Affiliation(s)
- Koichiro Wada
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan.
| | - Teruhiko Yokoyama
- Yokoyama Urological Clinic, 2-7-1 Ima, Kita-ku, Okayama, 700-0975, Japan
| | - Satoshi Uno
- Hirajima Clinic, 1041-4 Higashi-hirajima, Okayama, 709-0631, Japan
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Yuki Maruyama
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Herik Acosta
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Hirochika Nakajima
- Department of Urology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama, 721-8511, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University Hospital, S1 W17 Chuo-ku, Sapporo, 060-8556, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Yasuharu Kunishima
- Department of Urology, Sunagawa City Medical Center, N3-1-1 W4 Sunagawa, 073-0196, Japan
| | - Yoshikazu Togo
- Department of Urology, Kyowakai Medical Corporation Kyoritsu Hospital, 16-5 Chuo-cho, Kawanishi, 666-0016, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Takuhisa Nukaya
- Department of Urology, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Hiroki Yamada
- Department of Urology, Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, 125-8506, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Katsumi Shigemura
- Deartment of Urology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Shin Ito
- IClinic, 5-9-6 Nagamachi, Taihaku-ku, Sendai, 982-0011, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Masanobu Tanimura
- Department of Urology, JA Kochi Hospital, 526-1 Aza-Nakano, Myōken, Nankoku, 783-8509, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Kanao Kobayashi
- Department of Urology, Chugoku Rosai Hospital, 1-5-1 Tagaya, Kure, 737-0193, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Hiroyuki Kitano
- Department of Urology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Jun Teishima
- Department of Urology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Mitsuru Yasuda
- Center for Nutrition Support and Infection Control, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Shinya Uehara
- Department of Urology, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-ku, Okayama, 700-8505, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Ryoichi Hamasuna
- Department of Urology, Federation of National Public Services and Affiliated Personel Mutual Aid Associations, Shin-Kokura Hospital, 1-3-1 Kaneda-cho, Kita-ku, Kokura, Kita-kyusyu, 803-8505, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Toyohiko Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, 173-8606, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Hiroshi Hayami
- Blood Purification Center, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Jun Miyazaki
- Department of Urology, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Kounodai, Ichikawa, 272-0827, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical, University Hospital, S1 W17 Chuo-ku, Sapporo, 060-8556, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University Hospital, S1 W17 Chuo-ku, Sapporo, 060-8556, Japan
| | - Kiyohito Ishikawa
- Department of Urology, Fujita Health University Hospital, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Hiroshi Kiyota
- Department of Urology, Jikei University Katsushika Medical Center, 6-41-2 Aoto, Katsushika-ku, 125-8506, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Masato Fujisawa
- Deartment of Urology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Soichi Arakawa
- Department of Urology, Sanda City Hospital, 3-1-1 Keyakidai, Sanda, 669-1321, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
| | - Yasutomo Nasu
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Shingo Yamamoto
- Department of Urology, Hyogo College of Medicine College Hospital, 1-1 Mukogawa-machi, Nishinomiya, 663-8501, Japan; Japanese Research Group for Urinary Tract Infection (JRGU), 1-1 Mukogawa- Machi, Nishinomiya, 663-8501, Japan
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15
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Hiyama Y. Editorial Comment to Differential effects of chromosome and plasmid bla CTX-M-15 genes on antibiotic susceptibilities in extended-spectrum beta-lactamase-producing Escherichia coli isolates from patients with urinary tract infection. Int J Urol 2021; 28:628-629. [PMID: 34018251 DOI: 10.1111/iju.14579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Hakodate Goryoukaku Hospital, Hokadate, Hokkaido, Japan
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Hiyama Y, Sato T, Takahashi S, Yamamoto S, Fukushima Y, Nakajima C, Suzuki Y, Yokota SI, Masumori N. Sitafloxacin has a potent activity for eradication of extended spectrum β-lactamase-producing fluoroquinolone-resistant Escherichia coli forming intracellular bacterial communities in uroepithelial cells. J Infect Chemother 2020; 26:1272-1277. [PMID: 32768340 DOI: 10.1016/j.jiac.2020.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/08/2020] [Revised: 06/04/2020] [Accepted: 07/19/2020] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Eradication of asymptomatic bacteriuria (ASB) before urological procedures is important to reduce the risk for infectious complications after surgery. However, the appropriate regimen for antimicrobial treatment has not been fully determined. We experienced continuous (over 10 months) isolation of extended spectrum β-lactamase (ESBL)-producing fluoroquinolone-resistant Escherichia coli from urine of an asymptomatic patient. The four isolates obtained (SMESC1 to 4) were international high-risk clones of O25b:H4-ST131-H30R, and originated from one strain, as revealed by the whole genome sequences. Although the patient received meropenem (MEPM) and fosfomycin (FOM), to which the strains were susceptible before the urological procedures, they could not be eradicated. METHODS To explore the reason for the continuous isolation even after MEPM and FOM administration, antimicrobial killing of adherent and/or intracellular bacterial communities (IBC) formed by coculture of the E. coli cells and T24 bladder epithelial cells were examined. RESULTS FOM and levofloxacin did not decrease viable E. coli cells compared with gentamicin. MEPM partly decreased them, and sitafloxacin (STFX) decreased them most potently. These observations indicate that E. coli can survive in the urinary tract under antimicrobial administration, and some antimicrobials such as FOM and MEPM cannot eradicate E. coli in uroepithelial cells. Adhesion on urinary epithelial cells and/or IBC formation might result in continuous isolation from the urinary tract and recurrence of ASB and urinary tract infections. CONCLUSIONS The present study suggests that STFX is a promising optional agent for the eradication of ESBL-producing fluoroquinolone-resistant E. coli in the urinary tract before urological procedures.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toyotaka Sato
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Soh Yamamoto
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yukari Fukushima
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Chie Nakajima
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Yasuhiko Suzuki
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Shin-Ichi Yokota
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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17
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Nofuji S, Hiyama Y, Tanaka T, Takahashi S, Masumori N. [Clinical Outcome of Patients with Bacteremia Caused by Urinary Tract Infection]. Hinyokika Kiyo 2020; 66:141-145. [PMID: 32483949 DOI: 10.14989/actauroljap_66_5_141] [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: 06/11/2023]
Abstract
Although bacteremia is often concomitant with severe urinary tract infection (UTI), the treatment outcome has not been well studied. The aim of this study was to verify treatment outcome in patients with bacteremia caused by UTI. We also assessed the efficacy of sequential oral antibiotics. According to a retrospective chart review of patients treated in the Sapporo Medical University Hospital from 2013 to 2016, bacteremia caused by UTI was observed in 59 patients. Intravenous antibiotics were sequentially converted to oral agents in 48 patients. Of them, 14 patients had recurrence after initial treatment. There was no significant difference in recurrence rate between events with and without conversion to oral antibiotics. Use of a steroid or immunosuppressant was significantly associated with recurrence of bacteremia caused by UTI. In patients with recurrence of UTI, treatment period was significantly long. In patients with bacteremia caused by UTI, antibiotic agents can be converted to a culture-directed oral antibiotic safely. However, we should notice the high risk of recurrence in patients treated with a steroid or immunosuppressant.
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Affiliation(s)
- Seisuke Nofuji
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Yoshiki Hiyama
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Toshiaki Tanaka
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Satoshi Takahashi
- The Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine
| | - Naoya Masumori
- The Department of Urology, Sapporo Medical University School of Medicine
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18
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Hiyama Y, Takahashi S, Uehara T, Ichihara K, Hashimoto J, Matsukawa M, Taguchi K, Kunishima Y, Hotta H, Yanase M, Itoh N, Hirose T, Takeyama K, Tachiki H, Masumori N. Selective culture of Escherichia coli to prevent infective complications of transrectal ultrasound-guided prostate biopsy: Clinical efficacy and analysis of characteristics of quinolone-resistant Escherichia coli. Int J Urol 2019; 26:655-660. [PMID: 30959574 DOI: 10.1111/iju.13960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/28/2018] [Accepted: 03/11/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate a regimen of targeted prophylaxis using rectal swab culture in patients undergoing transrectal ultrasound-guided prostate biopsy, and to investigate the characteristics of isolated fluoroquinolone-resistant Escherichia coli. METHODS A prospective study was carried out from June 2013 through December 2014. Rectal swabs were cultured on agar plates containing either 2 μg/mL levofloxacin or 1 μg/mL sitafloxacin before transrectal ultrasound-guided prostate biopsy. Patients with susceptible organisms received levofloxacin or sitafloxacin, whereas those with resistant organisms received directed antimicrobial prophylaxis according to the results of the antimicrobial susceptibility test. Patients with infectious complications after prostate biopsy were identified, and characteristics of patients carrying fluoroquinolone-resistant Escherichia coli were analyzed. RESULTS A total of 397 men underwent transrectal ultrasound-guided prostate biopsy. Of these patients, 74 (18.6%) had fluoroquinolone-resistant Escherichia coli. All fluoroquinolone-resistant Escherichia coli were susceptible to amikacin and meropenem. The risk factor for possible fluoroquinolone-resistant Escherichia coli was age of ≥73 years. Three (0.7%) patients who received appropriate antimicrobial prophylaxis had high-grade fever after the prostate biopsy. However, the pathogens were not fluoroquinolone-resistant Escherichia coli. CONCLUSIONS Targeted antimicrobial prophylaxis in patients undergoing transrectal ultrasound-guided prostate biopsy can be associated with reducing severe infectious complications caused by fluoroquinolone-resistant Escherichia coli.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Teruhisa Uehara
- Department of Pediatric Urology, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Hokkaido, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Central Hospital, Sapporo, Hokkaido, Japan
| | - Jiro Hashimoto
- Department of Urology, Kushiro Red Cross Hospital, Kushiro, Hokkaido, Japan
| | - Masanori Matsukawa
- Department of Urology, Takikawa Municipal Hospital, Takikawa, Hokkaido, Japan
| | - Keisuke Taguchi
- Department of Urology, Oji General Hospital, Tomakomai, Hokkaido, Japan
| | - Yasuharu Kunishima
- Department of Urology, Obihiro Kyokai Hospital, Obihiro, Hokkaido, Japan.,Department of Urology, Sunagawa City Medical Center, Sunagawa, Hokkaido, Japan
| | - Hiroshi Hotta
- Department of Urology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan
| | - Masahiro Yanase
- Department of Urology, Sunagawa City Medical Center, Sunagawa, Hokkaido, Japan
| | - Naoki Itoh
- Department of Urology, NTT East Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Takaoki Hirose
- Department of Urology, Japan Community Health Care Organization Hokkaido Hospital, Sapporo, Hokkaido, Japan
| | - Koh Takeyama
- Department of Urology, Hakodate National Hospital, Hakodate, Hokkaido, Japan
| | - Hitoshi Tachiki
- Department of Urology, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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19
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Hiyama Y, Takahashi S, Sato T, Shinagawa M, Fukushima Y, Nakajima C, Suzuki Y, Masumori N, Yokota SI. Evaluation of Susceptibilities to Carbapenems and Faropenem Against Cephalosporin-Resistant Neisseria gonorrhoeae Clinical Isolates with penA Mosaic Alleles. Microb Drug Resist 2019; 25:427-433. [PMID: 30676251 DOI: 10.1089/mdr.2018.0263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Neisseria gonorrhoeae is a principal pathogen for sexually transmitted infections, especially for male urethritis. Currently, the prevalence of multidrug resistance is increasing. Carbapenems are broad-spectrum antimicrobials that are widely used in the clinical setting, especially for multidrug-resistant Gram-negative bacteria. However, susceptibility to carbapenems has not been well evaluated for cephalosporin-resistant N. gonorrhoeae isolates. In this study, we determined the susceptibility to a series of carbapenems (meropenem, imipenem, doripenem, and biapenem) and faropenem against cephalosporin-resistant (resistant to cefixime, but susceptible to ceftriaxone) and cephalosporin-susceptible N. gonorrhoeae clinical isolates. The gene mutations associated with β-lactam resistance were evaluated. All cephalosporin-resistant N. gonorrhoeae isolates possessed mosaic mutation alleles in penA (NG-STAR penA-10.001, 27.001, or 108.001). They exhibited a low minimum inhibitory concentration (MIC) (≤0.125 mg/L) for meropenem and markedly high MICs (0.5-2 mg/L) for other carbapenems and faropenem. The strongest association was observed between the mosaic alleles in penA and decreased susceptibility to carbapenems and faropenem compared with mutations in mtrR, porB, and ponA. These results suggest that meropenem may serve as an alternative therapeutic agent for cephalosporin-resistant N. gonorrhoeae with a mosaic allele in penA, whereas other carbapenems and faropenem may be ineffective.
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Affiliation(s)
- Yoshiki Hiyama
- 1 Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.,2 Department of Infection Control and Laboratory Medicine, and Sapporo Medical University School of Medicine, Sapporo, Japan.,3 Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- 2 Department of Infection Control and Laboratory Medicine, and Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toyotaka Sato
- 3 Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masaaki Shinagawa
- 4 Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yukari Fukushima
- 5 Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Chie Nakajima
- 5 Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan.,6 Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Yasuhiko Suzuki
- 5 Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan.,6 Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Naoya Masumori
- 1 Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shin-Ichi Yokota
- 3 Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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21
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Togo Y, Ichioka D, Miyazaki J, Maeda Y, Kameyama K, Yasuda M, Hiyama Y, Takahashi S, Nagae H, Hirota S, Yamamoto S. Oral administration of cernitin pollen extract (Cernilton ® ) for 30 days might be useful to avoid unnecessary biopsy in prostate biopsy candidates: A preliminary study. Int J Urol 2018; 25:479-485. [PMID: 29577437 DOI: 10.1111/iju.13549] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 07/20/2017] [Accepted: 01/29/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To assess the effect of cernitin pollen extract on serum prostate-specific antigen level prostate biopsy candidates, and to develop an ideal protocol to avoid an unnecessary biopsy procedure. METHODS A total of 61 patients were administrated cernitin pollen extract tablets (two tablets t.i.d.) for 30 days, and then underwent a prostate biopsy with ≥12 systematic and targeted biopsy cores obtained. Serum prostate-specific antigen levels were examined before and after administration of the pollen extract, and the change in serum prostate-specific antigen and the rate of change were analyzed in relation to negative and positive biopsy results for cancer. RESULTS The mean change in serum prostate-specific antigen and rate of change after administration of cernitin pollen extract in all patients were -0.6 ± 1.4 ng/mL and -7.6 ± 16.1%, respectively, which were significantly different from the baseline values (P = 0.0003 and P = 0.0005, respectively). When prostate-specific antigen change values and rates were compared between patients negative and positive for cancer, a significant difference between those groups was observed (P = 0.04 and P = 0.03, respectively). CONCLUSIONS The present study is the first to show that an ideal protocol using cernitin pollen extract has the potential to avoid an unnecessary prostate biopsy procedure in patients with elevated prostate-specific antigen, possibly caused by inflammation. Additional studies with greater numbers of participants are required to confirm our findings and develop an ideal protocol.
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Affiliation(s)
- Yoshikazu Togo
- Department of Urology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Daishi Ichioka
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Jun Miyazaki
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshiko Maeda
- Department of Urology, Showa University School of Medicine, Tokyo, Japan
| | - Koji Kameyama
- Department of Urology, Gifu University Hospital, Gifu, Japan
| | - Mitsuru Yasuda
- Department of Urology, Gifu University Hospital, Gifu, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Hiroshi Nagae
- Nagae Prostate-care Clinic, Hamamatsu, Shizuoka, Japan
| | - Seiichi Hirota
- Department of Pathology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Shingo Yamamoto
- Department of Urology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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Fujino K, Hiyama Y, Uehara T, Ichihara K, Hashimoto J, Fujii S, Shinagawa M, Takahashi S, Masumori N. The efficacy of faropenem for patients with acute cystitis caused by extended spectrum β-lactamase producing Escherichia coli. J Infect Chemother 2017; 23:336-338. [DOI: 10.1016/j.jiac.2016.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/25/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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23
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Hashimoto J, Takahashi M, Saito A, Murata M, Kurimura Y, Nishitani C, Takamiya R, Uehara Y, Hasegawa Y, Hiyama Y, Sawada N, Takahashi S, Masumori N, Kuroki Y, Ariki S. Surfactant Protein A Inhibits Growth and Adherence of UropathogenicEscherichia coliTo Protect the Bladder from Infection. J I 2017; 198:2898-2905. [DOI: 10.4049/jimmunol.1502626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 01/30/2017] [Indexed: 11/19/2022]
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Hiyama Y, Takahashi S, Uehara T, Ichihara K, Hashimoto J, Masumori N. A case of infective endocarditis and pyogenic spondylitis after transrectal ultrasound guided prostate biopsy. J Infect Chemother 2016; 22:767-769. [PMID: 27374863 DOI: 10.1016/j.jiac.2016.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/12/2016] [Accepted: 05/10/2016] [Indexed: 11/17/2022]
Abstract
We report a patient with infective endocarditis and pyrogenic spondylitis occurring simultaneously. The patient was a 59-year-old man. He was suspected of having prostate cancer due to a high prostate-specific antigen concentration noted in a checkup. He then underwent a transrectal ultrasound guided prostate biopsy with cefotiam as antimicrobial prophylaxis. He had a fever higher than 38 °C and lumbar pain for a few days after the biopsy. Enterococcus faecalis was isolated from 2 sets of blood culture. Magnetic resonance imaging revealed an abnormal image at C7/Th1 with a signal decrease in T1-weighted sequences and signal increase in T2-weighted sequences that were suspected to be due to bone destruction. Therefore, he was diagnosed as having pyogenic spondylitis by an orthopedist. At the same time, he complained of palpitation and a heart murmur was detected. Then transesophageal echocardiography was performed by a cardiologist and it revealed vegetation in his left ventricle and aortic regurgitation, and finally acute cardiac insufficiency was determined. He was treated with tazobactam/piperacillin and aortic valve displacement surgery. Based on the results of the prostate biopsy and image inspection, he was diagnosed as having localized prostate cancer. He was treated by androgen deprivation therapy and external beam radiation therapy. We have to keep in mind that E. faecalis can be a potential pathogen for severe infectious complications after prostate biopsy, especially if a cephalosporin is selected for antimicrobial prophylaxis.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Japan
| | | | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | | | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Japan
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25
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Hiyama Y, Wada O, Nakakita S, Mizuno K. Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength. Orthop Traumatol Surg Res 2016; 102:435-9. [PMID: 27052936 DOI: 10.1016/j.otsr.2016.02.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 02/11/2016] [Accepted: 02/24/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION There is a growing interest in the use of patient-reported outcomes to provide a more patient-centered view on treatment. Forgetting the artificial joint can be regarded as the goal in joint arthroplasty. The goals of the study were to describe changes in joint awareness in the artificial joint after total knee arthroplasty (TKA), and to determine which factors among pain, knee range of motion (ROM), quadriceps strength, and functional ability affect joint awareness after TKA. HYPOTHESIS Patients undergoing TKA demonstrate changes in joint awareness and joint awareness is associated with pain, knee ROM, quadriceps strength, and functional ability. PATIENTS AND METHODS This prospective cohort study comprised 63 individuals undergoing TKA, evaluated at 1, 6, and 12 months postoperatively. Outcomes included joint awareness assessed using the Forgotten Joint Score (FJS), pain score, knee ROM, quadriceps strength, and functional ability. RESULTS Fifty-eight individuals completed all postoperative assessments. All measures except for knee extension ROM improved from 1 to 6 months. However, there were no differences in any measures from 6 to 12 months. FJS was affected most greatly by pain at 1 month and by quadriceps strength at 6 and 12 months. DISCUSSION Patients following TKA demonstrate improvements in joint awareness and function within 6 months after surgery, but reach a plateau from 6 to 12 months. Quadriceps strength could contribute to this plateau of joint awareness. LEVEL OF EVIDENCE Prospective cohort study, IV.
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Affiliation(s)
- Y Hiyama
- Department of physical therapy, school of health sciences, Tokyo university of technology, 5-23-22, Nishikamata, Ota-ku, Tokyo, Japan.
| | - O Wada
- Anshin hospital, 1-4-12, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan
| | - S Nakakita
- Anshin hospital, 1-4-12, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan
| | - K Mizuno
- Anshin hospital, 1-4-12, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan
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Wanifuchi A, Taguchi K, Ikehata Y, Kurimura Y, Hiyama Y, Tomaru U. [A Case of Sarcomatoid Carcinoma of the Penis]. Hinyokika Kiyo 2015; 61:249-252. [PMID: 26153055] [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: 06/04/2023]
Abstract
A 75-year-old man visited our hospital complaining of a foul smelling, painful swelling of the glans of the penis. Physical examination showed a true phimosis and a huge solid mass on the glans under the foreskin. After postectomy and penile tumor biopsy, we performed partial penectomy. Histologically, the tumor was composed of atypical spindle cells arranged in an epithelioid pattern and stained positive for both epithelial and mesenchymal markers. Therefore we diagnosed the tumor as sarcomatoid carcinoma of the penis. One month after surgery, advanced gastric cancer was discovered. Thereafter, cancer rapidly spread throughout the whole body, and he died six months postoperatively.
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Affiliation(s)
| | | | | | | | - Yoshiki Hiyama
- The Department of Urologic Surgery and Andrology, Sapporo Medical University School of Medicine
| | - Utano Tomaru
- The Department of Pathology, Hokkaido University Graduate School of Medicine
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Kurimura Y, Takahashi S, Hiyama Y, Uehara T, Ichihara K, Hashimoto J, Nishiyama N, Kitamura H, Masumori N. [Significance of Procalcitonin Measurement in Cases with Febrile Condition during Chemotherapy for Urological Cancer]. Hinyokika Kiyo 2015; 61:141-145. [PMID: 26037672] [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: 06/04/2023]
Abstract
We examined the usefulness of measurement of procalcitonin (PCT) for patients, who developed febrile neutropenia during cancer chemotherapy for urological cancer. Of the Patients who underwent cancer chemotherapy for bladder, renal pelvic or ureteral, and testicular cancer in our department from 2010 to 2013, 51 had febrile events. Their clinical courses and PCT values were retrospectively reviewed and analyzed. PCT was positive in 12 patients and negative in 39. The duration with febrile status was significantly longer in the PCT-positive group than in the PCT-negative group. There was no significant difference between the blood count values in each group, but C-reactive protein (CRP) was significantly higher in the PCT-positive group than in the PCT-negative group. There were no significant differences between the 2 groups in other tests with blood. There were 12 patients with febrile neutropenia (FN) but all were classified into low-risk by the MASCC scoring system. Four of these 12 patients were positive for PCT. Our results suggested that, in patients with a fever of 37.5°C or more during the course of cancer chemotherapy for urologic cancer, bacteremia possibly existed if the patient was positive for PCT. In addition, the duration of fever tended to be longer and the condition was more severe. When the patients with urological cancer undergo cancer chemotherapy manifest high-grade fever, PCT is promising and valuable as an indicator of the severity of infection.
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Affiliation(s)
- Yuichiro Kurimura
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Satoshi Takahashi
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Yoshiki Hiyama
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Teruhisa Uehara
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Koji Ichihara
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Jiro Hashimoto
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Naotaka Nishiyama
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Hiroshi Kitamura
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Naoya Masumori
- The Department of Urology, Sapporo Medical University School of Medicine
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Takahashi S, Ichihara K, Hashimoto K, Hiyama Y, Muranaka T, Hashimoto J, Fukuta F, Kobayashi K, Niiyama Y, Yamakage M, Masumori N. Serum antimicrobial concentrations for surgical antimicrobial prophylaxis in radical nephrectomy and radical prostatectomy. J Infect Chemother 2015; 21:464-7. [PMID: 25817353 DOI: 10.1016/j.jiac.2015.03.001] [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: 01/29/2015] [Revised: 03/01/2015] [Accepted: 03/02/2015] [Indexed: 11/28/2022]
Abstract
To evaluate the current methods of surgical antimicrobial prophylaxis from the viewpoint of pharmacokinetics for patients undergo urologic surgery, this study was designed to measure the serum concentrations of two different prophylactic antimicrobial agents in different types of urologic surgery. This prospective study included 39 patients with prostate cancer, renal pelvic cancer, ureteral cancer or renal cancer treated by radical surgery from August 2005 to March 2006. Blood samples were taken intraoperatively at 30 min and 180 min after the beginning of the first administration. The half-life of the beta phase of cefazolin is 2.46 h and that of piperacillin is 0.7 h according to their manufacturers. The average serum concentration of cefazolin at 30 min was 144 μg/mL in the prostatectomy group and 175 μg/mL in the nephrectomy group. At 180 min, the average concentration of cefazolin was 37 μg/mL in prostatectomy group and 59 μg/mL in the nephrectomy group. The average concentration of piperacillin at 30 min was 134 μg/mL in the prostatectomy group and 137 μg/mL in the nephrectomy group. At 180 min, the average concentration of piperacillin was 10 μg/mL in the prostatectomy group and 22 μg/mL in the nephrectomy group. Thus, the concentration at 180 min after the beginning of infusion was different according to the half-life of each antimicrobial agent. Therefore, up-to-date guidelines for surgical antimicrobial prophylaxis that deal with additional types of intraoperative prophylaxis should be consulted if the operation exceeds two half-lives of the prophylactic antimicrobial agents used in real-life clinical practice.
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Affiliation(s)
- Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Takashi Muranaka
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Jiro Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Yukitoshi Niiyama
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Japan
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Takahashi S, Ichihara K, Hiyama Y, Uehara T, Hashimoto J, Masumori N. Do patients who complain of lower urinary tract symptoms frequently have clinically significant pyuria? J Infect Chemother 2015; 21:31-3. [DOI: 10.1016/j.jiac.2014.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 07/26/2014] [Accepted: 08/22/2014] [Indexed: 11/30/2022]
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Yamamoto T, Takahashi S, Ichihara K, Hiyama Y, Uehara T, Hashimoto J, Hirobe M, Masumori N. How do we understand the disagreement in the frequency of surgical site infection between the CDC and Clavien-Dindo classifications? J Infect Chemother 2014; 21:130-3. [PMID: 25434696 DOI: 10.1016/j.jiac.2014.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 09/01/2014] [Revised: 10/12/2014] [Accepted: 10/25/2014] [Indexed: 10/24/2022]
Abstract
To clarify the discrepancy in the incidence and severity of surgical site infections (SSI) for radical cystectomy between reports based on the CDC guideline and those using the Clavien-Dindo classification we evaluated 449 consecutive patients who underwent radical cystectomy for bladder cancer between 1990 and 2012. Of the 115 (25.6%) patients with SSI defined by the CDC guideline, 89 could be analyzed. We compared the SSI rates and severity defined by the CDC guideline and Clavien-Dindo classifications. There were 58 patients with superficial SSI, 16 with deep SSI, and 15 with organ/space SSI according to the CDC guideline. All patients with organ/space SSI were judged as "not having SSI" by the Clavien-Dindo classification. They were classified as having "intestinal prolapse", "intestinal fistula", "abdominal abscess" and "pelvic abscess." There was a significant association between the treatment duration and depth of SSI based on the CDC guideline by Spearman's rank-correlation coefficient (p < 0.001, r = 0.614) and with the grade of complications (p < 0.001, r = 0.632) in the Clavien-Dindo classification. Multivariate analysis showed that patients with grade III SSI in the Clavien-Dindo classification needed a significantly longer treatment duration. It is necessary to be aware that a discrepancy can occur automatically due to the different natures of the definitions. Using the CDC guideline, we can effectively estimate the future treatment period when SSI occurs. With the Clavien-Dindo classification, grade III SSI requires a longer treatment duration.
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Affiliation(s)
- Takanobu Yamamoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Teruhisa Uehara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Jiro Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Megumi Hirobe
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Japan
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Togo Y, Kubo T, Taoka R, Hiyama Y, Uehara T, Hashimoto J, Kurimura Y, Takahashi S, Tsukamoto T, Miyazaki J, Nishiyama H, Kira S, Kiyota H, Yazawa S, Niwa N, Hongo H, Oya M, Kato T, Yasuda M, Deguchi T, Ishikawa K, Hoshinaga K, Matsumoto M, Shigemura K, Tanaka K, Arakawa S, Fujisawa M, Wada K, Uehara S, Watanabe T, Kumon H, Kobayashi K, Matsubara A, Matsumoto M, Sho T, Hamasuna R, Matsumoto T, Hayami H, Nakagawa M, Yamamoto S. Corrigendum to “Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) – A multi-center retrospective study” [J Infect Chemother 20 (2014) 232–237]. J Infect Chemother 2014. [DOI: 10.1016/j.jiac.2014.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Takahashi S, Kiyota H, Ito S, Iwasawa A, Hiyama Y, Uehara T, Ichihara K, Hashimoto J, Masumori N, Sunaoshi K, Takeda K, Suzuki N, Hosobe T, Goto H, Suzuki H, Onodera S. Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis. Antibiotics (Basel) 2014; 3:109-20. [PMID: 27025738 PMCID: PMC4790393 DOI: 10.3390/antibiotics3020109] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 02/26/2014] [Accepted: 03/04/2014] [Indexed: 12/02/2022] Open
Abstract
To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011–2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33). The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43) and 37.2% (16/43), respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50). The microbiological eradication rates for the pathogens were 90.9% (30/33) for Neisseria gonorrhoeae, 91.5% (43/47) for Chlamydia trachomatis, 71.4% (5/7) for Mycoplasma genitalium, and 100% (13/13) for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120). The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.
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Affiliation(s)
- Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Hiroshi Kiyota
- Department of Urology, the Jikei University Katsushika Medical Center, 6-41-2 Aoto Katsushika-ku, Tokyo 1258506, Japan.
| | - Shin Ito
- iClinic, 5-9-6, Nagamachi, Taihaku-ku, Sendai, Miyagi 9820011, Japan.
| | - Akihiko Iwasawa
- Iwasawa Clinic, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0600061, Japan.
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Teruhisa Uehara
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Jiro Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Kenichi Sunaoshi
- Teine Urologic Clinic, 1-12, Maeda 6-7, Teine-ku, Sapporo 0060816, Japan.
| | - Koichi Takeda
- Teine Urologic Clinic, 1-12, Maeda 6-7, Teine-ku, Sapporo 0060816, Japan.
| | - Nobukazu Suzuki
- Teine Urologic Clinic, 1-12, Maeda 6-7, Teine-ku, Sapporo 0060816, Japan.
| | - Takahide Hosobe
- Hosobe Clinic, 1-1-15, Nezu, Bunkyo-ku, Tokyo 1130031, Japan.
| | - Hirokazu Goto
- Department of Urology, Fuji City General Hospital, 50 Takashima-Cho, Fuji, Shizuoka 4178567, Japan.
| | - Hidenori Suzuki
- Department of Urology, Fuji City General Hospital, 50 Takashima-Cho, Fuji, Shizuoka 4178567, Japan.
| | - Shoichi Onodera
- Department of Urology, Fuji City General Hospital, 50 Takashima-Cho, Fuji, Shizuoka 4178567, Japan.
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Togo Y, Kubo T, Taoka R, Hiyama Y, Uehara T, Hashimoto J, Kurimura Y, Takahashi S, Tsukamoto T, Miyazaki J, Nishiyama H, Kira S, Kiyota H, Yazawa S, Niwa N, Hongo H, Oya M, Kato T, Yasuda M, Deguchi T, Ishikawa K, Hoshinaga K, Matsumoto M, Shigemura K, Tanaka K, Arakawa S, Fujisawa M, Wada K, Uehara S, Watanabe T, Kumon H, Kobayashi K, Matsubara A, Matsumoto M, Sho T, Hamasuna R, Matsumoto T, Hayami H, Nakagawa M, Yamamoto S. Occurrence of infection following prostate biopsy procedures in Japan. J Infect Chemother 2014; 20:232-7. [DOI: 10.1016/j.jiac.2013.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/01/2013] [Accepted: 10/03/2013] [Indexed: 11/28/2022]
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Uehara T, Takahashi S, Ichihara K, Hiyama Y, Hashimoto J, Kurimura Y, Masumori N. Surgical site infection of scrotal and inguinal lesions after urologic surgery. J Infect Chemother 2014; 20:186-9. [PMID: 24462435 DOI: 10.1016/j.jiac.2013.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/01/2013] [Accepted: 10/03/2013] [Indexed: 11/19/2022]
Abstract
To clarify the incidence of surgical site infection (SSI) after urological scrotal and inguinal surgical procedures and the preventive effect of antimicrobial prophylaxis for SSI, retrospective analysis was performed. The patients who underwent scrotal and inguinal operations from 2001 to 2010 were included in this analysis. A first or second generation cephalosporin was administered as antimicrobial prophylaxis just before the start of surgery and no additional prophylaxis was conducted. The surgery was classified into 76 (38%) cases with testicular sperm extraction (TESE), 72 (36%) with radical orchiectomy, 29 (14.5%) with bilateral orchiectomy (surgical castration) and 23 (11.5%) with other scrotal and inguinal operations. The median age and age range were 36 years and 18-81 years, respectively. SSI occurred in 7 (3.5%) cases. The frequencies of SSI were 6.5% in the patients with urological inguinal surgery and 1.6% in those with scrotal surgery. The frequency of SSI in the patients with urological inguinal surgery was not negligible even though it is considered a clean operation, and further analysis is warranted to prevent SSI.
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Affiliation(s)
- Teruhisa Uehara
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Kohji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Jiro Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yuichiro Kurimura
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Takahashi S, Kurimura Y, Hashimoto J, Uehara T, Hiyama Y, Iwasawa A, Nishimura M, Sunaoshi K, Takeda K, Suzuki N, Tsukamoto T. Antimicrobial susceptibility and penicillin-binding protein 1 and 2 mutations in Neisseria gonorrhoeae isolated from male urethritis in Sapporo, Japan. J Infect Chemother 2012; 19:50-6. [PMID: 22797875 DOI: 10.1007/s10156-012-0450-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 06/18/2012] [Indexed: 11/25/2022]
Abstract
The spread of antimicrobial-resistant Neisseria gonorrhoeae worldwide is a critical issue in the control of sexually transmitted infections. The purpose of this study was to clarify recent trends in the susceptibility of N. gonorrhoeae to various antimicrobial agents and to compare these data with our previous data. Minimum inhibitory concentrations (MICs) of various antimicrobial agents were determined in N. gonorrhoeae strains clinically isolated from male gonococcal urethritis. In addition, amino acid sequencing of penicillin-binding protein (PBP) 2, encoded by the penA gene, was analyzed so that genetic analysis of mosaic PBP 2 could clarify the susceptibility of the strains to cefixime and other cephalosporins. The susceptibility rate for ceftriaxone, cefodizime, and spectinomycin, agents whose use is recommended by the guideline of the Japanese Society of Sexually Transmitted Infections (JSSTI), was 100 %. The susceptibility rates of the strains to penicillin G and ciprofloxacin were lower than those in previous reports. Mosaic PBP 2 structures were detected in 51.9 % of the strains and the MICs of the strains with the mosaic PBP 2 to cefixime were much higher than those of the strains without the mosaic PBP 2. In the clinical situation, the treatment regimen recommended by the JSSTI remains appropriate; however, the susceptibility to cephalosporins should be intensively surveyed because strains with mosaic PBP 2 were commonly detected.
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Affiliation(s)
- Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16 Chuo-ku, Sapporo, 0608543, Japan.
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Masumori N, Tanaka T, Takeuchi M, Ichihara K, Inoue R, Shinkai N, Maehana T, Mizuno T, Tabata H, Hiyama Y, Tsukamoto T. [A case of Crohn's disease developing bladder rupture 4 months after laparoscopic sigmoidectomy with partial cystectomy for vesicosigmoidal fistula]. Hinyokika Kiyo 2012; 58:237-241. [PMID: 22767277] [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: 06/01/2023]
Abstract
A 32-year-old well-nourished man having a vesicosigmoidal fistula due to Crohn's disease received laparoscopic sigmoidectomy with partial cystectomy. The bladder wall was closed with an all-layer running suture and additional interrupted sutures using 2-0 Vicryl. Four months after surgery, the suture site on the bladder showed perforation to the abdominal cavity. Since the same event occurred again 6 months after surgery, open partial cystectomy was performed to repair the perforated site 8 months after the initial surgery. The perforated site showed a thinning bladder wall composed of normal urothelium, scar tissue and thin detrusor muscle. Non-caseating granuloma was not found in the specimen, even though it was slightly observed in the margin of the detrusor muscle resected in the initial surgery. Although it was possible that the persisting activity of Crohn's disease, subclinical impaired nutrition due to Crohn's disease or insufficient suturing of the bladder wall were involved in the bladder rupture, the definitive cause remains unknown.
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Affiliation(s)
- Naoya Masumori
- The Department of Urology, Sapporo Medical University School of Medicine
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Hiyama Y, Kitamura H, Takahashi S, Masumori N, Shindo T, Tsujiwaki M, Mitsuhashi T, Hasegawa T, Tsukamoto T. Peritoneal dissemination of prostate cancer due to laparoscopic radical prostatectomy: a case report. J Med Case Rep 2011; 5:355. [PMID: 21819588 PMCID: PMC3175179 DOI: 10.1186/1752-1947-5-355] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 08/05/2011] [Indexed: 12/02/2022] Open
Abstract
Introduction Peritoneal dissemination with no further metastases of prostate cancer is very rare, with only three cases reported in the available literature. We report the first case of iatrogenic peritoneal dissemination due to laparoscopic radical prostatectomy. Case Presentation A 59-year-old Japanese man underwent laparoscopic radical prostatectomy for clinical T2bN0M0 prostate cancer, and the pathological diagnosis was pT3aN0 Gleason 3+4 adenocarcinoma with a negative surgical margin. Salvage radiation therapy was performed since his serum prostate-specific antigen remained at a measurable value. After the radiation, he underwent castration, followed by combined androgen blockade with estramustine phosphate and dexamethasone as each treatment was effective for only a few months to a year. Nine years after the laparoscopic radical prostatectomy, computed tomography revealed a peritoneal tumor, although no other organ metastasis had been identified until then. He died six months after the appearance of peritoneal metastasis. An autopsy demonstrated peritoneal dissemination of the prostate cancer without any other metastasis. Conclusion Physicians should take into account metastasis to unexpected sites. Furthermore, we suggest that meticulous care be taken not to disseminate cancer cells to the peritoneum during laparoscopic radical prostatectomy.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
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38
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Sakamoto T, Portieri A, Taday PF, Takada Y, Sasakura D, Aida K, Matsubara T, Miura T, Terahara T, Arnone DD, Kawanishi T, Hiyama Y. Detection of tulobuterol crystal in transdermal patches using terahertz pulsed spectroscopy and imaging. Pharmazie 2009; 64:361-365. [PMID: 19618670] [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: 05/28/2023]
Abstract
Applicability of a Terahertz Pulsed Spectroscopy (TPS) and a Terahertz Pulsed Imaging (TPI) for detection of tulobuterol (TBR) crystals in transdermal patches was investigated. Because TBR has high permeability in dermis, crystalline TBR in patch matrices contributes to controlling the release rate of TBR from a matrix. Therefore, crystalline TBR is one of the important factors for quality control of TBR transdermal tapes. A model tape that includes 5 w/w%, 10 w/w%, 20 w/w% or 30 w/w% of TBR was measured by TPS/TPI. TBR crystals in the matrices were successfully detected by TPI. Identification of TBR in an image of a crystal-like mass was done by comparison between the spectra of tapes and a TBR standard substance. These results indicate that TPS and TPI are applicable to identifying crystalline lumps of an active drug in tapes for quality control.
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Affiliation(s)
- T Sakamoto
- Division of Drugs, National Institute of Health Sciences, 1-18-1, Kami-yoga, Setagaya-ku, Tokyo 158-8501, Japan.
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Fujimaki Y, Matsubara T, Sakamoto T, Sasakura D, Miura T, Takekawa M, Hiyama Y. Distribution of ethenzamide and other ingredients on granule surfaces studied by Raman microspectroscopy and mapping. Pharmazie 2009; 64:316-322. [PMID: 19530442] [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: 05/27/2023]
Abstract
Distributions of API and medical additives in granules were analyzed using Raman microspectroscopy and mapping. In order to clearly detect ingredients present at low levels, the characteristic peak for each ingredient was used for identification. Two granulation processes, tumbling granulation and high-shear granulation were selected to examine the feasibility of Raman microspectroscopy for investigating granules. Ethenzamide, lactose monohydrate, cornstarch and methylcellulose were used to make model granules. Methylcellulose was distributed homogeneously from the early stage in both granulation methods. Cornstarch and lactose showed similar distribution properties in high-shear granulation. It was presumed from this observation that similar chemical structures with high-hydrophilic groups in the two compounds determined their similar distribution properties. These results suggest that Raman microspectroscopy using the unique absorption peak of each ingredient can detect each ingredient in the individual pixel size (2 x 2 microm). This analytical method can contribute to evaluation of granular conditions and granulation processes.
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Affiliation(s)
- Y Fujimaki
- Japan Health Science Foundation, Tokyo, Japan.
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40
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Sakamoto T, Matsubara T, Sasakura D, Takada Y, Fujimaki Y, Aida K, Miura T, Terahara T, Higo N, Kawanishi T, Hiyama Y. Chemical mapping of tulobuterol in transdermal tapes using microscopic laser Raman spectroscopy. Pharmazie 2009; 64:166-171. [PMID: 19348338] [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: 05/27/2023]
Abstract
Microscopic Laser Raman Spectroscopy and Mapping (MLRSM) technique was used to investigate the distribution of tulobuterol (TBR) crystals in transdermal tapes. TBR is one of suitable compounds for the transdermal pharmaceuticals because it has high permeability into skin. In case of TBR transdermal tapes, some commercial products also contain TBR crystals in order to control a release rate from a matrix. Therefore, the presence of TBR crystals in the matrix is a critical factor for quality assurance of this type of TDDS tapes. The model tapes prepared here employed two kinds of matrices, i.e., rubber or acrylic, which are generally used for transdermal pharmaceuticals. TBR crystals in the matrix were observed by MLRSM. Accurate observation of the distribution of TBR in the tapes was achieved by creating a Raman chemical map based on detecting unique TBR peak in each pixel. Moreover, differences in the growth of TBR crystals in the two kinds of matrices were detected by microscopic observation. MLRSM also enabled the detection of TBR crystals in commercial products. The present findings suggest that Raman micro-spectroscopic analysis would be very useful for verifying and/or assessing the quality of transdermal pharmaceuticals in development, as well as for manufacturing process control.
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Affiliation(s)
- T Sakamoto
- Division of Drugs, National Institute of Health Sciences, 1-18-1, Kami-yoga, Setagaya-ku, Tokyo 158-8501, Japan.
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Sakamoto T, Fujimaki Y, Hiyama Y. NIR spectroscopic investigation of two fluoroquinolones, levofloxacin and ofloxacin, and their tablets for qualitative identification of commercial products on the market. Pharmazie 2008; 63:628-632. [PMID: 18819512] [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: 05/26/2023]
Abstract
A rapid and nondestructive identification method for ofloxacin (OFLX) and levofloxacin (LVFX) utilizing diffusion reflectance near-infrared (NIR) spectroscopy was developed. An obvious difference in spectral patterns between LVFX that is used for commercial tablets and LVFX HCl that can be purchased as a reagent at a low price was also observed. These quinolones are especially important for use as drugs against bio-terrorism because of their effectiveness against anthrax infection. Therefore, the possibility of a distribution of counterfeit drugs containing LVFX HCl on the market would be expected. NIR spectroscopic analysis would be applicable to on-site quality analysis that can be carried out easily and nondestructively.
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Affiliation(s)
- T Sakamoto
- Division of Drugs, National Institute of Health Sciences, Tokyo, Japan.
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Sakamoto T, Hiyama Y. Rapid determination of nitazoxanide in tablets using reversed-phase ultra-performance liquid chromatography (UPLC) and high-performance liquid chromatography. Pharmazie 2008; 63:503-507. [PMID: 18717482] [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: 05/26/2023]
Abstract
A simple and rapid determination method for nitazoxanide (NTZ), an antiprotozoal agent, was developed using reverse-phase HPLC and Ultra Performance Liquid Chromatography (UPLC). Only six minutes gradient condition for NTZ analysis using UPLC was achieved. The mobile phase consisted of a mixture of phosphate buffer (pH 6.0) and acetonitrile. The repeatability (relative standard deviation (RSD), n = 6) and the correlation coefficient from linearity (the range from 80% to 120% of amount) were 0.25% and 0.9963 for UPLC and 0.15% and 0.9988 for HPLC, respectively. The quantitative values of NTZ in tablets were 103.2% for HPLC and 98.7% for UPLC. The RSDs of quantitative values of sample solution were calculated to be 4.06% to 4.64% for HPLC and 0.15% to 0.36% for UPLC.
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Affiliation(s)
- T Sakamoto
- Division of Drugs, National Institute of Health Sciences, Tokyo, Japan.
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Ishimura M, Suda M, Morizumi K, Kataoka S, Maeda T, Kurokawa S, Hiyama Y. Effects of KP-496, a novel dual antagonist at the cysteinyl leukotriene receptor 1 and the thromboxane A(2) receptor, on airway obstruction in guinea pigs. Br J Pharmacol 2007; 153:669-75. [PMID: 18037905 DOI: 10.1038/sj.bjp.0707602] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND PURPOSE KP-496 is a novel dual antagonist for cysteinyl leukotriene receptor 1 (CysLT(1)) and thromboxane A(2) (TXA(2)) receptor (TP). The aim of this study was to evaluate the pharmacological profile of inhaled KP-496 and its effects on airway obstruction. EXPERIMENTAL APPROACH Antagonist activities of inhaled KP-496 were investigated using bronchoconstriction induced in guinea pigs by LTD(4) or U46619, a stable TXA(2) mimetic. Guinea pigs sensitized with injections of ovalbumin were used to assess the effects of inhaled KP-496 on bronchoconstriction induced by antigen (i.v.). Another set of guinea pigs were sensitized and challenged with ovalbumin by inhalation and the effects of inhaled KP-496 on immediate and late airway responses and airway hyperresponsiveness were investigated. KEY RESULTS KP-496 significantly inhibited LTD(4)- and U46619-induced bronchoconstriction in a dose-dependent manner. The inhibitory effects of KP-496 (1%) were comparable to those of montelukast (a CysLT(1) antagonist, p.o., 0.3 mg kg(-1)) or seratrodast (a TP antagonist, p.o., 3 mg kg(-1)). KP-496 (1%) and oral co-administration of montelukast (10 mg kg(-1)) and seratrodast (20 mg kg(-1)) significantly inhibited antigen-induced bronchoconstriction, whereas administration of montelukast or seratrodast separately did not inhibit antigen-induced bronchoconstriction. KP-496 exhibited dose-dependent and significant inhibitory effects on the immediate and late airway responses and airway hyperresponsiveness following antigen challenge. CONCLUSIONS AND IMPLICATIONS KP-496 exerts effects in guinea pigs which could be beneficial in asthma. These effects of KP-496 were greater than those of a CysLT(1) antagonist or a TP antagonist, in preventing antigen-induced airway obstruction.
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Affiliation(s)
- M Ishimura
- Pharmacology Department, Central Research Laboratories, Kaken Pharmaceutical Co. Ltd, Kyoto, Japan.
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Sakamoto T, Fujimaki Y, Hiyama Y. Studies on the influence of uniformity of particle size of powder, tapping and sample replacement for diffusion reflectance quantitative NIR spectrometric analysis. Pharmazie 2007; 62:841-846. [PMID: 18065100] [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: 05/25/2023]
Abstract
The extent of deviation factors and the influence of pre-processing of spectra for a quantitative application of reflectance NIR measurement against powder sample were examined. Lactose monohydrate (NGLM), a medical additive was used for this study. Ground lactose monohydrate (GLM) and NGLM were measured by NIR reflectance spectroscopy. In the wave number range from 12000 cm(-1) to 4000 cm(-1), the ratios of absorbance values (a.v.) between the wave numbers of GLM and NGLM were almost the same and no influence of intensity of absorbance through the measurement range was observed concerning heterogeneity of particle size. Absorbance values of NGLM were decreased with increasing number of tapping without a bit difference of the change of a.v. The several statistical parameters of a.v. from both samples were estimated. The relative standard deviation (RSD) and 95% confidence intervals (CIs) of a.v. on successive measurements at a fixed position in GLM and NGLM vials were almost the same. However, the RSD and 95% confidence of absorbance value of NGLM were larger than these GLM, i.e., RSD: 0.66% for NGLM, 0.42% for GLM. The 95% of CI of NGLM was ten times larger than that of GLM in five replacement positions. The two kinds of baseline corrections, the SNV and MSC processing were examined to evaluate the extent of influence against a.v. The 95% CI calculated from a.v. by the SNV pre-processing showed a wider range compared with that from no pre-processing and MSC pre-processing. These results suggest that the statistical confidence of a.v. would also change by pre-processing. It is important to consider the statistical confidence of a.v. for precise quantitative application of the reflectance NIR spectroscopy.
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Affiliation(s)
- T Sakamoto
- Division of Drugs, National Institute of Health Sciences, Tokyo, Japan.
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Suda M, Morizumi K, Ishimura M, Maeda T, Kataoka S, Hiyama Y. Effects of KP-496DPI, a Novel Dual Antagonist for Cysteinyl Leukotriene Receptor (CysLT1R) and Thromboxane A2 Receptor (TP), on the Asthmatic Responses in Guinea Pigs. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Suzuki K, Hiyama Y, Fujiwara I, Tomoo K, Ishida T. Crystal structure of porcine pancreatic elastase complex with novel peptidiyl trifluoromethyl ketone inhibitor of human neutrophil elastase. Acta Crystallogr A 2002. [DOI: 10.1107/s0108767302096605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kawaguchi H, Nakamura K, Tabata Y, Ikada Y, Aoyama I, Anzai J, Nakamura T, Hiyama Y, Tamura M. Acceleration of fracture healing in nonhuman primates by fibroblast growth factor-2. J Clin Endocrinol Metab 2001; 86:875-80. [PMID: 11158060 DOI: 10.1210/jcem.86.2.7199] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.7] [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: 01/02/2023]
Abstract
One of the greatest needs in the clinical bone field is a bioactive agent to stimulate bone formation. We previously reported that fibroblast growth factor-2 (FGF-2) exhibited strong anabolic actions on bone formation in models of rodents and dogs. Aiming at a clinical application, this study was undertaken to clarify the effect of a single local application of recombinant human FGF-2 on fracture healing in nonhuman primates. After a fracture was created at the midshaft of the right ulna of animals and stabilized with an intramedullary nail, gelatin hydrogel alone (n = 10) or gelatin hydrogel containing 200 microg FGF-2 (n = 10) was injected into the fracture site. Although 4 of 10 animals treated with the vehicle alone remained in a nonunion state even after 10 weeks, bone union was complete at 6 weeks in all 10 animals treated with FGF-2. Significant differences in bone mineral content and density at the fracture site between the vehicle and FGF-2 groups were seen at 6 weeks and thereafter. FGF-2 also increased the mechanical property of the fracture site. We conclude that FGF-2 accelerates fracture healing and prevents nonunion in primates, and therefore propose that it is a potent bone anabolic agent for clinical use.
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Affiliation(s)
- H Kawaguchi
- Department of Orthopedic Surgery, University of Tokyo Graduate School of Medicine, Hongo 7-3-1, Bunkyo 113-8655, Tokyo.
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Kato T, Kawaguchi H, Hanada K, Aoyama I, Hiyama Y, Nakamura T, Kuzutani K, Tamura M, Kurokawa T, Nakamura K. Single local injection of recombinant fibroblast growth factor-2 stimulates healing of segmental bone defects in rabbits. J Orthop Res 1998; 16:654-9. [PMID: 9877388 DOI: 10.1002/jor.1100160605] [Citation(s) in RCA: 108] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The effects of a single local injection of recombinant human fibroblast growth factor-2 on the healing of segmental bone defects were evaluated in rabbits. One month after the external fixator originally designed for this experiment was installed in the tibia of the rabbit, a 3-mm bone defect was created by an osteotomy in the middle of the tibia and 0, 50, 100, 200, or 400 microg of fibroblast growth factor-2 in 100 microl of saline solution was injected into the defect. Injection of the growth factor increased the volume and mineral content of newly made bone at the defect in a dose-dependent manner with significant effects at concentrations of 100 microg or greater. These significant effects were observed at 5 weeks and later. One hundred micrograms of the growth factor increased the volume and mineral content of newly made bone by 95 and 36%, respectively, at 5 weeks. These results indicate that a single local injection of fibroblast growth factor-2 stimulates the healing of segmental defects. We speculate that such an injection could be clinically useful for the healing of fractures even when the fracture gap is rather large.
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Affiliation(s)
- T Kato
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, Japan
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Nakamura K, Kawaguchi H, Aoyama I, Hanada K, Hiyama Y, Awa T, Tamura M, Kurokawa T. Stimulation of bone formation by intraosseous application of recombinant basic fibroblast growth factor in normal and ovariectomized rabbits. J Orthop Res 1997; 15:307-13. [PMID: 9167636 DOI: 10.1002/jor.1100150222] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.2] [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: 02/04/2023]
Abstract
The effect on intraosseous bone formation of a single local injection of recombinant human basic fibroblast growth factor into the distal femur was examined in normal and ovariectomized rabbits. In normal rabbits, basic fibroblast growth factor increased bone mineral density around the injected site in a dose-dependent manner at 4 weeks, with significant effects at concentrations of 400 micrograms and greater. Doses of 400 and 1,600 micrograms of basic fibroblast growth factor increased bone mineral density by 8 and 9%, respectively, compared with the opposite control femur. Histological examination showed that basic fibroblast growth factor (400 micrograms) induced the proliferation or recruitment of undifferentiated mesenchymal cells around the existing trabeculae at 3 days after the injection. For the first 2 weeks, osteoid formation was strongly stimulated, and this was followed by mineral apposition for another 2 weeks, at which time the femurs were harvested. Consequently, basic fibroblast growth factor stimulated intraosseous bone formation at 4 weeks. We speculate that the direct action of basic fibroblast growth factor on bone formation may be to stimulate proliferation or recruitment of minimally differentiated mesenchymal cells and to initiate the cascade of events in later stages of bone formation. In ovariectomized rabbits, basic fibroblast growth factor (400 micrograms) also increased bone mineral density, histomorphometrical bone formation markers, and trabecular connectivity to levels similar to those in rabbits who had received sham operations.
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Affiliation(s)
- K Nakamura
- Department of Orthopaedic Surgery, University of Tokyo, Japan
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Nakamura K, Kurokawa T, Kawaguchi H, Kato T, Hanada K, Hiyama Y, Aoyama I, Nakamura T, Tamura M, Matsumoto T. Stimulation of endosteal bone formation by local intraosseous application of basic fibroblast growth factor in rats. Rev Rhum Engl Ed 1997; 64:101-5. [PMID: 9085444] [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: 02/04/2023]
Abstract
We investigated the effects of local intraosseous application of basic fibroblast growth factor under physiologic conditions. An aqueous solution containing 0 (vehicle), 25, 100, or 400 micrograms of basic fibroblast growth factor was injected via a needle into the ilium of rats. Two weeks later, bone mineral density of the ilium was significantly increased (P < 0.01) with all three doses, and a dose-effect relationship was apparent. Light microscopy revealed proliferation of undifferentiated mesenchymal cells on the endosteal and trabecular surfaces, as well as apposition of newly formed bone on existing trabeculae. Intraosseous injection of basic fibroblast growth factor may be of use for the treatment of osteoporosis.
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Affiliation(s)
- K Nakamura
- Department of Orthopedic Surgery, Medical School, University of Tokyo, Japan
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