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Li Y, Yamamoto S, Oshiro Y, Inamura N, Nemoto T, Horii K, Takeuchi JS, Mizoue T, Konishi M, Ozeki M, Sugiyama H, Sugiura W, Ohmagari N. Comparison of risk factors for SARS-CoV-2 infection among healthcare workers during Omicron and Delta dominance periods in Japan. J Hosp Infect 2023; 134:97-107. [PMID: 36805085 PMCID: PMC9933573 DOI: 10.1016/j.jhin.2023.01.018] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The risk factors for coronavirus disease (COVID-19) among healthcare workers (HCWs) might have changed since the emergence of the highly immune evasive Omicron variant. AIM To compare the risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCWs during the Delta- and Omicron-predominant periods. METHODS Using data from repeated serosurveys among the staff of a medical research centre in Tokyo, two cohorts were established: Delta period cohort (N = 858) and Omicron period cohort (N = 652). The potential risk factors were assessed using a questionnaire. Acute/current or past SARS-CoV-2 infection was identified by polymerase chain reaction or anti-nucleocapsid antibody tests, respectively. Poisson regression was used to calculate the risk ratio (RR) of infection risk. FINDINGS The risk of SARS-CoV-2 infection during the early Omicron-predominant period was 3.4-fold higher than during the Delta-predominant period. Neither working in a COVID-19-related department nor having a higher degree of occupational exposure to SARS-CoV-2 was associated with an increased infection risk during both periods. During the Omicron-predominant period, infection risk was higher among those who spent ≥30 min in closed spaces, crowded spaces, and close-contact settings without wearing mask (≥3 times versus never: RR: 6.62; 95% confidence interval: 3.01-14.58), whereas no such association was found during the Delta period. CONCLUSION Occupational exposure to COVID-19-related work was not associated with the risk of SARS-CoV-2 infection in the Delta or Omicron period, whereas high-risk behaviours were associated with an increased infection risk during the Omicron period.
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Affiliation(s)
- Y Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - N Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - T Nemoto
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - K Horii
- Infection Control Office, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - J S Takeuchi
- Department Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - M Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Ozeki
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - H Sugiyama
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - W Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Yamamoto S, Mizoue N, Mizoue T, Konishi M, Horii K, Sugiyama H, Ohmagari N. Living with school-age children and absence among staff of a tertiary hospital during the Omicron epidemic in Tokyo. J Hosp Infect 2022; 130:151-153. [PMID: 35995338 PMCID: PMC9389519 DOI: 10.1016/j.jhin.2022.08.003] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 12/01/2022]
Affiliation(s)
- S. Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - N. Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - T. Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan,Corresponding author. Address: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. Tel.: +81 3 3202 7181
| | - M. Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - K. Horii
- Infection Control Office, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - H. Sugiyama
- Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - N. Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Morioka S, Tsuzuki S, Suzuki M, Terada M, Akashi M, Osanai Y, Kuge C, Sanada M, Tanaka K, Maruki T, Takahashi K, Saito S, Hayakawa K, Teruya K, Hojo M, Ohmagari N. Post COVID-19 condition of the Omicron variant of SARS-CoV-2. J Infect Chemother 2022; 28:1546-1551. [PMID: 35963600 PMCID: PMC9365517 DOI: 10.1016/j.jiac.2022.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/04/2022] [Revised: 07/18/2022] [Accepted: 08/04/2022] [Indexed: 12/12/2022]
Abstract
Objectives To investigate the prevalence of post coronavirus disease (COVID-19) condition of the Omicron variant in comparison to other strains. Study design A single-center cross-sectional study. Methods Patients who recovered from Omicron COVID-19 infection (Omicron group) were interviewed via telephone, and patients infected with other strains (control group) were surveyed via a self-reporting questionnaire. Data on patients’ characteristics, information regarding the acute-phase COVID-19, as well as presence and duration of COVID-19-related symptoms were obtained. Post COVID-19 condition in this study was defined as a symptom that lasted for at least 2 months, within 3 months of COVID-19 onset. We investigated and compared the prevalence of post COVID-19 condition in both groups after performing propensity score matching. Results We conducted interviews for 53 out of 128 patients with Omicron and obtained 502 responses in the control group. After matching cases with controls, 18 patients from both groups had improved covariate balance of the factors: older adult, female sex, obesity, and vaccination status. There were no significant differences in the prevalence of each post COVID-19 condition between the two groups. The number of patients with at least one post COVID-19 condition in the Omicron and control groups were 1 (5.6%) and 10 (55.6%) (p = 0.003), respectively. Conclusions The prevalence of post Omicron COVID-19 conditions was less than that of the other strains. Further research with a larger sample size is needed to investigate the precise epidemiology of post COVID-19 condition of Omicron, and its impact on health-related quality of life and social productivity.
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Affiliation(s)
- S Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.
| | - S Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - M Suzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - M Terada
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Akashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Y Osanai
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - C Kuge
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - M Sanada
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Tanaka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - T Maruki
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Takahashi
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - S Saito
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Teruya
- AIDS Clinical Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - M Hojo
- Division of Respiratory Medicine, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
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Tsuzuki S, Yu J, Matsunaga N, Ohmagari N. Length of stay, hospitalisation costs and in-hospital mortality of methicillin-susceptible and methicillin-resistant Staphylococcus aureus bacteremia in Japan. Public Health 2021; 198:292-296. [PMID: 34507134 DOI: 10.1016/j.puhe.2021.07.046] [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: 04/19/2021] [Revised: 06/29/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To examine the length of stay, hospitalisation costs and case fatality of methicillin-susceptible and -resistant Staphylococcus aureus (MSSA and MRSA) bacteremia in Japan. STUDY DESIGN Retrospective cohort study. Patients with a diagnosis of S. aureus bacteremia who were admitted to a tertiary care hospital (the National Centre for Global Health and Medicine [NCGM]) in Tokyo, Japan, between 1st January 2016 and 31st December 2020 were included in the study. METHODS We combined Japan Nosocomial Infections Surveillance data and Diagnosis Procedure Combination data at NCGM from 2016 to 2020. The data were stratified into MSSA and MRSA groups. Length of stay (LoS), LoS after submission of a blood culture specimen (LoS-after), hospitalisation cost, hospitalisation costs per day and clinical outcome were compared after propensity score matching. RESULTS Median LoS was 46 (interquartile range [IQR] 28.5-64.5) days in the MSSA group and 66 (IQR 40-91) days in the MRSA group (P = 0.020). Median LoS-after was 38 (IQR 25-62.5) days and 45 (IQR 24-63) days (P = 0.691) in the MSSA and MRSA groups, respectively. Median hospitalisation cost was significantly higher in the MRSA group (26,035 [IQR 18,154-47,362] USD) than in the MSSA group (19,823 [IQR 13,764-32,042] USD) (P = 0.036), but cost per day was not (MRSA: 528.9 [IQR 374.9-647.4] USD; MSSA: 455.6 [IQR 359.2-701.7] USD; P = 0.990). Case fatality rate was higher in the MRSA group than in the MSSA group (22/60 vs 9/60, P = 0.012). CONCLUSIONS Patients with MRSA bacteremia had longer LoS and higher costs than those with MSSA bacteremia. However, LoS-after and hospitalisation costs per day were not different. The longer LoS of patients in Japan compared with other countries might contribute to the higher disease burden of S. aureus bacteremia in Japan.
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Affiliation(s)
- S Tsuzuki
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - J Yu
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Ohmagari
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan; Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Tanaka C, Kusama Y, Ishikane M, Hayakawa K, Muraki Y, Ohmagari N. Pharmacists document antimicrobial use during off-duty hours in half of Japanese hospital. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.294] [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: 10/22/2022] Open
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Morioka S, Tajima T, Sugiki Y, Hayakawa K, Ohmagari N. Adherence to personal protective equipment use among nurses in Japanese tertiary care hospitals: what determines variability? J Hosp Infect 2019; 104:344-349. [PMID: 31790746 DOI: 10.1016/j.jhin.2019.11.019] [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: 08/27/2019] [Accepted: 11/25/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Though nurses have frequent contact with patients, their personal protective equipment (PPE) compliance rate is low, which poses a significant challenge in infection control. AIM To investigate the relative influence of specific factors on PPE compliance. METHODS A sequential two-stage mixed-methods design was applied. In a qualitative study, semi-structured interviews were conducted from May to July 2018. In a quantitative study, a nationwide, cross-sectional survey was conducted from January to March 2019, in which a questionnaire was mailed to 735 nurses in 28 tertiary care hospitals in Japan. FINDINGS In the quantitative study, 435 (59.2%) analysable responses were obtained. In the linear regression analysis, the lack of the knowledge that 'standard precaution was the fundamental infection countermeasure applied when patients had signs of infections, and these countermeasures could be terminated if there was no infection found' was significantly associated with decreased PPE adherence, whereas an antimicrobial-resistant bacteria outbreak or a ward shutdown due to an outbreak and the belief 'I must never be the cause of spreading infection' were significantly associated with increased PPE adherence. The β of standard coefficients and t-values of the items were -0.344, -7.784, 0.090, 2.089, 0.088, 2.018, respectively. CONCLUSION This survey systematically identified nursing-associated factors that contribute to PPE compliance. As a practical approach to ensure positive outcomes, we suggest educating nurses by providing adequate knowledge on appropriate PPE use and sharing outbreak or ward shutdown experiences.
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Affiliation(s)
- S Morioka
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.
| | - T Tajima
- AMR Clinical Reference Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - Y Sugiki
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - K Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan
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Katanami Y, Hayakawa K, Shimazaki T, Sugiki Y, Takaya S, Yamamoto K, Kutsuna S, Kato Y, Ohmagari N. Adherence to contact precautions by different types of healthcare workers through video monitoring in a tertiary hospital. J Hosp Infect 2018; 100:70-75. [PMID: 29317259 DOI: 10.1016/j.jhin.2018.01.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 11/06/2017] [Accepted: 01/02/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Contact precautions are required to prevent transmission of multi-drug-resistant organisms; however, reports on adherence rates vary. This study used video monitoring to evaluate adherence to the use of personal protective equipment (PPE) by different types of healthcare workers. METHODS This observational study was conducted in a 781-bed tertiary hospital from July 2016 to March 2017. Cameras were installed in areas where staff don PPE. Infection control teams observed the videos and assessed adherence rates. RESULTS In total, 1097 opportunities for donning PPE were observed. Most staff observed were nurses and nursing assistants (Ns/Nsas) (880/1097, 80.2%). Overall, the adherence rate to appropriate PPE use was 34.0%. The adherence rate among Ns/Nsas was lower (239/858, 27.9%) compared with infectious disease doctors (18/18, 100%) and cleaning staff (42/49, 85.7%). The adherence rate for PPE use for Clostridium difficile infection (CDI) with toxin detection was significantly higher than that for CDI without toxin detection and multi-drug-resistant organisms (P<0.001 for both). The adherence rate for patients with an independent functional status was higher than that for patients with a dependent functional status (P=0.018). The adherence rate was lower in the intensive care unit (ICU) than in non-ICU wards (27.6% vs 36.5%; P=0.006). CONCLUSION Video monitoring is a useful tool for monitoring adherence to PPE use, facilitating observation of more PPE opportunities than direct observation. Adherence to contact precautions varied by occupation; however, overall adherence was insufficient. The lower adherence rate in nurses might be due to more frequent care visits.
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Affiliation(s)
- Y Katanami
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan.
| | - K Hayakawa
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - T Shimazaki
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Y Sugiki
- Infection Control and Prevention, National Centre for Global Health and Medicine, Tokyo, Japan
| | - S Takaya
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - K Yamamoto
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - S Kutsuna
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Y Kato
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
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Jiang Y, Cao B, Ohmagari N, Wu AH, Liu YX, Guo LP. Comprehensive understanding of health-seeking behaviour among pulmonary tuberculosis patients in China. Int J Tuberc Lung Dis 2017; 21:1094-1099. [PMID: 28911351 DOI: 10.5588/ijtld.17.0227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Y. Jiang
- Hospital Management Institute, Beijing University of Chinese Medicine, Beijing, Nosocomial Infection Control Office, China-Japan Friendship Hospital, Beijing
| | - B. Cao
- Nosocomial Infection Control Office, China-Japan Friendship Hospital, Beijing, National Clinical Research Center of Respiratory Diseases, Center for Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, China–Japan Friendship
Hospital, Beijing, Department of Pulmonary Medicine; Capital Medical University, Beijing, China
| | - N. Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Aichi Medical University Graduate School of Medicine, Aichi, Japan
| | - A-H. Wu
- Nosocomial Infection Control Office, Xiangya Hospital, Central South University, Changsha
| | - Y-X. Liu
- Nosocomial Infection Control Office, People's Liberation Army General Hospital, Beijing, China
| | - L-P. Guo
- Hospital Management Institute, Beijing University of Chinese Medicine, Beijing, Nosocomial Infection Control Office, China-Japan Friendship Hospital, Beijing
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Takeshita N, Kawamura I, Kurai H, Araoka H, Yoneyama A, Fujita T, Ainoda Y, Hase R, Hosokawa N, Shimanuki H, Sekiya N, Ohmagari N. Unique characteristics of community-onset healthcare- associated bloodstream infections: a multi-centre prospective surveillance study of bloodstream infections in Japan. J Hosp Infect 2017; 96:29-34. [PMID: 28377180 DOI: 10.1016/j.jhin.2017.02.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 01/12/2017] [Accepted: 02/22/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Analysis of bloodstream infections (BSIs) is valuable for their diagnosis, treatment and prevention. However, limited data are available in Japan. AIM To investigate the characteristics of patients with bacteraemia in Japan. METHODS This study was conducted in five hospitals from October 2012 to September 2013. Clinical, demographic, microbiological and outcome data for all blood-culture-positive cases were analysed. FINDINGS In total, 3206 cases of BSI were analysed: 551 community-onset healthcare-associated (CHA)-BSIs, 1891 hospital-acquired (HA)-BSIs and 764 community-acquired (CA)-BSIs. The seven- and 30-day mortality rates were higher in patients with CHA- and HA-BSIs than in patients with CA-BSIs. The odds ratios (ORs) for seven-day mortality were 2.56 [95% confidence interval (CI) 1.48-4.41] and 2.63 (95% CI 1.64-4.19) for CHA- and HA-BSIs, respectively. The ORs for 30-day mortality were 2.41 (95% CI 1.63-3.57) and 3.31 (95% CI 2.39-4.59) for CHA- and HA-BSIs, respectively. There were 499 cases (15.2%) of central-line-associated BSI and 163 cases (5.0%) of peripheral-line-associated BSI. Major pathogens included coagulase-negative staphylococci (N = 736, 23.0%), Escherichia coli (N = 581, 18.1%), Staphylococcus aureus (N = 294, 9.2%) and Klebsiella pneumoniae (N = 263, 8.2%). E. coli exhibited a higher 30-day mortality rate among patients with HA-BSIs (22.3%) compared with patients with CHA-BSIs (12.3%) and CA-BSIs (3.4%). K. pneumoniae exhibited higher 30-day mortality rates in patients with HA-BSIs (22.0%) and CHA-BSIs (22.7%) compared with patients with CA-BSIs (7.8%). CONCLUSION CHA- and HA-BSIs had higher mortality rates than CA-BSIs. The prognoses of E. coli- and K. pneumonia-related BSIs differed according to the category of bacteraemia.
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Affiliation(s)
- N Takeshita
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan
| | - I Kawamura
- Division of Infectious Diseases, Shizuoka Cancer Centre Hospital, Shizuoka, Japan
| | - H Kurai
- Division of Infectious Diseases, Shizuoka Cancer Centre Hospital, Shizuoka, Japan
| | - H Araoka
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - A Yoneyama
- Department of Infectious Diseases, Toranomon Hospital, Tokyo, Japan
| | - T Fujita
- Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan; Department of Infectious Diseases, National Hospital Organization, Hokkaido Cancer Centre, Hokkaido, Japan
| | - Y Ainoda
- Department of Infectious Diseases, Tokyo Women's Medical University, Tokyo, Japan; Department of Infectious Diseases, Tokyo Metropolitan Health and Medical Treatment Corporation, Ebara Hospital, Tokyo, Japan
| | - R Hase
- Department of Infectious Diseases, Kameda Medical Centre, Chiba, Japan
| | - N Hosokawa
- Department of Infectious Diseases, Kameda Medical Centre, Chiba, Japan
| | - H Shimanuki
- Centre for Clinical Science, National Centre for Global Health and Medicine, Tokyo, Japan
| | - N Sekiya
- Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan.
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Asayama N, Nagata N, Shimbo T, Nishimura S, Igari T, Akiyama J, Ohmagari N, Hamada Y, Nishijima T, Yazaki H, Teruya K, Oka S, Uemura N. Relationship between clinical factors and severity of esophageal candidiasis according to Kodsi's classification. Dis Esophagus 2014; 27:214-9. [PMID: 23826847 DOI: 10.1111/dote.12102] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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] [Indexed: 12/11/2022]
Abstract
Severe Candida esophagitis (CE) may lead to development of strictures, hemorrhage, esophagotracheal fistula, and a consequent decrease in quality of life. Although the severity of CE has been classified based on macroscopic findings on endoscopy, the clinical significance remains unknown. The aim of the study was to elucidate the predictive clinical factors for endoscopic severity of CE. Patients who underwent upper endoscopy and answered questionnaires were prospectively enrolled. Smoking, alcohol, human immunodeficiency virus (HIV) infection, diabetes mellitus, chronic renal failure, liver cirrhosis, systemic steroids use, proton pump inhibitor use, H2 blocker use, and gastrointestinal (GI) symptoms were assessed on the same day of endoscopy. GI symptoms including epigastric pain, heartburn, reflux, hunger cramps, nausea, dysphagia, and odynophagia were assessed on a 7-point Likert scale. Endoscopic severity was classified as mild (Kodsi's grade I/II) or severe (grade III/IV). Of 1855 patients, 71 (3.8%) were diagnosed with CE (mild, n = 48; severe, n = 23). In the CE patients, 50.0% (24/48) in the mild group and 23.1% (6/23) in the severe group did not have any GI symptoms. In HIV-infected patients (n = 17), a significant correlation was found between endoscopic severity and declining CD4 cell count (Spearman's rho = -0.90; P < 0.01). Multivariate analysis revealed that GI symptoms (odds ratio [OR], 3.32) and HIV infection (OR, 3.81) were independently associated with severe CE. Patients in the severe group experienced more epigastric pain (P = 0.02), reflux symptoms (P = 0.04), dysphagia (P = 0.05), and odynophagia (P < 0.01) than those in the mild group. Of the GI symptoms, odynophagia was independently associated with severe CE (OR 9.62, P = 0.02). In conclusion, the prevalence of CE in adults who underwent endoscopy was 3.8%. Silent CE was found in both mild and severe cases. Endoscopic severity was associated with characteristic GI symptoms and comorbidity of HIV infection. A decline in immune function correlated with CE disease progression.
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Affiliation(s)
- N Asayama
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
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Kutsuna S, Kato Y, Takasaki T, Moi ML, Kotaki A, Uemura H, Matono T, Fujiya Y, Mawatari M, Takeshita N, Hayakawa K, Kanagawa S, Ohmagari N. Two cases of Zika fever imported from French Polynesia to Japan, December 2013 to January 2014. Euro Surveill 2014; 19. [DOI: 10.2807/1560-7917.es2014.19.4.20683] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We present two cases of imported Zika fever to Japan, in travellers returning from French Polynesia, where an outbreak due to Zika virus (ZIKV) is ongoing since week 41 of 2013. This report serves to raise awareness among healthcare professionals, that the differential diagnosis of febrile and subfebrile patients with rash should include ZIKV infection, especially in patients returning from areas affected by this virus.
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Affiliation(s)
- S Kutsuna
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - Y Kato
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - T Takasaki
- Department of Virology 1, National Institute of Infectious Diseases, Shinjukuku, Tokyo, Japan
| | - M L Moi
- Department of Virology 1, National Institute of Infectious Diseases, Shinjukuku, Tokyo, Japan
| | - A Kotaki
- Department of Virology 1, National Institute of Infectious Diseases, Shinjukuku, Tokyo, Japan
| | - H Uemura
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - T Matono
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - Y Fujiya
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - M Mawatari
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - N Takeshita
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - K Hayakawa
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - S Kanagawa
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
| | - N Ohmagari
- National Center for Global health and Medicine, Disease Control and Prevention Center, Tokyo, Japan
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Mawatari M, Kato Y, Hayakawa K, Morita M, Yamada K, Mezaki K, Kobayashi T, Fujiya Y, Kutsuna S, Takeshita N, Kanagawa S, Ohnishi M, Izumiya H, Ohmagari N. Salmonella enterica serotype Paratyphi A carrying CTX-M-15 type extended-spectrum beta-lactamase isolated from a Japanese traveller returning from India, Japan, July 2013. Euro Surveill 2013; 18. [DOI: 10.2807/1560-7917.es2013.18.46.20632] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Gomi H, Nishigori H, Hosokawa N, Ohmagari N, Iwata K, Gremillion D, Lefor A, Dornan T. P351 Defining competencies for infectious diseases specialists from national and international perspectives. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70592-2] [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: 10/26/2022]
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14
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Uemura H, Hayakawa K, Hamada Y, Yamamoto K, Kutsuna S, Ujiie M, Takeshita N, Kato Y, Kanagawa S, Shimada K, Kirikae T, Ohmagari N. P324 Parvimonas micra as a causative organism of spondylodiscitis: A report of 3 cases. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70565-x] [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: 10/26/2022]
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15
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Kazama I, Aoshima M, Ohmagari N, Usui Y, Tada H, Chohnabayashi N, Furukawa K, Matsusako M, Doi O. [Psoas abscess caused by nephrolithiasis with perirenal abscess complicated with pleural effusion]. Nihon Kokyuki Gakkai Zasshi 2000; 38:860-4. [PMID: 11193322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Left pleural effusion was found in a 60-year-old woman in whom chest radiography performed during a physical check up revealed no abnormality. Abdominal CT scanning revealed an abscess in the left psoas muscle. The psoas abscess was eliminated temporarily by drainage under ultrasonographic guidance and by the administration of antibiotics, but recurred one month later. A stag-horn renal stone considered to have caused the psoas abscess by formation of a perirenal abscess was eliminated by left nephrectomy. It is suggested tentatively that the psoas abscess might have been the cause of the pleural effusion.
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16
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Ohmagari N, Aoshima M, Tada H, Chonabayashi N, Furukawa K, Ohtawa M, Watanabe F, Doi O, Uekusa T, Saiki S. [Arteriovenous fistula associated with Staphylococcus aureus sepsis in a patient with Rendu-Osler-Weber syndrome]. Nihon Kokyuki Gakkai Zasshi 2000; 38:143-7. [PMID: 10774175] [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: 02/16/2023]
Abstract
A 58-year-old man with a history of cerebral infarction and bleeding due to duodenal ulcer was admitted with fever and arthralgia. Methicillin-sensitive Staphylococcus aureus (MSSA) was isolated from his peripheral blood. Bacteremia with MSSA was diagnosed, and antibiotic therapy was started. However, chest X-ray films and computed tomographic scans disclosed mass shadows in both lungs accompanied by dilated vascular markings. Pulmonary arteriography and magnetic resonance angiography revealed the existence of arteriovenous fistulas in both lungs. Ga scintigraphy disclosed a hot spot in the left lower lobe, consistent with the location of one fistula. This indicated that the fistula might be the focus of MSSA sepsis. Because the patient also had telangiectasia in his gastric mucosa, oral cavity, and nasal cavity, he was given a diagnosis of Rendu-Osler-Weber syndrome.
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Affiliation(s)
- N Ohmagari
- Department of Pulmonary Medicine, St. Luke's International Hospital, Tokyo, Japan
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