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Ikebe T, Okuno R, Uchitani Y, Yamaguchi T, Isobe J, Maenishi E, Date Y, Otsuka H, Kazawa Y, Fujita S, Kobayashi A, Takano M, Tsukamoto S, Kanda Y, Ohnishi M, Akeda Y. Epidemiological shifts in and impact of COVID-19 on streptococcal toxic shock syndrome in Japan: A genotypic analysis of group A Streptococcus isolates. Int J Infect Dis 2024; 142:106954. [PMID: 38382822 DOI: 10.1016/j.ijid.2024.01.021] [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: 09/21/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES Streptococcal toxic shock syndrome (STSS) is caused by group A Streptococcus (GAS; Streptococcus pyogenes) strains. In Japan, the number of STSS cases has decreased; however, the underlying reason remains unclear. Moreover, information on distribution and prevalence of specific emm types in STSS cases is scarce. Hence, we investigated the reason for the decreased number of STSS cases in Japan. METHODS We genotyped emm of 526 GAS isolates obtained from 526 patients with STSS between 2019 and 2022. The distributions of emm types in each year were compared. RESULTS The emm1 type was predominant, with the highest proportion in 2019, which decreased after 2020 following the onset of the coronavirus disease 2019 (COVID-19) pandemic. Strains isolated during the pandemic correlated with strains associated with skin infection, whereas those isolated during the prepandemic period correlated with strains associated with both throat and skin infections. The decrease in the annual number of STSS cases during the COVID-19 pandemic could be due to a decreased proportion of strains associated with pharyngeal infections. CONCLUSIONS Potential associations between pandemic and STSS numbers with respect to public health measures, such as wearing masks and changes in healthcare-seeking behavior, may have affected the number of GAS-induced infections.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Yumi Uchitani
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Takahiro Yamaguchi
- Division of Microbiology, Osaka Institute of Public Health, Osaka, Japan
| | - Junko Isobe
- Department of Bacteriology, Toyama Institute of Health, Toyama, Japan
| | - Emi Maenishi
- Department of Bacteriology, Toyama Institute of Health, Toyama, Japan
| | - Yoshimi Date
- Division of Microbiology, Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan
| | - Hitoshi Otsuka
- Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Yu Kazawa
- Division of Microbiology, Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Shohei Fujita
- Division of Microbiology, Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Ayaka Kobayashi
- Division of Microbiology, Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Mami Takano
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, Oita, Japan
| | - Shinya Tsukamoto
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, Oita, Japan
| | - Yoshiko Kanda
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, Oita, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukihiro Akeda
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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Ogawa K, Kamiyama J, Ikebe T, Taguchi S, Kiyota K. STSS by Streptococcus pyogenes emm22 genotype accompanied by CsrS mutation: A case report. Jpn J Infect Dis 2024:JJID.2023.332. [PMID: 38417865 DOI: 10.7883/yoken.jjid.2023.332] [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] [Indexed: 03/01/2024]
Abstract
The patient was a 22-year-old woman with no comorbidities who was transferred to our hospital due to cardiac arrest. Treatment enabled return to spontaneous circulation in the patient before arriving at the hospital. At the hospital, the patient's vital signs were unstable. Vasopressors and hyperhydration therapy were administered. Computed Tomography (CT) showed no remarkable change that caused the cardiac arrest. Antibiotics were prescribed after a blood culture exam. The patient was admitted to the ICU. In the ICU, the high-capacity vasopressors, hyperhydration therapy and transfusion of fresh frozen plasma were continued. Two hours after examining the blood culture, the results remained positive. Gram staining revealed Streptococcus, and the antibiotics were switched to penicillin G potassium, clindamycin and immunoglobulin was added. Hyperhydration therapy caused respiratory failure. Ten hours after admission to the ICU, extracorporeal membrane oxygenation was introduced, but the patient's general status did not improve. The patient died at 40 hours after admission. Blood culture results proved Streptococcus pyogenes; T and M serotypes were unclassifiable. The emm genotype was emm22. Regarding fever toxin genes, speA and speB were positive, and speC was negative. Among CsrS, CsrR and Rgg amino acid sequences, mutations in CsrS were detected.
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Affiliation(s)
- Kaoru Ogawa
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
| | - Jiro Kamiyama
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
| | - Shigemasa Taguchi
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
| | - Kazuya Kiyota
- Altitude Emergency and Critical Care Medical, Saitama Red Cross Hospital, Japan
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3
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Ikebe T, Okuno R, Uchitani Y, Takano M, Yamaguchi T, Otsuka H, Kazawa Y, Fujita S, Kobayashi A, Date Y, Isobe J, Maenishi E, Ohnishi M, Akeda Y. Serotype Distribution and Antimicrobial Resistance of Streptococcus agalactiae Isolates in Nonpregnant Adults with Streptococcal Toxic Shock Syndrome in Japan in 2014 to 2021. Microbiol Spectr 2023; 11:e0498722. [PMID: 36786620 PMCID: PMC10100893 DOI: 10.1128/spectrum.04987-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
The incidence of streptococcal toxic shock syndrome (STSS) due to group B Streptococcus (GBS) has been increasing annually in Japan and is becoming a serious challenge. Furthermore, in recent years, penicillin- or clindamycin-resistant strains used in treating streptococcal toxic shock syndrome have been reported. However, no report analyzed >100 isolates of group B Streptococcus causing streptococcal toxic shock syndrome. Therefore, we aimed to perform serotyping and antimicrobial susceptibility testing of 268 isolated group B Streptococcus strains from streptococcal toxic shock syndrome cases involving nonpregnant adult patients in Japan between 2014 and 2021. The most prevalent serotype was Ib, followed by serotypes V, III, and Ia. Seven isolates were resistant to penicillin G, and 17.9% (48 isolates) were resistant to clindamycin. Of the penicillin-resistant group B Streptococcus isolates, 71.4% (5 isolates) were clindamycin resistant. In addition, group B Streptococcus strains resistant to penicillin and clindamycin were isolated from patients with streptococcal toxic shock syndrome. Therefore, before these strains become prevalent, introduction of the group B Streptococcus vaccine is essential for disease prevention. IMPORTANCE Group B Streptococcus (GBS) has been increasingly associated with invasive disease in nonpregnant adults. Such infections are responsible for substantial morbidity and mortality, particularly in individuals with underlying chronic conditions. Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock, multiorgan failure, and high mortality. In this study, we assessed 268 GBS-related STSS cases in nonpregnant adults in Japan between 2014 and 2021. Serotype Ib was the most prevalent, followed by serotypes V, III, and Ia, which were identified in more than 80% of STSS isolates. We found that 48 clindamycin-resistant strains and 7 penicillin G-resistant strains were isolated between 2014 and 2021. We believe that our study makes a significant contribution to the literature because we show that the GBS vaccine, particularly the hexavalent conjugate vaccine, is important to reduce the number of patients with STSS.
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Affiliation(s)
| | - Rumi Okuno
- Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Yumi Uchitani
- Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Mami Takano
- Oita Prefectural Institute of Health and Environment, Oita, Japan
| | | | - Hitoshi Otsuka
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Yu Kazawa
- Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Shohei Fujita
- Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Ayaka Kobayashi
- Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Yoshimi Date
- Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan
| | | | | | | | | | - the Working Group for Beta-Hemolytic Streptococci in Japan
- National Institute of Infectious Diseases, Tokyo, Japan
- Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
- Oita Prefectural Institute of Health and Environment, Oita, Japan
- Osaka Institute of Public Health, Osaka, Japan
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
- Fukushima Prefectural Institute of Public Health, Fukushima, Japan
- Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan
- Toyama Institute of Health, Toyama, Japan
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4
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Ikebe T, Otsuka H, Chiba K, Kazawa Y, Yamaguchi T, Okuno R, Date Y, Sasaki M, Isobe J, Ohnishi M, Akeda Y. Natural mutation in the regulatory gene (srrG) influences virulence-associated genes and enhances invasiveness in Streptococcus dysgalactiae subsp. equisimilis strains isolated from cases of streptococcal toxic shock syndrome. EBioMedicine 2022; 81:104133. [PMID: 35779495 PMCID: PMC9244731 DOI: 10.1016/j.ebiom.2022.104133] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022] Open
Abstract
Background Streptococcus dysgalactiae subspecies equisimilis (SDSE) has emerged as an important cause of severe invasive infections including streptococcal toxic shock syndrome (STSS). The present study aimed to identify genes involved in differences in invasiveness between STSS and non-invasive SDSE isolates. Methods STSS and non-invasive SDSE isolates were analysed to identify csrS/csrR mutations, followed by a comparative analysis of genomic sequences to identify mutations in other genes. Mutant strains were generated to examine changes in gene expression profiles and altered pathogenicity in mice. Findings Of the 79 STSS-SDSE clinical isolates, 15 (19.0%) harboured csrS/csrR mutations, while none were found in the non-invasive SDSE isolates. We identified a small RNA (sRNA) that comprised three direct repeats along with an inverted repeat and was transcribed in the same direction as the sagA gene. The sRNA was referred to as srrG (streptolysin S regulatory RNA in GGS). srrG mutations were identified in the STSS-SDSE strains and were found to be associated with elevated expression of the streptolysin S (SLS) gene cluster and enhanced pathogenicity in mice. Interpretation The csrS/csrR and srrG mutations that increased virulence gene expression in STSS-SDSE isolates were identified, and strains carrying these mutations caused increased lethality in mice. A significantly higher frequency of mutations was observed in STSS-SDSE isolates, thereby highlighting their importance in STSS. Funding Japan Agency for Medical Research and Development, the Japan Society for the Promotion of Science (JSPS), and the Ministry of Health, Labor, and Welfare of Japan.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Hitoshi Otsuka
- Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Kazuki Chiba
- Division of Microbiology, Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Yu Kazawa
- Division of Microbiology, Fukushima Prefectural Institute of Public Health, Fukushima, Japan
| | - Takahiro Yamaguchi
- Division of Microbiology, Osaka Institute of Public Health, Osaka, Japan
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Yoshimi Date
- Division of Microbiology, Kanagawa Prefectural Institute of Public Health, Kanagawa, Japan
| | - Mari Sasaki
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, Oita, Japan
| | - Junko Isobe
- Department of Bacteriology, Toyama Institute of Health, Toyama, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukihiro Akeda
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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5
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Ikebe T, Okuno R, Kanda Y, Sasaki M, Yamaguchi T, Otsuka H, Kazawa Y, Suzuki M, Ohya H, Uchida K, Ohnishi M. Molecular characterization and antimicrobial resistance of group A streptococcus isolates in streptococcal toxic shock syndrome cases in Japan from 2013 to 2018. Int J Med Microbiol 2021; 311:151496. [PMID: 33756191 DOI: 10.1016/j.ijmm.2021.151496] [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: 11/05/2020] [Revised: 03/08/2021] [Accepted: 03/14/2021] [Indexed: 12/01/2022] Open
Abstract
Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock, multi-organ failure, and puerperal sepsis and shows high mortality. Its primary cause is group A streptococcus (GAS, Streptococcus pyogenes). In this study, we genotyped the cell-surface M virulence protein gene (emm) from 621 GAS isolates obtained from patients with STSS in Japan in 2013-2018 and performed antimicrobial susceptibility testing using the broth microdilution method. The predominant emm type was found to be 1, followed by 89, 12, and 3, which were identified in more than 70 % of STSS isolates. The proportions of emm3 and emm89 increased from 2.4 % and 12.0 %, respectively, during 2010-2012 to 5.6 % and 23.3 % during 2013-2018. In contrast, the proportion of emm1 decreased from 60.6 % to 39.3 % during the same two periods. Some emm types showed increasing proportions and were not isolated from patients with STSS in 2010-2012. Among these, an emm76 type increased in prevalence and was not included in the 30-valent M protein-based vaccine. Continual investigation of changes in the epidemiology of GAS which causes STSS can provide useful monitoring information such as future vaccination strategies and the emergence status of antimicrobial-resistant bacteria.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunin-cho, Shinjuku-ku, Tokyo 169-0073, Japan
| | - Yoshiko Kanda
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, 2-8 Takae-Nishi, Oita 870-1117, Japan
| | - Mari Sasaki
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, 2-8 Takae-Nishi, Oita 870-1117, Japan
| | - Takahiro Yamaguchi
- Division of Microbiology, Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan
| | - Hitoshi Otsuka
- Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, 2-5-67 Aoi, Yamaguchi 753-0821, Japan
| | - Yu Kazawa
- Division of Microbiology, Fukushima Prefectural Institute of Public Health, 16-6 Mitouchi, Hokida, Fukushima 960-8560, Japan
| | - Miyuki Suzuki
- Division of Microbiology, Kanagawa Prefectural Institute of Public Health, 1-3-1 Shimomachiya, Chigasaki, Kanagawa 253-0087, Japan
| | - Hitomi Ohya
- Division of Microbiology, Kanagawa Prefectural Institute of Public Health, 1-3-1 Shimomachiya, Chigasaki, Kanagawa 253-0087, Japan
| | - Kaoru Uchida
- Department of Bacteriology, Toyama Institute of Health, 17-1 Naka-Taikouyama, Imizu, Toyama 939-0363, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
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6
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Hirose Y, Yamaguchi M, Takemoto N, Miyoshi-Akiyama T, Sumitomo T, Nakata M, Ikebe T, Hanada T, Yamaguchi T, Kawahara R, Okuno R, Otsuka H, Matsumoto Y, Terashima Y, Kazawa Y, Nakanishi N, Uchida K, Akiyama Y, Iwabuchi K, Nakagawa C, Yamamoto K, Nizet V, Kawabata S. Genetic Characterization of Streptococcus pyogenes emm89 Strains Isolated in Japan From 2011 to 2019. Infect Microbes Dis 2020; 2:160-166. [PMID: 38630060 PMCID: PMC7769053 DOI: 10.1097/im9.0000000000000038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 04/19/2024]
Abstract
Invasive infection caused by Streptococcus pyogenes emm89 strains has been increasing in several countries linked to a recently emergent clade of emm89 strains, designated clade 3. In Japan, the features of emm89 S. pyogenes strains, such as clade classification, remains unknown. In this study, we collected emm89 strains isolated from both streptococcal toxic shock syndrome (STSS) (89 STSS isolates) and noninvasive infections (72 non-STSS isolates) in Japan from 2011 to 2019, and conducted whole-genome sequencing and comparative analysis, which resulted in classification of a large majority into clade 3 regardless of disease severity. In addition, invasive disease-associated factors were found among emm89 strains, including mutations of control of virulence sensor, and absence of the hylP1 gene encoding hyaluronidase. These findings provide new insights into genetic features of emm89 strains.
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Affiliation(s)
- Yujiro Hirose
- Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- Department of Pediatrics, University of California at San Diego School of Medicine, La Jolla, CA, USA
| | - Masaya Yamaguchi
- Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Norihiko Takemoto
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Miyoshi-Akiyama
- Department of Infectious Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Sumitomo
- Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masanobu Nakata
- Department of Oral Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomoki Hanada
- Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Takahiro Yamaguchi
- Division of Microbiology, Osaka Institute of Public Health, Osaka City, Osaka, Japan
| | - Ryuji Kawahara
- Division of Microbiology, Osaka Institute of Public Health, Osaka City, Osaka, Japan
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Tokyo, Japan
| | - Hitoshi Otsuka
- Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment Yamaguchi City, Yamaguchi, Japan
| | - Yuko Matsumoto
- Microbiological Testing and Research Division, Yokohama City Institute of Public Health, Yokohama, Kanagawa, Japan
| | - Yuji Terashima
- Department of Microbiology, Fukushima Prefectural Institute of Public Health, Fukushima City, Fukushima, Japan
| | - Yu Kazawa
- Department of Microbiology, Fukushima Prefectural Institute of Public Health, Fukushima City, Fukushima, Japan
| | - Noriko Nakanishi
- Department of Infectious Diseases, Kobe Institute of Health, Kobe, Hyogo, Japan
| | - Kaoru Uchida
- Department of Bacteriology, Toyama Institute of Health, Imizu, Toyama, Japan
| | - Yumi Akiyama
- Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health Science, Kakogawa, Hyogo, Japan
| | - Kaori Iwabuchi
- Department of Health Science, Iwate Prefectural Research Institute for Environmental Sciences and Public Health, Morioka, Iwate, Japan
| | - Chikara Nakagawa
- Division of Microbiology, Kyoto City Institute of Health and Environmental Sciences, Kyoto City, Kyoto, Japan
| | - Kazunari Yamamoto
- Niigata City Institute of Public Health and the Environment, Niigata City, Niigata, Japan
| | - Victor Nizet
- Department of Pediatrics, University of California at San Diego School of Medicine, La Jolla, CA, USA
- Skaggs School of Pharmaceutical Sciences, University of California at San Diego, La Jolla, CA, USA
| | - Shigetada Kawabata
- Department of Oral and Molecular Microbiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
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7
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Shinoda Y, Hori T, Sasai H, Ikebe T, Ohnishi H. Neonatal bacteremia caused by emm type 80 group A Streptococcus: A case report. Pediatr Int 2020; 62:1305-1306. [PMID: 33145863 DOI: 10.1111/ped.14349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Yu Shinoda
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.,Division of Neonatal Intensive Care Unit, Gifu University Hospital, Gifu, Japan
| | - Tomohiro Hori
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.,Division of Neonatal Intensive Care Unit, Gifu University Hospital, Gifu, Japan.,Clinical Genetics Center, Gifu University Hospital, Gifu, Japan
| | - Hideo Sasai
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.,Division of Neonatal Intensive Care Unit, Gifu University Hospital, Gifu, Japan.,Clinical Genetics Center, Gifu University Hospital, Gifu, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hidenori Ohnishi
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.,Division of Neonatal Intensive Care Unit, Gifu University Hospital, Gifu, Japan.,Clinical Genetics Center, Gifu University Hospital, Gifu, Japan
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8
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Matsumura T, Nishiyama A, Aiko M, Ainai A, Ikebe T, Chiba J, Ato M, Takahashi Y. An anti-perfringolysin O monoclonal antibody cross-reactive with streptolysin O protects against streptococcal toxic shock syndrome. BMC Res Notes 2020; 13:419. [PMID: 32891180 PMCID: PMC7487723 DOI: 10.1186/s13104-020-05264-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/01/2020] [Indexed: 11/17/2022] Open
Abstract
Objective Streptococcus pyogenes (Group A Streptococcus; GAS) causes a variety of infections that include life-threatening, severe invasive GAS infections, such as streptococcal toxic shock syndrome (STSS), with > 30% mortality rate, despite effective antibiotics and treatment options. STSS clinical isolates highly express streptolysin O (SLO), a member of a large family of pore-forming toxins called cholesterol-dependent cytolysins (CDCs). SLO is an important toxic factor for GAS and may be an effective therapeutic target for the treatment of STSS. Our aim was to identify a monoclonal antibody (mAb) that reacts with SLO and has therapeutic potential for STSS treatment. Results We focused on mAbs that had originally been established as neutralizing reagents to perfringolysin O (PFO), another member of the CDC family, as some cross-reactivity with SLO had been reported. Here, we confirmed cross-reactivity of an anti-PFO mAb named HS1 with SLO. In vitro analysis revealed that HS1 mAb sufficiently prevented human neutrophils from being killed by STSS clinical isolates. Furthermore, prophylactic and therapeutic injection of HS1 mAb into C57BL/6 mice significantly improved the survival rate following lethal infection with an STSS clinical isolate. These results highlight the therapeutic potential of HS1 mAb for STSS treatment.
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Affiliation(s)
- Takayuki Matsumura
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
| | - Ayae Nishiyama
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Michio Aiko
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Joe Chiba
- Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Manabu Ato
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aobacho, Higashimurayamashi, Tokyo, 189-0002, Japan
| | - Yoshimasa Takahashi
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
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9
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Matsumura T, Ikebe T, Arikawa K, Hosokawa M, Aiko M, Iguchi A, Togashi I, Kai S, Ohara S, Ohara N, Ohnishi M, Watanabe H, Kobayashi K, Takeyama H, Yamasaki S, Takahashi Y, Ato M. Sequential Sensing by TLR2 and Mincle Directs Immature Myeloid Cells to Protect against Invasive Group A Streptococcal Infection in Mice. Cell Rep 2020; 27:561-571.e6. [PMID: 30970258 DOI: 10.1016/j.celrep.2019.03.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/26/2018] [Revised: 01/22/2019] [Accepted: 03/14/2019] [Indexed: 01/27/2023] Open
Abstract
Severe invasive group A Streptococcus (GAS) infection evades anti-bacterial immunity by attenuating the cellular components of innate immune responses. However, this loss of protection is compensated for by interferon (IFN)-γ-producing immature myeloid cells (γIMCs), which are selectively recruited upon severe invasive GAS infection in mice. Here, we demonstrate that γIMCs provide this IFN-γ-mediated protection by sequentially sensing GAS through two distinct pattern recognition receptors. In a mouse model, GAS is initially recognized by Toll-like receptor 2 (TLR2), which promptly induces interleukin (IL)-6 production in γIMCs. γIMC-derived IL-6 promotes the upregulation of a recently identified GAS-sensing receptor, macrophage-inducible C-type lectin (Mincle), in an autocrine or paracrine manner. Notably, blockade of γIMC-derived IL-6 abrogates Mincle expression, downstream IFN-γ production, and γIMC-mediated protection against severe invasive GAS infection. Thus, γIMCs regulate host protective immunity against severe invasive GAS infection via a TLR2-IL-6-Mincle axis.
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Affiliation(s)
- Takayuki Matsumura
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan.
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Koji Arikawa
- Research Organization for Nano and Life Innovation, Waseda University, 513 Waseda-tsurumaki-cho, Shinjuku-ku, Tokyo 162-0041, Japan; Computational Bio Big-Data Open Innovation Laboratory, National Institute of Advanced Industrial Science and Technology, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan
| | - Masahito Hosokawa
- Research Organization for Nano and Life Innovation, Waseda University, 513 Waseda-tsurumaki-cho, Shinjuku-ku, Tokyo 162-0041, Japan; Institute for Advanced Research of Biosystem Dynamics, Waseda Research Institute for Science and Engineering, Waseda University, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan
| | - Michio Aiko
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Aoi Iguchi
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan; Tokyo College of Biotechnology, 1-3-14 Kita-Kojiya, Ota-ku, Tokyo 144-0032, Japan
| | - Ikuko Togashi
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan; Tokyo College of Biotechnology, 1-3-14 Kita-Kojiya, Ota-ku, Tokyo 144-0032, Japan
| | - Sayaka Kai
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan; Dental School, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Sakiko Ohara
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan; Dental School, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Naoya Ohara
- Dental School, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan; Department of Oral Microbiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama-shi, Okayama 700-8558, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Haruo Watanabe
- School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita-shi, Chiba 286-8686, Japan
| | - Kazuo Kobayashi
- Division of Public Health, Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka-shi, Osaka 537-0025, Japan
| | - Haruko Takeyama
- Research Organization for Nano and Life Innovation, Waseda University, 513 Waseda-tsurumaki-cho, Shinjuku-ku, Tokyo 162-0041, Japan; Computational Bio Big-Data Open Innovation Laboratory, National Institute of Advanced Industrial Science and Technology, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan; Institute for Advanced Research of Biosystem Dynamics, Waseda Research Institute for Science and Engineering, Waseda University, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan; Department of Life Science and Medical Bioscience, Waseda University, 2-2 Wakamatsu-cho, Shinjuku-ku, Tokyo 162-8480, Japan
| | - Sho Yamasaki
- Division of Molecular Immunology, Research Institute for Microbial Diseases, Osaka University, 3-1 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Division of Molecular Immunology, Immunology Frontier Research Center (IFReC), Osaka University, 3-1 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Yoshimasa Takahashi
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Manabu Ato
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba-cho, Higashimurayama-shi, Tokyo 189-0002, Japan
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10
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Shizukuishi S, Ogawa M, Matsunaga S, Tomokiyo M, Ikebe T, Fushinobu S, Ryo A, Ohnishi M. Streptococcus pneumoniae hijacks host autophagy by deploying CbpC as a decoy for Atg14 depletion. EMBO Rep 2020; 21:e49232. [PMID: 32239622 PMCID: PMC7202210 DOI: 10.15252/embr.201949232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/16/2019] [Revised: 02/28/2020] [Accepted: 03/06/2020] [Indexed: 01/06/2023] Open
Abstract
Pneumococcal cell surface‐exposed choline‐binding proteins (CBPs) play pivotal roles in multiple infectious processes with pneumococci. Intracellular pneumococci can be recognized at multiple steps during bactericidal autophagy. However, whether CBPs are involved in pneumococci‐induced autophagic processes remains unknown. In this study, we demonstrate that CbpC from S. pneumoniae strain TIGR4 activates autophagy through an interaction with Atg14. However, S. pneumoniae also interferes with autophagy by deploying CbpC as a decoy to cause autophagic degradation of Atg14 through an interaction with p62/SQSTM1. Thus, S. pneumoniae suppresses the autophagic degradation of intracellular pneumococci and survives within cells. Domain analysis reveals that the coiled‐coil domain of Atg14 and residue Y83 of the dp3 domain in the N‐terminal region of CbpC are crucial for both the CbpC–Atg14 interaction and the subsequent autophagic degradation of Atg14. Although homology modeling indicates that CbpC orthologs have similar structures in the dp3 domain, autophagy induction through Atg14 binding is an intrinsic property of CbpC. Our data provide novel insights into the evolutionary hijacking of host‐defense systems by intracellular pneumococci.
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Affiliation(s)
- Sayaka Shizukuishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.,Department of Microbiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Michinaga Ogawa
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Satoko Matsunaga
- Department of Microbiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Mikado Tomokiyo
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.,School of Veterinary Medicine, Azabu University, Kanagawa, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shinya Fushinobu
- Department of Biotechnology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.,Collaborative Research Institute for Innovative Microbiology, The University of Tokyo, Tokyo, Japan
| | - Akihide Ryo
- Department of Microbiology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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11
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Ikebe T, Okuno R, Uchitani Y, Kanda Y, Sasaki M, Uchida K, Chiba K, Yamaguchi T, Otsuka H, Suzuki M, Ohya H, Watanabe H, Ohnishi M. T serotyping of group a streptococcus isolated from patients with pharyngitis or streptococcal toxic shock syndrome in Japan between 2005 and 2017. J Infect Chemother 2019; 26:157-161. [PMID: 31735631 DOI: 10.1016/j.jiac.2019.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/28/2019] [Revised: 08/22/2019] [Accepted: 10/22/2019] [Indexed: 11/20/2022]
Abstract
Streptococcus pyogenes (group A streptococcus; GAS) is an important gram-positive human pathogen capable of causing diseases ranging from mild superficial skin and pharyngeal infections to more severe invasive diseases, including streptococcal toxic shock syndrome (STSS). GAS produces a T protein, and T serotyping has considerable discriminatory power for epidemiological characterization of GAS. To clarify the relationship between STSS and pharyngitis in Japan, we examined the T serotypes of GAS strains isolated from clinical specimens of streptococcal infections (STSS, 951 isolates; pharyngitis, 16268 isolates) from 2005 to 2017. The most prevalent T serotype from pharyngitis isolates was T12, followed by T1, T4, and TB3264. The most prevalent T serotype from STSS isolates was T1, followed by TB3264. Trend of increase and decrease in the frequency of T1 or TB3264 isolation from pharyngitis was correlated with that of STSS patients. The increase of T1 or TB3264 strain-infection in pharyngitis patients may increase the probability of causing STSS, indicating that careful monitoring of GAS serotypes is essential for the prediction of rapid increase of STSS in time to develop effective management strategies.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan.
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073, Japan
| | - Yumi Uchitani
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunin-cho, Shinjuku-ku, Tokyo, 169-0073, Japan
| | - Yoshiko Kanda
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, 2-8 Takae-Nishi, Oita, 870-1117, Japan
| | - Mari Sasaki
- Laboratory of Microbiology, Oita Prefectural Institute of Health and Environment, 2-8 Takae-Nishi, Oita, 870-1117, Japan
| | - Kaoru Uchida
- Department of Bacteriology, Toyama Institute of Health, 17-1 Naka-Taikouyama, Imizu, Toyama, 939-0363, Japan
| | - Kazuki Chiba
- Department of Microbiology, Fukushima Prefectural Institute of Public Health, 16-6 Mitouchi, Hokida, Fukushima, 960-8560, Japan
| | - Takahiro Yamaguchi
- Division of Microbiology, Osaka Institute of Public Health, 1-3-69 Nakamichi, Higashinari-ku, Osaka, 537-0025, Japan
| | - Hitoshi Otsuka
- Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, 2-5-67 Aoi, Yamaguchi 753-0821, Japan
| | - Miyuki Suzuki
- Division of Microbiology, Kanagawa Prefectural Institute of Public Health, 1-3-1 Shimomachiya, Chigasaki, Kanagawa, 253-0087, Japan
| | - Hitomi Ohya
- Division of Microbiology, Kanagawa Prefectural Institute of Public Health, 1-3-1 Shimomachiya, Chigasaki, Kanagawa, 253-0087, Japan
| | - Haruo Watanabe
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
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12
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Matsui T, Yamaguchi K, Ikebe T, Aiga S, Kusakawa I. Prolonged PR Interval and Erythema Marginatum in a Child with Acute Rheumatic Fever. J Pediatr 2019; 212:239-239.e1. [PMID: 31229320 DOI: 10.1016/j.jpeds.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/02/2019] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases
| | - Saori Aiga
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
| | - Isao Kusakawa
- Department of Pediatrics, St. Luke's International Hospital, Tokyo, Japan
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13
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Yoshizawa S, Matsumura T, Ikebe T, Ichibayashi R, Fukui Y, Satoh T, Tsubota T, Honda M, Ishii Y, Tateda K, Ato M. Streptococcal toxic shock syndrome caused by β-hemolytic streptococci: Clinical features and cytokine and chemokine analyses of 15 cases. J Infect Chemother 2019; 25:355-361. [PMID: 30744988 DOI: 10.1016/j.jiac.2019.01.006] [Citation(s) in RCA: 3] [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: 09/27/2018] [Revised: 12/28/2018] [Accepted: 01/13/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES β-Hemolytic streptococci occasionally cause severe infections such as necrotizing fasciitis and streptococcal toxic shock syndrome (STSS). Here, we conducted a prospective study to investigate the production of cytokines and chemokines in patients with STSS to explore its pathogenesis in survivors and fatal cases. METHODS From January 2013 through August 2015, all culture results from normally sterile sites were prospectively followed and screened for STSS. Clinical characteristics of the patients with STSS were evaluated and compared between survivors and fatal cases. Serum samples were collected on admission for quantification of various cytokines and chemokines. Bacterial strains were categorized by Lancefield grouping and analyzed for the emm type, and presence of speA, speB, speC, and speF. RESULTS Fifteen patients received diagnosis of STSS. The median age of the patients was 60-year-old, and the mortality rate was 40% despite intensive treatment. Nine strains were categorized as group A, two belonged to group G, and four to group B. Group A contained various emm genotypes. Unexpectedly, potent proinflammatory cytokine levels such as TNF-α and IL-1β were not significantly elevated, and comparison with surviving patients showed that IL-6, IL-8, and MCP-1 levels were significantly decreased and creatine kinase level was significantly elevated in fatally ill cases. CONCLUSION Our results indicate that reduced production of proinflammatory cytokines and chemokines may be involved in STSS pathogenesis and critical for prognosis of patients with STSS.
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Affiliation(s)
- Sadako Yoshizawa
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Takayuki Matsumura
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, 162-8640, Tokyo, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, 162-8640, Tokyo, Japan
| | - Ryo Ichibayashi
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Yuto Fukui
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Takahiro Satoh
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Takaya Tsubota
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Mitsuru Honda
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Yoshikazu Ishii
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Kazuhiro Tateda
- Toho University School of Medicine, 5-21-16 Omori-nishi, Ota-ku, 143-8540, Tokyo, Japan
| | - Manabu Ato
- Department of Immunology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, 162-8640, Tokyo, Japan.
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14
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Yamamura Y, Mihara Y, Nakatani K, Nishiguchi T, Ikebe T. Unexpected Ventriculitis Complication of Neonatal Meningitis Caused by Streptococcus gallolyticus Subsp. pasteurianus: a Case Report. Jpn J Infect Dis 2017; 71:68-71. [PMID: 29279439 DOI: 10.7883/yoken.jjid.2017.053] [Citation(s) in RCA: 5] [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] [Indexed: 11/17/2022]
Abstract
Streptococcus gallolyticus subsp. pasteurianus, previously recognized as S. bovis biotype II/2, is an uncommon yet important cause of invasive infection in young infants. Here, we report the first case of ventriculitis that was unexpectedly diagnosed in the course of neonatal meningitis due to S. gallolyticus subsp. pasteurianus, and we review the relevant literature. A 28-day-old male infant from Japan presented with fever, lethargy, and irritability. S. bovis was isolated from blood and the cerebrospinal fluid culture and was then identified as S. gallolyticus subsp. pasteurianus. Intravenous antibiotic therapy was initiated, which helped improve the clinical course of the disease; however, the patient presented ventriculitis-related complications diagnosed using follow-up magnetic resonance imaging (MRI) on day 12 of hospitalization. Ampicillin was administered for 21 days and discontinued after the patient showed improvement, according to MRI findings. The patient was discharged without sequelae. Ventriculitis is a rare complication of childhood meningitis due to S. gallolyticus subsp. pasteurianus. However, it may have been underdiagnosed, especially in cases with no specific manifestations similar to the present case. We suggest that MRI should be performed to screen for ventriculitis in the course of meningitis to avoid failure in treatment.
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Affiliation(s)
- Yoshiko Yamamura
- Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital
| | - Yuka Mihara
- Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital
| | - Keigo Nakatani
- Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital
| | | | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases
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15
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Ogata M, Oshima K, Ikebe T, Takano K, Kanamori H, Kondo T, Ueda Y, Mori T, Hashimoto H, Ogawa H, Eto T, Ueki T, Miyamoto T, Ichinohe T, Atsuta Y, Fukuda T. Clinical characteristics and outcome of human herpesvirus-6 encephalitis after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2017; 52:1563-1570. [PMID: 28783148 DOI: 10.1038/bmt.2017.175] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/09/2017] [Accepted: 06/29/2017] [Indexed: 11/09/2022]
Abstract
In this retrospective analysis using the Transplant Registry Unified Management Program, we identified 145 patients with human herpesvirus (HHV)-6 encephalitis among 6593 recipients. The cumulative incidences of HHV-6 encephalitis at 100 days after transplantation in all patients, recipients of bone marrow or PBSCs and recipients of cord blood were 2.3%, 1.6% and 5.0%, respectively. Risk factors identified in multivariate analysis were male sex, type of transplanted cells (relative risk in cord blood transplantation, 11.09, P<0.001; relative risk in transplantation from HLA-mismatched unrelated donor, 9.48, P<0.001; vs transplantation from HLA-matched related donor) and GvHD prophylaxis by calcineurin inhibitor alone. At 100 days after transplantation, the overall survival rate was 58.3% and 80.5% among patients with and without HHV-6 encephalitis, respectively (P<0.001). Neuropsychological sequelae remained in 57% of 121 evaluated patients. With both foscarnet and ganciclovir, full-dose therapy (foscarnet ⩾180 mg/kg, ganciclovir ⩾10 mg/kg) was associated with better response rate (foscarnet, 93% vs 74%, P=0.044; ganciclovir, 84% vs 58%, P=0.047). HHV-6 encephalitis is not rare not only in cord blood transplant recipients but also in recipients of HLA-mismatched unrelated donors. In this study, development of HHV-6 encephalitis was associated with a poor survival rate, and neurological sequelae remained in many patients.
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Affiliation(s)
- M Ogata
- Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - K Oshima
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - T Ikebe
- Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - K Takano
- Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan
| | - H Kanamori
- Department of Hematology, Kanagawa Cancer Center, Kanagawa, Japan
| | - T Kondo
- Department of Hematology/Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Y Ueda
- Department of Hematology/Oncology, Kurashiki Central Hospital, Okayama, Japan
| | - T Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - H Hashimoto
- Department of Hematology, Kobe General Hospital/Institute of Biomedical Research and Innovation, Hyogo, Japan
| | - H Ogawa
- Division of Hematology, Hyogo College of Medicine, Hyogo, Japan
| | - T Eto
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - T Ueki
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - T Miyamoto
- Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Y Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Aichi, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - T Fukuda
- Division of Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan
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16
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Kaneko M, Maruta M, Shikata H, Hanayama M, Ikebe T. Acute abdomen due to group A streptococcus bacteremia caused by an isolate with a mutation in the csrS gene. J Infect Chemother 2015; 21:816-9. [PMID: 26231317 DOI: 10.1016/j.jiac.2015.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 06/26/2015] [Accepted: 06/30/2015] [Indexed: 01/22/2023]
Abstract
Streptococcus pyogenes (group A streptococcus) is an aerobic gram-positive coccus that causes infections ranging from non-invasive pharyngitis to severely invasive necrotizing fasciitis. Mutations in csrS/csrR and rgg, negative regulator genes of group A streptococcus, are crucial factors in the pathogenesis of streptococcal toxic shock syndrome, which is a severe, invasive infection characterized by sudden onset of shock and multiorgan failure, resulting in a high mortality rate. Here we present a case of group A streptococcal bacteremia in a 28-year-old Japanese woman with no relevant previous medical history. The patient developed progressive abdominal symptoms that may have been due to spontaneous bacterial peritonitis, followed by a state of shock, which did not fulfill the proposed criteria for streptococcal toxic shock. The isolate was found to harbor a mutation in the negative regulator csrS gene, whereas the csrR and rgg genes were intact. It was noteworthy that this strain carrying a csrS mutation had caused group A streptococcal bacteremia characterized by acute abdomen as the presenting symptom in a young individual who had been previously healthy. This case indicates that group A streptococcus with csrS mutations has potential virulence factors that are associated with the onset of group A streptococcal bacteremia that does not meet the diagnostic criteria for streptococcal toxic shock syndrome.
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Affiliation(s)
- Masahiko Kaneko
- Department of Internal Medicine, Uwajima City Hospital, 1-1 Goten-machi, Uwajima City, Ehime 798-8510, Japan.
| | - Masaki Maruta
- Department of Internal Medicine, Uwajima City Hospital, 1-1 Goten-machi, Uwajima City, Ehime 798-8510, Japan
| | - Hisaharu Shikata
- Department of Internal Medicine, Uwajima City Hospital, 1-1 Goten-machi, Uwajima City, Ehime 798-8510, Japan
| | - Masakazu Hanayama
- Department of Internal Medicine, Uwajima City Hospital, 1-1 Goten-machi, Uwajima City, Ehime 798-8510, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-Ku, Tokyo 162-8640, Japan
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17
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Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is likely to be caused by continuous imperfection of bone healing after surgical treatments in patients with long-term administration of nitrogen-containing bisphosphonates (NBPs). NBPs inhibit osteoclastic bone resorption by impairing the mevalonic acid sterol pathway in osteoclasts. Thus, we hypothesized that exogenous mevalonic acid metabolites restore the inhibitory effects of NBPs on osteoclastogenesis and bone remodeling. To clarify the effects of mevalonic acid metabolites, especially geranylgeranyl pyrophosphate (GGPP) and geranylgeranyl transferase substrate geranylgeranyl acid (GGOH), we examined the effects of zoledronic acid with or without GGOH or GGPP on osteoclast differentiation, multinucleation, and bone mineral deposition in tooth-extracted sockets. Zoledronic acid decreased the number of tartrate-resistant acid phosphatase (TRAP)-positive multinuclear cells derived from mouse osteoclast precursors treated with receptor activator of nuclear factor-κB ligand and macrophage colony-stimulating factor. Zoledronic acid simultaneously suppressed not only the expressions of osteoclastic differentiation-related molecules such as TRAP, cathepsin K, calcitonin receptor, and vacuolar H-ATPase but also those of multinucleation-related molecules such as dendrocyte-expressed 7 transmembrane proteins and osteoclast stimulatory transmembrane protein. Treatment with GGOH or GGPP, but not farnesyl acid, restored the zoledronic acid-inhibited number of TRAP-positive multinuclear cells together with the expressions of these molecules. Although intraperitoneal administration of zoledronic acid and lipopolysaccharide into mice appeared to induce BRONJ-like lesions with empty bone lacunae and decreased mineral deposition in tooth-extracted socket, both GGOH and GGPP partially restored the inhibitory effects on zoledronic acid-related mineral deposition. These results suggest the potential of mevalonic acid metabolites as therapeutic agents for BRONJ.
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Affiliation(s)
- Y Nagaoka
- Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka, Japan Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan
| | - H Kajiya
- Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka, Japan
| | - S Ozeki
- Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan
| | - T Ikebe
- Department of Oral and Maxillofacial Surgery, Fukuoka Dental College, Fukuoka, Japan
| | - K Okabe
- Department of Physiological Science and Molecular Biology, Fukuoka Dental College, Fukuoka, Japan
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18
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Kohayagawa Y, Ishitobi N, Yamamori Y, Wakuri M, Sano C, Tominaga K, Ikebe T. Streptococcal toxic shock syndrome from necrotizing soft-tissue infection of the breast caused by a mucoid type strain. J Infect Chemother 2014; 21:144-7. [PMID: 25260866 DOI: 10.1016/j.jiac.2014.08.031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 08/14/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022]
Abstract
Streptococcal toxic shock syndrome is a severe infectious disease. We report a Japanese case of Streptococcal toxic shock syndrome caused by a highly mucoid strain of Streptococcus pyogenes. A 31-year old female with shock vital sign presented at a tertiary medical center. Her left breast was necrotizing and S. pyogenes was detected by Immunochromatographic rapid diagnostic kits. Intensive care, including administration of antibiotics and skin debridement, was performed. After 53 days in our hospital, she was discharged. The blood cultures and skin swab cultures all grew S. pyogenes which displayed a highly mucoid morphology on culture media. In her course of the disease, the Streptococcus strain had infected two other family members. All of the strains possessed the T1 and M1 antigens, as well as the emm1.0 gene. As for fever genes, the strains were all positive for speA, speB, and speF, but negative for speC. All of the strains exhibited and the same pattern in PFGE with the SfiI restriction enzyme. The strain might have spread in the local area by the data from the Japanese Infectious Disease Surveillance Center. Immunochromatographic rapid diagnostic kits are very useful for detecting S. pyogenes. However, they can not be used to diagnose severe streptococcul disease by highly mucoid strain alone. Careful observation of patients and colony morphology are useful methods for diagnosing severe streptococcal disease by highly mucoid strain.
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Affiliation(s)
- Yoshitaka Kohayagawa
- Department of Clinical Laboratory, National Hospital Organization Disaster Medical Center, Tachikawa, Japan.
| | - Natsuko Ishitobi
- Department of Critical Care and Emergency Medicine, Shimane Prefectural Central Hospital, Izumo, Japan.
| | - Yuji Yamamori
- Department of Critical Care and Emergency Medicine, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Miho Wakuri
- Department of Clinical Laboratory, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Chiaki Sano
- Department of Microbiology, School of Medicine, Shimane University, Izumo, Japan
| | - Kiyoshi Tominaga
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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19
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Kawahara K, Nakayama H, Hirayama M, Hirosue A, Hiraki A, Ikebe T, Shinohara M. A case of advanced upper gingival cancer successfully treated with oral uracil-tegafur (UFT) alone. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.200] [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: 10/24/2022]
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20
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Okamoto F, Murakami K, Maeda E, Oishi A, Etoh Y, Kaida M, Makigusa M, Nakashima K, Jinnouchi Y, Takemoto H, Kakegawa H, Yamasaki C, Manabe S, Sasaki M, Ogata K, Ikebe T, Sera N. A foodborne outbreak of group A streptococcal infection in Fukuoka Prefecture, Japan. Jpn J Infect Dis 2014; 67:321-2. [PMID: 25056084 DOI: 10.7883/yoken.67.321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Fuyuki Okamoto
- Division of Pathology and Bacteriology, Fukuoka Institute of Health and Environmental Sciences
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21
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Morimoto M, Tamura S, Hayakawa T, Yamanishi H, Nakamoto C, Nakamoto H, Ikebe T, Nakano Y, Fujimoto T. Phlegmonous gastritis associated with group A streptococcal toxic shock syndrome. Intern Med 2014; 53:2639-42. [PMID: 25400190 DOI: 10.2169/internalmedicine.53.2741] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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: 12/18/2022] Open
Abstract
Phlegmonous gastritis (PG) is a rare, acute, severe infectious disease of the gastric wall that is often fatal due to Streptococcus spp. A 77-year-old man with diabetes and a gastric ulcer was urgently admitted due to prolonged nausea and vomiting. Computed tomography revealed widespread diffuse thickening of the gastric wall, and PG was suspected. The patient expired less than 9 hours after admission despite intensive treatments. Later, an analysis of the blood and gastric juice revealed group A streptococcus (GAS) and virulence factors associated with toxic shock syndrome (TSS). We herein diagnosed a patient with an extremely aggressive course of PG caused by GAS TSS.
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22
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Matsumoto M, Sakae K, Hashikawa S, Torii K, Hasegawa T, Horii T, Endo M, Okuno R, Murayama S, Hirasawa K, Suzuki R, Isobe J, Tanaka D, Katsukawa C, Tamaru A, Tomita M, Ogata K, Ikebe T, Watanabe H, Ohta M. Close Correlation of Streptococcal DNase B (sdaB) Alleles withemmGenotypes inStreptococcus pyogenes. Microbiol Immunol 2013; 49:925-9. [PMID: 16237270 DOI: 10.1111/j.1348-0421.2005.tb03684.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
DNase B is a major nuclease and a possible virulence factor in Streptococcus pyogenes. The allelic diversity of streptococcal DNase B (sdaB) gene was investigated in 83 strains with 14 emm genotypes. Of the 15 alleles identified, 11 alleles carried only synonymous nucleotide substitutions. On the other hand, 4 alleles had a non-synonymous substitution other than synonymous substitutions, resulting in the substitution of a single amino acid. The distribution of each allele was generally emm genotype-specific. Only sdaB7 was found in both emm2 and emm4. The promoter region was highly conserved and DNase B protein was similarly expressed in all alleles.
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Affiliation(s)
- Masakado Matsumoto
- Department of Microbiology, Aichi Prefectural Institute of Public Health, Nagoya, Japan.
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23
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Izumi K, Shimoda T, Okamoto Y, Yamashita Y, Ikebe T. Three-dimensional assesment of the accuracy of maxillary reposioning by Le Fort I osteotomy. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.552] [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: 11/29/2022]
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24
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Matsumura T, Ikebe T, Ohnishi M, Watanabe H, Kobayashi K, Ato M. The defensive role of interferon-γ-producing immature myeloid cells in severe invasive group A Streptococcus infections (118.7). The Journal of Immunology 2012. [DOI: 10.4049/jimmunol.188.supp.118.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Streptococcus pyogenes (group A Streptococcus; GAS) is one of the most versatile bacteria among human pathogens. Non-invasive GAS infections can cause common diseases, such as pharyngitis and impetigo. Whereas, severe invasive GAS infections can lead to rapid progressive and life-threatening manifestations, including sepsis, necrotizing fasciitis, and streptococcal toxic shock syndrome (STSS). Although GAS-derived superantigens activate T cells to release excessive amounts of cytokines which are considered to participate in the pathogenesis of STSS following severe invasive GAS infections, it remains unclear which factors are protective against such infections and which cell population is the source of them. Here we show that mice infected with severe invasive GAS isolates, but not with non-invasive GAS isolates, exhibit high concentrations of plasma interferon (IFN)-γ during the early stage of infection. IFN-γ is necessary to protect mice, and is produced by a novel population of granulocyte-macrophage colony-stimulating factor (GM-CSF)-dependent immature myeloid cells with ring-shaped nuclei (IFN-γ-producing immature myeloid cells; γIMCs). These γIMCs express monocyte and granulocyte markers, and also produce nitric oxide. The adoptive transfer of γIMCs ameliorates infection in wild-type and IFN-γ-deficient mice. Our results indicate that γIMCs have a defensive role during the early stage of severe invasive GAS infections.
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Affiliation(s)
- Takayuki Matsumura
- 1Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tadayoshi Ikebe
- 2Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Ohnishi
- 2Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Haruo Watanabe
- 2Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuo Kobayashi
- 1Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Manabu Ato
- 1Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
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25
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Asano-Mori Y, Nishida A, Ikebe T, Ishiwata K, Nakano N, Tsuji M, Yamamoto H, Izutsu K, Uchida N, Masuoka K, Wake A, Yoneyama A, Makino S, Taniguchi S. Varicella Zoster Reactivation After Cord Blood Transplantation: Comparison With Unrelated Bone Marrow Transplantation. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.438] [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: 10/18/2022]
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26
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Nakano N, Nishida A, Ohota H, Ikebe T, Shimazu H, Ishiwata K, Araoka H, Tsuji M, Yamamoto H, Asano-Mori Y, Izutsu K, Uchida N, Yoneyama A, Wake A, Makino S, Taniguchi S. Safety of Liposomal Amphotericin B in Allogenic Hematopoietic Transplantation (HSCT) Recipients. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.499] [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: 11/26/2022]
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27
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Ikebe T, Oguro Y, Ogata K, Katsukawa C, Isobe J, Shima T, Suzuki R, Ohya H, Tominaga K, Okuno R, Uchitani Y, Tada Y, Okabe N, Watanabe H. Surveillance of Severe Invasive Group G Streptococcal Infections in Japan during 2002–2008. Jpn J Infect Dis 2010. [DOI: 10.7883/yoken.63.372] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
| | - Yuuko Oguro
- Department of Bacteriology, Fukushima Institute of Public Health, Japan
| | - Kikuyo Ogata
- Department of Bacteriology, The Oita Prefectural Institute of Health and Environment, Japan
| | - Chihiro Katsukawa
- Department of Microbiology, Osaka Prefectural Institute of Public Health, Japan
| | - Junko Isobe
- Department of Bacteriology, Toyama Institute of Health, Japan
| | - Tomoko Shima
- Department of Bacteriology, Toyama Institute of Health, Japan
| | - Rieko Suzuki
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Japan
| | - Hitomi Ohya
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Japan
| | - Kiyoshi Tominaga
- Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, Japan
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Yumi Uchitani
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Yuki Tada
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
| | - Nobuhiko Okabe
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan
| | - Haruo Watanabe
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
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28
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Ikebe T, Oguro Y, Ogata K, Katsukawa C, Isobe J, Shima T, Suzuki R, Ohya H, Tominaga K, Okuno R, Uchitani Y, Tada Y, Okabe N, Watanabe H. Surveillance of severe invasive group G streptococcal infections in Japan during 2002-2008. Jpn J Infect Dis 2010; 63:372-375. [PMID: 20859009] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Group G Streptococcus strains isolated from patients with severe invasive infections in the period 2002-2008 were surveyed and their prevalence compared with that observed in the period 1995-2001 in Japan. Strains with genotypes stg485, stg6792, stc36, stg6, and stg652 were isolated in both periods, whereas various new genotypes appeared in 2002-2008 and some genotypes found in 1995-2001 were not found subsequently, thus indicating a change in the prevalent genotyped strains causing severe invasive streptococcal infections.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan.
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29
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Ikebe T, Wada A, Oguro Y, Ogata K, Katsukawa C, Isobe J, Shima T, Suzuki R, Ohya H, Tominaga K, Okuno R, Uchitani Y, Watanabe H. Emergence of Clindamycin-Resistant <i>Streptococcus pyogenes</i> Isolates Obtained from Patients with Severe Invasive Infections in Japan. Jpn J Infect Dis 2010. [DOI: 10.7883/yoken.63.304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
| | - Akihito Wada
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
| | - Yuuko Oguro
- Department of Bacteriology, Fukushima Institute of Public Health, Japan
| | - Kikuyo Ogata
- Department of Bacteriology, The Oita Prefectural Institute of Health and Environment, Japan
| | - Chihiro Katsukawa
- Department of Microbiology, Osaka Prefectural Institute of Public Health, Japan
| | - Junko Isobe
- Department of Bacteriology, Toyama Institute of Health, Japan
| | - Tomoko Shima
- Department of Bacteriology, Toyama Institute of Health, Japan
| | - Rieko Suzuki
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Japan
| | - Hitomi Ohya
- Department of Microbiology, Kanagawa Prefectural Institute of Public Health, Japan
| | - Kiyoshi Tominaga
- Department of Public Health Sciences, Yamaguchi Prefectural Institute of Public Health and Environment, Japan
| | - Rumi Okuno
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Yumi Uchitani
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Japan
| | - Haruo Watanabe
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
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30
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Ikebe T, Wada A, Oguro Y, Ogata K, Katsukawa C, Isobe J, Shima T, Suzuki R, Ohya H, Tominaga K, Okuno R, Uchitani Y, Watanabe H. Emergence of clindamycin-resistant Streptococcus pyogenes isolates obtained from patients with severe invasive infections in Japan. Jpn J Infect Dis 2010; 63:304-305. [PMID: 20657078] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan.
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31
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Yamada T, Yamada T, Yamamura MK, Katabami K, Hayakawa M, Tomaru U, Shimada S, Morikawa M, Seki T, Ariga S, Ishikawa K, Ikebe T, Gando S, Minakami H. Invasive group A streptococcal infection in pregnancy. J Infect 2010; 60:417-24. [DOI: 10.1016/j.jinf.2010.03.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 03/17/2010] [Accepted: 03/18/2010] [Indexed: 12/18/2022]
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32
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Ikebe T, Ato M, Matsumura T, Hasegawa H, Sata T, Kobayashi K, Watanabe H. Highly frequent mutations in negative regulators of multiple virulence genes in group A streptococcal toxic shock syndrome isolates. PLoS Pathog 2010; 6:e1000832. [PMID: 20368967 PMCID: PMC2848555 DOI: 10.1371/journal.ppat.1000832] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Accepted: 02/23/2010] [Indexed: 01/04/2023] Open
Abstract
Streptococcal toxic shock syndrome (STSS) is a severe invasive infection characterized by the sudden onset of shock and multiorgan failure; it has a high mortality rate. Although a number of studies have attempted to determine the crucial factors behind the onset of STSS, the responsible genes in group A Streptococcus have not been clarified. We previously reported that mutations of csrS/csrR genes, a two-component negative regulator system for multiple virulence genes of Streptococcus pyogenes, are found among the isolates from STSS patients. In the present study, mutations of another negative regulator, rgg, were also found in clinical isolates of STSS patients. The rgg mutants from STSS clinical isolates enhanced lethality and impaired various organs in the mouse models, similar to the csrS mutants, and precluded their being killed by human neutrophils, mainly due to an overproduction of SLO. When we assessed the mutation frequency of csrS, csrR, and rgg genes among S. pyogenes isolates from STSS (164 isolates) and non-invasive infections (59 isolates), 57.3% of the STSS isolates had mutations of one or more genes among three genes, while isolates from patients with non-invasive disease had significantly fewer mutations in these genes (1.7%). The results of the present study suggest that mutations in the negative regulators csrS/csrR and rgg of S. pyogenes are crucial factors in the pathogenesis of STSS, as they lead to the overproduction of multiple virulence factors. Group A streptococcus (GAS) causes life-threatening severe invasive diseases, including necrotizing fasciitis and streptococcal toxic shock-like syndrome. Although many studies have attempted to determine factors that are crucial for the onset of streptococcal toxic shock syndrome (STSS), bacterial factors responsible for it have not been clarified. By comparing genome sequences of clinical GAS isolates from STSS with those of non-invasive infections, we showed that mutations of negative regulator genes (csrS, csrR, rgg) were detected at a high frequency of more than 50% in STSS isolates, but at a low frequency of less than 2% in non-invasive isolates. These mutations of negative regulators were found in various emm-genotyped STSS isolates but not in a particular emm genotype. These mutants enhanced virulence in mouse models. Such results indicated that mutations of bacterial negative regulators are crucial for the pathogenesis of STSS due to the overproduction of multiple virulence factors under the de-repressed conditions.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
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33
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Ikebe T, Ato M, Kobayashi K, Watanabe H. [Mechanism behind streptococcus toxic shock-like syndrome onset--immune evasion and bacterial properties]. ACTA ACUST UNITED AC 2009; 83:485-9. [PMID: 19860247 DOI: 10.11150/kansenshogakuzasshi.83.485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Streptococcal toxic shock-like syndrome (STSS) was firstly reported in 1987 in the United States. Japan's first definitive STSS case was reported in 1992, with over 500 cases since confirmed. Mortality is extremely high at 40%. Pathological findings, bacteria aggregation, and a paucity of polymorphonuclear neutrophils (PMN) in the foci of invasive group A streptococcal (GAS) infection suggest that host defense disturbance plays an important role in invasive infection onset. GAS, clinically isolated from severely invasive, but not from non-invasive, infections, could compromise human PMN functions in at least two independent ways-by inducing necrosis to PMN by enhanced production of pore-forming toxin streptolysin O (SLO) and by PMN migration impairment via digesting interleukin-8, a PMN attracting chemokine, through increased serine protease ScpC production. Expression of these genes was upregulated by a loss of repressive function with the csrS gene mutation of the two-component sensor/regulator system.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology, National Institute of Infectious Diseases
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34
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Ogata M, Satou T, Kawano R, Takakura S, Goto K, Ikewaki J, Kohno K, Ikebe T, Ando T, Miyazaki Y, Ohtsuka E, Saburi Y, Saikawa T, Kadota J. Correlations of HHV-6 viral load and plasma IL-6 concentration with HHV-6 encephalitis in allogeneic stem cell transplant recipients. Bone Marrow Transplant 2009; 45:129-36. [DOI: 10.1038/bmt.2009.116] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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35
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Ikebe T, Takaki Y, Kishi D, Kono H, Shinoda K, Inoue M, Nakatsuka K. Visual perception of luxated intraocular lens by the patient. Br J Ophthalmol 2008; 92:1563-4. [PMID: 18952660 DOI: 10.1136/bjo.2008.138339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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36
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Ato M, Ikebe T, Kawabata H, Takemori T, Watanabe H. Incompetence of neutrophils to invasive group A streptococcus is attributed to induction of plural virulence factors by dysfunction of a regulator. PLoS One 2008; 3:e3455. [PMID: 18941623 PMCID: PMC2565068 DOI: 10.1371/journal.pone.0003455] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 09/29/2008] [Indexed: 01/10/2023] Open
Abstract
Group A streptococcus (GAS) causes variety of diseases ranging from common pharyngitis to life-threatening severe invasive diseases, including necrotizing fasciitis and streptococcal toxic shock-like syndrome. The characteristic of invasive GAS infections has been thought to attribute to genetic changes in bacteria, however, no clear evidence has shown due to lack of an intriguingly study using serotype-matched isolates from clinical severe invasive GAS infections. In addition, rare outbreaks of invasive infections and their distinctive pathology in which infectious foci without neutrophil infiltration hypothesized us invasive GAS could evade host defense, especially neutrophil functions. Herein we report that a panel of serotype-matched GAS, which were clinically isolated from severe invasive but not from non-invaive infections, could abrogate functions of human polymorphnuclear neutrophils (PMN) in at least two independent ways; due to inducing necrosis to PMN by enhanced production of a pore-forming toxin streptolysin O (SLO) and due to impairment of PMN migration via digesting interleukin-8, a PMN attracting chemokine, by increased production of a serine protease ScpC. Expression of genes was upregulated by a loss of repressive function with the mutation of csrS gene in the all emm49 severe invasive GAS isolates. The csrS mutants from clinical severe invasive GAS isolates exhibited high mortality and disseminated infection with paucity of neutrophils, a characteristic pathology seen in human invasive GAS infection, in a mouse model. However, GAS which lack either SLO or ScpC exhibit much less mortality than the csrS-mutated parent invasive GAS isolate to the infected mice. These results suggest that the abilities of GAS to abrogate PMN functions can determine the onset and severity of invasive GAS infection.
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Affiliation(s)
- Manabu Ato
- Department of Immunology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tadayoshi Ikebe
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
- * E-mail:
| | - Hiroki Kawabata
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Toshitada Takemori
- Laboratory for Immunological Memory, Riken Research Center for Allergy and Immunology, Yokohama-City, Kanagawa, Japan
| | - Haruo Watanabe
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, Japan
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37
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Hashimoto K, Tada T, Fukuzawa H, Ikebe T, Ozeki S. P.367 Two cases of malignant lymphoma in the salivary gland. J Craniomaxillofac Surg 2008. [DOI: 10.1016/s1010-5182(08)72155-3] [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: 10/21/2022] Open
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38
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Ikebe T, Watanabe H. [Streptococcal toxic shock syndrome]. Nihon Rinsho 2007; 65 Suppl 3:255-8. [PMID: 17491396] [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] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology, National Institute of Infectious Diseases
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39
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Chang B, Wada A, Ikebe T, Ohnishi M, Mita K, Endo M, Matsuo H, Asatuma Y, Kuramoto S, Sekiguchi H, Yamazaki M, Yoshikawa H, Watabe N, Yamada H, Kurita S, Imai Y, Watanabe H. Characteristics of Streptococcus suis isolated from patients in Japan. Jpn J Infect Dis 2006; 59:397-9. [PMID: 17186962] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Seven cases of Streptococcus suis infection in Japan during 1994 and 2006 were summarized. All cases had porcine exposure and five of them had hand skin injury during the exposure. Five cases presented symptoms of meningitis, three presented symptoms of sepsis, and one resulted in sudden death. All of the isolated S. suis belonged to Lancefield's group D and to serotype 2. They were susceptible to penicillin G, ampicillin, cefotaxime, and ciprofloxacin. However, six of them were resistant to both erythromycin and clindamycin, and four were also resistant to minocycline. Multilocus sequence typing of six isolates showed that they belonged to sequence type (ST) 1, and their pulsed-field gel electrophoresis (PFGE) patterns were similar. The remaining isolate was ST28 and its PFGE pattern was distinct from those of the others.
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Affiliation(s)
- Bin Chang
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
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40
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Hoshikawa T, Ikebe T, Kikuchi R, Eguchi K. Effects of electrolyte in dye-sensitized solar cells and evaluation by impedance spectroscopy. Electrochim Acta 2006. [DOI: 10.1016/j.electacta.2006.01.053] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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41
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Chang B, Ikebe T, Wada A, Ogata K, Tomita M, Katsukawa C, Kawahara R, Suzuki R, Endo M, Isobe J, Tanaka D, Hirasawa K, Watanabe H. Surveillance of group B streptococcal toxic shock-like syndrome in nonpregnant adults and characterization of the strains in Japan. Jpn J Infect Dis 2006; 59:182-5. [PMID: 16785700] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Nine group B streptococci (GBS) strains were isolated from five toxic shock-like syndrome cases of nonpregnant adults in Japan from 2001 to 2005. All of them were identified as Streptococcus agalactiae. The serotypes of these strains were Ib, III, V, and VII. Pulsed-field gel electrophoresis revealed that the patterns of the strains isolated from the different patients were variable. Antimicrobial susceptibility tests showed that all of the strains were susceptible to penicillin G, ampicillin, cefotaxime, clindamycin, and telithromycin. One strain showed intermediate resistance to erythromycin.
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Affiliation(s)
- Bin Chang
- Department of Bacteriology, National Institute of Infectious Diseases, Toyama, Tokyo 162-8640, Japan
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42
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Miyoshi-Akiyama T, Ikebe T, Watanabe H, Uchiyama T, Kirikae T, Kawamura Y. Use of DNA arrays to identify a mutation in the negative regulator, csrR, responsible for the high virulence of a naturally occurring type M3 group A streptococcus clinical isolate. J Infect Dis 2006; 193:1677-84. [PMID: 16703511 DOI: 10.1086/504263] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2005] [Accepted: 01/26/2006] [Indexed: 11/03/2022] Open
Abstract
We previously reported that type M3 group A streptococcus (GAS) showed a wide range of 50% lethal dose values in mice. Analysis using DNA arrays indicated that the most virulent strain, M3-f, expressed significantly higher levels of the products of several virulence genes than did the other M3 isolates. Sequencing of the csrS, csrR, luxS, and rgg genes in the isolates showed that the M-3f csrR gene contained a specific point mutation. Disruption of wild-type (wt) csrR in an M3 strain increased its virulence and the expression of hyaluronic acid, whereas complementation with wt but not type M3-f csrR attenuated these changes. Expression experiments showed that type M3-f CsrR counteracted the effects of wt CsrR. Although wt CsrR bound to the hasA promoter region, type M3-f CsrR did not. Thus, the high virulence of the type M3-f strain is associated with the decreased binding of type M3-f CsrR to its target sequences.
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Affiliation(s)
- Tohru Miyoshi-Akiyama
- Department of Infectious Diseases, International Medical Center of Japan, Tokyo, Japan.
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43
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Ikebe T, Watanabe H. Increased expression of ska gene in emm49-genotyped strains of Streptococcus pyogenes isolated from patients of severe invasive group A streptococcus infections. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ics.2005.08.053] [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] [Indexed: 11/30/2022]
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44
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Ikebe T, Endoh M, Watanabe H. Increased expression of the ska gene in emm49-genotyped Streptococcus pyogenes strains isolated from patients with severe invasive streptococcal infections. Jpn J Infect Dis 2005; 58:272-5. [PMID: 16249619] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Since 2000, emm49-genotyped Streptococcus pyogenes strains have been isolated from patients with severe invasive group A streptococcal infections in Japan, although they had not been isolated before 1999. We compare the characteristics of these strains with those of strains isolated from patients with non-invasive infections. SmaI-digested pulsed-field gel electrophoresis profiles of the isolates were almost indistinguishable between these groups, however, we found that ska (streptokinase gene) transcriptional levels in the strains isolated from patients with severe invasive infections were significantly higher than those in non-invasive infections.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
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45
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Ikebe T, Seki K, Nakamura S, Takenoshita Y, Nakayama H, Shinohara M, Shirasuna K. Severity of oral mucositis correlates with the response of oral cancer to preoperative radiochemotherapy. Int J Oral Maxillofac Surg 2005; 34:642-5. [PMID: 15869866 DOI: 10.1016/j.ijom.2005.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2004] [Revised: 03/04/2005] [Accepted: 03/15/2005] [Indexed: 11/23/2022]
Abstract
Oral mucositis is a dose-limiting toxic effect of radiotherapy and chemotherapy on oral cancer. The purpose of the present study is to assess the relationship between tumor response and oral mucositis in preoperative radiochemotherapy for oral cancer retrospectively. Fifty-four cases of oral squamous cell carcinoma were treated with concurrent radiochemotherapy prior to surgery. When oral mucositis was evaluated with the WHO scale, severe oral mucositis (Grades 3 and 4) developed in 22 cases (41%). A more than 50% reduction in tumor size was clinically observed in 38 cases (70%). From histopathological analysis of the surgical specimens all tumor cells observed appeared to be non-viable in 16 cases (29%). The cases with Grade 1, Grade 2, Grade 3 and Grade 4 oral mucositis included 33%, 62%, 85% and 89% of clinical good-response cases and 0%, 24%, 31% and 55% of histopathological good-response cases, respectively. This retrospective study suggests that severe oral mucositis promises a good response of oral squamous cell carcinoma to radiochemotherapy.
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Affiliation(s)
- T Ikebe
- Department of Oral and Maxillofacial Surgery, Sensory and Motor Organ Sciences, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, 1-1-1 Honjyo, Kumamoto 860-8556, Japan.
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46
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Ikebe T, Hirasawa K, Suzuki R, Isobe J, Tanaka D, Katsukawa C, Kawahara R, Tomita M, Ogata K, Endoh M, Okuno R, Watanabe H. Antimicrobial susceptibility survey of Streptococcus pyogenes isolated in Japan from patients with severe invasive group A streptococcal infections. Antimicrob Agents Chemother 2005; 49:788-90. [PMID: 15673769 PMCID: PMC547282 DOI: 10.1128/aac.49.2.788-790.2005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We assessed antimicrobial susceptibility against 211 Streptococcus pyogenes strains isolated from patients with severe invasive group A streptococcal infections. Overall, 3.8, 1.4, 1.4, and 0.5% of the isolates were resistant to erythromycin, clindamycin, telithromycin, and ciprofloxacin, respectively, and 10.4% had intermediate resistance to ciprofloxacin. All isolates were susceptible to ampicillin and cefotaxime.
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Affiliation(s)
- Tadayoshi Ikebe
- Department of Bacteriology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8640, Japan
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47
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Abstract
Clinical isolates of Streptococcus pyogenes were classified by serological typing of their surface M protein. Non-M typeable strains with the emm1 gene were characterized as the degradation of M protein caused by overproduction of the extracellular cysteine protease, SpeB. These events are dependent on the growth phase. M protein produced prior to expression of SpeB is degraded in the stationary phase when the active form of SpeB is detected. The proteolytic degradation of M protein should be considered for precise M typing analysis.
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Affiliation(s)
- Masatomo Morita
- Department of Bacteriology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
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48
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Matsumoto M, Sakae K, Ohta M, Endo M, Okuno R, Murayama S, Hirasawa K, Suzuki R, Isobe J, Tanaka D, Katsukawa C, Tamaru A, Tomita M, Ogata K, Yasuoka T, Ikebe T, Watanabe H. Molecular mechanisms of high level tetracycline-resistance in group A streptococcal isolates, T serotypes 4 and 11. Int J Antimicrob Agents 2005; 25:142-7. [PMID: 15664484 DOI: 10.1016/j.ijantimicag.2004.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2004] [Accepted: 09/17/2004] [Indexed: 11/28/2022]
Abstract
The molecular mechanism of high level tetracycline resistance in T serotypes 4 and 11 group A streptococcal (GAS) isolates was examined in 61 tetracycline-resistant isolates in Japan. PCR and sequencing analyses revealed that the T serotype/emm genotype, T4/4 isolates carried tet(O) genes, which were genetically homogenous. The T11/11 and T11/89 isolates carried different subtypes of tet(M) genes, which were present on transposons Tn916 and Tn1545, respectively. In addition, these T11 isolates may have obtained the tet(M) gene after the 1990s, because resistance to tetracycline in T11 isolates was rarely found before then. These results strongly suggested that the T4 and T11 GAS isolates acquired tetracycline-resistance via different molecular mechanisms.
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Affiliation(s)
- Masakado Matsumoto
- Department of Microbiology, Aichi Prefectural Institute of Public Health, Nagoya 462-8576, Japan.
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49
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Ikebe T, Endo M, Ueda Y, Okada K, Suzuki R, Minami T, Tanaka H, Nakanishi N, Tomita M, Nishie H, Ishii N, Sasaki E, Miura Y, Yamamura T, Watanabe H. The genetic properties of Streptococcus pyogenes emm49 genotype strains recently emerged among severe invasive infections in Japan. Jpn J Infect Dis 2004; 57:187-8. [PMID: 15329456] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Tadayoshi Ikebe
- National Institute of Infectious Diseases, Tokyo 162-8640, Japan
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50
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Ikebe T, Murayama S, Saitoh K, Yamai S, Suzuki R, Isobe J, Tanaka D, Katsukawa C, Tamaru A, Katayama A, Fujinaga Y, Hoashi K, Watanabe H. Surveillance of severe invasive group-G streptococcal infections and molecular typing of the isolates in Japan. Epidemiol Infect 2004; 132:145-9. [PMID: 14979600 PMCID: PMC2870088 DOI: 10.1017/s0950268803001262] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The number of patients with severe invasive group-G streptococcal (Streptococcus dysgalactiae subsp. equisimilis) infections has been increasing in Japan. The emm genotypes and SmaI-digested pulsed-field gel electrophoresis DNA profiles were variable among the strains isolated, suggesting there has not been clonal expansion of a specific subpopulation of strains. However, all strains carried scpA, ska, slo and sag genes, some of which may be involved in the pathogenesis of the disease.
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Affiliation(s)
- T Ikebe
- Department of Bacteriology, National Institute of Infectious Diseases, Tokyo, 162-8640, Japan
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