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Kawabata H, Iwahashi Y, Deguchi R, Muraoka S, Wakamiya T, Yamashita S, Kohjimoto Y, Koizumi Y, Shigemura K, Hara I. Poor performance status is a risk factor for higher detection of Gram positive coccus in stone-related pyelonephritis. J Infect Chemother 2024; 30:526-530. [PMID: 38122843 DOI: 10.1016/j.jiac.2023.12.008] [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: 08/16/2023] [Revised: 10/31/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION We aimed to investigate the detection rate of causative organisms in stone-related pyelonephritis and to compare their distribution according to patient backgrounds. METHODS We retrospectively identified patients with stone-related pyelonephritis. Clinical data were collected between November 2012 and August 2020 at Wakayama Medical University Hospital, including on patient backgrounds and causative organisms. Patients were categorized by Eastern Cooperative Oncology Group performance status (PS) as the good PS group (0, 1) and the poor PS group (2-4). Bacteria were divided into Gram-positive cocci (GPC) or non-GPC groups and logistic regression analysis was used to examine factors that predict detection of GPC. RESULTS Seventy-nine patients had stone-related pyelonephritis, 54 (68.4 %) in the good PS group and 25 (31.6 %) in the poor PS group. In the good PS group, Escherichia coli (67 %) was followed by Klebsiella species (9 %), while in the poor PS group, Escherichia coli (20 %) was followed by Enterococci and Staphylococci (12 %). GPC detection rate was significantly higher in the poor PS group than in the good PS group (40.0 % vs 14.8 %, p = 0.016), and multivariate logistic regression analysis showed that poor PS was an independent factor predicting detection of GPC (OR = 6.54, p = 0.02). CONCLUSIONS The distribution of the causative organisms in stone pyelonephritis was similar to that in common complicated urinary tract infections. Poor PS may be an independent predictor of GPC detection in patients with stone pyelonephritis.
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Affiliation(s)
- Hiroki Kawabata
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan.
| | - Yuya Iwahashi
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
| | - Ryusuke Deguchi
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
| | - Satoshi Muraoka
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
| | - Takahito Wakamiya
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
| | - Shimpei Yamashita
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
| | - Yasuo Kohjimoto
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
| | - Yusuke Koizumi
- Department of Infection Control and Prevention, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
| | - Katsumi Shigemura
- Department of Urology, Kobe University Hospital, 7-5-1 Kusunokicho, Chuo Ward, Kobe City, Japan
| | - Isao Hara
- Department of Urology, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Japan
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Morita T, Sasaki T, Koizumi Y, Fukushima H, Shimbashi W, Mitani H. Favourable swallowing outcomes after subtotal glossectomy with laryngeal suspension. Int J Oral Maxillofac Surg 2024; 53:191-198. [PMID: 37516548 DOI: 10.1016/j.ijom.2023.07.002] [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: 01/05/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/31/2023]
Abstract
Subtotal or total glossectomy for advanced tongue cancer has an adverse impact on swallowing. The purpose of this retrospective study was to analyse postoperative swallowing outcomes and to determine the ideal reconstruction method in these patients. The clinical and swallowing data of patients with tongue cancer who underwent subtotal glossectomy at the study institution between 2005 and 2019 were reviewed retrospectively. Data were available for 101 patients. The most common reconstruction method was a free rectus abdominis musculocutaneous flap (69 cases). The postoperative feeding tube dependency rate was 11.1% at discharge and 9.4% at 1 year. During the study period, laryngeal suspension and/or a cricopharyngeal myotomy was performed in 39 patients (38.6%), with 25 of these operations performed after 2017. Patients treated in 2017-2019 were significantly more able to take thin liquid (P < 0.001) and lost less weight (P = 0.015) compared to those treated in 2005-2016. Multivariate analysis of 61 patients who did not undergo laryngeal suspension and/or cricopharyngeal myotomy showed significant feeding tube dependency in those aged 65 years and older (P = 0.004). Thin liquid intake was significantly improved after subtotal glossectomy with laryngeal suspension, which led to better postoperative swallowing and improved quality of life.
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Affiliation(s)
- T Morita
- Department of Head and Neck, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - T Sasaki
- Department of Head and Neck, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Y Koizumi
- Department of Head and Neck, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - H Fukushima
- Department of Head and Neck, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - W Shimbashi
- Department of Head and Neck, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - H Mitani
- Department of Head and Neck, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Mitsutake K, Shinya N, Seki M, Ohara T, Uemura K, Fukunaga M, Sakai J, Nagao M, Sata M, Hamada Y, Kawasuji H, Yamamoto Y, Nakamatsu M, Koizumi Y, Mikamo H, Ukimura A, Aoyagi T, Sawai T, Tanaka T, Izumikawa K, Takayama Y, Nakamura K, Kanemitsu K, Tokimatsu I, Nakajima K, Akine D. Antimicrobial therapy and outcome of methicillin-resistant Staphylococcus aureus endocarditis: A retrospective multicenter study in Japan. J Infect Chemother 2024:S1341-321X(24)00068-0. [PMID: 38432557 DOI: 10.1016/j.jiac.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/08/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND MRSA (methicillin-resistant Staphylococcus aureus)-infective endocarditis (IE) is associated with high morbidity and mortality. This study aimed to assess data from patients with MRSA-IE across multiple facilities in Japan, with a specific focus on antimicrobial therapy and prognosis. METHODS This retrospective study enrolled patients with a confirmed diagnosis of IE attributed to MRSA, spanning the period from January 2015 to April 2019. RESULTS Sixty-four patients from 19 centers were included, with a median age of 67 years. The overall mortality rate was 28.1% at 30 days, with an in-hospital mortality of 45.3%. The most frequently chosen initial anti-MRSA agents were glycopeptide in 67.2% of cases. Daptomycin and linezolid were selected as initial therapy in 23.4% and 17.2% of cases, respectively. Approximately 40% of all patients underwent medication changes due to difficulty in controlling infection or drug-related side effects. Significant prognostic factors by multivariable analysis were DIC for 30-day mortality and surgical treatment for 30-day and in-hospital mortality. For vancomycin as initial monotherapy, there was a trend toward a worse prognosis for 30-day and in-hospital mortality (OR, 6.29; 95%CI, 1.00-39.65; p = 0.050, OR, 3.61; 95%CI, 0.93-14.00; p = 0.064). Regarding the choice of initial antibiotic therapy, statistical analysis did not show significant differences in prognosis. CONCLUSION Glycopeptide and daptomycin were the preferred antibiotics for the initial therapy of MRSA-IE. Antimicrobial regimens were changed for various reasons. Prognosis was not significantly affected by choice of antibiotic therapy (glycopeptide, daptomycin, linezolid), but further studies are needed to determine which antimicrobials are optimal as first-line agents.
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Affiliation(s)
- Kotaro Mitsutake
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan.
| | - Natsuki Shinya
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan
| | - Masafumi Seki
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan; Department of Infectious Diseases, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Takahiro Ohara
- Division of Geriatric and Community Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Kohei Uemura
- Department of Biostatistics and Bioinformatics, Interfaculty Initiative in Information Studies, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Masato Fukunaga
- Department of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita, Kitakyushu, Fukuoka, 802-8555, Japan
| | - Jun Sakai
- Department of Infectious Disease and Infection Control, Saitama Medical University Hospital, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan
| | - Makoto Sata
- National Cerebral and Cardiovascular Center Division of Pulmonology and Infection Control, 6-1, Kishibe Shinmachi, Suita, Osaka, 564-8565, Japan
| | - Yohei Hamada
- Department of Infectious Disease and Hospital Epidemiology, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-0937, Japan
| | - Hitoshi Kawasuji
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Masashi Nakamatsu
- Department of Infection Control, University of the Ryukyus Hospital, 207 Aza-Uehara, Nishihara, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Iwasaku, Ganmata, Nagakute, Aichi, 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Iwasaku, Ganmata, Nagakute, Aichi, 480-1195, Japan
| | - Akira Ukimura
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-cho, Takatsuki, Osaka, 569-0801, Japan
| | - Tetsuji Aoyagi
- Department of Clinical Microbiology and Infection, Tohoku University Graduate School of Medicine, Department of Comprehensive Infectious Diseases, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Toyomitsu Sawai
- Nagasaki Harbor Medical Center, Department of Respiratory Medicine, 6-39 Shinchi-cho, Nagasaki City, Nagasaki, 850-0842, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, 1 Chome-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1 Chome-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yoko Takayama
- Department of Infection Control and Infectious Diseases Research and Development Center for New Medical Frontiers Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Kiwamu Nakamura
- Department of Infection Control, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295, Japan
| | - Keiji Kanemitsu
- Department of Infection Control, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295, Japan
| | - Issei Tokimatsu
- Department of Medicine, Division of Clinical Infectious Diseases, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kazuhiko Nakajima
- Department of Infection Prevention and Control, Hyogo Medical University, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-850, Japan
| | - Dai Akine
- Division of Clinical Infectious Diseases, School of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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Morioka H, Koizumi Y, Watariguchi T, Oka K, Tomita Y, Kojima Y, Okudaira M, Ito Y, Shimizu J, Watamoto K, Kato H, Nagaoka M, Yokota M, Hasegawa C, Tsuji T, Shimizu S, Ito K, Kawasaki S, Akita K, Kitagawa Y, Mutoh Y, Ishihara M, Iwata S, Nozaki Y, Nozawa M, Kato M, Katayama M, Yagi T. Surgical antimicrobial prophylaxis in Japanese hospitals: Real status and challenges. J Infect Chemother 2024:S1341-321X(24)00023-0. [PMID: 38272262 DOI: 10.1016/j.jiac.2024.01.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/24/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Information regarding the status of surgical antimicrobial prophylaxis (SAP) in Japanese hospitals is lacking. This study aimed to explore the status of SAP prescriptions for surgeries and adherence to Japanese SAP guidelines. METHODS From February to July 2020, a 1-day multicentre point prevalent survey was conducted at 27 hospitals in Aichi Prefecture, Japan. Patients prescribed SAP were included in this study. The appropriateness of the SAP was evaluated based on the guidelines for selection of antimicrobials and their duration. Surgery was defined as appropriate when all the items were appropriate. RESULTS A total of 728 patients (7.1 %; 728/10,199) received antimicrobials for SAP. Among them, 557 patients (76.5 %, 557/728) underwent the surgeries described in the guidelines. The overall appropriateness of all surgeries was 33.9 % (189/557). The appropriate selection of antimicrobial before/during and after surgery and their durations were 67.5 % (376/557), 67.5 % (376/557), and 43.3 % (241/557), respectively. The overall appropriateness ranged from 0 % (0/37, oral and maxillofacial surgery) to 58.7 % (88/150, orthopaedic surgery) and 27.7 % (36/130, community hospitals with 400-599 beds) to 47.2 % (17/36, specific hospitals). Cefazolin was the most prevalent antimicrobial prescribed before/during (55.5 %, 299/539), and after (45.1 %, 249/552) surgery. In total, 101 oral antimicrobials were prescribed postoperatively. CONCLUSIONS SAP adherence by specific surgical fields and hospitals was shown in this study. Intensive intervention and repeated surveillance are necessary to improve SAP prescriptions in Japanese hospitals.
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Affiliation(s)
- Hiroshi Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Japan.
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Japan; Department of Infection Prevention and Control, Wakayama Medical University, Wakayama, Japan
| | | | - Keisuke Oka
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Japan; Antimicrobial Stewardship Team, Kariya Toyota General Hospital, Kariya, Japan
| | - Yuka Tomita
- Department of Infectious Diseases, Japanese Red Cross Aichi Medical Centre Nagoya Daini Hospital, Nagoya, Japan
| | - Yumi Kojima
- Infection Control Team, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | | | - Yuji Ito
- Department of Respiratory Medicine, Daiyukai General Hospital, Ichinomiya, Japan
| | - Junichi Shimizu
- Department of Thoracic Oncology, Aichi Cancer Centre Hospital, Nagoya, Japan
| | - Koichi Watamoto
- Department of Hematology, Komaki City Hospital, Komaki, Japan
| | - Hiroki Kato
- Department of Infectious Diseases, Toyota Memorial Hospital, Toyota, Japan
| | | | - Manabu Yokota
- Department of Pharmacy, Handa City Hospital, Handa, Japan
| | - Chihiro Hasegawa
- Department of Infectious Diseases, Nagoya City East Medical Centre, Nagoya, Japan
| | - Takeshi Tsuji
- Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan
| | - Shinsuke Shimizu
- Infection Control Team, Kamiiida Daiichi General Hospital, Nagoya, Japan
| | - Kenta Ito
- Department of General Pediatrics, Aichi Children's Health and Medical Centre, Obu, Japan
| | - Shohei Kawasaki
- Department of Pharmacy, Nishichita General Hospital, Tokai, Japan
| | - Kenji Akita
- Department of Respiratory Medicine, Nagoya City University West Medical Centre, Nagoya, Japan
| | - Yuichi Kitagawa
- Department of Infection Control, National Centre for Geriatrics and Gerontology, Obu, Japan
| | - Yoshikazu Mutoh
- Department of Infectious Diseases, Tosei General Hospital, Seto, Japan
| | | | - Susumu Iwata
- Department of Respiratory Medicine, Kasugai Municipal Hospital, Kasugai, Japan
| | - Yasuhiro Nozaki
- Department of Respiratory Medicine, Tokoname Municipal Hospital, Tokoname, Japan
| | | | - Munehiro Kato
- Department of Respiratory Medicine, Asahi Rosai Hospital, Owariasahi, Japan
| | - Masao Katayama
- Department of Internal Medicine and Rheumatology and Department of Infection Control Team, NHO Nagoya Medical Center, Nagoya, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Japan
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Teramoto K, Tamura S, Yoshida K, Inada Y, Yamashita Y, Morimoto M, Mushino T, Koreeda D, Miyamoto K, Komiya N, Nakano Y, Takagaki Y, Koizumi Y. Clinical Characteristics and Diagnostic Prediction of Severe Fever with Thrombocytopenia Syndrome and Rickettsiosis in the Co-Endemic Wakayama Prefecture, Japan. Medicina (Kaunas) 2023; 59:2024. [PMID: 38004073 PMCID: PMC10672843 DOI: 10.3390/medicina59112024] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/07/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: The Wakayama prefecture is endemic for two types of tick-borne rickettsioses: Japanese spotted fever (JFS) and scrub typhus (ST). Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne hemorrhagic viral disease with a high mortality rate and is often difficult to differentiate from such rickettsioses. SFTS cases have recently increased in Wakayama prefecture. For early diagnosis, this study aimed to evaluate the clinical characterization of such tick-borne infections in the co-endemic area. Materials and Methods: The study included 64 febrile patients diagnosed with tick-borne infection in Wakayama prefecture between January 2013 and May 2022. Medical records of 19 patients with SFTS and 45 with rickettsiosis (JSF, n = 26; ST, n = 19) were retrospectively examined. The receiver operating curve (ROC) and area under the curve (AUC) were calculated to evaluate potential factors for differentiating SFTS from rickettsiosis. Results: Adults aged ≥70 years were most vulnerable to tick-borne infections (median, 75.5 years; interquartile range, 68.5-84 years). SFTS and rickettsiosis occurred mostly between summer and autumn. However, no significant between-group differences were found in age, sex, and comorbidities; 17 (89%) patients with SFTS, but none of those with rickettsiosis, experienced gastrointestinal symptoms such as vomiting, abdominal pain, and diarrhea. Meanwhile, 43 (96%) patients with rickettsiosis, but none of those with SFTS, developed a skin rash. The AUCs of white blood cells (0.97) and C-reactive protein (CRP) levels (0.98) were very high. Furthermore, the differential diagnosis of SFTS was significantly associated with the presence of gastrointestinal symptoms (AUC 0.95), the absence of a skin rash (AUC 0.98), leukopenia <3.7 × 109/L (AUC 0.95), and low CRP levels < 1.66 mg/dL (AUC 0.98) (p < 0.001 for each factor). Conclusions: Clinical characteristics and standard laboratory parameters can verify the early diagnosis of SFTS in areas where tick-borne infections are endemic.
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Affiliation(s)
- Kan Teramoto
- Department of Internal Medicine, National Health Insurance Susami Hospital, Wakayama 649-2621, Japan
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shinobu Tamura
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Kikuaki Yoshida
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yukari Inada
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yusuke Yamashita
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Masaya Morimoto
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Toshiki Mushino
- Department of Hematology, Kinan Hospital, Wakayama 641-8509, Japan
- Department of Hematology/Oncology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Daisuke Koreeda
- Department of Emergency and Intensive Care Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Japan
| | - Kyohei Miyamoto
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Nobuhiro Komiya
- Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, Wakayama 640-8558, Japan
| | - Yoshio Nakano
- Department of Internal Medicine, Kinan Hospital, Wakayama 646-8588, Japan
| | - Yusaku Takagaki
- Department of Internal Medicine, National Health Insurance Susami Hospital, Wakayama 649-2621, Japan
| | - Yusuke Koizumi
- Department of Infection Control and Prevention, Wakayama Medical University, Wakayama 641-8509, Japan
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Mikamo H, Koizumi Y, Yamagishi Y, Asai N, Miyazono Y, Shinbo T, Horie M, Togashi K, Robbins EM, Hirotsu N. Comparing the cobas Influenza A/B Nucleic acid test for use on the cobas Liat System (Liat) with rapid antigen tests for clinical management of Japanese patients at the point of care. PLoS One 2022; 17:e0276099. [PMID: 36301841 PMCID: PMC9612487 DOI: 10.1371/journal.pone.0276099] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background Rapid diagnosis of influenza is critical in preventing the spread of infection and ensuring patients quickly receive antiviral medication to reduce the severity and duration of influenza symptoms, whilst controlling the spread of the causative virus. In Japan patients are often administered anti-influenza medication following a positive rapid antigen detection test (RADT) result. However, the sensitivity of RADTs can lead to false negative results. The cobas® Influenza A/B Nucleic acid test for use on the cobas Liat® System (Liat) is a molecular point-of-care method that can provide a more sensitive alternative to RADTs for rapid influenza diagnosis and treatment. Methods In this prospective multicenter study, diagnostic performance of the Liat test was compared with RADTs in patients presenting with influenza-like-illness. Test performance was also assessed by time since symptom onset. Results Of 419 patients enrolled, 413 were evaluable for all designated tests. Most patients had type-A infection, and only one patient had influenza type B. In 413 patients, the sensitivity and specificity (95% CI) of the Liat test were 99.5% (97.2–99.9%) and 99.5% (97.4–99.9%), respectively, and were 79.7% (73.5–84.7%) and 95.4% (91.7–97.5%) for RADTs. For patients tested <12 hours from symptom onset, the Liat test had significantly higher sensitivity than RADTs (p<0.0001). Conclusion Overall, compared with standard of care RADTs, the Liat test was more sensitive and specific in children and adults, particularly in the early stages of infection. Greater sensitivity can enable earlier diagnosis and may better inform appropriate antiviral treatment decisions.
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Affiliation(s)
| | - Yusuke Koizumi
- Aichi Medical University, Nagakute, Aichi, Japan
- Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Yuka Yamagishi
- Aichi Medical University, Nagakute, Aichi, Japan
- Kochi University, Nankoku, Kochi, Japan
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Rimini M, Rimassa L, Ueshima K, Burgio V, Shigeo S, Tada T, Suda G, Yoo C, Cheon J, Pinato DJ, Lonardi S, Scartozzi M, Iavarone M, Di Costanzo GG, Marra F, Soldà C, Tamburini E, Piscaglia F, Masi G, Cabibbo G, Foschi FG, Silletta M, Pressiani T, Nishida N, Iwamoto H, Sakamoto N, Ryoo BY, Chon HJ, Claudia F, Niizeki T, Sho T, Kang B, D'Alessio A, Kumada T, Hiraoka A, Hirooka M, Kariyama K, Tani J, Atsukawa M, Takaguchi K, Itobayashi E, Fukunishi S, Tsuji K, Ishikawa T, Tajiri K, Ochi H, Yasuda S, Toyoda H, Ogawa C, Nishimur T, Hatanaka T, Kakizaki S, Shimada N, Kawata K, Tanaka T, Ohama H, Nouso K, Morishita A, Tsutsui A, Nagano T, Itokawa N, Okubo T, Arai T, Imai M, Naganuma A, Koizumi Y, Nakamura S, Joko K, Iijima H, Hiasa Y, Pedica F, De Cobelli F, Ratti F, Aldrighetti L, Kudo M, Cascinu S, Casadei-Gardini A. Atezolizumab plus bevacizumab versus lenvatinib or sorafenib in non-viral unresectable hepatocellular carcinoma: an international propensity score matching analysis. ESMO Open 2022; 7:100591. [PMID: 36208496 PMCID: PMC9808460 DOI: 10.1016/j.esmoop.2022.100591] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND A growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy. MATERIALS AND METHODS We carried out a retrospective analysis of prospectively collected data from consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population. RESULTS One hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS [hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268] and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed. CONCLUSIONS The present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC.
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Affiliation(s)
- M Rimini
- IRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy
| | - L Rimassa
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - K Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - V Burgio
- IRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy
| | - S Shigeo
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Tada
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - G Suda
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - C Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J Cheon
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - D J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - S Lonardi
- Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - M Scartozzi
- Medical Oncology, University and University Hospital of Cagliari, Cagliari, Italy
| | - M Iavarone
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | | | - F Marra
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy
| | - C Soldà
- Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - E Tamburini
- Department of Oncology and Palliative Care, Cardinale Hospital, Naples, Italy
| | - F Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - G Masi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - G Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
| | - F G Foschi
- Internal Medicine, Infermi Hospital, Faenza (AUSL ROMAGNA), Ravenna, Italy
| | - M Silletta
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - T Pressiani
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - N Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - H Iwamoto
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - B-Y Ryoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H J Chon
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - F Claudia
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - T Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - B Kang
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - A D'Alessio
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - T Kumada
- Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - A Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - M Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - K Kariyama
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - J Tani
- Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan
| | - M Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - K Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - E Itobayashi
- Department of Gastroenterology, Asahi General Hospital, Asahi, Japan
| | - S Fukunishi
- Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan
| | - K Tsuji
- Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - T Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - K Tajiri
- Department of Gastroenterology, Toyama University Hospital, Toyama, Japan
| | - H Ochi
- Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan
| | - S Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - H Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - C Ogawa
- Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan
| | - T Nishimur
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - T Hatanaka
- Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan
| | - S Kakizaki
- Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - N Shimada
- Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan
| | - K Kawata
- Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Tanaka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Ohama
- Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan
| | - K Nouso
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - A Morishita
- Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan
| | - A Tsutsui
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Nagano
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - N Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - M Imai
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - A Naganuma
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - Y Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - S Nakamura
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - K Joko
- Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan
| | - H Iijima
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Y Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - F Pedica
- Department of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F De Cobelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - F Ratti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Aldrighetti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - S Cascinu
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - A Casadei-Gardini
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
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Yokoyama Y, Shiota A, Asai N, Koizumi Y, Yamagishi Y, Sakanashi D, Nakamura A, Suematsu H, Ohnishi M, Mikamo H. Risk factors of first recurrence of Clostridioides difficile infection. Anaerobe 2022; 75:102556. [PMID: 35395406 DOI: 10.1016/j.anaerobe.2022.102556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Clostridioides difficile infection (CDI) often recurs. Approximately 25% of patients have recurrences after the initial treatment, and patients who have relapsed once are more likely to relapse. We aimed to identify the risk factors for initial CDI recurrence. METHODS We performed a retrospective survey of patient backgrounds and treatment-related factors. Risk factors were analyzed using single and multiple logistic regression analyses. RESULTS A total of 134 patients were included in the study. Prophylactic probiotic use and nasogastric tube feeding were independent risk factors for the initial recurrence of CDI. Patients using prophylactic probiotics had significantly higher recurrence rates than those not using prophylactic probiotics. CONCLUSION Prophylactic probiotic use and nasogastric tube placement may be risk factors for the initial recurrence of CDI. It is noteworthy that CDI that occurs during the use of prophylactic probiotics may be prone to recurrence.
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Affiliation(s)
- Yuki Yokoyama
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Japan; Department of Pharmacy, Aichi Medical University Hospital, Aichi, Japan
| | - Arufumi Shiota
- Department of Pharmacy, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Nobuhiro Asai
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Masafumi Ohnishi
- Department of Pharmacy, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan.
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Asai N, Suematsu H, Sakanashi D, Kato H, Shiota A, Hagihara M, Koizumi Y, Yamagishi Y, Mikamo H. Empyema and bacteremia caused by Aeromonas hydrophila: Case report and review of the literature. J Infect Chemother 2022; 28:705-708. [PMID: 35031202 DOI: 10.1016/j.jiac.2021.12.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 09/14/2021] [Revised: 12/13/2021] [Accepted: 12/27/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Despite the advance in antibiotics and widespread chest tube drainage, acute empyema still shows a high mortality rate, accounting for 10-25%. We experienced a case of acute empyema caused by A. hydrophila, which is extremely uncommon, and reviewed all previously published articles. CASE PRESENTATION A 76-year older man with a medical history of liver cirrhosis (LC) due to chronic hepatitis C and hepatic cell carcinoma was admitted to our institute. Elevated inflammatory reaction and effusions on chest CT were seen, and he was suspected of having acute empyema. Although an empiric antibiotic therapy of meropenem with chest tube drainage was performed as an initial treatment, he died within 8 hours of admission. Postmortem, both blood and left pleural fluid cultures yielded Aeromonas hydrophila. The final diagnosis was acute empyema caused by A. hydrophila. We reviewed previously reported empyema caused by Aeromonas species cases (4 A. hydrophila, and 1 A. veronii) in 4 previous reports written in English, including ours. Of 5, all were male, and the mean age was 52 years (range 27-76 years). All patients had LC due to alcohol or viral infections. As for antibiotics initially prescribed, third-generation cephalosporins were most frequently used in 3/5 (60%). Thoracentesis was performed in all patients (100%). As for prognosis, 2 (40%) survived, and 3 (60%) died. CONCLUSION Physicians should be aware of the possibility of acute empyema caused by A. hydrophila among patients with chronic hepatic disease.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Rimini M, Kudo M, Tada T, Shigeo S, Kang W, Suda G, Jefremow A, Burgio V, Iavarone M, Tortora R, Marra F, Lonardi S, Tamburini E, Piscaglia F, Masi G, Cabibbo G, Foschi FG, Silletta M, Kumada T, Iwamoto H, Aoki T, Goh MJ, Sakamoto N, Siebler J, Hiraoka A, Niizeki T, Ueshima K, Sho T, Atsukawa M, Hirooka M, Tsuji K, Ishikawa T, Takaguchi K, Kariyama K, Itobayashi E, Tajiri K, Shimada N, Shibata H, Ochi H, Yasuda S, Toyoda H, Fukunishi S, Ohama H, Kawata K, Tani J, Nakamura S, Nouso K, Tsutsui A, Nagano T, Takaaki T, Itokawa N, Okubo T, Arai T, Imai M, Joko K, Koizumi Y, Hiasa Y, Cucchetti A, Ratti F, Aldrighetti L, Cascinu S, Casadei-Gardini A. Nonalcoholic steatohepatitis in hepatocarcinoma: new insights about its prognostic role in patients treated with lenvatinib. ESMO Open 2021; 6:100330. [PMID: 34847382 PMCID: PMC8710492 DOI: 10.1016/j.esmoop.2021.100330] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) treatment remains a big challenge in the field of oncology. The liver disease (viral or not viral) underlying HCC turned out to be crucial in determining the biologic behavior of the tumor, including its response to treatment. The aim of this analysis was to investigate the role of the etiology of the underlying liver disease in survival outcomes. PATIENTS AND METHODS We conducted a multicenter retrospective study on a large cohort of patients treated with lenvatinib as first-line therapy for advanced HCC from both Eastern and Western institutions. Univariate and multivariate analyses were performed. RESULTS Among the 1232 lenvatinib-treated HCC patients, 453 (36.8%) were hepatitis C virus positive, 268 hepatitis B virus positive (21.8%), 236 nonalcoholic steatohepatitis (NASH) correlate (19.2%) and 275 had other etiologies (22.3%). The median progression-free survival (mPFS) was 6.2 months [95% confidence interval (CI) 5.9-6.7 months] and the median overall survival (mOS) was 15.8 months (95% CI 14.9-17.2 months). In the univariate analysis for OS NASH-HCC was associated with longer mOS [22.2 versus 15.1 months; hazard ratio (HR) 0.69; 95% CI 0.56-0.85; P = 0.0006]. In the univariate analysis for PFS NASH-HCC was associated with longer mPFS (7.5 versus 6.5 months; HR 0.84; 95% CI 0.71-0.99; P = 0.0436). The multivariate analysis confirmed NASH-HCC (HR 0.64; 95% CI 0.48-0.86; P = 0.0028) as an independent prognostic factor for OS, along with albumin-bilirubin (ALBI) grade, extrahepatic spread, neutrophil-to-lymphocyte ratio, portal vein thrombosis, Eastern Cooperative Oncology Group (ECOG) performance status and alpha-fetoprotein. An interaction test was performed between sorafenib and lenvatinib cohorts and the results highlighted the positive predictive role of NASH in favor of the lenvatinib arm (P = 0.0047). CONCLUSION NASH has been identified as an independent prognostic factor in a large cohort of patients with advanced HCC treated with lenvatinib, thereby suggesting the role of the etiology in the selection of patients for tyrosine kinase treatment. If validated, this result could provide new insights useful to improve the management of these patients.
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Affiliation(s)
- M Rimini
- Department of Oncology and Hematology, Division of Oncology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-osaka, Japan
| | - T Tada
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - S Shigeo
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - W Kang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - G Suda
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - A Jefremow
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Erlangen, Germany
| | - V Burgio
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - M Iavarone
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Division of Gastroenterology and Hepatology, Milan, Italy
| | - R Tortora
- Liver Unit, Department of Transplantation, Cardarelli Hospital, Naples, Italy
| | - F Marra
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - S Lonardi
- Medical Oncology Unit 3, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - E Tamburini
- Department of Medical Oncology, Card. G. Panico Hospital of Tricase, Tricase, Italy
| | - F Piscaglia
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - G Masi
- Unit of Medical Oncology, Pisa University Hospital, Pisa, Italy
| | - G Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
| | - F G Foschi
- Azienda Unità Sanitaria della Romagna, Ospedale degli Infermi, Faenza, Italy
| | - M Silletta
- Medical Oncology Unit, University Campus Bio-Medico, Rome, Italy
| | - T Kumada
- Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - H Iwamoto
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - T Aoki
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-osaka, Japan
| | - M J Goh
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - J Siebler
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nuremberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Erlangen, Germany
| | - A Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - T Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - K Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-osaka, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - M Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - M Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - K Tsuji
- Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - T Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - K Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - K Kariyama
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - E Itobayashi
- Department of Gastroenterology, Asahi General Hospital, Asahi, Japan
| | - K Tajiri
- Department of Gastroenterology, Toyama University Hospital, Toyama, Japan
| | - N Shimada
- Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan
| | - H Shibata
- Department of Gastroenterology, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - H Ochi
- Hepato-biliary Center, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - S Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - H Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - S Fukunishi
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - H Ohama
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - K Kawata
- Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - J Tani
- Department of Gastroenterology and Neurology, Kagawa University School of Medicine, Kagawa, Japan
| | - S Nakamura
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - K Nouso
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - A Tsutsui
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Nagano
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Takaaki
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - N Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - M Imai
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - K Joko
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Koizumi
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Y Hiasa
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - A Cucchetti
- Department of Medical and Surgical Sciences-DIMEC, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Department of Surgery, Morgagni - Pierantoni Hospital, Forlì, Italy
| | - F Ratti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Aldrighetti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - S Cascinu
- Vita-Salute San Raffaele University, Milan, Italy; Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - A Casadei-Gardini
- Department of Oncology, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
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11
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Murakami Y, Soyano T, Kozuka T, Ushijima M, Koizumi Y, Miyauchi H, Kaneko M, Nakano M, Kamima T, Hashimoto T, Oguchi M, Yoshioka Y. Can Dosiomics Features Be Relevant Predictive Factors for Biochemical Recurrence After Radiotherapy in Prostate Cancer Patients? Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.498] [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: 11/25/2022]
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12
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Miyamoto K, Koizumi Y, Tamura S, Nakashima T, Kobai K, Tanaka R, Shibata M, Shima N, Nemoto S, Fukumoto N, Kato S. Multisystem inflammatory syndrome in adults after acute coronavirus disease 2019 in a Japanese woman: A case report. J Infect Chemother 2021; 28:99-102. [PMID: 34620535 PMCID: PMC8486615 DOI: 10.1016/j.jiac.2021.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 01/13/2023]
Abstract
Multisystem inflammatory syndrome in adults (MIS-A) is a rare and emerging syndrome after coronavirus disease 2019 (COVID-19). To the best of our knowledge, Japanese cases of MIS-A are rarely reported. Here, we describe a case of MIS-A in a 44-year-old Japanese woman presenting with multiorgan dysfunction (i.e., cardiovascular and mucocutaneous involvement) and markedly elevated inflammatory markers 2 weeks after recovery from COVID-19. Treatment with intravenous immunoglobulins and corticosteroids resolved her symptoms. On the 13th day, she was discharged from the hospital with no recurrences on follow-up. This study highlights the importance of recognizing this emerging syndrome when treating patients with multiorgan dysfunction after COVID-19.
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Affiliation(s)
- Kyohei Miyamoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan; Department of Infection Prevention and Control, Wakayama Medical University, Wakayama City, Wakayama, Japan.
| | - Yusuke Koizumi
- Department of Infection Prevention and Control, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Shinobu Tamura
- Department of Infection Prevention and Control, Wakayama Medical University, Wakayama City, Wakayama, Japan; Department of Hematology/Oncology, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Tsuyoshi Nakashima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Kaori Kobai
- Department of Anesthesiology, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Rikako Tanaka
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Mami Shibata
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Nozomu Shima
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Shigeki Nemoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Nobu Fukumoto
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Seiya Kato
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama City, Wakayama, Japan
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13
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Asai N, Ohashi W, Watanabe H, Shiota A, Shibata Y, Kato H, Sakanashi D, Hagihara M, Koizumi Y, Yamagishi Y, Suematsu H, Mikamo H. Efficacy and validity of guideline-concordant treatment according to the JRS guidelines for the managements of pneumonia in adults updated in 2017 for nursing and healthcare-associated pneumonia. A propensity-matching score analysis. J Infect Chemother 2021; 28:24-28. [PMID: 34580007 DOI: 10.1016/j.jiac.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/15/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Patients with nursing and healthcare-associated pneumonia (NHCAP) commonly receive empiric antibiotic therapy according to the guideline's recommendation corresponding to the patient's deteriorated conditions. However, it is unclear whether guideline-concordant treatment (GCT) could be effective or not. PATIENTS AND METHODS To evaluate the efficacy and validity of GCT according to the current guideline for pneumonia, we conducted this retrospective study. NHCAP patients who were admitted to our institute between 2014 and 2017 were enrolled. Based on the initial antibiotic treatment, these patients were divided into two groups, the GCT group (n = 83) and the non-GCT group (n = 146). Propensity score matching (PSM) was used to balance the baseline characteristics and potential confounders between the two groups. After PSM, patients' characteristics, microbial profiles, and clinical outcomes were evaluated. RESULTS Both groups were well-balanced after PSM, and 78 patients were selected from each group. There were no differences in patients' characteristics or microbial profiles between the two groups. As for outcomes, there were no differences in 30-day, in-hospital mortality rate, duration of antibiotic treatment, or admission. The severity of pneumonia was more severe in patients with the GCT group than those with the non-GCT group. Anti-pseudomonal agents as initial treatment were more frequently seen in patients with the GCT group than those in the non-GCT group. CONCLUSION Unlike previous studies, GCT's recommendation for management of pneumonia by the JRS in 2017 would appear to be valid and does not increase the mortality rate.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Pharmacy, Mie University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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14
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Hagihara M, Ariyoshi T, Kuroki Y, Eguchi S, Higashi S, Mori T, Nonogaki T, Iwasaki K, Yamashita M, Asai N, Koizumi Y, Oka K, Takahashi M, Yamagishi Y, Mikamo H. Clostridium butyricum enhances colonization resistance against Clostridioides difficile by metabolic and immune modulation. Sci Rep 2021; 11:15007. [PMID: 34294848 PMCID: PMC8298451 DOI: 10.1038/s41598-021-94572-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/07/2021] [Indexed: 01/21/2023] Open
Abstract
Clostridioides difficile infection (CDI) represents the leading cause of nosocomial diarrhea worldwide and is associated with gut dysbiosis and intestinal damage. Clostridium butyricum MIYAIRI 588 (CBM 588) contributes significantly to reduce epithelial damage. However, the impacts of CBM 588 on antibacterial therapy for CDI are not clear. Here we show that CBM 588 enhanced the antibacterial activity of fidaxomicin against C. difficile and negatively modulated gut succinate levels to prevent C. difficile proliferation and downregulate tumor necrosis factor-α (TNF-α) producing macrophages in the colon lumina propria (cLP), resulting in a significant decrease in colon epithelial damage. Additionally, CBM 588 upregulated T cell-dependent pathogen specific immunoglobulin A (IgA) via interleukin (IL)-17A producing CD4+ cells and plasma B cells in the cLP, and Th17 cells in the cLP enhanced the gut epithelial barrier function. IL-17A and succinic acid modulations with CBM 588 enhance gut colonization resistance to C. difficile and protect the colon tissue from CDI.
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Affiliation(s)
- Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute, 480-1195, Japan.,Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Tadashi Ariyoshi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan.,Miyarisan Pharmaceutical Co., Ltd., Saitama, 114-0016, Japan
| | - Yasutoshi Kuroki
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan.,Miyarisan Pharmaceutical Co., Ltd., Saitama, 114-0016, Japan
| | - Shuhei Eguchi
- Miyarisan Pharmaceutical Co., Ltd., Saitama, 114-0016, Japan
| | - Seiya Higashi
- Miyarisan Pharmaceutical Co., Ltd., Saitama, 114-0016, Japan
| | - Takeshi Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Tsunemasa Nonogaki
- Department of Pharmacy, College of Pharmacy, Kinjo Gakuin University, Nagoya, 463-8521, Japan
| | - Kenta Iwasaki
- Departments of Kidney Disease and Transplant Immunology, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Makoto Yamashita
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Kentaro Oka
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan.,Miyarisan Pharmaceutical Co., Ltd., Saitama, 114-0016, Japan
| | - Motomichi Takahashi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan.,Miyarisan Pharmaceutical Co., Ltd., Saitama, 114-0016, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan.
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15
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Kato H, Hagihara M, Okudaira M, Asai N, Koizumi Y, Yamagishi Y, Mikamo H. Systematic review and meta-analysis to explore optimal therapeutic range of vancomycin trough level for infected paediatric patients with Gram-positive pathogens to reduce mortality and nephrotoxicity risk. Int J Antimicrob Agents 2021; 58:106393. [PMID: 34174409 DOI: 10.1016/j.ijantimicag.2021.106393] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 05/14/2020] [Revised: 05/09/2021] [Accepted: 05/19/2021] [Indexed: 11/28/2022]
Abstract
The aim of this study was to investigate the association between vancomycin trough level and clinical outcomes (mortality and nephrotoxicity) among infected paediatric patients with Gram-positive pathogens. We systematically searched the Scopus, EMBASE, Cochrane Central Register of Controlled Trials, PubMed and CINAHL databases up to March 2020. A total of seven retrospective cohort or case-control studies were included to compare clinical effects and safety: three studies set the threshold of vancomycin trough level at 10 mg/L and the others set it at 15 mg/L. Our analysis showed that vancomycin trough level of 10-15 mg/L was associated with significantly lower mortality [<10 mg/L vs. ≥10 mg/L, odds ratio (OR) = 3.21, 95% confidence interval (CI) 1.74-5.91; and <15 mg/L vs. ≥15 mg/L, OR = 0.31, 95% CI 0.10-0.95). The high vancomycin trough group (≥10 mg/L or ≥15 mg/L) showed a higher incidence of nephrotoxicity (<10 mg/L vs. ≥10 mg/L, OR = 0.06, 95% CI 0.03-0.12; and <15 mg/L vs. ≥15 mg/L, OR = 0.28, 95% CI 0.12-0.65). This is the first meta-analysis to reveal the optimal therapeutic range of vancomycin trough level in children. Our findings strongly suggest a superior benefit of vancomycin trough of 10-15 mg/L for paediatric patients.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan; Tokai Regional Infection Control Study Group (TRICSG)
| | | | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Tokai Regional Infection Control Study Group (TRICSG)
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Tokai Regional Infection Control Study Group (TRICSG).
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16
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Asai N, Suematsu H, Ohashi W, Shibata Y, Sakanashi D, Kato H, Shiota A, Watanabe H, Hagihara M, Koizumi Y, Yamagishi Y, Mikamo H. Ceftriaxone versus tazobactam/piperacillin and carbapenems in the treatment of aspiration pneumonia: A propensity score matching analysis. J Infect Chemother 2021; 27:1465-1470. [PMID: 34158237 DOI: 10.1016/j.jiac.2021.06.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/16/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Aspiration pneumonia (AP) accounts for 5.0-53.2% of hospitalized pneumonia and the treatment commonly used is by broad-spectrum antibiotics to cover anaerobes. Since ceftriaxone (CTRX) could generally cover oral streptococcus and anaerobes implicated in AP, it could be a useful option in the treatment of AP, instead of piperacillin-tazobactam/(PIPC/TAZ) or Carbapenems. PATIENTS AND METHODS For the purpose of examining whether CTRX is as effective as broad-spectrum antibiotics for the treatment of AP, this retrospective study included consecutive community-onset patients who were admitted to our institute between 2014 and 2017. These patients were divided into two groups, a CTRX group (n = 25) and a PIPC/TAZ or carbapenems group (n = 97) based on the initial antibiotic treatment. Propensity score matching (PSM) was used to balance the potential confounders, and 23 patients were selected from each group. Patients among CTXR group received CTRX, while those among PIPC/TAZ or carbapenems group received PIPC/TAZ, or carbapenems and/or other agents. RESULTS Both groups were well-balanced after PSM. There were no differences in 30-day mortality, duration of hospital stay or antibiotic treatments in the between them. The medical costs were much more expensive in the PIPC/TAZ or carbapenems group than in the CTR group (35,582 v. s. 8678 Japanese yen, p < 0.001). CONCLUSION CTRX is one of the most useful antibiotic treatment for AP, which is not inferior to broad-spectrum antibiotic treatment. In addition, usage of CTRX in the treatment of AP is more economical than broad-spectrum antibiotic treatment, and could contribute to reduction of medical costs.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Japan
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; University of Queensland Centre for Clinical Research, The University of Queensland, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
| | - Arufumi Shiota
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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17
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Koizumi Y, Mikamo H. Anti-Interferon Gamma Autoantibody and Disseminated Nontuberculous Mycobacteria Infection: What Should Be Done to Improve Its Clinical Outcome? Clin Infect Dis 2021; 72:2209-2211. [PMID: 32745203 DOI: 10.1093/cid/ciaa1098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan.,Department of Infection Control and Prevention, Wakayama Medical University Hospital, Wakayama, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
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18
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Kitoh T, Ohara T, Muto T, Okumura A, Baba R, Koizumi Y, Yamagishi Y, Mikamo H, Daigo K, Hamakubo T. Increased Pentraxin 3 Levels Correlate With IVIG Responsiveness and Coronary Artery Aneurysm Formation in Kawasaki Disease. Front Immunol 2021; 12:624802. [PMID: 33912155 PMCID: PMC8072470 DOI: 10.3389/fimmu.2021.624802] [Citation(s) in RCA: 4] [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: 11/01/2020] [Accepted: 03/17/2021] [Indexed: 12/19/2022] Open
Abstract
Kawasaki disease (KD) is a febrile disease of childhood characterized by systemic vasculitis that can lead to coronary artery lesions (CAL). This was a prospective cohort study to determine the levels of the pentraxin 3 (PTX3), soluble CD24-Subtype (Presepsin) and N-terminal pro-brain natriuretic peptide (NT-pro BNP) in consecutive KD patients. From January 2013 to March 2015, all patients with KD admitted to Aichi Medical University Hospital who provided consent had their plasma saved before IVIG administration. In total, 97 cases were registered. 22 cases of incomplete KD were excluded from the outcome analysis. The total 75 cases were used for statistical analyses. A PTX3 threshold of >7.92 ng/ml provided a specificity of 88.5 %, a sensitivity of 94.4 %, and a likelihood ratio as high as 15.92 for the diagnosis of KD compared with febrile non-KD controls. Although an echocardiographic diagnosis of CAL in the early course of the disease was confirmed in 24 cases, it was not in the remaining 51 cases. Neither NT-proBNP nor Presepsin had statistical significance for the prediction of the echocardiographic CAL diagnosis. Only PTX3 was significantly predictive of the echocardiographic CAL diagnosis (p=0.01). The PTX3 level was significantly higher in the intravenous immunoglobulin (IVIG) non-responders (45.9±7.45) than in the IVIG responders (17.0 ± 1.46 ng/ml) (p< 0.001). The PTX3 level also correlated with the number of IVIG treatment courses needed to resolve fever (R² =0.64). Persistent CAL (pCAL) formation was observed in three cases; one of aneurysm only and two aneurysms with dilatations. The patients with pCAL had significantly higher PTX3 levels (85 ± 8.4 ng/ml) than patients without pCAL (22 ± 2.2 ng/ml) (p< 0.0001). In terms of pCAL prediction, the area under the curve (AUC) of receiver operating characteristic ROC curve of PTX3 was 0.99, and it was significantly greater than that of Presepsin (0.67) or NT-proBNP (0.75). PTX3 is a soluble pattern recognition molecule that acts as a main component of the innate immune system. These data suggest that PTX3 can be utilized as a definitive biomarker for the prediction of IVIG resistance and subsequent CAL formation in patients with KD.
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Affiliation(s)
- Toshiyuki Kitoh
- Laboratory of Pediatrics, School of Pharmacy, Aichi Gakuin University, Nagoya, Japan.,Department of Pediatrics, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Tsuyoshi Ohara
- Laboratory of Pediatrics, School of Pharmacy, Aichi Gakuin University, Nagoya, Japan
| | - Taichiro Muto
- Department of Pediatrics, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Akihisa Okumura
- Department of Pediatrics, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Reizo Baba
- Department of Pediatrics, School of Medicine, Aichi Medical University, Nagakute, Japan.,Department of Lifelong Sports and Health Sciences, College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, School of Medicine, Aichi Medical University, Nagakute, Japan
| | - Kenji Daigo
- Department of Protein-protein Interaction Research, Institute for Advanced Medical Sciences, Nippon Medical School, Tokyo, Japan
| | - Takao Hamakubo
- Department of Protein-protein Interaction Research, Institute for Advanced Medical Sciences, Nippon Medical School, Tokyo, Japan
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19
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Hagihara M, Kato H, Sugano T, Okade H, Sato N, Shibata Y, Sakanashi D, Asai N, Koizumi Y, Suematsu H, Yamagishi Y, Mikamo H. Pharmacodynamic evaluation of meropenem, cefepime, or aztreonam combined with a novel β-lactamase inhibitor, nacubactam, against carbapenem-resistant and/or carbapenemase-producing Klebsiella pneumoniae and Escherichia coli using a murine thigh-infection model. Int J Antimicrob Agents 2021; 57:106330. [PMID: 33789129 DOI: 10.1016/j.ijantimicag.2021.106330] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/10/2021] [Accepted: 03/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Carbapenem-resistant Enterobacterales (CRE) and carbapenemase-producing Enterobacterales (CPE) are difficult to treat and are a serious public health threat. Nacubactam (NAC) is a novel non-β-lactam diazabicyclooctane β-lactamase inhibitor with in vitro activity against some Enterobacterales expressing classes of β-lactamases. METHODS The antimicrobial efficacy of meropenem (MEM), cefepime (FEP), and aztreonam (ATM), each in combination with NAC, were assessed in vitro and in vivo against Klebsiella pneumoniae and Escherichia coli. Ten isolates, including CRE and/or CPE with β-lactamase genes, were used in this study. The relationship between phenotype and in vivo efficacy was assessed in a murine neutropenic thigh-infection model. Efficacy was determined by the change in bacterial quantity. RESULTS The results of the in vitro study showed the minimum inhibitory concentrations of the combination of NAC with either MEM, FEP, or ATM in a 1:1 ratio were 2 to >128-fold lower than those of MEM, FEP, or ATM alone against CRE+ isolates. In addition, combinations of β-lactams and NAC administered in the murine thigh-infection model showed greater efficacy against CRE+/CPE+, CRE+/CPE-, and CRE-/CPE+ isolates harboring various β-lactamase genes (IMP-1, IMP-6, KPC, DHA-1, or OXA-48) compared with MEM, FEP, ATM, and NAC alone. CONCLUSION MEM, FEP, or ATM in combination with NAC showed potent in vivo antimicrobial activity in a murine thigh-infection model caused by K. pneumoniae and E. coli, including CRE and/or CPE isolates. These findings indicate that these combinations of β-lactams and NAC are potential candidates for the treatment of CRE and/or CPE infections.
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Affiliation(s)
- Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | | | | | - Nobuo Sato
- Meiji Seika Pharma Co., Ltd, Yokohama, Japan
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Daisuke Sakanashi
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Hiroyuki Suematsu
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan.
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Kato H, Hagihara M, Asai N, Koizumi Y, Yamagishi Y, Mikamo H. A systematic review and meta-analysis of myelosuppression in pediatric patients treated with linezolid for Gram-positive bacterial infections. J Infect Chemother 2021; 27:1143-1150. [PMID: 33727025 DOI: 10.1016/j.jiac.2021.03.003] [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: 01/10/2021] [Revised: 02/27/2021] [Accepted: 03/03/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The incidence of linezolid-induced myelosuppression in pediatric patients was reported at large difference among prospective studies, with a range of 0-24%. Additionally, there is little study which evaluated the impact of linezolid administration period on myelosuppression in pediatric patients, while it is one of the most frequent reason that linezolid therapy has to be discontinued in adult patients. Here, we performed a systematic review and meta-analysis to reveal the incidence of linezolid-induced thrombocytopenia and anemia, and impact of the administration period of linezolid on myelosuppression based on individual data analysis of pediatric patients. METHODS We systematically searched the Scopus, EMBASE, Cochrane Central Register of Controlled Trials, PubMed, and CINAHL until April 2020. We investigated the incidence of linezolid-induced thrombocytopenia and anemia using pooled analysis, and evaluated the impact of linezolid administration period on myelosuppression using meta-analysis. RESULTS Thirteen studies with 969 pediatric patients were identified. The pooled incidences of thrombocytopenia and anemia were 9% (95% confidence interval (CI), 3-18%) and 4% (95% CI, 0-12%), respectively. Our meta-analysis showed the extension of linezolid administration period (more than 14 days) resulted in higher incidence of thrombocytopenia (OR 4.86, 95% CI 1.10-21.55) and anemia (OR 4.57, 95% CI 0.13-160.49). CONCLUSIONS The incidence of linezolid-induced myelosuppression in pediatric patients was less than 10%. However, our meta-analysis revealed linezolid administration period for more than 14 days was one of risk factors associated with linezolid-induced myelosuppression. Therefore, especially for pediatric patients treated with linezolid for more than 14 days, careful monitoring of myelosuppression is required.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
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21
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Asai N, Ohashi W, Sakanashi D, Suematsu H, Kato H, Hagihara M, Watanabe H, Shiota A, Koizumi Y, Yamagishi Y, Mikamo H. Combination of Sequential Organ Failure Assessment (SOFA) score and Charlson Comorbidity Index (CCI) could predict the severity and prognosis of candidemia more accurately than the Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score. BMC Infect Dis 2021; 21:77. [PMID: 33451284 PMCID: PMC7811217 DOI: 10.1186/s12879-020-05719-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 11/03/2019] [Accepted: 12/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Candidemia has emerged as an important nosocomial infection, with a mortality rate of 30-50%. It is the fourth most common nosocomial bloodstream infection (BSI) in the United States and the seventh most common nosocomial BSI in Europe and Japan. The aim of this study was to assess the performance of the Sequential Organ Failure Assessment (SOFA) score for determining the severity and prognosis of candidemia. METHODS We performed a retrospective study of patients admitted to hospital with candidemia between September 2014 and May 2018. The severity of candidemia was evaluated using the SOFA score and the Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) score. Patients' underlying diseases were assessed by the Charlson Comorbidity Index (CCI). RESULTS Of 70 patients enrolled, 41 (59%) were males, and 29 (41%) were females. Their median age was 73 years (range: 36-93 years). The most common infection site was catheter-related bloodstream infection (n=36, 51%).The 30-day, and in-hospital mortality rates were 36 and 43%, respectively. Univariate analysis showed that SOFA score ≥5, APACHE II score ≥13, initial antifungal treatment with echinocandin, albumin < 2.3, C-reactive protein > 6, disturbance of consciousness, and CCI ≥3 were related with 30-day mortality. Of these 7, multivariate analysis showed that the combination of SOFA score ≥5 and CCI ≥3 was the best independent prognostic indicator for 30-day and in-hospital mortality. CONCLUSIONS The combined SOFA score and CCI was a better predictor of the 30-day mortality and in-hospital mortality than the APACHE II score alone.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Nagakute, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan. .,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan.
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Kato H, Hagihara M, Asai N, Shibata Y, Koizumi Y, Yamagishi Y, Mikamo H. Meta-analysis of vancomycin versus linezolid in pneumonia with proven methicillin-resistant Staphylococcus aureus. J Glob Antimicrob Resist 2021; 24:98-105. [PMID: 33401013 DOI: 10.1016/j.jgar.2020.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 11/26/2020] [Accepted: 12/09/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines suggest that linezolid (LZD) is preferred over vancomycin (VCM) for treating methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. We conducted a systematic review and comparative meta-analysis to compare VCM and LZD efficacy against proven MRSA pneumonia. METHODS We searched EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and PubMed up to November 2019. The outcomes of the meta-analysis were mortality, clinical cure, microbiological evaluation, and adverse events. RESULTS Seven randomized controlled trials (RCTs) with a total of 1239 patients and eight retrospective cohort or case-control studies (CSs) with a total 6125 patients were identified. Clinical cure and microbiological eradication rates were significantly increased in patients treated with LZD in RCTs (clinical cure: risk ratio (RR) = 0.81, 95% confidential interval (CI) = 0.71-0.92; microbiological eradication: RR = 0.71, 95% CI = 0.62-0.81) and CSs (clinical cure: odds ratio (OR) = 0.35, 95% CI = 0.18-0.69). However, mortality was comparable between patients treated with VCM and LZD in RCTs (RR = 1.08, 95% CI = 0.88-1.32) and CSs (OR = 1.20, 95% CI = 0.94-1.53). Likewise, there was no significant difference in adverse events between VCM and LZD in CSs (thrombocytopenia: OR = 0.95, 95% CI = 0.50-1.82; nephrotoxicity: OR = 1.72, 95% CI = 0.85-3.45). CONCLUSIONS According to our meta-analysis of RCTs and CSs conducted worldwide, we found robust evidence to corroborate the IDSA guidelines for the treatment of proven MRSA pneumonia.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan.
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
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Asai N, Sakanashi D, Suematsu H, Kato H, Hagihara M, Shiota A, Koizumi Y, Yamagishi Y, Mikamo H. To what degree could clinical trials in evidence based medicine reflect reality in the treatment of candidemia? J Microbiol Immunol Infect 2020; 55:147-153. [PMID: 33339744 DOI: 10.1016/j.jmii.2020.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/03/2020] [Accepted: 11/23/2020] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Evidenced based medicine (EBM) is necessary to standardize or treatment for infection since EBM is established based on the results of clinical trials. Entry criteria for clinical trials are very strict, and many patients have difficulties in being enrolled in any clinical trials regarding candidemia. It is questionable if the results of clinical trials reflect the real world of general medicine in this case. PATIENTS AND METHODS For the purpose of examining how many patients could join any randomized clinical trials for the treatment of candidemia, we reviewed all the candidemia patients in our institute during 2014-2018. The patients were divided into two groups: patients who were eligible for clinical trials (participation possible group), and those who were not (participation impossible group). Exclusion criteria for clinical trials were set based on previous clinical trials. RESULTS A total of 70 patients was enrolled in this study. The median age was 73 years (range 36-93 years). Of these, 41 patients (59%) were male. As for site of infections, catheter related blood stream infection was most frequently seen in 37 (53%). Seventeen patients (24%) were classified as participation possible group and 53 patients (76%) were participation impossible group. Comparing the two groups, participation possible group patients have much better performance status, have less comorbidities and have longer overall survival times than participation impossible group patients. CONCLUSION Only 24% of candidemia patients were eligible for the clinical trials. Thus, we can see that clinical trials might not correctly reflect the real world among candidemia patients.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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24
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Kato H, Hagihara M, Asai N, Shibata Y, Koizumi Y, Yamagishi Y, Mikamo H. Meta-analysis of fluoroquinolones versus macrolides for treatment of legionella pneumonia. J Infect Chemother 2020; 27:424-433. [PMID: 33268272 DOI: 10.1016/j.jiac.2020.10.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/19/2020] [Accepted: 10/03/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Only a single meta-analysis has reported the clinical benefit of fluoroquinolones (FQs) for Legionella pneumonia; however, there is no robust data available to confirm this result, based on current guidelines. METHODS We performed a systematic review and meta-analysis comparing FQs with macrolides (MCs) on their efficacy and safety in Legionella pneumonia, using studies published until January 2020. The outcomes included mortality (overall; 30-day), clinical cure, time to apyrexia, length of hospital stay, and adverse events. RESULTS Five RCTs and twelve retrospective studies were identified. Clinical cure was comparable between the treatment groups (risk rate (RR) 1.07, 95% confidential interval (CI) 0.86-1.31). Mortality was significantly higher for MCs than for FQs (overall, odd rate (OR) 0.59, 95% CI 0.35-0.98; 30-day, OR 0.41, 95% CI 0.20-0.85). FQs significantly reduced the length of hospital stay, compared to MCs (mean difference -3.58, 95% CI -5.48-1.69). Other outcomes were not significantly different between the treatment groups (time to apyrexia; mean difference -1.83, 95% CI -5.15-1.5, adverse events; OR 0.61, 95% CI 0.33-1.15). In subgroup analyses, levofloxacin significantly reduced the length of hospital stay over two specific MCs (azithromycin and clarithromycin) (mean difference -3.03, 95% CI -5.33-0.72), whereas mortality was not significantly different between the treatment groups (overall, OR 0.49, 95% CI 0.19-1.24; 30-day, OR 0.38, 95% CI 0.13-1.13). CONCLUSIONS FQs exhibited superior effects in terms of mortality and length of hospital stay in Legionella pneumonia. These results support current guidelines recommending FQs for the treatment of Legionella pneumonia.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
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Sakanashi D, Asai N, Nakamura A, Miyazaki N, Kawamoto Y, Ohno T, Yamada A, Koita I, Suematsu H, Hagihara M, Shiota A, Kurumiya A, Sakata M, Kato S, Muramatsu Y, Koizumi Y, Kishino T, Ohashi W, Yamagishi Y, Mikamo H. Comparative evaluation of nasopharyngeal swab and saliva specimens for the molecular detection of SARS-CoV-2 RNA in Japanese patients with COVID-19. J Infect Chemother 2020; 27:126-129. [PMID: 33060046 PMCID: PMC7524660 DOI: 10.1016/j.jiac.2020.09.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/25/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022]
Abstract
Considering the issues of shortage of medical resources and the invasiveness and infection risk involved in the collection of nasopharyngeal swab specimens, there is a need for an effective alternative test specimen for SARS-CoV-2 RNA detection. Here, we investigated suitability of saliva as a non-invasively obtained specimen for molecular detection of SARS-CoV-2 RNA in Japanese patients with COVID-19. In total, 28 paired clinical specimens of saliva and nasopharyngeal swabs were collected from 12 patients at various time points after symptom onset. Each specimen was assayed using reverse transcription real-time polymerase chain reaction (rRT-PCR) on the BD MAX open system using primers and probes targeting the N-gene. The saliva and nasopharyngeal swab specimens showed 19 and 15 positive results, respectively. No invalid (PCR inhibition) result was observed for any specimen. The qualitative results of each specimen obtained in the period immediately after symptom onset were similar. Three convalescent patients presented saliva-positive results, whereas their nasopharyngeal swabs were negative at four different time points, suggesting that saliva may be superior to nasopharyngeal swabs in terms of obtaining stable assay result of SARS-CoV-2. In conclusion, our results suggest that saliva can potentially serve as an alternative to nasopharyngeal swabs as a specimen for SARS-CoV-2 rRT-PCR. As saliva can be collected by patients themselves, it may be an effective way to overcome the shortage of personal protective equipment and specimen sampling tools.
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Affiliation(s)
- Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Nobuhiro Asai
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Narimi Miyazaki
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Yuzuka Kawamoto
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Tomoko Ohno
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Isao Koita
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Ai Kurumiya
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Miki Sakata
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Syunji Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Yuki Muramatsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Yusuke Koizumi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Takaaki Kishino
- Department of Emergency and Critical Care Medicine, Aichi Medical University Hospital, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan.
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Asai N, Sakanashi D, Ohashi W, Nakamura A, Yamada A, Kawamoto Y, Miyazaki N, Ohno T, Koita I, Suematsu H, Kishino T, Kato H, Hagihara M, Shiota A, Koizumi Y, Yamagishi Y, Mikamo H. Could threshold cycle value correctly reflect the severity of novel coronavirus disease 2019 (COVID-19)? J Infect Chemother 2020; 27:117-119. [PMID: 32994136 PMCID: PMC7480734 DOI: 10.1016/j.jiac.2020.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/26/2020] [Accepted: 09/04/2020] [Indexed: 01/01/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) is diagnosed by positive result of reverse transcription polymerase chain reaction (RT-PCR) for the novel coronavirus. We concluded that cycle threshold value (Ct-value) of real-time RT-PCR (rRT-PCR) assay could decrease as patients recover. Results of rRT-PCR assay could remain positive among asymptomatic patients for longer than 2 weeks. The discharge criteria of COVID-19 patients using a negative result of rRT-PCR should be reconsidered.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Japan
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuzuka Kawamoto
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Narimi Miyazaki
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Tomoko Ohno
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Isao Koita
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Takaaki Kishino
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Emergency and Critical Care Medicine, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; University of Queensland Centre for Clinical Research, The University of Queensland, Royal Brisbane & Women's Hospital, Brisbane, QLD, Australia
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan
| | - Arufumi Shiota
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Koizumi Y, Sakanashi D, Ohno T, Nakamura A, Yamada A, Shibata Y, Shiota A, Kato H, Hagihara M, Asai N, Watarai M, Murotani K, Yamagishi Y, Suematsu H, Mikamo H. Plasma procalcitonin levels remain low at the onset of gram-positive bacteremia regardless of severity or the presence of shock: A retrospective analysis of patients with detailed clinical characteristics. J Microbiol Immunol Infect 2020; 54:1028-1037. [PMID: 32893142 DOI: 10.1016/j.jmii.2020.08.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 07/25/2020] [Accepted: 08/16/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Procalcitonin (PCT) is an early diagnosis marker of sepsis/bacteremia. However, some reports refer to its lower responsiveness to gram-positive bacteremia. We retrospectively evaluated the PCT values at the onset of bacteremia in relation to severity index. METHODS Patients with bacteremia caused by two gram-negative bacteria (46 E. coli and 50 Klebsiella pneumoniae) and three gram-positive bacteria (45 S. aureus, 56 S. epidermidis, and 10 S. mitis) were studied. The plasma PCT and C-reactive protein (CRP) levels were compared between species and different Sequential Organ Failure Assessment (SOFA) score groups. RESULTS The median PCT level was higher in gram-negative than in gram-positive bacteremia in overall (13.09 vs. 0.50 ng/mL, p < 0.0001), in SOFA score≥4 group (28.85 vs.1.72 ng/mL, p < 0.0001) and in SOFA<4 group (2.64 vs. 0.42 ng/mL, p < 0.0001). Only 46%, and 11% of patients showed PCT ≥0.5 ng/mL in S. epidermidis, and S. mitis bacteremia, respectively. PCT was significantly better than CRP in discriminating gram-negative from gram-positive bacteremia (AUCROC; 0.828 and 0.634, p < 0.001), but it was low in Staphylococcus epidermidis bacteremia regardless of SOFA scores. CONCLUSIONS PCT levels are lower in gram-positive bacteremia regardless of SOFA scores or the presence of shock. The conventional sepsis cutoff of 0.5 ng/mL may overlook certain proportions of gram-positive bacteremia.
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Affiliation(s)
- Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Wakayama Medical University, Japan.
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Tomoko Ohno
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuichi Shibata
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Masaya Watarai
- Department of Hematology, Aichi Medical University Hospital, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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Asai N, Sakanashi D, Nakamura A, Kishino T, Kato H, Hagihara M, Shiota A, Koizumi Y, Yamagishi Y, Mikamo H. Clinical manifestations and radiological features by chest computed tomographic findings of a novel coronavirus disease-19 pneumonia among 92 patients in Japan. J Microbiol Immunol Infect 2020; 54:748-751. [PMID: 32868193 PMCID: PMC7438216 DOI: 10.1016/j.jmii.2020.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/16/2020] [Accepted: 07/22/2020] [Indexed: 12/24/2022]
Abstract
Introduction The novel coronavirus disease (COVID-19) could cause a severe acute respiratory infectious disease, showing a high mortality rate of 12–45% among cases who required intensive care unit admission. COVID-19 pneumonia Patients and methods For the purpose of identifying clinical manifestations and radiological findings of COVID-19 pneumonia, we reviewed all cases of COVID-19 pneumonia which were published by the homepage of the Japanese Association for Infectious Diseases from Feb 5 2020 until April 30 2020, including our cases. All patients were diagnosed based on positive results of the novel coronavirus-real-time RT-PCR with chest computed tomography (CT) findings. Results A total of 92 patients were enrolled in this study. The median age was 66 years (range 16–92 years). For all, 50 (54%) were males. The most common underlying disease was hypertension in 32 (36%). Any comorbidity was seen in 60 (67%). The mortality rate was 4 (6%). In terms of clinical symptoms on an initial visit, fever and cough were confirmed in 66 (72%) and 37 (40%). Forty-three (47%) had no respiratory symptoms. As for radiological findings by chest CT scan, ground-glass opacities (GGO)s, peripheral distribution, bilateral lung involvements were seen in 88 (96%), 76 (83%) and 78 (85%), respectively. Conclusion It is difficult to diagnose as COVID-19 pneumonia due to poor respiratory symptoms. Chest CT findings typically show GGO, peripheral and bilateral shadows. Patients should have chest CT performed if suspected for early diagnosis and therapeutic intervention, resulting in a favorable outcome and prevention of secondary nosocomial transmitted infection.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Takaaki Kishino
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Emergency and Critical Care Medicine, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Asai N, Sakanashi D, Suematsu H, Kato H, Shiota A, Hagihara M, Koizumi Y, Yamagishi Y, Mikamo H. Observational study in a single institute in Japan: How many community-onset pneumonia patients would have Clostridioides difficile infections after treatment? J Infect Chemother 2020; 26:1104-1106. [PMID: 32713744 DOI: 10.1016/j.jiac.2020.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/28/2020] [Accepted: 03/10/2020] [Indexed: 01/05/2023]
Abstract
While community-onset pneumonia patients such as community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) have several risk factors of Clostridium difficile infection (CDI), prognostic guidelines for pneumonia never mention the occurrence of CDI following treatment for pneumonia. For the purpose of examining the occurrence and prevalence of CDI, we reviewed all community-onset pneumonia patients who were admitted to our institute during the study period. A total of 406 patients were enrolled in this study. Among them, 257 patients (63%) were male, and the median age was 79 years (range 19-103 years). Surprisingly, 155 CAP (88%) and all HCAP (100%) patients had one or more risk factors for CDI. Furthermore, 70 CAP (40%) and 157 HCAP (69%) patients had more than 3 risk factors for CDI. Despite these facts, probiotic medication for prevention of CDI were prescribed for 12 (7%) CAP and 15 (7%) HCAP patients as the initial treatment. Finally, 3% and 9% of CAP and HCAP patients had CDI after completing the treatment for pneumonia. Regarding the duration of antibiotic therapy, 146 CAP (82%) and 176 HCAP (77%) patients received it for longer than 8 days, even though bacteremia was not confirmed in those patients. In addition, 27 CAP (15%) and 26 HCAP (11%) patients received a combination antibiotic therapy as an initial treatment. They seemed to be unnecessary. Physicians should acknowledge community-onset pneumonia has several risk factors for CDI, and should avoid a longer than necessary antibiotic therapy and unnecessary combination antibiotic therapy for pneumonia patients with risk factors for CDI.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Koizumi Y, Sakanashi D, Mohri T, Watanabe H, Shiota A, Asai N, Kato H, Hagihara M, Murotani K, Yamagishi Y, Suematsu H, Mikamo H. Can presepsin uniformly respond to various pathogens? - an in vitro assay of new sepsis marker. BMC Immunol 2020; 21:33. [PMID: 32503419 PMCID: PMC7275309 DOI: 10.1186/s12865-020-00362-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Presepsin (soluble CD14 subtype) is a novel biomarker of sepsis used for early diagnosis. Originally, CD14 is known as the pattern recognition receptor for the lipopolysaccharide (LPS)/LBP complexes, and the diagnostic value of this molecule for gram-positive bacteria, which contain less amount of LPS, is uncertain. To confirm its effectiveness in the diagnosis of bacteremia caused by gram positive bacteria, and to evaluate the interspecies difference of presepsin production against various bacterial strains, we conducted an in vitro assay to evaluate presepsin levels in response to five Gram negative and four Gram positive bacteria. RESULTS Whole blood was yielded from five healthy volunteers and co-cultured with bacterial strains at 37 °C for 4 h. Twenty seven clinical isolates of nine species (E. coli, K. pneumoniae, E. cloacae, P. aeruginosa, S. maltophilia, S. aureus, S. pyogenes, B. cereus, and C. striatum) derived from blood cultures of non-neutropenic bacteremia patients were used. Culture supernatants were harvested and presepsin levels were measured. The presepsin level in the gram-negative bacteria 273 (218-352) pg/mL was significantly higher than in the gram-positive bacteria 200 (143-275) pg/mL (p = 0.0002). The presepsin levels were significantly lower in C. striatum, in comparison to other bacteria, and S. pyogenes showed similar results. And the presepsin levels in P. aeruginosa were significantly lower compared to E. cloacae, K. pneumoniae, and S. aureus. CONCLUSIONS Presepsin production can also be evoked by gram-positive bacteria, and interspecies differences of presepsin response may exist, which should be considered in the diagnosis of sepsis, especially in certain gram-positive bacteremia such as S. pyogenes or C. striatum.
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Affiliation(s)
- Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan. .,Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
| | - Daisuke Sakanashi
- Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Tetsuo Mohri
- Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.,Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Arufumi Shiota
- Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.,Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hideo Kato
- Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Mao Hagihara
- Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Kenta Murotani
- Biostatistics center, Graduate School of Medicine, Kurume University, Kurume, Fukuoka, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.,Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.,Department of Infection Control, Aichi Medical University Hospital, Nagakute, Aichi, Japan
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Hagihara M, Kato H, Uchida S, Yamashita R, Tanaka S, Sakanashi D, Shiota A, Asai N, Koizumi Y, Suematsu H, Yamagishi Y, Namiki N, Mikamo H. The First Report on Pharmacokinetic/Pharmacodynamic Study of Trimethoprim/Sulfamethoxazole against Staphylococcus aureus with a Neutropenic Murine Thigh Infection Model. Chemotherapy 2020; 64:224-232. [PMID: 32434196 DOI: 10.1159/000507540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/26/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION With an increase in the incidence of Staphylococcus aureus infections in the healthcare settings and in the community, trimethoprim/sulfamethoxazole (TMP/SMX) has been suggested as a convenient treatment option. However, the appropriate dosage regimen of TMP/SMX is unclear. OBJECTIVE This study aimed to examine the pharmacokinetics/pharmacodynamics (PK/PD) of TMP/SMX against S. aureus using a neutropenic murine thigh infection model. METHODS Five S. aureus isolates with TMP/SMX (1:5 fixed ratio) minimum inhibitory concentrations (MICs) of 0.032-64 μg/mL were tested. The antimicrobial efficacy of TMP/SMX (1-689 mg/kg/day: dose shown as SMX dosage) was calculated as the change in bacterial density after 24 h of treatment. The plasma concentrations of TMP/SMX were detected using high-performance liquid chromatography. RESULTS After TMP/SMX single dose (130 mg/kg), the half-life, area under the blood concentration curve (AUC0-∞), and the protein binding ratio of SMX were 1.5 h, 718.2 μg h/mL, and 73.0 ± 8.3%, respectively. The free AUC/MIC and free %time (%T) above the MIC of SMX were better correlated with the in vivo antimicrobial activity than Cmax/MIC (free AUC/MIC, R2 = 0.69; free %T > MIC, R2 = 0.71; free Cmax/MIC, R2 = 0.53). The distributed doses (2-3 times per day) of TMP/SMX (130, 260, and 390 mg/kg/day) showed higher antimicrobial activity than the single dosage. However, TMP/SMX did not show its antimicrobial activity at <100% free %T > MIC. CONCLUSIONS The TMP/SMX treatment demonstrated that the free AUC/MIC of SMX was the better predictor of the PK/PD index of TMP/SMX.
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Affiliation(s)
- Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan.,Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Shinya Uchida
- Department of Pharmacy Practice and Science, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Rieko Yamashita
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan
| | - Shimako Tanaka
- Department of Pharmacy Practice and Science, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Daisuke Sakanashi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Arufumi Shiota
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Noriyuki Namiki
- Department of Pharmacy Practice and Science, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan,
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Asai N, Sakanashi D, Suematsu H, Kato H, Hagihara M, Watanabe H, Shiota A, Koizumi Y, Yamagishi Y, Mikamo H. Clinical characteristics and relevance of coagulase-negative Staphylococci other than S. epidermidis by positive blood culture. J Microbiol Immunol Infect 2020; 54:632-638. [PMID: 32299785 DOI: 10.1016/j.jmii.2020.03.001] [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] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Staphylococci is the most commonly isolated bacteria in blood cultures (BC), and is mostly regarded as contamination. However, the clinical relevance and characteristics of CNS other than Staphylococcus epidermidis (Non-SE-CNS) is still unknown. METHODS For the purpose of clarifying the epidemiology and clinical significance of Non-Se-CNS infections, we retrospectively evaluated BC isolates of Non-Se-CNS at our institute from May 2013 to March 2017. Infections were defined as true bacteremia if (1) two or more positive BCs of the same species were present (or detection of the same species in another clinically relevant sample), (2) the patient had clinical symptoms as outlined in the Centers for Disease Control and Prevention's definition of primary blood stream infection8 and the symptoms or markers of inflammation (e.g., fever, symptoms, white cell counts, C-reactive protein, or procalcitonin) were improved after pathogen-directed therapy (e.g. either antibiotic therapy and/or removal of the foreign body in the case of catheter-related blood stream infections suspected) and (3) without any other infection. RESULTS During the period, 279 patients with BC positive for Non Se-CNS were identified. 44 patients were excluded, either due to missing data or multiple pathogens in the same BC. Among the remaining 235 patients, 67 (29%) were categorized as true bacteremia (n = 43) or possible infections (n = 24). Resistance rate to methicillin among Non-SE-CNS is about 60%, which is lower than those among S. epidermidis of 78%. CONCLUSION About 30% of Non-Se-CNS isolates were clinically relevant in our study. Antibiotic susceptibility of Non-SE-CNS is quite different than those of S. epidermidis.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Koizumi Y, Sakata M, Shiota A, Hagihara M, Asai N, Yamagishi Y, Mikamo H. The diagnostic ability of plasma Procalcitonin levels in Gram positive bacteremia. J Infect Public Health 2020. [DOI: 10.1016/j.jiph.2020.01.081] [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: 11/30/2022] Open
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Koizumi Y, Okuno T, Minamiguchi H, Hodohara K, Mikamo H, Andoh A. Survival of a case of Bacillus cereus meningitis with brain abscess presenting as immune reconstitution syndrome after febrile neutropenia - a case report and literature review. BMC Infect Dis 2020; 20:15. [PMID: 31906936 PMCID: PMC6945728 DOI: 10.1186/s12879-019-4753-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background Bacillus cereus sometimes causes central nervous system infection, especially in compromised hosts. In cases of meningitis arising during neutropenia, CSF abnormalities tend to be subtle and can be easily overlooked, and mortality rate is high. We report a survived case of B. cereus meningitis/brain abscess in severe neutropenia, presenting as immune reconstitution syndrome. Case presentation A 54-year-old Japanese female with acute myelogenous leukemia developed B. cereus bacteremia and meningitis during consolidation chemotherapy. At the onset, she presented with mild meningism. She had marked leukocytopenia (WBC <100/μL, neutrophils 0/μL) and lumbar puncture yielded only mild pleocytosis. She was transferred to intensive care unit, and meropenem, linezolid and vancomycin was started. With intensive therapy, she recovered and once became afebrile. On day 19, however, her fever, meningism and consciousness level dramatically worsened despite recovery of bone marrow function. The antimicrobial chemotherapy was continued and finally she was cured with no complications. Conclusions With early diagnosis and prompt initiation and of antibiotics, the case was successfully treated without any sequelae. It is important to remember that, even under optimal antimicrobial therapy, bone marrow recovery can cause transient reaggravation of the disease. In such cases, timely and appropriate evaluation should be done to make the clinical decision to change, continue, or intensify treatment.
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Affiliation(s)
- Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan. .,Department of Hematology, Shiga University of Medical Science, Otsu, Shiga, Japan.
| | - Takafumi Okuno
- Department of Hematology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Hitoshi Minamiguchi
- Department of Hematology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Keiko Hodohara
- Department of Hematology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Akira Andoh
- Department of Hematology, Shiga University of Medical Science, Otsu, Shiga, Japan
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Hagihara M, Kato H, Yamashita R, Soda M, Watanabe H, Sakanashi D, Shiota A, Asai N, Koizumi Y, Suematsu H, Yamagishi Y, Kitaichi K, Mikamo H. In vivo study assessed meropenem and amikacin combination therapy against carbapenem-resistant and carbapenemase-producing Enterobacteriaceae strains. J Infect Chemother 2020; 26:1-7. [DOI: 10.1016/j.jiac.2019.10.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/06/2019] [Accepted: 10/15/2019] [Indexed: 11/26/2022]
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Shibata Y, Hagihara M, Kato H, Asai N, Koizumi Y, Watarai M, Suematsu H, Yamagishi Y, Mikamo H. Relationship between cytopenia and gestational age in infants and neonates treated with linezolid therapy. J Infect Chemother 2020; 26:95-100. [DOI: 10.1016/j.jiac.2019.07.022] [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] [Received: 04/19/2019] [Revised: 07/10/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
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Ohno T, Suematsu H, Nakamura A, Kawamoto Y, Miyazaki N, Sakanashi D, Yamada A, Koita I, Watanabe H, Asai N, Koizumi Y, Yamagishi Y, Mikamo H. [Performance Evaluation of "BinaxNOW™ Streptococcus pneumoniae" Using Alere™ Reader]. Rinsho Biseibutshu Jinsoku Shindan Kenkyukai Shi 2019; 29:11-17. [PMID: 31856573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Streptococcus pneumoniae is one of the major bacterial pathogens of community-acquired pneumonia. Immunochromatographic assay tests are used to detect pneumococcal capsular antigen. In many cases, They can be read visually. The Alere™ reader (Reader), which was developed in October 2018 by Alere Medical Co., Ltd. (currently, Abbott Diagnostics Medical Co., Ltd.) for interpreting BinaxNOW™ Streptococcus pneumoniae test (BinaxNOW™), quickly displays the results of the immunochromatographic tests, objectively and accurately, as it was launched for the purpose of streamlining laboratory workflow. The performance of the reader was evaluated by using urine samples from 100 patients, who were ordered pneumococcal urine antigen test from September 2018 to February 2019 at our hospital. Of the 100 samples, 14 were visually positive and 19 were reader positive. All visually positive samples generated reader positive result. Because 1 of the 5 cases which indicated a negative visual determination and positive reader determination was a sample with strong viscosity and turbidity, it was retested after centrifugation at 3,000×g for 10 min, resulting in negative reader determination. In 2 cases, S. pneumoniae were detected in sputum gram stains and culture tests. 5 discrepant samples were all visually and reader positive after concentration by centrifugal ultrafiltration. A questionnaire about visual interpretation was conducted among 31 individuals, by using urine from day 0 to day 4 collected from the patients whose test result was visually negative, reader positive and sputum culture positive at day 0. As a result, the number of operators who determined visually positive was 0 on day 0 (0%), 16 on day 1 (51.6%), 13 on day 2 (41.9%), 2 on day 3 (6.5%), and 0 on day 4 (0%). There were individual differences in ability to interpret low level positive result visually. On the other hand, reader can remove individual differences among operators from the interpretation of BinaxNOW™ and interpret positive result earlier than visual interpretation. Therefore reader was considered to be useful tool in clinical settings.
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Affiliation(s)
- Tomoko Ohno
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Hiroyuki Suematsu
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Akiko Nakamura
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yuzuka Kawamoto
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Narimi Miyazaki
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Daisuke Sakanashi
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Atsuko Yamada
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Isao Koita
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Yuka Yamagishi
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan. Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
| | - Hiroshige Mikamo
- Division of Microbiological Laboratory, Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan. Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan
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Koizumi Y, Sakanashi D, Ohno T, Yamada A, Shiota A, Kato H, Hagihara M, Watanabe H, Asai N, Watarai M, Murotani K, Yamagishi Y, Suematsu H, Mikamo H. The clinical characteristics of Acinetobacter bacteremia differ among genomospecies: A hospital-based retrospective comparative analysis of genotypically identified strains. J Microbiol Immunol Infect 2019; 52:966-972. [PMID: 31813733 DOI: 10.1016/j.jmii.2019.09.007] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 09/21/2019] [Accepted: 09/30/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND/PURPOSE Acinetobacter is an aerobic, gram-negative coccobacillus, which causes nosocomial infections including bacteremia. Recent development of molecular techniques has made classification of the Acinetobacter genomospecies possible, but there are still only a few studies comparing clinical features of the subspecies. We investigated bacteremia caused by Acinetobacter, isolated subspecies, and compared clinical features for each group. METHODS A retrospective analysis of Acinetobacter bacteremia cases was made in a 900-bed hospital in Japan. In addition to conventional procedures, subspecies identification based on rpoB sequence was made, and comparison of clinical characteristics between each subspecies were analyzed. RESULTS We collected 35 cases (Acinetobacter baumannii 14, A. nosocomialis 12, Acinetobacter ursingii 6, and A. seifertii 3). All of the A. seifertii bacteremia cases were blood stream infection occurring in cerebrovascular disease patients, showing particularly higher incidence of shock (100%) and high Pitt bacteremia score (PBS) (6.33 ± 2.52) in comparison to A. baumannii (43% and 2.86 ± 2.25, respectively). Sequential Organ Failure Assessment (SOFA) score and the PBS were slightly higher in A. nosocomialis in comparison to A. baumannii, and the 7 day mortality rate was higher in A. nosocomialis (25%) than in A. baumannii (7%), though this difference was not found to be significant. CONCLUSIONS A.seifertii, the recently defined novel species, showed distinctive clinical features of bacteremia. And, in contrast to previous studies, the severity of A. nosocomialis infection was not lower than that of A. baumannii, which might suggest the influence of local epidemiology. Further characterization of these subspecies should be continued.
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Affiliation(s)
- Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Tomoko Ohno
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Masaya Watarai
- Department of Hematology, Aichi Medical University Hospital, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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Kato H, Hagihara M, Shibata Y, Asai N, Koizumi Y, Watarai M, Yamagishi Y, Mikamo H. Retrospective study on clinical efficacy and safety for daptomycin intermittent doses with or without loading dose in renal failure patients. J Infect Chemother 2019; 26:215-224. [PMID: 31575501 DOI: 10.1016/j.jiac.2019.09.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/09/2019] [Accepted: 09/08/2019] [Indexed: 11/26/2022]
Abstract
This retrospective study is to evaluate the efficacy and safety of daptomycin (DAP) intermittent doses and the effectiveness of DAP loading dose in renal failure patients received DAP intermittent doses. One hundred and ninety-seven patients received DAP for at least 3 days from 2014 to 2017. Clinical and microbiological outcomes and the safety were assessed. A total of 183 patients (93, 60 and 30 patients received DAP daily dose, every 48 h dose and thrice per week dose) were included. DAP intermittent doses, such as every 48 h dose (28.3%) and thrice per week dose (30.0%), showed significantly higher mortality rates than that of DAP daily dose (6.5%) (p = 0.0320). Especially for bacteremia patients, significantly higher mortality was admitted, compared with patients received DAP daily doses (p = 0.0160). Moreover, patients received DAP intermittent doses were admitted slower improvements of their inflammation after DAP therapy started, compared with patients received daily dose. Additionally, DAP loading dose for renal failure patients decreased their mortality and improved patients' inflammation early. Especially for patients received DAP thrice per week dose, they showed significantly lower mortality than patients received non-loading dose (p = 0.0306). Additionally, these clinical enhancements of DAP therapy with loading dose were admitted without any enhancements of its adverse effect risks, except alkaline phosphatase elevation, compared with non-loading dose. In conclusion, DAP intermittent doses showed poor clinical outcomes, compared with daily dose. Then, DAP loading dose would be better clinical option for patients received DAP intermittent doses.
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Affiliation(s)
- Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Japan
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Nobuhiro Asai
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Yusuke Koizumi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Masaya Watarai
- Division of Hematology Department of Internal Medicine, Aichi Medical University, Japan
| | - Yuka Yamagishi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Hiroshige Mikamo
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan.
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40
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Shiota A, Asai N, Koizumi Y, Watanabe H, Sakata M, Kurumiya A, Takahashi T, Muramatsu Y, Hagihara M, Suematsu H, Yamagishi Y, Mikamo H. Extended drip infusion of peripheral parental nutrition containing amino acids might be associated with Bacillus cereus bloodstream infection. Am J Infect Control 2019; 47:1154-1156. [PMID: 31047689 DOI: 10.1016/j.ajic.2019.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/25/2022]
Abstract
In some Japanese hospitals, patients using infusion bags for parenteral nutrition containing amino acids have developed Bacillus cereus bloodstream infections. We considered that proliferation of contaminated B cereus in the bag during prolonged drip infusion might be one of the causes of infection. This study indicated that 8 h is the maximum appropriate drip infusion time for peripheral parental nutrition containing amino acids to prevent B cereus bloodstream infections.
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Asai N, Sakanashi D, Suematsu H, Kato H, Watanabe H, Shiota A, Hagihara M, Koizumi Y, Yamagishi Y, Mikamo H. Clinical manifestations and risk factors of community-onset Acinetobacter species pneumonia in Japan; case control study in a single institute in Japan. J Infect Chemother 2019; 25:639-642. [DOI: 10.1016/j.jiac.2019.03.016] [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] [Received: 11/07/2018] [Revised: 03/12/2019] [Accepted: 03/18/2019] [Indexed: 10/26/2022]
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42
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Kato H, Hagihara M, Yokoyama Y, Suematsu H, Asai N, Koizumi Y, Yamagishi Y, Mikamo H. Comparison of the in Vivo Activities of Garenoxacin and Levofloxacin in a Murine Model of Pneumonia by Mixed-Infection with Streptococcus pneumoniae and Parvimonas micra. Jpn J Infect Dis 2019; 72:407-412. [PMID: 31366860 DOI: 10.7883/yoken.jjid.2019.109] [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: 11/17/2022]
Abstract
Community-acquired pneumonia (CAP) can involve mixed-species bacterial infection. However, few studies have investigated antimicrobial efficacy in the treatment of mixed species infections. This study aimed to compare the in vivo antimicrobial activity of garenoxacin (GRNX) and levofloxacin (LVFX) against Streptococcus pneumoniae and Parvimonas micra in a murine model of mixed species bacterial pneumonia. S. pneumoniae D-6888 and P. micra No. 242 were used in this study. Antimicrobial activity toward each isolate was calculated as the change in bacterial count in the lungs (Δlog10 CFU/mL) of mice after 24 h of treatment compared with the count in pretreated animals (0 h). The MICs of GRNX and LVFX against S. pneumoniae D-6888 were 0.06 and 0.5 mg/L and the MICs against P. micra No. 242 were 0.03 and 0.12 mg/L, respectively. In a murine pneumonia mixed-infection model, GRNX showed significantly higher in vivo antimicrobial activity against S. pneumoniae than LVFX (GRNX; -2.02 ± 0.99 log10 CFU/mL vs. LVFX; -0.97 ± 0.61 log10 CFU/mL, p = 0.0188). GRNX displayed about 2-fold more potent activity against P. micra than LVFX (GRNX; -1.12 ± 0.56 log10 CFU/mL vs. LVFX; -0.61 ± 0.43 log10 CFU/mL, p = 0.1029). These results suggest that GRNX is preferable for the treatment of mixed species bacterial CAP.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University.,Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University
| | - Yuki Yokoyama
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Hiroyuki Suematsu
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University
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Asai N, Shiota A, Ohashi W, Watanabe H, Shibata Y, Kato H, Sakanashi D, Hagihara M, Koizumi Y, Yamagishi Y, Suematsu H, Mikamo H. The SOFA score could predict the severity and prognosis of infective endocarditis. J Infect Chemother 2019; 25:965-971. [PMID: 31320197 DOI: 10.1016/j.jiac.2019.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 05/08/2019] [Accepted: 05/16/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Although infectious endocarditis (IE) is a potentially severe infectious disease, there are no prognostic tools for in-hospital mortality for IE patients. This is the first report documenting that the Sequential Organ Failure Assessment (SOFA) score could evaluate the severity and outcome among IE patients. PATIENTS AND METHODS From 2007 to 2018, we reviewed all patients who were diagnosed as having IE at our institue. Patients diagnosed as definite IE according to the modified Duke criteria or by surgical procedure were included in this study. RESULTS A total of 66 IE patients were enrolled in this study. They were 45 males (68%) and the median age was 70 years. As for prognostic factors for in-hospital death among IE patients, SOFA score ≥6, CCI ≥3, surgical procedure, heart failure, immunological phenomena and detection of S. aureus as a causative pathogen were identified as prognostic factors by univariate analysis. Of these 6 factors, SOFA score ≥6 (OR 7.6, 95%CI 1.3-46.6, p = 0.029), heart failure (OR 9.7, 95%CI 1.1-86.1, p = 0.042), surgery (OR 0.1, 95%CI 0-0.8, p = 0.037) and immunological phenomena (OR 0.1, 95%CI 0-0.9, p = 0.042) were independent prognostic factors for in-hospital mortality among IE by logistic regression analysis. CONCLUSION The SOFA score could be a good prognostic tool to use for IE patients. Also, SOFA score ≥6, surgery, immunological phenomena and heart failure were independent prognostic factors for in-hospital mortality among IE patients.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuichi Shibata
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Asai N, Watanabe H, Shiota A, Kato H, Sakanashi D, Hagihara M, Koizumi Y, Yamagishi Y, Suematsu H, Mikamo H. Efficacy and accuracy of qSOFA and SOFA scores as prognostic tools for community-acquired and healthcare-associated pneumonia. Int J Infect Dis 2019; 84:89-96. [DOI: 10.1016/j.ijid.2019.04.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/14/2019] [Accepted: 04/18/2019] [Indexed: 12/30/2022] Open
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Asai N, Sakanashi D, Suematsu H, Nishiyama N, Watanabe H, Kato H, Shiota A, Hagihara M, Koizumi Y, Yamagishi Y, Mikamo H. Infective endocarditis caused by Cardiobacterium hominis endocarditis: A case report and review of the literature. J Infect Chemother 2019; 25:626-629. [PMID: 31043327 DOI: 10.1016/j.jiac.2019.02.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/16/2019] [Accepted: 02/01/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND While it has been increasing cases of C. hominis endocarditis in the past decades due to advances of diagnostic methods, the epidemiology and clinical manifestations of IE caused by C. hominis is still unknown. CASE PRESENTATION A 62-year old man was admitted to our institute with fever, anorexia and general fatigue for the preceding one month. He had a past medical history of both aortic and mitral valves replacement due to cardiac diseases. He was diagnosed as IE caused by C. hominis according to the modified duke criteria. The patient received 2 weeks of combination therapy of intravenous ceftriaxone (CTRX) 2g and gentamycin 180mg daily followed by 4 weeks CTRX 2g daily alone. Oral moxifloxacin 400mg once daily was given for an additional 4 weeks. After the antibiotic therapy was discontinued, disease recurrence was not observed. We reviewed previously reported C. hominis IE cases in 60 publications including ours. Of 73 patients enrolled, 53 were male, the mean age was 52 years. The most common risk factor of IE was past history of cardiac diseases in 44/73 (60%). As for antibiotics initially prescribed, third-generation cephalosporins was most frequently used in 28/69 (41%). While the cure rate was 67/73 (93%), 31/73 patients (43%) received a surgical intervention. Embolic lesions to the central nervous system and vertebrae were seen in 16/72 (22%) and 5/72 (7%). CONCLUSION IE caused by C. hominis has a favorable prognosis, showing the cure rate of 93%. Physicians should recognize the possible occurrence of emboli among IE patients.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Naoya Nishiyama
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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Asai N, Suematsu H, Yamada A, Watanabe H, Nishiyama N, Sakanashi D, Kato H, Shiota A, Hagihara M, Koizumi Y, Yamagishi Y, Mikamo H. Brevibacterium paucivorans bacteremia: case report and review of the literature. BMC Infect Dis 2019; 19:344. [PMID: 31023246 PMCID: PMC6485150 DOI: 10.1186/s12879-019-3962-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 05/02/2018] [Accepted: 04/08/2019] [Indexed: 11/10/2022] Open
Abstract
Background Brevibacteria are obligate aerobic gram-positive rods that are associated with milk products and are also found on human skin. Brevibacterium has been reported as a rare cause of catheter related blood steam infection mainly in immunocompromised hosts such as malignancies or AIDS patients. Case presentation A 94-year old woman, which had a past history of diabetes mellitus and chronic heart failure, presented with high fever associated with decreased oral intake and appetite loss and was admitted to our institute. A physical examination at the time of presentation was unremarkable. On day 2, both blood cultures collected on admission became positive with coryneform organism within 24 h without Staphylococci and Brevibacterium species were identified by Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Subsequently, genetic investigation by 16S ribosomal RNA analysis was performed in order to identify the organism. Finally, the result identified this pathogen as Brevibacterium paucivorans with 99.5% homology on the Ez taxon database. The patient was started empirically on meropenem and teicoplanin for broad-spectrum antibiotic coverage. The patient’s fever finally abated and labs were also improved. On day 14, the antibiotic therapy was discontinued. The site of infections was unknown. We hereby report a case of Brevibacterium paicivorans bacteremia in an immunocompetent patient and review cases of Brevibacterium specises bacteremia previously reported. This is the first case of B. paucivorans bacteremia as far as we could search. Conclusion Physicians and microbiologists should be aware that Brevibacteria are uncommon but important agents which could cause opportunistic infections in immunocompetent.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, ₸480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, ₸480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Naoya Nishiyama
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, ₸480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, ₸480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, ₸480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, ₸480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan. .,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Japan.
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47
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Koizumi Y, Kachi A, Tsuboi K, Muto J, Watanabe H, Asai N, Nobata H, Shiota A, Kato H, Sakanashi D, Hagihara M, Yamagishi Y, Suematsu H, Banno S, Mikamo H. Clostridioides difficile-related toxic megacolon after Cryptococcus neoformans cellulitis: A complex of two rare infections in an immunocompromised host. J Infect Chemother 2019; 25:379-384. [PMID: 30797689 DOI: 10.1016/j.jiac.2018.12.003] [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: 04/15/2018] [Revised: 10/22/2018] [Accepted: 12/06/2018] [Indexed: 01/05/2023]
Abstract
A 76-year-old Japanese woman was admitted due to uncontrolled cellulitis of the right lower leg. She had deep vein thrombosis on the right limb. Moreover, she had a long history of rheumatoid arthritis treated with corticosteroids. Skin biopsy and lumbar puncture were performed to diagnose disseminated cryptococcosis. She was administered antifungal agents (liposomal amphotericin B and 5-fluorocytosine). On treatment day 14, debridement was performed, and cryptococcosis was controlled. However, she developed toxic megacolon due to Clostridioides difficile infection (CDI). On day 32, she was transferred to the intensive care unit due to severe acidosis and acute kidney injury secondary to CDI-related toxic megacolon. Vancomycin, metronidazole, and tigecycline were administered for treatment of CDI. After several weeks of intensive care, toxic megacolon was improved, but renal replacement therapy was discontinued according to the patient's will. On day 73, she died of renal failure. We experienced a complex of rare diseases, Cryptococcus neoformans cellulitis and Clostridioides difficile-related toxic megacolon. Both diseases were presumed to be the result of corticosteroid and methotrexate use. Hence, careful monitoring is required when treating immunocompromised hosts to reduce the risk of developing complications.
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Affiliation(s)
- Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Asako Kachi
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Kenji Tsuboi
- Department of Plastic Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Jun Muto
- Department of Dermatology, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hironobu Nobata
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Mao Hagihara
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Shogo Banno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
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48
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Sakanashi D, Miyazaki N, Kawamoto Y, Ohno T, Yamada A, Koita I, Suematsu H, Hagihara M, Asai N, Koizumi Y, Yamagishi Y, Mikamo H. A novel disk-based detection method with superior sensitivity for β-lactamase production in third-generation cephalosporin-resistant Enterobacteriaceae. J Infect Chemother 2019; 25:330-336. [PMID: 30797690 DOI: 10.1016/j.jiac.2018.12.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/18/2018] [Accepted: 12/21/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Current phenotypic methods for extended-spectrum β-lactamase (ESBL), AmpC β-lactamase (AmpC), and carbapenemases fail to detect isolates that co-produce other classes of β-lactamases. In this study, we have developed a novel assay (Applied Multiplex Disk Method: AMU-DM) for the phenotypic detection and identification of β-lactamases produced by Enterobacteriaceae. METHODS We evaluated the performance of the method by comparison with PCR results for 78 Enterobacteriaceae clinical isolates that were positive by the ESBL screening test and negative by the ESBL confirmation test. Additionally, one NCTC strain and four ATCC strains were also included in the test population for the study as reference. RESULTS For 79/83 (95%) isolates tested, the AMU-DM results matched those obtained by PCR. The concordance rates were 31/31 (100%), 11/11 (100%), 3/3 (100%), 0/1 (0%), 15/15 (100%), 16/19 (84%), and 3/3 (100%) for AmpC, ESBL and AmpC co-production, Klebsiella pneumoniae carbapenemase (KPC), KPC and ESBL co-production, metallo β-lactamase (MBL), MBL and ESBL co-production, and MBL and AmpC co-production, respectively. CONCLUSION The AMU-DM is convenient to perform, economical, and highly sensitive in identifying ESBLs, AmpCs, and carbapenemases. Our method may be useful in clinical settings for the implementation of relevant infection control measures and for surveillance purposes.
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Affiliation(s)
- Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Narimi Miyazaki
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Yuzuka Kawamoto
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Tomoko Ohno
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Isao Koita
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Japan
| | - Nobuhiro Asai
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Yusuke Koizumi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan.
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Asai N, Koizumi Y, Yamada A, Sakanashi D, Watanabe H, Kato H, Shiota A, Hagihara M, Suematsu H, Yamagishi Y, Mikamo H. Pantoea dispersa bacteremia in an immunocompetent patient: a case report and review of the literature. J Med Case Rep 2019; 13:33. [PMID: 30755259 PMCID: PMC6373044 DOI: 10.1186/s13256-019-1969-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 03/27/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022] Open
Abstract
Background Pantoea is a Gram-negative, non-encapsulated, non-spore-forming, ubiquitous straight rod which can be isolated from geographical and ecological sources such as plant surfaces, buckwheat seeds, human feces, and the environment. The genus Pantoea is a rare pathogen in a clinical setting, and is divided into 20 different species such as Pantoea agglomerans, Pantoea ananatis, Pantoea deleyi, Pantoea dispersa, Pantoea septica, Pantoea stewartii or Pantoea rwandensis. Pantoea dispersa has been reported to cause other infections, including respiratory infections, neonatal sepsis, and bloodstream infections. We report a case of Pantoea dispersa bacteremia caused by acute cholangitis. This is the first case report of Pantoea dispersa bacteremia caused by acute cholangitis as far as we had searched. Case presentation A 38-year-old Japanese woman suffered from acute cholangitis; a blood culture showed that Gram-negative rod was positive. The treatment was successful with intravenously administered meropenem, and it was switched to orally administered levofloxacin according to microbiological susceptibility. The organism was identified as Pantoea dispersa by both genetic investigation by 16S ribosomal RNA and additional biochemical tests. To the best of our knowledge, this is the first case report of Pantoea dispersa bacteremia caused by acute cholangitis. Conclusion The epidemiology and clinical features of Pantoea dispersa are still unknown. More cases of infections caused by Pantoea dispersa might be revealed with advancing technical methods, such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry or 16S ribosomal RNA analysis. Physicians must know that a variety of infections caused by Pantoea dispersa could occur in immunocompromised as well as immunocompetent patients.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan. .,Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
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50
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Asai N, Suematsu H, Sakanashi D, Kato H, Hagihara M, Watanabe H, Shiota A, Koizumi Y, Yamagishi Y, Mikamo H. A severe case of Streptococcal pyogenes empyema following influenza A infection. BMC Pulm Med 2019; 19:25. [PMID: 30691434 PMCID: PMC6350381 DOI: 10.1186/s12890-019-0787-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Any immunological mechanisms induced by influenza virus could cause severe secondary bacterial superinfection such as those by Streptococcus pyogenes [group A streptococcus (GAS)], Streptococcus pneumoniae or Staphylococcus aureus. Over recent years, the frequency of pleural empyema has increased in children with influenza infection. We present a severe case of acute empyema caused by S.pyogenes after influenza A infection. CASE PRESENTATION A previously healthy 39-year old woman was diagnosed as influenza A and received oral Oseltamivir 75 mg twice daily for 5 days. She had no vaccination of influenza A. Although her influenza A infection improved, she complained of fever and cough to our institute. Chest radiography showed encapsulated pleural effusion of the left lung and pleural effusion which was consistent with acute empyema. Then, she was diagnosed as having acute empyema and was admitted to our institute. Streptococcus pyogenes was identified by pleural fluid culture on day 4. thus, MNZ was changed to clindamycin (CLDM) 600 mg three times a day. While thoracic drainage with intrapleural urokinase and combination antibiotic therapy of ceftriaxone and CLDM were performed, her general condition and chest radiographic findings were not improved. She received video-assisted thoracic debridement on day 10. After the operation, the antibiotic therapy was changed to ABPC 6 g daily iv. Due to good clinical course, the antibiotic therapy was switched to oral amoxicillin 500 mg three times daily on day 28. Then, she was discharged. CONCLUSION Influenza A virus infection could lead to severe GAS infection, while the latter can occur in otherwise healthy individual as well. Physician must consider the possibility of severe GAS infection after influenza A infection.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.,Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan. .,Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, 480-1195, Aichi, Japan.
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