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Hamasuna R, You CL, Fukuda K, Fujimoto N, Hachisuga T, Matsumoto T, Taniguchi H. P05.12 Analysis of bacterial flora of the urine specimens from male patients with urethritis by the clone library method based on the 16s rrna gene. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hamasuna R, Yasuda M, Ishikawa K, Uehara S, Hayami H, Takahashi S, Matsumoto T, Yamamoto S, Minamitani S, Watanabe A, Iwata S, Kaku M, Kadota J, Sunakawa K, Sato J, Hanaki H, Tsukamoto T, Kiyota H, Egawa S, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Kobayashi K, Matsubara A, Naito S, Kuroiwa K, Hirayama H, Narita H, Hosobe T, Ito S, Ito K, Kawai S, Ito M, Chokyu H, Matsumura M, Yoshioka M, Uno S, Monden K, Takayama K, Kaji S, Kawahara M, Sumii T, Kadena H, Yamaguchi T, Maeda S, Nishi S, Nishimura H, Shirane T, Yoh M, Akiyama K, Imai T, Kano M. The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013. J Infect Chemother 2015; 21:340-5. [PMID: 25727286 DOI: 10.1016/j.jiac.2015.01.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/15/2015] [Accepted: 01/20/2015] [Indexed: 11/20/2022]
Abstract
Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 μg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 μg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 μg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 μg/ml.
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Hamasuna R, Takahashi S, Nagae H, Kubo T, Yamamoto S, Arakawa S, Matsumoto T. Obstructive pyelonephritis as a result of urolithiasis in Japan: diagnosis, treatment and prognosis. Int J Urol 2014; 22:294-300. [PMID: 25400222 DOI: 10.1111/iju.12666] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 10/01/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To study the current scenario of diagnosis, treatment and mortality of obstructive pyelonephritis secondary to urolithiasis in Japan. METHODS The study was a retrospective and multicenter survey for hospitalized patients with obstructive pyelonephritis as a result of urolithiasis in educational facilities for specialists by the Japanese Urological Association. Patients' characteristics including physical or laboratory examinations, treatment and prognosis were recorded, and the risk factors for disease death were analyzed. RESULTS A total of 1363 patients from 208 hospitals were analyzed. The median age of patients was 68 years, and there were 2.2-fold more female patients than male patients. From 844 patients, 891 species of bacteria or fungi were isolated, and Gram-negative rods accounted for 76.5% of cases. The mortality of patients was 2.3%. The risk factors related to disease death by univariate analysis were identified as older age, solitary kidney, ambulance use to visit hospital, disturbance of consciousness, severe appetite loss, higher performance status, disseminated intravascular coagulation status or systemic inflammatory response syndrome, vasopressors and anti-disseminated intravascular coagulation therapies, increased pulse rates, lower hemoglobin, lower serum albumin, and high blood urea nitrogen values. The predictive risk factors for disease death of patients' status at hospitalization were age over 80 years, systemic inflammatory response syndrome, disseminated intravascular coagulation status, disturbance of consciousness and solitary kidney by multivariate analysis. CONCLUSIONS Obstructive pyelonephritis as a result of urolithiasis represents an emergent disease in the urological field with relatively high mortality. Patients with older age or poor conditions should be hospitalized, and intervention by a urology specialist is likely to be required.
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Togo Y, Kubo T, Taoka R, Hiyama Y, Uehara T, Hashimoto J, Kurimura Y, Takahashi S, Tsukamoto T, Miyazaki J, Nishiyama H, Kira S, Kiyota H, Yazawa S, Niwa N, Hongo H, Oya M, Kato T, Yasuda M, Deguchi T, Ishikawa K, Hoshinaga K, Matsumoto M, Shigemura K, Tanaka K, Arakawa S, Fujisawa M, Wada K, Uehara S, Watanabe T, Kumon H, Kobayashi K, Matsubara A, Matsumoto M, Sho T, Hamasuna R, Matsumoto T, Hayami H, Nakagawa M, Yamamoto S. Corrigendum to “Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) – A multi-center retrospective study” [J Infect Chemother 20 (2014) 232–237]. J Infect Chemother 2014. [DOI: 10.1016/j.jiac.2014.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Yasuda M, Nakane K, Yamada Y, Matsumoto M, Sho T, Matsumoto M, Kobayashi K, Shigemura K, Nakano Y, Tanaka K, Hamasuna R, Ishihara S, Arakawa S, Yamamoto S, Matsubara A, Fujisawa M, Deguchi T, Matsumoto T. Clinical effectiveness and safety of tazobactam/piperacillin 4.5 g for the prevention of febrile infectious complication after prostate biopsy. J Infect Chemother 2014; 20:631-4. [PMID: 25043444 DOI: 10.1016/j.jiac.2014.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 06/10/2014] [Accepted: 06/24/2014] [Indexed: 11/26/2022]
Abstract
We investigated the clinical effectiveness and safety of tazobactam/piperacillin (TAZ/PIPC) in a 1:8 ratio, a β-lactamase inhibitor with penicillin antibiotic, for the prevention of febrile infectious complication after prostate biopsy. Each patient received a single dose of TAZ/PIPC 4.5 g, 30 min before the biopsy in Group 1 or TAZ/PIPC 4.5 g twice, once 30 min before and once after the biopsy (just before discharge or 5 h after the biopsy), in Group 2. Estimation of efficacy was performed within 1-month after prostate biopsy. Clinical diagnosis of febrile infectious complication was based on a body temperature elevation greater than 38 °C. Infectious complication after prostate biopsy was detected in 2.5% (4/160 patients) in Group 1 and in 0.45% (2/442 patients) in Group 2. All of the patients with febrile infectious complication had risk factors: 5 patients had voiding disturbance, 2 patients had diabetes mellitus and 1 patient had steroid dosing. In group 1, 88 patients had at least one risk factor and 72 patients had no risk factors. Of the patients with a risk factor, 4 had febrile infectious complication after prostate biopsy, but there was no significant difference between the two groups. In group 2, 87 patients had at least one risk factor and 255 patients had no risk factors. The patients with a risk factor had febrile infectious complication significantly more frequently than did patients without a risk factor (P = 0.038). Therefore, TAZ/PIPC appears to be effective as preoperative prophylaxis against the occurrence of febrile infectious complication after prostate biopsy.
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Nakane K, Yasuda M, Deguchi T, Takahashi S, Tanaka K, Hayami H, Hamasuna R, Yamamoto S, Arakawa S, Matsumoto T. Nationwide survey of urogenital tuberculosis in Japan. Int J Urol 2014; 21:1171-7. [PMID: 25040540 DOI: 10.1111/iju.12549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 05/29/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine current epidemiology and treatment patterns of urogenital tuberculosis in Japan. METHODS A questionnaire was sent to the urological departments of 1203 Japanese hospitals. Clinical data was reviewed retrospectively; no time range was specified. RESULTS Of the 1203 hospitals, 399 returned questionnaires with information about 355 urogenital tuberculosis patients. Of the 399, 153 institutions reported at least one patient, and 201 patients were identified between 2000 and 2007. Infections were located in the kidneys (n = 242), ureter (n = 96), bladder (n = 100), epididymis or testes (n = 81) and prostate (n = 9). CONCLUSIONS Urogenital tuberculosis is rare in Japan, but patients do exist, and we should not ignore them.
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Togo Y, Kubo T, Taoka R, Hiyama Y, Uehara T, Hashimoto J, Kurimura Y, Takahashi S, Tsukamoto T, Miyazaki J, Nishiyama H, Kira S, Kiyota H, Yazawa S, Niwa N, Hongo H, Oya M, Kato T, Yasuda M, Deguchi T, Ishikawa K, Hoshinaga K, Matsumoto M, Shigemura K, Tanaka K, Arakawa S, Fujisawa M, Wada K, Uehara S, Watanabe T, Kumon H, Kobayashi K, Matsubara A, Matsumoto M, Sho T, Hamasuna R, Matsumoto T, Hayami H, Nakagawa M, Yamamoto S. Occurrence of infection following prostate biopsy procedures in Japan. J Infect Chemother 2014; 20:232-7. [DOI: 10.1016/j.jiac.2013.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/01/2013] [Accepted: 10/03/2013] [Indexed: 11/28/2022]
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Hamasuna R, Tanaka K, Hayami H, Yasuda M, Takahashi S, Kobayashi K, Kiyota H, Yamamoto S, Arakawa S, Matsumoto T. Treatment of acute uncomplicated cystitis with faropenem for 3 days versus 7 days: multicentre, randomized, open-label, controlled trial. J Antimicrob Chemother 2014; 69:1675-80. [PMID: 24508899 DOI: 10.1093/jac/dku014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The increasing prevalence of resistant bacteria such as fluoroquinolone-resistant or extended-spectrum β-lactamase-producing strains in pathogens causing acute uncomplicated cystitis has been of concern in Japan. Faropenem sodium is a penem antimicrobial that demonstrates a wide antimicrobial spectrum against both aerobic and anaerobic bacteria. It is stable against a number of β-lactamases. METHODS We compared 3 and 7 day administration regimens of faropenem in a multicentre, randomized, open-label, controlled study. RESULTS In total, 200 female patients with cystitis were enrolled and randomized into 3 day (N = 97) or 7 day (N = 103) treatment groups. At the first visit, 161 bacterial strains were isolated from 154 participants, and Escherichia coli accounted for 73.9% (119/161) of bacterial strains. At 5-9 days after the completion of treatment, 73 and 81 patients from the 3 day and 7 day groups, respectively, were evaluated by intention-to-treat analysis; the microbiological efficacies were 58.9% eradication (43/73), 20.5% persistence (15/73) and 8.2% replaced (6/73), and 66.7% eradication (54/81), 6.2% persistence (5/81) and 7.4% replaced (6/81), respectively (P = 0.048). The clinical efficacies were 76.7% (56/73) and 80.2% (65/81), respectively (P = 0.695). Adverse events due to faropenem were reported in 9.5% of participants (19/200), and the most common adverse event was diarrhoea. CONCLUSIONS The 7 day regimen showed a superior rate of microbiological response. E. coli strains were in general susceptible to faropenem, including fluoroquinolone- and cephalosporin-resistant strains.
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Wakeda H, Hamasuna R, Asada Y, Kamoto T. Superior vena cava syndrome due to metastasis from urothelial cancer: A case report and literature review. Urol Ann 2013; 5:291-3. [PMID: 24311914 PMCID: PMC3835992 DOI: 10.4103/0974-7796.120313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 07/21/2012] [Indexed: 12/04/2022] Open
Abstract
Superior vena cava (SVC) syndrome is caused by compression or obstruction of the SVC. We report here in a case of SVC syndrome due to lymph node metastasis from urothelial cancer to the mediastinum and lung. The origin of metastasis was determined by computed tomography (CT)-guided biopsy of metastases. After radiotherapy to the mediastinum with glucocorticoid failed, anticancer pharmacotherapy including paclitaxel, gemicitabine, and cisplatin proved effective and SVC syndrome resolved. But patient died from cerebral bleeding from newer brain metastases 10 months later.
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Hamasuna R, Kawai S, Ando Y, Ito K, Kurashima M, Nishimura H, Yamaguchi T, Yoshimura M, Kobayashi T, Muratani T, Matsumoto T. [Usefulness of real-time PCR in detecting Chlamydia trachomatis and Neisseria gonorrhoeae in endocervical swabs and first-voided urine specimens]. KANSENSHOGAKU ZASSHI. THE JOURNAL OF THE JAPANESE ASSOCIATION FOR INFECTIOUS DISEASES 2013; 87:17-23. [PMID: 24475696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We evaluated performance of Abbott RealTime CT/NG assay (real-time PCR, Abbott Japan) for detect Chlamydia trachomatis and Neisseria gonorrhoeae by real-time PCR in 88 female patients with cervicitis symptoms seen at gynecological clinics and 100 male patients with urethritis symptoms seen at urological or dermatology clinics in Kitakyushu, Japan. Endocervical swab and first-voided urine (FVU) specimens were then collected from women and FVU specimens from men. Detection rates of C. trachomatis and N. gonorrhoeae by real-time PCR in the 3 types of specimens were compared to those by ProbeTec ET assay (ProbeTec, BD Diagnostic System). The overall positive concordance between real-time PCR and ProbTec were 97.1% (66/68) for C. trachomatis and 100% (33/33) for N. gonorrhoeae, C. trachomatis detection yielded 3 discordant results in endocervical specimens and 1 discordant result in male FVU by real-time PCR and ProbTec. Three of 4 reexamined using Aptime Combo 2 Assay (Fuji Rebio Inc.) were positive for C. trachomatis. Endocervical swab and FVU specimen results for C. trachomatis were discordant in 3 cases in real-time PCR and 4 in ProbeTec. Subjects with 2 or more positive endocervical awab results in female or male FVU specimens were assumed to be "true positive" for C. trachomatis. The sensitivities of real-time PCR for detecting C. trachomatis was 94.4% in endocervical swabs, 77.8% in female FVU and 97.4% in the male FVU. The sensitivities for real-time PCR for detectig N. gonorrhoeae was 100% in all 3 specimen types. Abbott RealTime CT/NG assay was useful for detecting C. trachomatis using endocervical swabs or male FVU specimens and for detecting N. gonorrhoeae using endocervical swabs and all FVU specimens.
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Hamasuna R, Sho T, Matsumoto M, Matsumoto T. P1.017 Unique Activity of Sitafloxacin, One of Newer Fluoroquinolones, Against Ciprofloxacin-Resistant N. Gonorrhoeae. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Takahashi S, Matsumoto T, Yamamoto S, Ishikawa K, Uehara S, Hamasuna R, Yasuda M, Hayami H, Hanaki H, Kadota J. P2.085 The Current Antimicrobial Susceptibility in Chlamydia Trachomatis in Japan from the Nationwide Surveillance. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hamasuna R, Yasuda M, Ishikawa K, Uehara S, Takahashi S, Hayami H, Yamamoto S, Matsumoto T, Hanaki H, Kadota J. P2.081 Antimicrobial Susceptibilities of Neisseria GonorrhoeaeStrains from Male Urethritis in Japan -the First National Surveillance. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Takahashi S, Hamasuna R, Yasuda M, Ito S, Deguchi T, Matsumoto T. P2.100 Clinical Efficacy of Sitafloxacin 100Mg Twice Daily For 7 Days For Patients with Non-Gonococcal Urethritis. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nishii H, Hamasuna R, Sho T, Matsumoto M, Nakamura H, Tomisaki I, Terado M, Yoshida T, Hamasaki T, Fujimoto N, Matsumoto T. P337 Tazobactam/piperacillin 4.5 g twice a day was effective as antimicrobial prophylaxis for the transrectal prostate biopsy. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70578-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hamasuna R, Sho T, Matsumoto M, Matsumoto T. P93 Antimicrobial activity of sitafloxacin against fluoroquinolone-resistant Neisseria gonorrhoeae. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70338-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Togo Y, Yasuda M, Miyazaki J, Takahashi S, Hayami H, Tanaka K, Ishikawa K, Hamasuna R, Yamamoto S, Kiyota H, Arakawa S, Matsumoto T. P229 Incidence of infection following a prostate biopsy in Japan – a multi-center retrospective study. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sho T, Hamasuna R, Honda M, Muratani T, Fujimoto N, Mukae H, Matsumoto T. P268 Trends in species distribution and antifungal susceptibilities of Candida species isolated from urine at the University Hospital. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ishikawa K, Hamasuna R, Yasuda M, Uehara S, Takahashi S, Hayami H, Yamamoto S, Matsumoto T, Watanabe A, Iwamoto A, Sunagawa K, Kadota J. P63 The second nationwide surveillance of bacterial urinary pathogens for complicated urinary tract infection conducted by JSC, JAID and JSCM. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70308-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hamasuna R. SP6-1 Pathogenicity of Mycoplasma genitalium in men. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70144-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hayami H, Takahashi S, Kiyota H, Ishikawa K, Yasuda M, Arakawa S, Yamamoto S, Uehara S, Hamasuna R, Matsumoto T, Hanaki H, Kadota J. P62 Nationwide surveillance of bacterial pathogens from patients with acute uncomplicated cystitis in Japan. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70307-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Hamasuna R. Mycoplasma genitaliumin male urethritis: Diagnosis and treatment in Japan. Int J Urol 2013; 20:676-84. [DOI: 10.1111/iju.12152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 03/05/2013] [Indexed: 11/30/2022]
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Sho T, Muratani T, Hamasuna R, Yakushiji H, Fujimoto N, Matsumoto T. The mechanism of high-level carbapenem resistance in Klebsiella pneumoniae: underlying Ompk36-deficient strains represent a threat of emerging high-level carbapenem-resistant K. pneumoniae with IMP-1 β-lactamase production in Japan. Microb Drug Resist 2013; 19:274-81. [PMID: 23514607 DOI: 10.1089/mdr.2012.0248] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The mechanisms of high-level carbapenem resistance in Klebsiella pneumoniae isolated in Japan were investigated. High-level carbapenem-resistant K. pneumoniae Mkp4437 and a less carbapenem-sensitive K. pneumoniae strain, Mkp4365, were recovered from the same patient. These two strains were found to be homologous by pulsed-field gel electrophoresis, and both strains contained blaIMP-1, blaDHA-1, blaCTXM-14, blaTEM-1, and blaSHV-1. Based on the sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis, the lack of Ompk36 was observed in Mkp4437. Direct sequencing of the ompK36 gene demonstrated that a new insertional sequence in the open reading frame of the ompK36 gene was found in Mkp4437. Three clinical isolates (minimum inhibitory concentration [MIC] 2-4 mg/L to imipenem) were identified upon screening the strains of K. pneumoniae isolated in the University hospital with MICs of ≥ 1 mg/L to imipenem. Interestingly, these three isolates all lacked OmpK36. Conjugation of the plasmid harboring IMP-1 to these three OmpK36-deficient strains led to the isolation of high-level carbapenem-resistant transconjugants. In conclusion, the mechanisms of high-level carbapenem resistance in K. pneumoniae entail not only the production of IMP-1 β-lactamase but also the lack of OmpK36. It is vital to monitor for the presence of less carbapenem-sensitive K. pneumoniae strains, which lack OmpK36, because blaIMP-1 transmission to these strains may result in isolates with a high-level carbapenem-resistant phenotype.
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Hayami H, Takahashi S, Ishikawa K, Yasuda M, Yamamoto S, Uehara S, Hamasuna R, Matsumoto T, Minamitani S, Watanabe A, Iwamoto A, Totsuka K, Kadota J, Sunakawa K, Sato J, Hanaki H, Tsukamoto T, Kiyota H, Egawa S, Kimura T, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Kobayashi K, Matsubara A, Naito S, Tatsugami K, Yamaguchi T, Ito S, Kanokogi M, Narita H, Kawano H, Hosobe T, Takayama K, Sumii T, Fujii A, Sato T, Yamauchi T, Izumitani M, Chokyu H, Ihara H, Akiyama K, Yoshioka M, Uno S, Monden K, Kano M, Kaji S, Kawai S, Ito K, Inatomi H, Nishimura H, Ikuyama T, Nishi S, Takahashi K, Kawano Y, Ishihara S, Tsuneyoshi K, Matsushita S, Yamane T, Hirose T, Fujihiro S, Endo K, Oka Y, Takeyama K, Uemura T. Nationwide surveillance of bacterial pathogens from patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2009 and 2010: antimicrobial susceptibility of Escherichia coli and Staphylococcus saprophyticus. J Infect Chemother 2013; 19:393-403. [DOI: 10.1007/s10156-013-0606-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 04/13/2013] [Indexed: 11/29/2022]
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Taoka R, Togo Y, Yamamoto S, Kubo T, Kido M, Miki K, Egawa S, Kiyota H, Sugawara T, Yasuda M, Nakano M, Deguchi T, Nishino M, Ishikawa K, Shiroki R, Matsumoto M, Shigemura K, Tanaka K, Arakawa S, Fujisawa M, Wada K, Watanabe T, Kumon H, Kobayashi K, Matsubara A, Sho T, Hamasuna R, Matsumoto T, Hayami H, Nakagawa M. Assessment of antimicrobial prophylaxis to prevent perioperative infection in patients undergoing prostate brachytherapy: multicenter cohort study. J Infect Chemother 2013; 19:926-30. [DOI: 10.1007/s10156-013-0610-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
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