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Akata K, Yamasaki K, Kawaguchi T, Chiba Y, Sennari K, Shigemi S, Nemoto K, Funada M, Suzuki K, Yatera K. Infectious respiratory pathogens among patients with acute exacerbation of idiopathic pulmonary fibrosis during the coronavirus disease 2019 pandemic in Japan. Heart Lung 2024; 67:1-4. [PMID: 38569435 DOI: 10.1016/j.hrtlng.2024.03.007] [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: 01/13/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Few studies have investigated the prevalence of pathogens in patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF), specifically, the interactions between respiratory pathogens and AE-IPF during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES We aimed to analyze pathogens in patients with AE-IPF between September 2020 and December 2022. METHODS This retrospective observational study was conducted at our hospital between September 2020 and December 2022. In patients with AE-IPF, pre-hospitalization polymerase chain reaction (PCR) tests for respiratory pathogens, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), were performed using multiplex PCR or Smart Gene assay with nasopharyngeal swab specimens. Microbiological assays, including Gram staining, sputum cultures, blood cultures, and urinary antigen tests for Streptococcus pneumoniae and Legionella pneumophila, were also performed. RESULTS Forty-nine patients with AE-IPF were included. The median age was 75 years old and 42 (86 %) were male. Only one of the 49 patients (2 %) was positive for SARS-CoV-2. Two of 28 patients (7 %) were positive for human rhinovirus/enterovirus. No bacteria were detected in sputum culture, blood culture, or urinary antigen tests. CONCLUSIONS The detection frequency of SARS-CoV-2 infection in patients with AE-IPF was lower than that of human rhinovirus/enterovirus. Continuous analysis for the presence of pathogens is necessary for appropriate infection control because respiratory viruses may increase as the coronavirus pandemic subsides.
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Affiliation(s)
- Kentaro Akata
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Takako Kawaguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yosuke Chiba
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Konomi Sennari
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Saki Shigemi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Midori Funada
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Katsunori Suzuki
- Department of Infectious Disease Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Akata K, Yamasaki K, Kohrogi R, Kawakami Y, Furuya Y, Eto K, Honda M, Suzuki K, Yatera K. Clinical factors associated with viral shedding time of SARS-CoV-2 Omicron variant in Japan. J Infect Chemother 2024; 30:172-175. [PMID: 37820950 DOI: 10.1016/j.jiac.2023.09.023] [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: 08/04/2023] [Revised: 09/09/2023] [Accepted: 09/19/2023] [Indexed: 10/13/2023]
Abstract
The Omicron variant of severe acute respiratory syndrome coronavirus 2 exhibits increased infectivity compared with all prior variants, and the timing of quarantine release should be carefully considered. However, to date, only two Chinese studies have analyzed the association between the viral shedding time (VST) and risk factors among patients infected with the Omicron variant. These studies included only limited numbers of severe cases and no analysis of underlying diseases and immunosuppressive drug use. Therefore, the current study aimed to analyze them in Japan. This retrospective observational study was conducted at the University of Occupational and Environmental Health, Japan, from January 2022 to October 2022 and included 87 hospitalized patients and 305 healthcare workers (HCWs) with coronavirus 2019 (COVID-19). In comparison with HCWs, hospitalized patients were significantly older and had a higher proportion of severe COVID-19 cases and significantly longer VST. A simple regression analysis showed that severe, current, or ex-smoking status, cardiovascular diseases, chronic kidney disease, and use of corticosteroids for underlying diseases were significantly correlated with a longer VST. Moreover, multiple linear regression analysis revealed that cardiovascular diseases, chronic kidney disease, and corticosteroid use were significantly associated with a longer VST. Therefore, COVID-19 patients with these underlying diseases may require a longer isolation period and the timing of quarantine release should be carefully considered.
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Affiliation(s)
- Kentaro Akata
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan; Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Rikuto Kohrogi
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoko Kawakami
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yorikazu Furuya
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kohichiro Eto
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masahisa Honda
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Katsunori Suzuki
- Department of Infectious Disease Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Akata K, Yamasaki K, Chiba Y, Kawaguchi T, Dosaka H, Morimoto T, Higashi Y, Nishida C, Shimajiri S, Yatera K. Difficulty differentiating primary mediastinal classical Hodgkin lymphoma from inflammatory myofibroblastic tumor: A case report. Thorac Cancer 2024; 15:410-414. [PMID: 38158872 PMCID: PMC10864112 DOI: 10.1111/1759-7714.15197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024] Open
Abstract
A 20-year-old Japanese man visited our hospital because an enlarged mediastinal shadow had been detected on chest x-ray. Chest computed tomography revealed a large mediastinal mass with multiple lymph node enlargement, pericardial effusion, and bilateral pleural effusion. He was diagnosed with inflammatory myofibroblastic tumor (IMT) based on a thoracoscopic tumor biopsy. Initial corticosteroid and celecoxib treatment was only partially effective; therefore, additional tumor rebiopsy and left axillary lymph node biopsy were performed. Based on the findings, the patient was rediagnosed with classical Hodgkin lymphoma (CHL). To date, there has only been one report of a case initially diagnosed as IMT and rediagnosed as CHL, as in our case, and only three reports of malignant lymphoma mimicking IMT. When IMT is suspected based on pathological findings and subsequently with treatment failure, possible CHL and performing rebiopsy should be considered.
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Affiliation(s)
- Kentaro Akata
- Division of Infection Control and PreventionUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Kei Yamasaki
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Yosuke Chiba
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Takako Kawaguchi
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Hiroki Dosaka
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Toshiki Morimoto
- Department of Environmental Health EngineeringInstitute of Industrial Ecological Sciences, University of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Yasuyuki Higashi
- Department of Environmental Health EngineeringInstitute of Industrial Ecological Sciences, University of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Chinatsu Nishida
- Department of Environmental Health EngineeringInstitute of Industrial Ecological Sciences, University of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Shohei Shimajiri
- Department of PathologyUniversity of Environmental and Occupational Health, JapanKitakyushuJapan
| | - Kazuhiro Yatera
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
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Akata K, Yamasaki K, Nemoto K, Ikegami H, Kawaguchi T, Noguchi S, Kawanami T, Fukuda K, Mukae H, Yatera K. Sarcoidosis Associated with Enlarged Mediastinal Lymph Nodes with the Detection of Streptococcus gordonii and Cutibacterium acnes Using a Clone Library Method. Intern Med 2024; 63:299-304. [PMID: 37258161 PMCID: PMC10864086 DOI: 10.2169/internalmedicine.1887-23] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
A 77-year-old Japanese woman with mediastinal lymphadenopathy and uveitis was diagnosed with sarcoidosis. The bacterial flora in biopsied samples from mediastinal lymph nodes was analyzed using a clone library method with Sanger sequencing of the 16S rRNA gene, and Streptococcus gordonii (52 of 71 clones) and Cutibacterium acnes (19 of 71 clones) were detected. No previous study has conducted a bacterial floral analysis using the Sanger method for the mediastinal lymph node in sarcoidosis, making this case report the first to document the presence of S. gordonii and C. acnes in the mediastinal lymph node of a patient with sarcoidosis.
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Affiliation(s)
- Kentaro Akata
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Takako Kawaguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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Ikushima I, Yamasaki K, Tahara M, Nemoto K, Akata K, Ikegami H, Nishida C, Muramatsu K, Fujino Y, Matsuda S, Fushimi K, Mukae H, Yatera K. Epidemiologic evaluation of pulmonary paragonimiasis in Japan using a Japanese nationwide administrative database. J Infect Chemother 2024:S1341-321X(24)00007-2. [PMID: 38219980 DOI: 10.1016/j.jiac.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Paragonimiasis is a parasitic disease primarily contracted through consumption of undercooked freshwater crustaceans or wild boar meat. Large-scale nationwide epidemiological data on paragonimiasis are lacking. In this study, we aimed to investigate the nationwide epidemiology of hospitalized patients with paragonimiasis in Japan using a comprehensive nationwide Japanese administrative database. METHODS We evaluated the Japanese Diagnosis Procedure Combination (DPC) data of patients diagnosed with pulmonary paragonimiasis between April 1, 2012 and March 30, 2020. The patients' address and information, including age, sex, treatment (medication: praziquantel; surgery: open thoracotomy or intracranial mass extirpation), Japan coma scale, comorbidities, and length of hospital stay, were extracted. RESULTS Of the 49.6 million hospitalized patients, data were extracted on 73 patients with paragonimiasis, of whom 36 were male and 37 were female. The mean age was 49.7 years and the mean length of stay was 12.5 days. The most frequent comorbidity was pleural effusion (31.5 %), followed by pneumothorax (13.7 %). The sites of ectopic paragonimiasis in organs other than the lung included the liver (5.5 %), skin (4.1 %), and brain (2.7 %). Geographically, most patients were from the Kyushu region (54.8 %), followed by the Kanto region (22.0 %). Fukuoka Prefecture had the highest number of patients (22.0 %) by prefecture. During the study period, an average of 9.1 patients/year were hospitalized with lung paragonimiasis in Japan. CONCLUSION Paragonimiasis has not completely disappeared in Japan; thus, physicians should be aware of paragonimiasis in the Kyushu region, especially in the Fukuoka Prefecture.
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Affiliation(s)
- Issei Ikushima
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Masahiro Tahara
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Chinatsu Nishida
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Shinya Matsuda
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Nemoto K, Yatera K, Akata K, Ikegami H, Yamasaki K, Hata R, Naito K, Noguchi S, Kawanami T, Fukuda K, Mukae H. Comparative study of bacterial flora in bronchoalveolar lavage fluid of pneumonia patients based on their pneumonia subtypes and comorbidities using 16S ribosomal RNA gene analysis. J Infect Chemother 2022; 28:1402-1409. [DOI: 10.1016/j.jiac.2022.06.014] [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: 01/31/2022] [Revised: 06/08/2022] [Accepted: 06/25/2022] [Indexed: 11/28/2022]
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Iwanaga Y, Yamasaki K, Nemoto K, Akata K, Ikegami H, Uchimura K, Noguchi S, Nishida C, Kawanami T, Fukuda K, Mukae H, Yatera K. Combined Radiographic Features and Age Can Distinguish Mycoplasma pneumoniae Pneumonia from Other Bacterial Pneumonias: Analysis Using the 16S rRNA Gene Sequencing Data. J Clin Med 2022; 11:jcm11082201. [PMID: 35456296 PMCID: PMC9032927 DOI: 10.3390/jcm11082201] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
The study objective was to evaluate chest radiographic features that distinguish Mycoplasma pneumoniae pneumonia (MPP) from other bacterial pneumonias diagnosed based on the bacterial floral analysis with 16S rRNA gene sequencing, using bronchoalveolar lavage fluid samples directly obtained from pneumonia lesions. Patients were grouped according to the dominant bacterial phenotype; among 120 enrolled patients with CAP, chest CT findings were evaluated in 55 patients diagnosed with a mono-bacterial infection (one bacterial phylotype occupies more than 80% of all phylotypes in a sample) by three authorized respiratory physicians. Among this relatively small sample size of 55 patients with CAP, 10 had MPP, and 45 had other bacterial pneumonia and were categorized into four groups according to their predominant bacterial phylotypes. We created a new scoring system to discriminate MPP from other pneumonias, using a combination of significant CT findings that were observed in the M. pneumoniae group, and age (<60 years) (MPP−CTA scoring system). When the cutoff value was set to 1, this scoring system had a sensitivity of 80%, a specificity of 93%, a positive predictive value of 73%, and a negative predictive value of 95%. Among the CT findings, centrilobular nodules were characteristic findings in patients with MPP, and a combination of chest CT findings and age might distinguish MPP from other bacterial pneumonias.
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Affiliation(s)
- Yuto Iwanaga
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
- Correspondence: ; Tel.: +81-93-691-7453; Fax: +81-93-602-9373
| | - Kazuki Nemoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Keigo Uchimura
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Chinatsu Nishida
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan;
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan;
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan; (Y.I.); (K.N.); (K.A.); (H.I.); (K.U.); (S.N.); (C.N.); (T.K.); (K.Y.)
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Tachiwada T, Noguchi S, Muramatsu K, Akata K, Yamasaki K, Kido T, Asakawa T, Fujino Y, Fushimi K, Matsuda S, Mukae H, Yatera K. Effects of additive corticosteroid therapy on 90-day survival in patients with community-onset pneumonia. J Infect Chemother 2021; 28:496-503. [PMID: 34955409 DOI: 10.1016/j.jiac.2021.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/01/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Systemic corticosteroid therapy is occasionally used as an additive therapy, especially for patients with severe pneumonia. However, its recommendation for use in patients with pneumonia varies worldwide, and its efficacy is unclear. METHODS Adult Japanese patients hospitalized with community-onset pneumonia between January and December 2012 were analyzed using the Diagnostic Procedure Combination database. The patients were classified into mild-to-moderate and severe groups using the A-DROP (age, dehydration, respiration, orientation, and blood pressure) system. The 90-day survival rate was evaluated between the presence or absence of corticosteroid treatment using the Kaplan-Meier method in the overall, mild-to-moderate and severe groups, respectively. The patients' clinical characteristics were adjusted between the two groups using the inverse probability of treatment weighting method. RESULTS Among 123,811, 110,534 patients were classified as mild-to-moderate grade (corticosteroid group: 8,465, non-corticosteroid group: 102,069) and 13,277 patients were classified as severe grade (corticosteroid group: 1,338, non-corticosteroid group: 11,939). The 90-day survival rate was higher in the non-corticosteroid group than in the corticosteroid group in patients with pneumonia of overall grade (weighted hazard ratio [HR]: 1.36; P < 0.001) and those with mild-to-moderate grade (weighted HR: 1.46; P < 0.001). However, there were no significant differences in the outcomes between the two groups in those with severe grade (weighted HR: 1.08; P = 0.38). CONCLUSIONS Additive systemic corticosteroid therapy may be related to poor 90-day prognosis in patients with mild-to-moderate grade community-onset pneumonia, although it may not be positively associated with its prognosis in those with severe grade.
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Affiliation(s)
- Takashi Tachiwada
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Keiji Muramatsu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Takashi Kido
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan; Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan
| | - Takeshi Asakawa
- Department of Information Management Center, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyoku, Tokyo, 113-8510, Japan.
| | - Shinya Matsuda
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8501, Japan.
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu City, Fukuoka, 807-8555, Japan.
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Akata K, Leung JM, Yamasaki K, Filho FSL, Yang J, Yang CX, Takiguchi H, Shaipanich T, Sahin B, Whalen BA, Yang CWT, Sin DD, van Eeden SF. Altered polarization and impaired phagocytic activity of lung macrophages in people with HIV and COPD. J Infect Dis 2021; 225:862-867. [PMID: 34610114 DOI: 10.1093/infdis/jiab506] [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: 06/22/2021] [Accepted: 10/03/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND People with HIV (PWH) have an increased risk of developing Chronic Obstructive Pulmonary Disease (COPD). METHODS We phenotyped lung macrophages in four subgroups: M1 (CD40+CD163-), M2 (CD40-CD163+), Double Positives (CD40+CD163+), Double Negatives (CD40-CD163-) and determined their phagocytic capacity in PWH with and without COPD. RESULTS PWH with COPD have more double negative macrophages (84.1%) vs PWH without (54.3%) vs controls (23.9%) (p=0.004) and reduced phagocytosis (p=0.012). Double negative macrophages had the worst phagocytic capacity (p<0.001). CONCLUSIONS PWH with COPD have an abundance of non-polarized macrophages which have poor phagocytic capacity therefore predispose them to increased risk of disease progression.
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Affiliation(s)
- Kentaro Akata
- Division of Infection Control and Prevention, University of Occupational and Environmental Health, Japan, Fukuoka, Japan.,Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | - Janice M Leung
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Fukuoka, Japan
| | | | - Julia Yang
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Chen Xi Yang
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Hiroto Takiguchi
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tawimas Shaipanich
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Basak Sahin
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Beth A Whalen
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Cheng Wei Tony Yang
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Stephan F van Eeden
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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10
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Ikegami H, Noguchi S, Fukuda K, Akata K, Yamasaki K, Kawanami T, Mukae H, Yatera K. Refinement of microbiota analysis of specimens from patients with respiratory infections using next-generation sequencing. Sci Rep 2021; 11:19534. [PMID: 34599245 PMCID: PMC8486753 DOI: 10.1038/s41598-021-98985-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 09/16/2021] [Indexed: 12/12/2022] Open
Abstract
Next-generation sequencing (NGS) technologies have been applied in bacterial flora analysis. However, there is no standardized protocol, and the optimal clustering threshold for estimating bacterial species in respiratory infection specimens is unknown. This study was conducted to investigate the optimal threshold for clustering 16S ribosomal RNA gene sequences into operational taxonomic units (OTUs) by comparing the results of NGS technology with those of the Sanger method, which has a higher accuracy of sequence per single read than NGS technology. This study included 45 patients with pneumonia with aspiration risks and 35 patients with lung abscess. Compared to Sanger method, the concordance rates of NGS technology (clustered at 100%, 99%, and 97% homology) with the predominant phylotype were 78.8%, 71.3%, and 65.0%, respectively. With respect to the specimens dominated by the Streptococcus mitis group, containing several important causative agents of pneumonia, Bray Curtis dissimilarity revealed that the OTUs obtained at 100% clustering threshold (versus those obtained at 99% and 97% thresholds; medians of 0.35, 0.69, and 0.71, respectively) were more similar to those obtained by the Sanger method, with statistical significance (p < 0.05). Clustering with 100% sequence identity is necessary when analyzing the microbiota of respiratory infections using NGS technology.
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Affiliation(s)
- Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-city, Fukuoka, 807-8555, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-city, Fukuoka, 807-8555, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-city, Fukuoka, 807-8555, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-city, Fukuoka, 807-8555, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-city, Fukuoka, 807-8555, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-city, Fukuoka, 807-8555, Japan.
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11
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Leitao Filho FS, Takiguchi H, Akata K, Ra SW, Moon JY, Kim HK, Cho Y, Yamasaki K, Milne S, Yang J, Yang CWT, Li X, Nislow C, van Eeden SF, Shaipanich T, Lam S, Leung JM, Sin DD. Effects of Inhaled Corticosteroid/long-acting beta-2 Agonist Combination on the Airway Microbiome of Patients with COPD: A Randomized Controlled Trial (DISARM). Am J Respir Crit Care Med 2021; 204:1143-1152. [PMID: 34464242 DOI: 10.1164/rccm.202102-0289oc] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Inhaled corticosteroids (ICS) are commonly prescribed with long-acting beta-2 agonists (LABA) in COPD. To date, the effects of ICS therapy on the airway microbiome in COPD are unknown. OBJECTIVES To determine the effects of ICS/LABA on the airway microbiome of COPD patients. METHODS Clinically stable COPD patients were enrolled into a 4-week run-in period during which ICS was discontinued and all participants were placed on formoterol 12 µg twice daily (BID). The participants were then randomized to: budesonide/formoterol (Bud + Form; 400/12 µg BID), fluticasone/salmeterol (Flu + Salm; 250/50 µg BID) or formoterol only (Form; 12 µg BID) for 12 weeks. Participants underwent bronchoscopy before and after the 12-week treatment period. The primary endpoint was the comparison of changes in the airway microbiome over the trial period between the ICS/LABA and LABA-only groups. MEASUREMENTS AND MAIN RESULTS 63 participants underwent randomization: Bud + Form (n=20), Flu + Salm (n=22) and Form (n=21) groups; 56 subjects completed all visits. After the treatment period, changes in alpha diversity were significantly different across groups, especially between Flu + Salm and Form groups (Δ richness: p = 0.02; Δ Shannon Index: p = 0.03). Longitudinal differential abundance analyses revealed more pronounced microbial shifts from baseline in the fluticasone (vs. budesonide or formoterol only) group. CONCLUSIONS Fluticasone-based ICS/LABA therapy modifies the airway microbiome in COPD, leading to a relative reduction in alpha diversity and a greater number of bacterial taxa changes. These data may have implications in patients who develop pneumonia on ICS. Clinical trial registration available at www.clinicaltrials.gov, ID:NCT02833480.
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Affiliation(s)
- Fernando Sergio Leitao Filho
- The University of British Columbia, 8166, Department of Medicine (Division of Respiratory Medicine), Vancouver, British Columbia, Canada
| | - Hiroto Takiguchi
- The University of British Columbia, 8166, Department of Medicine (Division of Respiratory Medicine), Vancouver, British Columbia, Canada
| | - Kentaro Akata
- University of Occupational and Environmental Health Japan, 13137, Respiratory Medicine, Kitakyushu, Japan
| | - Seung Won Ra
- University of Ulsan College of Medicine, 37994, Medicine, Ulsan, Korea (the Republic of)
| | - Ji-Yong Moon
- Hanyang University, 26716, Seongdong-gu, Korea (the Republic of)
| | - Hyun Kuk Kim
- Inje University Haeundae Paik Hospital, 222187, Busan, Korea (the Republic of)
| | - Yuji Cho
- Gyeongsang National University Hospital, Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Jinju, Korea (the Republic of)
| | - Kei Yamasaki
- University of Occupational and Environmental Health, Japan, Respiratory Medicine, Kitakyushu, Japan
| | - Stephen Milne
- The University of British Columbia, 8166, Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada.,The University of British Columbia, 8166, Division of Respiratory Medicine, Vancouver, British Columbia, Canada
| | - Julia Yang
- St. Paul's Hospital, University of British Columbia, Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada
| | - Cheng Wei Tony Yang
- The University of British Columbia, 8166, Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, British Columbia, Canada.,Providence Health Care, 173031, Providence Airway Centre, Vancouver, British Columbia, Canada
| | - Xuan Li
- The University of British Columbia, 8166, Centre for Heart Lung Innovation, St. Paul's Hospital, & Department of Medicine (Division of Respiratory Medicine), Vancouver, British Columbia, Canada
| | - Corey Nislow
- The University of British Columbia, 8166, Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada
| | | | - Tawimas Shaipanich
- Division of Respiratory Medicine, Medicine, Vancouver, British Columbia, Canada
| | - Stephen Lam
- British Columbia Cancer Research Centre, Integrative Oncology, Vancouver, British Columbia, Canada
| | - Janice M Leung
- National Institutes of Health, Critical Care Medicine Department, Bethesda, Maryland, United States
| | - Don D Sin
- University of Alberta, 3158, Medicine, Edmonton, Alberta, Canada;
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12
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Takiguchi H, Yang CX, Yang CWT, Sahin B, Whalen BA, Milne S, Akata K, Yamasaki K, Yang JSW, Cheung CY, Vander Werff R, McNagny KM, Leitao Filho FS, Shaipanich T, van Eeden SF, Obeidat M, Leung JM, Sin DD. Macrophages with reduced expressions of classical M1 and M2 surface markers in human bronchoalveolar lavage fluid exhibit pro-inflammatory gene signatures. Sci Rep 2021; 11:8282. [PMID: 33859282 PMCID: PMC8050093 DOI: 10.1038/s41598-021-87720-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 08/15/2020] [Accepted: 04/01/2021] [Indexed: 02/01/2023] Open
Abstract
The classical M1/M2 polarity of macrophages may not be applicable to inflammatory lung diseases including chronic obstructive pulmonary disease (COPD) due to the complex microenvironment in lungs and the plasticity of macrophages. We examined macrophage sub-phenotypes in bronchoalveolar lavage (BAL) fluid in 25 participants with CD40 (a M1 marker) and CD163 (a M2 marker). Of these, we performed RNA-sequencing on each subtype in 10 patients using the Illumina NextSeq 500. Approximately 25% of the macrophages did not harbor classical M1 or M2 surface markers (double negative, DN), and these cells were significantly enriched in COPD patients compared with non-COPD patients (46.7% vs. 14.5%, p < 0.001). 1886 genes were differentially expressed in the DN subtype compared with all other subtypes at a 10% false discovery rate. The 602 up-regulated genes included 15 mitochondrial genes and were enriched in 86 gene ontology (GO) biological processes including inflammatory responses. Modules associated with cellular functions including oxidative phosphorylation were significantly down-regulated in the DN subtype. Macrophages in the human BAL fluid, which were negative for both M1/M2 surface markers, harbored a gene signature that was pro-inflammatory and suggested dysfunction in cellular homeostasis. These macrophages may contribute to the pathogenesis and manifestations of inflammatory lung diseases such as COPD.
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Affiliation(s)
- Hiroto Takiguchi
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada.,Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Chen X Yang
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Cheng Wei Tony Yang
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Basak Sahin
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Beth A Whalen
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Stephen Milne
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada.,Division of Respiratory Medicine, UBC Department of Medicine, Vancouver, BC, Canada.,Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kentaro Akata
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Kei Yamasaki
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Julia Shun Wei Yang
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Chung Yan Cheung
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Ryan Vander Werff
- The Biomedical Research Centre, University of British Columbia, Vancouver, BC, Canada
| | - Kelly M McNagny
- The Biomedical Research Centre, University of British Columbia, Vancouver, BC, Canada
| | - Fernando Sergio Leitao Filho
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Tawimas Shaipanich
- Division of Respiratory Medicine, UBC Department of Medicine, Vancouver, BC, Canada
| | - Stephan F van Eeden
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada.,Division of Respiratory Medicine, UBC Department of Medicine, Vancouver, BC, Canada
| | - Ma'en Obeidat
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada
| | - Janice M Leung
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada.,Division of Respiratory Medicine, UBC Department of Medicine, Vancouver, BC, Canada
| | - Don D Sin
- St Paul's Hospital, The University of British Columbia (UBC) Centre for Heart Lung Innovation (HLI), Vancouver, BC, Canada. .,Division of Respiratory Medicine, UBC Department of Medicine, Vancouver, BC, Canada.
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13
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Iwanaga Y, Kawanami T, Yamasaki K, Sakakibara H, Ikushima I, Ikegami H, Tahara M, Akata K, Mukae H, Yatera K. A fatal case of COVID-19-associated invasive pulmonary aspergillosis. J Infect Chemother 2021; 27:1102-1107. [PMID: 33867266 PMCID: PMC8015426 DOI: 10.1016/j.jiac.2021.03.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 12/03/2022]
Abstract
A 79-year-old Japanese man with polymyalgia rheumatica was admitted to hospital with coronavirus disease (COVID-19). On admission, he was treated with ciclesonide inhalation, ivermectin, and meropenem. He was intubated 6 days after admission, and methylprednisolone therapy was initiated (1000 mg/day). Hypoxemia and chest radiographic findings temporarily improved. However, chest computed tomography showed bilateral ground-glass attenuations, multiple nodules, and consolidation. Aspergillus fumigatus was cultured from the tracheal aspirate and he was diagnosed with COVID-19-associated invasive pulmonary aspergillosis (CAPA) and treated with liposomal amphotericin B. However, he died 28 days after admission.
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Affiliation(s)
- Yuto Iwanaga
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Hideki Sakakibara
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Issei Ikushima
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Masahiro Tahara
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, University Graduate School of Biomedical Sciences, Nagasaki City, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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14
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Ikegami H, Yamasaki K, Kawanami T, Fukuda K, Akata K, Nakamura M, Ikushima I, Fukuda Y, Noguchi S, Yatera K. Pulmonary Mycobacterium parascrofulaceum Infection in a Patient with Chronic Progressive Pulmonary Aspergillosis: A Case Report and Literature Review. Intern Med 2020; 59:1417-1422. [PMID: 31866624 PMCID: PMC7332639 DOI: 10.2169/internalmedicine.3540-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 67-year-old man with a pulmonary cavity was admitted to our hospital. Mycobacterial culture of the bronchoalveolar lavage fluid sample obtained from the right upper pulmonary lesion tested positive for mycobacterium, and sequencing of the 16S rRNA genes, hsp65, and rpoB revealed that the cultured mycobacterium was Mycobacterium parascrofulaceum. Treatment with antimycobacterial agents was ineffective, and repeated culturing of bronchoscopic specimens revealed that the specimens were positive for Aspergillus fumigatus. Combination treatment of antimycobacterial agents and voriconazole improved the lung lesion. This is the first report of a patient with pulmonary M. parascrofulaceum infection complicated with chronic progressive pulmonary aspergillosis.
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Affiliation(s)
- Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Midori Nakamura
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Issei Ikushima
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Yoko Fukuda
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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15
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Hata R, Kawanami T, Noguchi S, Fukuda K, Akata K, Yamasaki K, Saito M, Yatera K, Mukae H. Clinical characteristics of patients with bacterial pleuritis in the presence of Streptococcus anginosus group and obligate anaerobes detected by clone library analysis. Clin Respir J 2019; 14:267-276. [PMID: 31816139 DOI: 10.1111/crj.13127] [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] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/09/2019] [Accepted: 12/04/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Bacterial pleuritis is one of the most important pleural and respiratory infectious diseases, in addition, there have been no reports describing the clinical characteristics of patients with bacterial pleuritis according to molecular methods. An accurate understanding of the clinical characteristics and etiology of bacterial pleuritis is an issue that must be addressed. OBJECTIVES The aim of this study was to clarify the clinical characteristics of the bacterial species in bacterial pleuritis. METHODS Pleural effusion samples were obtained from 29 patients with bacterial pleuritis. The microbiota of pleural effusion samples was analyzed by clone library analysis using the 16S ribosomal RNA gene. RESULTS The phylotypes of Fusobacterium spp. (24.1%) were most frequently the predominant phylotypes, followed by those of Streptococcus anginosus group (SAG) (20.7%) and S. aureus (17.2%). The predominant phylotypes of obligate anaerobes, including the Fusobacterium spp., were detected in 11 of 29 patients (37.9%). Patients in the SAG group were significantly older and presented lower serum albumin levels than those in the obligate anaerobe and other bacterial groups. Patients from the obligate anaerobe group took longer to present symptoms, and therefore the diagnosis of pleuritis was also delayed, in comparison to patients in the other bacterial groups. CONCLUSIONS Our results demonstrated that there were characteristic differences between patients in SAG, obligate anaerobe and other bacterial groups. Physicians may need to consider treatment strategy options based on the clinical characteristics of patients with bacterial pleuritis.
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Affiliation(s)
- Ryosuke Hata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Mitsumasa Saito
- Department of Microbiology, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki City, Japan
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16
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Hata R, Noguchi S, Kawanami T, Yamasaki K, Akata K, Ikegami H, Fukuda K, Hirashima S, Miyawaki A, Fujino Y, Oya R, Yatera K, Mukae H. Poor oral hygiene is associated with the detection of obligate anaerobes in pneumonia. J Periodontol 2019; 91:65-73. [DOI: 10.1002/jper.19-0043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/20/2019] [Accepted: 06/05/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Ryosuke Hata
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Shingo Noguchi
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Toshinori Kawanami
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kei Yamasaki
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kentaro Akata
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Hiroaki Ikegami
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kazumasa Fukuda
- Department of MicrobiologyUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Soichi Hirashima
- Department of Dentistry and Oral SurgeryUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Akihiko Miyawaki
- Department of Dentistry and Oral SurgeryUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Yoshihisa Fujino
- Department of Environmental EpidemiologyInstitute of Industrial Ecological SciencesUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Ryoichi Oya
- Department of Dentistry and Oral SurgeryUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Kazuhiro Yatera
- Department of Respiratory MedicineUniversity of Occupational and Environmental Health Kitakyushu Fukuoka Japan
| | - Hiroshi Mukae
- Department of Respiratory MedicineUnit of Translational MedicineNagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
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17
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Noguchi S, Yatera K, Akata K, Chang B, Ikegami H, Hata R, Yamasaki K, Kawanami T, Mukae H. Distribution and annual changes in the proportion of Streptococcus pneumoniae serotypes in Japanese adults with pneumococcal pneumonia from 2011 to 2017. J Infect Chemother 2019; 25:925-929. [PMID: 31350184 DOI: 10.1016/j.jiac.2019.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/02/2019] [Accepted: 07/06/2019] [Indexed: 10/26/2022]
Abstract
In 2014, vaccinations with 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13) were implemented in Japan for all adults aged ≥65 years. We previously clarified reductions in the proportions of PCV7-, PCV13-, and PPSV23-covered serotypes in patients with pneumococcal pneumonia after the initiation of PCV7 and PCV13 vaccinations for Japanese children; however, information about the annual changes in the proportion of Streptococcus pneumoniae serotypes in patients with pneumococcal pneumonia after the initiation of routine PPSV23 vaccinations remains unclear. We retrospectively studied 229 adults with pneumococcal pneumonia which S. pneumoniae was cultured from their lower respiratory tract samples between 2011 and 2017 and investigated the annual changes in the proportion of S. pneumoniae serotypes. The proportion of PPSV23-covered serotypes decreased from 71.4% in 2011 to 52.2% in 2014, but it remained essentially unchanged from 2015 to 2017. The proportions of PCV7-covered serotypes decreased from 46.4% in 2011 to 4.3% in 2014; however, this rate increased beginning in 2015 and reached 20.6% in 2017. Among the PCV7-covered serotypes, the proportion of the 19F serotype increased from 2015 to 2017. In conclusion, there were no obvious changes in the proportion of PPSV23-covered and PCV13-covered serotypes in patients with pneumococcal pneumonia after the initiation of routine PPSV23 vaccinations.
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Affiliation(s)
- Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Bin Chang
- Department of Bacteriology I, National Institute of Infectious Diseases, Japan
| | - Hiroaki Ikegami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Ryosuke Hata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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18
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Akata K, Muratani T, Yatera K, Naito K, Noguchi S, Yamasaki K, Kawanami T, Kido T, Mukae H. Induction of plasmid-mediated AmpC β-lactamase DHA-1 by piperacillin/tazobactam and other β-lactams in Enterobacteriaceae. PLoS One 2019; 14:e0218589. [PMID: 31283769 PMCID: PMC6613692 DOI: 10.1371/journal.pone.0218589] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 06/06/2019] [Indexed: 01/10/2023] Open
Abstract
Chromosomal AmpC β-lactamase induction by several types of β-lactams has been reported, but not enough data are available on DHA-1 β-lactamase, a plasmid-mediated AmpC β-lactamase. Therefore, we evaluated the DHA-1 β-lactamase induction by various antibiotics including piperacillin/tazobactam (PIP/TZB) in this study. Six strains (Enterobacter cloacae 2 strains, Citrobacter freundii 1 strain, Serratia marcescens 2 strain, and Morganella morganii 1 strain) possessing chromosomal inducible AmpC β-lactamase were used as controls. Four strains (Escherichia coli 2 strains, Klebsiella pneumoniae 1 strain, and C. koseri 1 strain) possessing DHA-1 β-lactamase were used. The β-lactamase activities were determined by a spectrophotometer using nitrocefin. β-lactamase induction by PIP, PIP/TZB was not observed in any strains and β-lactamase induction by third- and fourth-generation cephems was not observed in most strains. The induction ratios of the chromosomal AmpC β-lactamase in the reference group by PIP/TZB were <1.51, and those of the DHA-1 β-lactamase were <1.36, except for K. pneumoniae Rkp2004 (2.22). The β-lactamase induction by first- and second-generation cephems, flomoxef, and carbapenem differed in each strain. Cefmetazole (CMZ) strongly induced β-lactamase. This study demonstrated that the induction of DHA-1 β-lactamase was similar to that of chromosomal AmpC using various Enterobacteriaceae, although the induction of β-lactamase in both groups by PIP/TZB was low. We also reported that the induction of PIP/TZB, a β-lactamase inhibitor combination antibiotic, against various AmpC-producing Enterobacteriaceae, including DHA-1 producers, was low.
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Affiliation(s)
- Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Tetsuro Muratani
- Department of Clinical Microbiology, Kyurin Medical Laboratory, Kitakyushu City, Fukuoka, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
- * E-mail:
| | - Keisuke Naito
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka, Japan
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki City, Nagasaki, Japan
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Abstract
The number of patients with pneumonia has been increasing as the population ages, and most fatal pneumonia cases are the elderly with aspiration pneumonia. Although aspiration pneumonia leads to poor short- and long-term prognosis, there have been no practical ways to diagnose it precisely. Persistent subclinical aspiration without any subjective symptoms is problematic in clinical practice in patients with aspiration pneumonia, and physicians can only use aspiration risks such as brain infarction to diagnose aspiration pneumonia. Anaerobes have been believed to be major causative pathogens in aspiration pneumonia, based on data from the 1970's. In relation to these data, Marik insisted that there is a possible overestimation of anaerobes because 1) the sampling of microbiologic specimens was in the late phase in the course of the illness, especially frequently after developing complications such as abscesses, necrotizing pneumonia, or empyema thoracis; 2) the organisms recovered by percutaneous transtracheal aspiration (PTA) sampling could have been contaminated by the aspiration of oropharyngeal flora during the PTA procedure or colonized in the trachea; and 3) many of the patients had chronic alcoholism or were under general anesthesia. In addition, 4) oral care was not common in the 1970s, and 5) the patients in these reports were relatively young. Molecular biological approaches using the 16S ribosomal RNA (rRNA) gene have recently been used, and have enabled us to detect more exact pathogens compared to conventional bacterial culture. Using the method with the detection of the 16S rRNA gene, we evaluated the bacterial phylotypes in bronchoalveolar lavage fluid in patients with aspiration pneumonia and found that oral streptococci were the most detected phylotypes (31.0%), while anaerobes were only 6.0%. Our results suggest that oral streptococci are important, and anaerobes may have been overestimated as causative pathogens in patients with aspiration pneumonia.
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Affiliation(s)
- Kentaro Akata
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Ryosuke Hata
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Keisuke Naito
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University School of Medicine
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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Noguchi S, Yatera K, Kato T, Chojin Y, Furuta N, Akata K, Kawanami T, Yoshii C, Mukae H. Using oral health assessment to predict aspiration pneumonia in older adults. Gerodontology 2018; 35:110-116. [DOI: 10.1111/ger.12324] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Shingo Noguchi
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Tatsuji Kato
- Department of Respiratory Medicine; Tobata Kyoritsu Hospital; Kitakyushu Fukuoka Japan
| | - Yasuo Chojin
- Department of Respiratory Medicine; Tobata Kyoritsu Hospital; Kitakyushu Fukuoka Japan
| | - Norihiko Furuta
- Department of Dental Surgery; Tobata Kyoritsu Hospital; Kitakyushu Fukuoka Japan
| | - Kentaro Akata
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Chiharu Yoshii
- Department of Respiratory Medicine; Wakamatsu Hospital of the University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine; Unit of Translational Medicine; Nagasaki University Graduate School of Biomedical Sciences; Nagasaki Japan
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Noguchi S, Yatera K, Kato T, Chojin Y, Fujino Y, Akata K, Kawanami T, Sakamoto N, Mukae H. Impact of the number of aspiration risk factors on mortality and recurrence in community-onset pneumonia. Clin Interv Aging 2017; 12:2087-2094. [PMID: 29263657 PMCID: PMC5724415 DOI: 10.2147/cia.s150499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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] [Indexed: 12/25/2022] Open
Abstract
Introduction The clinical significance of the number of aspiration risk factors in patients with pneumonia is unknown as yet. In the present study, we clarify the significance of the number of aspiration risk factors for mortality and recurrence in pneumonia patients. Methods This study included 322 patients hospitalized with pneumonia between December 2014 and June 2016. We investigated associations between the number of aspiration risk factors present (orientation disturbance, bedridden, chronic cerebrovascular disease, dementia, sleeping medications and gastroesophageal disease) and 30-day and 6-month mortality, and pneumonia recurrence within 30 days. Results Patients were categorized by number of risk factors present into groups of 0–1, 2, 3, and 4 or more. Of a total of 322 patients, 93 (28.9%) had 0–1 risk factors, 112 (34.8%) had 2, 88 (27.3%) had 3, and 29 (9.0%) had 4 or more risk factors. The percentages of patients with recurrence of pneumonia were 13.0%, 33.0%, 43.2%, and 54.2% in the 0–1, 2, 3, and 4 or more risk factor groups, respectively. The percentages of patients with 30-day mortality were 2.2%, 5.4%, 11.4%, and 24.1%, and those of patients with 6-month mortality were 6.6%, 24.5%, 30.7%, and 50.0%, in the 0–1, 2, 3, and 4 or more risk factor groups, respectively. Conclusions The number of aspiration risk factors was associated with increases in both mortality and recurrence in pneumonia patients. Therefore, in clinical practice, physicians should consider not only the presence of aspiration risks but also the number of aspiration risk factors in these patients.
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Affiliation(s)
- Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tatsuji Kato
- Department of Respiratory Medicine, Tobata Kyoritsu Hospital, Kitakyushu, Japan
| | - Yasuo Chojin
- Department of Respiratory Medicine, Tobata Kyoritsu Hospital, Kitakyushu, Japan
| | - Yoshihisa Fujino
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Noguchi S, Yatera K, Kawanami T, Fukuda K, Yamasaki K, Naito K, Akata K, Ishimoto H, Mukae H. Frequency of detection of Chlamydophila pneumoniae using bronchoalveolar lavage fluid in patients with community-onset pneumonia. Respir Investig 2017; 55:357-364. [PMID: 29153416 DOI: 10.1016/j.resinv.2017.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 12/08/2016] [Revised: 07/27/2017] [Accepted: 08/06/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Chlamydophila pneumoniae is a causative pathogen of lower respiratory tract infection, which generally infects healthy, young people. However, it is often difficult to evaluate acute C. pneumoniae infection using upper respiratory tract specimens and/or sputum samples due to its persistent infection or colonization. The interpretation of frequency of detection of C. pneumoniae seems to be insufficient in community-onset pneumonia. The aim of this study was to evaluate the presence of C. pneumoniae using bronchoalveolar lavage fluid (BALF) samples. METHODS BALF samples from 147 patients with pneumonia were retrospectively evaluated using C. pneumoniae-specific polymerase chain reaction (PCR) primers. RESULTS None of the samples had positive PCR results for C. pneumoniae using two different sets of specific primers. Single and paired serological analyses were performed in 54 (36.7%) and 37 (25.2%) patients, respectively. These analyses revealed that 1 of 37 (2.7%) patients had a presumptive acute infection with C. pneumoniae, 8 of the 54 (14.8%) patients were suspected of having a C. pneumoniae infection, and 7 of the 37 (18.9%) patients were suspected of having past C. pneumoniae infection. In addition, cultivation and/or 16S rRNA gene sequencing detected Haemophilus influenzae in the presumptive case using the serological method. CONCLUSIONS The results of the present study revealed that C. pneumoniae might be a minor causative agent of community-onset pneumonia according to an evaluation of specimens obtained from the lower respiratory tract.
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Affiliation(s)
- Shingo Noguchi
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, 1-17-1, Hamamachi, Wakamatsuku, Kitakyusyu city, Fukuoka 808-0024, Japan; Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka 807-8555, Japan.
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka 807-8555, Japan.
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka 807-8555, Japan.
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka 807-8555, Japan.
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka 807-8555, Japan.
| | - Keisuke Naito
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka 807-8555, Japan.
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka 807-8555, Japan.
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki city, Nagasaki 852-8501, Japan.
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1, Sakamoto, Nagasaki city, Nagasaki 852-8501, Japan.
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Chojin Y, Kato T, Rikihisa M, Omori M, Noguchi S, Akata K, Ogoshi T, Yatera K, Mukae H. Evaluation of the Mann Assessment of Swallowing Ability in Elderly Patients with Pneumonia. Aging Dis 2017; 8:420-433. [PMID: 28840057 PMCID: PMC5524805 DOI: 10.14336/ad.2017.0102] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 10/17/2016] [Accepted: 01/02/2017] [Indexed: 11/16/2022] Open
Abstract
Elderly pneumonia patients have various underlying diseases and social backgrounds, and it is difficult to predict their mortality using the current severity assessment tools. However, aspiration is a risk factor for mortality in pneumonia patients. In the evaluation of aspiration, endoscopic and video fluoroscopic methods are reliable but cannot be performed in all pneumonia patients. We evaluated the significance of the Mann Assessment of Swallowing Ability (MASA) in these patients. This study was prospectively performed between December 2014 and June 2015, and all adult hospitalized patients with pneumonia were consecutively enrolled. The MASA score was evaluated soon after admission. The outcome measures were in-hospital mortality, a recurrence of pneumonia within 30 days, 6-month mortality, and the detection of antibiotic-resistant bacteria. A total of 153 patients were ultimately included. The proportion of in-hospital mortality was greater among the severe MASA score patients than normal score patients (p < 0.01), as was the proportion of recurrence of pneumonia (p < 0.01) and 6-month mortality (p < 0.01). In addition, patients with a moderate MASA score more often experienced recurrence of pneumonia than normal score patients (p < 0.05). Furthermore, patients with a mild MASA score more often experienced recurrence of pneumonia (p < 0.01) and 6-month mortality (p < 0.05) than normal score patients. The areas under the curve were 0.74 (95% confidence interval [CI], 0.67-0.82) for in-hospital mortality, 0.75 (95% CI, 0.68-0.82) for recurrence of pneumonia, 0.72 (95% Cl, 0.64-0.81) for 6-month mortality, and 0.60 (95% CI, 0.46-0.73) for detection of antibiotic-resistant bacteria. A multivariate analysis showed an abnormal MASA score to be an independent risk factor for the recurrence of pneumonia (p = 0.001) and 6-month mortality (p = 0.005). The MASA is useful for predicting the mortality and recurrence of pneumonia in elderly patients.
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Affiliation(s)
- Yasuo Chojin
- 1Department of Respiratory Medicine, Tobata Kyoritsu Hospital
| | - Tatsuji Kato
- 1Department of Respiratory Medicine, Tobata Kyoritsu Hospital
| | | | - Masami Omori
- 2Department of Rehabilitation, Tobata Kyoritsu Hospital
| | - Shingo Noguchi
- 3Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.,4Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan
| | - Kentaro Akata
- 3Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Takaaki Ogoshi
- 3Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Kazuhiro Yatera
- 3Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- 3Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.,5Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Naito K, Yamasaki K, Yatera K, Akata K, Noguchi S, Kawanami T, Fukuda K, Kido T, Ishimoto H, Mukae H. Bacteriological incidence in pneumonia patients with pulmonary emphysema: a bacterial floral analysis using the 16S ribosomal RNA gene in bronchoalveolar lavage fluid. Int J Chron Obstruct Pulmon Dis 2017; 12:2111-2120. [PMID: 28790814 PMCID: PMC5530061 DOI: 10.2147/copd.s140901] [Citation(s) in RCA: 14] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Pulmonary emphysema is an important radiological finding in chronic obstructive pulmonary disease patients, but bacteriological differences in pneumonia patients according to the severity of emphysematous changes have not been reported. Therefore, we evaluated the bacteriological incidence in the bronchoalveolar lavage fluid (BALF) of pneumonia patients using cultivation and a culture-independent molecular method. Japanese patients with community-acquired pneumonia (83) and healthcare-associated pneumonia (94) between April 2010 and February 2014 were evaluated. The BALF obtained from pneumonia lesions was evaluated by both cultivation and a molecular method. In the molecular method, ~600 base pairs of bacterial 16S ribosomal RNA genes in the BALF were amplified by polymerase chain reaction, and clone libraries were constructed. The nucleotide sequences of 96 randomly selected colonies were determined, and a homology search was performed to identify the bacterial species. A qualitative radiological evaluation of pulmonary emphysema based on chest computed tomography (CT) images was performed using the Goddard classification. The severity of pulmonary emphysema based on the Goddard classification was none in 47.4% (84/177), mild in 36.2% (64/177), moderate in 10.2% (18/177), and severe in 6.2% (11/177). Using the culture-independent molecular method, Moraxella catarrhalis was significantly more frequently detected in moderate or severe emphysema patients than in patients with no or mild emphysematous changes. The detection rates of Haemophilus influenzae and Pseudomonas aeruginosa were unrelated to the severity of pulmonary emphysematous changes, and Streptococcus species – except for the S. anginosus group and S. pneumoniae – were detected more frequently using the molecular method we used for the BALF of patients with pneumonia than using culture methods. Our findings suggest that M. catarrhalis is more frequently detected in pneumonia patients with moderate or severe emphysema than in those with no or mild emphysematous changes on chest CT. M. catarrhalis may play a major role in patients with pneumonia complicating severe pulmonary emphysema.
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Affiliation(s)
| | | | | | | | | | | | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan, Kitakyushu City, Fukuoka
| | | | - Hiroshi Ishimoto
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki City, Nagasaki, Japan
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki City, Nagasaki, Japan
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Shiraishi T, Ishimoto H, Akata K, Kawanami T, Yatera K, Mukae H. [An Autopsy Case Report of Adult T-cell Leukemia Accompanied by Rheumatoid Arthritis Mimicking Diffuse Panbronchiolitis]. J UOEH 2017; 39:55-61. [PMID: 28331122 DOI: 10.7888/juoeh.39.55] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 50-year-old female with a history of chronic sinusitis and rheumatoid arthritis visited our department with repetitive lower respiratory tract infections of Pseudomonas aeruginosa. Her chest CT showed diffuse panbronchiolitis-like pulmonary lesions, her blood examination revealed atypical lymphocytes, and she was serologically positive for anti-human T-lymphotrophic virus type 1 (HTLV-1) antibody. Her rheumatoid arthritis had been well-controlled after biological agent treatment followed by anti-inflammatory analgesic treatment. She received long-term low-dose macrolide therapy for four years. The Pseudomonas aeruginosa gradually became multi-antibiotic-resistant. Her lower respiratory infection gradually became uncontrollable, and her adult T cell leukemia (ATL) developed to the acute phase. Due to repetitive lower respiratory tract infections and respiratory failure, however, she could not receive any treatment for ATL, and she eventually died due to the progression of the disease. An autopsy revealed an invasion of abnormal lymphocytes in multiple organs, including the lungs, which indicated that the HTLV-1 infection and the progression of ATL were the dominant factors in this patient's clinical course. There have been no diffuse panbronchiolitis-like cases accompanied by rheumatoid arthritis and HTLV-1 infection so far. Because these diseases show similar clinical features, it is difficult to discriminate between them. There are presently no appropriate criteria for the proper time of treatment of patients with pulmonary lesion-associated ATL, but further research is expected to elucidate this matter.
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Affiliation(s)
- Tomoko Shiraishi
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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Yatera K, Noguchi S, Yamasaki K, Kawanami T, Fukuda K, Naito K, Akata K, Kido T, Ishimoto H, Sakamoto N, Taniguchi H, Mukae H. Determining the Possible Etiology of Hospital-Acquired Pneumonia Using a Clone Library Analysis in Japan. TOHOKU J EXP MED 2017; 242:9-17. [DOI: 10.1620/tjem.242.9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan
| | - Keisuke Naito
- Department of Respiratory Medicine, University of Occupational and Environmental Health
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health
| | - Takashi Kido
- Department of Respiratory Medicine, University of Occupational and Environmental Health
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Noriho Sakamoto
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Hatsumi Taniguchi
- Department of Microbiology, University of Occupational and Environmental Health, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences
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Mukae H, Noguchi S, Naito K, Kawanami T, Yamasaki K, Fukuda K, Akata K, Fukuda Y, Kido T, Ishimoto H, Sakamoto N, Taniguchi H, Yatera K. The Importance of Obligate Anaerobes and the Streptococcus anginosus Group in Pulmonary Abscess: A Clone Library Analysis Using Bronchoalveolar Lavage Fluid. Respiration 2016; 92:80-9. [DOI: 10.1159/000447976] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/21/2016] [Indexed: 11/19/2022] Open
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Akata K, Yatera K, Yamasaki K, Kawanami T, Naito K, Noguchi S, Fukuda K, Ishimoto H, Taniguchi H, Mukae H. The significance of oral streptococci in patients with pneumonia with risk factors for aspiration: the bacterial floral analysis of 16S ribosomal RNA gene using bronchoalveolar lavage fluid. BMC Pulm Med 2016; 16:79. [PMID: 27169775 PMCID: PMC4864928 DOI: 10.1186/s12890-016-0235-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [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: 01/25/2016] [Accepted: 05/01/2016] [Indexed: 11/10/2022] Open
Abstract
Background Aspiration pneumonia has been a growing interest in an aging population. Anaerobes are important pathogens, however, the etiology of aspiration pneumonia is not fully understood. In addition, the relationship between the patient clinical characteristics and the causative pathogens in pneumonia patients with aspiration risk factors are unclear. To evaluate the relationship between the patient clinical characteristics with risk factors for aspiration and bacterial flora in bronchoalveolar lavage fluid (BALF) in pneumonia patients, the bacterial floral analysis of 16S ribosomal RNA gene was applied in addition to cultivation methods in BALF samples. Methods From April 2010 to February 2014, BALF samples were obtained from the affected lesions of pneumonia via bronchoscopy, and were evaluated by the bacterial floral analysis of 16S rRNA gene in addition to cultivation methods in patients with community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP). Factors associated with aspiration risks in these patients were analyzed. Results A total of 177 (CAP 83, HCAP 94) patients were enrolled. According to the results of the bacterial floral analysis, detection rate of oral streptococci as the most detected bacterial phylotypes in BALF was significantly higher in patients with aspiration risks (31.0 %) than in patients without aspiration risks (14.7 %) (P = 0.009). In addition, the percentages of oral streptococci in each BALF sample were significantly higher in patients with aspiration risks (26.6 ± 32.0 %) than in patients without aspiration risks (13.8 ± 25.3 %) (P = 0.002). A multiple linear regression analysis showed that an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of ≥3, the presence of comorbidities, and a history of pneumonia within a previous year were significantly associated with a detection of oral streptococci in BALF. Conclusions The bacterial floral analysis of 16S rRNA gene revealed that oral streptococci were mostly detected as the most detected bacterial phylotypes in BALF samples in CAP and HCAP patients with aspiration risks, especially in those with a poor ECOG-PS or a history of pneumonia.
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Affiliation(s)
- Kentaro Akata
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Kei Yamasaki
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Toshinori Kawanami
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Keisuke Naito
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan.,Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Hatsumi Taniguchi
- Department of Microbiology, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishiku, Kitakyushu city, Fukuoka, 807-8555, Japan. .,Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
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29
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Uchimura K, Yamasaki K, Ishimoto H, Kakinouchi S, Kimura K, Kanaya T, Matsunaga T, Kawaguchi T, Fukuda Y, Sakagami K, Hata R, Ideguchi S, Takaki T, Shiraishi T, Akata K, Hanaka M, Nishida C, Kido T, Yatera K, Mukae H. [Factors Associated with Diagnostic Yield of Endobronchial Ultrasonography with a Guide Sheath for Peripheral Lung Cancer]. J UOEH 2016; 38:17-23. [PMID: 26972941 DOI: 10.7888/juoeh.38.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Endobronchial ultrasonography with a guide sheath (EBUS-GS) has recently been used for improved diagnostic yields for peripheral pulmonary lesions. This study retrospectively evaluated the factors related to the diagnostic yield of EBUS-GS for peripheral lung cancer. The medical records of 76 patients who had been diagnosed with lung cancer and had undergone bronchoscopy with EBUS-GS in our hospital between August 2014 and September 2015 were reviewed. The total diagnostic ratio of peripheral lung cancer was 71.1%. The following factors of the diagnostic yield were evaluated: location of pulmonary lesion; size; feature; bronchus sign; location of EBUS probe; EBUS detection; number of biopsies performed; procedure time; use of virtual bronchoscopic navigation; use of EBUS-guided transbronchial needle aspiration with EBUS-GS; CT slice thickness; operator's years of medical experience; and specialized training in bronchoscopy at the National Cancer Center. In all cases, lesion size ≧ 20 mm (80.8% vs. 50.0%, P = 0.006), EBUS probe location "within" (90.0% vs. 50.0%, P < 0.001), EBUS detection (80.7% vs. 28.6%, P < 0.001), number of biopsies ≧ 5 (78.0% vs. 47.1%, P = 0.013), and bronchoscopy training (81.6% vs. 60.5%, P = 0.043) significantly contributed to an increase in the diagnostic yield. Following a multivariate analysis, EBUS probe location "within" was found to be the most significant factor affecting the diagnostic yield (odds ratio 14.10, 95% CI 3.53-56.60, P < 0.001), and bronchoscopy training was the second most significant factor (odds ratio 6.93, 95% CI 1.86-25.80, P = 0.004). EBUS probe location "within" and bronchoscopy training are the most important factors for improved diagnostic yield by bronchoscopy with EBUS-GS for peripheral lung cancer.
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Affiliation(s)
- Keigo Uchimura
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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30
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Yamasaki K, Yatera K, Kato K, Noguchi S, Kawanami T, Fukuda K, Naito K, Akata K, Ishimoto H, Taniguchi H, Mukae H. Successful Additional Corticosteroid Treatment in a Patient with Mycoplasma pneumoniae Pneumonia in whom a Monobacterial Infection was Confirmed by a Molecular Method Using Bronchoalveolar Lavage Fluid. Intern Med 2016; 55:703-7. [PMID: 26984095 DOI: 10.2169/internalmedicine.55.5124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 23-year-old Japanese woman was admitted to A hospital due to pneumonia. IgM for Mycoplasma pneumoniae was positive, and the patient was treated with imipenem/cilastatin, clindamycin, pazufloxacin and minocycline. However, both the chest radiological findings and the symptoms became exacerbated, and she was therefore transferred to our hospital. The bronchoalveolar lavage fluid was obtained, and a 16S rRNA gene sequencing analysis revealed a monobacterial infection of Mycoplasma pneumoniae. Therefore, corticosteroid treatment in addition to minocycline was administered, and the patients symptoms, laboratory data and chest radiographs improved. Corticosteroid therapy may therefore be considered for patients with refractory M. pneumoniae pneumonia.
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Affiliation(s)
- Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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31
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Akata K, Yatera K, Wang KY, Naito K, Ogoshi T, Noguchi S, Kido T, Toyohira Y, Shimokawa H, Yanagihara N, Tsutsui M, Mukae H. Decreased Bronchial Eosinophilic Inflammation and Mucus Hypersecretion in Asthmatic Mice Lacking All Nitric Oxide Synthase Isoforms. Lung 2015; 194:121-4. [PMID: 26685897 DOI: 10.1007/s00408-015-9833-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/08/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Asthma is characterized by airflow limitation with chronic airway inflammation, hyperresponsiveness and mucus hypersecretion. NO is generated by three nitric oxide synthase (i/n/eNOSs) isoforms, but conflicting results have been reported using asthmatic mice treated with NOSs inhibitors and NOS-knockout mice. To elucidate the authentic role of NO/NOSs in asthma, we used asthmatic mice lacking all NOSs (n/i/eNOS(-/-)). METHODS Wild-type and n/i/eNOS(-/-) mice were sensitized and challenged with ovalbumin. Pathological findings and expressions of interferon (IFN)-γ, interleukin (IL)-4, -5, -10, -13 and chemokines in the lung were evaluated. RESULTS Decreased eosinophilic inflammation, bronchial thickening and mucus secretion, IL-4, -5 and -13, monocyte chemoattractant protein-1, eotaxin-1 and thymus and activation-regulated chemokine expressions were observed in n/i/eNOS(-/-) mice compared to wild-type, but expressions of IFN-γ and IL-10 were similar. CONCLUSION Using asthmatic n/i/eNOS(-/-) mice, NO plays important roles in accelerating bronchial eosinophilic inflammation and mucus hypersecretion in the pathophysiology of asthma.
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Affiliation(s)
- Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
| | - Ke-Yong Wang
- Shared-Use Research Center, UOEH, Kitakyushu, Japan
| | - Keisuke Naito
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Takaaki Ogoshi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Shingo Noguchi
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Takashi Kido
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Yumiko Toyohira
- Department of Pharmacology, School of Medicine, UOEH, Kitakyushu, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Masato Tsutsui
- Department of Pharmacology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan (UOEH), 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
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32
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Noguchi S, Yatera K, Kawanami T, Yamasaki K, Naito K, Akata K, Shimabukuro I, Ishimoto H, Yoshii C, Mukae H. The clinical features of respiratory infections caused by the Streptococcus anginosus group. BMC Pulm Med 2015; 15:133. [PMID: 26502716 PMCID: PMC4624190 DOI: 10.1186/s12890-015-0128-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [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: 06/25/2015] [Accepted: 10/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Streptococcus anginosus group (SAG) play important roles in respiratory infections. It is ordinarily difficult to distinguish them from contaminations as the causative pathogens of respiratory infections because they are often cultured in respiratory specimens. Therefore, it is important to understand the clinical characteristics and laboratory findings of respiratory infections caused by the SAG members. The aim of this study is to clarify the role of the SAG bacteria in respiratory infections. METHODS A total of 30 patients who were diagnosed with respiratory infections which were caused by the SAG bacteria between January 2005 and February 2015 were retrospectively evaluated. RESULTS Respiratory infections caused by the SAG were mostly seen in male patients with comorbid diseases and were typically complicated with pleural effusion. Pleural effusion was observed in 22 (73.3%) patients. Empyema was observed in half of the 22 patients with pleural effusion. S. intermedius, S. constellatus and S. anginosus were detected in 16 (53.3 %), 11 (36.7 %) and 3 (10.0 %) patients, respectively. Six patients had mixed-infections. The duration from the onset of symptoms to the hospital visit was significantly longer in "lung abscess" patients than in "pneumonia" patients among the 24 patients with single infections, but not among the six patients with mixed-infection. The peripheral white blood cell counts of the "pneumonia" patients were higher than those of the "lung abscess" patients and S. intermedius was identified significantly more frequently in patients with pulmonary and pleural infections (pneumonia and lung abscess) than in patients with bacterial pleurisy only. In addition, the patients in whom S. intermedius was cultured were significantly older than those in whom S. constellatus was cultured. CONCLUSIONS Respiratory infections caused by the SAG bacteria tended to be observed more frequently in male patients with comorbid diseases and to more frequently involve purulent formation. In addition, S. intermedius was mainly identified in elderly patients with having pulmonary infection complicated with pleural effusion, and the aspiration of oral secretions may be a risk factor in the formation of empyema thoracis associated with pneumonia due to S. intermedius.
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Affiliation(s)
- Shingo Noguchi
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, 1-17-1, Hamamachi, Wakamatsuku, Kitakyushu city, 808-0024, Fukuoka, Japan.
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.
| | - Toshinori Kawanami
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.
| | - Kei Yamasaki
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.
| | - Keisuke Naito
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.
| | - Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.
| | - Ikuko Shimabukuro
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, 1-17-1, Hamamachi, Wakamatsuku, Kitakyushu city, 808-0024, Fukuoka, Japan.
| | - Hiroshi Ishimoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.
| | - Chiharu Yoshii
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, 1-17-1, Hamamachi, Wakamatsuku, Kitakyushu city, 808-0024, Fukuoka, Japan.
| | - Hiroshi Mukae
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, 1-1, Iseigaoka, Yahatanishiku, Kitakyushu City, 807-8555, Fukuoka, Japan.
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Akata K, Kawanami T, Yatera K, Tachiwada T, Takenaka M, Noguchi S, Yamasaki K, Nishida C, Orihashi T, Ishimoto H, Yoshii C, Tanaka F, Mukae H. In-hospital airborne tuberculous infection from a lesion of calcified pleural thickening during thoracic surgery in a patient with lung cancer. Intern Med 2015; 54:2699-703. [PMID: 26466714 DOI: 10.2169/internalmedicine.54.4317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 75-year-old Japanese man underwent thoracic surgery to treat a large lung cancer lesion in the left upper lobe with calcified pleural thickening. Postoperatively, viable Mycobacterium tuberculosis was detected in the margin of the resected thickened calcified pleural lesion. Therefore, an infection control investigation of medical staff who had come in contact with the patient was conducted. Consequently, two of the 14 healthcare professionals who had been in the operating room were diagnosed with latent tuberculous infections. Therefore, strict precautions against airborne infections are required to prevent the in-hospital transmission of M. tuberculosis in such cases.
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Affiliation(s)
- Kentaro Akata
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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Noguchi S, Yatera K, Kawanami T, Yamasaki K, Akata K, Oda K, Nishida C, Kawanami Y, Ishimoto H, Fukuda K, Taniguchi H, Mukae H. P323 The significant role of oral bacteria in CAP and HCAP patients with aspiration pneumonia. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70564-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Yanagihara T, Moriwaki A, Seki N, Akata K, Imanaga T. [A brain abscess as a complication of hepatopulmonary syndrome coexisting with interstitial pneumonia]. Nihon Kokyuki Gakkai Zasshi 2011; 49:534-537. [PMID: 21842692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 76-year-old woman with a 20-year history of chronic hepatitis C was referred to our hospital for worsening exertional dyspnea. She had been given a diagnosis of interstitial pneumonia based on chest computed tomography findings 5 years previously. Contrast-enhanced echocardiography confirmed an intrapulmonary right-to-left shunt, and therefore we diagnosed hepatopulmonary syndrome comorbid with interstitial pneumonia. In July 2009 she was admitted to our hospital with a low grade fever, headache, and vomiting. We diagnosed a left cerebellar brain abscess caused by Streptococcus intermedius. She underwent stereotactic burr-hole drainage and received vancomycin, piperacillin and cefotaxime. Cases of brain abscess secondary to hepatopulmonary syndrome are rare. Nevertheless, we should be aware of this complication of hepatopulmonary syndrome.
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