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Matsumoto Y, Murata M, Ohta A, Yamasaki S, Ikezaki H, Toyoda K, Shimono N. The humoral and cellular immune responses following booster vaccination with SARS-CoV-2 mRNA in people living with human immunodeficiency virus. J Infect Chemother 2024; 30:417-422. [PMID: 37977325 DOI: 10.1016/j.jiac.2023.11.014] [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: 07/02/2023] [Revised: 10/31/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION People living with human immunodeficiency virus (PLWH) have higher mortality rates from COVID-19 than those without HIV. Additionally, the seroconversion rate of antibodies following a second dose of SARS-CoV-2 vaccine is lower in PLWH than non-infected individuals, indicating the need for booster vaccination. Here, we evaluated the humoral and cellular immune responses to booster SARS-CoV-2 vaccination in PLWH. METHODS The dynamics of anti-spike IgG titers and antigen-specific interferon (IFN)-γ levels to SARS-CoV-2 vaccination were assessed over a 6-month period following a third vaccination of 34 PLWH. RESULTS Antibody titers for humoral immunity were 50 % lower at 24 weeks post-vaccination than those at 12 weeks. However, those at 24 weeks after the booster vaccination were approximately eight times higher than before. Regarding cellular immunity, IFN-γ levels at 24 weeks after the third vaccination were lower than those at 12 weeks, but nearly 90 % of participants maintained a cut-off value of ≥0.15 IU/mL. A comparison between two groups with CD4+ T lymphocytes counts of <500/μL or ≥500/μL exhibited no statistically significant differences in antibody or IFN-γ levels. However, in the group with CD4+ T lymphocyte counts of <500/μL, the rate of IFN-γ above the cut-off value at 24 weeks after the booster vaccination was lower than that of ≥500/μL. CONCLUSION An immune response is expected in PLWH given successful antiretroviral therapy with booster SARS-CoV-2 vaccination. However, caution should be exercised for cases with low CD4+ T-lymphocyte counts. (240/250 words).
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Affiliation(s)
- Yuji Matsumoto
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Azusa Ohta
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Sho Yamasaki
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
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Kosaka S, Shimizu S, Nakayamada S, Nawata A, Shimono N, Tanaka M, Maruyama H, Osada Y, Tanaka Y. A delayed diagnosis of fascioliasis: The importance of appropriate fecal diagnostic method. J Infect Chemother 2024; 30:454-458. [PMID: 37944698 DOI: 10.1016/j.jiac.2023.11.006] [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: 04/12/2023] [Revised: 09/26/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
Fascioliasis, a zoonotic helminthiasis, occurs sporadically in Japan. In this report, we describe a case of fascioliasis that was initially difficult to diagnose because the fecal examination method was negative for the Fasciola sp. eggs. A 64-year-old man living in Shimonoseki City, Japan, presented with fatigue and anorexia. Laboratory tests showed hepatic dysfunction and eosinophilia. Abdominal dynamic contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography suggested intrahepatic biliary cysts. Thereafter, fever and night sweats persisted, and positron emission tomography and biopsy of the porta hepatis lymph node were performed on suspicion of malignancy. However, histopathological diagnosis found non-specific inflammation. As fascioliasis was suspected due to eosinophilia and the multiple hepatic masses, fecal egg examination was performed by an external private laboratory, which adopted the flotation method and reported the absence of parasite eggs. However, fecal examination was retried in our laboratory using the formalin-ether concentration method, and we detected Fasciola sp. eggs. This case suggests that misdiagnosis may occur depending on the fecal examination method; thus, it is necessary to choose a suitable method for certain parasite species.
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Affiliation(s)
- Shumpei Kosaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shoichi Shimizu
- Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
| | - Shingo Nakayamada
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Aya Nawata
- Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Mio Tanaka
- Department of Infectious Diseases, Division of Parasitology, Faculty of Medicine, University of Miyazaki, Japan
| | - Haruhiko Maruyama
- Department of Infectious Diseases, Division of Parasitology, Faculty of Medicine, University of Miyazaki, Japan
| | - Yoshio Osada
- Department of Immunology and Parasitology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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Kashiwado Y, Kimoto Y, Ohshima S, Sawabe T, Irino K, Nakano S, Hiura J, Yonekawa A, Wang Q, Doi G, Ayano M, Mitoma H, Ono N, Arinobu Y, Niiro H, Hotta T, Kang D, Shimono N, Akashi K, Takeuchi T, Horiuchi T. Immunosuppressive therapy and humoral response to third mRNA COVID-19 vaccination with a six-month interval in rheumatic disease patients. Rheumatology (Oxford) 2024; 63:725-733. [PMID: 37289506 DOI: 10.1093/rheumatology/kead275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023] Open
Abstract
OBJECTIVES To evaluate the long-term impact of immunosuppressive therapeutic agents on antibody response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mRNA vaccination in patients with autoimmune rheumatic diseases (AIRD) in order to propose a strategy for annual vaccination. METHODS This prospective multicentre cohort study evaluated the humoral response to second and third BNT162b2 and/or mRNA-1273 vaccines in 382 Japanese AIRD patients classified into 12 different medication groups and in 326 healthy controls (HCs). The third vaccination was administered six months after the second vaccination. Antibody titres were measured using the Elecsys Anti-SARS-CoV-2 S assay. RESULTS The seroconversion rate and antibody titres were lower in AIRD patients than in HCs 3-6 weeks after the second vaccination and 3-6 weeks after the third vaccination. Seroconversion rates were <90% after the third vaccination in patients receiving mycophenolate mofetil and rituximab. Antibody levels after the third vaccination were significantly lower in the groups prescribed TNF inhibitor with or without methotrexate, abatacept and rituximab or cyclophosphamide than those of HCs in a multivariate analysis adjusting for age, sex, and glucocorticoid dosage. The third vaccination induced an adequate humoral response in patients treated with sulfasalazine, bucillamine, methotrexate monotherapy, iguratimod, interleukin-6 inhibitors or calcineurin inhibitors including tacrolimus. CONCLUSIONS Repeated vaccinations in many immunosuppressed patients produced antibody responses similar to those observed in HCs. In contrast, annual vaccination in patients receiving TNF inhibitors, abatacept, mycophenolate mofetil and rituximab may require caution.
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Affiliation(s)
- Yusuke Kashiwado
- Department of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan
| | - Yasutaka Kimoto
- Department of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan
| | - Shiro Ohshima
- Department of Clinical Research, Rheumatology and Allergology, Osaka Minami Medical Center, Osaka, Japan
| | - Takuya Sawabe
- Department of Rheumatology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Kensuke Irino
- Department of Rheumatology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Shota Nakano
- Department of Rheumatology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
| | - Junki Hiura
- Department of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan
| | - Akiko Yonekawa
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Qiaolei Wang
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Goro Doi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Masahiro Ayano
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroki Mitoma
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Nobuyuki Ono
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yojiro Arinobu
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroaki Niiro
- Department of Medical Education, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Taeko Hotta
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Dongchon Kang
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Tsutomu Takeuchi
- Division of Rheumatology and Clinical Immunology, Keio University, Tokyo, Japan
| | - Takahiko Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Oita, Japan
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Yamamoto K, Asai Y, Nakagawa H, Nakatani I, Hayashi K, Matono T, Kanai S, Yamato M, Mikawa T, Shimatani M, Shimono N, Shinohara K, Kitaura T, Nagasaka A, Manabe A, Komiya N, Imakita N, Yamamoto Y, Iwamoto N, Okumura N, Ohmagari N. Characteristics of preventive intervention acceptance for international travel among clients aged 60 years and older from a Japanese multicenter pretravel consultation registry. J Infect Chemother 2023; 29:1137-1144. [PMID: 37598777 DOI: 10.1016/j.jiac.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/13/2023] [Accepted: 08/17/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES Pretravel consultation (PTC) is important for older adults owing to health problems associated with overseas travel. Although older adults in Japan, their PTC characteristics are less known. This study aimed to investigate the epidemiology of clients aged ≥ 60 years based on data from the Japan Pre-travel Consultation Registry (J-PRECOR). METHODS Clients aged ≥ 60 years who visited J-PRECOR cooperative hospitals from February 1, 2018, to May 31, 2022, were included. The primary endpoint was a comparison of prescriptions for vaccines for hepatitis A, tetanus toxoid, and malaria prophylaxis in travelers to high-risk malaria countries in yellow fever vaccination (YFV)-available facilities with and without YFV. RESULTS In total, 1000 clients (median age: 67 years) were included. Although 523 clients were immunized with YFV, only 38.6% of the 961 unimmunized clients were vaccinated with the tetanus toxoid-containing vaccine. Malaria chemoprophylaxis was prescribed to 25.7% of clients traveling for ≤55 days. At YFV-capable institutes, 557 clients traveling to yellow fever risk countries took PTC, 474 of whom received YFV and 83 were unvaccinated. Lower age (odds rate 0.85 per 1 year; 95% CI 0.80-0.90) and lower hepatitis A vaccination rate (0.29; 95% CI 0.14-0.63) were significantly associated with YFV. CONCLUSIONS Preventive interventions other than YFV should be offered to older adults.
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Affiliation(s)
- Kei Yamamoto
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
| | - Yusuke Asai
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Hidenori Nakagawa
- Department of Infectious Diseases, Osaka City General Hospital, Osaka, 534-0021, Japan
| | | | - Kenichi Hayashi
- Department of Infectious Diseases, Kenwakai Otemachi Hospital, Kitakyushu, 803-0814, Japan
| | - Takashi Matono
- Department of Infectious Diseases, Aso Iizuka Hospital, Iizuka, 820-8505, Japan
| | - Shinichiro Kanai
- Department of Infection Control, Shinshu University Hospital, Matsumoto, 390-0802, Japan
| | - Masaya Yamato
- Department of General Medicine and Infectious Diseases, Travel Clinic, Rinku General Medical Center, Izumisano, 598-8577, Japan
| | - Takahiro Mikawa
- Department of General Medicine and Infectious Diseases, Yamanashi Prefectural Central Hospital, Kofu, 400-0027, Japan
| | - Michitsugu Shimatani
- Department of Infectious Diseases, Hamamatsu Medical Center, Hamamatsu, 432-8580, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, 812-8582, Japan
| | - Koh Shinohara
- Department of Infectious Diseases, Kyoto City Hospital, Kyoto, 604-8845, Japan
| | - Tsuyoshi Kitaura
- Division of Infectious Diseases, Faculty of Medicine, Tottori University, Yonago, 683-8504, Japan
| | - Atsushi Nagasaka
- Department of Infectious Diseases, Sapporo City General Hospital, Sapporo, 060-8604, Japan
| | - Akihiro Manabe
- Department of Clinical Laboratory Medicine, Fukuyama City Hospital, Fukuyama, 721-8511, Japan
| | - Nobuhiro Komiya
- Department of Infectious Diseases, Japanese Red Cross Society Wakayama Medical Center, Wakayama, 640-8558, Japan
| | - Natsuko Imakita
- Center for Infectious Diseases, Nara Medical University Hospital, Kashihara, 634-8522, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Hospital, Toyama, 930-0152, Japan
| | - Noriko Iwamoto
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Nobumasa Okumura
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center/Travel Clinic, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
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Goto T, Chong Y, Tani N, Susai N, Yoshinaga T, Sasaki T, Taniguchi M, Kusakabe T, Shimono N, Akashi K, Ikematsu H. Distinct features of SARS-CoV-2 humoral immunity against Omicron breakthrough infection. Vaccine 2023; 41:7019-7025. [PMID: 37858449 DOI: 10.1016/j.vaccine.2023.10.035] [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: 09/27/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND SARS-CoV-2 Omicron breakthrough infection (Omicron-BTI) after vaccination has been frequently observed. A more detailed understanding of the humoral immunity against Omicron-BTI is required. METHODS We measured strain-specific live-virus based neutralizing activity, anti-spike IgG, and anti-receptor-binding domain (RBD) IgG titers in individuals with Omicron/BA.1-BTI and directly compared them with controls with diverse combinations of wild-type (WT) mRNA vaccination and infection history. RESULTS Omicron-BTI individuals showed markedly higher neutralizing titers against all the WT, Delta, and Omicron strains in convalescent sera, compared with unvaccinated Omicron-infection individuals with only Omicron neutralizing activity. Similar tendencies were found in strain-specific anti-spike and anti-RBD IgG titers. The Omicron-specificity (BA.1/WT neutralizing ratio), Omicron-neutralizing efficiency per antibody unit, and anti-Omicron RBD-directivity of anti-spike antibodies in Omicron-BTI individuals were all significantly lower than those in unvaccinated Omicron-infection individuals, but they were equivalent to or higher than those in uninfected vaccinees. The induction of Omicron-specific neutralizing activity after Omicron-BTI was not weakened for eight months from the last vaccination. CONCLUSIONS These findings suggest that cross-reactive vaccine-induced immunity was intensively stimulated following Omicron breakthrough infection, which contributed to Omicron neutralization. Measuring SARS-CoV-2 variant-specific antibody levels as well as neutralizing activity is useful for evaluating humoral immunity after breakthrough infection in the current situation of antigenic gaps between vaccinated and epidemic (Omicron sub-lineages) strains.
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Affiliation(s)
- Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan.
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Natsumi Susai
- Laboratory for Bio-Drug Discovery, Shionogi & Co., Ltd., Osaka, Japan
| | - Tomoyo Yoshinaga
- Laboratory for Bio-Drug Discovery, Shionogi & Co., Ltd., Osaka, Japan
| | - Tomoki Sasaki
- R&D Department, KAICO Ltd., Fukuoka, Japan; Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | | | - Takahiro Kusakabe
- Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
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Tani N, Ikematsu H, Goto T, Kondo S, Gondo K, Fujiyoshi N, Minami J, Harada Y, Nagano S, Horiuchi T, Kuwano H, Akashi K, Shimono N, Chong Y. Correlation between specific antibody response to wild-type BNT162b2 booster and the risk of breakthrough infection with omicron variants: Impact of household exposure in hospital healthcare workers. Vaccine 2023; 41:6672-6678. [PMID: 37775465 DOI: 10.1016/j.vaccine.2023.09.051] [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: 04/11/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The emergence of omicron variants exhibiting antigenic changes has led to an increase in breakthrough infection among individuals with a wild-type SARS-CoV-2 vaccine booster. The correlation between post-booster spike-specific antibodies and omicron infection risk remains unclear. METHODS This prospective cohort study included SARS-CoV-2-naive healthcare workers with three-dose BNT162b2. Post-booster spike-specific IgG and interferon-γ levels were measured. Breakthrough infection was documented during a 10-month omicron-predominant period. Household and healthcare contacts were followed to identify subsequent infections. The IgG titers were additionally measured at the end of follow-up, and the titers at exposure were estimated from the two-point titers. RESULTS Of 333 participants, 89 developed infection, of whom 37 (41.6 %) were household contacts. Kaplan-Meier curves indicated that higher IgG titers were significantly correlated with lower cumulative infection incidence (p = 0.029), whereas the interferon-γ levels were not (p = 0.926). Multivariate Cox analysis showed that increasing IgG titers were associated with a reduced hazard ratio (HR) of 0.26 (95% CI, 0.12-0.55). Household exposure posed a greater infection risk than healthcare exposure (HRs, 11.24 [6.88-18.40] vs. 2.82 [1.37-5.44]). The difference in geometric mean IgG titers of infected and uninfected participants was significant among household contacts (20,244 AU/mL vs. 13,842 AU/mL, p = 0.031). Estimation of IgG titers at exposure showed a significantly higher infection incidence in those exposed with titers of <3,000 AU/mL than in those with higher titers (79.2 % vs. 32.3 %, p < 0.001). CONCLUSIONS Spike-specific antibodies induced by a wild-type SARS-CoV-2 vaccine booster are suggested to be effective in protecting against omicron infection. Household exposure would be a significant source of infection for hospital healthcare workers.
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Affiliation(s)
- Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka 812-8582, Japan
| | | | - Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka 812-8582, Japan
| | - Satoko Kondo
- Department of Nursing, Fukuoka City Hospital, Fukuoka 812-0046, Japan
| | - Kei Gondo
- Clinical Laboratory, Fukuoka City Hospital, Fukuoka 812-0046, Japan
| | - Naoko Fujiyoshi
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka 812-0046, Japan
| | - Junya Minami
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka 812-0046, Japan
| | - Yukiko Harada
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka 812-0046, Japan
| | - Sukehisa Nagano
- Department of Neurology, Fukuoka City Hospital, Fukuoka 812-0046, Japan
| | | | | | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka 812-8582, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, 812-8582 Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka 812-8582, Japan.
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Toyoda M, Tan TS, Motozono C, Barabona G, Yonekawa A, Shimono N, Minami R, Nagasaki Y, Miyashita Y, Oshiumi H, Nakamura K, Matsushita S, Kuwata T, Ueno T. Evaluation of Neutralizing Activity against Omicron Subvariants in BA.5 Breakthrough Infection and Three-Dose Vaccination Using a Novel Chemiluminescence-Based, Virus-Mediated Cytopathic Assay. Microbiol Spectr 2023; 11:e0066023. [PMID: 37310218 PMCID: PMC10433814 DOI: 10.1128/spectrum.00660-23] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/28/2023] [Indexed: 06/14/2023] Open
Abstract
Neutralizing potency of humoral immune responses induced by prior infection or vaccination is vital for protecting of individuals and population against severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2). However, the emergence of viral variants that can evade neutralization by vaccine- or infection-induced immunity is a significant public health threat and requires continuous monitoring. Here, we have developed a novel scalable chemiluminescence-based assay for assessing SARS-CoV-2-induced cytopathic effect to quantify the neutralizing activity of antisera. The assay leverages the correlation between host cell viability and ATP levels in culture to measure the cytopathic effect on target cells induced by clinically isolated, replication-competent, authentic SARS-CoV-2. With this assay, we demonstrate that the recently arisen Omicron subvariants BQ.1.1 and XBB.1 display a significant decrease in sensitivity to neutralization by antibodies elicited from breakthrough infections with Omicron BA.5 and from receipt of three doses of mRNA vaccines. Thus, this scalable neutralizing assay provides a useful platform to assess the potency of acquired humoral immunity against newly emerging SARS-CoV-2 variants. IMPORTANCE The ongoing global pandemic of SARS-CoV-2 has emphasized the importance of neutralizing immunity in protecting individuals and populations against severe respiratory illness. In light of the emergence of viral variants with the potential to evade immunity, continuous monitoring is imperative. A virus plaque reduction neutralization test (PRNT) is a "gold standard" assay for analyzing neutralizing activity for authentic viruses that form plaques, like influenza virus, dengue virus, and SARS-CoV-2. However, this method is labor intensive and is not efficient for performing large-scale neutralization assays on patient specimens. The assay system established in this study allows for the detection of a patient's neutralizing activity by simply adding an ATP detection reagent, providing a simple evaluation system for neutralizing activity of antisera as an alternative to the plaque reduction method. Our extended analysis of the Omicron subvariants highlights their increasing capability to evade neutralization by both vaccine- and infection-induced humoral immunity.
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Affiliation(s)
- Mako Toyoda
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
- Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toong Seng Tan
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Chihiro Motozono
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Godfrey Barabona
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Akiko Yonekawa
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Rumi Minami
- Internal Medicine, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Yoji Nagasaki
- Division of Infectious Diseases, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Yusuke Miyashita
- Department of Immunology, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
- Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroyuki Oshiumi
- Department of Immunology, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kimitoshi Nakamura
- Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shuzo Matsushita
- Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Takeo Kuwata
- Division of Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Takamasa Ueno
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
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8
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Ikezaki H, Furusyo N, Ai M, Okazaki M, Kohzuma T, Hayashi J, Shimono N, Schaefer EJ. Relationship between the cholesterol and triglyceride content of lipoprotein subclasses and carotid intima-media thickness: A cross-sectional population-based study. Clin Chim Acta 2023; 548:117521. [PMID: 37597644 DOI: 10.1016/j.cca.2023.117521] [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: 02/23/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND The association between lipoprotein subclasses and carotid intima-media thickness (cIMT) progression has yet to be fully evaluated. We assessed which lipoprotein subclasses were associated with maximum cIMT levels in the general population. METHODS In this study, cholesterol and triglyceride content of 20 lipoprotein subclasses were analyzed using gel permeation high-performance liquid chromatography (GP-HPLC) in 864 Japanese women and men (mean age 57 y, free of chronic liver or kidney diseases and off lipid-lowering, hormone replacement, or adrenocorticosteroid medications). Univariate and multivariate regression analyses and univariate and partial correlation analyses were performed to examine the relationships between lipoprotein subclasses and maximum cIMT levels. RESULTS After adjusting for age, sex, systolic blood pressure, smoking, diabetes, and anti-hypertensive agents, elevated low-density lipoprotein (LDL)-2 and -3 cholesterol (particle diameter 25.5 nm and 23.0 nm, respectively; medium and small LDL) were associated with higher maximum cIMT levels in both women and men (all p for trend < 0.05). These associations were significant even after participants taking anti-diabetic or anti-hypertensive agents were excluded. No significant associations were found between any triglyceride subclasses and maximum cIMT levels. CONCLUSIONS Smaller LDL particle cholesterol values are the most atherogenic lipoprotein parameter.
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Affiliation(s)
- Hiroaki Ikezaki
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan; Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, and Tufts University School of Medicine, Boston, MA, United States; Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan.
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan
| | - Masumi Ai
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, and Tufts University School of Medicine, Boston, MA, United States; Department of Insured Medical Care Management, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mitsuyo Okazaki
- Professor emeritus of Tokyo Medical and Dental University, Tokyo, Japan
| | - Takuji Kohzuma
- Diagnostics Department, Asahi Kasei Pharma Corporation, Tokyo, Japan
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu Hospital, Fukuoka, Japan
| | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Human Nutrition Research Center on Aging at Tufts University, and Tufts University School of Medicine, Boston, MA, United States
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9
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Chong Y, Goto T, Watanabe H, Tani N, Yonekawa A, Ikematsu H, Shimono N, Tanaka Y, Akashi K. Achievement of sufficient antibody response after a fourth dose of wild-type SARS-CoV-2 mRNA vaccine in nursing home residents. Immun Inflamm Dis 2023; 11:e962. [PMID: 37647452 PMCID: PMC10461422 DOI: 10.1002/iid3.962] [Citation(s) in RCA: 1] [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: 02/27/2023] [Revised: 07/09/2023] [Accepted: 07/13/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Infection control during COVID-19 outbreaks in nursing facilities is a critical public health issue. Antibody responses before and after the fourth (second booster) dose of wild-type severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in nursing home residents have not been fully characterized. METHODS This study included 112 individuals: 54 nursing home residents (mean age: 84.4 years; 35 SARS-CoV-2-naive and 19 previously infected) and 58 healthcare workers (mean age: 47.7 years; 25 SARS-CoV-2-naive and 33 previously infected). Antispike and antinucleocapsid antibody responses to messenger RNA vaccination were evaluated using serum samples collected shortly and 5 months after the third dose, and shortly after the fourth dose. RESULTS The median immunoglobulin G (IgG) level in SARS-CoV-2-naive residents was similar to that in SARS-CoV-2-naive healthcare workers after the fourth dose (24,026.3 vs. 30,328.6 AU/mL, p = .79), whereas after the third dose the IgG level of SARS-CoV-2-naive residents was approximately twofold lower than that in SARS-CoV-2-naive healthcare workers. In residents with previous SARS-CoV-2 infection, timing of infection in relation to vaccination affected the kinetics of antibody responses. Residents infected after the third dose showed the highest IgG levels after the fourth dose among all groups (median: 64,328.8 AU/mL), in contrast to residents infected before initiating vaccination with antibody levels similar to those of SARS-CoV-2-naive residents. CONCLUSIONS Advanced aged nursing home residents, poor responders in the initial SARS-CoV-2 vaccine series, could achieve sufficient antibody responses after the fourth (second booster) vaccination, comparable to those of younger adults.
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Affiliation(s)
- Yong Chong
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Takeyuki Goto
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Haruka Watanabe
- Department of Clinical Immunology, Rheumatology, and Infectious DiseaseKyushu University HospitalFukuokaJapan
| | - Naoki Tani
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Akiko Yonekawa
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
| | - Hideyuki Ikematsu
- Division of Influenza ResearchJapan Physicians AssociationTokyoJapan
| | - Nobuyuki Shimono
- Department of Center for the Study of Global InfectionCenter for the Study of Global Infection, Kyushu University HospitalFukuokaJapan
| | - Yosuke Tanaka
- Department of Internal MedicineMedical Corporation SOUSEIKAI, Kanenokuma HospitalFukuokaJapan
| | - Koichi Akashi
- Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine)FukuokaJapan
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10
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Ikezaki H, Nomura H, Shimono N. Impact of peripheral mitochondrial DNA level on immune response after COVID-19 vaccination. iScience 2023; 26:107094. [PMID: 37351502 PMCID: PMC10256584 DOI: 10.1016/j.isci.2023.107094] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/30/2023] [Accepted: 06/07/2023] [Indexed: 06/24/2023] Open
Abstract
The efficacy of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the elderly is partially hindered by immunosenescence, resulting from decreased mtDNA levels. This study evaluated the correlation between mtDNA levels in peripheral leukocytes and immune response to the SARS-CoV-2 vaccine. Two hundred ten participants (median age 79.5 years), including 83 frail residents/inpatients and 70 robust outpatients, were analyzed. Anti-spike IgG antibody (IgG(S)) titers were serially measured from before the first vaccination to after the third vaccination. The mtDNA levels and cell-mediated immunity were measured in 45 elderly and 22 elderly individuals two months after the third vaccination. The robust group had consistently higher IgG(S) titers than the frail group. The mtDNA levels positively correlated with IgG(S) titers, as well as with cell-mediated immunity. These findings suggest that mtDNA levels positively impact vaccine-induced immunity. Further studies into maintaining mtDNA levels may provide insights into immunosenescence in the elderly.
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Affiliation(s)
- Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka 8128582, Japan
- Department of Internal Medicine, Haradoi Hospital, Fukuoka 8138588, Japan
| | - Hideyuki Nomura
- Department of Internal Medicine, Haradoi Hospital, Fukuoka 8138588, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
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11
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Nishida R, Eriguchi Y, Miyake N, Nagasaki Y, Yonekawa A, Mori Y, Kato K, Akashi K, Shimono N. Breakthrough candidemia with hematological disease: Results from a single-center retrospective study in Japan, 2009-2020. Med Mycol 2023:myad056. [PMID: 37312399 DOI: 10.1093/mmy/myad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Breakthrough candidemia (BrC) is a significant problem in immunocompromised patients, particularly those with hematological disorders. To assess the characteristics of BrC in patients with hematologic disease treated with novel antifungal agents, we collected clinical and microbiological information on said patients from 2009 to 2020 in our institution. Forty cases were identified, of which 29 (72.5%) received hematopoietic stem cell transplant (HSCT)-related therapy. At BrC onset, the most administered class of antifungal agents were echinocandins, administered to 70% of patients. C. guilliermondii complex was the most frequently isolated species (32.5%), followed by C. parapsilosis (30%). These two isolates were echinocandin-susceptible in vitro but had naturally occurring FKS gene polymorphisms that reduced echinocandin susceptibility. Frequent isolation of these echinocandin-reduced-susceptible strains in BrC may be associated with the widespread use of echinocandins. In this study, the 30-day crude mortality rate in the group receiving HSCT-related therapy was significantly higher than in the group not receiving it (55.2% vs 18.2%, p = 0.0297). Most patients affected by C. guilliermondii complex BrC (92.3%) received HSCT-related therapy and had a 30-day mortality rate of 53.8%; despite treatment administration, 3 of 13 patients had persistent candidemia. Based on our results, C. guilliermondii complex BrC is a potentially fatal condition in patients receiving HSCT-related therapy with echinocandin administration.
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Affiliation(s)
- Ruriko Nishida
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Yoshihiro Eriguchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Noriko Miyake
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Yoji Nagasaki
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
- Department of Infectious Disease, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Akiko Yonekawa
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Yasuo Mori
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Koji Kato
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
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12
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Tanimoto T, Eriguchi Y, Sato T, Yonekawa A, Miyake N, Akashi K, Shimono N. Platypnea-Orthodeoxia Syndrome in Coronavirus Disease 2019 Pneumonia: A Case Report and Literature Review. Int Med Case Rep J 2023; 16:201-207. [PMID: 37007669 PMCID: PMC10065003 DOI: 10.2147/imcrj.s402537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/09/2023] [Indexed: 03/28/2023] Open
Abstract
Platypnea-orthodeoxia syndrome (POS) is a rare disorder associated with coronavirus disease 2019 (COVID-19) pneumonia. However, POS may be underdiagnosed. We report the case of a 59-year-old female patient with POS complicated by pulmonary embolism in COVID-19. Imaging revealed ground-glass opacities predominantly in the lower lobes and a pulmonary embolus in the right upper lobe. She was diagnosed with POS due to marked postural discrepancies between supine and upright oxygen saturations and blood oxygenation. Intracardiac shunt, one of the etiologies of POS, was not detected by bubble contrast echocardiography, and postural de-saturation gradually improved with methylprednisolone and edoxaban administration. In our literature review, only 3 of the 16 patients with POS associated with COVID-19 had cardiac shunting, suggesting that moderate to severe COVID-19 causes POS without cardiac shunts. COVID-19-associated vasculopathy and lower lung lesion predominance in COVID-19 pneumonia may cause ventilation-perfusion mismatch due to gravitational shunting of blood into the poorly ventilated lower lungs in the upright position, which may ultimately cause POS. Hypoxemia impedes rehabilitation, whereas early initiation of supine positioning in bed, with knowledge of the pathophysiology of POS, may have a positive effect.
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Affiliation(s)
- Takahiko Tanimoto
- Department of Clinical Immunology and Rheumatology / Infectious Disease, Kyushu University Hospital, Fukuoka, Japan
- Department of Infectious Diseases, Kagoshima Seikyo Hospital, Kagoshima, Japan
| | - Yoshihiro Eriguchi
- Department of Clinical Immunology and Rheumatology / Infectious Disease, Kyushu University Hospital, Fukuoka, Japan
- Correspondence: Yoshihiro Eriguchi, Department of Clinical Immunology and Rheumatology / Infectious Disease, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan, Tel +81 92-801-1011, Fax +81 92-862-8200, Email
| | - Tomonori Sato
- Department of Clinical Immunology and Rheumatology / Infectious Disease, Kyushu University Hospital, Fukuoka, Japan
| | - Akiko Yonekawa
- Department of Clinical Immunology and Rheumatology / Infectious Disease, Kyushu University Hospital, Fukuoka, Japan
| | - Noriko Miyake
- Department of Clinical Immunology and Rheumatology / Infectious Disease, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Department of Clinical Immunology and Rheumatology / Infectious Disease, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
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13
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Ikezaki H, Schaefer EJ, Murata M, Shimono N. Abstract P555: Variants of Neurocan, a Nonalcoholic Fatty Liver Disease Risk Allele, Are Associated With Plaque Development in the Carotid Artery Over 5 Years. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Introduction:
Nonalcoholic fatty liver disease (NAFLD) genetic risk alleles are associated with lipid metabolism. However, the association between those variants and atherosclerosis has not yet been fully evaluated.
Hypothesis:
We hypothesized that NAFLD risk alleles are associated with the progression of atherosclerosis.
Methods:
A total of 1,050 Japanese men and women (median age 55 years and median body mass index 22.9 kg/m2) free of cardiovascular disease, dyslipidemia, hypertension, and diabetes were studied. . Among NAFLD risk SNPs, variants of patatin-like phospholipase domain containing 3 (
PNPLA3
), transmembrane 6 superfamily member 2 (
TM6SF2
), glucokinase regulator (
GCKR
), and neurocan (
NCAN
) were assessed. Plasma total cholesterol, low-density lipoprotein cholesterol (LDL-C), small dense LDL-C, LDL-triglycerides, high-density lipoprotein cholesterol (HDL-C), HDL3-C, triglycerides, remnant-like particle cholesterol, lipoprotein(a), and adiponectin were also measured. At both baseline and after a five-year follow-up, carotid intima-media thickness (cIMT) was assessed. Atherosclerosis was defined as cIMT ≥ 1.1mm or the presence of a plaque. Univariate and multivariate analyses and chi-square and Fisher’s exact tests were performed to examine the associations between NAFLD risk SNPs, lipoproteins, and progression of atherosclerosis.
Results:
Both median and maximum cIMT of total participants did not differ between baseline and after a five-year follow-up. Among participants without atherosclerosis at baseline, the rate of plaque development was 13.8% (121/880) with the major allele (CC) of
NCAN
being significantly higher than other alleles. Variants of
NCAN
were associated with the development of plaque (
P
= 0.04, Fisher’s exact test). Participants with the CT allele of
NCAN
had significantly lower RLP cholesterol at baseline than those with the CC allele (7.6 mg/dl vs. 10.5 mg/dl, P = 0.02). Variants of
PNPLA3
,
TM6SF2
,
GCKR
, and
NCAN
were not associated with changes in lipoproteins.
Conclusions:
A
NCAN
variant, one of the NAFLD risk SNPs, was associated with the development of plaque independent of lipoprotein alterations among healthy Japanese participants.
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14
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Yahata H, Kato K, Shimokawa M, Kawamura K, Shimono N, Kawana K, Okamoto A, Aoki D, Kimura T. Study of the effects of in-person attendance at academic conferences on the health of the attendees under COVID-19 pandemic. J Obstet Gynaecol Res 2023; 49:1083-1089. [PMID: 36812688 DOI: 10.1111/jog.15626] [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: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To analyze the effects of in-person attendance at an academic conference held during the Covid-19 pandemic on the health of the attendees, as assessed based on symptoms such as fever and cough attributed to infection with the Covid-19 virus. METHODS A questionnaire was used to survey the members of the Japan Society of Obstetrics and Gynecology (JSOG) about their health during the period from August 7 to August 12, 2022, after the 74th Annual Congress of the JSOG, which was held August 5 to 7. RESULTS Our survey yielded responses from 3054 members (1566 of whom had attended the congress in person and 1488 of whom had not attended in person); 102 (6.5%) of the in-person attendees and 93 (6.2%) of the people who did not attend in person reported problems with their health. No statistically significant difference was found between these two groups (p = 0.766). In a univariate analysis of factors affecting the presence of health problems, attendees with age ≥60 years had significantly fewer health problems than attendees who were in their 20s (odds ratio: 0.366 [0.167-0.802; p = 0.0120]). In a multivariate analysis, attendees who had received four vaccine shots had significantly fewer health problems than attendees who had received three shots (odds ratio: 0.397 [0.229-0.690, p = 0.0010]). CONCLUSION Congress attendees who took precautions at the congress to avoid being infected and who had a high vaccination rate did not develop significantly more health problems associated with in-person attendance at the congress.
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Affiliation(s)
- Hideaki Yahata
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Mototsugu Shimokawa
- Department of Biostatistics, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Keiko Kawamura
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Kei Kawana
- Department of Obstetrics and Gynecology, Nihon University School of Medicine, Tokyo, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
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15
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Goto T, Sasaki T, Chong Y, Taniguchi M, Lee JM, Masuda A, Ebihara T, Shiraishi K, Tani N, Yonekawa A, Gondo K, Kuwano H, Shimono N, Ikematsu H, Akashi K, Kusakabe T. SARS-CoV-2 strain-specific anti-spike IgG ELISA utilizing spike protein produced by silkworms. Hum Antibodies 2023; 31:27-33. [PMID: 37458030 DOI: 10.3233/hab-230006] [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] [Indexed: 07/18/2023]
Abstract
BACKGROUND A cost-effective and eco-friendly method is needed for the assessment of humoral immunity against SARS-CoV-2 in large populations. OBJECTIVE We investigated the performance of an ELISA that uses silkworm-produced proteins to quantify the strain-specific anti-Spike IgG (anti-S IgG) titer. METHODS The OD values for the anti-His-tag antibody, a standard material of ELISA quantification, were measured. Correlations between the ELISA for each strain and the Abbott SARS-CoV-2 IgG II Quant assay for the wild type were evaluated with serum samples from nine participants with various infection and vaccination statuses. RESULTS Linear dose-responses were confirmed by high coefficients of determination: 0.994, 0.994, and 0.996 for the wild-type, Delta, and Omicron (BA.1) strain assays, respectively. The coefficient of determination for the wild-type and Delta strain assays was high at 0.959 and 0.892, respectively, while the Omicron strain assay had a relatively low value of 0.563. Booster vaccinees showed similar or higher titers against all strains compared to infected persons without vaccination. The Omicron-infected persons without vaccination had lower antibody titers against wild type than did the vaccinated persons. CONCLUSIONS This study provides data indicating that the ELISA with silkworm-produced proteins makes it possible to discriminate and quantify the strain-specific anti-S IgG antibody induced by vaccination or infection.
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Affiliation(s)
- Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Tomoki Sasaki
- R&D Department, KAICO Ltd, Fukuoka, Japan
- Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | | | - Jae Man Lee
- Laboratory of Creative Science for Insect Industries Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | - Akitsu Masuda
- Laboratory of Creative Science for Insect Industries Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | - Takeru Ebihara
- Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
| | - Kenichiro Shiraishi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Akiko Yonekawa
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Kei Gondo
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
| | | | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | | | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Takahiro Kusakabe
- Laboratory of Insect Genome Science, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University, Fukuoka, Japan
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16
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Nakano Y, Murata M, Matsumoto Y, Toyoda K, Ota A, Yamasaki S, Otakeno H, Yokoo K, Shimono N. Clinical characteristics and factors related to infection with SCCmec type II and IV Methicillin-resistant Staphylococcus aureus in a Japanese secondary care facility: a single-center retrospective study. J Glob Antimicrob Resist 2022; 31:355-362. [PMID: 36372183 DOI: 10.1016/j.jgar.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Differences in virulence genes, including psm-mec, which is a phenol-soluble modulin-mec (PSM-mec) encoding gene, of predominant staphylococcal cassette chromosome mec (SCCmec) types II and IV Methicillin-resistant Staphylococcus aureus (MRSA) may contribute to the virulence and clinical features of MRSA in Japan. We aimed to clarify the clinical characteristics and risk factors of infection among SCCmec types II and IV MRSA isolates from a Japanese secondary acute care hospital. METHODS We analysed 58 SCCmec type II and 83 SCCmec type IV MRSA isolates collected from blood, central venous catheter tips, deep or superficial tissues, and sputum. RESULTS SCCmec type II MRSA risk factors for progression to infection were seb, enterotoxin gene cluster, psm-mec mutation, and vancomycin minimum inhibitory concentrations (MIC) of 1 or 2 mg/L as virulence factors (adjusted odds ratio [aOR] = 11.8; 95% confidence interval [CI]: 2.49-77.7; P = 0.004); solid tumour was a host factor (aOR = 25.9; 95% CI: 3.66-300; P = 0.003). SCCmec type IV MRSA risk factors were sea, cna, and vancomycin MIC of 1 or 2 mg/L as virulence factors (aOR = 3.14; 95% CI: 1.06-10.6; P = 0.049) and intravascular indwelling catheter as host factors (aOR = 3.78; 95% CI: 1.03-14.5; P = 0.045). Compared with SCCmec type II, SCCmec type IV MRSA resulted in more frequent bloodstream infections and higher Sequential Organ Failure Assessment scores. CONCLUSION We found that factors related to virulence genes and bacteriological and host characteristics are associated with SCCmec types II and IV MRSA infection and severity. These risk factors may be useful criteria for designing infection control programs.
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Affiliation(s)
- Yuki Nakano
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of Pharmacy, Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan
| | - Masayuki Murata
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan.
| | - Yuji Matsumoto
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Azusa Ota
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Sho Yamasaki
- Department of Environmental Medicine and Infectious Disease, Kyushu University, Higashi-Ku, Fukuoka, Japan; Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
| | - Hisao Otakeno
- Department of Pharmacy, Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan
| | - Kenjo Yokoo
- Department of Pharmacy, Saiseikai Futsukaichi Hospital, Chikushino, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan; Center for the Study of Global Infection, Kyushu University Hospital, Higashi-Ku, Fukuoka, Japan
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17
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Ikezaki H, Nomura H, Shimono N. Dynamics of anti-spike IgG antibody after a third BNT162b2 COVID-19 vaccination in Japanese health care workers. Heliyon 2022; 8:e12125. [PMID: 36506407 PMCID: PMC9726652 DOI: 10.1016/j.heliyon.2022.e12125] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 09/09/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Many countries are administering a third dose of some coronavirus disease 2019 (COVID-19) vaccines, but the evaluation of vaccine-induced immunity after boosting in East Asia is insufficient. This study aimed to evaluate anti-spike immunoglobulin G [IgG(S)] titers after the third BNT162b2 vaccination. Methods The dynamics of IgG(S) titers were assessed two months following the third BNT162b2 vaccination in 52 participants. All participants received the primary series of vaccination with BNT162b2 and received the third dose eight months after the second vaccination. Associations among the IgG(S) titer, baseline characteristics, and adverse reactions were also evaluated. Results The geometric mean titer of IgG(S) one month after the third vaccination was 17,400 AU/ml, which increased by approximately 30 times that immediately before the third vaccination. The rate of IgG(S) titer decline was significantly slower after the third vaccination (35.7%) than after the second vaccination (59.1%). The IgG(S) titer was significantly negatively associated with age (r = -0.31). Participants who had a headache at the time of vaccination showed significantly higher IgG(S) titers than those without a headache. Conclusions The IgG(S) titer induced by primary immunization with BNT162b2 waned over time. The third dose of BNT162b2 substantially increased the IgG(S) titer, with a slower rate of decline.
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Affiliation(s)
- Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 8128582, Japan,Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 8128582, Japan,Department of Internal Medicine, Haradoi Hospital, 6-40-8, Aoba, Higashi-ku, Fukuoka, 8138588, Japan,Corresponding author
| | - Hideyuki Nomura
- Department of Internal Medicine, Haradoi Hospital, 6-40-8, Aoba, Higashi-ku, Fukuoka, 8138588, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu University Hospital, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 8128582, Japan
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18
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Yamamoto K, Asai Y, Nakatani I, Hayashi K, Nakagawa H, Shinohara K, Kanai S, Shimatani M, Yamato M, Shimono N, Kitaura T, Komiya N, Nagasaka A, Mikawa T, Manabe A, Matono T, Yamamoto Y, Ogawa T, Kutsuna S, Ohmagari N. Characteristics and potential quality indicators for evaluating pre-travel consultations in Japan hospitals: the Japan Pretravel consultation registry (J-PRECOR). Trop Dis Travel Med Vaccines 2022; 8:6. [PMID: 35101123 PMCID: PMC8805374 DOI: 10.1186/s40794-021-00160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background Awareness of pre-travel consultations (PTCs) and prevention methods for overseas travel-related diseases, and the understanding of PTCs among Japanese travelers and medical professionals remains low in Japan. A multicenter registry was established to examine PTCs in Japan. This study assessed the PTC implementation rate and examined the indicators of PTCs that can be used as criteria for evaluating quality. Methods Clients who presented for their PTCs at 17 facilities and were registered between February 1, 2018, and May 31, 2020, were included. Medical information was extracted retrospectively via a web-based system. Correlations between vaccination risk categories and advice/intervention proportions by the facility were evaluated using Spearman’s ordered phase relations (α = 0.05). Results Of the 9700 eligible clients (median age, 32 years; 880 [9.1%] aged < 16 years and 549 [5.7%] aged ≥65 years), the most common travel duration was ≥181 days (35.8%); higher among younger clients. The most common reason for travel was business (40.5%); the US (1118 [11.5%]) and Asia (4008 [41.3%]) were the most common destinations and continents, respectively. The vaccine number (median three per person) increased after the PTCs except for the tetanus toxoid. Only 60.8% of the clients recommended for malaria prophylaxis received anti-malarial agents. The gross national income; the incidence of human rabies, typhoid fever, falciparum malaria; and dengue risk category were associated with the percentage of hepatitis-A vaccines; explaining rabies post-exposure prophylaxis, typhoid-fever vaccinations, malaria-prophylaxis prescriptions; and mosquito repellants, respectively. Conclusions Although the characteristics of the travelers differed, the quality of the PTCs should be improved to address, for example, the lower rate of acceptance of malaria prophylaxis in Japan. Supplementary Information The online version contains supplementary material available at 10.1186/s40794-021-00160-4.
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Tani N, Ikematsu H, Goto T, Gondo K, Yanagihara Y, Kurata Y, Oishi R, Minami J, Onozawa K, Nagano S, Kuwano H, Akashi K, Shimono N, Chong Y. No significant influence of pre-vaccination antipyretic use on specific antibody response to a BNT162b2 vaccine booster against COVID-19. Vaccine X 2022; 12:100224. [PMID: 36213591 PMCID: PMC9528015 DOI: 10.1016/j.jvacx.2022.100224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
The influence of antipyretic use before a BNT162b2 booster is of concern. Anti-spike IgG titer and adverse reactions were compared by pre/non antipyretic use. The geometric mean IgG titer was comparable for the cases and controls. The frequency and severity of adverse reactions were also comparable. Consistent results were obtained after propensity score matching.
The relation between pre-vaccination antipyretic use and antibody responses to SARS-CoV-2 vaccination has been unclear. We measured the pre- and post-BNT162b2 booster spike-specific IgG titers and recorded antipyretic use and adverse reactions for SARS-CoV-2-naive hospital healthcare workers. The data of 20 cases who used antipyretics within 24 h before vaccination were compared to that of 281 controls. The post-booster geometric mean IgG titers were 15,559 AU/mL (95 % CI, 11,474–21,203) for the cases and 16,850 AU/mL (95 % CI, 15,563–18,243) for the controls (p = 0.622). No significant reduction in the frequency or severity of any of the solicited adverse reactions was found for the cases. Similar results were obtained after adjustment with propensity-score matching for demographic characteristics, baseline IgG titer, and post-vaccination antipyretic use. Antipyretic use within 24 h before vaccination would not affect mRNA COVID-19 vaccine-induced specific antibody responses and that postponement of vaccination due to pre-vaccination antipyretic use would be unnecessary.
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Affiliation(s)
- Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | - Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kei Gondo
- Clinical Laboratory, Fukuoka City Hospital, Fukuoka, Japan
| | | | | | - Ryo Oishi
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Junya Minami
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Kyoko Onozawa
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Sukehisa Nagano
- Department of Neurology, Fukuoka City Hospital, Fukuoka, Japan
| | | | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan,Corresponding author at: Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ward, Fukuoka 812-8582, Japan.
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20
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Tani N, Ikematsu H, Goto T, Gondo K, Inoue T, Yanagihara Y, Kurata Y, Oishi R, Minami J, Onozawa K, Nagano S, Kuwano H, Akashi K, Shimono N, Chong Y. Correlation of Postvaccination Fever With Specific Antibody Response to Severe Acute Respiratory Syndrome Coronavirus 2 BNT162b2 Booster and No Significant Influence of Antipyretic Medication. Open Forum Infect Dis 2022; 9:ofac493. [PMID: 36267253 PMCID: PMC9578158 DOI: 10.1093/ofid/ofac493] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/22/2022] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine booster elicits sufficient antibody responses that protect against coronavirus disease 2019, whereas adverse reactions such as fever have been commonly reported. Associations between adverse reactions and antibody responses have not been fully characterized, nor has the influence of antipyretic use. METHODS This is a prospective observational cohort study in Japan, following our prior investigation of BNT162b2 2-dose primary series. Spike-specific immunoglobulin G (IgG) titers were measured for SARS-CoV-2-naive hospital healthcare workers who received a BNT162b2 booster. The severity of solicited adverse reactions, including the highest body temperature, and self-medicated antipyretics were reported daily for 7 days following vaccination through a web-based self-reporting diary. RESULTS The data of 281 healthcare workers were available. Multivariate analysis extracted fever after the booster dose (β = .305, P < .001) as being significantly correlated with the specific IgG titers. The analysis of 164 participants with data from the primary series showed that fever after the second dose was associated with the emergence of fever after the booster dose (relative risk, 3.97 [95% confidence interval, 2.48-6.35]); however, the IgG titers after the booster dose were not associated with the presence or degree of fever after the second dose. There were no significant differences in the IgG titers by the use, type, or dosage of antipyretic medication. CONCLUSIONS These results suggest an independent correlation between mRNA vaccine-induced specific IgG levels and post-booster vaccination fever, without any significant influence of fever after the primary series. Antipyretic medications for adverse reactions should not interfere with the elevation of specific IgG titers.
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Affiliation(s)
- Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | - Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kei Gondo
- Clinical Laboratory, Fukuoka City Hospital, Fukuoka, Japan
| | - Takeru Inoue
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | | | - Ryo Oishi
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Junya Minami
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Kyoko Onozawa
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Sukehisa Nagano
- Department of Neurology, Fukuoka City Hospital, Fukuoka, Japan
| | - Hiroyuki Kuwano
- Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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21
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Chong Y, Goto T, Tani N, Yonekawa A, Ikematsu H, Shimono N, Tanaka Y, Akashi K. Pronounced antibody elevation after SARS-CoV-2 BNT162b2 mRNA booster vaccination in nursing home residents. Influenza Other Respir Viruses 2022; 16:1066-1071. [PMID: 35962568 PMCID: PMC9530588 DOI: 10.1111/irv.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background Infection control during COVID‐19 outbreaks in nursing facilities is a critical public health issue. Antibody responses before and after the third (booster) dose of SARS‐CoV‐2 vaccination in nursing home residents have not been fully characterized. Methods This study included 117 individuals: 54 nursing home residents (mean age, 83.8 years; 39 SARS‐CoV‐2‐naive and 15 previously infected) and 63 healthcare workers (mean age, 45.8 years; 32 SARS‐CoV‐2‐naive and 31 previously infected). Anti‐spike (receptor‐binding domain [RBD]) and anti‐nucleocapsid antibody responses to BNT162b2 mRNA vaccination and their related factors were evaluated using pre‐ (shortly and 6 months after the second dose) and post‐booster vaccination samples. Results The median anti‐spike (RBD) IgG level in SARS‐CoV‐2‐naive residents 6 months after the second dose was the lowest among the four groups, with a decreasing rate of over 90%. The median rate of increase before and after the third dose in SARS‐CoV‐2‐naive residents was significantly higher than that in SARS‐CoV‐2‐naive healthcare workers (64.1‐ vs. 37.0‐fold, P = 0.003), with the highest level among the groups. The IgG ratio of SARS‐CoV‐2‐naive residents to healthcare workers after the second and third doses changed from one‐fifth (20%) to one‐half (50%). The rate of increase after the third dose in previously infected individuals was three‐ to fourfold, regardless of residents or healthcare workers. Conclusions Advanced aged nursing home residents, poor responders in the initial SARS‐CoV‐2 vaccine series, could obtain sufficient antibody responses with the additional booster dose, despite more than 6 months after the second.
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Affiliation(s)
- Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Akiko Yonekawa
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | | | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yosuke Tanaka
- Medical Corporation SOUSEIKAI, Kanenokuma Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
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22
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Ikezaki H, Ai M, Okazaki M, Hayashi J, Shimono N, Schaefer E. Relationship between the cholesterol and triglyceride content of lipoprotein subclasses and carotid intima-media thickness: Results from the Kyushu and Okinawa Population Study (KOPS). Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.502] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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23
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Goto T, Tani N, Ikematsu H, Gondo K, Oishi R, Minami J, Onozawa K, Kuwano H, Akashi K, Shimono N, Chong Y. Post-vaccination antibody evaluation for nosocomial SARS-CoV-2 delta variant breakthrough infection. PLoS One 2022; 17:e0272056. [PMID: 35877668 PMCID: PMC9312404 DOI: 10.1371/journal.pone.0272056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Waning humoral immunity after mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a significant problem for public health. Breakthrough infection in hospitals over several months after vaccination has not been fully characterized, especially against the delta (B.1.617.2) variant. Here, we describe an outbreak in our hospital in September of 2021, mainly through serological evaluation of the breakthrough infection. This retrospective observational study was done at an emergency and acute care hospital with 204 beds and 486 staff members where most staff members (92.6%) had had their second BNT162b2 vaccination by May of 2021. The peri-infection anti-spike RBD protein IgG (anti-S IgG) titers (lowest values between 11 days before and 7 days after onset or diagnosis) of serum samples from the breakthrough-infected persons were quantified. We also logarithmically estimated the anti-S IgG titers during the exposure period in September of uninfected staff members from their samples collected in May and December 2021. Whole-genome sequencing was done on obtained samples. In this outbreak, twelve persons (ten inpatients and two staff members) were diagnosed with SARS-CoV-2 infection by Loop-Mediated Isothermal Amplification (LAMP) or RT-PCR, eight of whom had been vaccinated twice. Peri-infection anti-S IgG titers could be determined in seven of the eight breakthrough cases, with a geometric mean titer (GMT) of 1,034 AU/ml (95% confidence interval [CI], 398 to 2,686). Among 289 uninfected staff members with data from the two sampling points, the GMT of the estimated anti-S IgG titers during the exposure period in 51 staff members, who were working at the outbreak ward and potentially exposed but uninfected, and 238 other unexposed staff members were 1,458 AU/ml (95% CI, 1,196 to 1,777) and 1,628 AU/ml (95% CI, 1,500 to 1,766), respectively. All viruses from the eight samples for which whole-genome sequencing was available were identified as delta variants. Of the infected persons, one remained asymptomatic throughout the course of treatment, and eleven had an illness of mild to moderate severity, including ten who received monoclonal antibody cocktail (Casirivimab/imdevimab) therapy. Measurement and estimation of anti-spike antibody levels after SARS-CoV-2 vaccination would be helpful for evaluating the risk of breakthrough infection and for determining the necessity of booster vaccination.
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Affiliation(s)
- Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | | | - Kei Gondo
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
| | - Ryo Oishi
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Junya Minami
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Kyoko Onozawa
- COVID-19 Team, Fukuoka City Hospital, Fukuoka, Japan
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | | | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
- * E-mail:
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24
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Morioka H, Ohge H, Nagao M, Kato H, Kokado R, Yamada K, Yamada T, Shimono N, Nukui Y, Yoshihara S, Sakamaki I, Nosaka K, Kubo Y, Kawamura H, Fujikura Y, Kitaura T, Sunakawa M, Yagi T. Appropriateness of surgical antimicrobial prophylaxis in Japanese university hospitals. J Hosp Infect 2022; 129:189-197. [PMID: 35835283 DOI: 10.1016/j.jhin.2022.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to determine the adherence to the Japanese surgical antimicrobial prophylaxis (SAP) guidelines in Japanese university hospitals. DESIGN A retrospective cohort study. SETTING Fifteen general and one dental university hospitals. METHODS We evaluated up to three cases of 18 designated surgeries regarding adherence to Japanese SAP guidelines: selection of antibiotics, timing of administration, re-dosing intervals, and duration of SAP. When all items were appropriate, surgery was defined as 'appropriate.' RESULTS In total, 688 cases (22-45 cases per surgery) were included. The overall appropriateness was 46.8% (322/688), and the appropriateness of each surgery ranged from 8.0% (2/25, cardiac implantable electronic device implantation) to 92.1% (35/38, distal gastrectomy). The appropriateness of each item was as follows: pre/intraoperative selections, 78.5% (540/688); timing of administrations, 96.0% (630/656); re-dosing intervals, 91.8% (601/656); postoperative selection, 78.9% (543/688); and duration of SAP, 61.4% (423/688). The overall appropriateness of hospitals ranged from 17.6% (9/51) to 73.3% (33/45). The common reasons for inappropriateness were the longer duration (38.5%, 265/688) and choice of antibiotics with a non-optimal antimicrobial spectrum before/during, and after surgery (19.0%, 131/688 and 16.8%, 116/688, respectively), compared to the guideline. CONCLUSIONS Adherence to the guidelines differed greatly between the surgeries and hospitals. Large-scale multicentre surveillance of SAP in Japanese hospitals is necessary to identify inappropriate surgeries, factors related to the appropriateness, and incidences of surgical site infections.
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Affiliation(s)
- Hiroshi Morioka
- Nagoya University Hospital, Department of Infectious Diseases, Nagoya, Japan.
| | - Hiroki Ohge
- Hiroshima University, Project Research Center for Nosocomial Infectious Diseases, Hiroshima, Japan
| | - Miki Nagao
- Kyoto University Graduate School of Medicine, Department of Clinical Laboratory Medicine, Kyoto, Japan
| | - Hideaki Kato
- Yokohama City University Hospital, Infection Prevention and Control Department, Yokohama, Japan
| | - Ryohei Kokado
- Osaka University Hospital, Division of Infection Control and Prevention, Suita, Japan
| | - Koichi Yamada
- Osaka Metropolitan University, Graduate School of Medicine, Department of Infection Control Science, Osaka, Japan
| | - Takahiro Yamada
- Hamamatsu University School of Medicine, Department of Hospital Pharmacy, Hamamatsu, Japan
| | - Nobuyuki Shimono
- Kyushu University Hospital, Center for the Study of Global Infection, Fukuoka, Japan
| | - Yoko Nukui
- Tokyo Medical and Dental University Hospital, Department of Infection Control and Prevention, Bunkyo City, Japan; Kyoto Prefectural University of Medicine, Department of Infection Control and Laboratory Medicine
| | - Shingo Yoshihara
- Nara Medical University, Center for Infectious Diseases, Kashihara, Japan
| | - Ippei Sakamaki
- Toyama University Hospital, Department of Clinical Infectious Diseases, Toyama, Japan
| | - Kisato Nosaka
- Kumamoto University Hospital, Department of Hematology, Rheumatology and Infectious Disease, Kumamoto, Japan
| | - Yuko Kubo
- Hiroshima University Hospital, Department of Pharmaceutical Services, Hiroshima, Japan
| | - Hideki Kawamura
- Kagoshima University Hospital, Department of Infection Control and Prevention, Kagoshima, Japan
| | - Yuji Fujikura
- National Defense Medical College Hospital, Department of Medical Risk Management and Infection Control, Tokorozawa, Japan
| | - Tsuyoshi Kitaura
- Tottori University Hospital, Division of Infectious Diseases, Yonago, Japan
| | - Mitsuhiro Sunakawa
- Tokyo Medical and Dental University, Dental Hospital, Infection Control Team, Tokyo, Japan
| | - Tetsuya Yagi
- Nagoya University Hospital, Department of Infectious Diseases, Nagoya, Japan
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25
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Oka K, Matsumoto A, Tetsuka N, Morioka H, Iguchi M, Ishiguro N, Nagamori T, Takahashi S, Saito N, Tokuda K, Igari H, Fujikura Y, Kato H, Kanai S, Kusama F, Iwasaki H, Furuhashi K, Baba H, Nagao M, Nakanishi M, Kasahara K, Kakeya H, Chikumi H, Ohge H, Azuma M, Tauchi H, Shimono N, Hamada Y, Takajo I, Nakata H, Kawamura H, Fujita J, Yagi T. Clinical characteristics and treatment outcomes of carbapenem-resistant Enterobacterales infections in Japan. J Glob Antimicrob Resist 2022; 29:247-252. [PMID: 35429667 DOI: 10.1016/j.jgar.2022.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 01/19/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The dissemination of difficult-to-treat carbapenem-resistant Enterobacterales (CRE) is of great concern. We clarified the risk factors underlying CRE infection mortality in Japan. METHODS We conducted a retrospective, multicentre, observational cohort study of patients with CRE infections at 28 university hospitals from September 2014 to December 2016, using the Japanese National Surveillance criteria. Clinical information, including patient background, type of infection, antibiotic treatment, and treatment outcome, was collected. The carbapenemase genotype was determined using PCR sequencing. Multivariate analysis was performed to identify the risk factors for 28-day mortality. RESULTS Among the 179 patients enrolled, 65 patients (36.3%) had bloodstream infections, with 37 (20.7%) infections occurring due to carbapenemase-producing Enterobacterales (CPE); all carbapenemases were of IMP-type (IMP-1: 32, IMP-6: 5). Two-thirds of CPE were identified as Enterobacter cloacae complex. Combination therapy was administered only in 46 patients (25.7%), and the 28-day mortality rate was 14.3%. Univariate analysis showed that solid metastatic cancer, Charlson Comorbidity Index ≥3, bloodstream infection, pneumonia, or empyema, central venous catheters, mechanical ventilation, and prior use of quinolones were significant risk factors for mortality. Multivariate analysis revealed that mechanical ventilation (OR: 6.71 [1.42-31.6], P = 0.016), solid metastatic cancers (OR: 5.63 [1.38-23.0], P = 0.016), and bloodstream infections (OR: 3.49 [1.02-12.0], P = 0.046) were independent risk factors for 28-day mortality. CONCLUSION The significant risk factors for 28-day mortality in patients with CRE infections in Japan are mechanical ventilation, solid metastatic cancers, and bloodstream infections.
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Affiliation(s)
- Keisuke Oka
- Department of Infectious Diseases, Nagoya University Hospital, Showa-ku, Nagoya, Aichi, Japan
| | - Akane Matsumoto
- Department of Pediatrics, Kyoto Katsura Hospital, Saikyou-ku, Kyoto, Japan
| | - Nobuyuki Tetsuka
- Department of Infection Control, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Showa-ku, Nagoya, Aichi, Japan
| | - Mitsutaka Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Showa-ku, Nagoya, Aichi, Japan
| | - Nobuhisa Ishiguro
- Division of Infection Control, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Tsunehisa Nagamori
- Department of Infection Control, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Norihiro Saito
- Department of Clinical Laboratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Koichi Tokuda
- Department of Infection Control and Laboratory Diagnostics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hidetoshi Igari
- Division of Infection Control, Chiba University Hospital, Chiba, Chiba, Japan
| | - Yuji Fujikura
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Shinichiro Kanai
- Department of Infection Control, Shinshu University Hospital, Matsumoto, Nagano, Japan
| | - Fumiko Kusama
- Department of Clinical Laboratory, Niigata University Medical and Dental Hospital, Niigata, Niigata, Japan
| | - Hiromichi Iwasaki
- Department of Infection Control and Prevention, University of Fukui, Fukui, Fukui, Japan
| | - Kazuki Furuhashi
- Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hisashi Baba
- Centre for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Gifu, Japan
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan
| | - Masaki Nakanishi
- Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan
| | - Kei Kasahara
- Centre for Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Osaka, Japan
| | - Hiroki Chikumi
- Centre for Infectious Diseases, Tottori University Hospital, Yonago, Tottori, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Hiroshima, Japan
| | - Momoyo Azuma
- Department of Infection Control, Tokushima University Hospital, Tokushima, Tokushima, Japan
| | - Hisamichi Tauchi
- Division of Infectious Disease, Control and Prevention, Ehime University Hospital, Toon, Ehime, Japan
| | - Nobuyuki Shimono
- Centre for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Fukuoka, Japan
| | - Yohei Hamada
- Department of Infectious Disease and Hospital Epidemiology, Saga University Hospital, Saga, Saga, Japan
| | - Ichiro Takajo
- Center for Infection Control, Miyazaki University Hospital, Miyazaki, Miyazaki, Japan
| | - Hirotomo Nakata
- Department of Infection Control, Kumamoto University Hospital, Kumamoto, Kumamoto, Japan
| | - Hideki Kawamura
- Department of Infection Control, Kagoshima University Hospital, Kagoshima, Kagoshima, Japan
| | - Jiro Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Nakagami-gun, Okinawa, Japan
| | - Tetsuya Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Showa-ku, Nagoya, Aichi, Japan.
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Tani N, Chong Y, Kurata Y, Gondo K, Oishi R, Goto T, Minami J, Onozawa K, Nagano S, Shimono N, Ikematsu H, Kuwano H. Relation of fever intensity and antipyretic use with specific antibody response after two doses of the BNT162b2 mRNA vaccine. Vaccine 2022; 40:2062-2067. [PMID: 35177298 PMCID: PMC8842119 DOI: 10.1016/j.vaccine.2022.02.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 10/05/2021] [Revised: 01/17/2022] [Accepted: 02/04/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The reactogenicity of BNT162b2 COVID-19 vaccine has been commonly reported and antipyretic medications are often used for mitigating adverse reactions. Possible associations between the reactogenicity events and specific antibody responses have not been fully investigated, nor has the influence of using antipyretics. METHODS Serum samples were collected from hospital healthcare workers with no COVID-19 history and the SARS-CoV-2 spike-specific IgG titer after two doses was measured. Degree of solicited adverse reactions in a day, including the highest body temperature, were reported using a self-reporting diary for five days after each dose. The highest body temperature during the five days was divided into three grades (<37.0 °C, 37.0-37.9 °C, or ≥ 38.0 °C). Self-medicated antipyretics were reported using a questionnaire. RESULTS The data of 335 participants were available for analysis. Multivariate analysis extracted the fever grade after the second dose (standardized coefficient beta = 0.301, p < 0.0001), female sex (beta = 0.196, p = 0.0014), and age (beta = -0.119, p = 0.0495) as being significantly correlated with the IgG titers. The positive correlation of the fever grade after the second dose with the IgG titers was also observed when analyzed by sex and age. The use of antipyretics did not interfere with the IgG titers irrespective of the fever grade. CONCLUSIONS The fever intensity after the second dose was associated with the IgG titer and antipyretic medications may be beneficial to mitigate the suffering from adverse reactions, without interfering with the acquisition of sufficient antibody responses.
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Affiliation(s)
- Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
| | - Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | | - Kei Gondo
- Clinical Laboratory, Fukuoka City Hospital, Fukuoka, Japan
| | - Ryo Oishi
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Takeyuki Goto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Junya Minami
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Kyoko Onozawa
- Department of Infectious Diseases, Fukuoka City Hospital, Fukuoka, Japan
| | - Sukehisa Nagano
- Department of Neurology, Fukuoka City Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
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Ikezaki H, Nomura H, Shimono N. Dynamics of anti-Spike IgG antibody level after the second BNT162b2 COVID-19 vaccination in health care workers. J Infect Chemother 2022; 28:802-805. [PMID: 35288023 PMCID: PMC8901382 DOI: 10.1016/j.jiac.2022.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/15/2022] [Accepted: 02/27/2022] [Indexed: 11/02/2022]
Abstract
Introduction Methods Results Conclusions
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Ikezaki H, Furusyo N, Nakashima R, Umemoto M, Yamamoto K, Matsumoto Y, Ohta A, Yamasaki S, Hiramine S, Takayama K, Ogawa E, Toyoda K, Murata M, Shimono N, Hayashi J. Kyushu and Okinawa Population Study (KOPS): a large prospective cohort study in Japan. BMJ Open 2021; 11:e053763. [PMID: 34933862 PMCID: PMC8693098 DOI: 10.1136/bmjopen-2021-053763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The Kyushu and Okinawa Population Study (KOPS) was established to investigate gene-environmental interactions in non-communicable diseases in Japan. Besides collecting blood samples and anthropometric measurements, we also obtained medical histories, psychological status and lifestyle habits, including physical activities and dietary patterns. PARTICIPANTS KOPS is a community-based prospective cohort study and consists of participants from four southwestern areas in Japan. Baseline surveys were conducted between 2004 and 2007 (wave 1), and 2009 and 2012 (wave 2) at the sites of municipality-based health check-ups. A total of 17 077 participants were included, comprising 10 697 participants of wave 1 and 6380 participants of wave 2; the median age in both groups was 61 years. Among them, 3006 individuals participated in both wave 1 and wave 2 surveys. FINDINGS TO DATE We have focused on either risk or confounding factors for non-communicable diseases. We have assessed the clinical utility of the newly developed biomarkers for impaired glucose tolerance, such as urinary myo-inositol and glycated albumin, and atherosclerosis, such as small dense low-density lipoprotein cholesterol. We have conducted an international collaborative study with Framingham Offspring Study to investigate ethnic differences in impaired glucose tolerance and cardiovascular diseases. We have found that insulin resistance and deficiency might account for the ethnic differences in impaired glucose tolerance and cardiovascular disease risks. As gene-environmental interaction analyses, we found a synergic effect of interleukin 28B single nucleotide polymorphisms (SNPs) and gender on the spontaneous elimination of hepatitis C, and a beneficial interaction of SNPs of high-density lipoprotein cholesterol and gender on the impact of physical activity. In addition, we reported eight novel loci contributing to the development and severity of coronary artery disease from a large genome-wide association study. FUTURE PLANS We plan to investigate further the clinical utility of the newly developed biomarkers and the gene-environmental interactions using prospective data.
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Affiliation(s)
- Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Comprehensive General Internal Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Taihaku Avenue Clinic, Fukuoka, Japan
| | - Ryoko Nakashima
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Makiko Umemoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Ken Yamamoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yuji Matsumoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Azusa Ohta
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Sho Yamasaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Satoshi Hiramine
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Takayama
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Environmental Medicine and Infectious Diseases, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Kazuhiro Toyoda
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
- Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan
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Motozono C, Toyoda M, Zahradnik J, Saito A, Nasser H, Tan TS, Ngare I, Kimura I, Uriu K, Kosugi Y, Yue Y, Shimizu R, Ito J, Torii S, Yonekawa A, Shimono N, Nagasaki Y, Minami R, Toya T, Sekiya N, Fukuhara T, Matsuura Y, Schreiber G, Ikeda T, Nakagawa S, Ueno T, Sato K. SARS-CoV-2 spike L452R variant evades cellular immunity and increases infectivity. Cell Host Microbe 2021; 29:1124-1136.e11. [PMID: 34171266 PMCID: PMC8205251 DOI: 10.1016/j.chom.2021.06.006] [Citation(s) in RCA: 321] [Impact Index Per Article: 107.0] [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: 04/13/2021] [Revised: 05/22/2021] [Accepted: 06/09/2021] [Indexed: 01/15/2023]
Abstract
Many SARS-CoV-2 variants with naturally acquired mutations have emerged. These mutations can affect viral properties such as infectivity and immune resistance. Although the sensitivity of naturally occurring SARS-CoV-2 variants to humoral immunity has been investigated, sensitivity to human leukocyte antigen (HLA)-restricted cellular immunity remains largely unexplored. Here, we demonstrate that two recently emerging mutations in the receptor-binding domain of the SARS-CoV-2 spike protein, L452R (in B.1.427/429 and B.1.617) and Y453F (in B.1.1.298), confer escape from HLA-A24-restricted cellular immunity. These mutations reinforce affinity toward the host entry receptor ACE2. Notably, the L452R mutation increases spike stability, viral infectivity, viral fusogenicity, and thereby promotes viral replication. These data suggest that HLA-restricted cellular immunity potentially affects the evolution of viral phenotypes and that a further threat of the SARS-CoV-2 pandemic is escape from cellular immunity.
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Affiliation(s)
- Chihiro Motozono
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan
| | - Mako Toyoda
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan
| | - Jiri Zahradnik
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Akatsuki Saito
- Department of Veterinary Science, Faculty of Agriculture, University of Miyazaki, Miyazaki 8892192, Japan; Center for Animal Disease Control, University of Miyazaki, Miyazaki 8892192, Japan; Graduate School of Medicine and Veterinary Medicine, University of Miyazaki, Miyazaki 8892192, Japan
| | - Hesham Nasser
- Division of Molecular Virology and Genetics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan; Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia 41511, Egypt
| | - Toong Seng Tan
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan
| | - Isaac Ngare
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan
| | - Izumi Kimura
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, The Institute of Medical Science, The University of Tokyo, Tokyo 1088639, Japan
| | - Keiya Uriu
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, The Institute of Medical Science, The University of Tokyo, Tokyo 1088639, Japan
| | - Yusuke Kosugi
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, The Institute of Medical Science, The University of Tokyo, Tokyo 1088639, Japan
| | - Yuan Yue
- Division of Molecular Virology and Genetics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan
| | - Ryo Shimizu
- Division of Molecular Virology and Genetics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan
| | - Jumpei Ito
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, The Institute of Medical Science, The University of Tokyo, Tokyo 1088639, Japan
| | - Shiho Torii
- Department of Molecular Virology, Research Institute for Microbial Diseases, Osaka University, Osaka 5650871, Japan; Division of Microbiology and Immunology, Center for Infectious Diseases Education and Research, Osaka University, Osaka 5650871, Japan; Laboratory of Virus Control, Research Institute for Microbial Diseases, Osaka University, Osaka 5650871, Japan
| | - Akiko Yonekawa
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8128582, Japan
| | - Nobuyuki Shimono
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8128582, Japan
| | - Yoji Nagasaki
- Division of Infectious Diseases, Clinical Research Institute, National Hospitalization Organization, Kyushu Medical Center, Fukuoka 8108563, Japan
| | - Rumi Minami
- Internal Medicine, Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka 8108563, Japan
| | - Takashi Toya
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 1138677, Japan
| | - Noritaka Sekiya
- Department of Infection Prevention and Control, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 1138677, Japan; Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 1138677, Japan
| | - Takasuke Fukuhara
- Department of Microbiology and Immunology, Graduate School of Medicine, Hokkaido University, Hokkaido 0608638, Japan
| | - Yoshiharu Matsuura
- Department of Molecular Virology, Research Institute for Microbial Diseases, Osaka University, Osaka 5650871, Japan; Division of Microbiology and Immunology, Center for Infectious Diseases Education and Research, Osaka University, Osaka 5650871, Japan; Laboratory of Virus Control, Research Institute for Microbial Diseases, Osaka University, Osaka 5650871, Japan
| | - Gideon Schreiber
- Department of Biological Chemistry, Weizmann Institute of Science, Rehovot 76100, Israel
| | | | - Terumasa Ikeda
- Division of Molecular Virology and Genetics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan.
| | - So Nakagawa
- Department of Molecular Life Science, Tokai University School of Medicine, Kanagawa 2591193, Japan; CREST, Japan Science and Technology Agency, Saitama 3220012, Japan.
| | - Takamasa Ueno
- Division of Infection and Immunity, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto 8600811, Japan.
| | - Kei Sato
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, The Institute of Medical Science, The University of Tokyo, Tokyo 1088639, Japan; CREST, Japan Science and Technology Agency, Saitama 3220012, Japan.
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Chong Y, Tani N, Ikematsu H, Terazawa N, Nakashima H, Shimono N, Akashi K, Tanaka Y. Genetic testing and serological screening for SARS-CoV-2 infection in a COVID-19 outbreak in a nursing facility in Japan. BMC Infect Dis 2021; 21:263. [PMID: 33722204 PMCID: PMC7957465 DOI: 10.1186/s12879-021-05972-5] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/09/2021] [Indexed: 11/14/2022] Open
Abstract
Background The Pandemic of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has critically impacted the spread of infection within nursing facilities. We evaluated the usefulness of genetic and serological tests conducted during a COVID-19 outbreak in a nursing facility in Japan. Methods After the first identification of SARS-CoV-2 infection, a comprehensive, facility- and/or unit-wide PCR testing from nasopharyngeal swabs was repeatedly performed in a three-unit facility including 99 residents with dementia and 53 healthcare personnel. Additionally, PCR testing was conducted separately for residents and staff with fever of ≥37.5 °C. Facility-wide serological testing, including rapid kit testing and quantitative assay, was conducted twice over 1 month apart. Results A total of 322 PCR and 257 antibody tests were performed. 37 (24.3%) of the 152 individuals (25/99 residents, 25.3%; 12/53 staff, 22.6%) were identified as PCR-positive. Seven residents died with a mortality of 7.1% (7/99). Among the 37 individuals, 10 (27.0%) were asymptomatic at the time of testing. PCR positivity was concentrated on one unit (Unit 1) (20/30 residents, 66.7%; 9/14 staff, 64.3%). The other units showed a limited spread of infection. In unit-wide and separate tests, PCR positivity detection was highly prevalent (22.9 and 44.4%, respectively) in Unit 1, compared with that in the other units. Serological testing identified two additional infected residents with a negative PCR result and showed that no staff was newly identified as infected. Conclusions Thorough PCR testing, in combination with comprehensive and separate tests, is critical for managing COVID-19 outbreaks in nursing facilities, particularly, in units considered an epicenter. Serological testing is also beneficial for tracing contacts, confirming the number of infected individuals, and authorizing the termination of the outbreak. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05972-5.
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Affiliation(s)
- Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | | | - Nobuto Terazawa
- Medical Corporation SOUSEIKAI, Kanenokuma Hospital, Fukuoka, Japan
| | | | - Nobuyuki Shimono
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.,Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yosuke Tanaka
- Medical Corporation SOUSEIKAI, Kanenokuma Hospital, Fukuoka, Japan
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31
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Lee TH, Lye DC, Chung DR, Thamlikitkul V, Lu M, Wong AT, Hsueh PR, Wang H, Cooper C, Wong JG, Shimono N, Pham VH, Perera J, Yang YH, Shibl AM, Kim SH, Hsu LY, Song JH. Antimicrobial stewardship capacity and manpower needs in the Asia Pacific. J Glob Antimicrob Resist 2021; 24:387-394. [PMID: 33548495 DOI: 10.1016/j.jgar.2021.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 12/03/2020] [Accepted: 01/23/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Antimicrobial stewardship is a strategy to combat antimicrobial resistance in hospitals. Given the burden and impact of antimicrobial resistance in the Asia Pacific, it is important to document capacity and gaps in antimicrobial stewardship programmes (ASP). We aimed to understand existing capacities and practices, and define the resources needed to establish antimicrobial stewardship where it is lacking. METHODS An anonymous online survey, consisting of questions on antimicrobial control at country, hospital and programme levels, was circulated to healthcare providers in the field of infectious diseases and microbiology through Asian Network for Surveillance of Resistant Pathogens, ReAct Group and the Australasian Society for infectious Diseases. RESULTS 139 participants from 16 countries or regions completed the survey. The majority of participants were adult infectious diseases physicians (61/139, 43.9%) and microbiologists (31/139, 22.3%). Participants from 7 countries reported that antimicrobials can be obtained without prescriptions. Despite the high percentage (75.5%) of respondents working in large hospitals, only 22/139 participants (15.8%) from Australia, China, Singapore, Taiwan, Thailand and Vietnam reported having more than 10 infectious diseases physicians. Hospital empiric antimicrobial guidelines for common infections were available according to 110/139 (79.1%) participants. Pre-authorisation of antimicrobials was reported by 88/113 (77.9%) respondents while prospective audit and feedback was reported by 93/114 (81.6%). Automatic stop orders and culture-guided de-escalation were reported by only 52/113 (46.0%) and 27/112 (24.1%) respectively. CONCLUSION The survey reveals a wide range of ASP development in Asia Pacific. Establishing national workgroups and guidelines will help advance antimicrobial stewardship in this diverse region.
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Affiliation(s)
- Tau Hong Lee
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - David C Lye
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Doo Ryeon Chung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asia Pacific Foundation for Infectious Diseases, Seoul, Republic of Korea
| | | | - Min Lu
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Andrew Ty Wong
- Infectious Disease Control Training Centre, Hospital Authority, Hong Kong
| | - Po-Ren Hsueh
- Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Celia Cooper
- Department of Infectious Diseases, Women's and Children's Hospital, South Australia, Australia
| | - Joshua Gx Wong
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Japan
| | - Van Hung Pham
- School of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam
| | - Jennifer Perera
- Department of Microbiology, Faculty of Medicine, University of Colombo, Sri Lanka
| | - Yong-Hong Yang
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Atef M Shibl
- Department of Microbiology and Immunology, College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia
| | - So Hyun Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Asia Pacific Foundation for Infectious Diseases, Seoul, Republic of Korea
| | - Li Yang Hsu
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore; Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jae-Hoon Song
- Asia Pacific Foundation for Infectious Diseases, Seoul, Republic of Korea; CHA Bio Group, Gyeonggi-do, Republic of Korea
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32
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Yonekawa A, Miyake N, Minami J, Murakami D, Fukano H, Hoshino Y, Kubo K, Chong Y, Akashi K, Shimono N. Parotitis caused by Mycobacteroides abscessus subspecies abscessus. Auris Nasus Larynx 2020; 49:525-528. [PMID: 33246745 DOI: 10.1016/j.anl.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/22/2020] [Accepted: 11/12/2020] [Indexed: 11/26/2022]
Abstract
Rapidly growing mycobacteria rarely causes parotitis. We report a rare case of Mycobacteroides abscessus subspecies abscessus (MAB) parotitis in a previously healthy 26-year-old woman. She presented to the previous hospital with a swelling over the right parotid region, and a computed tomography scan revealed multiple abscesses in the swollen parotid gland. Histopathology showed granulomatous inflammation with acid-fast bacilli; however, a subsequent culture failed to isolate mycobacterium. Despite repeated antibiotic therapy and multiple surgical interventions including partial incision and drainage of the abscesses, the parotitis did not resolved. At six months after presentation, she was referred to our institute. We performed enlarged resection of the necrotic tissue and abscesses, and the sample cultivated after homogenization was positive for mycobacterium. The isolate was finally identified as MAB. She underwent long-term postoperative antibiotic therapy for MAB, with a favorable outcome. To the best of our knowledge, this is the first case of MAB parotitis where the subspecies has been identified. MAB is much more intractable than the other subspecies. We highlight the importance of the correct identification of MAB, which leads to the appropriate treatment.
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Affiliation(s)
- Akiko Yonekawa
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Noriko Miyake
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Junya Minami
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Murakami
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hanako Fukano
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshihiko Hoshino
- Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuhiko Kubo
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Otorhinolaryngology & Head and Neck Surgery, Chidoribashi General Hospital, Fukuoka, Japan
| | - Yong Chong
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Chong Y, Ikematsu H, Tani N, Arimizu Y, Watanabe H, Fukamachi Y, Yonekawa A, Iwasaka S, Nishida R, Eriguchi Y, Miyake N, Shimoda S, Nagasaki Y, Shimono N, Akashi K. Clinical significance of SARS-CoV-2-specific IgG detection with a rapid antibody kit for COVID-19 patients. Influenza Other Respir Viruses 2020; 15:13-18. [PMID: 32909661 PMCID: PMC7767946 DOI: 10.1111/irv.12802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 01/23/2023] Open
Abstract
Background The longitudinal observation of the detection of antibody responses to SARS‐CoV‐2 using antibody kits during the clinical course of COVID‐19 is not yet fully investigated. Objectives To understand the significance of the detection of anti‐SARS‐CoV‐2 antibodies, particularly IgG, using a rapid antibody kit, during the clinical course of COVID‐19 patients with different severities. Methods Sixty‐three serum samples from 18 patients (5 asymptomatic and 13 symptomatic patients) were retrospectively examined using a commercial SARS‐CoV‐2 IgM/IgG antibody kit. PCR positivity of patient samples was also examined as a marker of current SARS‐CoV‐2 infection. Results IgG antibodies were detected in all cases in this study. The IgG detection rates reached 100.0% in samples collected on day 13 or later. IgG seropositivity after an initial negative status was observed in 13 patients (3/5 asymptomatic and 10/13 symptomatic cases). Interestingly, the persistence of both PCR and IgG positivity was detected in seven cases, of which three were asymptomatic. The longest overlap duration of the PCR and IgG positivity was 17 days in asymptomatic status. Conclusions SARS‐CoV‐2‐specific IgG production can be detected in all infected individuals, using a rapid antibody kit, irrespective of clinical status. However, these findings suggest that, in some infected individuals, particularly those with asymptomatic status, the presence of virus‐specific IgG antibodies does not imply prompt viral clearance.
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Affiliation(s)
- Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | | | - Naoki Tani
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Yoko Arimizu
- Department of Infectious Disease, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Haruka Watanabe
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Yukako Fukamachi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Akiko Yonekawa
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Sho Iwasaka
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan.,Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Ruriko Nishida
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan.,Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshihiro Eriguchi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Noriko Miyake
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Shinji Shimoda
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
| | - Yoji Nagasaki
- Department of Infectious Disease, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Nobuyuki Shimono
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan.,Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences (The First Department of Internal Medicine), Fukuoka, Japan
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34
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Iwasaka S, Shono Y, Tokuda K, Nakashima K, Yamamoto Y, Maki J, Nagasaki Y, Shimono N, Akahoshi T, Taguchi T. Clinical improvement in a patient with severe coronavirus disease 2019 after administration of hydroxychloroquine and continuous hemodiafiltlation with nafamostat mesylate. J Infect Chemother 2020; 26:1319-1323. [PMID: 32893123 PMCID: PMC7409929 DOI: 10.1016/j.jiac.2020.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 01/08/2023]
Abstract
The number of people infected with severe acute respiratory syndrome coronavirus 2 is increasing globally, and some patients have a fatal clinical course. In light of this situation, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020. While clinical studies and basic research on a treatment for COVID-19 are ongoing around the world, no treatment has yet been proven to be effective. Several clinical studies have demonstrated the efficacy of chloroquine phosphate and nafamostat mesylate with COVID-19. Here, we report the case of a Japanese patient with COVID-19 with severe respiratory failure who improved following the administration of hydroxychloroquine and continuous hemodiafiltlation with nafamostat mesylate. Hence, hydroxychloroquine with nafamostat mesylate might be a treatment option for severe COVID-19.
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Affiliation(s)
- Sho Iwasaka
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan; Department of Clinical Immunology and Rheumatology/Infectious Diseases, Kyushu University Hospital, Fukuoka, Japan.
| | - Yuji Shono
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Kentaro Tokuda
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Kosuke Nakashima
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Yuzo Yamamoto
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Maki
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Yoji Nagasaki
- Department of Infectious Diseases, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of Clinical Immunology and Rheumatology/Infectious Diseases, Kyushu University Hospital, Fukuoka, Japan
| | - Tomohiko Akahoshi
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
| | - Tomoaki Taguchi
- Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan
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35
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Tani N, Nakamura K, Sumida K, Suzuki M, Imaoka K, Shimono N. An Immunocompetent Case of Capnocytophaga canimorsus Infection Complicated by Secondary Thrombotic Microangiopathy and Disseminated Intravascular Coagulation. Intern Med 2019; 58:3479-3482. [PMID: 31327837 PMCID: PMC6928499 DOI: 10.2169/internalmedicine.3110-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/13/2023] Open
Abstract
A 62-year-old woman with no previous history developed a Capnocytophaga canimorsus infection followed by thrombotic microangiopathy (TMA) and disseminated intravascular coagulation (DIC). She was treated with antibiotics and plasma exchange (PE) and recovered. C. canimorsus sepsis sometimes causes not only DIC but also TMA. The mortality of TMA is extremely high, so we should not hesitate to perform PE when a patient shows TMA symptoms.
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Affiliation(s)
- Naoki Tani
- Department of Infectious Diseases, Saiseikai Fukuoka General Hospital, Japan
| | - Keiji Nakamura
- Department of Infectious Diseases, Saiseikai Fukuoka General Hospital, Japan
| | - Kosuke Sumida
- Department of Infectious Diseases, Saiseikai Fukuoka General Hospital, Japan
| | - Michio Suzuki
- Department of Veterinary Science, National Institute of Infectious Diseases, Japan
| | - Koichi Imaoka
- Department of Veterinary Science, National Institute of Infectious Diseases, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Japan
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36
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Iwakiri R, Tanaka K, Gotoda T, Oka S, Ohtsuka T, Sakata Y, Chiba T, Higuchi K, Masuyama H, Nozaki R, Matsuda K, Shimono N, Fujimoto K, Tajiri H. Guidelines for standardizing cleansing and disinfection of gastrointestinal endoscopes. Dig Endosc 2019; 31:477-497. [PMID: 31241788 DOI: 10.1111/den.13474] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/23/2019] [Indexed: 02/05/2023]
Abstract
As part of the activities toward standardizing endoscopy procedures, the Japan Gastroenterological Endoscopy Society has prepared guidelines for cleansing and disinfection of gastrointestinal endoscopes. The environment of gastrointestinal endoscopy differs between Japan and advanced Western countries. In advanced Western countries, gastrointestinal endoscopy is performed almost exclusively at specialized facilities, where strict provisions are observed for cleansing and disinfecting endoscopes. In Japan, however, gastrointestinal endoscopy is performed even in small clinics, and the annual number of gastrointestinal endoscopy cases is enormous. In addition, the method for cleansing and disinfecting endoscopes differs among hospitals. Although there is a distinct lack of evidence for how gastrointestinal endoscopes are cleaned and disinfected, it is necessary to standardize the method for doing so to advance the field of endoscopic medicine.
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Affiliation(s)
| | | | - Takuji Gotoda
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shiro Oka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takao Ohtsuka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Toshimi Chiba
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | - Ryoichi Nozaki
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | - Hisao Tajiri
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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37
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Fukuda H, Yano T, Shimono N. 1921. Attributable Inpatient Costs of Hospital-Onset Clostridium difficile Infection: A Nationwide Case–Control Study in Japan. Open Forum Infect Dis 2018. [PMCID: PMC6252407 DOI: 10.1093/ofid/ofy210.1577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Hospital-onset Clostridium difficile infections (CDIs) have a considerable clinical and economic impact on both patients and payers. Quantifying the economic impact of CDIs can guide treatment strategies. However, previous studies have generally focused on acute care hospitals, and few have included cost estimates from nonacute care hospitals such as rehabilitation centres and long-term care facilities. The aim of this study was to quantify the hospital-onset CDI-attributable inpatient costs and length-of-stay durations in all healthcare institutions that provide inpatient care (including acute and nonacute care) in Japan. Methods Using national-level insurance claims data, we analyzed patients who had been hospitalized between April 2010 and December 2016. CDI case patients were identified and matched with non-CDI control patients using hospitalization year, treating hospital, age, sex, surgical procedure, comorbidities, and main diagnoses. Using multivariable regression analyses, we estimated the CDI-attributable inpatient costs and length-of-stay durations while adjusting for variations in factors such as age, sex, comorbidities, surgery, prescribed antibiotic, geographic region, and hospitalization year. We also analyzed the CDI-attributable inpatient costs and length-of-stay durations according to hospital type (acute care and rehabilitation/long-term care). Results The analysis was conducted using 3,768 matched pairs. Overall CDI-attributable inpatient costs and length-of-stay durations were US$3,213 and 11.96 days, respectively. Rehabilitation/long-term care hospitals had substantially higher inpatient costs and longer hospitalizations than acute care hospitals. Conclusion This study quantified the hospital-onset CDI-attributable inpatient costs and hospitalizations in both acute and nonacute care hospitals. The inclusion of nonacute care hospitals provides a more accurate representation of the economic burden of CDIs. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Haruhisa Fukuda
- Health Care Administration and Management, Kyushu University, Fukuoka, Japan
| | - Takahisa Yano
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
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38
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Fukuda H, Yano T, Shimono N. Inpatient Expenditures Attributable to Hospital-Onset Clostridium difficile Infection: A Nationwide Case-Control Study in Japan. Pharmacoeconomics 2018; 36:1367-1376. [PMID: 30022364 DOI: 10.1007/s40273-018-0692-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Hospital-onset Clostridium difficile infections (CDIs) have a considerable clinical and economic impact on patients and payers. Quantifying the economic impact of CDIs can guide treatment strategies. However, previous studies have generally focused on acute care hospitals, and few have included cost estimates from non-acute care hospitals such as long-term care facilities. AIM This study aimed to quantify the hospital-onset CDI-attributable inpatient expenditures and length-of-stay durations in all healthcare institutions that provide inpatient care (including acute and non-acute care) in Japan. METHODS Using national-level insurance claims data, we analyzed patients who had been hospitalized between April 2010 and December 2016. CDI cases were identified and matched with non-CDI controls using hospitalization year, treating hospital, age, sex, surgical procedure, comorbidities, and main diagnoses. Through multivariable regression analyses, we estimated the CDI-attributable inpatient expenditures (2016 US dollars) and length-of-stay durations (days) while adjusting for variations in factors such as patient characteristics, comorbidities, surgery, prescribed antibiotic, geographic region, and hospitalization year. We also analyzed the CDI-attributable inpatient expenditures and length-of-stay durations according to hospital type (acute care and rehabilitation/long-term care). RESULTS The analysis was conducted using 3768 matched pairs. Overall, CDI-attributable inpatient expenditures and length-of-stay durations were US$3213 and 11.96 days, respectively. Rehabilitation/long-term care hospitals had substantially higher inpatient expenditures and longer hospitalizations than acute care hospitals. CONCLUSION This study quantified the hospital-onset CDI-attributable inpatient expenditures and hospitalizations in both acute and non-acute care hospitals. The inclusion of non-acute care hospitals provides a more accurate representation of the economic burden of CDIs.
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Affiliation(s)
- Haruhisa Fukuda
- Department of Health Care Administration and Management, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
| | - Takahisa Yano
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
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39
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Mori Y, Yoshimoto G, Nishida R, Sugio T, Miyawaki K, Shima T, Nagasaki Y, Miyake N, Harada Y, Kunisaki Y, Kamezaki K, Numata A, Kato K, Shiratsuchi M, Maeda T, Takenaka K, Iwasaki H, Shimono N, Akashi K, Miyamoto T. Gastrointestinal Graft-versus-Host Disease Is a Risk Factor for Postengraftment Bloodstream Infection in Allogeneic Hematopoietic Stem Cell Transplant Recipients. Biol Blood Marrow Transplant 2018; 24:2302-2309. [PMID: 29909153 DOI: 10.1016/j.bbmt.2018.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/04/2018] [Indexed: 01/13/2023]
Abstract
Bloodstream infection (BSI) is a well-known cause of morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. Here, we conducted a retrospective study to assess the morbidity, etiology, risk factors, and outcomes of BSI in the postengraftment period (PE-BSI) after allo-HSCT. Forty-three of 316 patients (13.6%) developed 57 PE-BSI episodes, in which 62 pathogens were isolated: Gram-positive bacteria, gram-negative bacteria, and fungi, respectively, accounted for 54.8%, 35.5%, and 9.7% of the isolates. Multivariate analysis revealed methylprednisolone use for graft-versus-host disease (GVHD) prophylaxis (odds ratio [OR], 6.49; 95% confidence interval [CI], 1.49 to 28.2; P = .013) and acute gastrointestinal GVHD (GI-GVHD) (OR, 8.82; 95% CI, 3.99 to 19.5; P < .0001) as risk factors for developing PE-BSI. This finding suggested that GI-GVHD increases the risk of bacterial translocation and subsequent septicemia. Moreover, among patients with GI-GVHD, insufficient response to corticosteroids, presumably related to an intestinal dysbiosis, significantly correlated with this complication. Patients with PE-BSI presented worse outcome compared with those without (3-year overall survival, 47.0% versus 18.6%; P < .001). Close microbiologic monitoring for BSIs and minimizing intestinal dysbiosis may be crucial to break the vicious cycle between GI-GVHD and bacteremia and to improve transplant outcomes especially in patients who require additional immunosuppressants.
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Affiliation(s)
- Yasuo Mori
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Goichi Yoshimoto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Ruriko Nishida
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takeshi Sugio
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Kohta Miyawaki
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Shima
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yoji Nagasaki
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Noriko Miyake
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yukiko Harada
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yuya Kunisaki
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kenjiro Kamezaki
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Akihiko Numata
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koji Kato
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Motoaki Shiratsuchi
- Medicine and Bioregulatory Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Takahiro Maeda
- Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Katsuto Takenaka
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiromi Iwasaki
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Nobuyuki Shimono
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Koichi Akashi
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan; Center for Cellular and Molecular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Toshihiro Miyamoto
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
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40
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Chong Y, Shimoda S, Shimono N. Current epidemiology, genetic evolution and clinical impact of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Infect Genet Evol 2018; 61:185-188. [PMID: 29626676 DOI: 10.1016/j.meegid.2018.04.005] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 03/29/2018] [Accepted: 04/02/2018] [Indexed: 01/01/2023]
Abstract
The worldwide spread of extended-spectrum β-lactamase (ESBL)-producing bacteria, particularly Escherichia coli and Klebsiella pneumoniae, is a critical concern for the development of therapies against multidrug-resistant bacteria. Since the 2000s, detection rates of CTX-M types ESBL-producing E. coli in the community have been high, possibly contributing to their nosocomial detection. Various factors, such as environmental sources, food animals, and international travel, accelerate the global ESBL spread in the community. The dramatic dissemination of ESBLs in the community is associated with the relatively recent emergence of CTX-M-15-producing ST131 E. coli clones, which often carry many other antibiotic resistance genes (including quinolone). The usefulness of β-lactam/β-lactamase inhibitor, particularly, piperacillin/tazobactam, has been considered as a carbapenem-sparing regimen for ESBL infections, although the global trend of AmpC β-lactamase-producing bacteria should be monitored carefully. Careful therapeutic selection and continued surveillance for the detection of multidrug-resistant bacteria are required.
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Affiliation(s)
- Yong Chong
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan.
| | - Shinji Shimoda
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
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41
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Kurose S, Onozawa K, Yoshikawa H, Yaita K, Takahashi H, Shimono N, Nagasaki Y. Invasive meningococcal disease due to a non-capsulated Neisseria meningitidis strain in a patient with IgG4-related disease. BMC Infect Dis 2018; 18:146. [PMID: 29606119 PMCID: PMC5879769 DOI: 10.1186/s12879-018-3064-2] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/26/2018] [Indexed: 12/13/2022] Open
Abstract
Background Invasive Meningococcal Disease (IMD) is a rare and critical disease in Japan. Most of these cases are caused by capsulated Neisseria meningitidis strains. Non-capsulated (non-typable) strains are considered relatively low-pathogenic and can colonize in the nasopharynx of healthy children and young adults. As far as could be ascertained, only twelve IMD cases due to non-capsulated strains have been reported in the literature. No clear risk factors could be identified in a literature review (unknown or immunocompetent, seven cases; C6 deficiency, three cases). Case presentation We report a Japanese male taxi driver with bacteremia and meningitis due to non-capsulated N. meningitidis. He had a fever and shaking chills. Ceftriaxone was administered, and the patient finally recovered. During the clinical course, relative adrenal insufficiency occurred and was treated with hydrocortisone. A hidden co-morbidity, immunoglobulin G4 (IgG4)-related disease, was revealed in the past surgical history (a resection of bilateral orbital tumors), which included symptoms (swelling lachrymal glands and lymph nodes), elevated IgG4, immunoglobulin E, and hypocomplementemia. He recovered finally and no recurrence was observed. Conclusions Our IMD case is the first reported in Japan, where IMD is not considered pandemic. The patient had a history of IgG4-related disease, although we could not establish a clear relationship between the patient’s IMD and co-morbidity. A collection of further clinical cases might establish the risk factors and characteristics of IMD that could be caused by this neglected pathogen, non-capsulated N. meningitidis.
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Affiliation(s)
- Shun Kurose
- Division of Infectious Diseases, Fukuoka City Hospital, 13-1 Yoshizuka-Honmachi, Hakata-ku, Fukuoka, 812-0046, Japan
| | - Kyoko Onozawa
- Division of Infectious Diseases, Fukuoka City Hospital, 13-1 Yoshizuka-Honmachi, Hakata-ku, Fukuoka, 812-0046, Japan.
| | - Hiroshi Yoshikawa
- Department of Ophthalmology, Graduate School of Medical Science at Kyushu University, Fukuoka, Japan
| | - Kenichiro Yaita
- Division of Infection Control and Prevention, Kurume University Hospital, Kurume, Japan
| | - Hideyuki Takahashi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yoji Nagasaki
- Division of Infectious Diseases, Fukuoka City Hospital, 13-1 Yoshizuka-Honmachi, Hakata-ku, Fukuoka, 812-0046, Japan
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Chong Y, Shimoda S, Miyake N, Aoki T, Ito Y, Kamimura T, Shimono N. Incomplete recovery of the fecal flora of hematological patients with neutropenia and repeated fluoroquinolone prophylaxis. Infect Drug Resist 2017; 10:193-199. [PMID: 28721078 PMCID: PMC5500534 DOI: 10.2147/idr.s133333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Routine fluoroquinolone prophylaxis in neutropenic patients with hematological malignancies is still controversial, because of antibiotic resistance concerns. The recovery of the fecal microbiota to the initial composition in patients receiving multiple courses of quinolone prophylaxis and repeated chemotherapy has not been evaluated. Methods We prospectively examined the changes in the fecal bacterial composition before and after levofloxacin prophylaxis. A sequential observation of bacterial resistance in patients receiving multiple prophylactic courses was also conducted. Results In this trial, 68 cases, including (35 with the first course and 33 with the second and subsequent courses) were registered. The disappearance of quinolone-susceptible (QS) Entero-bacteriaceae and dominant emergence of quinolone-resistant (QR) coagulase negative staphylococci (CNS) and QR Enterococci were observed after the first prophylaxis. The detection of QS Enterobacteriaceae was recovered before the second and subsequent courses to a level of the initial composition (28/35 samples, 80.0% before the first course vs 23/33 samples, 69.7% before the second and subsequent courses, P=0.41). In contrast, the detection rate of QR CNS and Enterococci significantly increased at the second and subsequent courses, even before prophylaxis (8/35 samples, 22.9% before the first course vs 20/33 samples, 60.6% before the second and subsequent courses, P=0.003). The incomplete recovery of the initial bacterial composition was associated with a prophylactic interval of within 30 days. Of the patients receiving multiple prophylactic courses, six had QR Escherichia coli, including extended-spectrum β-lactamase (ESBL) producers, at the first course, and four (66.3%) of the six patients had persistent detection of QR E. coli at the second course. Conclusion In patients receiving multiple courses of prophylactic quinolone, along with a common chemotherapy schedule, newly emergent resistant bacteria could be frequently persistent in their fecal flora.
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Affiliation(s)
- Yong Chong
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
| | - Shinji Shimoda
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
| | - Noriko Miyake
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences
| | - Takatoshi Aoki
- Department of Blood and Marrow Transplantation, Hara-Sanshin Hospital, Fukuoka
| | - Yoshikiyo Ito
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu
| | - Tomohiko Kamimura
- Department of Blood and Marrow Transplantation, Hara-Sanshin Hospital, Fukuoka
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
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Sutthiruk N, Botti M, Considine J, Driscoll A, Hutchinson A, Malathum K, Cucunawangsih C, Wiwing V, Puspitasari V, Shanmugakani RK, Akeda Y, Kodera T, Santanirand P, Tomono K, Yamanaka T, Moriuchi H, Kitajima H, Horikoshi Y, Lavrinenko A, Azizov I, Tabriz N, Kozhamuratov M, Serbo Y, Yang D, Lee W, Bae IK, Lee JH, Lee H, Kim JO, Jeong SH, Lee K, Peremalo T, Madhavan P, Hamzah S, Than L, Wong EH, Desa MNM, Ng KP, Geronimo M, Tayzon MF, Maño MJ, Chow A, Hon PY, Win MK, Ang B, Leo YS, Chow A, Hon PY, See T, Ang B, Marin RA, de Sousa MA, Kieffer N, Nordmann P, Poirel L, Laochareonsuk W, Petyu S, Wanasitchaiwat P, Thana S, Bunyaphongphan C, Boonsomsuk W, Maneepongpermpoon P, Jamulitrat S, Sureshkumar D, Supraja K, Sharmila S, Cucunawangsih C, Setiawan B, Lumbuun N, Nakayama H, Ota T, Shirane N, Matuoka C, Kodama K, Ohtsuka M, Bacolcol SAA, Velmonte M, Alde A, Chavez K, Esteban AJ, Lee AJ, Hsieh TC, Shio-ShinJean, Huang HJ, Huang SJ, Huang YH, Cheng PC, Yu SF, Tsao SM, Lee YT, Li CF, Lu MC, Pruetpongpun N, Khawcharoenporn T, Damronglerd P, Suwantarat N, Apisarnthanarak A, Rutjanawech S, Cushinotto L, McBride P, Williams H, Liu H, Hang PT, Anh DPP, Le N, Khu D, Nguyen L, Castillo RB, Sureshkumar D, Gopalakrishnan R, Ramasubramanian V, Sreevidya S, Jayapradha R, Umetsu A, Noda T, Hashimoto K, Hayashi A, Kabashima M, Jadczak U, Elvelund K, Johnsen M, Borgen B, Lingaas E, Mao CH, Chang FC, Liu CP, Chao RH, Chang FC, Liu CP, Pawapotako J, Prasertpan C, Malaihuan W, Uirungroj P, Prasertpan C, Saenjum C, Ouirungrog T, Uirungroj P, Borrell S, Bass P, Worth L, Xian-li Z, Xiao-long L, Xue-hua Y, Wei R, Zeng ZX, Kong MY, Lai CKC, Lee SY, Tsang NC, O’Donoghue MM, Boost MV, Suen LKP, Siu GK, Mui KW, Lai CKC, Tsang DNC, Sato Y, Tateishi M, Mihashi M, Flor JP, Bautista M, De Roxas VJ, Vergara J, Añonuevo NA, Kwek M, Acuin J, Sanchez AJ, Bathan A, Jantan JB, Guek CC, Kian EC, Pirido PA, Aron NFBM, Estacio LM, Palana FA, Gracia M, Shamsuddin NSB, Castro KT, Baloria M, Adam FB, Wei Z, Fong PB, Kalisvar M, Chow A, Ang B, Chuang IJ, Yi-ChunCho, Chiu YF, Chen LC, Lin YC, Dong SX, Lee YC, Kuan HC, Lin HH, Chi CC, Lu CT, Chang FC, Liu CP, Ya-Fen T, Li-Hsiang S, Jien-Wei L, Chao H, ChangChien P, Chen W, Lai C, Ara L, Mowla SMN, Vashkar SMK, Chan WF, ChunYau MY, LingChong KK, OnLi T, Kaur R, Yan NP, Chiu GCS, Cheung CWY, Ching PTY, Ching RHC, Lam CHS, Kan CH, Lee SSY, Chen CP, Chan RFY, Leung AFY, Wong ILC, Lam SS, Chan QWL, Chan C, Kaur R, Nematian SSS, Palenik CJ, Askarian M, Nematian SSS, Palenik CJ, Hatam N, Askarian M, Nakamura I, Fujita H, Tsukimori A, Kobayashi T, Sato A, Fukushima S, Matsumoto T, Flor JP, Añonuevo NA, Bautista M, Vergara J, De Roxas VJ, Kwek M, Flor JP, Bautista M, Vergara J, De Roxas VJ, AndreiAñonuevo N, Kwek M, Ho YM, Kum JQ, Poh BF, Marimuthu K, Ang B, Liu TY, Chu SM, Chen HZ, Chen TC, Chen Y, Tsao YC, Skuntaniyom S, Malathum K, Tipluy P, Paengta S, wongsaen R, thanomphan S, Tariyo S, Thongchuea B, Khamfu P, Thanomphan S, Songtaweesin WN, Anugulruengkit S, Samransamruajkit R, Sosothikul D, Tansrijitdee O, Nakphunsung A, Srimuan P, Sophonphan J, ThanyaweePuthanakit, Payuk K, Picheansathian W, Viseskul N, DeNardo E, Leslie R, Cartner T, Barbosa L, Werner HP, Brill FHH, Kawagoe JY, De Nardo E, Wilson SE, Macinga D, Mays-Suko P, Duley C, Hang PT, Hang TTT, Hanh TTM, Gordon C, Sureshkumar D, Durairaj R, Rohit A, Saravanakumar S, Hemalatha J, Hirano R, Sakamoto Y, Yamamoto S, Tachibana N, Miura M, Hieda F, Sakai Y, Watanabe H, Velmonte M, Bacolcol SA, Alde A, Chavez K, Esteban AJ, Lee AJ, Chow A, Lim JW, Hon PY, Hein AA, Tin G, Lim V, Ang B, Chow A, Hein AA, Lim JW, Hon PY, Lim V, Tin G, Ang B, Chow A, Tin G, Hein AA, Lim V, Lim JW, Hon PY, Ang B, Chao HC, Yeh CY, Lo MF, Chao HC, Piwpong C, Rajborirug S, Preechawetchakul P, Pruekrattananapa Y, Sangsuwan T, Jamulitrat S, Wongsaen R, Paengta S, Nilchon N, Thanompan S, Tariyo S, Le N, Khu D, Kolesnichenko S, Azizov I, Lavrinenko A, Tishkambayev Y, Lavrinenko A, Azizov I, Tishkambayev Y, Alibecov A, Kolesnichenko S, Serbo Y, Nam Y, Park JH, Hong YJ, Kim TS, Park JS, Park KU, Kim EC, Aziegbemhin SA, Enabulele O, Tung YS, Chen AC, Huang SM, Yang YY, Wu LH, Lin CC, Chang FC, Liu CP, Lien TH, Chang JH, Huang YS, Chen YS, Saenjum C, Sirilun S, Ouirungrog T, Ouirungroj P, Trakulsomboon S, Prasajak P, Kwok MWN, Ng LSH, Wong LMT, Poon LSL, Lai MKL, Cheng HHS, Fong SK, Leung CFY, Hasegawa J, Shirakawa H, Wakai S, Mieno M, Hatakeyama S, Tateishi M, Mihashi M, Sato Y, Saenjum C, Deeudom M, Tharavichitkul P, Ouirungrog T, Ouirungroj P, Chinniah T, Tan J, Prabu K, Alam S, Wynn AK, Ahmad R, Sidek A, Samsuddin DA, Ajis N, Ahmad A, Magon S, Chu B, Kuang J, Gao Y, Wang S, Hao Y, Liu R, Li D, Wang H, Yan NP, Nishio H, Mori H, Morokuma Y, Yamada T, Kiyosuke M, Yasunaga S, Toyoda K, Shimono N, Babenko D, Turmuhambetova A, Cheşcă A, Toleman MA, Babenko D, Turmuhambetova A, Cheşcă A, Toleman MA, Babenko D, Turmuhambetova A, Azizov I, Cheşcă A, Toleman MA, Akhmaltdinova LL, Turmuhambetova A, Cheşcă A, Babenko D, Magsakay MA, Macatibag A, Tayzon MF, Lerios JK, Azizov I, Lavrineko A, Babenko D, Sheck E, Edelstein M, Liu TY, Li LY, Chan CW, Pan HC, Chen TC, Vanishakije W, Jaikampun W, Cheng PC, Huang HJ, Huang SJ, Huang YH, Li SY, Yu SF, Li JF, Wu YP, Lee YT, Lin CH, Chang PC, Tariyo S, Paengta S, Wongsaen R, Thanompan S, Skuntaniyom S, Malathum K, Sukkra S, Zaman K, Zaman SF, Zaman F, Aziz A, Faisal SB, Traskine M, Ruiz-Guiñazú J, Borys D, Zaman K, Zaman SF, Zaman F, Aziz A, Faisal SB, Traskine M, Ruiz-Guiñazú J, Borys D, Lam WWY, Chow M, Choy L, Kam J, Salleh SA, Yacob R, Yusof SR, Jalil NA, Flor JP, Añonuevo NA, Bautista M, De Roxas VJ, Vergara J, Millan ML, Kwek M, Acuin JL, Lee AJ, Velmonte MA, Bacolcol SAA, Alde A, Chavez K, Esteban AJ, Ting CI, Dissayasriroj S, Chinniah TR, Prabu K, Ahmad R, Magon S, DiniSuhaimi J, Mirasin A, Morni N, Chu B, Samsuddin A, Ahmad A, Sidek A, Ajis N, AbuBakar A, Shafiee A, Safar J, Yan NP, Annie L, Ling FY, Edna L, Kristine L, Shinomiya S, Yamamoto K, Kjiwara K, Yamaguchi M, Chow A, Tin G, Zhang W, Hon PY, Poh BF, Marimuthu K, Ang B, Chan MC, Wang CC, Huang SJ, Huang HJ, Yu SF, Huang HY, Cheng PC, Li JF, Lee YT, Lai CL, Lu MC, Kosol S, Sakolwirat W, Paepong P, Jansanga S, Jaisamoot P, Thongnuanual N, Srithong C, Somsakul S, Malathum K, Plongpunth S, Punpop M, Malathum P, Malathum K, Thanomphan S, Wongsaen R, Peautiwat K, boon kirdram N, Picheansathian W, Klunklin P, Samethadka G, Suzuki N, Asada H, Katayama M, Komano A, Sato A, Nakamura I, Watanabe H, Matsumoto T, Seo HK, Hwang JH, Shin MJ, Kim SY, Kim ES, Song KH, Kim HB, Un LS, Vong CI, Flor JP, Añonuevo NA, Bautista M, De Roxas VJ, Vergara J, Kwek M, Koh J, Agustinus S, Hassan RBA, Thinn YP, Ng B, Tun SP, Ha SMT, Xiaoting X, Li L, Chuang L, Niroshika AMC, Perera KAK, Fernando DKDG, Hemamala BR, Yeh CY, Chao HC, Yang HC, Chiu HJ, Shih YL, Chien YS, Lin WY, Pan CY, Chang YY, Yea CY, Chu MH, Lee LC, Chiu HJ, Shih YL, Yang HC, Yu-Hsiu L, Siao-Pei G, Pak-On L, Mei-Fe S, Jyh-Jou C, Yu-Hsiu L, Yong-Yuan C, Kuo SY, Lin YH, Zhang JS, Leung PO, Sie MF, Chen JJ, Chen YR, Lin YH, Chen YL, Taou CF, Chen HS, Tang HJ, Chen SY, Chen YY, Der Wang F, Shih TP, Chen CY, Chen SJ, Wu MC, Yang WJ, Chou ML, Yu ML, Li LC, Chu CW, Tsou WH, Wu WC, Cheng WC, Sun CC, Shih TP, Chen CY, Lu SH, Chen SJ, Yang HL, Lu CY, Yu ML, Li LC, Chu CW, Tsou WH, Wu WC, Cheng WC, Sun CC, Hirunprapakorn N, Malathum K, Apivanich S, Pornmee T, Beowsomboon C, Rajborirug S, Pruekrattananapa Y, Sangsuwan T, Jamulitrat S, Kumkoom I, Kasatpibal N, Chitreecheur J, Kasatpibal N, Whitney JD, Saokaew S, Kengkla K, Heitkemper MM, Apisarnthanarak A, Muntajit T, Apivanich S, Malathum K, Somsakul S, Phan HT, Dinh APP, Nguyen TTK. Abstracts from the 8th International Congress of the Asia Pacific Society of Infection Control (APSIC). Antimicrob Resist Infect Control 2017. [PMCID: PMC5333188 DOI: 10.1186/s13756-017-0176-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
A 40-year-old woman with systemic lupus erythematosus (SLE) presented with high-grade fever and severe thrombocytopenia. Acalculous cholecystitis and thrombocytopenia were initially suspected to be complicated with SLE and vasculitis. Contrary to our expectation, however, the patient was finally diagnosed with Helicobacter cinaedi bacteremia. SLE patients show various symptoms, especially when their condition is complicated with vasculitis, which mimics H. cinaedi bacteremia. It is therefore difficult to provide a definite diagnosis. Physicians should be mindful of the presence of H. cinaedi infection.
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Affiliation(s)
- Ruriko Nishida
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Japan
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Nakamura K, Miyake N, Yarimizu A, Nishida R, Kadowaki M, Tanabe K, Chong Y, Shimoda S, Shimono N. [Disseminated Cryptococcosis with Eosinophilia and Elevated IgE in a Non-HIV-infected Patient]. Kansenshogaku Zasshi 2016; 90:819-824. [PMID: 30277676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In general, disseminated cryptococcosis usually occurs among immunocompromised patients, especially those with cell-mediated immunodeficiency, such as HIV-infected patients. We present herein a rare case of an apparently immunocompetent 33-year-old woman who developed disseminated cryptococcal diseases, which included meningitis and pneumonia with eosinophilia, and pulmonary tuberculosis during her disease course. Pneumonia with a diffuse micronodular pattern, immediately followed by meningitis, was diagnosed as disseminated cryptococcosis, because of the presence of yeast-like-fungi demonstrated by transbronchial lung biopsy and a positive cerebrospinal fluid (CSF) culture. In addition, the pneumonia exhibited eosinophilia in the peripheral blood and bronchoalveolar lavage fluid. Re-exacerbation of the pneumonia occurred approximately 3 weeks after onset, along with a sputum culture positive for Mycobacterium tuberculosis. Administration of anti-tuberculosis drugs resulted in recovery from the pulmonary tuberculosis. The treatment of cryptococcal meningitis was initiated using a standard induction regimen;however, an unrecovered status, highlighted by elevated CSF pressure, persisted. Finally, full recovery was induced by the addition of flucytosine treatment (100 mg/kg/day) and repeated daily via lumbar puncture. The allergic condition of this patient may have contributed to the onset of disseminated cryptococcosis.
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Nishida R, Kiyosuke M, Kato K, Shimono N. Increase of Breakthrough Bacteremia Along With Excessive use of Carbapenems in HSCT Recipients. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.64] [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: 11/13/2022] Open
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Higashioka K, Miyake N, Nishida R, Chong Y, Shimoda S, Shimono N. [Bilateral Granulomatous Renal Masses after Intravesical BCG Therapy for Non-muscle-invasive Bladder Cancer and Carcinoma in Situ of the Upper Urinary Tract: A Case Study]. Kansenshogaku Zasshi 2015; 89:481-4. [PMID: 26554225 DOI: 10.11150/kansenshogakuzasshi.89.481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Bacillus Calmette-Guèrin (BCG) is commonly used not only as an infant vaccination, but also as a treatment of and prophylaxis to prevent recurrence in the management of non-muscle-invasive bladder cancer. However, the use of "live" BCG is sometimes complicated by associated infection. We present a case study of a 77-year-old man who developed bilateral renal masses after intravesical BCG therapy was initiated in November 2013, following transurethral resection of non-muscle-invasive bladder cancer. After four courses of BCG (Japan strain, 80 mg per treatment) instillations, a computed tomography examination for febrile episodes showed multiple bilateral renal masses, accompanied by a histological finding of a granulomatous reaction. An acid fast bacterium was cultured from only urine among blood, urine, and microscopic samples. Using the cultured strain, BCG infection was confirmed by the specific gene deletion pattern based on allele-specific polymerase chain reaction analysis. Anti-tuberculosis treatment, including isoniazid (300 mg/day), rifampicin (600 mg/day), and ethambutol (1,000 mg/day), was started for the BCG-related renal granuloma in February 2014. After 3 months, antibiotic therapy was discontinued owing to severe appetite loss, though the masses remained solid. No rapid growth has been detected after anti-BCG therapy. Intravesical BCG therapy is recommended worldwide as one of standard treatments for non-muscle-invasive bladder cancer. We should closely observe patients undergoing this approach for emerging BCG complications.
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Miyake N, Chong Y, Nishida R, Nagasaki Y, Kibe Y, Kiyosuke M, Shimomura T, Shimono N, Shimoda S, Akashi K. A dramatic increase in the positive blood culture rates of Helicobacter cinaedi: the evidence of differential detection abilities between the Bactec and BacT/Alert systems. Diagn Microbiol Infect Dis 2015; 83:232-3. [DOI: 10.1016/j.diagmicrobio.2015.07.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 06/25/2015] [Accepted: 07/22/2015] [Indexed: 11/28/2022]
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Kiyosuke M, Kibe Y, Oho M, Kusaba K, Shimono N, Hotta T, Kang D, Shoubuike T, Miyamoto H. Comparison of two types of matrix-assisted laser desorption/ionization time-of-flight mass spectrometer for the identification and typing of Clostridium difficile. J Med Microbiol 2015; 64:1144-1150. [DOI: 10.1099/jmm.0.000136] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Makiko Kiyosuke
- Division of Microbiology, Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Yasushi Kibe
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Megumi Oho
- Department of Laboratory Medicine, Saga University Hospital, Saga, Japan
| | - Koji Kusaba
- Department of Laboratory Medicine, Saga University Hospital, Saga, Japan
| | - Nobuyuki Shimono
- Center for the Study of Global Infection, Kyushu University Hospital, Fukuoka, Japan
| | - Taeko Hotta
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Dongchon Kang
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Takeo Shoubuike
- Division of Microbiology, Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan
| | - Hiroshi Miyamoto
- Division of Microbiology, Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan
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Eriguchi Y, Nakamura K, Hashimoto D, Shimoda S, Shimono N, Akashi K, Ayabe T, Teshima T. Decreased secretion of Paneth cell α-defensins in graft-versus-host disease. Transpl Infect Dis 2015. [PMID: 26198302 DOI: 10.1111/tid.12423] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 12/11/2022]
Abstract
BACKGROUND Intestinal microbial ecology is actively regulated by Paneth cell-derived antimicrobial peptides, α-defensins. Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplantation (SCT). We previously demonstrated that Paneth cells are targeted by GVHD, and their expression of antimicrobial peptide α-defensins is impaired, leading to a loss of physiological diversity among the microflora and development of bloodstream infection. Herein, we evaluated whether fecal levels of α-defensins could be surrogate marker of intestinal dysbiosis. METHODS We directly measured α-defensin cryptdin-1 (Crp1) in fecal pellets of mice with GVHD by using a novel enzyme-linked immunosorbent assay. RESULTS Fecal levels of Crp1 were significantly decreased in mice with GVHD but unchanged in mice without GVHD after SCT. These were correlated with intestinal flora diversity. CONCLUSION We demonstrate a link between reduced secretion of Paneth cell α-defensins and dysbiosis of intestinal flora in GVHD. Fecal levels of α-defensins could be surrogate markers for intestinal microbial homeostasis.
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Affiliation(s)
- Y Eriguchi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - K Nakamura
- Department of Cell Biological Science, Graduate School of Life Science, Faculty of Advanced Life Science, Hokkaido University, Sapporo, Japan
| | - D Hashimoto
- Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - S Shimoda
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - N Shimono
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - K Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan
| | - T Ayabe
- Department of Cell Biological Science, Graduate School of Life Science, Faculty of Advanced Life Science, Hokkaido University, Sapporo, Japan
| | - T Teshima
- Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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