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Mikamo H, Takahashi S, Yamagishi Y, Hirakawa A, Harada T, Nagashima H, Noguchi C, Masuko K, Maekawa H, Kashii T, Ohbayashi H, Hosokawa S, Maejima K, Yamato M, Manosuthi W, Paiboonpol S, Suganami H, Tanigawa R, Kawamura H. Efficacy and safety of ivermectin in patients with mild COVID-19 in Japan and Thailand. J Infect Chemother 2024; 30:536-543. [PMID: 38154616 DOI: 10.1016/j.jiac.2023.12.012] [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: 10/24/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Ivermectin is an antiparasitic drug administered to hundreds of millions of people worldwide. Fundamental research suggests that ivermectin is effective against coronavirus disease 2019 (COVID-19); therefore, we investigated the efficacy and safety of ivermectin as a COVID-19 treatment option. METHODS This multi-regional (Japan and Thailand), multicenter, placebo-controlled, randomized, double-blind, parallel-group, Phase III study evaluated the efficacy and safety of ivermectin in patients with mild COVID-19 (IVERMILCO Study). The participants took a specified number of the investigational product (ivermectin or placebo) tablets of, adjusted to a dose of 0.3-0.4 mg/kg, orally on an empty stomach once daily for three days. The primary efficacy endpoint was the time at which clinical symptoms first showed an improving trend by 168 h after investigational product administration. RESULTS A total of 1030 eligible participants were assigned to receive the investigational product; 502 participants received ivermectin and 527 participants received a placebo. The primary efficacy endpoint was approximately 96 h (approximately four days) for both ivermectin and placebo groups, which did not show statistically significant difference (stratified log-rank test, p = 0.61). The incidence of adverse events and adverse drug reactions did not show statistically significant differences between the ivermectin and placebo groups (chi-square test, p = 0.97, p = 0.59). CONCLUSIONS The results show that ivermectin (0.3-0.4 mg/kg), as a treatment for patients with mild COVID-19, is ineffective; however, its safety has been confirmed for participants, including minor participants of 12 years or older (IVERMILCO Study ClinicalTrials.gov number, NCT05056883.).
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Affiliation(s)
- Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata Nagakute-shi, Aichi, 480-1195, Japan.
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, 16-291, Minami1-jonishi, Chuo-ku, Sapporo-shi, Hokkaido, 060-8543, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, 185-1, Okocho-Kohasu, Nankoku-shi, Kochi, 783-8505, Japan
| | - Akihiro Hirakawa
- Department of Clinical Biostatistics, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Toshiyuki Harada
- Center for Respiratory Diseases, Department of Pulmonary Medicine, Japan Community Healthcare Organization Hokkaido Hospital, 1-8-3-18, Nakanoshima, Toyohira-ku, Sapporo, Hokkaido, 062-8618, Japan
| | | | - Chiaki Noguchi
- Sumida General Clinic, 3-4-8, Taihei, Sumida-ku, Tokyo, 130-0012, Japan
| | - Kentaro Masuko
- Shimamura Memorial Hospital, 2-4-1, Sekimachi-Kita, Nerima-ku, Tokyo, 177-0051, Japan
| | - Hiromitsu Maekawa
- Maekawa Medical Clinic, 1-1-8, Kitasaiwai, Nishi-ku, Yokohama-shi, Kanagawa, 220-0004, Japan
| | - Tatsuhiko Kashii
- Department of Oncology, Japan Organization of Occupational Health and Safety Toyama Rosai Hospital, 992, Rokuromaru, Uozu-shi, Toyama, 937-0042, Japan
| | - Hiroyuki Ohbayashi
- Department of Allergy and Respiratory Medicine, Tohno Chuo Clinic, 1-14-1, Matsugasecho, Mizunami-shi, Gifu, 509-6134, Japan
| | - Shinichiro Hosokawa
- Hosokawa Surgical Clinic, 1-75-2, Nishikomenocho, Nakamura-ku, Nagoya-shi, Aichi, 453-0812, Japan
| | - Katsuyuki Maejima
- Department of Internal Medicine, Diabetes Medicine, Maejima Clinic, 1-15-1, Midoricho, Showa-ku, Nagoya-shi, Aichi, 466-0013, Japan
| | - Masaya Yamato
- Department of General Internal Medicine, Infectious Disease, Rinku General Medical Center, 2-23, Rinku-Oraikita, Izumisano-shi, Osaka, 598-8577, Japan
| | - Weerawat Manosuthi
- Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, 38 Moo 4, Talat Khwan, Tiwanon Road, Mueang District, Nonthaburi 11000, Thailand
| | - Supachai Paiboonpol
- Department of Medicine, Ratchaburi Hospital, 85 Somboonkul Road, Na Mueang Subdistrict Muang District, Ratchaburi Provinc 70000, Thailand
| | - Hideki Suganami
- Global Data Science Center, Kowa Company, Ltd., 4-14, 3-Chome, Nihonbashi-Honcho Chuo-ku, Tokyo, 103-8433, Japan
| | - Ryohei Tanigawa
- Global Clinical Development Department, Kowa Company, Ltd., 4-14, 3-Chome, Nihonbashi-Honcho Chuo-ku, Tokyo, 103-8433, Japan
| | - Hitoshi Kawamura
- Medical Writing Department, Kowa Company, Ltd., 4-14, 3-Chome, Nihonbashi-Honcho Chuo-ku, Tokyo, 103-8433, Japan
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Shibata Y, Asai N, Hirai J, Mori N, Hagihara M, Mikamo H. Retrospective study to investigate appropriate duration of antibiotic treatment for uncomplicated Staphylococcus aureus bacteremia in patients with immunodeficiency. J Infect Chemother 2024:S1341-321X(24)00126-0. [PMID: 38729565 DOI: 10.1016/j.jiac.2024.04.013] [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: 03/16/2024] [Revised: 04/21/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Since the appropriate antibiotic duration for uncomplicated Staphylococcus aureus (S. aureus) bacteremia (u-SAB) in an immunocompromised state is still unclear, physicians are likely to extend antibiotic therapy from 2 weeks to 4-6 weeks. To examine the appropriate duration of antibiotic therapy for u-SAB, we performed this study. PATIENTS AND METHODS We reviewed all patients with u-SAB at our institute seen between January 2020 and August 2023. A total of 51 patients were enrolled, and they were divided into the following two groups by antibiotic duration: longer duration group ≥28 days after blood culture negativity, and shorter duration group. Then, the patients were matched by a propensity score using the covariates of age, sex, qSOFA, and CCI. The primary outcome was to identify the prognosis by duration of antibiotic treatment. RESULTS After propensity score matching, all-cause 30-day mortality was 0 % in both groups. Hence, there was no significant difference in all-cause 90 days mortality (19.0% vs 9.5%, p = 0.33) or recurrence (9.5%% vs 0%, p = 0.22). Before propensity-score matching, we found that a serum level of CRP 2.0 mg/dL and greater after intravenous antibiotic treatment was one of the poor prognostic factors. The cut-off value of serum CRP level was 2.0 mg/dL with a sensitivity of 82.1% and a specificity of 75.0%. CONCLUSION We suggested that 4-6 weeks of antibiotic treatment for immunodeficient u-SAB patients was unnecessary. Moreover, the serum level of CRP after completion of IV antibiotic treatment could be a prognostic marker for u-SAB.
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Affiliation(s)
- Yuichi Shibata
- Department of Pharmacy, Aichi Medical University Hospital, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Nobuhiro Asai
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Jun Hirai
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Nobuaki Mori
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Japan
| | - Hiroshige Mikamo
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan.
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Kunishima H, Ichiki K, Ohge H, Sakamoto F, Sato Y, Suzuki H, Nakamura A, Fujimura S, Matsumoto K, Mikamo H, Mizutani T, Morinaga Y, Mori M, Yamagishi Y, Yoshizawa S. Japanese Society for infection prevention and control guide to Clostridioides difficile infection prevention and control. J Infect Chemother 2024:S1341-321X(24)00102-8. [PMID: 38714273 DOI: 10.1016/j.jiac.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 05/09/2024]
Affiliation(s)
- Hiroyuki Kunishima
- Department of Infectious Diseases. St. Marianna University School of Medicine, Japan.
| | - Kaoru Ichiki
- Department of Infection Control and Prevention, Hyogo Medical University Hospital, Japan
| | - Hiroki Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Japan
| | - Fumie Sakamoto
- Quality Improvement and Safety Center, Itabashi Chuo Medical Center, Japan
| | - Yuka Sato
- Department of Infection Control and Nursing, Graduate School of Nursing, Aichi Medical University, Japan
| | - Hiromichi Suzuki
- Department of Infectious Diseases, University of Tsukuba School of Medicine and Health Sciences, Japan
| | - Atsushi Nakamura
- Department of Infection Prevention and Control, Graduate School of Medical Sciences, Nagoya City University, Japan
| | - Shigeru Fujimura
- Division of Clinical Infectious Diseases and Chemotherapy, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Japan
| | - Kazuaki Matsumoto
- Division of Pharmacodynamics, Faculty of Pharmacy, Keio University, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | | | - Yoshitomo Morinaga
- Department of Microbiology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Minako Mori
- Department of Infection Control, Hiroshima University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Japan
| | - Sadako Yoshizawa
- Department of Laboratory Medicine/Department of Microbiology and Infectious Diseases, Faculty of Medicine, Toho University, Japan
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Kato H, Umemura T, Hagihara M, Shiota A, Asai N, Hamada Y, Mikamo H, Iwamoto T. Development of a therapeutic drug-monitoring algorithm for outpatients receiving voriconazole: A multicentre retrospective study. Br J Clin Pharmacol 2024; 90:1222-1230. [PMID: 38320604 DOI: 10.1111/bcp.16004] [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: 08/14/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024] Open
Abstract
AIMS Although therapeutic drug monitoring (TDM) of voriconazole is performed in outpatients to prevent treatment failure and toxicity, whether TDM should be performed in all or only selected patients remains controversial. This study evaluated the association between voriconazole trough concentrations and clinical events. METHODS We investigated the aggravation of clinical symptoms, incidence of hepatotoxicity and visual disturbances, change in co-medications and interaction between voriconazole and co-medications in outpatients receiving voriconazole between 2017 and 2021 in three facilities. Abnormal trough concentrations were defined as <1.0 mg/L (low group) and >4.0 mg/L (high group). RESULTS A total of 141 outpatients (578 concentration measurements) met the inclusion criteria (treatment, 37 patients, 131 values; prophylaxis, 104 patients, 447 values). The percentages of patients with abnormal concentrations were 29.0% and 31.5% in the treatment and prophylaxis groups, respectively. Abnormal concentrations showed 50% of the concentrations at the first measurement in both therapies. Aggravation of clinical symptoms was most frequently observed in the low treatment group (18.2%). Adverse events were most common in the high group for both therapies (treatment, hepatotoxicity 6.3%, visual disturbance 18.8%; prophylaxis, hepatotoxicity 27.9%). No differences were found in changes to co-medications and drug interactions. In the prophylaxis group, prescription duration in the presence of clinical events tended to be longer than in their absence (47.4 ± 23.4 days vs 39.7 ± 21.9 days, P = .1132). CONCLUSIONS We developed an algorithm based on clinical events for appropriate implementation of TDM in outpatients. However, future interventions based on this algorithm should be validated.
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Affiliation(s)
- Hideo Kato
- Department of Pharmacy, Mie University Hospital, Tsu, Mie, Japan
- Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Tsu, Mie, Japan
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan
| | - Takumi Umemura
- Department of Pharmacy, Tosei General Hospital, Seto, Aichi, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Arifumi Shiota
- Department of Pharmacy, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yukihiro Hamada
- Department of Pharmacy, Kochi Medical School Hospital, Nankoku, Kochi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Tsu, Mie, Japan
- Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Kato H, Hagihara M, Asai N, Mikamo H, Iwamoto T. Evaluation of effectiveness, hyperkalaemia, and hepatotoxicity of trimethoprim-sulphamethoxazole prophylaxis for Pneumocystis jirovecii pneumonia in paediatric patients: A single-centre retrospective study. Int J Antimicrob Agents 2024; 63:107151. [PMID: 38508538 DOI: 10.1016/j.ijantimicag.2024.107151] [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: 12/04/2023] [Revised: 03/04/2024] [Accepted: 03/15/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND American guidelines recommend trimethoprim-sulphamethoxazole (TMP-SMX) for preventing Pneumocystis jirovecii pneumonia (PJP) in paediatric patients at doses of 5-10 mg/kg/d of the TMP component, administered either daily, three times weekly, or twice weekly. However, limited studies describe the effectiveness and safety of these prophylactic regimens. Our study aimed to assess the clinical effectiveness and incidence of adverse events associated with each TMP-SMX regimen in paediatric patients, and to identify risk factors for adverse events. METHODS We collected data regarding the onset of PJP, hyperkalaemia, and hepatotoxicity in patients aged 0-18 years who underwent prophylaxis with TMP-SMX from July 2018 to June 2023. RESULTS A total of 215 paediatric patients met the inclusion criteria. No patients developed PJP. Hyperkalaemia occurred in 14.7%, patients receiving TMP-SMX daily, 15.4% receiving it three times weekly, and 15.5% receiving it twice weekly. Hepatotoxicity was most frequent in patients receiving TMP-SMX twice weekly (19%), followed by those receiving it three times weekly (7.7%), and daily (5.9%). Younger patients were significantly more prone to developing hyperkalaemia or hepatotoxicity. Patients aged <1 year had the highest incidences of hyperkalaemia (56.5%), and those aged 1-2 years had the highest incidence of hepatotoxicity (25%). CONCLUSIONS No patient developed PJP under various dosage prophylactic regimens of TMP-SMX. However, our findings suggest the need to monitor potassium levels and hepatic function in patients undergoing any of the three TMP-SMX regimens. In particular, patients aged <1 year old and 1-2 years old face a higher risk of hyperkalaemia and hepatotoxicity, respectively.
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Affiliation(s)
- Hideo Kato
- Department of Pharmacy, Mie University Hospital, Tsu, Mie, Japan; Division of Clinical Medical Science, Department of Clinical Pharmaceutics, Mie University Graduate School of Medicine, Tsu, Mie, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan.
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Tsu, Mie, Japan; Division of Clinical Medical Science, Department of Clinical Pharmaceutics, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Yamagishi Y, Nakayama N, Doke A, Iwame S, Nishida Y, Arakawa Y, Mikamo H. Rapid screening of positive blood cultures for extended-spectrum β-lactamases and metallo-β-lactamases using a drug susceptibility testing microfluidic method. J Infect Chemother 2024:S1341-321X(24)00124-7. [PMID: 38697390 DOI: 10.1016/j.jiac.2024.04.011] [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: 03/02/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVES An increasing number of drug-resistant bacteria have been identified recently. In particular, drug-resistant bacteria have been linked to unfavorable prognoses in patients with bacteremia, highlighting the need for rapid testing. Our previous studies have focused on the utility of a drug susceptibility testing microfluidic (DSTM) method using microfluidic channels. A system with this DSTM method for screening for β-lactamases can rapidly detect extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs). In this study, we have evaluated the clinical utility of pre-treatment for screening positive blood cultures using the DSTM method. METHODS A total of 178 positive blood cultures and five simulated samples of MBL-producing bacteria were prepared at Kochi University Hospital, Japan. The pretreatment consisted of a two-step centrifugation. The obtained sediments were screened with the DSTM method for the production of β-lactamase based on morphological changes in the bacteria after 3 h of incubation. RESULTS The pretreatment functioned properly for all samples. Of the 25 ESBL samples, 21 were positive for ESBLs. Four false-negative samples, all obtained from the same patient, contained CTX-M-2 enzyme-producing Proteus mirabilis and showed insusceptibility to an ESBL inhibitor. The simulated samples prepared for MBL screening were positive for MBLs. CONCLUSIONS When combined with a method for rapidly identifying bacterial species, DSTM may enable patients with bloodstream infections to start receiving appropriate treatment within 4 h after positive blood cultures are screened.
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Affiliation(s)
- Yuka Yamagishi
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Kochi, Japan.
| | | | - Akito Doke
- Division of Clinical Laboratory, Kochi Medical School Hospital, Kochi University, Kochi, Japan
| | - Saya Iwame
- Division of Clinical Laboratory, Kochi Medical School Hospital, Kochi University, Kochi, Japan
| | - Yoshie Nishida
- Division of Clinical Laboratory, Kochi Medical School Hospital, Kochi University, Kochi, Japan
| | - Yu Arakawa
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Kochi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
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Umemura T, Kato H, Asai N, Hagihara M, Hirai J, Yamagishi Y, Mikamo H. Comparison of efficacy and safety between daptomycin plus β-lactam and daptomycin monotherapy for bloodstream infections due to gram-positive cocci: A systematic review and meta-analysis. Heliyon 2024; 10:e29811. [PMID: 38681574 PMCID: PMC11046193 DOI: 10.1016/j.heliyon.2024.e29811] [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: 11/15/2023] [Revised: 03/19/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024] Open
Abstract
Objectives We performed a comprehensive systematic review and meta-analysis to evaluate the clinical or microbiological outcomes and safety of a combination of daptomycin (DAP) and β-lactams compared to DAP monotherapy in patients with blood stream infection (BSI) due to gram-positive cocci (GPC). Methods We searched Scopus, PubMed, EMBASE, CINAHL, and Ityuushi databases up to January 30, 2023. Outcomes included all-cause mortality, clinical failure, and creatine phosphokinase (CPK) elevation. Results Six cohorts or case-control studies fulfilled the inclusion criteria and were included in the final meta-analysis. Combination therapy of DAP and β-lactams significantly reduced the mortality and clinical failure rate for all BSI due to GPC compared with the DAP monotherapy (mortality, odds ratio [OR] = 0.63, 95 % confidence interval [CI] = 0.41-0.98; clinical failure, OR = 0.42, 95 % CI = 0.22-0.81). In contrast, no significant difference was noted in the incidence of CPK elevation between the two groups (OR = 0.85, 95 % CI = 0.39-1.84). Conclusion Altogether, combination therapy of DAP and β-lactams can improve the prognosis for patients with BSI due to GPC compared with DAP alone. Therefore, it should be considered as an option for the empirical treatment of BSI caused by GPC.
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Affiliation(s)
- Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
- Department of Pharmacy, Mie University Hospital, 2-174, Tsu, Mie, Japan
- Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, 2-174, Tsu, Mie, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, Japan
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Mori N, Hirai J, Ohashi W, Asai N, Shibata Y, Mikamo H. Derivation of clinical predictive factors (CHIEF) for first recurrent Clostridioides difficile infection. Am J Infect Control 2024; 52:419-423. [PMID: 37832921 DOI: 10.1016/j.ajic.2023.10.004] [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: 07/30/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Current models for predicting Clostridioides difficile infection (CDI) recurrence rates have a limited capacity to account for important risk factors. This study developed a clinical prediction rule for CDI recurrence. METHODS This retrospective cohort study evaluated 209 patients with CDI at a university hospital in Japan. Logistic regression and receiver operating characteristic curve analyses were performed to identify potential predictors (age, sex, underlying diseases, antibiotic use, acid suppressants, immunosuppressants, CDI history) of CDI recurrence. RESULTS Forty-five patients developed recurrent CDI. Univariate analyses identified several significant recurrence predictors (enteral feeding, inflammatory bowel diseases [IBD], community-onset CDI, severe CDI). Enteral feeding (odds ratio: 3.87, 95% confidence interval: 1.75-8.56) and IBD (odds ratio: 7.08, 95% confidence interval: 1.28-39.06) were significant factors in the multivariate analysis. The CHIEF predictive scoring system was developed using 5 relevant variables (carbapenem use, hematologic malignancy, IBD, enteral feeding, fluoroquinolone use); the area under the receiver operating characteristic curve for the CHIEF score was 0.70. DISCUSSION The CHIEF score incorporates useful, clinically available factors and could help identify patients at risk of recurrent CDI. CONCLUSIONS These findings contribute to the understanding of risk factors associated with CDI recurrence and provide support for the development of prevention strategies.
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Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Yuichi Shibata
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan.
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Arakawa Y, Nishida Y, Sakanashi D, Nakamura A, Ota H, Tokuhiro S, Mikamo H, Yamagishi Y. Clinical evaluation of a modified SARS-CoV-2 rapid molecular assay, ID NOW ™ COVID-19 2.0. J Infect Chemother 2024:S1341-321X(24)00073-4. [PMID: 38437982 DOI: 10.1016/j.jiac.2024.02.032] [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: 10/24/2023] [Revised: 02/10/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
In the diagnosis of coronavirus disease 2019 (COVID-19), several types of instruments and reagents for SARS-CoV-2 nucleic acid testing have been introduced to meet clinical needs. We evaluated the clinical performances of ID NOW™ COVID-19 2.0 (ID NOW™ 2.0), which is capable of detecting SARS-CoV-2 within 12 min as part of point-of-care testing (POCT). Patients who displayed COVID-19 related symptoms, and who were tested for screening purposes, were recruited to this study. Two nasopharyngeal swabs were collected and tested using the ID NOW™ 2.0 test. Reference testing was performed using the cobas 8800 or 6800 (reagents: cobas SARS-CoV-2 and Flu A/B). A total of 38 samples and 46 samples were tested positive and negative, respectively, by the reference test. The ID NOW™ 2.0 showed a sensitivity of 94.7% (95% CI: 82.3-99.4) and a specificity of 100% (95% CI: 92.3-100). Samples that were positive by reference testing had cycle threshold (Ct) values ranging from 11.90 to 35.41. Among these reference positive samples, two samples were negative by ID NOW™ 2.0 with Ct values of 35.25 and 35.41. For samples with Ct values < 35, the sensitivity of ID NOW™ 2.0 was 100%. In Japan, the restrictions related to COVID-19 have been relaxed, however the COVID-19 epidemic still continues. ID NOW™ 2.0 is expected to be used as a rapid and reliable alternative to laboratory-based RT-PCR methods.
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Affiliation(s)
- Yu Arakawa
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Kochi, Japan; Department of Infection Prevention and Control, Kochi Medical School Hospital, Kochi, Japan
| | - Yoshie Nishida
- Department of Infection Prevention and Control, Kochi Medical School Hospital, Kochi, Japan; Department of Clinical Laboratory, Kochi Medical School Hospital, Kochi, Japan
| | - Daisuke Sakanashi
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Akiko Nakamura
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Hirotoshi Ota
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Shinji Tokuhiro
- Department of Clinical Laboratory, Kochi Medical School Hospital, Kochi, Japan
| | - Hiroshige Mikamo
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Kochi, Japan; Department of Infection Prevention and Control, Kochi Medical School Hospital, Kochi, Japan.
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10
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Mori N, Nakamura A, Hirai J, Asai N, Shibata Y, Takayama M, Kawamoto Y, Miyazaki N, Sakanashi D, Ohno T, Yamada A, Suematsu H, Koita I, Chida S, Ohta T, Mikamo H. Clinical characteristics and antimicrobial susceptibility of Fusobacterium species isolated over 10 years at a Japanese university hospital. Eur J Clin Microbiol Infect Dis 2024; 43:423-433. [PMID: 38112966 DOI: 10.1007/s10096-023-04734-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Anaerobic bacteria, existing on human skin and mucous membranes, can cause severe infections with complications or mortality. We examined the clinical characteristics of patients infected with Fusobacterium spp. and assessed their antibiotic susceptibility. METHODS Clinical data were collated from patients diagnosed with Fusobacterium infections in a Japanese university hospital between 2014 and 2023. Antibiotic susceptibility tests were conducted following the Clinical and Laboratory Standards Institute guidelines. RESULTS We identified 299 Fusobacterium isolates. The median age was 61 years (range, 14-95 years), with females constituting 43.1% of the patients. Most infections were community-acquired (84.6%, 253/299). Multiple bacterial strains were isolated simultaneously in 74.6% of cases. One-fourth of the patients had solid organ malignancies (25.4%, 76/299), and 14.5% (11/76) of those had colorectal cancer. The 30-day mortality rate was 1.3%. Fusobacterium species were isolated from blood cultures in 6% (18/299) of the patients. Patients, aged 75 years or older, with cerebrovascular disease or hematologic malignancy exhibited significantly higher prevalence of blood culture isolates in univariate analysis. Each Fusobacterium species had its characteristic infection site. Approximately 5% F. nucleatum and F. necrophorum isolates showed penicillin G resistance. Moxifloxacin resistance was observed in varying degrees across strains, ranging from 4.6 to 100% of isolates. All isolates were sensitive to β-lactam/β-lactamase inhibitors, carbapenems, and metronidazole. CONCLUSION We show a link between Fusobacterium species and solid organ malignancies. We observed resistance to penicillin, cefmetazole, clindamycin, and moxifloxacin, warranting caution in their clinical use. This study offers valuable insights for managing Fusobacterium infections and guiding empirical treatments.
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Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Akiko Nakamura
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Yuichi Shibata
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Mina Takayama
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Yuzuka Kawamoto
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Narimi Miyazaki
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Daisuke Sakanashi
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Tomoko Ohno
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Atsuko Yamada
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Hiroyuki Suematsu
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Isao Koita
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Sumie Chida
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Toshiaki Ohta
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan.
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata Nagakute-Shi, Aichi, 480-1195, Japan.
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11
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Mitsutake K, Shinya N, Seki M, Ohara T, Uemura K, Fukunaga M, Sakai J, Nagao M, Sata M, Hamada Y, Kawasuji H, Yamamoto Y, Nakamatsu M, Koizumi Y, Mikamo H, Ukimura A, Aoyagi T, Sawai T, Tanaka T, Izumikawa K, Takayama Y, Nakamura K, Kanemitsu K, Tokimatsu I, Nakajima K, Akine D. Antimicrobial therapy and outcome of methicillin-resistant Staphylococcus aureus endocarditis: A retrospective multicenter study in Japan. J Infect Chemother 2024:S1341-321X(24)00068-0. [PMID: 38432557 DOI: 10.1016/j.jiac.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/08/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND MRSA (methicillin-resistant Staphylococcus aureus)-infective endocarditis (IE) is associated with high morbidity and mortality. This study aimed to assess data from patients with MRSA-IE across multiple facilities in Japan, with a specific focus on antimicrobial therapy and prognosis. METHODS This retrospective study enrolled patients with a confirmed diagnosis of IE attributed to MRSA, spanning the period from January 2015 to April 2019. RESULTS Sixty-four patients from 19 centers were included, with a median age of 67 years. The overall mortality rate was 28.1% at 30 days, with an in-hospital mortality of 45.3%. The most frequently chosen initial anti-MRSA agents were glycopeptide in 67.2% of cases. Daptomycin and linezolid were selected as initial therapy in 23.4% and 17.2% of cases, respectively. Approximately 40% of all patients underwent medication changes due to difficulty in controlling infection or drug-related side effects. Significant prognostic factors by multivariable analysis were DIC for 30-day mortality and surgical treatment for 30-day and in-hospital mortality. For vancomycin as initial monotherapy, there was a trend toward a worse prognosis for 30-day and in-hospital mortality (OR, 6.29; 95%CI, 1.00-39.65; p = 0.050, OR, 3.61; 95%CI, 0.93-14.00; p = 0.064). Regarding the choice of initial antibiotic therapy, statistical analysis did not show significant differences in prognosis. CONCLUSION Glycopeptide and daptomycin were the preferred antibiotics for the initial therapy of MRSA-IE. Antimicrobial regimens were changed for various reasons. Prognosis was not significantly affected by choice of antibiotic therapy (glycopeptide, daptomycin, linezolid), but further studies are needed to determine which antimicrobials are optimal as first-line agents.
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Affiliation(s)
- Kotaro Mitsutake
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan.
| | - Natsuki Shinya
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan
| | - Masafumi Seki
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, 397-1, Hidaka, Saitama, 350-1298, Japan; Department of Infectious Diseases, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Takahiro Ohara
- Division of Geriatric and Community Medicine, Tohoku Medical and Pharmaceutical University, 1-15-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8536, Japan
| | - Kohei Uemura
- Department of Biostatistics and Bioinformatics, Interfaculty Initiative in Information Studies, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655, Japan
| | - Masato Fukunaga
- Department of Cardiology, Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita, Kitakyushu, Fukuoka, 802-8555, Japan
| | - Jun Sakai
- Department of Infectious Disease and Infection Control, Saitama Medical University Hospital, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8507, Japan
| | - Makoto Sata
- National Cerebral and Cardiovascular Center Division of Pulmonology and Infection Control, 6-1, Kishibe Shinmachi, Suita, Osaka, 564-8565, Japan
| | - Yohei Hamada
- Department of Infectious Disease and Hospital Epidemiology, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-0937, Japan
| | - Hitoshi Kawasuji
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Masashi Nakamatsu
- Department of Infection Control, University of the Ryukyus Hospital, 207 Aza-Uehara, Nishihara, Nakagami-gun, Okinawa, 903-0215, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Iwasaku, Ganmata, Nagakute, Aichi, 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Iwasaku, Ganmata, Nagakute, Aichi, 480-1195, Japan
| | - Akira Ukimura
- Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, 2-7 Daigaku-cho, Takatsuki, Osaka, 569-0801, Japan
| | - Tetsuji Aoyagi
- Department of Clinical Microbiology and Infection, Tohoku University Graduate School of Medicine, Department of Comprehensive Infectious Diseases, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan
| | - Toyomitsu Sawai
- Nagasaki Harbor Medical Center, Department of Respiratory Medicine, 6-39 Shinchi-cho, Nagasaki City, Nagasaki, 850-0842, Japan
| | - Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, 1 Chome-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, 1 Chome-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Yoko Takayama
- Department of Infection Control and Infectious Diseases Research and Development Center for New Medical Frontiers Kitasato University School of Medicine, 1-15-1, Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Kiwamu Nakamura
- Department of Infection Control, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295, Japan
| | - Keiji Kanemitsu
- Department of Infection Control, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295, Japan
| | - Issei Tokimatsu
- Department of Medicine, Division of Clinical Infectious Diseases, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Kazuhiko Nakajima
- Department of Infection Prevention and Control, Hyogo Medical University, 1-1, Mukogawa, Nishinomiya, Hyogo, 663-850, Japan
| | - Dai Akine
- Division of Clinical Infectious Diseases, School of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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12
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Shiraishi C, Kato H, Hagihara M, Asai N, Iwamoto T, Mikamo H. Comparison of clinical efficacy and safety of baloxavir marboxil versus oseltamivir as the treatment for influenza virus infections: A systematic review and meta-analysis. J Infect Chemother 2024; 30:242-249. [PMID: 37866622 DOI: 10.1016/j.jiac.2023.10.017] [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: 08/21/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Baloxavir marboxil (BXM), a newly developed cap-dependent endonuclease inhibitor, is widely used to treat influenza virus infections in inpatients and outpatients. A previous meta-analysis included only outpatients and patients suspected of having an influenza virus infection based on clinical symptoms. However, whether BXM or oseltamivir is safer and more effective for inpatients remains controversial. Therefore, we conducted a systematic review and meta-analysis validating the effectiveness and safety of BXM versus oseltamivir in inpatients with influenza virus. METHODS The Scopus, EMBASE, PubMed, Ichushi, and CINAHL databases were systematically searched for articles published until January 2023. The outcomes were mortality, hospitalization period, incidence of BXM- or oseltamivir-related adverse events, illness duration, and changes of virus titers and viral RNA load in patients with influenza virus infections. RESULTS Two randomized controlled trials with 1624 outpatients and two retrospective studies with 874 inpatients were enrolled. No deaths occurred in outpatients treated with BXM or oseltamivir. Among inpatients, BXM reduced mortality (p = 0.06) and significantly shortened hospitalization period (p = 0.01) compared to oseltamivir. In outpatients, BXM had a significantly lower incidence of adverse events (p = 0.03), reductions in influenza virus titers (p < 0.001) and viral RNA loads (p < 0.001), and a tendency to be a shorter illness duration compared with that of oseltamivir (p = 0.27). CONCLUSIONS Our meta-analysis showed that BXM was safer and more effective in patients than oseltamivir; thus, supporting the use of BXM for the initial treatment of patients with proven influenza virus infection.
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Affiliation(s)
- Chihiro Shiraishi
- Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Hideo Kato
- Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
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13
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Hagihara M, Ariyoshi T, Eguchi S, Oka K, Takahashi M, Kato H, Shibata Y, Umemura T, Mori T, Miyazaki N, Hirai J, Asai N, Mori N, Mikamo H. Oral Clostridium butyricum on mice endometritis through uterine microbiome and metabolic alternations. Front Microbiol 2024; 15:1351899. [PMID: 38450161 PMCID: PMC10915095 DOI: 10.3389/fmicb.2024.1351899] [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: 12/07/2023] [Accepted: 02/02/2024] [Indexed: 03/08/2024] Open
Abstract
Endometritis occurs frequently in humans and animals, which can negatively affect fertility and cause preterm parturition syndrome. Orally administered Clostridium butyricum, a butyrate-producing gram-positive anaerobe, exhibits anti-inflammatory effects. However, the precise mechanism by which Clostridium butyricum attenuates endometritis remains unclear. This in vivo study evaluated the anti-inflammatory effects of orally administered Clostridium butyricum on uterine tissues. In addition, we conducted uterine microbiome and lipid metabolome analyses to determine the underlying mechanisms. Female Balb/c mice were divided into the following four groups (n = 5-20): (1) mock group, (2) only operation group (mice only underwent operation to exposed uterine horns from the side), (3) control group (mice underwent the same operation with the operation group + perfusion of lipopolysaccharide solution from uterine horns), and (4) Clostridium butyricum administration group (mice underwent the same operation with the control group + oral Clostridium butyricum administration from days 0 to 9). Clostridium butyricum was administered via oral gavage. On day 10, we investigated protein expression, uterine microbiome, and lipid metabolism in uterine tissues. Consequently, orally administered Clostridium butyricum altered the uterine microbiome and induced proliferation of Lactobacillus and Limosilactobacillus species. The effects can contribute to show the anti-inflammatory effect through the interferon-β upregulation in uterine tissues. Additionally, oral Clostridium butyricum administration resulted in the upregulations of some lipid metabolites, such as ω-3 polyunsaturated fatty acid resolvin D5, in uterine tissues, and resolvin D5 showed anti-inflammatory effects. However, the orally administered Clostridium butyricum induced anti-inflammatory effect was attenuated with the deletion of G protein-coupled receptor 120 and 15-lipooxgenase inhibition. In conclusion, Clostridium butyricum in the gut has anti-inflammatory effects on uterine tissues through alterations in the uterine microbiome and lipid metabolism. This study revealed a gut-uterus axis mechanism and provided insights into the treatment and prophylaxis of endometritis.
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Affiliation(s)
- Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute, Japan
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Tadashi Ariyoshi
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama, Japan
| | - Shuhei Eguchi
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama, Japan
| | - Kentaro Oka
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama, Japan
| | | | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Takeshi Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Narimi Miyazaki
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
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Hagihara M, Kato H, Yamashita M, Shibata Y, Umemura T, Mori T, Hirai J, Asai N, Mori N, Mikamo H. Lung cancer progression alters lung and gut microbiomes and lipid metabolism. Heliyon 2024; 10:e23509. [PMID: 38169741 PMCID: PMC10758782 DOI: 10.1016/j.heliyon.2023.e23509] [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: 06/01/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Despite advances in medical technology, lung cancer still has one of the highest mortality rates among all malignancies. Therefore, efforts must be made to understand the precise mechanisms underlying lung cancer development. In this study, we conducted lung and gut microbiome analyses and a comprehensive lipid metabolome analysis of host tissues to assess their correlation. Alternations in the lung microbiome due to lung cancer, such as a significantly decreased abundance of Firmicutes and Deferribacterota, were observed compared to a mock group. However, mice with lung cancer had significantly lower relative abundances of Actinobacteria and Proteobacteria and higher relative abundances of Cyanobacteria and Patescibacteria in the gut microbiome. The activations of retinol, fatty acid metabolism, and linoleic acid metabolism metabolic pathways in the lung and gut microbiomes was inversely correlated. Additionally, changes occurred in lipid metabolites not only in the lungs but also in the blood, small intestine, and colon. Compared to the mock group, mice with lung cancer showed that the levels of adrenic, palmitic, stearic, and oleic (a ω-9 polyunsaturated fatty acid) acids increased in the lungs. Conversely, these metabolites consistently decreased in the blood (serum) and colon. Leukotriene B4 and prostaglandin E2 exacerbate lung cancer, and were upregulated in the lungs of the mice with lung cancer. However, isohumulone, a peroxisome proliferator-activated receptor gamma activator, and resolvin (an ω-3 polyunsaturated fatty acid) both have anti-cancer effects, and were upregulated in the small intestine and colon. Our multi-omics data revealed that shifts in the microbiome and metabolome occur during the development of lung cancer and are of possible clinical importance. These results reveal one of the gut-lung axis mechanisms related to lung cancer and provide insights into potential new targets for lung cancer treatment and prophylaxis.
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Affiliation(s)
- Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute, 480-1195, Japan
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Makoto Yamashita
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Takeshi Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, 480-1195, Japan
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15
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Hioki T, Soejima K, Goto Y, Sugiura M, Umemura T, Ishihara Y, Mutoh Y, Sakanashi D, Mikamo H. Co-infection with Neisseria mucosa in a patient with tuberculous otitis media. J Otol 2024; 19:1-4. [PMID: 38313762 PMCID: PMC10837539 DOI: 10.1016/j.joto.2023.10.001] [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: 06/27/2023] [Revised: 09/27/2023] [Accepted: 10/11/2023] [Indexed: 02/06/2024] Open
Abstract
Tuberculous otitis media (TOM) is a rare manifestation caused by Mycobacterium tuberculosis with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of several clinical manifestations and the high prevalence of secondary bacterial infections. Few reports have attributed secondary bacterial infections in patients with TOM to commensal Neisseria. Thus, understanding the pathogenic mechanisms and clinical features of commensal Neisseria is important, considering its recent presentation as an infection-causing pathogen. Neisseria mucosa is a commensal inhabitant in humans and is generally considered non-pathogenic but can cause infection in rare cases. Here, we report an atypical secondary infection caused by Neisseria mucosa in an 81-year-old woman with TOM being treated for pulmonary tuberculosis. Direct purulent otorrhea smear microscopy revealed no acid-fast bacilli using Ziehl-Neelsen staining, whereas the phagocytosis of gram-negative cocci by white blood cells was confirmed using Gram staining. Otorrhea culture revealed the growth of N. mucosa. Subsequently, M. tuberculosis infection in the otorrhea was identified using a culture-based method. Vigilance is critical for the early detection of TOM to prevent further complications. This report raises awareness regarding TOM and provides insight into the pathogenicity of N. mucosa in otitis media.
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Affiliation(s)
- Tatsuya Hioki
- Department of Clinical Laboratory, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Kazuaki Soejima
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Yuki Goto
- Department of Otolaryngology, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Makoto Sugiura
- Department of Otolaryngology, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Takumi Umemura
- Department of Infection Control Team, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Yoshimi Ishihara
- Department of Clinical Laboratory, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Yoshikazu Mutoh
- Department of Infectious Diseases, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Daisuke Sakanashi
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Infection Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
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Mori N, Mikamo H, Mukae H, Yanagihara K, Kunishima H, Sasaki J, Yotsuyanagi H. Influence of the coronavirus infectious disease 2019 pandemic on infectious disease practice and infection control in Japan: A web questionnaire survey. J Infect Chemother 2024; 30:1-6. [PMID: 37717609 DOI: 10.1016/j.jiac.2023.09.018] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/02/2023] [Accepted: 09/15/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Infection and mortality rates caused by the coronavirus infectious disease 2019 (COVID-19) pandemic were high. However, the influence of the COVID-19 pandemic on the clinical burden in medical facilities remains to be clarified in Japan. MATERIALS AND METHODS This study used a questionnaire-based web survey to clarify how the COVID-19 pandemic affected infectious disease practice and infection control. The questionnaire was sent to healthcare professionals at nationwide medical facilities between January 13, 2023, and February 15, 2023. RESULTS Responses were obtained from 1784 healthcare professionals throughout Japan. Hospital management of COVID-19 patients was the responsibility of 96.5% of respondents. Furthermore, 75.1% had experienced nosocomial spread of COVID-19. Manuals and infection control measures for COVID-19 have been arranged in most facilities. In many facilities, the timing of an infected employee's return to work was determined in accordance with the isolation period for coronavirus-positive patients with symptoms established by the Ministry of Health, Labor and Welfare in Japan. Approximately 30% of respondents reported that caring for COVID-19 patients, including the use of personal protective equipment, was their most stressful job. Approximately 50% of the respondents reported an increase in overtime hours. Approximately 90% of facilities are now capable of performing COVID-19 testing onsite. CONCLUSION Infection control for COVID-19 has been improved, and testing equipment for SARS-CoV-2 has been prepared. Patient care-related burdens and burdens caused by having to compensate for vacancies due to infected staff members have increased. In the future, a reduction in workload and role sharing should be considered.
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Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Yotsuyanagi
- Division of Infectious Diseases, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
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Ohno T, Sakanashi D, Yamada A, Takayama M, Kawamoto Y, Miyazaki N, Suematsu H, Tida S, Nakamura A, Oota H, Mikamo H. [Relationship between Serotypes and Biotypes of Yersinia enterocolitica and the Names of Identified Bacteria in the Microbial Identification and Susceptibility Testing Devices]. Rinsho Biseibutshu Jinsoku Shindan Kenkyukai Shi 2023; 33:13-18. [PMID: 38229457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Yersinia enterocolitica is a causative agent of food poisoning and has been isolated from pork and stream water, causing Yersinia enterocolitica in humans. The bacterium is divided into multiple serotypes and biotypes, among which serotypes O3 and O8 and biotypes 1B, 3, and 4 are frequently isolated in Japan. Biotype 3 can be classified as [VP+, Suc+], [VP-, Suc+], [VP-, Suc-] based on the biochemical properties. Among them, [O3, 3, VP-, Suc-] has been reported to be identified as Yersinia kristensenii in a simple identification kit. An increasing number of facilities in the field of microbiological testing are currently using mass spectrometers to identify species of microorganisms. However, there are many facilities where mass spectrometers have not yet been installed and microbial identification and susceptibility testing devices are used to identify bacterial species. No reports have described how the [O3, 3, VP-, Suc-] type, which is identified as Y. kristensenii in the simple identification kit, is identified by the microbial identification and susceptibility testing devices. In this study, 15 strains of Y. enterocolitica, which were previously isolated, serotyped, and biotyped from fecal culture tests at our hospital, were analyzed to see how these strains were identified in RAISUS S4, Microscan WalkAway, VITEK2 Blue, and BD Phoenix. [O3, 3, VP-, Suc-] was identified as Y. kristensenii in RAISUS S4, Microscan WalkAway, and VITEK2 Blue and as Y. enterocolitica in BD Phoenix. [O3, 3, VP-, Suc+], [O3, 4] and [O8, 1B] were identified as Y. enterocolitica. Therefore, when a sample was identified as Y. kristensenii by RAISUS S4, Microscan WalkAway, or VITEK2 Blue, the possibility that it was actually [O3, 3, VP-, Suc-] could not be ruled out. The possibility of Y. enterocolitica should be informed to attending physicians.
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Affiliation(s)
- Tomoko Ohno
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Mina Takayama
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Yuzuka Kawamoto
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Narimi Miyazaki
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Sumie Tida
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Hirotoshi Oota
- Department of Infection Control and Prevention, Aichi Medical University Hospital
| | - Hiroshige Mikamo
- Department of Infection Control and Prevention, Aichi Medical University Hospital. Department of Clinical Infectious Diseases, Aichi Medical University
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Kosai K, Yamagishi Y, Mikamo H, Ishii Y, Tateda K, Yanagihara K. Epidemiological analysis and antimicrobial susceptibility profile of Gram-negative bacilli that cause bacteremia in Japan. J Infect Chemother 2023; 29:1091-1096. [PMID: 37597749 DOI: 10.1016/j.jiac.2023.08.012] [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: 05/19/2023] [Revised: 07/28/2023] [Accepted: 08/13/2023] [Indexed: 08/21/2023]
Abstract
We investigated the epidemiology and antimicrobial susceptibility profiles of seven major Gram-negative bacilli (Escherichia coli, Klebsiella spp., Enterobacter spp., Pseudomonas aeruginosa, Acinetobacter spp., Stenotrophomonas maltophilia, and Bacteroides spp.) that caused bacteremia in Japan. We collected clinical information and isolates from patients aged 20 years or older who developed bacteremia during a year at three Japanese university hospitals and performed microbiological examination. In total, 628 cases were included, half of which were caused by E. coli (315 isolates). P. aeruginosa (56 isolates) was isolated most frequently among non-fermenting bacteria and 33 Bacteroides spp. were isolated. Mortality rates were the highest for P. aeruginosa (7-day, 16.1%; 30-day, 26.8%). The 7- and 30-day mortality rates ranged 3.8-9.0% and 8.3-17.6%, respectively, for Enterobacterales, and they were 15.2% each for Bacteroides spp. Regarding antimicrobial resistance, Enterobacterales and Acinetobacter spp. showed susceptibility to carbapenems and amikacin (98.0-100.0%). The susceptibility rates to ceftolozane/tazobactam ranged 82.4-99.0% for Enterobacterales and 92.9% for P. aeruginosa. More than 30.0% of E. coli isolates were resistant to fluoroquinolone. Extended-spectrum β-lactamase (ESBL) producers were found in 21.0% of E. coli and approximately 80% of those were resistant to fluoroquinolones. The susceptibility of the 33 Bacteroides spp. to carbapenems, ampicillin/sulbactam, and piperacillin/tazobactam was 100.0%. Among the ESBL producers, blaCTX-M group 9 was the major subgroup in E. coli (77.3%), and blaCTX-M group 1 was detected in 18.2% of E. coli and 50.0% of Klebsiella spp. Continuous surveillance is needed to understand the epidemiology and consider appropriate therapeutic strategies.
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Affiliation(s)
- Kosuke Kosai
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Kochi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yoshikazu Ishii
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Kazuhiro Tateda
- Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Hirai J, Mori N, Sakanashi D, Shibata Y, Asai N, Hagihara M, Mikamo H. Intra-Abdominal Abscess and Bacteremia Due to Stenotrophomonas maltophilia After Total Gastrectomy: A Case Report and Literature Review. Infect Drug Resist 2023; 16:7197-7204. [PMID: 38023400 PMCID: PMC10644874 DOI: 10.2147/idr.s433564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023] Open
Abstract
Stenotrophomonas maltophilia (S. maltophilia) is increasingly recognized as a pathogen responsible for nosocomial infections, particularly in immunocompromised patients. The most common types of S. maltophilia infections are pneumonia and catheter-related bloodstream infection, and clinical cases of intra-abdominal abscesses due to S. maltophilia are rare. We present a rare case of intra-abdominal abscess and bacteremia as a surgical site infection (SSI) caused by S. maltophilia in a patient following total gastrectomy. We also reviewed previous literature to elucidate the clinical characteristics of intra-abdominal abscess due to S. maltophilia. The patient, a 75-year-old man with diabetes and polymyositis (treated with prednisolone), developed a fever 17 days after undergoing a total gastrectomy for gastric cancer. Abdominal computed tomography revealed a hypodense solid mass at the esophagojejunostomy site, which appeared to be an intra-abdominal abscess. The culture of both blood and drained abscess pus confirmed only S. maltophilia. Treatment with intravenous trimethoprim-sulfamethoxazole and abscess drainage led to complete resolution. The patient recovered and was discharged and did not experience a recurrence. We reviewed the English literature and found only two additional case reports of intra-abdominal abscesses caused by S. maltophilia. As in our case, the intra-abdominal abscess occurred after abdominal surgery and the source was suspected to be deep SSI. This case highlights the importance of considering S. maltophilia as a potential pathogen in patients with atypical post-surgical abdominal infections. Physicians should be aware that S. maltophilia has the potential to cause intra-abdominal abscesses secondary to SSI, in addition to Enterobacteriaceae, a major causative pathogen of SSI. Further studies are required to elucidate the etiology, epidemiology, and risk factors for SSI caused by S. maltophilia.
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Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Yuichi Shibata
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
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20
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Tashiro M, Namie H, Ito Y, Takazono T, Kakeya H, Miyazaki Y, Mukae H, Mikamo H, Tomoo F, Shibuya K, Izumikawa K. Prognostic Association of Liposomal Amphotericin B Doses Above 5 mg/kg/d in Mucormycosis: A Nationwide Epidemiologic and Treatment Analysis in Japan. Open Forum Infect Dis 2023; 10:ofad480. [PMID: 37808895 PMCID: PMC10552064 DOI: 10.1093/ofid/ofad480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023] Open
Abstract
Background Mucormycosis is a potentially fatal fungal infection, and there is limited information on its precise epidemiology and treatment practices, including the optimal dosage of liposomal amphotericin B. Methods A retrospective, multicenter, nationwide analysis of 82 proven and probable cases of mucormycosis was performed. Cases between 2015 and 2022 were collected from 51 hospitals in Japan by hematologists and infectious disease specialists. The study included the epidemiology, treatment details, and association between the dose of liposomal amphotericin B and the outcome. Results The lungs were the most commonly involved organ (70.7% of cases), and 35.4% of patients had disseminated disease. Rhizopus spp., Cunninghamella spp., and Mucor spp. were the most common organisms. Mortality at 4 weeks was 41.5%. The survivors had a shorter duration of neutropenia (P = .006) and less persistent hyperglycemia (P = .023). The site of infection and species of Mucorales had no detectable effect on survival. Survival did not differ between patients receiving liposomal amphotericin B at 5 mg/kg/d relative to those receiving >5 mg/kg/d (P = .625). Using Cox proportional hazards models and adjusting for confounders, the hazard ratio for the influence of >5 mg/kg/d liposomal amphotericin B on 4-week survival was 0.86 (95% CI, 0.28-2.68; P = .796) compared with 5 mg/kg/d. Conclusions This study provides important insights into the precise epidemiology and treatment practices of mucormycosis. Treatment with liposomal amphotericin B at doses higher than 5 mg/kg/d did not improve outcomes relative to 5 mg/kg/d.
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Affiliation(s)
- Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Hotaka Namie
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuya Ito
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Kakeya
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yoshitsugu Miyazaki
- Department of Fungal Infection, National Institute of Infectious Disease, Tokyo, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
| | - Fukuda Tomoo
- Department of Dermatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Kazutoshi Shibuya
- Department of Pathology, Toho University Omori Medical Center, Tokyo, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
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21
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Hirai J, Mori N, Sakanashi D, Ohashi W, Shibata Y, Asai N, Kato H, Hagihara M, Mikamo H. Real-World Experience of the Comparative Effectiveness and Safety of Combination Therapy with Remdesivir and Monoclonal Antibodies versus Remdesivir Alone for Patients with Mild-to-Moderate COVID-19 and Immunosuppression: A Retrospective Single-Center Study in Aichi, Japan. Viruses 2023; 15:1952. [PMID: 37766358 PMCID: PMC10538070 DOI: 10.3390/v15091952] [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: 08/25/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic continues to threaten global public health. Remdesivir and monoclonal antibodies have shown promise for COVID-19 treatment of patients who are immunocompromised, including those with cancer, transplant recipients, and those with autoimmune disorder. However, the effectiveness and safety of this combination therapy for patients who are immunosuppressed remain unclear. We compared the efficacy and safety of combination therapy and remdesivir monotherapy for patients with mild-to-moderate COVID-19 who were immunosuppressed. Eighty-six patients treated in July 2021-March 2023 were analyzed. The combination therapy group (CTG) showed a statistically significant reduction in viral load compared with the monotherapy group (MTG) (p < 0.01). Patients in the CTG also experienced earlier resolution of fever than those in the MTG (p = 0.02), although this difference was not significant in the multivariate analysis (p = 0.21). Additionally, the CTG had significantly higher discharge rates on days 7, 14, and 28 than the MTG (p < 0.01, p < 0.01, and p = 0.04, respectively). No serious adverse events were observed with combination therapy. These findings suggest that combination therapy may improve the clinical outcomes of immunosuppressed COVID-19 patients by reducing the viral load and hastening recovery. Further studies are required to fully understand the benefits of this combination therapy for immunocompromised COVID-19 patients.
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Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (J.H.); (N.M.); (N.A.)
- Department of Infection, Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (D.S.); (Y.S.)
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (J.H.); (N.M.); (N.A.)
- Department of Infection, Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (D.S.); (Y.S.)
| | - Daisuke Sakanashi
- Department of Infection, Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (D.S.); (Y.S.)
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan;
| | - Yuichi Shibata
- Department of Infection, Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (D.S.); (Y.S.)
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (J.H.); (N.M.); (N.A.)
- Department of Infection, Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (D.S.); (Y.S.)
| | - Hideo Kato
- Department of Pharmacy, Mie University Hospital, 2-174 Edobashi, Tsu-shi 514-8507, Mie, Japan;
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan;
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (J.H.); (N.M.); (N.A.)
- Department of Infection, Prevention and Control, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute-shi 480-1195, Aichi, Japan; (D.S.); (Y.S.)
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22
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Hirai J, Mori N, Mikamo H. A man with bright-golden orange phlegm. Eur J Intern Med 2023; 115:128-129. [PMID: 37173193 DOI: 10.1016/j.ejim.2023.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan.
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
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23
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Mori N, Hirai J, Ohashi W, Asai N, Shibata Y, Mikamo H. Clinical Efficacy of Fidaxomicin and Oral Metronidazole for Treating Clostridioides difficile Infection and the Associated Recurrence Rate: A Retrospective Cohort Study. Antibiotics (Basel) 2023; 12:1323. [PMID: 37627743 PMCID: PMC10451525 DOI: 10.3390/antibiotics12081323] [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: 07/24/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Clostridioides difficile infection (CDI) has significant implications for healthcare economics. Although clinical trials have compared fidaxomicin (FDX) and vancomycin, comparisons of FDX and oral metronidazole (MNZ) are limited. Therefore, we compared the therapeutic effects of FDX and oral MNZ. Patients diagnosed with CDI between January 2015 and March 2023 were enrolled. Those treated with oral MNZ or FDX were selected and retrospectively analyzed. The primary outcome was the global cure rate. Secondary outcomes included factors contributing to the CDI global cure rate; the rate of medication change owing to initial treatment failure; and incidence rates of clinical cure, recurrence, and all-cause mortality within 30 days. Of the 264 enrolled patients, 75 and 30 received initial oral MNZ and FDX treatments, respectively. The corresponding CDI global cure rates were 53.3% and 70% (p = 0.12). In multivariate analysis, FDX was not associated with the global cure rate. In the MNZ group, 18.7% of the patients had to change medications owing to initial treatment failure. The FDX group had a higher clinical cure rate and lower recurrence rate than the MNZ group, although not significant. However, caution is necessary owing to necessary treatment changes due to MNZ failure.
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Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
- Department of Infection Prevention and Control, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
- Department of Infection Prevention and Control, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
- Department of Infection Prevention and Control, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
| | - Yuichi Shibata
- Department of Infection Prevention and Control, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
- Department of Infection Prevention and Control, Aichi Medical University, 1-1 Yazakokarimata Nagakute-shi, Aichi 480-1195, Japan
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Kato H, Hagihara M, Asai N, Umemura T, Hirai J, Yamagishi Y, Iwamoto T, Mikamo H. Comparison of microbial detection rates in microbial culture methods versus next-generation sequencing in patients with prosthetic joint infection: a systematic review and meta-analysis. J Orthop Surg Res 2023; 18:604. [PMID: 37587529 PMCID: PMC10428596 DOI: 10.1186/s13018-023-03973-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Accurate diagnosis of prosthetic joint infection (PJI) enables early and effective treatment. However, there is currently no gold standard test for microbial detection of PJI and traditional synovial fluid culture is relatively insensitive. Recently, it has been reported that sonicating fluid culture and next-generation sequencing (NGS) improve microbial detection rates. Hence, we performed a systematic review and meta-analysis to compare microbial detection rates in microbial culture methods with and without sonication versus NGS. METHODS We systematically searched EMBASE, PubMed, Scopus, CINAHL, and Ichushi databases and other sources (previous reviews) until August 2022. We evaluated the detection rates of pathogens in NGS and microbial cultures using samples of synovial or sonicated fluid. RESULTS Of the 170 citations identified for screening, nine studies were included. Pooled analysis indicated that NGS had the highest detection rate among the microbial detection methods (NGS vs. sonicated, odds ratios [OR] 5.09, 95% confidential interval [CI] 1.67-15.50; NGS vs. synovial, OR 4.52, 95% CI 2.86-7.16). Sonicated fluid culture showed a higher detection rate than synovial fluid culture (OR 2.11, 95% CI 1.23-3.62). CONCLUSION NGS might be useful as a screening tool for culture-negative patients. In clinical settings, sonicated fluid culture is a practical method for diagnosing PJI.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Pharmacy, Mie University Hospital, Mie, Japan
- Division of Clinical Medical Science, Department of Clinical Pharmaceutics, Mie University Graduate School of Medicine, Mie, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Mie, Japan
- Division of Clinical Medical Science, Department of Clinical Pharmaceutics, Mie University Graduate School of Medicine, Mie, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan.
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Mori N, Hirai J, Asai N, Mikamo H. Efficacy of Bezlotoxumab Against Clostridioides difficile Infection: A Case-Series Study at a University Hospital in Japan and Literature Review. Cureus 2023; 15:e42779. [PMID: 37664309 PMCID: PMC10469635 DOI: 10.7759/cureus.42779] [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] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background Clostridioides difficile infection (CDI) recurrence is a public health concern as well as a health economic burden. Bezlotoxumab treatment is one way to prevent recurrence; however, its clinical results have not been reported in Japan. Therefore, we investigated the efficacy and safety of bezlotoxumab in patients with CDI at a university hospital in Japan and compared them with previously reported findings. Methodology We retrospectively examined all patients with some risk factors for recurrent CDI who received bezlotoxumab at the discretion of physicians at the Aichi Medical University Hospital, Aichi, Japan, between July 2018 and July 2022. The primary outcome was the three-month CDI recurrence rate. The secondary outcomes were an initial clinical cure and the six-month CDI recurrence rate. The safety of the administration was also assessed. Results A total of nine patients who received bezlotoxumab were included during the study period. The rate of CDI recurrence within three months was 28.5% (2/9). Two patients died due to other causes before their diarrhea improved. None of the patients experienced CDI recurrence between three and six months after the initial clinical cure of the baseline episode. Patients showed good tolerability to bezlotoxumab with no adverse effects. Two patients with a single episode of CDI recurrence before bezlotoxumab administration showed no recurrence. Conclusions In this Japanese case-series study, the efficacy of bezlotoxumab in preventing CDI recurrence in elderly patients with CDI and multiple underlying diseases was inferior to that reported in previous studies that analyzed real-world data. It is possible that bezlotoxumab may not be fully effective in elderly patients with CDI.
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Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, JPN
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, JPN
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, JPN
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, JPN
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Mohamed M, Tandon N, Kim Y, Kopp I, Tanaka N, Mikamo H, Friedman K, Bajpai S. Needlestick Injuries With Insulin Injections: Risk Factors, Concerns, and Implications of the Use of Safety Pen Needles in the Asia-Pacific Region. J Diabetes Sci Technol 2023:19322968231186402. [PMID: 37475682 DOI: 10.1177/19322968231186402] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Globally, health care workers (HCWs) are at a high risk of occupational exposure to needlestick injuries (NSIs). Needlestick injuries not only are associated with an increased risk of infections caused by bloodborne pathogens but are also a primary source of emotional distress and job burnout for HCWs and patients. Insulin injection-related NSIs are common among HCWs working in hospitals in the Asia-Pacific (APAC) region and impose a significant burden. Insulin pen needles have a high risk of transmitting infections (at both the patient-end and cartridge end of the sharp) after use. Recapping a needle after administering an insulin injection poses a major risk to HCWs. Currently, several safety-engineered needle devices (SENDs) are available with active or passive safety mechanisms. Passive insulin safety pen needles with dual-ended protection and automatic recapping capabilities have resulted in a significant drop in accidental punctures to HCWs while administering insulin to patients with diabetes. In this article, we have reviewed the burden and common causes of NSIs with insulin injections among HCWs in the APAC region. We have discussed current approaches to address the issues associated with NSIs and the benefits of introducing SENDs in health care settings, including long-term care facilities, nursing homes, and home care settings where patients may require assisted insulin injections. This review also summarizes key strategies/recommendations to prevent NSIs in HCWs and patients with diabetes in the APAC region.
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Affiliation(s)
- Mafauzy Mohamed
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Youngsoon Kim
- Kangwon National University Hospital, Gangwon-do, South Korea
| | - Irene Kopp
- Nepean Diabetes Service, Nepean Hospital, Kingswood, NSW, Australia
| | - Nagaaki Tanaka
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Kevin Friedman
- embecta (formerly BD Diabetes Care), Parsippany, NJ, USA
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Mori N, Hirai J, Asai N, Mikamo H. Appropriate Outcome Settings for the Effectiveness of Oral Zinc Treatment for Coronavirus Disease 2019. Clin Infect Dis 2023; 76:2210-2211. [PMID: 36928492 DOI: 10.1093/cid/ciad153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan
| | - Jun Hirai
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Disease, Aichi Medical University Hospital, Aichi, Japan
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28
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Kato H, Hagihara M, Asai N, Umemura T, Hirai J, Mori N, Yamagishi Y, Iwamoto T, Mikamo H. A systematic review and meta-analysis of efficacy and safety of isavuconazole for the treatment and prophylaxis of invasive fungal infections. Mycoses 2023. [PMID: 37300337 DOI: 10.1111/myc.13622] [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: 03/20/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Isavuconazole is a novel triazole antifungal agent. However, the previous outcomes were highlighted by statistical heterogeneity. This meta-analysis aimed to validate the efficacy and safety of isavuconazole for the treatment and prophylaxis of invasive fungal infections (IFIs) compared with other antifungal agents (amphotericin B, voriconazole and posaconazole). METHODS Scopus, EMBASE, PubMed, CINAHL and Ichushi databases were searched for relevant articles that met the inclusion criteria through February 2023. Mortality, IFI rate, discontinuation rate of antifungal therapy and incidence of abnormal hepatic function were evaluated. The discontinuation rate was defined as the percentage of therapy discontinuations due to adverse events. The control group included patients who received other antifungal agents. RESULTS Of the 1784 citations identified for screening, 10 studies with an overall total of 3037 patients enrolled. Isavuconazole was comparable with the control group in mortality and IFI rate in the treatment and prophylaxis of IFIs, respectively (mortality, odds rate (OR) 1.11, 95% confidential interval (CI) 0.82-1.51; IFI rate, OR 1.02, 95% CI 0.49-2.12). Isavuconazole significantly reduced the discontinuation rate in the treatment (OR 1.96, 95% CI 1.26-3.07) and incidence of hepatic function abnormalities in the treatment and prophylaxis, compared with the control group (treatment, OR 2.31, 95% CI 1.41-3.78; prophylaxis, OR 3.63, 95% CI 1.31-10.05). CONCLUSIONS Our meta-analysis revealed that isavuconazole was not inferior to other antifungal agents for the treatment and prophylaxis of IFIs, with substantially fewer drug-associated adverse events and discontinuations. Our findings support the use of isavuconazole as the primary treatment and prophylaxis for IFIs.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
- Department of Pharmacy, Mie University Hospital, Tsu, Japan
- Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Tsu, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Nagakute, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Tsu, Japan
- Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
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Mori N, Hirai J, Sakanashi D, Takayama M, Nakamura A, Ohta H, Asai N, Mikamo H. Complicated pyelonephritis caused by Proteus alimentorum in a woman with peritoneal cancer: a case report. BMC Infect Dis 2023; 23:328. [PMID: 37189038 DOI: 10.1186/s12879-023-08296-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/30/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Proteus spp. are widespread in the environment and comprise a part of the normal flora of the human gastrointestinal tract. Only six species in this genus, including Proteus mirabilis, Proteus vulgaris, Proteus terrae, Proteus penneri, Proteus hauseri, and Proteus faecis, have been isolated from human clinical specimens. However, there are no reports of Proteus alimentorum isolated from humans, and the clinical characteristics of P. alimentorum infection are unknown. CASE PRESENTATION An 85-year-old female patient with peritoneal cancer was hospitalized for complicated pyelonephritis and bacteremia caused by P. alimentorum. The patient received antimicrobial therapy and was discharged on day 7 of hospitalization. No recurrence was observed 14 days after the treatment. Various methods were used to identify the Proteus sp. Furthermore, the VITEK-2 GN ID card resulted in low discrimination between P. hauseri and P. penneri. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry showed P. hauseri with a spectral score of 2.22 as the best match. Nevertheless, the pathogen was identified as P. alimentorum based on genetic investigation using 16 S rRNA gene sequencing and biochemical tests. CONCLUSION Proteus alimentorum is a human pathogen, and its infection has an excellent therapeutic response to antimicrobials based on antimicrobial susceptibility. Genomic methods may be helpful for the precise identification of P. alimentorum.
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Affiliation(s)
- Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan.
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan.
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
| | - Mina Takayama
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
| | - Hirotoshi Ohta
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, 1-1 Yazakokarimata , Nagakute- shi, 480-1195, Aichi, Japan
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Arakawa Y, Yagi Y, Kamioka S, Nishida Y, Tadashi A, Mikamo H, Yamagishi Y. First case of bacteremia caused by Cetobacterium somerae following necrotizing cholecystitis. J Infect Chemother 2023:S1341-321X(23)00115-0. [PMID: 37178976 DOI: 10.1016/j.jiac.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/14/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Cetobacterium somerae, a gram-negative anaerobic rod, first identified in the feces of children with autism, also colonize freshwater fish intestinal tract. However there have been no reports of human C. somerae infection. Here, we describe the first case of C. somerae bacteremia in a patient with necrotizing cholecystitis. A 72-year-old male presented to the emergency department with chills, vomiting, and fever and was diagnosed with acute necrotizing cholecystitis. An emergency cholecystectomy was performed and the following day, two sets of blood culture were positive for gram-negative bacilli. Identification of C. somerae from the biochemical profile was difficult but possible by mass spectrometry and 16s rRNA sequence.
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Affiliation(s)
- Yu Arakawa
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Japan; Division of Infection and Prevention, Kochi Medical University Hospital, Japan
| | - Yusuke Yagi
- Division of Infection and Prevention, Kochi Medical University Hospital, Japan; Department of Clinical Laboratory, Kochi Medical University Hospital, Japan
| | - Saya Kamioka
- Division of Infection and Prevention, Kochi Medical University Hospital, Japan; Department of Pharmacy, Kochi Medical University Hospital, Japan
| | - Yoshie Nishida
- Division of Infection and Prevention, Kochi Medical University Hospital, Japan; Department of Pharmacy, Kochi Medical University Hospital, Japan
| | - Ariyoshi Tadashi
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Japan; Division of Infection and Prevention, Kochi Medical University Hospital, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Japan.
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31
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Kato H, Hagihara M, Asai N, Umemura T, Hirai J, Mori N, Yamagishi Y, Iwamoto T, Mikamo H. Efficacy and safety of recombinant human soluble thrombomodulin in patients with sepsis-induced disseminated intravascular coagulation - A meta-analysis. Thromb Res 2023; 226:165-172. [PMID: 37182388 DOI: 10.1016/j.thromres.2023.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/30/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Recombinant human soluble thrombomodulin (rhTM) is used to treat sepsis-induced disseminated intravascular coagulation (DIC). However, no consistent clinical guidelines exist regarding the administration of rhTM in patients with sepsis-induced DIC. Therefore, we conducted this meta-analysis to evaluate the efficacy and safety of rhTM therapy in patients with sepsis-induced DIC. METHODS EMBASE, PubMed, Scopus, Ichushi, and CINAHL databases were used to search for relevant articles that met the inclusion criteria of patients with sepsis-induced DIC treated with and without rhTM through November 2022. Mortality, DIC resolution, and incidence of bleeding complications were evaluated. DIC resolution was defined as the recovery from DIC after the start of DIC treatment. RESULTS Of the 1697 citations identified for screening, 17 studies involving 2296 patients were included. Administering rhTM significantly reduced mortality (odds ratio (OR) 0.54, 95 % confidence interval (CI) 0.42-0.71) and improved DIC resolution (OR 2.88, 95 % CI 1.83-4.52). There were no significant differences in the incidence of bleeding complications between the rhTM and control groups (OR 0.92, 95 % CI 0.66-1.28). CONCLUSIONS Our meta-analysis revealed that rhTM could reduce mortality and improve DIC resolution without increasing the risk of bleeding in patients with sepsis-induced DIC. Our findings suggest that rhTM is a relatively effective and safe anticoagulant for the treatment of sepsis-induced DIC. SUMMARY Recombinant human soluble thrombomodulin reduced mortality without increasing the bleeding risk in the treatment of sepsis-induced disseminated intravascular coagulation.
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Affiliation(s)
- Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Takuya Iwamoto
- Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
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Tokimatsu I, Matsumoto T, Tsukada H, Fujikura Y, Miki M, Morinaga Y, Sato J, Wakamura T, Kiyota H, Tateda K, Yanagisawa H, Sasaki T, Ikeda H, Horikawa H, Takahashi H, Seki M, Mori Y, Takeda H, Kurai D, Hasegawa N, Uwamino Y, Kudo M, Yamamoto M, Nagano Y, Nomura S, Tetsuka T, Hosokai M, Aoki N, Yamamoto Y, Iinuma Y, Mikamo H, Suematsu H, Maruyama T, Kawabata A, Sugaki Y, Nakamura A, Fujikawa Y, Fukumori T, Ukimura A, Kakeya H, Niki M, Yoshida K, Kobashi Y, Tokuyasu H, Yatera K, Ikegami H, Fujita M, Matsumoto T, Yanagihara K, Matsuda J, Hiramatsu K, Shinzato T. Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of the Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2019-2020: General view of the pathogens' antibacterial susceptibility. J Infect Chemother 2023:S1341-321X(23)00099-5. [PMID: 37116613 DOI: 10.1016/j.jiac.2023.04.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/22/2023] [Accepted: 04/16/2023] [Indexed: 04/30/2023]
Abstract
The trends and prevalence of antimicrobial susceptibility of pathogens vary by country, region, and time. Long-term regular surveillance is required to investigate trends in the antimicrobial resistance of various isolated bacterial pathogens. We report the results of a nationwide surveillance on the antimicrobial susceptibility of bacterial respiratory pathogens in Japan conducted by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology. The isolates were collected from clinical specimens obtained from adult patients who visited a collaborating medical facility between June 2019 and December 2020 and were diagnosed with respiratory tract infections by a physician. Antimicrobial susceptibility testing was performed in a centralized laboratory according to the methods recommended by the Clinical and Laboratory Standards Institute. Susceptibility testing was performed for 932 strains (201 Staphylococcus aureus, 158 Streptococcus pneumoniae, 6 S. pyogenes, 136 Haemophilus influenzae, 127 Moraxella catarrhalis, 141 Klebsiella pneumoniae, and 163 Pseudomonas aeruginosa) collected from 32 facilities in Japan. The proportions of methicillin-resistant S. aureus and penicillin-resistant S. pneumoniae were 35.3% and 0%, respectively. In H. influenzae, 16.2% and 16.9% were β-lactamase-producing ampicillin resistant and β-lactamase-negative ampicillin resistant, respectively. Extended-spectrum β-lactamase-producing K. pneumoniae accounted for 5.0% of all K. pneumoniae infections. Carbapenemase-producing K. pneumoniae and multi-drug-resistant P. aeruginosa with metallo-β-lactamase were not detected in this study. This surveillance will be a useful reference for treating respiratory infections in Japan and will provide evidence to enhance the appropriate use of antimicrobial agents.
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Affiliation(s)
- Issei Tokimatsu
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Showa University School of Medicine, Tokyo, Japan.
| | - Tetsuya Matsumoto
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Hiroki Tsukada
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; The Jikei University Kashiwa Hospital, Chiba, Japan
| | - Yuji Fujikura
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; National Defense Medical College Hospital, Saitama, Japan
| | - Makoto Miki
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan; Japanese Red Cross Sendai Hospital, Miyagi, Japan
| | - Yoshitomo Morinaga
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Junko Sato
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Tomotaro Wakamura
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Hiroshi Kiyota
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | - Kazuhiro Tateda
- The Surveillance Committee of Japanese Society of Chemotherapy (JSC), The Japanese Association for Infectious Disease (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan
| | | | | | | | | | | | - Masafumi Seki
- Tohoku Medical and Pharmaceutical University, Miyagi, Japan
| | | | | | | | | | | | - Makoto Kudo
- Yokohama City University Medical Center, Kanagawa, Japan
| | | | - Yuko Nagano
- The Jikei University Kashiwa Hospital, Chiba, Japan
| | - Sakika Nomura
- National Defense Medical College Hospital, Saitama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | - Tatsuya Fukumori
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Akira Ukimura
- Osaka Medical and Pharmaceutical University Hospital, Osaka, Japan
| | | | - Makoto Niki
- Osaka Metropolitan University Hospital, Osaka, Japan
| | | | | | | | - Kazuhiro Yatera
- University of Occupational and Environmental Health, Fukuoka, Japan
| | - Hiroaki Ikegami
- University of Occupational and Environmental Health, Fukuoka, Japan
| | - Masaki Fujita
- Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Hirai J, Mori N, Sakanashi D, Morishita Y, Kuge Y, Kishino T, Asai N, Hagihara M, Takahashi N, Mikamo H. Usefulness of the FilmArray blood culture identification panel for identifying causative pathogens of bone and joint infections. J Infect Chemother 2023; 29:722-725. [PMID: 37088145 DOI: 10.1016/j.jiac.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/24/2023] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
As bone and joint infections (BJIs) require long-term treatment, identifying their causative pathogens is vital. However, the detection rate of conventional culturing remains inadequate. This study aimed to evaluate the usefulness of the FilmArray blood culture identification (BCID) panel for identifying causative pathogens in patients with BJIs. We tested a BCID panel using collected samples, in addition to conventional cultures. The primary outcome was to evaluate the diagnostic performance of the BCID panel, calculated using conventional culturing methods. A total of 44 patients who underwent BJI-related specimen collection were enrolled. Of the 44 patients, 22 were diagnosed with a BJI. Conventional culture identified 15 of 22 organisms (68.2%), whereas the BCID panel identified 14 of 22 organisms (63.4%). The overall sensitivity and specificity of the BCID panel were 73.3% and 57.1%, respectively, compared to those of the conventional culture. However, the sensitivity reached 100% when only pathogens included in the BCID panel were considered. In seven culture-negative cases, the BCID panel identified three organisms (42.9%). The BCID panel also indicated the appropriate therapy against a BJI caused by methicillin-resistant Staphylococcus aureus by detecting the mecA gene. This study demonstrated that the BCID panel has the potential for early and accurate diagnosis of the causative organism of BJI using specimens such as joint fluid and bone tissue. Our results suggest that BCID panels, in addition to routine culture, may improve our ability to diagnose the causative microorganisms of BJI in clinical practice, thereby contributing to the selection of appropriate antimicrobial agents.
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Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan.
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Yusuke Morishita
- Department of Orthopedic Surgery, Aichi Medical University, Aichi, Japan
| | - Yuji Kuge
- Department of Emergency and Critical Care Medicine, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Takaaki Kishino
- Department of Emergency and Critical Care Medicine, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan
| | - Nobunori Takahashi
- Department of Orthopedic Surgery, Aichi Medical University, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Aichi, Japan
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Asai N, Shibata Y, Nakamura A, Suematsu H, Yamada A, Ohno T, Sakanashi D, Kawamoto Y, Miyazaki N, Koita I, Kato H, Hagihara M, Ohta H, Mikamo H. Three Successfully Treated Cases of Lodderomyces elongisporus Fungemia: Case Reports and a Review of the Literature. Microorganisms 2023; 11:microorganisms11041076. [PMID: 37110499 PMCID: PMC10142367 DOI: 10.3390/microorganisms11041076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/12/2023] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
Fungemia is a fatal systemic infection that can occur in immunocompromised patients. Despite that, antifungal stewardship is spreading widely, but the mortality rate is extremely high, showing 40-60%. Loderomyces elongiporus is a newly morphologically detected pathogen, first described in 1994, followed by isolation in humans in 2008. It has been misrecognized as Candida parapsilosis. Recently, fever attributable to L. elongisporus fungemia cases has been reported, and the etiology and clinical features are still unknown. Here, we present three successfully treated L. elongisporus fungemia cases by echinocandin. In total, 11 cases were reviewed, including ours. Six of the eleven cases (55%) had external devices. All cases had some immunocompromised conditions or underlying diseases, such as diabetes mellitus, lung cancer, etc. Six patients survived, and the remaining five died. Seven patients who had received echinocandin initially survived. Risk factors for L. elongiporus fungemia overlap with those of candidemia. Even though there is no breakpoint for L. elongiporus, echinocandin can be a helpful treatment regimen for L. elongiporus fungemia.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Akiko Nakamura
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Atsuko Yamada
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Tomoko Ohno
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Yuzuka Kawamoto
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Narimi Miyazaki
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Isao Koita
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Department of Pharmacy, Mie University Hospital, Tsu 514-0001, Japan
- Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Tsu 514-0001, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute 480-1195, Japan
| | - Hirotoshi Ohta
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Japan
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Samura M, Takada K, Hirose N, Kurata T, Nagumo F, Uchida M, Inoue J, Tanikawa K, Enoki Y, Taguchi K, Matsumoto K, Ueda T, Fujimura S, Mikamo H, Takesue Y, Mitsutake K. Comparison of the efficacy and safety of standard- and high-dose daptomycin: A systematic review and meta-analysis. Br J Clin Pharmacol 2023; 89:1291-1303. [PMID: 36693240 DOI: 10.1111/bcp.15671] [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: 10/25/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023] Open
Abstract
AIMS Standard doses of daptomycin at 4 and 6 mg/kg were used for the treatment of skin and soft tissue for infections and bacteraemia, respectively. However, increased doses of daptomycin are recommended for complicated infections by Gram-positive organisms. METHODS A systematic review was conducted using 4 databases. We compared treatment success between standard-dose (SD, 4-6 mg/kg) and high-dose (HD, >6 mg/kg) daptomycin in patients with all-cause bacteraemia, complicated bacteraemia, infective endocarditis, osteomyelitis and foreign body/prosthetic infection as the primary outcome. We also compared the success between SD and HD2 (≥8 mg/kg) daptomycin treatments in patients with these diseases as the secondary outcome. The incidence of creatine phosphokinase (CPK) elevation was evaluated as safety. RESULTS In patients with complicated bacteraemia and infective endocarditis, the treatment success was significantly lower in the SD group than in the HD group (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.30-0.76 and OR 0.50, 95% CI 0.30-0.82) and HD2 group (OR 0.38, 95% CI 0.21-0.69 and OR 0.30, 95% CI 0.15-0.60), respectively. A significant difference was demonstrated only in the HD2 group in patients with bacteraemia, including simple infection. SD did not decrease the success rate for the treatment of osteomyelitis and foreign body/prosthetic infection. The incidence of elevated CPK was significantly lower in SD group than in HD group. CONCLUSION SD daptomycin was associated with significantly lower treatment success than HD in patients with complicated bacteraemia/infective endocarditis. The CPK elevation should be considered in patients treated with high daptomycin doses.
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Affiliation(s)
- Masaru Samura
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan.,Division of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Keisuke Takada
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
| | - Naoki Hirose
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
| | - Takenori Kurata
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
| | - Fumio Nagumo
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
| | - Masaki Uchida
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
| | - Junki Inoue
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
| | - Koji Tanikawa
- Department of Pharmacy, Yokohama General Hospital, Yokohama, Japan
| | - Yuki Enoki
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Kazuaki Taguchi
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Kazuaki Matsumoto
- Division of Pharmacodynamics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Takashi Ueda
- Department of Infection Prevention and Control, Hyogo College of Medicine, Nishinomiya, Japan
| | - Shigeru Fujimura
- Division of Clinical Infectious Diseases & Chemotherapy, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Japan
| | - Yoshio Takesue
- Department of Infection Prevention and Control, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Clinical Infectious Diseases, Tokoname City Hospital, Tokoname, Japan
| | - Kotaro Mitsutake
- Department of Infectious Diseases and Infection Control, Saitama International Medical Center, Saitama Medical University, Saitama, Japan
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Hirai J, Mori N, Asai N, Mikamo H. Necrotizing pneumonia due to Pseudomonas aeruginosa secondary to severe COVID-19 pneumonia. Clin Case Rep 2023; 11:e7164. [PMID: 37006846 PMCID: PMC10064028 DOI: 10.1002/ccr3.7164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
Necrotizing pneumonia (NP) can occur as a secondary infection even if the clinical course of COVID-19 pneumonia is favorable, particularly in patients on mechanical ventilation and under immunosuppression.
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Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious DiseasesAichi Medical University HospitalNagakuteJapan
- Department of Infection Control and PreventionAichi Medical University HospitalNagakuteJapan
| | - Nobuaki Mori
- Department of Clinical Infectious DiseasesAichi Medical University HospitalNagakuteJapan
- Department of Infection Control and PreventionAichi Medical University HospitalNagakuteJapan
| | - Nobuhiro Asai
- Department of Clinical Infectious DiseasesAichi Medical University HospitalNagakuteJapan
- Department of Infection Control and PreventionAichi Medical University HospitalNagakuteJapan
| | - Hiroshige Mikamo
- Department of Clinical Infectious DiseasesAichi Medical University HospitalNagakuteJapan
- Department of Infection Control and PreventionAichi Medical University HospitalNagakuteJapan
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Hirai J, Mori N, Kato H, Asai N, Hagihara M, Mikamo H. A Case of Severe Pneumocystis Pneumonia in an HIV-Negative Patient Successfully Treated with Oral Atovaquone. Infect Drug Resist 2023; 16:1561-1566. [PMID: 36969941 PMCID: PMC10032339 DOI: 10.2147/idr.s406904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
Currently, atovaquone is not recommended for treating severe Pneumocystis jirovecii pneumonia (PCP) due to insufficient evidence in clinical studies. This report describes a case of severe PCP in a human immunodeficiency virus (HIV)-negative immunosuppressed patient who was successfully treated with oral atovaquone and corticosteroids. A 63-year-old Japanese woman complained of fever and dyspnea for 3 days. She had been treated with oral prednisolone (30 mg/day) for interstitial pneumonia for 3 months without PCP prophylaxis. Although we could not confirm P. jirovecii from the respiratory specimen, a diagnosis of PCP was indicated by marked elevation of serum beta-D-glucan levels and bilateral ground-glass opacities in the lung fields. Based on the arterial blood gas test results (alveolar-arterial oxygen difference >45 mmHg), the disease status of PCP was defined as severe. Trimethoprim-sulfamethoxazole (SXT) is the first-line drug for treating severe PCP. However, given the patient's history of SXT-induced toxic epidermal necrolysis, she was administered atovaquone instead of SXT. Her clinical symptoms and respiratory condition gradually improved, with a 3-week treatment showing a good clinical course. Previous clinical studies on atovaquone have only been conducted in HIV-positive patients with mild or moderate PCP. Accordingly, the clinical efficacy of atovaquone for severe PCP cases or PCP in HIV-negative patients remains unclear. There is a rising incidence of PCP among HIV-negative patients, given the increasing number of patients receiving immunosuppressive medications; moreover, atovaquone has less severe side effects than SXT. Therefore, there is a need for further clinical investigation to confirm the efficacy of atovaquone in cases of severe PCP, especially among HIV-negative patients. In addition, it also remains unclear whether corticosteroids are beneficial for severe PCP in non-HIV patients. Thus, the use of corticosteroids in cases of severe PCP in non-HIV patients should also be investigated.
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Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Correspondence: Jun Hirai, Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 1-1, Yazako-karimata, Nagakute, Aichi, 480-1195, Japan, Tel +81-561-62-3311, Fax +81-561-76-2673, Email
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hideo Kato
- Department of Pharmacy, Mie University Hospital, Mie, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
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Asai N, Shibata Y, Hirai J, Ohashi W, Sakanashi D, Kato H, Hagihara M, Suematsu H, Mikamo H. A Gap of Patients with Infective Endocarditis between Clinical Trials and the Real World. J Clin Med 2023; 12:jcm12041566. [PMID: 36836100 PMCID: PMC9964769 DOI: 10.3390/jcm12041566] [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: 01/12/2023] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction: A randomized control trial (RCT) is considered to be the highest level in the Evidence-Based Medicine (EBM) pyramid. While EBM is essential to make a practical tool such as a prognostic guideline, it has been unclear how many patients in the real world can be eligible for a randomized control trial (RCT). Patients and method: This study was performed to clarify if there is a difference in patients' profiles and clinical outcomes between the patients eligible and not eligible for any RCT. We reviewed all IE patients at our institute between 2007 and 2019. The patients were divided into two groups: those eligible for RCTs (RCT appropriate group) and those who were not (RCT inappropriate group). Exclusion criteria for clinical trials were set based on previous clinical trials. Results: A total of 66 patients were enrolled in the study. The median age was 70 years (range 18 to 87 years), and 46 (70%) were male. Seventeen (26%) of the patients were eligible for RCTs. Comparing the two groups, patients in the RCT appropriate group were younger and had fewer comorbidities. The disease severity was milder in the RCT appropriate groups than in the RCT inappropriate groups. Patients in the RCT appropriate group showed significantly longer overall survival times than those in the RCT inappropriate group (Log-Rank test, p < 0.001). Conclusions: We found a significant gap in patients' characteristics and clinical outcomes between the groups. Physicians should be aware that RCT can never reflect the real-world population.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Department of Pathology, University of Michigan, Ann Arbor, MI 48105, USA
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Department of Pharmacy, Mie University Hospital, Tsu 514-8507, Mie, Japan
- Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Tsu 514-8507, Mie, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute 480-1195, Aichi, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1195, Aichi, Japan
- Correspondence:
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Kato H, Morikawa Y, Hagihara M, Mikamo H, Iwamoto T. Investigation of in-line filter replacement intervals for infusion. J Hosp Infect 2023; 134:147-152. [PMID: 36738993 DOI: 10.1016/j.jhin.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND In-line filters in peripheral and central venous catheters are used to remove bacterial cells mechanically. A recent study indicated an extension of the use of infusion sets to 7 days. There is no evidence regarding replacement intervals for in-line filters. AIM To test in-line filters that were used continuously for 7 days in order to investigate their ability to remove bacteria and assess the flow rate. METHODS Three different in-line filters were attached to an ELNEOPA-NF No. 2 premixed infusion bag of intravenous hyperalimentation, into which Staphylococcus epidermidis ATCC12228 or Escherichia coli ATCC25922 was inoculated. These experiments were compared with a control infusion. The infusion was dropped at a flow rate of 40 mL/h and replaced at 24-h intervals for 7 days. Samples were collected 24 h after drop initiation. FINDINGS S. epidermidis was not detected in droplets between Days 1 and 6, but In-line filters 1 and 2 showed droplets containing 6-10 colony-forming units/mL on Day 7. E. coli was not detected in any of the filters after 7 days of continuous use. Flow rates <40 mL/h were observed on Day 7 for In-line filter 3 in studies of S. epidermidis, and on Days 4 and 3 for In-line filters 2 and 3, respectively, in studies of E. coli. CONCLUSION This study revealed differences in bacterial removal and flow rates under high inoculation between the three in-line filters tested. It is suggested that in-line filters can be used continuously for a maximum of 6 days, and reductions in flow rate after 48 h of continuous use should be noted carefully.
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Affiliation(s)
- H Kato
- Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan.
| | - Y Morikawa
- Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - M Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan; Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University Hospital, Aichi, Japan
| | - H Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - T Iwamoto
- Department of Pharmacy, Mie University Hospital, Mie, Japan; Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
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Hagihara M, Kato H, Shibata Y, Umemura T, Ariyoshi T, Hirai J, Asai N, Mori N, Mikamo H. Mycobiome and Mycobiome-Associated Diseases. Med Mycol J 2023; 64:55-62. [PMID: 37648499 DOI: 10.3314/mmj.23-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The human body is host to a large number of commensal microbial species such as bacteria, fungi, and viruses. Among these, the human mycobiome is often neglected as a potential cause of disease, as it is thought to be comparatively much less abundant and less diverse than the human bacteriome. Additionally, most fungi are not easily cultured, even in specific media. Hence, their study has been limited to date, mainly because of the unavailability of methods used for their detection. However, the utilization of a novel metagenomic methodology will enable the identification of well-characterized mycobiomes in several parts of the human body and broaden our knowledge of their contribution to human health and disease. In this article, we review the role of the human mycobiome in the gut, respiratory organs, skin, genital tract, and carcinogenesis, highlighting the correlations between the human mycobiome and mycobiome-associated diseases.
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Affiliation(s)
- Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Yuichi Shibata
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Tadashi Ariyoshi
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University
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Takano T, Kudo H, Eguchi S, Matsumoto A, Oka K, Yamasaki Y, Takahashi M, Koshikawa T, Takemura H, Yamagishi Y, Mikamo H, Kunishima H. Inhibitory effects of vaginal Lactobacilli on C andida albicans growth, hyphal formation, biofilm development, and epithelial cell adhesion. Front Cell Infect Microbiol 2023; 13:1113401. [PMID: 37201113 PMCID: PMC10188118 DOI: 10.3389/fcimb.2023.1113401] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/19/2023] [Indexed: 05/20/2023] Open
Abstract
Introduction Antifungal agents are not always efficient in resolving vulvovaginal candidiasis (VVC), a common genital infection caused by the overgrowth of Candida spp., including Candida albicans, or in preventing recurrent infections. Although lactobacilli (which are dominant microorganisms constituting healthy human vaginal microbiota) are important barriers against VVC, the Lactobacillus metabolite concentration needed to suppress VVC is unknown. Methods We quantitatively evaluated Lactobacillus metabolite concentrations to determine their effect on Candida spp., including 27 vaginal strains of Lactobacillus crispatus, L. jensenii, L. gasseri, Lacticaseibacillus rhamnosus, and Limosilactobacillus vaginalis, with inhibitory abilities against biofilms of C. albicans clinical isolates. Results Lactobacillus culture supernatants suppressed viable fungi by approximately 24%-92% relative to preformed C. albicans biofilms; however, their suppression differed among strains and not species. A moderate negative correlation was found between Lactobacillus lactate production and biofilm formation, but no correlation was observed between hydrogen peroxide production and biofilm formation. Both lactate and hydrogen peroxide were required to suppress C. albicans planktonic cell growth. Lactobacillus strains that significantly inhibited biofilm formation in culture supernatant also inhibited C. albicans adhesion to epithelial cells in an actual live bacterial adhesion competition test. Discussion Healthy human microflora and their metabolites may play important roles in the development of new antifungal agent against C. albicans-induced VVC.
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Affiliation(s)
- Tomonori Takano
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Hayami Kudo
- Research Department, R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama-shi, Saitama, Japan
| | - Shuhei Eguchi
- Research Department, R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama-shi, Saitama, Japan
| | - Asami Matsumoto
- Research Department, R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama-shi, Saitama, Japan
| | - Kentaro Oka
- Research Department, R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama-shi, Saitama, Japan
| | - Yukitaka Yamasaki
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Motomichi Takahashi
- Research Department, R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama-shi, Saitama, Japan
| | - Takuro Koshikawa
- Department of Microbiology, St. Marianna University School of Medicine, Kawasaki-shi, Japan
| | - Hiromu Takemura
- Department of Microbiology, St. Marianna University School of Medicine, Kawasaki-shi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan
- Department of Clinical Infectious Diseases, Kochi Medical School, Nankoku-shi, Kochi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute, Aichi, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
- *Correspondence: Hiroyuki Kunishima,
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Sada J, Hirai J, Ota K, Numoto S, Honma H, Mori N, Sakanashi D, Mikamo H, Okumura A. Bacteremia Caused by Kalamiella piersonii Found in an Infant During the Course of Gastrointestinal Food Allergy. Infect Drug Resist 2023; 16:2647-2651. [PMID: 37159826 PMCID: PMC10163890 DOI: 10.2147/idr.s402364] [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: 01/12/2023] [Accepted: 03/29/2023] [Indexed: 05/11/2023] Open
Abstract
Kalamiella piersonii is rare pathogen, and its pathogenicity to humans has been unknown. We describe an infant with bacteremia caused by Kalamiella piersonii. The patient was a 2-month-old girl presented with diarrhea, poor oral intake, and vomiting. The patient was tentatively diagnosed with acute enterocolitis. After admission, the patient developed a fever and blood culture yielded Gram-negative cocci, first determined to be Pantoea septica by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. However, genetic analysis of 16S rRNA allowed its identification as Kalamiella piersonii (GenBank accession number is OQ547240). Other housekeeping genes such as gyrB, rpoB, and atpD also identified the isolated strain as Kalamiella piersonii. The patient was successfully treated with cefotaxime without sequelae. Later, the patient was diagnosed as non-IgE-mediated gastrointestinal food allergy. Our experience indicated that Kalamiella piersonii is a potential human pathogen that can cause invasive infections even in infants and children. Identification of Kalamiella piersonii is difficult with routine conventional tests, and detailed studies including genetic analyses are necessary to clarify the pathogenicity of Kalamiella piersonii in humans.
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Affiliation(s)
- Jun Sada
- Department of Pediatrics, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Koki Ota
- Department of Pediatrics, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Shingo Numoto
- Department of Pediatrics, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hitoshi Honma
- Department of Pediatrics, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Nobuaki Mori
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute, Aichi, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Aichi Medical University Hospital, Nagakute, Aichi, Japan
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Nakagama Y, Candray K, Kaku N, Komase Y, Rodriguez-Funes MV, Dominguez R, Tsuchida T, Kunishima H, Nagai E, Adachi E, Ngoyi DM, Yamasue M, Komiya K, Hiramatsu K, Uemura N, Sugiura Y, Yasugi M, Yamagishi Y, Mikamo H, Shiraishi S, Izumo T, Nakagama S, Watanabe C, Nitahara Y, Tshibangu-Kabamba E, Kakeya H, Kido Y. Antibody avidity maturation, following recovery from infection or the booster vaccination, grants breadth in SARS-CoV-2 neutralizing capacity. J Infect Dis 2022; 227:780-787. [PMID: 36546706 PMCID: PMC10044078 DOI: 10.1093/infdis/jiac492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/09/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
Cross-neutralizing capacity of antibodies against SARS-CoV-2 variants is important in mitigating (re-)exposures. Role of antibody maturation, the process whereby selection of higher affinity antibodies augments host immunity, to determine SARS-CoV-2 neutralizing capacity was investigated.
Methods
Sera from SARS-CoV-2 convalescents at 2-, 6-, or 10-months post-recovery, and BNT162b2 vaccine recipients at 3- or 25-weeks post-vaccination, were analyzed. Anti-spike IgG avidity was measured on urea-treated ELISAs. Neutralizing capacity was assessed by surrogate neutralization assays. Fold change between variant and wild-type neutralization inferred the breadth of neutralizing capacity.
Results
Compared with early-convalescence, avidity indices of late-convalescent sera were significantly higher (median 37.7 (interquartile range 28.4–45.1) vs. 64.9 (57.5–71.5), p < 0.0001). Urea-resistant, high-avidity IgG best predicted neutralizing capacity (Spearman’s r = 0.49 vs. 0.67 (wild-type); 0.18–0.52 vs. 0.48–0.83 (variants)). Higher-avidity convalescent sera better cross-neutralized SARS-CoV-2 variants (p < 0.001 (Alpha); p < 0.01 (Delta and Omicron)). Vaccinees only experienced meaningful avidity maturation following the booster dose, exhibiting rather limited cross-neutralizing capacity at week-25.
Conclusions
Avidity maturation was progressive beyond acute recovery from infection, or became apparent after the booster vaccine dose, granting broader anti-SARS-CoV-2 neutralizing capacity. Understanding the maturation kinetics of the two building blocks of anti-SARS-CoV-2 humoral immunity is crucial.
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Affiliation(s)
- Yu Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Katherine Candray
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Centro Nacional de Investigaciones Científicas de El Salvador (CICES) , San Salvador, El Salvador
| | - Natsuko Kaku
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Yuko Komase
- Department of Respiratory Internal Medicine, St. Marianna University, Yokohama Seibu Hospital , Yokohama , Japan
| | | | - Rhina Dominguez
- El Salvador National Institute of Health , San Salvador, El Salvador
| | - Tomoya Tsuchida
- Division of General Internal Medicine, St. Marianna University School of Medicine , Kawasaki , Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University School of Medicine , Kawasaki , Japan
| | - Etsuko Nagai
- Department of Infectious Diseases and Applied Immunology, Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Eisuke Adachi
- Department of Infectious Diseases and Applied Immunology, Institute of Medical Science, The University of Tokyo , Tokyo , Japan
| | - Dieudonné Mumba Ngoyi
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Mari Yamasue
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Kosaku Komiya
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Kazufumi Hiramatsu
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Naoto Uemura
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine , Oita , Japan
| | - Yuki Sugiura
- Center for Cancer Immunotherapy and Immunobiology, Kyoto University Graduate School of Medicine , Kyoto , Japan
| | - Mayo Yasugi
- Graduate School of Veterinary Science, Osaka Metropolitan University , Osaka , Japan
- Asian Health Science Research Institute, Osaka Metropolitan University , Osaka , Japan
- Osaka International Research Center for Infectious Diseases, Osaka Metropolitan University , Osaka , Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University , Aichi , Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University , Aichi , Japan
| | - Satoshi Shiraishi
- Department of Respiratory Medicine, Osaka City Juso Hospital , Osaka , Japan
| | - Takehiro Izumo
- Department of Respiratory Medicine, Japanese Red Cross Medical Center , Tokyo , Japan
| | - Sachie Nakagama
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Chihiro Watanabe
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Yuko Nitahara
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Evariste Tshibangu-Kabamba
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Hiroshi Kakeya
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
| | - Yasutoshi Kido
- Department of Virology & Parasitology, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
- Research Center for Infectious Disease Sciences, Graduate School of Medicine, Osaka Metropolitan University , Osaka , Japan
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Hagihara M, Yamashita M, Ariyoshi T, Eguchi S, Minemura A, Miura D, Higashi S, Oka K, Nonogaki T, Mori T, Iwasaki K, Hirai J, Shibata Y, Umemura T, Kato H, Asai N, Yamagishi Y, Ota A, Takahashi M, Mikamo H. Clostridium butyricum-induced ω-3 fatty acid 18-HEPE elicits anti-influenza virus pneumonia effects through interferon-λ upregulation. Cell Rep 2022; 41:111755. [PMID: 36516771 DOI: 10.1016/j.celrep.2022.111755] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 04/12/2022] [Revised: 07/11/2022] [Accepted: 11/09/2022] [Indexed: 12/15/2022] Open
Abstract
The precise mechanism by which butyrate-producing bacteria in the gut contribute to resistance to respiratory viral infections remains to be elucidated. Here, we describe a gut-lung axis mechanism and report that orally administered Clostridium butyricum (CB) enhances influenza virus infection resistance through upregulation of interferon (IFN)-λ in lung epithelial cells. Gut microbiome-induced ω-3 fatty acid 18-hydroxy eicosapentaenoic acid (18-HEPE) promotes IFN-λ production through the G protein-coupled receptor (GPR)120 and IFN regulatory factor (IRF)-1/-7 activations. CB promotes 18-HEPE production in the gut and enhances ω-3 fatty acid sensitivity in the lungs by promoting GPR120 expression. This study finds a gut-lung axis mechanism and provides insights into the treatments and prophylaxis for viral respiratory infections.
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Affiliation(s)
- Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute 480-1195, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan
| | - Makoto Yamashita
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan
| | - Tadashi Ariyoshi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan; R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama 331-0804, Japan
| | - Shuhei Eguchi
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama 331-0804, Japan
| | - Ayaka Minemura
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama 331-0804, Japan
| | - Daiki Miura
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama 331-0804, Japan
| | - Seiya Higashi
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama 331-0804, Japan
| | - Kentaro Oka
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan; R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama 331-0804, Japan
| | - Tsunemasa Nonogaki
- Department of Pharmacy, College of Pharmacy Kinjo Gakuin University, Nagoya 463-8521, Japan
| | - Takeshi Mori
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan
| | - Kenta Iwasaki
- Departments of Kidney Disease and Transplant Immunology, Aichi Medical University, Nagakute 480-1195, Japan
| | - Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan
| | - Yuichi Shibata
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute 480-1195, Japan
| | - Takumi Umemura
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan
| | - Hideo Kato
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan; Department of Pharmacy, Mie University Hospital, Tsu, Mie, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan
| | - Akinobu Ota
- Departments of Biochemistry, Aichi Medical University, Nagakute 480-1195, Japan
| | - Motomichi Takahashi
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan; R&D Division, Miyarisan Pharmaceutical Co., Ltd., Saitama 331-0804, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan.
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Shibasaki C, Hagihara M, Oka K, Takahashi M, Mikamo H. 19: HOST IMMUNE RESPONSE IN THE MICE INOCULATED WITH DIFFERENT DOSES OF CLOSTRIDIUM PERFRINGENS. J Glob Antimicrob Resist 2022. [DOI: 10.1016/s2213-7165(22)00298-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Hirai J, Yamaoka T, Takahashi T, Mikamo H. Shoulder Injury Related to Zoster Vaccine Administration. Intern Med 2022; 61:3631-3632. [PMID: 35491135 PMCID: PMC9790784 DOI: 10.2169/internalmedicine.9484-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Takanari Yamaoka
- Department of Orthopedic Surgery, Aichi Medical University, Japan
| | - Tomoko Takahashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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Hirai J, Asai N, Hagihara M, Kishino T, Kato H, Sakanashi D, Ohashi W, Mikamo H. Comparative Effectiveness of Ampicillin/Sulbactam versus Cefazolin as Targeted Therapy for Bacteremia Caused by Beta-Lactamase-Producing Methicillin-Sensitive Staphylococcus aureus: A Single-Center Retrospective Study. Antibiotics (Basel) 2022; 11:1505. [PMID: 36358161 PMCID: PMC9686817 DOI: 10.3390/antibiotics11111505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/22/2022] [Accepted: 10/27/2022] [Indexed: 02/06/2024] Open
Abstract
Cefazolin (CFZ) is the first-line treatment for beta-lactamase-producing methicillin-sensitive Staphylococcus aureus (BP-MSSA) infection. In 2019, Japan experienced a CFZ shortage because of foreign object inclusion in a batch. Ampicillin/sulbactam (SAM) was preferred in many cases as definitive therapy for the treatment of BP-MSSA bacteremia to preserve broad-spectrum antibiotic stock. However, there are no previous studies reporting the clinical efficacy of SAM for BP-MSSA bacteremia. We aimed to compare the clinical efficacy and adverse effects of SAM versus CFZ in patients with BP-MSSA bacteremia. In total, 41 and 30 patients treated with SAM and CFZ, respectively, were identified. The baseline characteristics were similar in both groups. No significant differences were observed in length of hospital stay and all 30-day mortality between the two groups (p = 0.270 and 0.643, respectively). Moreover, no intergroup difference in 90-day mortality was found (hazard ratio 1.02, 95% confidential interval 0.227-4.53). Adverse effects, such as liver dysfunction, were less in the CFZ group than in the SAM group (p = 0.030). Therefore, in cases of poor CFZ supply or in patients allergic to CFZ and penicillinase-stable penicillins, SAM can be an effective therapeutic option for bacteremia due to BP-MSSA with attention of adverse effects, such as liver dysfunction.
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Affiliation(s)
- Jun Hirai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1103, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1103, Japan
| | - Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1103, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1103, Japan
| | - Mao Hagihara
- Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Nagakute 480-1103, Japan
| | - Takaaki Kishino
- Department of Emergency and Critical Care Medicine, Aichi Medical University Hospital, Nagakute 480-1103, Japan
| | - Hideo Kato
- Department of Pharmacy, Mie University Hospital, Tsu 514-8507, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1103, Japan
| | - Wataru Ohashi
- Division of Biostatistics, Clinical Research Center, Aichi Medical University, Nagakute 480-1103, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Nagakute 480-1103, Japan
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute 480-1103, Japan
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Mikamo H, Koizumi Y, Yamagishi Y, Asai N, Miyazono Y, Shinbo T, Horie M, Togashi K, Robbins EM, Hirotsu N. Comparing the cobas Influenza A/B Nucleic acid test for use on the cobas Liat System (Liat) with rapid antigen tests for clinical management of Japanese patients at the point of care. PLoS One 2022; 17:e0276099. [PMID: 36301841 PMCID: PMC9612487 DOI: 10.1371/journal.pone.0276099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
Background Rapid diagnosis of influenza is critical in preventing the spread of infection and ensuring patients quickly receive antiviral medication to reduce the severity and duration of influenza symptoms, whilst controlling the spread of the causative virus. In Japan patients are often administered anti-influenza medication following a positive rapid antigen detection test (RADT) result. However, the sensitivity of RADTs can lead to false negative results. The cobas® Influenza A/B Nucleic acid test for use on the cobas Liat® System (Liat) is a molecular point-of-care method that can provide a more sensitive alternative to RADTs for rapid influenza diagnosis and treatment. Methods In this prospective multicenter study, diagnostic performance of the Liat test was compared with RADTs in patients presenting with influenza-like-illness. Test performance was also assessed by time since symptom onset. Results Of 419 patients enrolled, 413 were evaluable for all designated tests. Most patients had type-A infection, and only one patient had influenza type B. In 413 patients, the sensitivity and specificity (95% CI) of the Liat test were 99.5% (97.2–99.9%) and 99.5% (97.4–99.9%), respectively, and were 79.7% (73.5–84.7%) and 95.4% (91.7–97.5%) for RADTs. For patients tested <12 hours from symptom onset, the Liat test had significantly higher sensitivity than RADTs (p<0.0001). Conclusion Overall, compared with standard of care RADTs, the Liat test was more sensitive and specific in children and adults, particularly in the early stages of infection. Greater sensitivity can enable earlier diagnosis and may better inform appropriate antiviral treatment decisions.
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Affiliation(s)
| | - Yusuke Koizumi
- Aichi Medical University, Nagakute, Aichi, Japan
- Wakayama Medical University, Wakayama, Wakayama, Japan
| | - Yuka Yamagishi
- Aichi Medical University, Nagakute, Aichi, Japan
- Kochi University, Nankoku, Kochi, Japan
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Matsumoto A, Yamagishi Y, Miyamoto K, Higashi S, Oka K, Takahashi M, Mikamo H. Comparison of clinical severity, genotype and toxin gene expression of binary toxin-producing Clostridioides difficile clinical isolates in Japan. Access Microbiol 2022; 4:acmi000362. [PMID: 36415735 PMCID: PMC9675170 DOI: 10.1099/acmi.0.000362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/14/2022] [Indexed: 11/07/2023] Open
Abstract
The emerging Clostridioides difficile strain BI/NAP1/027 has been reported to be associated with more severe clinical symptoms and higher mortality rates, thought in part due to production of a novel binary toxin alongside conventional A and B toxins. However, recent studies suggest that this may not always be the case. Therefore, the purpose of this report was to investigate the correlation between clinical severity and microbiological characteristics of CDT-producing C. difficile isolates in Japan. Eight Japanese isolates of CDT producing C. difficile were investigated using genotyping, cytotoxic activity assays and toxin gene expression. Correlation with clinical severity was performed retrospectively using the patient record. Three of eight patients were assessed as having severe C. difficile infection (CDI). PCR ribotyping resolved six ribotypes including ribotype 027. No specific genes were identified determining severe compared with non-severe cases. Positive correlation of expression levels of tcdA, tcdB and cdtB were observed although these expression levels were not correlated with cytotoxicity. CDI severity index neither correlated with toxin gene expression level nor cytotoxicity. These data indicate that the possession of the CDT gene and toxin gene expression levels may not relate to C. difficile cytotoxicity or clinical severity.
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Affiliation(s)
- Asami Matsumoto
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute City, Aichi 480-1195, Japan
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., 2-22-9, Toro-cho, Kita-ku, Saitama 331-0804, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute City, Aichi 480-1195, Japan
- Department of Clinical Infectious Diseases, Kochi Medical School, 185-1, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan
| | - Kentaro Miyamoto
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., 2-22-9, Toro-cho, Kita-ku, Saitama 331-0804, Japan
| | - Seiya Higashi
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., 2-22-9, Toro-cho, Kita-ku, Saitama 331-0804, Japan
| | - Kentaro Oka
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute City, Aichi 480-1195, Japan
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., 2-22-9, Toro-cho, Kita-ku, Saitama 331-0804, Japan
| | - Motomichi Takahashi
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute City, Aichi 480-1195, Japan
- R&D Division, Miyarisan Pharmaceutical Co., Ltd., 2-22-9, Toro-cho, Kita-ku, Saitama 331-0804, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, 1-1, Yazakokarimata, Nagakute City, Aichi 480-1195, Japan
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, 1-1, Yazakokarimata, Nagakute City, Aichi, 480-1195, Japan
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Ruzicka D, Kondo T, Fujimoto G, Craig AP, Kim SW, Mikamo H. Development of a clinical prediction model for recurrence and mortality outcomes after Clostridioides difficile infection using a machine learning approach. Anaerobe 2022; 77:102628. [PMID: 35985607 DOI: 10.1016/j.anaerobe.2022.102628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 06/29/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Clostridioides difficile infection (CDI) is associated with a large burden of morbidity and mortality worldwide. Previous studies have developed models for predicting recurrence and mortality following CDI, but no machine learning predictive models have been developed specifically using data from Japanese patients. METHODS Using a database of records from acute care hospitals in Japan, we extracted records from January 2012 to September 2016 (plus a 60-day lookback window). A total of 19,159 patients were included. We used a machine learning approach, XGBoost, and compared it to a traditional unregularized logistic regression model. The first 80% of the dataset (by patient index date) was used to optimize model hyperparameters and train the final models, and evaluation was performed on the remaining 20%. We measured model performance by the area under the receiver operator curve and assessed feature importance using Shapley additive explanations. RESULTS Performance was similar between the machine learning approach and the classical logistic regression model. Logistic regression performed slightly better than XGBoost for predicting mortality. CONCLUSION XGBoost performed slightly better than logistic regression for predicting recurrence, but it was not competitive with existing published models. Despite this, a future machine learning-based application provided in a bedside setting at low cost might be a clinically useful tool.
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Affiliation(s)
- Daniel Ruzicka
- Medical Affairs, MSD K.K., Tokyo, Japan, Kitanomaru Square, 1-13-12 Kudan-kita, Chiyoda-ku, Tokyo, 102-8667, Japan
| | - Takayuki Kondo
- Medical Affairs, MSD K.K., Tokyo, Japan, Kitanomaru Square, 1-13-12 Kudan-kita, Chiyoda-ku, Tokyo, 102-8667, Japan.
| | - Go Fujimoto
- Medical Affairs, MSD K.K., Tokyo, Japan, Kitanomaru Square, 1-13-12 Kudan-kita, Chiyoda-ku, Tokyo, 102-8667, Japan
| | - Andrew P Craig
- Real World Evidence Solutions, IQVIA Solutions Japan K.K., Takanawa 4-10-18, Minato-ku, Tokyo, 108-0074, Japan
| | - Seok-Won Kim
- Real World Evidence Solutions, IQVIA Solutions Japan K.K., Takanawa 4-10-18, Minato-ku, Tokyo, 108-0074, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Graduate School of Medicine, 1-1, Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
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