Details of a Researcher - TAKAHASHI Satoshi

Papers - TAKAHASHI Satoshi

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Acute eosinophilic pneumonia accompanied with COVID-19: a case report.

Koutaro Murao, Atsushi Saito, Koji Kuronuma, Yoshihiro Fujiya, Satoshi Takahashi, Hirofumi Chiba

Respirology case reports 8 ( 9 ) e00683 2020.12 [International journal]

We report a case of acute eosinophilic pneumonia (AEP) triggered by coronavirus disease 2019 (COVID-19) infection. A 77-year-old man experienced left-sided chest pain and shortness of breath. Reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) revealed a positive result, and he was treated with favipiravir, ciclesonide, and lascufloxacin, but he showed poor improvement. On the other hand, computed tomography (CT) images were atypical for COVID-19 infection, and the elevation of eosinophil was found in blood and the fluid obtained by bronchoscopy. So, we clinically diagnosed this case as AEP. Administration of prednisolone dramatically improved the patient's clinical condition and chest radiograph findings, which were consistent with the clinical course of AEP. This case suggests the importance of considering the complications of AEP when treating patients with COVID-19 infection.

Sitafloxacin has a potent activity for eradication of extended spectrum β-lactamase-producing fluoroquinolone-resistant Escherichia coli forming intracellular bacterial communities in uroepithelial cells.

Yoshiki Hiyama, Toyotaka Sato, Satoshi Takahashi, Soh Yamamoto, Yukari Fukushima, Chie Nakajima, Yasuhiko Suzuki, Shin-Ichi Yokota, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 26 ( 12 ) 1272 - 1277 2020.12 [International journal]

INTRODUCTION: Eradication of asymptomatic bacteriuria (ASB) before urological procedures is important to reduce the risk for infectious complications after surgery. However, the appropriate regimen for antimicrobial treatment has not been fully determined. We experienced continuous (over 10 months) isolation of extended spectrum β-lactamase (ESBL)-producing fluoroquinolone-resistant Escherichia coli from urine of an asymptomatic patient. The four isolates obtained (SMESC1 to 4) were international high-risk clones of O25b:H4-ST131-H30R, and originated from one strain, as revealed by the whole genome sequences. Although the patient received meropenem (MEPM) and fosfomycin (FOM), to which the strains were susceptible before the urological procedures, they could not be eradicated. METHODS: To explore the reason for the continuous isolation even after MEPM and FOM administration, antimicrobial killing of adherent and/or intracellular bacterial communities (IBC) formed by coculture of the E. coli cells and T24 bladder epithelial cells were examined. RESULTS: FOM and levofloxacin did not decrease viable E. coli cells compared with gentamicin. MEPM partly decreased them, and sitafloxacin (STFX) decreased them most potently. These observations indicate that E. coli can survive in the urinary tract under antimicrobial administration, and some antimicrobials such as FOM and MEPM cannot eradicate E. coli in uroepithelial cells. Adhesion on urinary epithelial cells and/or IBC formation might result in continuous isolation from the urinary tract and recurrence of ASB and urinary tract infections. CONCLUSIONS: The present study suggests that STFX is a promising optional agent for the eradication of ESBL-producing fluoroquinolone-resistant E. coli in the urinary tract before urological procedures.

Emergence of vancomycin- and teicoplanin-resistant Enterococcus faecium via vanD5-harbouring large genomic island.

Toyotaka Sato, Takayuki Wada, Masaaki Shinagawa, Yukari Fukushima, Chie Nakajima, Yasuhiko Suzuki, Satoshi Takahashi, Shin-Ichi Yokota

The Journal of antimicrobial chemotherapy 75 ( 9 ) 2411 - 2415 2020.09 [International journal]

BACKGROUND: Treatment of VRE is of clinical concern. While certain numbers of vanD-type VRE have been isolated, only two vanD5-harbouring Enterococcus faecium isolates have been reported in Canada and Japan. METHODS: We report the isolation of vanD5-type E. faecium and the first ever determination of the whole-genome sequence to investigate the possible mechanisms of the acquisition of the vanD5 gene cluster in E. faecium. RESULTS: Two vanD5-harbouring vancomycin-resistant E. faecium were isolated from the skin (SMVRE19) and faeces (SMVRE20) of a patient with a skin ulcer in Japan. The isolates exhibited vancomycin and teicoplanin MIC values of 128 mg/L, whilst the previous isolates of vanD5-harbouring E. faecium were only resistant to vancomycin. SMVRE19 and SMVRE20 were clones related to ST18, which is also seen in vanA- and vanB-type VRE. These isolates harboured an insertion element, ISEfm1, in the ddl gene, similar to a previously described teicoplanin-resistant vanD3-type E. faecium. The vanD5 gene cluster was integrated into the SMVRE20 chromosome as a part of a large genomic island (approximately 127 kb), similar to other recently spreading vanD variants in the Netherlands. The genomic island shared the greatest similarity with a part of the Blautia coccoides genome sequence, except for the region surrounding the vanD gene cluster. CONCLUSIONS: This study reports that emergence of vancomycin- and teicoplanin-resistant vanD5-type E. faecium occurred via acquisition of the vanD5 cluster and ISEfm1 insertion into ddl. Considering the genetic similarity between the various VRE strains, the current study should serve as a warning against the spread of vanD5-type VRE.

[Clinical Outcome of Patients with Bacteremia Caused by Urinary Tract Infection].

Seisuke Nofuji, Yoshiki Hiyama, Toshiaki Tanaka, Satoshi Takahashi, Naoya Masumori

Hinyokika kiyo. Acta urologica Japonica 66 ( 5 ) 141 - 145 2020.05 [Domestic journal]

Although bacteremia is often concomitant with severe urinary tract infection (UTI), the treatment outcome has not been well studied. The aim of this study was to verify treatment outcome in patients with bacteremia caused by UTI. We also assessed the efficacy of sequential oral antibiotics. According to a retrospective chart review of patients treated in the Sapporo Medical University Hospital from 2013 to 2016, bacteremia caused by UTI was observed in 59 patients. Intravenous antibiotics were sequentially converted to oral agents in 48 patients. Of them, 14 patients had recurrence after initial treatment. There was no significant difference in recurrence rate between events with and without conversion to oral antibiotics. Use of a steroid or immunosuppressant was significantly associated with recurrence of bacteremia caused by UTI. In patients with recurrence of UTI, treatment period was significantly long. In patients with bacteremia caused by UTI, antibiotic agents can be converted to a culture-directed oral antibiotic safely. However, we should notice the high risk of recurrence in patients treated with a steroid or immunosuppressant.

The third national Japanese antimicrobial susceptibility pattern surveillance program: Bacterial isolates from complicated urinary tract infection patients.

Kanao Kobayashi, Shingo Yamamoto, Satoshi Takahashi, Kiyohito Ishikawa, Mitsuru Yasuda, Koichiro Wada, Ryoichi Hamasuna, Hiroshi Hayami, Shinichi Minamitani, Tetsuya Matsumoto, Hiroshi Kiyota, Kazuhiro Tateda, Junko Sato, Hideaki Hanaki, Naoya Masumori, Yoshiki Hiyama, Hiroki Yamada, Shin Egawa, Takahiro Kimura, Hiroyuki Nishiyama, Jun Miyazaki, Kazumasa Matsumoto, Yukio Homma, Jun Kamei, Kiyohide Fujimoto, Kazumasa Torimoto, Kazushi Tanaka, Yoshikazu Togo, Shinya Uehara, Akio Matsubara, Koichi Shoji, Hirokazu Goto, Hisao Komeda, Toru Ito, Katsuhisa Mori, Koji Mita, Masao Kato, Yoshinori Fujimoto, Takako Masue, Hisato Inatomi, Yoshito Takahashi, Satoshi Ishihara, Kazuo Nishimura, Kenji Mitsumori, Noriyuki Ito, Sojun Kanamaru, Daisuke Yamada, Maeda Hiroshi, Masuo Yamashita, Masaya Tsugawa, Tadasu Takenaka, Koichi Takahashi, Yasuhiko Oka, Tomihiko Yasufuku, Shuji Watanabe, Yoshitomo Chihara, Kazuhiro Okumura, Hiroaki Kawanishi, Masanori Matsukawa, Masanobu Shigeta, Shuntaro Koda

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 26 ( 5 ) 418 - 428 2020.05 [International journal]

The antimicrobial susceptibility patterns of bacterial pathogens isolated from patients with complicated urinary tract infections were analyzed using national surveillance data. The data consisted of 881 bacterial strains from eight clinically relevant species. The data were collected for the third national surveillance project from January 2015 to March 2016 by the Japanese Society of Chemotherapy, the Japanese Association for Infectious Disease, and the Japanese Society of Clinical Microbiology. Surveillance was undertaken with the cooperation of 41 medical institutions throughout Japan. Fluoroquinolone required a MIC90 of 2-64 mg/L to inhibit the 325 Escherichia coli strains tested and the proportion of levofloxacin resistant E. coli strains increased to 38.5% from 29.6% in 2011 and 28.6% in 2008. The proportion of levofloxacin resistant strains of Pseudomonas aeruginosa and Enterococcus faecalis decreased from previous reports and the proportion of multidrug-resistant P. aeruginosa and carbapenem-resistant Enterobacteriaceae remained low. Among methicillin-resistant Staphylococcus aureus (MRSA) strains, strains with reduced susceptibility to vancomycin (minimum inhibitory concentration, 2 μg/mL) increased to 14.7% from 5.5%. Bacterial strains that produced extended-spectrum β-lactamase included E. coli (79 of 325 strains, 24.3%), Klebsiella pneumoniae (9 of 177 strains, 7.7%), and Proteus mirabilis (6 of 55 strains, 10.9%). The proportion of extended-spectrum β-lactamase producing E. coli and K. pneumoniae strains increased from previous surveillance reports.

Contribution of β-lactamase and efflux pump overproduction to tazobactam-piperacillin resistance in clinical isolates of Escherichia coli.

Yuuki Suzuki, Toyotaka Sato, Yukari Fukushima, Chie Nakajima, Yasuhiko Suzuki, Satoshi Takahashi, Shin-Ichi Yokota

International journal of antimicrobial agents 55 ( 4 ) 105919 - 105919 2020.04 [International journal]

INTRODUCTION: Tazobactam-piperacillin (TZP) is a mixture of a broad-spectrum penicillin and an irreversible β-lactamase inhibitor. TZP is effective against Gram-negative bacteria that produce extended-spectrum β-lactamases, and it is used as a first-line or second-line drug to treat serious infections. METHODS: This study identified three TZP-resistant and two TZP-intermediate strains among 514 clinical isolates of Escherichia coli. RESULTS: These five isolates possessed one or more β-lactamase genes, blaTEM-1, blaCTX-M-2, blaCTX-M-14, and/or blaCMY-8. The expression levels of β-lactamase genes and acrAB genes in the strains were examined by using real-time reverse transcription PCR. The total enzymatic piperacillin-degrading activity in cells was determined. Two TZP-resistance mechanisms were identified: hyperproduction of TEM-1 in the two resistant strains; and simultaneous high production of β-lactamase and efflux pump AcrAB in the two TZP-intermediate isolates. The latter are an international high-risk clone O25b:H4-ST131-H30R. CONCLUSION: TZP resistance is still rare in clinical isolates of E. coli. However, resistance can develop on high production and/or combinations of known antimicrobial resistance mechanisms in different ways.

Prevalence and characterization of Clostridioides difficile isolates from retail food products (vegetables and meats) in Japan.

Masaru Usui, Aika Maruko, Michiko Harada, Fumi Kawabata, Tsubasa Sudo, Sayo Noto, Toyotaka Sato, Masaaki Shinagawa, Satoshi Takahashi, Yutaka Tamura

Anaerobe 61 102132 - 102132 2020.02 [International journal]

The present study aimed to elucidate the prevalence of Clostridioides difficile in Japanese retail food products. For this purpose, retail food samples (242 fresh vegetables and 266 retail meat samples: 89 chicken meat; 28 chicken liver; 200 pork meat; 24 pig liver; 127 beef meat) were collected from 14 supermarkets between 2015 and 2019. C. difficile was isolated from eight (3.3%) fresh vegetable, six (6.7%) chicken meat, one (3.6%) chicken liver, one (0.5%) pork meat, and two (1.6%) beef meat samples; it was not isolated from pig liver. Of these isolates, 35% were toxigenic. All isolates were typable by PCR ribotyping and were resolved into 12 PCR ribotypes. Among these isolates, ribotype 014, which is distributed worldwide including in Japanese clinical cases, was detected among vegetable isolates. Therefore, although the C. difficile contamination rate in Japanese retail foods was low, these sources can be contaminated and could transmit these bacteria to humans.

In Vitro Derivation of Fluoroquinolone-Resistant Mutants from Multiple Lineages of Haemophilus influenzae and Identification of Mutations Associated with Fluoroquinolone Resistance.

Hiroyuki Honda, Toyotaka Sato, Masaaki Shinagawa, Yukari Fukushima, Chie Nakajima, Yasuhiko Suzuki, Koji Kuronuma, Satoshi Takahashi, Hiroki Takahashi, Shin-Ichi Yokota

Antimicrobial agents and chemotherapy 64 ( 2 ) 2020.01 [International journal]

Haemophilus influenzae is a pathogenic bacterium that causes respiratory and otolaryngological infections. The increasing prevalence of β-lactamase-negative high-level ampicillin-resistant H. influenzae (high-BLNAR) is a clinical concern. Fluoroquinolones are alternative agents to β-lactams. However, the emergence and increasing prevalence of fluoroquinolone-resistant H. influenzae have been reported. The current risk of fluoroquinolone resistance in H. influenzae (especially in high-BLNAR) has not yet been evaluated. Here, we examined the development of fluoroquinolone resistance in fluoroquinolone-susceptible clinical H. influenzae isolates in vitro during passaging in the presence of moxifloxacin (from 0.03 to 128 mg/liter). Twenty-nine isolates were examined. Seventeen isolates (58.6%) showed reduced moxifloxacin susceptibility, and 10 of these 17 isolates (34.5% of all isolates) exceeded the Clinical and Laboratory Standards Institute breakpoint for moxifloxacin (MIC of >1 mg/liter) after repeat cultivation on moxifloxacin-containing agar. Seven of these ten isolates were high-BLNAR and represented multiple lineages. We identified 56 novel mutations in 45 genes induced during the development of fluoroquinolone resistance, except the defined quinolone resistance-determining regions (Ser84Leu and Asp88Tyr/Gly/Asn in GyrA and Gly82Asp, Ser84Arg, and Glu88Lys in ParC). Glu153Leu and ΔGlu606 in GyrA, Ser467Tyr and Glu469Asp in GyrB, and ompP2 mutations were novel mutations contributing to fluoroquinolone resistance in H. influenzae In conclusion, H. influenzae clinical isolates from multiple lineages can acquire fluoroquinolone resistance by multiple novel mutations. The higher rate of derivation of fluoroquinolone-resistant H. influenzae from high-BLNAR than β-lactamase-negative ampicillin-susceptible isolates (P = 0.01) raises the possibility of the emergence and spread of fluoroquinolone-resistant high-BLNAR in the clinical setting.

Intraocular infiltration of Philadelphia chromosome-positive acute lymphoblastic leukemia diagnosed by polymerase chain reaction from the aqueous humor: A case report.

Miki Hiraoka, Hiroshi Ohguro, Hiroshi Ikeda, Daisuke Furuya, Satoshi Takahashi

Medicine 99 ( 4 ) e18872 2020.01 [International journal]

RATIONALE: Intraocular manifestation of hematopoietic tumors is rare and often difficult to distinguish from inflammation. We report a patient with acute lymphoblastic leukemia (ALL) who developed intraocular infiltration during the remission period. PATIENT CONCERNS: A 40-year-old man presented with hypopyon in his right eye. Three months later, extensive subretinal infiltration and the elevation of intraocular pressure were observed. Fourteen months prior to this, he had been diagnosed with Philadelphia chromosome-positive ALL, and had received chemotherapy and bone marrow transplantation that resulted in complete remission. DIAGNOSIS: The breakpoint cluster region-Ableson (BCR/ABL) chimera was detected by polymerase chain reaction (PCR) analysis in the patient's aqueous humor. Additionally, a high expression of WT1 (Wilms tumor gene) mRNA in the aqueous humor was discovered. A bone marrow examination yielded a high expression of BCR/ABL fusion gene, and it was determined the patient had experienced a relapse of ALL. INTERVENTIONS: The dasatinib was administered orally to the patient. OUTCOMES: The intraocular infiltration disappeared, and intraocular pressure was normalized. LESSONS: Intraocular infiltration in leukemia patients may be an indication of relapse regardless of systemic conditions. Analyzing mRNA expression of BCR/ABL and WT1 of ocular fluid in patients with hypopyon is beneficial in diagnosing topical relapses in leukemia.

Clonality investigation of clinical Escherichia coli isolates by polymerase chain reaction-based open-reading frame typing method.

Masachika Saeki, Toyotaka Sato, Daisuke Furuya, Yuki Yakuwa, Yuki Sato, Ryo Kobayashi, Mayumi Ono, Shinya Nirasawa, Makito Tanaka, Hirotaka Nakafuri, Mami Nakae, Masaaki Shinagawa, Kouichi Asanuma, Nozomi Yanagihara, Shin-Ichi Yokota, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 26 ( 1 ) 38 - 42 2020.01 [International journal]

Escherichia coli (E. coli) causes urinary tract infections, pneumonia, surgical site infections, and bloodstream infections and is the important pathogen for both community-acquired and healthcare-associated infections. To investigate the clonality of E. coli is important for infection control and prevention. We aimed to investigate the clonality of clinical E. coli isolates using Cica Geneus E. coli polymerase chain reaction (PCR)-based open-reading frame typing (POT) KIT and clarify the clinical usefulness of this kit. About 124 E. coli isolates obtained from inpatients at Sapporo Medical University Hospital were used. The POT method was used to classify 124 clinical isolates into 87 POT numbers. In addition to the clonality, it was possible to obtain additional information that 20 of the 124 isolates were extended-spectrum β-lactamase (ESBL) producing E. coli (5 isolates of CTX-M-1 group and 15 isolates of CTX-M-9 group) and 13 were sequence type (ST) 131 clone. Furthermore, when these ESBL-producing 20 isolates were compared with pulsed-field gel electrophoresis (PFGE) or multilocus sequence typing (MLST), Simpson's index of diversity was 0.968 in POT method, 0.979 in PFGE, and 0.584 in MLST. POT method had an analytical power similar to that of PFGE. In conclusion, attention should be paid to the difference in the interpretation of the results between the POT method and the PFGE, but POT method may be useful to timely monitor the spread of E. coli in medical facilities.

Veno-venous extracorporeal membrane oxygenation and prone ventilation for therapeutic management of COVID-19.

Takehiko Kasai, Naofumi Bunya, Kenshiro Wada, Ryuichiro Kakizaki, Hirotoshi Mizuno, Hiroyuki Inoue, Shuji Uemura, Satoshi Takahashi, Eichi Narimatsu, Shinhiro Takeda

Acute medicine & surgery 7 ( 1 ) e546 2020 [International journal]

BACKGROUND: The efficacy and safety of the combined use of veno-venous extracorporeal membrane oxygenation (ECMO) and prone ventilation are currently not known for coronavirus disease 2019 (COVID-19). CASE PRESENTATION: We report two cases in which the combination of veno-venous ECMO and prone ventilation for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia were successfully carried out. Both patients had developed severe respiratory failure due to SARS-CoV-2 pneumonia, thus requiring veno-venous ECMO. Prone ventilation was also administered safely. CONCLUSION: Oxygenation and lung compliance gradually improved during prone ventilation, and both patients were successfully extubated. For patients with severe SARS-CoV-2 pneumonia who require veno-venous ECMO, the use of prone ventilation could be beneficial, and should be considered.

The resonance® metallic ureteral stent in the treatment of malignant ureteral obstruction: a prospective observational study.

Jun Miyazaki, Mizuki Onozawa, Satoshi Takahashi, Yuka Maekawa, Mitsuru Yasuda, Koichiro Wada, Yuji Maeda, Takuro Masaki, Akito Yamaguchi, Masahiko Suzuki, Yasuyuki Sakai, Tomokazu Kimura, Manabu Takai, Kensaku Seike, Takahiko Hashimoto, Shingo Yamamoto

BMC urology 19 ( 1 ) 137 - 137 2019.12 [International journal]

BACKGROUND: To study the outcomes and experiences of using metallic stents in treating patients with malignant ureteral obstruction (MUO), we examined the effects of metallic ureteral stenting using the Cook Resonance® stent in the treatment of MUO. METHODS: All patients who had a Resonance metallic stent inserted between April 2015 and March 2018 at one of multiple facilities were prospectively observed with a 1-year follow-up. The primary outcome was the patency rate of the metallic ureteral stent. The secondary outcomes included the complications (e.g., infection and fever). RESULTS: Although stent insertion was attempted in 50 patients, the stent could not be inserted as a ureteral stent in three patients due to severe ureteral stricture, and one ureteral cancer patient was excluded from the analysis. The remaining 46 patients' median age was 67 years (range 28-85 years) (16 males, 30 females). Twenty-four patients died during the study; their median survival time was 226 days. The median follow-up period for the censored patients was 355 days (range 16-372 days), and just seven patients were still alive without Resonance failure > 1 year later. The women's IPSS scores tended to be lower than those of the men. Regarding the OABSS score, although the women's total score tended to be low, the difference between the men's and women's scores was nonsignificant. The bacteria detected from urine culture after stent insertion were more gram-positive than gram-negative. CONCLUSION: Metallic ureteric stenting using the Resonance stent is safe and effective for treating MUO. Subjective symptoms were relatively less in the female patients.

Insufficient serum L-ficolin is associated with disease presence and extent of pulmonary Mycobacterium avium complex disease.

Tomofumi Kobayashi, Koji Kuronuma, Atsushi Saito, Kimiyuki Ikeda, Shigeru Ariki, Atsushi Saitou, Mitsuo Otsuka, Hirofumi Chiba, Satoshi Takahashi, Motoko Takahashi, Hiroki Takahashi

Respiratory research 20 ( 1 ) 224 - 224 2019.10 [International journal]

BACKGROUND: The incidence of infectious disease caused by nontuberculous mycobacteria is increasing worldwide. Pulmonary Mycobacterium avium complex (MAC) disease is difficult to treat with chemotherapy, and its mechanism of infection, infection route, disease onset, and severity remain unknown. Ficolins are oligomeric defense lectins. L-ficolin plays an important role in innate immunity. This study's aim was to identify L-ficolin's role in patients with pulmonary MAC disease. METHODS: Between April 2011 and September 2017, 61 Japanese patients with pulmonary MAC disease were seen at our hospital. A control group, comprising 30 healthy individuals, without respiratory disease were enrolled in our study. The relationship between serum L-ficolin levels and disease severity was assessed, and L-ficolin's antibacterial role was examined. RESULTS: Serum L-ficolin levels were significantly lower in patients with pulmonary MAC disease than in healthy subjects (1.69 ± 1.27 μg/ml vs. 3.96 ± 1.42 μg/ml; p < 0.001). The cut-off value, based on receiver operating characteristic (ROC) analysis results, was 2.48 μg/ml (area under the curve (AUC) 0.90, sensitivity and specificity 83.6 and 86.7%, respectively). Serum L-ficolin levels were significantly lower in the patients with nodular bronchiectatic type disease compared with the patients with fibrocavitary type disease and were lower in the high-resolution computed tomography high-scoring group compared with low-scoring group. An in vitro analysis showed that purified recombinant L-ficolin bound to M. avium and its major cell wall component, lipoarabinomannan, in a concentration-dependent manner. In addition, recombinant L-ficolin suppressed M. avium growth in a concentration-dependent manner. CONCLUSIONS: Insufficient serum L-ficolin is associated with disease progression in pulmonary MAC disease, and the level of serum L-ficolin is a possible biomarker. TRIAL REGISTRATION: This study is registered with UMIN ( UMIN000022392 ).

Chip-based digital polymerase chain reaction technology is useful for monitoring the JAK2 V617F allele burden in Philadelphia-negative myeloproliferative neoplasms.

Daisuke Furuya, Mikako Moriai, Ryosei Murai, Ryosuke Moriai, Yuki Koizumi, Teruo Endo, Kouichi Asanuma, Nozomi Yanagihara, Satoshi Takahashi

International journal of laboratory hematology 41 ( 5 ) e113-e116 2019.10 [International journal]

Prevalence of Various Vaccine Candidate Proteins in Clinical Isolates of Streptococcus pneumoniae: Characterization of the Novel Pht Fusion Proteins PhtA/B and PhtA/D.

Mitsuyo Kawaguchiya, Noriko Urushibara, Meiji Soe Aung, Masaaki Shinagawa, Satoshi Takahashi, Nobumichi Kobayashi

Pathogens (Basel, Switzerland) 8 ( 4 ) 2019.09 [International journal]

Pneumococcal proteins unrelated to serotypes are considered to be candidates of antigens in next-generation vaccines. In the present study, the prevalence of vaccine candidate protein genes, along with serotypes and antimicrobial resistance determinants, was investigated in a total of 57 isolates obtained from a tertiary care hospital in Japan. All of the pediatric isolates and 76.6% of the adult isolates did not belong to PCV13 (a 13-valent pneumococcal conjugate vaccine) serotypes, and 70.2% of all isolates showed multidrug resistance. All of the isolates had ply, pavA, nanA, and nanB, and high prevalence was noted for the pspA and pspC genes (96.5% and 78.9%, respectively). Detection rates for the pneumococcal histidine triad protein (Pht) genes phtA, phtB, phtD, and phtE were 49.1%, 26.3%, 61.4%, and 100%, respectively. Two fusion-type genes, phtA/B and phtA/D, were identified, with a prevalence of 36.9% and 14.0%, respectively. These fusion types showed 78.1-90.0% nucleotide sequence identity with phtA, phtB, and phtD. The most prevalent pht profile was phtA + phtD + phtE (26.3%), followed by phtA/B + phtE (19.3%) and phtA/B + phtD + phtE (17.5%), while pht profiles including phtD and/or phtA/phtD were found in 71.9% of isolates. The present study revealed the presence of two fusion types of Pht and their unexpectedly high prevalence. These fusion types, as well as PhtA and PhtB, contained sequences similar to the B cell epitopes that have been previously reported for PhtD.

Analysis of major BCR-ABL1 mRNA by digital polymerase chain reaction is useful for prediction of international scale.

Daisuke Furuya, Mikako Moriai, Yuki Koizumi, Teruo Endo, Kouichi Asanuma, Nozomi Yanagihara, Satoshi Takahashi

International journal of clinical oncology 24 ( 7 ) 871 - 875 2019.07 [Domestic journal]

BACKGROUND: Major BCR-ABL1 mRNA in patients with chronic myeloid leukemia (CML) has generally been analysed by real-time polymerase chain reaction (PCR). Application of the international scale (IS) for the quantification of major BCR-ABL1 mRNA has been recommended in several sets of guidelines, including those of the European LeukemiaNet. The aim of this study was to clarify the efficacy of digital PCR technology for the IS of BCR-ABL1 mRNA in the patients with CML by comparing with real-time PCR. METHODS: The analysis of BCR-ABL1 mRNA was carried out by the Ipsogen® BCR-ABL1 Mbcr IS-MMR DX Kit (Qiagen), and the QuantStudio 3D Digital PCR System (Thermo Fisher Scientific‎) using 20 peripheral blood samples obtained from the 9 patients with CML at Sapporo Medical University Hospital. RESULTS: The correlation between the data obtained by digital PCR and by real-time PCR was really high at R = 0.96. The detection limit of digital PCR was up to 0.003% and was equal to IS with 0.01% or less in comparison with real-time PCR. CONCLUSIONS: Digital PCR technology is promising for predicting the IS value with similar efficacy to real-time PCR and should be useful for simple monitoring of the effects of tyrosine kinase inhibitor (TKI) treatments.

Editorial Comment from Dr Takahashi to Electrofulguration in the advanced management of antibiotic-refractory recurrent urinary tract infections in women.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 26 ( 6 ) 668 - 669 2019.06 [International journal]

Selective culture of Escherichia coli to prevent infective complications of transrectal ultrasound-guided prostate biopsy: Clinical efficacy and analysis of characteristics of quinolone-resistant Escherichia coli.

Yoshiki Hiyama, Satoshi Takahashi, Teruhisa Uehara, Koji Ichihara, Jiro Hashimoto, Masanori Matsukawa, Keisuke Taguchi, Yasuharu Kunishima, Hiroshi Hotta, Masahiro Yanase, Naoki Itoh, Takaoki Hirose, Koh Takeyama, Hitoshi Tachiki, Naoya Masumori

International journal of urology : official journal of the Japanese Urological Association 26 ( 6 ) 655 - 660 2019.06 [International journal]

OBJECTIVES: To evaluate a regimen of targeted prophylaxis using rectal swab culture in patients undergoing transrectal ultrasound-guided prostate biopsy, and to investigate the characteristics of isolated fluoroquinolone-resistant Escherichia coli. METHODS: A prospective study was carried out from June 2013 through December 2014. Rectal swabs were cultured on agar plates containing either 2 μg/mL levofloxacin or 1 μg/mL sitafloxacin before transrectal ultrasound-guided prostate biopsy. Patients with susceptible organisms received levofloxacin or sitafloxacin, whereas those with resistant organisms received directed antimicrobial prophylaxis according to the results of the antimicrobial susceptibility test. Patients with infectious complications after prostate biopsy were identified, and characteristics of patients carrying fluoroquinolone-resistant Escherichia coli were analyzed. RESULTS: A total of 397 men underwent transrectal ultrasound-guided prostate biopsy. Of these patients, 74 (18.6%) had fluoroquinolone-resistant Escherichia coli. All fluoroquinolone-resistant Escherichia coli were susceptible to amikacin and meropenem. The risk factor for possible fluoroquinolone-resistant Escherichia coli was age of ≥73 years. Three (0.7%) patients who received appropriate antimicrobial prophylaxis had high-grade fever after the prostate biopsy. However, the pathogens were not fluoroquinolone-resistant Escherichia coli. CONCLUSIONS: Targeted antimicrobial prophylaxis in patients undergoing transrectal ultrasound-guided prostate biopsy can be associated with reducing severe infectious complications caused by fluoroquinolone-resistant Escherichia coli.

Second nationwide surveillance of bacterial pathogens in patients with acute uncomplicated cystitis conducted by Japanese Surveillance Committee from 2015 to 2016: antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.

Hiroshi Hayami, Satoshi Takahashi, Kiyohito Ishikawa, Mitsuru Yasuda, Shingo Yamamoto, Koichiro Wada, Kanao Kobayashi, Ryoichi Hamasuna, Shinichi Minamitani, Tetsuya Matsumoto, Hiroshi Kiyota, Kazuhiro Tateda, Junko Sato, Hideaki Hanaki, Naoya Masumori, Hiroyuki Nishiyama, Jun Miyazaki, Kiyohide Fujimoto, Kazushi Tanaka, Shinya Uehara, Akio Matsubara, Kenji Ito, Kenji Hayashi, Yuichiro Kurimura, Shin Ito, Toshimi Takeuchi, Harunori Narita, Masanobu Izumitani, Hirofumi Nishimura, Motoshi Kawahara, Makoto Hara, Takahide Hosobe, Kenji Takashima, Hirofumi Chokyu, Masaru Matsumura, Hideari Ihara, Satoshi Uno, Koichi Monden, Toru Sumii, Shuichi Kawai, Satoru Kariya, Takashi Sato, Masaru Yoshioka, Hitoshi Kadena, Shinji Matsushita, Shohei Nishi, Yukinari Hosokawa, Takeshi Shirane, Mutsumasa Yoh, Syuji Watanabe, Shinichi Makinose, Tetsuji Uemura, Hirokazu Goto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 25 ( 6 ) 413 - 422 2019.06 [International journal]

The Japanese Surveillance Committee conducted a second nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for acute uncomplicated cystitis (AUC) in premenopausal patients aged 16-40 years old at 31 hospitals throughout Japan from March 2015 to February 2016. In this study, the susceptibility of causative bacteria (Escherichia coli, Klebsiella pneumoniae, Staphylococcus saprophyticus) for various antimicrobial agents was investigated by isolation and culturing of organisms obtained from urine samples. In total, 324 strains were isolated from 361 patients, including E. coli (n = 220, 67.9%), S. saprophyticus (n = 36, 11.1%), and K. pneumoniae (n = 7, 2.2%). The minimum inhibitory concentrations (MICs) of 20 antibacterial agents for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. At least 93% of the E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, whereas 100% of the S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 6.4% (13/220) and 4.1% (9/220), respectively. The antimicrobial susceptibility of K. pneumoniae was retained during the surveillance period, while no multidrug-resistant strains were identified. In summary, antimicrobial susceptibility results of our second nationwide surveillance did not differ significantly from those of the first surveillance. Especially the numbers of fluoroquinolone-resistant and ESBL-producing E. coli strains were not increased in premenopausal patients with AUC in Japan.

Evaluation of Susceptibilities to Carbapenems and Faropenem Against Cephalosporin-Resistant Neisseria gonorrhoeae Clinical Isolates with penA Mosaic Alleles.

Yoshiki Hiyama, Satoshi Takahashi, Toyotaka Sato, Masaaki Shinagawa, Yukari Fukushima, Chie Nakajima, Yasuhiko Suzuki, Naoya Masumori, Shin-Ichi Yokota

Microbial drug resistance (Larchmont, N.Y.) 25 ( 3 ) 427 - 433 2019.04 [International journal]

Neisseria gonorrhoeae is a principal pathogen for sexually transmitted infections, especially for male urethritis. Currently, the prevalence of multidrug resistance is increasing. Carbapenems are broad-spectrum antimicrobials that are widely used in the clinical setting, especially for multidrug-resistant Gram-negative bacteria. However, susceptibility to carbapenems has not been well evaluated for cephalosporin-resistant N. gonorrhoeae isolates. In this study, we determined the susceptibility to a series of carbapenems (meropenem, imipenem, doripenem, and biapenem) and faropenem against cephalosporin-resistant (resistant to cefixime, but susceptible to ceftriaxone) and cephalosporin-susceptible N. gonorrhoeae clinical isolates. The gene mutations associated with β-lactam resistance were evaluated. All cephalosporin-resistant N. gonorrhoeae isolates possessed mosaic mutation alleles in penA (NG-STAR penA-10.001, 27.001, or 108.001). They exhibited a low minimum inhibitory concentration (MIC) (≤0.125 mg/L) for meropenem and markedly high MICs (0.5-2 mg/L) for other carbapenems and faropenem. The strongest association was observed between the mosaic alleles in penA and decreased susceptibility to carbapenems and faropenem compared with mutations in mtrR, porB, and ponA. These results suggest that meropenem may serve as an alternative therapeutic agent for cephalosporin-resistant N. gonorrhoeae with a mosaic allele in penA, whereas other carbapenems and faropenem may be ineffective.

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