研究者詳細 - 髙橋　聡

論文 - 髙橋　聡

分割表示 208 件中 101 - 120 件目／全件表示 >>

Pathogenic Lineage of mcr-Negative Colistin-Resistant Escherichia coli, Japan, 2008-2015.

Toyotaka Sato, Akira Fukuda, Yuuki Suzuki, Tsukasa Shiraishi, Hiroyuki Honda, Masaaki Shinagawa, Soh Yamamoto, Noriko Ogasawara, Masaru Usui, Hiroki Takahashi, Satoshi Takahashi, Yutaka Tamura, Shin-Ichi Yokota

Emerging infectious diseases 22 ( 12 ) 2223 - 2225 2016年12月 [国際誌]

DOI PubMed

A case of infective endocarditis and pyogenic spondylitis after transrectal ultrasound guided prostate biopsy.

Yoshiki Hiyama, Satoshi Takahashi, Teruhisa Uehara, Koji Ichihara, Jiro Hashimoto, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 22 ( 11 ) 767 - 769 2016年11月 [国際誌]

We report a patient with infective endocarditis and pyrogenic spondylitis occurring simultaneously. The patient was a 59-year-old man. He was suspected of having prostate cancer due to a high prostate-specific antigen concentration noted in a checkup. He then underwent a transrectal ultrasound guided prostate biopsy with cefotiam as antimicrobial prophylaxis. He had a fever higher than 38 °C and lumbar pain for a few days after the biopsy. Enterococcus faecalis was isolated from 2 sets of blood culture. Magnetic resonance imaging revealed an abnormal image at C7/Th1 with a signal decrease in T1-weighted sequences and signal increase in T2-weighted sequences that were suspected to be due to bone destruction. Therefore, he was diagnosed as having pyogenic spondylitis by an orthopedist. At the same time, he complained of palpitation and a heart murmur was detected. Then transesophageal echocardiography was performed by a cardiologist and it revealed vegetation in his left ventricle and aortic regurgitation, and finally acute cardiac insufficiency was determined. He was treated with tazobactam/piperacillin and aortic valve displacement surgery. Based on the results of the prostate biopsy and image inspection, he was diagnosed as having localized prostate cancer. He was treated by androgen deprivation therapy and external beam radiation therapy. We have to keep in mind that E. faecalis can be a potential pathogen for severe infectious complications after prostate biopsy, especially if a cephalosporin is selected for antimicrobial prophylaxis.

DOI PubMed

Pulmonary vascular resistance estimated by Doppler echocardiography predicts mortality in patients with interstitial lung disease.

Kenji Yasui, Satoshi Yuda, Kiyoshi Abe, Atsuko Muranaka, Mitsuo Otsuka, Hirofumi Ohnishi, Akiyoshi Hashimoto, Hiroki Takahashi, Kazufumi Tsuchihashi, Hiroki Takahashi, Satoshi Takahashi, Tetsuji Miura

Journal of cardiology 68 ( 4 ) 300 - 7 2016年10月 [国際誌]

BACKGROUND: Pulmonary hypertension (PH) is a strong predictor of mortality in patients with interstitial lung disease (ILD). However, patients with ILD often have poor outcomes even in the absence of PH. Pulmonary vascular resistance (PVR) assessed by right heart catheterization is a predictor of mortality in patients with ILD. However, the clinical utility of PVR assessed by Doppler echocardiography (PVRecho) as a predictor of the outcome in patients with ILD remains unclear. The aim of this study was to examine whether PVRecho independently predicts mortality in patients with ILD. METHODS: Echocardiographic examinations were performed in 133 consecutively enrolled patients with ILD (age, 67±9 years; 53% men). Tricuspid annular plane systolic excursion (TAPSE) was measured, and PVRecho was calculated by the following formula: PVRecho=[TRV×10/time-velocity integral of right ventricular outflow (RVOT-VTI)]+0.16. Data for parameters of pulmonary functional tests and for serum biomarkers, which were measured within 3 months before or after the echocardiographic examinations, were collected. RESULTS: During a mean follow-up period of 18±7 months, 13 patients died due to respiratory failure (n=10), heart failure (n=1), or unknown causes (n=2). In univariate analysis, body mass index, idiopathic pulmonary fibrosis, use of an antifibrotic drug (AD), RVOT-VTI, PVRecho, percentage of predicted vital capacity (%VC), percentage of predicted forced expiratory volume in 1second, and percentage of predicted diffusion capacity of the lungs for carbon monoxide (%DLco), but not TAPSE or serum biomarkers, were significantly associated with mortality. Cox proportional hazard multivariate analysis indicated that %VC [hazard ratio (HR): 0.92, p=0.001], use of AD (HR: 4.05, p=0.043), and PVRecho (HR: 3.79, p=0.029) independently predict mortality in patients with ILD. Replacement of %VC with %DLco in the multivariate analysis did not change the results: %DLco (HR: 0.90, p=0.001), use of AD (HR: 7.53, p=0.029), and PVRecho (HR: 3.65, p=0.020). CONCLUSIONS: In addition to parameters of pulmonary function tests and use of AD, increased PVRecho is an independent predictor of mortality in patients with ILD who were evaluated for screening of PH by echocardiography.

DOI PubMed

Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition.

Shingo Yamamoto, Katsumi Shigemura, Hiroshi Kiyota, Koichiro Wada, Hiroshi Hayami, Mitsuru Yasuda, Satoshi Takahashi, Kiyohito Ishikawa, Ryoichi Hamasuna, Soichi Arakawa, Tetsuro Matsumoto

International journal of urology : official journal of the Japanese Urological Association 23 ( 10 ) 814 - 824 2016年10月 [国際誌]

After publication of the initial version of the Japanese guidelines for urological surgery in 2007, new surgical techniques have been introduced. Furthermore, several important issues, such as criteria for use of single-dose antimicrobial prophylaxis and control of hospitalized infection, were also established, which led to alterations of the methods used for antimicrobial prophylaxis as well as perioperative management. The purpose of antimicrobial prophylaxis is to protect the surgical wound from contamination by normal bacterial flora. Antimicrobial prophylaxis should be based on penicillins with beta-lactamase inhibitors, or first- or second-generation cephalosporins, though penicillins without beta-lactamase inhibitors should not be prescribed because of the high prevalence of antimicrobial resistance. As an adequate intratissue concentration of the antimicrobial at the surgical site should be accomplished by the time of initiation of surgery, antimicrobial prophylaxis should be started up to 30 min before beginning the operation. Antimicrobial prophylaxis should be terminated within 24 h in clean and clean-contaminated surgery, and within 2 days of surgery using the bowels, because a longer duration is a risk factor for surgical site infection development. Importantly, possible risk factors for surgical site infections include the antimicrobial prophylaxis methodology used as well as others, such as duration of preoperative hospitalization, hand washing, the American Society of Anesthesiologists score, diabetes and smoking history. These guidelines are to be applied only for preoperatively non-infected low-risk patients. In cases with preoperative infection or bacteriuria that can cause a surgical site infection or urinary tract infection after surgery, patients must receive adequate preoperative treatment based on the individual situation.

DOI PubMed

Japanese guideline for clinical research of antimicrobial agents on urogenital infections: Second edition.

Mitsuru Yasuda, Tetsuro Muratani, Kiyohito Ishikawa, Hiroshi Kiyota, Hiroshi Sakata, Katsumi Shigemura, Satoshi Takahashi, Ryoichi Hamasuna, Hiroshi Hayami, Hiroshige Mikamo, Shingo Yamamoto, Toyohiko Watanabe, Soichi Arakawa

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 22 ( 10 ) 651 - 61 2016年10月 [国際誌]

DOI PubMed

Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan.

Satoshi Takahashi, Ryoichi Hamasuna, Mitsuru Yasuda, Kiyohito Ishikawa, Hiroshi Hayami, Shinya Uehara, Shingo Yamamoto, Shinichi Minamitani, Junichi Kadota, Satoshi Iwata, Mitsuo Kaku, Akira Watanabe, Junko Sato, Hideaki Hanaki, Naoya Masumori, Hiroshi Kiyota, Shin Egawa, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Hiromi Kumon, Koichiro Wada, Kanao Kobayashi, Akio Matsubara, Tetsuro Matsumoto, Masatoshi Eto, Katsunori Tatsugami, Kentaro Kuroiwa, Kenji Ito, Takahide Hosobe, Hideo Hirayama, Harunori Narita, Takamasa Yamaguchi, Shin Ito, Toru Sumii, Shuichi Kawai, Mototsugu Kanokogi, Hiromi Kawano, Hirofumi Chokyu, Satoshi Uno, Koichi Monden, Shinichi Kaji, Motoshi Kawahara, Kazuo Takayama, Masayasu Ito, Masaru Yoshioka, Motonori Kano, Takatoshi Konishi, Hitoshi Kadena, Shohei Nishi, Hirofumi Nishimura, Takamine Yamauchi, Shinichi Maeda, Masanobu Horie, Hideari Ihara, Masaru Matsumura, Takeshi Shirane, Koh Takeyama, Kikuo Akiyama, Koichi Takahashi, Toshihiro Ikuyama, Hisato Inatomi, Mutsumasa Yoh

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 22 ( 9 ) 581 - 6 2016年09月 [国際誌]

Genital chlamydial infection is a principal sexually transmitted infection worldwide. Chlamydia trachomatis can cause male urethritis, acute epididymitis, cervicitis, and pelvic inflammatory disease as sexually transmitted infections. Fortunately, homotypic resistant C. trachomatis strains have not been isolated to date; however, several studies have reported the isolation of heterotypic resistant strains from patients. In this surveillance study, clinical urethral discharge specimens were collected from patients with urethritis in 51 hospitals and clinics in 2009 and 38 in 2012. Based on serial cultures, the minimum inhibitory concentration (MIC) could be determined for 19 isolates in 2009 and 39 in 2012. In 2009 and 2012, the MICs (MIC90) of ciprofloxacin, levofloxacin, tosufloxacin, sitafloxacin, doxycycline, minocycline, erythromycin, clarithromycin, and azithromycin were 2 μg/ml and 1 μg/ml, 0.5 μg/ml and 0.5 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.063 μg/ml and 0.063 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.125 μg/ml and 0.125 μg/ml, 0.016 μg/ml and 0.016 μg/ml, and 0.063 μg/ml and 0.063 μg/ml, respectively. In summary, this surveillance project did not identify any resistant strain against fluoroquinolone, tetracycline, or macrolide agents in Japan.

DOI PubMed

Editorial Comment to Novel strategy for cystitis glandularis: Oral treatment with cyclooxygenase-2 inhibitor.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 23 ( 8 ) 709 - 709 2016年08月 [国際誌]

DOI PubMed

Incidence and risk factors for acute kidney injury after radical cystectomy.

Yoshinori Ikehata, Toshiaki Tanaka, Koji Ichihara, Ko Kobayashi, Hiroshi Kitamura, Satoshi Takahashi, Naoya Masumori

International journal of urology : official journal of the Japanese Urological Association 23 ( 7 ) 558 - 63 2016年07月 [国際誌]

OBJECTIVES: To clarify the incidence, risk factors and clinical impact of acute kidney injury after radical cystectomy. METHODS: A total of 210 patients who underwent radical cystectomy at Sapporo Medical University Hospital, Sapporo, Japan, from January 2006 through December 2012 were evaluated. The incidence of acute kidney injury was evaluated over the first 7 days postoperatively, during which time a ureteral catheter was inserted. Risk factors for postoperative acute kidney injury and its impacts on short-term clinical outcomes were evaluated. RESULTS: Finally, 145 patients were eligible for this study. Postoperative acute kidney injury was observed in 48 patients (33.1%), with stages 1, 2, and 3 found in 33 (22.7%), 14 (9.6%) and 1 (0.7%), respectively. All patients with stage 1 and 2 acute kidney injury recovered by postoperative day 7, except for one with stage 1. Hypertension (P < 0.001), preoperative estimated glomerular filtration rate <60 mL/min/1.73 m(2) (P = 0.04) and neoadjuvant chemotherapy (P = 0.03) were independent risk factors for postoperative acute kidney injury. Furthermore, postoperative acute kidney injury was an independent risk factor for acute kidney injury after ureteral stent removal, but not of persistent elevated serum creatinine, prolonged hospital stay or the new onset of cardiovascular disorders during the hospital stay. CONCLUSIONS: The incidence of acute kidney injury after radical cystectomy is relatively high, although most cases are low grade and can be resolved. We should be aware of the risk for postoperative acute kidney injury, especially in patients who have comorbid hypertension, impaired renal function and received naoadjuvant chemotherapy.

DOI PubMed

Incidence and risk factors for acute kidney injury after radical cystectomy

Yoshinori Ikehata, Toshiaki Tanaka, Koji Ichihara, Ko Kobayashi, Hiroshi Kitamura, Satoshi Takahashi, Naoya Masumori

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY-BLACKWELL ) 23 ( 7 ) 558 - 563 2016年07月 [査読有り] [国際誌]

Objectives: To clarify the incidence, risk factors and clinical impact of acute kidney injury after radical cystectomy. Methods: A total of 210 patients who underwent radical cystectomy at Sapporo Medical University Hospital, Sapporo, Japan, from January 2006 through December 2012 were evaluated. The incidence of acute kidney injury was evaluated over the first 7 days postoperatively, during which time a ureteral catheter was inserted. Risk factors for postoperative acute kidney injury and its impacts on short-term clinical outcomes were evaluated. Results: Finally, 145 patients were eligible for this study. Postoperative acute kidney injury was observed in 48 patients (33.1%), with stages 1, 2, and 3 found in 33 (22.7%), 14 (9.6%) and 1 (0.7%), respectively. All patients with stage 1 and 2 acute kidney injury recovered by postoperative day 7, except for one with stage 1. Hypertension (P < 0.001), preoperative estimated glomerular filtration rate <60 mL/min/1.73 m(2) (P = 0.04) and neoadjuvant chemotherapy (P = 0.03) were independent risk factors for postoperative acute kidney injury. Furthermore, postoperative acute kidney injury was an independent risk factor for acute kidney injury after ureteral stent removal, but not of persistent elevated serum creatinine, prolonged hospital stay or the new onset of cardiovascular disorders during the hospital stay. Conclusions: The incidence of acute kidney injury after radical cystectomy is relatively high, although most cases are low grade and can be resolved. We should be aware of the risk for postoperative acute kidney injury, especially in patients who have comorbid hypertension, impaired renal function and received naoadjuvant chemotherapy.

DOI PubMed

[The Study of a New Formula for Correcting Serum Calcium Levels, Considering the Difference in Albumin Analysis Methods].

Makito Tanaka, Yusuke Takahashi, Yoshifumi Umemori, Koichi Asanuma, Satoshi Takahashi

Rinsho byori. The Japanese journal of clinical pathology 64 ( 6 ) 619 - 624 2016年06月 [国内誌]

In Japan, Payne's formula [corrected Ca=total Ca+ (4-ALB)] has been used to correct serum calcium concentration levels. However, the current methods for measuring calcium and albumin differ from those that were used to establish the Payne's formula. For albumin measurement, particularly, values differ be- tween BCG and improved BCP method. In 2014, Ohba et al. reported a modified formula [corrected Ca= total Ca+0.7X (4-ALB)], which is more suitable for correcting calcium with the improved BCP method than with the Payne's method. In the same year, the recommendation for converting albumin concentration with the improved BCP method to that with the BCG method was presented by the Japanese Society of La- boratory Medicine. Thus, we conceived a new modified formula [corrected Ca=total Ca+ {4- (BCP+ 0.3) }], which is included in the contents of this recommendation, and examined the effects of this formula in comparison with the Payne and Ohba methods. The patients recruited for the calcium adjustment were as follows: (i) all patients; (ii) patients with albumin concentrations <4.0 g/dL; and (iii) patients with albumin concentrations ≤3.5 g/dL. Payne's formula overcorrected calcium with the improved BCP method. Ohba's method was suitable for (i), while the new for- mula was specifically more suitable for (iii) than the Payne and Ohba formulas. The present study showed that our new formula is more suitable for calcium adjustment in patients with albumin concentrations ≤3.5 g/dL. [Original].

PubMed

Serum procalcitonin level in chronic hemodialytic patients with no evidence of bacterial infection

Koji Ichihara, Toshiaki Tanaka, Satoshi Takahashi, Masanori Matsukawa, Masahiro Yanase, Hiroshi Kitamura, Naoya Masumori

Renal Replacement Therapy ( BioMed Central Ltd. ) 2 ( 1 ) 2016年03月

Background: The baseline levels of serum procalcitonin (PCT) have not been determined in patients with endstage renal disease needing renal replacement therapy. The purpose of the present study is to verify the reference range of PCT and parameters affecting its value in patients receiving chronic hemodialysis. Methods: A total of 125 dialytic patients who had no obvious clinical signs of systemic infection were included in this prospective observational study. The PCT level was measured, and its relationships to other clinical and laboratory parameters were evaluated. Results: The baseline PCT levels of 82 male and 43 female patients were evaluated. Mean baseline PCT level was 0.24 ± 0.22 ng/ml. Sixteen (12.8 %) patients showed elevated PCT (> 0.3 ng/ml) and Creactive protein (CRP) (> 0.3 mg/dl), and 11 (8.8 %) patients showed only abnormal PCT. In 9 patients (7.2 %), PCT levels exceeded 0.5 ng/ml, which is a common cutoff point for sepsis although they had no clinical signs of systemic bacterial infection. The PCT level was statistically correlated with the duration of chronic dialysis, urine volume per day, dialysis time, the serum CRP, β2microglobulin levels, and normalized dialysis dose. Conclusions: Most dialysis patients had PCT levels within the reference range of nondialytic individuals. However, a not negligible number of patients had higher PCT levels than the upper limit of healthy individuals, despite there being no sign of infection. Impairment of renal function and hemodialytic status may affect PCT level.

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A characteristic of polymorphic membrane protein F of Chlamydia trachomatis isolated from male urogenital tracts in Japan.

Tomohiro Yamazaki, Junji Matsuo, Satoshi Takahashi, Shouta Kumagai, Tomoko Shimoda, Kiyotaka Abe, Kunihiro Minami, Hiroyuki Yamaguchi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 12 ) 842 - 8 2015年12月 [国際誌]

Although sexually transmitted disease due to Chlamydia trachomatis occurs similarly in both men and women, the female urogenital tract differs from that of males anatomically and physiologically, possibly leading to specific polymorphisms of the bacterial surface molecules. In the present study, we therefore characterized polymorphic features in a high-definition phylogenetic marker, polymorphic outer membrane protein (Pmp) F of C. trachomatis strains isolated from male urogenital tracts in Japan (Category: Japan-males, n = 12), when compared with those isolated from female cervical ducts in Japan (Category: Japan-females, n = 11), female cervical ducts in the other country (Category: Ref-females, n = 12) or homosexual male rectums in the other country (Category: Ref-males, n = 7), by general bioinformatics analysis tool with MAFFT software. As a result, phylogenetic reconstruction of the PmpF amino acid sequences showing three distinct clusters revealed that the Japan-males were limited into cluster 1 and 2, although there were only four clusters even though including an outgroup. Meanwhile, the phylogenetic distance values of PmpF passenger domain without hinge region, but not its full-length sequence, showed that the Japan-males were more stable and displayed less diversity when compared with the other categories, supported by the sequence conservation features. Thus, PmpF passenger domain is a useful phylogenetic maker, and the phylogenic features indicate that C. trachomatis strains isolated from male urogenital tracts in Japan may be unique, suggesting an adaptation depending on selective pressure, such as the presence or absence of microbial flora, furthermore possibly connecting to sexual differentiation.

DOI PubMed

Draft Genome Sequence of Chlamydia trachomatis Strain 54, Isolated from the Urogenital Tract of a Male in Japan.

Tomohiro Yamazaki, Junji Matsuo, Momoka Kikuchi, Kentaro Miyamoto, Kentaro Oka, Motomichi Takahashi, Satoshi Takahashi, Torahiko Okubo, Hiroyuki Yamaguchi

Genome announcements 3 ( 5 ) 2015年10月 [国際誌]

DOI PubMed

Emergence of antimicrobial-resistant uropathogens isolated from pediatric patients with cystitis on daily clean intermittent catheterization

Yoshiki Hiyama, Satoshi Takahashi, Teruhisa Uehara, Jiro Hashimoto, Kazuyuki Nishinaka, Hiroshi Kitamura, Naoya Masumori

Journal of Infection and Chemotherapy ( Elsevier ) 21 ( 10 ) 703 - 706 2015年10月

One of the major complications of clean intermittent catheterization (CIC) is urinary tract infection (UTI). Recent reports showed that community-acquired UTIs caused by antimicrobial-resistant pathogens were gradually presenting in adults. However, there have been few reports about UTIs caused by antimicrobial-resistant bacteria in pediatric patients. Therefore, we retrospectively reviewed the medical charts of 45 children with CIC due to neurogenic bladder dysfunction from January 2010 to March 2013. Sixty-two episodes of cystitis occurred in 27 patients. Seventy bacterial strains were isolated from urine samples. The rate of Gram-negative bacteria was 84.3%. Six extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) strains were isolated from 4 patients. An ESBL-producing Proteus mirabilis strain and a methicillin-resistant Staphylococcus aureus strain were isolated from one patient each. Most of the pathogens of cystitis in the pediatric patients with CIC were Gram-negative bacilli, especially E. coli. We should be aware that ESBL producing E. coli as potential pathogens cause cystitis and regularly survey antimicrobial susceptibility to understand the resistant strains that develop.

DOI PubMed

Clinical analysis of febrile neutropenia in urological anticancer chemotherapy: retrospective single center study.

Naotaka Nishiyama, Satoshi Takahashi, Takahiro Mizuno, Teruhisa Uehara, Jiro Hashimoto, Yuichirou Kurimura, Naoya Masumori

International journal of clinical oncology 20 ( 5 ) 1012 - 7 2015年10月 [国内誌]

OBJECTIVES: The aims of this study were to clarify the frequency and prognosis of febrile neutropenia (FN) in patients who received urological anticancer chemotherapy. METHODS: Between May 2005 and January 2010, 141 patients underwent urological anticancer chemotherapy at the Sapporo Medical University Hospital, Sapporo, Japan. They consisted of 124 men and 17 women aged 62 (range 16-80) years. The patients underwent a total of 626 treatment courses of urological anticancer chemotherapy. RESULTS: Of the 626 urological anticancer chemotherapy courses, grades 3 and 4 neutropenia occurred in 451 (72.0 %) courses. FN developed in 57 (9.1 %) courses in which 7 (12.3 %) and 50 (87.7 %) patients were classified as high risk and low risk, respectively, according to the Multinational Association for Supportive Care in Cancer (MASCC) risk index scoring system. There was no anticancer chemotherapy-related death in either the high- or low-risk group. The frequencies of bacteria isolated from courses with FN were 0 and 10.0 % for the high- and low-risk groups, respectively. CONCLUSIONS: According to the MASCC scoring system, there were fewer patients in the high-risk group than in the low-risk group in this study. There were no cases of anticancer chemotherapy-related death in either group. Therefore, urological anticancer chemotherapy can be conducted safely with the proper management of neutropenia and FN.

DOI PubMed

Japanese nationwide surveillance in 2011 of antibacterial susceptibility patterns of clinical isolates from complicated urinary tract infection cases.

Kiyohito Ishikawa, Ryoichi Hamasuna, Shinya Uehara, Mitsuru Yasuda, Shingo Yamamoto, Hiroshi Hayami, Satoshi Takahashi, Tetsuro Matsumoto, Shinichi Minamitani, Jun-ichi Kadota, Satoshi Iwata, Mitsuo Kaku, Akira Watanabe, Keisuke Sunakawa, Junko Sato, Hideaki Hanaki, Taiji Tsukamoto, Hiroshi Kiyota, Shin Egawa, Takashi Deguchi, Minori Matsumoto, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Hironobu Wakeda, Yoshinosuke Amemoto, Shoichi Onodera, Hirokazu Goto, Hisao Komeda, Masuo Yamashita, Tadasu Takenaka, Yoshinori Fujimoto, Masaya Tsugawa, Yoshito Takahashi, Hiroshi Maeda, Hiroyuki Onishi, Satoshi Ishitoya, Kazuo Nishimura, Kenji Mitsumori, Toru Ito, Yoshikazu Togo, Ichiro Nakamura, Noriyuki Ito, Sojun Kanamaru, Takaoki Hirose, Takashi Muranaka, Daisuke Yamada, Satoshi Ishihara, Hiroya Oka, Hisato Inatomi, Takashi Matsui, Makoto Kobuke, Yasuharu Kunishima, Takahiro Kimura, Takaharu Ichikawa, Ichiro Kagara, Masanori Matsukawa, Koichi Takahashi, Koji Mita, Masao Kato, Kazuhiro Okumura, Hiroaki Kawanishi, Takayuki Hashimura, Teruyoshi Aoyama, Masanobu Shigeta, Shuntaro Koda, Keisuke Taguchi, Yohei Matsuda

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 9 ) 623 - 33 2015年09月 [国際誌]

To investigate antimicrobial susceptibility patterns of various bacterial pathogens isolated from complicated urinary tract infection (UTI) cases, the Japanese Society of Chemotherapy, the Japanese Association of Infectious Disease, and the Japanese Society of Clinical Microbiology conducted the second nationwide surveillance from January to September 2011. With the cooperation of 42 medical institutions throughout Japan, 1036 strains belonging to 8 clinically relevant bacterial species were collected. Among methicillin-resistant Staphylococcus aureus (MRSA) strain, the vancomycin (VCM) MIC for 5.5% (3/55) of the strains was 2 μg/mL. Ampicillin, VCM, and linezolid were relatively active against 209 Enterococcus faecalis strains. The proportion of fluoroquinolone (FQ)-resistant strains was >20%. The MIC90 of FQs against the 382 Escherichia coli strains was 2-64 mg/L and the proportion resistant to FQs was approximately 30%. However, susceptibility of E. coli to sitafloxacin was still high (MIC90 = 2 mg/L). Fifty-eight (15.2%) of 382 E. coli, 6 (4.5%) of 132 Klebsiella pneumoniae, 1 (2.4%) of 41 Klebsiella oxytoca and 4 (6.8%) of 59 Proteus mirabilis strains were suspected of producing extended-spectrum beta-lactamase. Of 93 Pseudomonas aeruginosa strains, the proportions resistant to imipenem, amikacin, and ciprofloxacin were 21.5%, 4.3%, and 20.4%, respectively. Four strains (4.3%) were found to be multidrug-resistant. In complicated UTI cases, all of MRSA and E. faecalis were susceptible to all anti-MRSA agents. Sitafloxacin was active against other FQ-resistant E. coli strains. The isolation of extended-spectrum beta-lactamase-producing and multidrug-resistant strains increased.

DOI PubMed

Serum cystatin C can be used as a marker of renal function even in patients with intestinal urinary diversion.

Masahiro Matsuki, Toshiaki Tanaka, Takeshi Maehana, Koji Ichihara, Masahiro Yanase, Masanori Matsukawa, Hideki Adachi, Satoshi Takahashi, Naoya Masumori

Asian journal of urology 2 ( 3 ) 167 - 169 2015年07月 [国際誌]

OBJECTIVE: Recently, serum cystatin C (CysC) has been used as a novel marker of renal function. However, there is a lack of data on CysC levels in patients with intestinal urinary diversion (UD). Here we report CysC levels in such patients. METHODS: We prospectively observed 38 patients who were diagnosed with bladder cancer and subsequently treated with radical cystectomy and UD at our institution in 2012 and 2013. Serum creatinine (sCr) and CysC were obtained optionally at the same time at least 1 month after radical cystectomy and UD. RESULTS: The median CysC and sCr concentrations were 1.12 mg/L (range 0.75-2.47 mg/L) and 0.99 mg/dL (range 0.61-2.22 mg/dL), respectively. The median estimated concentrations of glomerular filtration rate (GFR) based on CysC (eGFRcys) and GFR based on creatinine (eGFRcreat) were 61.08 mL/min/1.73 m2 (range 22.64-99.89 mL/min/1.73 m2) and 58.01 mL/min/1.73 m2 (range 23.48-91.82 mL/min/1.73 m2), respectively. CysC had a significant correlation with sCr (r = 0.8607, p < 0.0001) and eGFRcreat (r = -0.8993, p < 0.0001). eGFRcys also had a significant correlation with eGFRcreat (r = 0.8104, p < 0.0001). CONCLUSION: The correlation between CysC and sCr was strong and the correlation coefficient was equivalent to that in patients without UD. The results suggest that CysC is not affected by UD and can be used as a marker of renal function similarly to sCr in patients with UD.

DOI PubMed

Serum antimicrobial concentrations for surgical antimicrobial prophylaxis in radical nephrectomy and radical prostatectomy.

Satoshi Takahashi, Koji Ichihara, Kohei Hashimoto, Yoshiki Hiyama, Takashi Muranaka, Jiro Hashimoto, Fumimasa Fukuta, Ko Kobayashi, Yukitoshi Niiyama, Michiaki Yamakage, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 6 ) 464 - 7 2015年06月 [国際誌]

To evaluate the current methods of surgical antimicrobial prophylaxis from the viewpoint of pharmacokinetics for patients undergo urologic surgery, this study was designed to measure the serum concentrations of two different prophylactic antimicrobial agents in different types of urologic surgery. This prospective study included 39 patients with prostate cancer, renal pelvic cancer, ureteral cancer or renal cancer treated by radical surgery from August 2005 to March 2006. Blood samples were taken intraoperatively at 30 min and 180 min after the beginning of the first administration. The half-life of the beta phase of cefazolin is 2.46 h and that of piperacillin is 0.7 h according to their manufacturers. The average serum concentration of cefazolin at 30 min was 144 μg/mL in the prostatectomy group and 175 μg/mL in the nephrectomy group. At 180 min, the average concentration of cefazolin was 37 μg/mL in prostatectomy group and 59 μg/mL in the nephrectomy group. The average concentration of piperacillin at 30 min was 134 μg/mL in the prostatectomy group and 137 μg/mL in the nephrectomy group. At 180 min, the average concentration of piperacillin was 10 μg/mL in the prostatectomy group and 22 μg/mL in the nephrectomy group. Thus, the concentration at 180 min after the beginning of infusion was different according to the half-life of each antimicrobial agent. Therefore, up-to-date guidelines for surgical antimicrobial prophylaxis that deal with additional types of intraoperative prophylaxis should be consulted if the operation exceeds two half-lives of the prophylactic antimicrobial agents used in real-life clinical practice.

DOI PubMed

The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013.

Ryoichi Hamasuna, Mitsuru Yasuda, Kiyohito Ishikawa, Shinya Uehara, Hiroshi Hayami, Satoshi Takahashi, Tetsuro Matsumoto, Shingo Yamamoto, Shinichi Minamitani, Akira Watanabe, Satoshi Iwata, Mitsuo Kaku, Junichi Kadota, Keisuke Sunakawa, Junko Sato, Hideaki Hanaki, Taiji Tsukamoto, Hiroshi Kiyota, Shin Egawa, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Seiji Naito, Kentaro Kuroiwa, Hideo Hirayama, Harunori Narita, Takahide Hosobe, Shin Ito, Kenji Ito, Shuichi Kawai, Masayasu Ito, Hirofumi Chokyu, Masaru Matsumura, Masaru Yoshioka, Satoshi Uno, Koichi Monden, Kazuo Takayama, Shinichi Kaji, Motoshi Kawahara, Toru Sumii, Hitoshi Kadena, Takamasa Yamaguchi, Shinichi Maeda, Shohei Nishi, Hirofumi Nishimura, Takeshi Shirane, Mutsumasa Yoh, Kikuo Akiyama, Toshio Imai, Motonori Kano

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 5 ) 340 - 5 2015年05月 [国際誌]

Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 μg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 μg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 μg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 μg/ml.

DOI PubMed

膀胱におけるサーファクタント蛋白質Aの発現と尿路病原性大腸菌に対する感染防御機構

橋本次朗, 高橋聡, 舛森直哉, 有木茂, 高宮里奈, 高橋素子, 黒木由夫, 上原康昭, 長谷川善弘

泌尿器外科 ( 医学図書出版(株) ) 28 ( 5 ) 1001 - 1002 2015年05月

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