Details of a Researcher - TAKAHASHI Satoshi

Papers - TAKAHASHI Satoshi

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Rapid and Integrated Bacterial Evolution Analysis unveils gene mutations and clinical risk of Klebsiella pneumoniae.

Kojiro Uemura, Toyotaka Sato, Soh Yamamoto, Noriko Ogasawara, Jirachaya Toyting, Kotaro Aoki, Akira Takasawa, Masayuki Koyama, Atsushi Saito, Takayuki Wada, Kaho Okada, Yurie Yoshida, Koji Kuronuma, Chie Nakajima, Yasuhiko Suzuki, Motohiro Horiuchi, Kenichi Takano, Satoshi Takahashi, Hirofumi Chiba, Shin-Ichi Yokota

Nature communications 16 ( 1 ) 2917 - 2917 2025.03 [International journal]

Bacteria continually evolve. Previous studies have evaluated bacterial evolution in retrospect, but this approach is based on only speculation. Cohort studies are reliable but require a long duration. Additionally, identifying which genetic mutations that have emerged during bacterial evolution possess functions of interest to researchers is an exceptionally challenging task. Here, we establish a Rapid and Integrated Bacterial Evolution Analysis (RIBEA) based on serial passaging experiments using hypermutable strains, whole-genome and transposon-directed sequencing, and in vivo evaluations to monitor bacterial evolution in a cohort for one month. RIBEA reveals bacterial factors contributing to serum and antimicrobial resistance by identifying gene mutations that occurred during evolution in the major respiratory pathogen Klebsiella pneumoniae. RIBEA also enables the evaluation of the risk for the progression and the development of invasive ability from the lung to blood and antimicrobial resistance. Our results demonstrate that RIBEA enables the observation of bacterial evolution and the prediction and identification of clinically relevant high-risk bacterial strains, clarifying the associated pathogenicity and the development of antimicrobial resistance at genetic mutation level.

DOI PubMed

Traces of pandemic fluoroquinolone-resistant Escherichia coli clone ST131 transmitted from human society to aquatic environments and wildlife in Japan

Toyotaka Sato, Kojiro Uemura, Mitsuru Yasuda, Aiko Maeda, Toshifumi Minamoto, Kazuki Harada, Michiyo Sugiyama, Shiori Ikushima, Shin-ichi Yokota, Motohiro Horiuchi, Satoshi Takahashi, Testuo Asai

One Health ( Elsevier BV ) 18 100715 - 100715 2024.06 [Refereed] [International journal]

Transmission of antimicrobial-resistant bacteria among humans, animals, and the environment is a growing concern worldwide. The distribution of an international high-risk fluoroquinolone-resistant Escherichia coli clone, ST131, has been documented in clinical settings. However, the transmission of ST131 from humans to surrounding environments remains poorly elucidated. To comprehend the current situation and identify the source of ST131 in nature, we analyzed the genetic features of ST131 isolates from the aquatic environment (lake/river water) and wildlife (fox, raccoon, raccoon dog, and deer) and compared them with the features of isolates from humans in Japan using accessory and core genome single nucleotide polymorphism (SNP) analyses. We identified ST131 isolates belonging to the same phylotype and genome clusters (four of eight clusters were concomitant) with low SNP distance between the human isolates and those from the aquatic environment and wildlife. These findings warn of ST131 transmission between humans and the surrounding environment in Japan.

DOI PubMed

JANISでは把握が困難な中小規模病院における緑膿菌の薬剤耐性の状況

藤谷好弘, 富樫篤生, 齋藤充史, 黒沼幸治, 高橋聡

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 ( 日本感染症学会・日本化学療法学会 ) 98回・72回 np255 - np255 2024.05

当院改修時におけるアスペルギルス対策の評価

黒沼幸治, 中江舞美, 韮澤慎也, 富樫篤生, 藤谷好弘, 齋藤充史, 高橋聡

感染症学雑誌 ( (一社)日本感染症学会 ) 98 ( 2 ) 281 - 281 2024.03

当院改修時におけるアスペルギルス対策の評価

黒沼幸治, 中江舞美, 韮澤慎也, 富樫篤生, 藤谷好弘, 齋藤充史, 高橋聡

感染症学雑誌 ( (一社)日本感染症学会 ) 98 ( 2 ) 281 - 281 2024.03

Affinity of β-Lactam Antibiotics for Neisseria gonorrhoeae Penicillin-Binding Protein 2 Having Wild, Cefixime-Reduced-Susceptible, and Cephalosporin (Ceftriaxone)-Resistant penA Alleles.

Yoshiki Hiyama, Soh Yamamoto, Toyotaka Sato, Noriko Ogasawara, Naoya Masumori, Satoshi Takahashi, Shin-Ichi Yokota

Microbial drug resistance (Larchmont, N.Y.) 2024.01 [International journal]

Multidrug-resistant Neisseria gonorrhoeae is a serious concern worldwide. Resistance to β-lactam antibiotics occurs through mutations in penicillin-binding proteins (PBPs), acquisition of β-lactamases, and alteration of antibiotic penetration. Mosaic structures of penA, which encodes PBP2, play a major role in resistance to β-lactams, especially cephalosporins. Ceftriaxone (CRO) is recognized as the only satisfiable antibiotic for the treatment of gonococcal infections; however, CRO-resistant isolates have emerged in the community. Here, we examined the affinity of β-lactam antibiotics for recombinant PBP2 in a competition assay using fluorescence-labeled penicillin. We found no or little difference in the affinities of penicillins and meropenem (MEM) for PBP2 from cefixime (CFM)-reduced-susceptible strain and cephalosporin-resistant strain. However, the affinity of cephalosporins, including CRO, for PBP2 from the cephalosporin-resistant strain was markedly lower than that for PBP2 from the CFM-reduced-susceptible-resistant strain. Notably, piperacillin (PIP) showed almost the same affinity for PBP2 from penicillin-susceptible, CFM-reduced-susceptible, and cephalosporin (including CRO)-resistant strains. Thus, PIP/tazobactam and MEM are candidate antibiotics for the treatment of CRO-resistant/multidrug-resistant N. gonorrhoeae.

DOI PubMed

手洗器の水栓口や給水システムの汚染による緑膿菌の感染伝播

藤谷好弘, 中江舞美, 佐藤勇樹, 韮澤慎也, 富樫篤生, 齋藤充史, 黒沼幸治, 高橋聡

感染症学雑誌 ( (一社)日本感染症学会 ) 98 ( 1 ) 119 - 119 2024.01

手洗器の水栓口や給水システムの汚染による緑膿菌の感染伝播

藤谷好弘, 中江舞美, 佐藤勇樹, 韮澤慎也, 富樫篤生, 齋藤充史, 黒沼幸治, 高橋聡

感染症学雑誌 ( (一社)日本感染症学会 ) 98 ( 1 ) 119 - 119 2024.01

Tazobactam/ceftolozane and tobramycin combination therapy in extensively drug-resistant Pseudomonas aeruginosa infections in severe burn injury: a case report.

Yuta Ibe, Ryuichiro Kakizaki, Hirotoshi Inamura, Tomoyuki Ishigo, Yoshihiro Fujiya, Hiroyuki Inoue, Shuji Uemura, Satoshi Fujii, Satoshi Takahashi, Eichi Narimatsu, Masahide Fukudo

Journal of pharmaceutical health care and sciences 9 ( 1 ) 25 - 25 2023.08 [International journal]

BACKGROUND: Combination therapy with tazobactam/ceftolozane (TAZ/CTLZ) and high-dose aminoglycosides has been reported to be efficacious in extensively drug-resistant (XDR)-Pseudomonas aeruginosa infection. However, there are no reports of efficacy in XDR-P. aeruginosa infection for combination therapy with low-dose aminoglycosides and TAZ/CTLZ. Herein, we describe a rare case of severe burn injury patients with persistent bacteremia due to XDR-P. aeruginosa, which was successfully treated with TAZ/CTLZ and low-dose tobramycin (TOB). CASE PRESENTATION: A 31-year-old man was admitted to the intensive care unit with severe burn injury involving 52% of the total body surface area and a prognostic burn index of 79.5. The patient had recurrent bacterial infections since admission, and blood cultures collected on the 37th day of admission revealed the presence of P. aeruginosa strains that were resistant to all β-lactams and amikacin (AMK). The results of the antimicrobial synergistic study showed no synergistic effect of low-dose meropenem (MEPM) and AMK combination therapy. The patient had acute renal failure, and it was difficult to increase the dose of MEPM and AMK, respectively. Thus, we initiated TAZ/CTLZ 1.5 g/8 h instead of the AMK and MEPM combination therapy on the 43rd day of hospitalization. Low-dose TAZ/CTLZ was continued because of prolonged renal dysfunction and resulted in a transient clinical improvement. However, the dosage of TAZ/CTLZ could be increased as the renal function improved, but despite an increased TAZ/CTLZ dose, bacteremia persisted, and the blood cultures remained positive. Thus, TOB was added to TAZ/CTLZ at low doses for synergistic effect against Gram-negative bacteria. Blood cultures collected after initiation of combination therapy with TAZ/CTLZ and low-dose TOB were negative on two consecutive follow-up evaluations. Thereafter, although the patient had several episodes of fever and increased inflammatory response, blood cultures consistently tested negative, and all of the wounds healed. On the 93rd day, due to the good healing progress, the patient was transferred to another hospital. CONCLUSIONS: TAZ/CTLZ and low-dose TOB combination therapy showed the potential for synergistic effects. Our present report suggests a novel synergistic treatment strategy for rare cases that are refractory to the treatment of infections, such as XDR-P. aeruginosa infection.

DOI PubMed

Factors affecting the sensitivity of quantitative severe acute respiratory syndrome coronavirus 2 antigen test.

Yuki Sato, Ryosei Murai, Ryo Kobayashi, Atsuo Togashi, Yoshihiro Fujiya, Koji Kuronuma, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 29 ( 8 ) 754 - 758 2023.08 [International journal]

INTRODUCTION: The accuracy of nucleic acid amplification tests (NAATs) is affected by various factors; however, studies examining the factors affecting the accuracy of quantitative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen test (QAT) are limited. METHODS: A total of 347 nasopharyngeal samples were collected from patients with coronavirus disease 2019 (COVID-19), and the date of onset was obtained from the electronic medical records. The SARS-CoV-2 antigen level was measured using Lumipulse Presto SARS-CoV-2 Ag (Presto), while NAAT was performed using the Ampdirect 2019-nCoV Detection Kit. RESULTS: Presto had a sensitivity rate of 95.1% (95% confidence interval: 92.8-97.4) in detecting the SARS-CoV-2 antigen in 347 samples. The number of days from symptom onset to sample collection was negatively correlated with the amount of antigen (r = -0.515) and sensitivity of Presto (r = -0.711). The patients' age was lower in the Presto-negative samples (median age, 39 years) compared with that in the Presto-positive samples (median age, 53 years; p < 0.01). A significant positive correlation was observed between age (excluding teenagers) and Presto sensitivity (r = 0.764). Meanwhile, no association was found between the mutant strain, sex, and Presto results. CONCLUSION: Presto is useful for the accurate diagnosis of COVID-19 owing to its high sensitivity when the number of days from symptom onset to sample collection is within 12 days. Furthermore, age may affect the results of Presto, and this tool has a relatively low sensitivity in younger patients.

DOI PubMed

High prevalence of colistin heteroresistance in specific species and lineages of Enterobacter cloacae complex derived from human clinical specimens.

Shota Fukuzawa, Toyotaka Sato, Kotaro Aoki, Soh Yamamoto, Noriko Ogasawara, Chie Nakajima, Yasuhiko Suzuki, Motohiro Horiuchi, Satoshi Takahashi, Shin-Ichi Yokota

Annals of clinical microbiology and antimicrobials 22 ( 1 ) 60 - 60 2023.07 [International journal]

BACKGROUND: Colistin (CST) is a last-line drug for multidrug-resistant Gram-negative bacterial infections. CST-heteroresistant Enterobacter cloacae complex (ECC) has been isolated. However, integrated analysis of epidemiology and resistance mechanisms based on the complete ECC species identification has not been performed. METHODS: Clinical isolates identified as "E. cloacae complex" by MALDI-TOF MS Biotyper Compass in a university hospital in Japan were analyzed. Minimum inhibitory concentrations of CST were determined by the broth microdilution method. The population analysis profiling (PAP) was performed for detecting the heteroresistant phenotype. The heat shock protein 60 (hsp60) cluster was determined from its partial nucleotide sequence. From the data of whole-genome sequencing, average nucleotide identity (ANI) for determining ECC species, multilocus sequence type, core genome single-nucleotide-polymorphism-based phylogenetic analysis were performed. phoPQ-, eptA-, and arnT-deleted mutants were established to evaluate the mechanism underlying colistin heteroresistance. The arnT mRNA expression levels were determined by reverse transcription quantitative PCR. RESULTS: Thirty-eight CST-resistant isolates, all of which exhibited the heteroresistant phenotype by PAP, were found from 138 ECC clinical isolates (27.5%). The prevalence of CST-resistant isolates did not significantly differ among the origin of specimens (29.0%, 27.8%, and 20.2% for respiratory, urine, and blood specimens, respectively). hsp60 clusters, core genome phylogeny, and ANI revealed that the CST-heteroresistant isolates were found in all or most of Enterobacter roggenkampii (hsp60 cluster IV), Enterobacter kobei (cluster II), Enterobacter chuandaensis (clusters III and IX), and Enterobacter cloacae subspecies (clusters XI and XII). No heteroresistant isolates were found in Enterobacter hormaechei subspecies (clusters VIII, VI, and III) and Enterobacter ludwigii (cluster V). CST-induced mRNA upregulation of arnT, which encodes 4-amino-4-deoxy-L-arabinose transferase, was observed in the CST-heteroresistant isolates, and it is mediated by phoPQ pathway. Isolates possessing mcr-9 and mcr-10 (3.6% and 5.6% of total ECC isolates, respectively) exhibited similar CST susceptibility and PAP compared with mcr-negative isolates. CONCLUSIONS: Significant prevalence (approximately 28%) of CST heteroresistance is observed in ECC clinical isolates, and they are accumulated in specific species and lineages. Heteroresistance is occurred by upregulation of arnT mRNA induced by CST. Acquisition of mcr genes contributes less to CST resistance in ECC.

DOI PubMed

Colistin-resistant bacteria poses few risks under physiological conditions

Soh Yamamoto, Masaru Usui, Noriko Ogasawara, Wataru Hayashi, Masato Suzuki, Noriyuki Nagano, Chie Nakajima, Yasuhiko Suzuki, Motohiro Horiuchi, Satoshi Takahashi, Shin-ichi Yokota, Yutaka Tamura, Toyotaka Sato

Research Square ( Research Square Platform LLC ) 2023.06

Abstract Globally, 5.0 million people die annually from infections associated with antimicrobial-resistant bacteria, most commonly Escherichia coli¹. As colistin is a last-resort antibiotic for multidrug-resistant bacterial infections, the global spread of plasmid-mediated colistin resistance genes (mcr) gene is considered a major public health risk^2-4. However, the actual health risks of colistin resistance in hazardous bacteria have never been evaluated under physiological conditions. Here, we show that the fitness/virulence and colistin resistance of the pandemic multidrug-resistant E. coli clone ST131⁵ very depending on the acquired colistin resistance determinants and differ between physiological and in vitro conditions. The fitness/virulence of ST131 was unaffected by chromosomal-gene (pmrB) mutations or the acquisition of mcr-5-harbouring plasmids in mouse models. However, the acquisition of mcr-1- or mcr-3-harbouring plasmids attenuated fitness/virulence and promoted colistin susceptibility in human serum. We identified two virulence attenuation factors (vafA and vafB) on the pIncI2_mcr-1 plasmid that hijacked the ST131 transcriptome and inhibited nucleotide synthesis, attenuating colistin resistance. Our results demonstrate that colistin resistance poses much less of a threat than believed^6,7. We suggest that “nonresistance genes,” rather than resistance genes, are important antimicrobial resistance determinants for human health because they determine fitness/virulence and ultimately antimicrobial susceptibility under physiological conditions.

DOI

ゲノム解析は同時期に複数病棟で発生したCOVID-19クラスター事例の全体像の把握に有用である

藤谷好弘, 中江舞美, 中村広士, 富樫篤生, 齋藤充史, 黒沼幸治, 高橋聡, 大久保和洋, 川代愛梨, 田宮和真

日本環境感染学会総会プログラム・抄録集 ( (一社)日本環境感染学会 ) 38回 271 - 271 2023.06

COVID-19の濃厚接触者が陽性となる要因の検討

中江舞美, 藤谷好弘, 富樫篤生, 中村広士, 斎藤充史, 黒沼幸治, 高橋聡

日本環境感染学会総会プログラム・抄録集 ( (一社)日本環境感染学会 ) 38回 382 - 382 2023.06

Pseudo-outbreak of Mycobacterium lentiflavum at a general hospital in Japan.

Yutaro Nagano, Koji Kuronuma, Yasuo Kitamura, Kanami Nagano, Hayato Yabe, Sayaka Kudo, Toyotaka Sato, Shinya Nirasawa, Mami Nakae, Motohiro Horiuchi, Shin-Ichi Yokota, Yoshihiro Fujiya, Atsushi Saito, Satoshi Takahashi, Hirofumi Chiba

Infection control and hospital epidemiology 1 - 7 2023.04 [International journal]

BACKGROUND: Mycobacterium lentiflavum is a slow-growing nontuberculous mycobacterium that is widely distributed in soil and water systems, but it is sometimes pathogenic to humans. Although cases of M. lentiflavum infections are rare, 22 isolates of M. lentiflavum were identified at a single hospital in Japan. We suspected a nosocomial outbreak; thus, we conducted transmission pattern and genotype analyses. METHODS: Cases of M. lentiflavum isolated at Kushiro City General Hospital in Japan between May 2020 and April 2021 were analyzed. The patient samples and environmental culture specimens underwent whole-genome sequencing (WGS). Additionally, we retrospectively collected clinical data from patient medical records. RESULTS: Altogether, 22 isolates of M. lentiflavum were identified from sputum and bronchoalveolar lavage samples. Clinically, the instances with M. lentiflavum isolates were considered contaminants. In the WGS analysis, 19 specimens, including 18 patient samples and 1 environmental culture from the hospital's faucet, showed genetic similarity. The frequency of M. lentiflavum isolation decreased after we prohibited the use of taps where M. lentiflavum was isolated. CONCLUSIONS: WGS analysis identified that the cause of M. lentiflavum pseudo-outbreak was the water used for patient examinations, including bronchoscopy.

DOI PubMed

Corrigendum to 'Clonal/subclonal changes and accumulation of CTX-M-type β-lactamase genes in fluoroquinolone-resistant Escherichia coli ST131 and ST1193 strains isolated during the past 12 years, Japan' [Journal of Global Antimicrobial Resistance 27 (2021) 150-155].

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

Journal of global antimicrobial resistance 32 195 - 195 2023.03 [International journal]

DOI PubMed

SARS-CoV-2ワクチン接種後の長期的抗体価推移と次期接種のタイミングの検討

藤谷好弘, 中江舞美, 富樫篤生, 齋藤充史, 黒沼幸治, 高橋聡

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 ( 日本感染症学会・日本化学療法学会 ) 97回・71回 O - 127 2023.03

Analysis of diagnostic performance and factors causing nonspecific reactions in SARS-CoV-2 rapid antigen detection tests.

Natsuki Narumi, Takashi Kondo, Yuki Sato, Yuki Katayama, Shinya Nirasawa, Masachika Saeki, Yuki Yakuwa, Yoshihiro Fujiya, Koji Kuronuma, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 29 ( 2 ) 157 - 162 2023.02 [International journal]

INTRODUCTION: Early diagnosis and appropriate infection control are important to prevent the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this study, we aimed to assess the diagnostic performance of SARS-CoV-2 rapid antigen detection (RAD) tests and the factors that cause nonspecific reactions. METHODS: Nasopharyngeal swab specimens (n = 100), sputum specimens (n = 10), and lithium-heparin plasma samples (n = 100) were collected. We evaluated Espline®SARS-CoV-2 (Espline) and SARS-CoV-2 Rapid Antigen Test that also known as STANDARD Q® (STANDARD Q), with reverse transcription-polymerase chain reaction (RT-PCR) and Lumipulse® Presto SARS-CoV-2 Ag as reference tests. In addition, we investigated the effects of inadequate pretreatment methods and five potential causes of nonspecific reactions. RESULTS: The sensitivities of Espline and STANDARD Q were 60% and 57%, respectively, and their specificity was 100%. It was confirmed that the judgment line for the positive insufficiently mixed specimens was faint. A false-positive result was observed with STANDARD Q when sputum was used as a specimen to investigate judgment the effect of viscosity. CONCLUSIONS: Espline and STANDARD Q show good sensitivity for specimens with Ct values less than 25, but specimens collected within 9 days of symptom onset may still give false negatives. The test should be performed carefully, and the results should be judged comprehensively, taking into account clinical symptoms and patient background.

DOI PubMed

Serum Testosterone Is Associated With the Severity of COVID-19.

Ema Suzuki, Koji Kuronuma, Ryosei Murai, Yoshihiro Fujiya, Atsushi Saito, Hirofumi Chiba, Satoshi Takahashi

In vivo (Athens, Greece) 37 ( 5 ) 2314 - 2319 2023 [International journal]

BACKGROUND/AIM: Coronavirus disease 2019 (COVID-19) is more likely to be severe in men than in women. Its association with sex hormones as an aggravating factor for male patients has been attracting attention. This study aimed to investigate whether serum testosterone is associated with the aggravation of COVID-19. PATIENTS AND METHODS: Serum testosterone concentrations in 116 male patients with COVID-19 and residual serum were measured and examined upon their admission to Sapporo Medical University Hospital between February 1, 2020 and March 31, 2021. RESULTS: Blood samples collected from these patients with COVID-19 were analyzed. The serum testosterone levels were 2.19±1.35, 1.29±0.88, and 0.75±0.58 ng/ml in mild, moderate, and severe groups, respectively. Patients with severe COVID-19 on admission had lower testosterone levels (p<0.001). At a cutoff level of 1.31 ng/ml, the area under the curve for the comparison of severe with non-severe cases was 0.825. Furthermore, serum testosterone levels negatively correlated with C-reactive protein and serum amyloid A levels but positively correlated with calcium, zinc, C3, and C4. CONCLUSION: In male patients with COVID-19, low serum testosterone levels correlated with disease severity, accompanied by a strong inflammatory reaction and proportion of complement consumption.

DOI PubMed

Effect of albumin measurement methods on the albumin-bilirubin grade.

Makito Tanaka, Shingo Tanaka, Ema Suzuki, Ryo Kobayashi, Satoshi Takahashi

Annals of clinical biochemistry 45632221143685 - 45632221143685 2022.12 [International journal]

BACKGROUND: Albumin-bilirubin (ALBI) grade is an index of liver function based on total bilirubin (T-BIL) and albumin levels, and its usefulness has been widely reported. This study aimed to investigate the effect of different methods of measuring T-BIL and albumin levels on the ALBI grade in patients with liver disease. METHODS: In total, 170 patients from our hospital were included in this study. Correlations between T-BIL levels measured using the vanadate oxidation and enzymatic methods were analysed. Similarly, a correlation analysis of albumin levels between the bromocresol green (BCG) and modified bromocresol purple (BCP) methods was performed. Additionally, the ALBI grade was calculated for patients with liver disease, and the differences between each method of albumin measurement were compared. RESULTS: No differences were observed in the measured T-BIL values between the two methods. Contrastingly, the albumin levels of 100 random samples and 70 liver disease patients obtained using the modified BCP method were significantly lower than those measured using the BCG method. The rate of change in the modified ALBI grade between the BCG and BCP methods was 25.7%. CONCLUSIONS: Caution should be taken when comparing ALBI grades with those measured by other facilities because the method of albumin measurement can affect the ALBI grade. Standardization of albumin measurement is needed worldwide.

DOI PubMed

Study of post-opening stability of active ingredients in hand sanitizers.

Ryo Kobayashi, Ryosei Murai, Yuki Sato, Mami Nakae, Shinya Nirasawa, Koichi Asanuma, Koji Kuronuma, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 12 ) 1605 - 1609 2022.12 [International journal]

INTRODUCTION: Hand disinfection plays an important role in infection control. Currently, hand sanitizers containing ethanol and chlorhexidine gluconate as active ingredients are widely used. Most of hand sanitizers have a defined expiration date for use. However, there was no rule about the expiration date after opening defined with the evidence. Therefore, we examined the fluctuation of active ingredients and disinfection effect after opening the bottle. METHOD: Twelve hand sanitizers from 44 to 921 days after opening set in different places in the hospital were examined and unopened hand sanitizer used as a control. Chlorhexidine gluconate and ethanol of each samples were measured by high performance liquid chromatography and gas chromatography, respectively. The correlation between the concentration of each ingredient obtained and the number of days after opening, bottle weight, storage temperature and humidity was analyzed. A time-kill test based on ASTM E2315-03 was performed to confirm the actual disinfection effect. RESULTS: It was observed that active ingredients had not been decreased up to 921 days after opening and were not affected by storage conditions after opening. In addition, a decrease of disinfection effect was not observed in any sample. CONCLUSIONS: We found that hand sanitizers do not need to be discard after a number of days have passed because the active ingredients are retained even after opening in it.

DOI PubMed

Viral load may impact the diagnostic performance of nasal swabs in nucleic acid amplification test and quantitative antigen test for SARS-CoV-2 detection.

Yoshihiro Fujiya, Yuki Sato, Yuki Katayama, Shinya Nirasawa, Mikako Moriai, Masachika Saeki, Yuki Yakuwa, Ikumi Kitayama, Koichi Asanuma, Koji Kuronuma, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 11 ) 1590 - 1593 2022.11 [International journal]

INTRODUCTION: Compared to nasopharyngeal swabs (NPS), there has been insufficient evaluation of the diagnostic performance of nasal swabs (NS) for the detection of severe acute respiratory coronavirus 2 (SARS-CoV-2) in the nucleic acid amplification test (NAAT) and quantitative SARS-CoV-2 antigen test (QAT). METHODS: We prospectively compared healthcare worker-collected and flocked NS within nine days after symptom onset to paired NPS to detect SARS-CoV-2 in NAAT and QAT on the fully automated Lumipulse system. The agreement between sample types was evaluated, and cycle threshold (Ct) values and antigen levels were used as surrogate viral load measures. RESULTS: Sixty sets of NPS and NS samples were collected from 40 patients with COVID-19. The overall agreements between NAAT and QAT samples were 76.7% and 65.0%, respectively. In NAAT, the Ct value of NS was significantly higher, 5.9, than that of NPS. Thirty-nine (95.1%) NS tested positive in 41 positive-paired NPS with Ct ≤ 30. The negative correlation was observed between antigen levels of NS in QAT and Ct values of NS in NAAT (r = -0.88). In QAT, the antigen level of NS was significantly lower than that of NPS. Thirty-six (90.0%) NS tested positive in 40 positive-paired NPS with antigen levels >100 pg/mL, which were collected significantly earlier than those with antigen levels ≤100 pg/mL. CONCLUSIONS: In NAAT and QAT, NS had limited performance in detecting SARS-CoV-2 compared to NPS. However, NS may be helpful for patients with COVID-19 with high viral loads or those in the early stages of the illness.

DOI PubMed

Age-Stratified Seroprevalence of SARS-CoV-2 Antibodies before and during the Vaccination Era, Japan, February 2020-March 2022.

Seiya Yamayoshi, Kiyoko Iwatsuki-Horimoto, Moe Okuda, Michiko Ujie, Atsuhiro Yasuhara, Jurika Murakami, Calvin Duong, Taiki Hamabata, Mutsumi Ito, Shiho Chiba, Ryo Kobayashi, Satoshi Takahashi, Keiko Mitamura, Masao Hagihara, Akimichi Shibata, Yoshifumi Uwamino, Naoki Hasegawa, Toshiaki Ebina, Akihiko Izumi, Hideaki Kato, Hideaki Nakajima, Norio Sugaya, Yuki Seki, Asef Iqbal, Isamu Kamimaki, Masahiko Yamazaki, Yoshihiro Kawaoka, Yuki Furuse

Emerging infectious diseases 28 ( 11 ) 2198 - 2205 2022.11 [International journal]

Japan has reported a relatively small number of COVID-19 cases. Because not all infected persons receive diagnostic tests for COVID-19, the reported number must be lower than the actual number of infections. We assessed SARS-CoV-2 seroprevalence by analyzing >60,000 samples collected in Japan (Tokyo Metropolitan Area and Hokkaido Prefecture) during February 2020-March 2022. The results showed that ≈3.8% of the population had become seropositive by January 2021. The seroprevalence increased with the administration of vaccinations; however, among the elderly, seroprevalence was not as high as the vaccination rate. Among children, who were not eligible for vaccination, infection was spread during the epidemic waves caused by the SARS-CoV-2 Delta and Omicron variants. Nevertheless, seroprevalence for unvaccinated children <5 years of age was as low as 10% as of March 2022. Our study underscores the low incidence of SARS-CoV-2 infection in Japan and the effects of vaccination on immunity at the population level.

DOI PubMed

男性COVID-19患者の血清テストステロン値は重症度と関連する

黒沼幸治, 鈴木瑛真, 村井良精, 中江舞美, 藤谷好弘, 齋藤充史, 高橋聡

日本感染症学会東日本地方会学術集会・日本化学療法学会東日本支部総会合同学会プログラム・抄録集 ( 日本感染症学会東日本地方会・日本化学療法学会東日本支部 ) 71回・69回 125 - 125 2022.10

当院における10年間のvanC保有腸球菌菌血症の特徴から見る治療において重要なこと

藤谷好弘, 佐藤勇樹, 富樫篤生, 齋藤充史, 黒沼幸治, 高橋聡

日本感染症学会東日本地方会学術集会・日本化学療法学会東日本支部総会合同学会プログラム・抄録集 ( 日本感染症学会東日本地方会・日本化学療法学会東日本支部 ) 71回・69回 118 - 118 2022.10

COVID-19における血清レクチン値の臨床バイオマーカーとしての有用性についての検討

齋藤充史, 黒沼幸治, 富樫篤生, 藤谷好弘, 高橋聡

Performance analysis among multiple fully automated anti-SARS-CoV-2 antibody measurement reagents: A potential indicator for the correlation of protection in the antibody titer.

Ryo Kobayashi, Ema Suzuki, Ryosei Murai, Makito Tanaka, Yoshihiro Fujiya, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 9 ) 1295 - 1303 2022.09 [International journal]

BACKGROUND: To evaluate the performance of various reagents in automated analyzers for antibody detection against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Using 100 serum samples from 100 individual patients diagnosed with SARS-CoV-2 infection, the precision, linearity, determination agreement, and correlation of five qualitative reagents (Elecsys Anti-SARS-CoV-2, ARCHITECT SARS-CoV-2 IgG, ARCHITECT SARS-CoV-2 IgM, Access SARS-CoV-2 IgM, and SARS-CoV-2 IgM) and four quantitative reagents (Elecsys Anti-SARS-CoV-2 S, ARCHITECT SARS-CoV-2 IgG II, Access SARS-CoV-2 IgG 1st IS, and SARS-COV-2 IgG S) were analyzed. A surrogate virus-neutralizing test (sVNT) kit was used to evaluate the measurement value of each quantitative reagent corresponding to the amount of neutralizing antibody, similar to that of patients in the late stage of infection. RESULTS: Precision and linearity were found to be sufficient for clinical use. Five discrepant samples were observed in the positive and negative judgments of the qualitative reagents for IgG, and one discrepant sample was observed in the qualitative reagent for IgM. Although the measurement values of the quantitative reagents were different, they were correlated with each reagent. The reference values inferred from the sVNT were Elecsys Anti-SARS-CoV-2: 71.8 U/L, ARCHITECT SARS-CoV-2 IgGⅡ: 2976.3 AU/mL, Access SARS-CoV-2 IgG 1st IS: 689.6 IU/mL, and SARS-CoV-2 IgG S: 19.3 U/L. CONCLUSIONS: The performance observed for each anti-SARS-CoV-2 antibody detection reagent was sufficient. The reference values based on the inhibition rate of sVNT have potential as indicators of the correlation of protection and are expected to be leveraged in automated antibody tests.

DOI PubMed

Does the timing of saliva collection affect the diagnosis of SARS-CoV-2 infection?

Yuki Katayama, Ryosei Murai, Mikako Moriai, Shinya Nirasawa, Masachika Saeki, Yuki Yakuwa, Yuki Sato, Koichi Asanuma, Yoshihiro Fujiya, Koji Kuronuma, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 7 ) 1012 - 1014 2022.07 [International journal]

We evaluated the optimal timing of saliva sample collection to diagnose the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We obtained 150 saliva samples at four specific time points from 13 patients with confirmed SARS-CoV-2 infection. The time points were (1) early morning (immediately after waking), (2) immediately after breakfast before tooth brushing, (3) 2 h after breakfast, and (4) before lunch. On the 2nd hospital day, patients collected saliva at the four time points by themselves. We collected samples at two time points, (1) and (3), from the 3rd hospital day to day 9 following symptom onset. In 52 samples collected at the four time points, there was no significant difference. Meanwhile, there was no significant difference in the positive proportion or the viral load between the two time points in both analyses by the day from symptom onset and by all samples. In this study, there was no difference in the positive proportions in saliva collected at various time points within 9 days after symptom onset. The timing of saliva collection was not affected by the diagnosis of SARS-CoV-2 infection.

DOI PubMed

Delayed dexamethasone treatment at initiation of oxygen supplementation for coronavirus disease 2019 is associated with the exacerbation of clinical condition.

Yuta Ibe, Tomoyuki Ishigo, Satoshi Fujii, Yoshihiro Fujiya, Koji Kuronuma, Takeshi Tsugawa, Satoshi Takahashi, Masahide Fukudo

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 7 ) 875 - 883 2022.07 [International journal]

INTRODUCTION: Coronavirus disease 2019 (COVID-19) frequently causes inflammatory lung injury as its symptoms progress. While dexamethasone reportedly reduces inflammation and prevents progression to respiratory failure, the appropriate time to administer dexamethasone in patients with COVID-19 remains unclear. METHODS: This was a single-center, retrospective cohort study, where we consecutively enrolled patients hospitalized with COVID-19 who received oxygen and oral dexamethasone (n = 85). We assessed the association between the number of days to the initiation of dexamethasone and the cumulative rate of exacerbation defined as death or initiation of mechanical ventilation within 28 days of symptom onset. RESULTS: The optimal cut-off value from the initiation of oxygen supplementation to that of dexamethasone administration was two days (sensitivity, 85%; specificity, 59%), whereas that from oxygen saturation (SpO2) < 95% to the initiation of dexamethasone administration was five days (sensitivity, 78%; specificity, 59%). adjusting for age, sex, body mass index, Charlson comorbidity index score, time of oxygen supplementation (two or more days), and SpO2 < 95% (five or more days), Cox regression analysis results showed that delayed dexamethasone administration since the initiation of oxygen supplementation was significantly associated with a higher risk of death or greater need for mechanical ventilation (hazard ratio: 5.51, 95% confidence interval, 1.79-16.91). CONCLUSIONS: In patients with COVID-19 and hypoxemia, early administration of dexamethasone, preferably less than two days from initiation of oxygen supplementation, may be required to improve clinical outcomes.

DOI PubMed

Comparative study of rapid antigen testing and two nucleic acid amplification tests for influenza virus detection.

Yuki Sato, Shinya Nirasawa, Masachika Saeki, Yuki Yakuwa, Mayumi Ono, Ryo Kobayashi, Hirotaka Nakafuri, Ryosei Murai, Yoshihiro Fujiya, Koji Kuronuma, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 7 ) 1033 - 1036 2022.07 [International journal]

INTRODUCTION: This study aimed to evaluate rapid antigen detection (RAD) and rapid nucleic acid amplification tests (NAATs) to detect influenza virus (IV). METHODS: The conventional RAD test (Quick Chaser Flu A, B: QC), using silver amplified immunochromatography (Quick Chaser Auto Flu A, B: QCA), as well as two NAATs (Xpert Xpress Flu/RSV: Xpert, cobas Influenza A/B & RSV: cobas) were evaluated using nasopharyngeal swabs from suspected cases of influenza. A reference method was performed using real-time reverse transcription polymerase chain reaction according to the manual of the Japanese National Institute of Infectious Disease (NIID). RESULTS: From a total of 177 samples, 51 were positive according to the NIID assay. The kappa (κ) coefficient in Xpert and cobas for influenza A virus (IAV)/influenza B virus (IBV) was 1.00, which was the highest among the four detection assays. However, the κ coefficients in QC and QCA for IAV/IBV were 0.71-0.77 and 0.87-0.89, respectively. The sensitivities of the RAD tests were 41.7% in QC and 50.0% in QCA at < 6 h after onset, and 100.0% in both QC and QCA at 24-48 h after onset. The cycle threshold (Ct) values were significantly lower in the group in which all detection assays were positive for IAV. CONCLUSIONS: Xpert and cobas have comparable analytical performances and are highly useful as influenza virus detection assays. QC and QCA could show false negatives frequently in the early stage of infection and when viral load is low.

DOI PubMed

Clinical characteristics and treatment outcomes of carbapenem-resistant Enterobacterales infections in Japan.

Keisuke Oka, Akane Matsumoto, Nobuyuki Tetsuka, Hiroshi Morioka, Mitsutaka Iguchi, Nobuhisa Ishiguro, Tsunehisa Nagamori, Satoshi Takahashi, Norihiro Saito, Koichi Tokuda, Hidetoshi Igari, Yuji Fujikura, Hideaki Kato, Shinichiro Kanai, Fumiko Kusama, Hiromichi Iwasaki, Kazuki Furuhashi, Hisashi Baba, Miki Nagao, Masaki Nakanishi, Kei Kasahara, Hiroshi Kakeya, Hiroki Chikumi, Hiroki Ohge, Momoyo Azuma, Hisamichi Tauchi, Nobuyuki Shimono, Yohei Hamada, Ichiro Takajo, Hirotomo Nakata, Hideki Kawamura, Jiro Fujita, Tetsuya Yagi

Journal of global antimicrobial resistance 29 247 - 252 2022.06 [International journal]

OBJECTIVES: The dissemination of difficult-to-treat carbapenem-resistant Enterobacterales (CRE) is of great concern. We clarified the risk factors underlying CRE infection mortality in Japan. METHODS: We conducted a retrospective, multicentre, observational cohort study of patients with CRE infections at 28 university hospitals from September 2014 to December 2016, using the Japanese National Surveillance criteria. Clinical information, including patient background, type of infection, antibiotic treatment, and treatment outcome, was collected. The carbapenemase genotype was determined using PCR sequencing. Multivariate analysis was performed to identify the risk factors for 28-day mortality. RESULTS: Among the 179 patients enrolled, 65 patients (36.3%) had bloodstream infections, with 37 (20.7%) infections occurring due to carbapenemase-producing Enterobacterales (CPE); all carbapenemases were of IMP-type (IMP-1: 32, IMP-6: 5). Two-thirds of CPE were identified as Enterobacter cloacae complex. Combination therapy was administered only in 46 patients (25.7%), and the 28-day mortality rate was 14.3%. Univariate analysis showed that solid metastatic cancer, Charlson Comorbidity Index ≥3, bloodstream infection, pneumonia, or empyema, central venous catheters, mechanical ventilation, and prior use of quinolones were significant risk factors for mortality. Multivariate analysis revealed that mechanical ventilation (OR: 6.71 [1.42-31.6], P = 0.016), solid metastatic cancers (OR: 5.63 [1.38-23.0], P = 0.016), and bloodstream infections (OR: 3.49 [1.02-12.0], P = 0.046) were independent risk factors for 28-day mortality. CONCLUSION: The significant risk factors for 28-day mortality in patients with CRE infections in Japan are mechanical ventilation, solid metastatic cancers, and bloodstream infections.

DOI PubMed

Distribution of the positive UPOINT domain in patients with chronic prostatitis or chronic pelvic pain syndrome: A multicenter observational study.

Koji Ichihara, Satoshi Takahashi, Yoshiki Hiyama, Naoya Masumori, Hiroshi Nagae, Shin Ito, Koichiro Wada, Hironori Betsunoh, Ryoichi Hamasuna, Yoshikazu Togo, Katsumi Shigemura, Ko Takeyama

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 5 ) 631 - 634 2022.05 [International journal]

OBJECTIVE: To determine the UPOINT-positive domain numbers and evaluate the significance of the sexual dysfunction domain in patients with chronic prostatitis or chronic pelvic pain (CP/CPPS) in Japan. METHODS: A total of 58 patients with CP/CPPS with moderate or greater symptoms were included. Symptom severity was determined by > 14 on the chronic prostatitis symptom index (CPSI). The main outcome was to confirm the number and distribution of the positive UPOINT domains in this group. As secondary outcomes, the correlation between positive domain numbers and CPSI scores was evaluated. We also examined whether the sexual dysfunction subdomain, as determined by the five-item international index of erectile function, could improve the correlation with symptom severity. RESULTS: The mean age was 48.6 ± 15.4 years, CPSI score 24.3 ± 6.1, and positive UPOINT domain number 2.4 ± 0.9. The distribution of each positive domain was 67.2% for urinary, 15.5% for psychosocial, 75.8% for organ-specific, 3.4% for infection, 5.1% for neurological/systemic conditions, and 75.8% for tenderness. Although the mean CPSI total scores tended to increase with an increasing number of positive UPOINT domains, a significant correlation was not observed (r = 0.134, p = 0.312). The sexual dysfunction domain was positive in 62.0% of the cases, but the correlation could not be improved. CONCLUSIONS: Urinary, organ specific, and tenderness domains were mainly observed in patients with CP/CPPS. When patients with moderate or grater CPSI scores are clinically evaluated, clinicians should recognize that the UPOINT-positive domain and CPSI score are clinically and pathologically different concepts. (250 words).

DOI PubMed

COVID-19肺炎重症度予測マーカーとしてのIL-6、INF-λ3、NGALの検討

黒沼幸治, 中江舞美, 藤谷好弘, 高橋聡, 齋藤充史, 安田健人, 千葉弘文

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 70 ( Suppl.A ) 299 - 299 2022.05

COVID-19 臨床経過予測因子 COVID-19肺炎重症度予測マーカーとしてのIL-6、INF-λ3、NGALの検討

齋藤充史, 安田健人, 黒沼幸治, 中江舞美, 藤谷好弘, 高橋聡, 千葉弘文

日本呼吸器学会誌 ( (一社)日本呼吸器学会 ) 11 ( 増刊 ) 153 - 153 2022.04

Extensive mucosal sloughing of the small intestine and colon in a patient with severe COVID-19.

Tsukasa Yamakawa, Keisuke Ishigami, Ayumu Takizawa, Yumemi Takada, Sae Ohwada, Yoshihiro Yokoyama, Tomoe Kazama, Daisuke Hirayama, Shinji Yoshii, Hiro-O Yamano, Rina Ohizumi, Naofumi Bunya, Taro Sugawara, Mitsuhiro Tsujiwaki, Shintaro Sugita, Satoshi Takahashi, Eichi Narimatsu, Hiroshi Nakase

DEN open 2 ( 1 ) e42 2022.04 [International journal]

Patients with coronavirus disease 2019 (COVID-19) primarily cause respiratory symptoms. However, gastrointestinal (GI) symptoms can also occur. The endoscopic characteristics of the GI tract in COVID-19 patients remain unclear. We herein report a 62-year-old male with severe COVID-19 who needed multidisciplinary treatment, including extracorporeal membrane oxygenation (ECMO). Despite the improvement in his respiratory status, GI bleeding developed. Capsule endoscopy and colonoscopy revealed extensive mucosal sloughing in the lower intestinal tract. Additionally, we performed a comprehensive analysis of the mRNA expression levels of various proinflammatory cytokines in the intestinal mucosal tissues. The results suggested a significant elevation of IL-6, which could be involved in the pathophysiology of the GI involvement in COVID-19. Further investigation with more clinical data, including endoscopic findings and molecular analyses, will contribute to a comprehensive understanding of COVID-19-associated GI injury.

DOI PubMed

COVID-19 臨床経過予測因子 COVID-19肺炎重症度予測マーカーとしてのIL-6、INF-λ3、NGALの検討

齋藤充史, 安田健人, 黒沼幸治, 中江舞美, 藤谷好弘, 高橋聡, 千葉弘文

日本呼吸器学会誌 ( (一社)日本呼吸器学会 ) 11 ( 増刊 ) 153 - 153 2022.04

Solid-Phase Total Synthesis of Plusbacin A3.

Kazuki Takashina, Akira Katsuyama, Rintaro Kaguchi, Kazuki Yamamoto, Toyotaka Sato, Satoshi Takahashi, Motohiro Horiuchi, Shin-Ichi Yokota, Satoshi Ichikawa

Organic letters 24 ( 11 ) 2253 - 2257 2022.03 [International journal]

DOI PubMed

AAUS guideline for chlamydial urethritis.

Yoshiki Hiyama, Satoshi Takahashi, Mitsuru Yasuda

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 2 ) 142 - 145 2022.02 [International journal]

Urogenital chlamydial infection is the most common sexually transmitted infection. Many cases of chlamydial infection are reported worldwide every year. Genital chlamydial infection in women can also cause obstetric issues, including infertility and miscarriage. For that purpose, appropriate care should be conducted with the latest knowledge. Only few guidelines come from Asian countries. The Asian Association of Urinary Tract Infection and Sexually Transmitted Infection (AAUS) belonging to the Urological Association of Asia (UAA) had developed the guidelines regarding chlamydial urethritis. We have collected the feedback and updated the guidelines which is now submitted for consideration of publication. In addition to the levels of evidence, the recommendation grades were defined using the modified GRADE methodology. Herein, we present the new edition of the UAA-AAUS guidelines for chlamydial urethritis.

DOI PubMed

Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan: Comparison with the first surveillance report.

Satoshi Takahashi, Mitsuru Yasuda, Koichiro Wada, Masahiro Matsumoto, Hiroshi Hayami, Kanao Kobayashi, Jun Miyazaki, Hiroshi Kiyota, Tetsuya Matsumoto, Hiroshi Yotsuyanagi, Kazuhiro Tateda, Junko Sato, Hideaki Hanaki, Naoya Masumori, Yoshiki Hiyama, Shin Egawa, Hiroki Yamada, Kazumasa Matsumoto, Kiyohito Ishikawa, Shingo Yamamoto, Yoshikazu Togo, Kazushi Tanaka, Katsumi Shigemura, Shinya Uehara, Hiroyuki Kitano, Keijiro Kiyoshima, Ryoichi Hamasuna, Kenji Ito, Hideo Hirayama, Shuichi Kawai, Yutaka Shiono, Takahiro Maruyama, Shin Ito, Mutsumasa Yoh, Masayasu Ito, Koichi Hatano, Hideari Ihara, Satoshi Uno, Koichi Monden, Teruhiko Yokoyama, Kazuo Takayama, Toru Sumii, Hitoshi Kadena, Motoshi Kawahara, Takahide Hosobe, Masanobu Izumitani, Motonori Kano, Hirofumi Nishimura, Ryuji Fujita, Shinichi Kaji, Kenji Hayashi, Takanori Tojo, Masaru Matumura

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 28 ( 1 ) 1 - 5 2022.01 [International journal]

The Urogenital Sub-committee and the Surveillance Committee of the Japanese Society of Chemotherapy, The Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology conducted the second nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis. In this second surveillance study, clinical urethral discharge specimens were collected from patients with urethritis in 26 hospitals and clinics from May 2016 to July 2017. Based on serial cultures, the minimum inhibitory concentration (MIC) could be determined for 41 isolates; the MICs (MIC90) of ciprofloxacin, levofloxacin, tosufloxacin, sitafloxacin, doxycycline, minocycline, erythromycin, clarithromycin, azithromycin and solithromycin were 2 μg/ml (2 μg/ml), 1 μg/ml (0.5 μg/ml), 0.25 μg/ml (0.25 μg/ml), 0.125 μg/ml (0.063 μg/ml), 0.125 μg/ml (0.125 μg/ml), 0.25 μg/ml (0.25 μg/ml), 0.031 μg/ml (0.031 μg/ml), 0.25 μg/ml (0.125 μg/ml), and 0.016 μg/ml (0.008 μg/ml), respectively. In summary, this surveillance project did not identify any strains resistant to fluoroquinolone, tetracycline, or macrolide agents in Japan. In addition, the MIC of solithromycin was favorable and lower than that of other antimicrobial agents. However, the MIC of azithromycin had a slightly higher value than that reported in the first surveillance report, though this might be within the acceptable margin of error. Therefore, the susceptibility of azithromycin, especially, should be monitored henceforth.

DOI PubMed

Reduction of susceptibility to azoles and 5-fluorocytosine and growth acceleration in Candida albicans in glucosuria.

Yoshiki Hiyama, Toyotaka Sato, Satoshi Takahashi, Soh Yamamoto, Noriko Ogasawara, Naoya Masumori, Shin-Ichi Yokota

Diagnostic microbiology and infectious disease 102 ( 1 ) 115556 - 115556 2022.01 [International journal]

Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia and glucosuria, and is a risk factor for Candida infections. To reveal the potential effects of glucosuria on Candida spp., we investigated their growth and antifungal susceptibilities in normal human urine to which glucose was added. The viable cell numbers of Candida spp. were more than 10 fold higher in the urine added 3000 mg/dL glucose than in plain urine. In antifungal susceptibility, more than 80% of Candida albicans clinical isolates increased minimum inhibitory concentrations of azoles and 5-fluorocytosine with the addition of glucose, and exceeded their breakpoints. In most of the C. albicans clinical isolates, the mRNA expression of the azole resistance genes ERG11, CDR1, CDR2, and MDR1 in the presence of glucose in urine. These observations provide valuable information about the clinical course and therapeutic effects of azoles against C. albicans infections in patients with diabetes mellitus and hyperglucosuria.

DOI PubMed

ファビピラビルおよびデキサメタゾン投与開始時期とCOVID-19臨床転帰の関連性

伊部裕太, 石郷友之, 藤居賢, 藤谷好弘, 黒沼幸治, 高橋聡

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 70 ( 1 ) 164 - 165 2022.01

Impaired tryptophan metabolism in the gastrointestinal tract of patients with critical coronavirus disease 2019.

Yoshihiro Yokoyama, Tomoko Ichiki, Tsukasa Yamakawa, Yoshihisa Tsuji, Koji Kuronuma, Satoshi Takahashi, Eichi Narimatsu, Hiroshi Nakase

Frontiers in medicine 9 941422 - 941422 2022 [International journal]

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is still causing a global pandemic. But the mechanism of COVID-19 severity is not well elucidated. MATERIALS AND METHODS: We conducted two single-center observational studies of patients with COVID-19. In the first study, the enrolled patients were distinguished based on critical vs. non-critical COVID-19. We collected blood samples from the patients at admission to measure markers related to inflammation and thrombosis and stool samples to analyze the fecal microbiome, metabolome, and calprotectin level. In the second study, we collected ileum and colon tissue samples from patients with critical COVID-19 who required colonoscopy due to severe gastrointestinal symptoms and analyzed mucosal gene expression. RESULTS: A total of 19 blood samples and 10 stool samples were collected. Interleukin (IL)-6 was the only serum inflammatory marker with significantly higher levels in the critical group than in the non-critical group. The fecal calprotectin level in the critical group was significantly higher than that in the non-critical group (P = 0.03), regardless of the presence of gastrointestinal symptoms. Stool metabolomic analysis showed that the level of indole-3-propionic acid, a ligand for aryl hydrocarbon receptor (AhR), was markedly decreased in the critical group compared to that in the non-critical group (P = 0.01). The expression of genes involved in tryptophan metabolism, including ACE2, AHR, CARD9, and IL22, was downregulated in the ileum of critical COVID-19 patients who required a colonoscopy. DISCUSSION: Critical COVID-19 patients have gastrointestinal inflammation potentially caused by impaired tryptophan metabolism in the small intestine due to decreased expression of genes involved in tryptophan metabolism.

DOI PubMed

Self-reported Smell and Taste Disorders in Patients With COVID-19: A Japanese Single-center Study.

Keisuke Yamamoto, Yoshihiro Fujiya, Koji Kuronuma, Noriko Ogasawara, Tsuyoshi Ohkuni, Shin-Ichi Yokota, Satoshi Takahashi, Kenichi Takano

In vivo (Athens, Greece) 36 ( 2 ) 918 - 924 2022 [International journal]

BACKGROUND/AIM: Smell and taste disorders are among the most common symptoms of COVID-19. However, the relationship between smell and taste disorders and systemic symptoms is not fully understood in Japan. PATIENTS AND METHODS: Questionnaires were mailed to 105 of 111 COVID-19 patients who were hospitalized at our hospital between March and July 2020 in Japan. RESULTS: A total of 74 patients (response rate: 70.5%) completed the survey. Of these, six patients (8.1%) presented with smell disorders only, 16 (21.6%) presented with taste disorders only, and 17 (23.0%) presented with both smell and taste disorders. The mean Visual Analog Scale for smell and taste was 0.5 and 20, respectively, at the time of the most severe symptoms. CONCLUSION: Among COVID-19 patients in Japan, smell and taste disorders are often followed by fever and may not be the first symptoms. Sense of smell is particularly impaired. These symptoms often improve, although they sometimes persist for a long time as sequelae.

DOI PubMed

Guidelines for Infection Control in the Urological Field, including Urinary Tract Management (revised second edition).

Satoshi Takahashi, Soichi Arakawa, Kiyohito Ishikawa, Jun Kamei, Kanao Kobayashi, Katsumi Shigemura, Satoru Takahashi, Yoshiki Hiyama, Ryoichi Hamasuna, Hiroshi Hayami, Satoshi Yazawa, Mitsuru Yasuda, Yoshikazu Togo, Shingo Yamamoto, Koichiro Wada, Toyohiko Watanabe

International journal of urology : official journal of the Japanese Urological Association 28 ( 12 ) 1198 - 1211 2021.12 [International journal]

The Committee for the Development of Guidelines for Infection Control in the Urological Field, including Urinary Tract Management of the Japanese Urological Association, together with its systematic review team and external reviewers, have prepared a set of practice guidelines, an abridged version of which is published herein. These guidelines cover the following topics: (i) foundations of infection control, standard precautions, route-specific precautions, and occupational infection control (including vaccines); (ii) the relationship between urologists and infection control; (iii) infection control in urological wards and outpatient clinics; (iv) response to hepatitis B virus reactivation; (v) infection control in urological procedures and examinations; (vi) prevention of infections occurring in conjunction with medical procedures and examinations; (vii) responses to urinary tract tuberculosis and bacillus Calmette-Guérin; (viii) aseptic handling, cleaning, disinfection, and sterilization of urinary tract endoscopes (principles of endoscope manipulation, endoscope lumen cleaning, and disinfection); (ix) infection control in the operating room (principles of hand washing, preoperative rubbing methods, etc.); (x) prevention of needlestick and blood/bodily fluid exposure and response to accidental exposure; (xi) urinary catheter-associated urinary tract infection and purple urinary bag syndrome; and (xii) urinary catheter-associated urinary tract infections in conjunction with home care. In addressing these topics, the relevant medical literature was searched to the extent possible, and content was prepared for the purpose of providing useful information for clinical practice.

DOI PubMed

Prognostic value of 6-min walk stress echocardiography in patients with interstitial lung disease.

Kenji Yasui, Satoshi Yuda, Kiyoshi Abe, Kouichi Asanuma, Nozomi Yanagihara, Yuta Sudo, Kimiyuki Ikeda, Atsuko Muranaka, Mitsuo Otsuka, Daigo Nagahara, Hirofumi Ohnishi, Hiroki Takahashi, Tetsuji Miura, Satoshi Takahashi

Journal of echocardiography 19 ( 4 ) 232 - 242 2021.12 [Domestic journal]

BACKGROUND: The 6-min walk test (6MWT) provides prognostic information for patients with interstitial lung disease (ILD). Parameter determined by Doppler echocardiography after the 6MWT (6 MW stress echocardiography) is shown to be a predictor of future development of pulmonary hypertension in patients with connective tissue disease. However, the clinical utility of 6 MW stress echocardiography in predicting cardiopulmonary events in patients with ILD remains unknown. We examined whether parameters determined by 6 MW stress echocardiography independent predictors of adverse events in patients with ILD. METHODS: Echocardiographic examinations were performed in 68 consecutively enrolled patients with ILD (age, 65 ± 10 years, 65% men). A pressure gradient of tricuspid regurgitation (TRPG) and pulmonary vascular resistance (PVRecho) calculated using the following formula [PVRecho = (peak velocity of TR × 10/time-velocity integral of right ventricular outflow (RVOT-VTI)) + 0.16] were measured at baseline and at post 6MWT. Data for parameters of pulmonary functional tests and for 6MWT were collected. RESULTS: During a mean follow-up period of 22 ± 12 months, 22 patients experienced cardiopulmonary events. In univariate analysis, %VC, TRPG, PVRecho, TRPG post 6MWT, and PVRecho post 6MWT were significantly associated with cardiopulmonary events. Multivariate analysis using the Cox proportional hazards model indicated that %VC [hazard ratio (HR): 0.97, p = 0.009] and PVRecho post 6MWT (HR: 1.77, p = 0.004) were independent predictors of cardiopulmonary events in patients with ILD. CONCLUSIONS: In addition to parameters of pulmonary function tests, increased PVRecho post 6MWT is a significant predictor of cardiopulmonary events in patients with ILD. A 6 MW stress echocardiography is useful in assessing the risk of adverse events in patients with ILD.

DOI PubMed

Clinical performance and potential of a SARS-CoV-2 detection kit without RNA purification steps

Yuki Sato, Takashi Kondo, Mikako Moriai, Shinya Nirasawa, Masachika Saeki, Yuki Yakuwa, Yuki Katayama, Ikumi Kitayama, Ryo Kobayashi, Akemi Endoh, Koichi Asanuma, Yoshihiro Fujiya, Satoshi Takahashi

Journal of Laboratory Medicine ( Walter de Gruyter GmbH ) 45 ( 4-5 ) 205 - 212 2021.10

Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is rapidly spreading globally. Early diagnosis plays an essential role in controlling the infection. Therefore, early and accurate SARS-CoV-2 detection assays along with easy operation are required. The aim of this study was to compare the clinical performance of the Ampdirect™ 2019-nCoV Detection Kit (SHIMADZU assay), which does not require RNA purification steps, with that of the preexisting SARS-CoV-2 detection assays, which use a purified RNA template. Methods: A total of 71 samples (65 nasopharyngeal specimens and 6 sputum specimens) were collected from 32 individuals, including patients infected with SARS-CoV-2 and those with suspected infection. The sensitivity and kappa (κ) coefficient were assessed between the SARS-CoV-2 detection assays using the reference standard, which was defined as a true positive result by any one of the four SARS-CoV-2 detection assays. Results: The overall sensitivity and κ coefficient of the SHIMADZU assay were 86.0% (95% confidence interval [CI]: 77.9-94.2) and 0.83 (95% CI: 0.69-0.96), respectively. In particular, among the 18 samples collected within 10 days from symptom onset, the sensitivity and κ coefficient of the SHIMADZU assay were 100% and 1.0, respectively. Conclusions: Although a relatively small number of samples was evaluated, the SHIMADZU assay showed good analytical performance and as such would be highly useful for the detection of SARS-CoV-2. The test can be performed easily and quickly and has the potential for future applications in situations where a highly sensitive diagnosis is required.

DOI

Significance of urinary liver-type fatty acid-binding protein in patients with normal renal function after undergoing intestinal urinary diversion: a preliminary study.

Takeshi Maehana, Koji Ichihara, Satoshi Takahashi, Yusuke Takahashi, Kohei Hashimoto, Toshiaki Tanaka, Naoya Masumori

Clinical and experimental nephrology 25 ( 10 ) 1151 - 1157 2021.10 [Domestic journal]

BACKGROUND: Liver-type fatty acid-binding protein (L-FABP) in urine is one of the early diagnostic biomarkers for acute and chronic kidney injuries. Although this protein is also identified in the intestine, there is no verified reference value for patients with intestinal urinary diversion (UD). The aim of the present study was to measure L-FABP values in such patients and compare them with the results for patients without UD. METHODS: Spot urine specimens were collected from 41 patients with UD and 50 subjects without UD with estimated glomerular filtration rates of over 60 ml/min/1.73 m2, and the L-FABP values were measured. The normal upper cutoff value in healthy subjects without UD is considered to be 7.24 μg/g Cr. First, the median values of the two groups were compared. Next, the subjects with negative proteinuria and without comorbidities associated with renal function were further selected and the median values of the groups were compared. RESULTS: The mean age was significantly higher in the UD group. The types of UD were ileal conduit (38 patients) and ileal neobladder (three patients). The median L-FABP value in the UD group was significantly higher than that in the non-diversion group (89.1 μg/g Cr vs. 2.0 μg/g Cr, p < 0.0001). After adjustment for their backgrounds, the median value remained higher in the UD group. CONCLUSIONS: L-FABP values in subjects with UD are higher than in those without UD. By this result, to develop a reference value in patients with intestinal UD population, further studies are required.

DOI PubMed

Evaluation of false positives in the SARS-CoV-2 quantitative antigen test.

Ryo Kobayashi, Ryosei Murai, Mikako Moriai, Shinya Nirasawa, Hitoshi Yonezawa, Takashi Kondoh, Masachika Saeki, Yuki Yakuwa, Yuki Sato, Yuki Katayama, Hirotaka Nakafuri, Ikumi Kitayama, Koichi Asanuma, Yoshihiro Fujiya, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 10 ) 1477 - 1481 2021.10 [International journal]

INTRODUCTION: Highly sensitive reagents for detecting SARS-CoV-2 antigens have been developed for accurate and rapid diagnosis till date. In this study, we aim to clarify the frequency of false-positive reactions and reveal their details in SARS-CoV-2 quantitative antigen test using an automated laboratory device. METHODS: Nasopharyngeal swab samples (n = 4992) and saliva samples (n = 5430) were collected. We measured their SARS-CoV-2 antigen using Lumipulse® Presto SARS-CoV-2 Ag and performed a nucleic acid amplification test (NAAT) using the Ampdirect™ 2019 Novel Coronavirus Detection Kit as needed. The results obtained from each detection test were compared accordingly. RESULTS: There were 304 nasopharyngeal samples and 114 saliva samples were positive in the Lumipulse® Presto SARS-CoV-2 Ag test. All positive nasopharyngeal samples in the antigen test were also positive for NAAT. In contrast, only three (2.6%) of all the positive saliva samples in the antigen test were negative for NAAT. One showed no linearity with a dilute solution in the dilution test. Additionally, the quantitative antigen levels of all the three samples did not decrease after reaction with the anti-SARS-CoV-2 antibody. CONCLUSIONS: The judgment difference between the quantitative antigen test and NAAT seemed to be caused by non-specific reactions in the antigen test. Although the high positive and negative predictive value of this quantitative antigen test could be confirmed, we should consider the possibility of false-positives caused by non-specific reactions and understand the characteristics of antigen testing. We recommend that repeating centrifugation before measurement, especially in saliva samples, should be performed appropriately.

DOI PubMed

Determination of reactivation rate and risk factors for Hepatitis B virus reactivation in low-positive cases: A retrospective cohort study.

Hitoshi Yonezawa, Shingo Tanaka, Momoko Furuya, Koji Yamada, Koichi Asanuma, Yoshihiro Fujiya, Koji Miyanishi, Satoshi Takahashi, Junji Kato

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 10 ) 1454 - 1458 2021.10 [International journal]

INTRODUCTION: In quantitative assays for hepatitis B virus (HBV) DNA, although the amplification reaction signal is detected for low-positive cases, quantification remains challenging. HBV reactivation has been reported in many studies, but only a few have focused on HBV low-positive cases. This study aimed to determine the reactivation rate and risk factors for HBV reactivation in low-positive cases. METHODS: In this retrospective cohort study, we analyzed 7498 patients who had their HBV DNA measured at Sapporo Medical University Hospital between April 2008 and November 2020. Patient selection criteria were defined as follows: hepatitis B surface antigen was negative; HBV DNA was detectable but not quantifiable at least once. HBV DNA was monitored according to the guidelines for HBV reactivation. RESULTS: In total, 49,086 HBV DNA quantitative tests were performed. HBV DNA levels of 2578 tests were detectable but not quantifiable. Eighty patients met the criteria in this study. The median observation period was 497 days, and the 2-year reactivation rate was 15%. Ten patients had low HBV DNA positivity at baseline. Malignant lymphoma was observed in 15 patients; chemotherapy was used to treat other solid tumors in 35 patients, and immunosuppressive therapy was used in 30 patients. Multivariate analysis revealed that HBV DNA detected below the quantification level at baseline was an independent risk factor for HBV reactivation (adjusted hazard ratio 5.82; P = 0.010). CONCLUSIONS: Patients with low HBV DNA positivity, especially at baseline, are at high risk for HBV reactivation and therefore require closer monitoring.

DOI PubMed

Clonal/subclonal changes and accumulation of CTX-M-type β-lactamase genes in fluoroquinolone-resistant Escherichia coli ST131 and ST1193 strains isolated during the past 12 years, Japan.

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

Journal of global antimicrobial resistance 27 150 - 155 2021.09 [International journal]

OBJECTIVES: Fluoroquinolone (FQ)- and third-generation cephalosporin-resistant Escherichia coli are increasing in Japan. In the early 2000s, the FQ-resistant E. coli clone ST131 increased in clinical settings worldwide. It frequently produces extended-spectrum β-lactamases (ESBLs) such as CTX-M. This study aimed to explore the characteristics of FQ-resistant E. coli isolated in Japan during 2008-2009 and 2020. METHODS: We compared FQ-resistant E. coli clinical isolates from urine samples collected in 2020 (151 isolates) with a FQ-resistant E. coli collection isolated in 2008-2009 (42 isolates). Identification of E. coli ST131 clades and blaCTX-M were determined by multiplex PCR. Sequence types of non-ST131 isolates were determined by whole-genome sequencing. RESULTS: Although the prevalence of ST131 was comparable in 2020 (74.2%) and 2008-2009 (78.6%), the subclades differed during the two time periods (C1-nM27: 40.2% in 2008-2009 vs. 78.8% in 2020; C1-M27: 32.1% in 2008-2009 vs. 9.1% in 2020). The incidence of blaCTX-M among ST131 isolates increased from 27.3% in 2008-2009 to 64.3% in 2020. blaCTX-M was found in 80.6% and 93.8% of C1-M27 and C2 in 2020, respectively, and blaCTX-M possession in C1-nM27 increased from 19.2% in 2008-2009 to 40% in 2020. FQ-resistant ST1193 was detected only in 2020 (17.9% of 151 isolates, of which 14.8% possessed blaCTX-M). CONCLUSION: Increased resistance of E. coli to FQs and third-generation cephalosporins in Japan can be attributed to the accumulation of blaCTX-M in C1-nM27 and the increase of C1-M27 and C2 clades with high blaCTX-M possession, alongside the spread of ST1193.

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Nationwide surveillance of bacterial pathogens isolated from patients with acute uncomplicated cystitis in 2018: Conducted by the Japanese Research Group for Urinary Tract Infections (JRGU).

Koichiro Wada, Teruhiko Yokoyama, Satoshi Uno, Motoo Araki, Takuya Sadahira, Yuki Maruyama, Herik Acosta, Hirochika Nakajima, Yoshiki Hiyama, Yasuharu Kunishima, Yoshikazu Togo, Takuhisa Nukaya, Hiroki Yamada, Katsumi Shigemura, Shin Ito, Masanobu Tanimura, Kanao Kobayashi, Hiroyuki Kitano, Jun Teishima, Mitsuru Yasuda, Shinya Uehara, Ryoichi Hamasuna, Toyohiko Watanabe, Tohru Nakagawa, Hiroshi Hayami, Jun Miyazaki, Satoshi Takahashi, Naoya Masumori, Kiyohito Ishikawa, Hiroshi Kiyota, Masato Fujisawa, Soichi Arakawa, Yasutomo Nasu, Shingo Yamamoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 8 ) 1169 - 1180 2021.08 [International journal]

INTRODUCTION: The aim of this study was to monitor the development of drug-resistant bacteria isolated from acute uncomplicated cystitis (AUC) and to evaluate methodology of the survey conducted by collecting only clinical data. METHODS: We enrolled female patients at least 16 years of age diagnosed with AUC in 2018. Patient information including age, menopausal status, and results of bacteriological examination were collected and analyzed regardless of bacterial identification, antimicrobial susceptibility testing or extended-spectrum β-lactamase (ESBL) detection method. RESULTS: A total of 847 eligible cases were collected. Escherichia coli (E. coli) was the most frequently isolated bacterial species at about 70%, with proportions of fluoroquinolone-resistant E. coli (QREC) and ESBL-producing E. coli isolates at 15.6% and 9.5% of all E. coli isolates, respectively. The proportion of Staphylococcus saprophyticus (S. saprophyticus) was significantly higher in premenopausal women. Regarding the drug susceptibility of E. coli, isolates from Eastern Japan had significantly higher susceptibility to cefazolin, cefotiam and cefpodoxime and lower susceptibility to levofloxacin in postmenopausal women. ESBL-producing E. coli isolates had a high susceptibility to tazobactam-piperacillin, cefmetazole, carbapenems, aminoglycosides, and fosfomycin. In S. saprophyticus, the susceptibility to β-lactams including carbapenems was 40-60%. CONCLUSIONS: The proportions of QREC and ESBL-producing E. coli were increasing trends and lower susceptibility to LVFX in postmenopausal women was observed. Such surveillance, consisting of the collecting only clinical data, could be conducted easily and inexpensively. It is expected to be continuously performed as an alternative survey to conventional one collecting bacterial strains.

DOI PubMed

Early favipiravir treatment was associated with early defervescence in non-severe COVID-19 patients.

Satoshi Fujii, Yuta Ibe, Tomoyuki Ishigo, Hirotoshi Inamura, Yusuke Kunimoto, Yoshihiro Fujiya, Koji Kuronuma, Hiromasa Nakata, Masahide Fukudo, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 7 ) 1051 - 1057 2021.07 [International journal]

INTRODUCTION: The antiviral drug favipiravir has been shown to have in vitro antiviral activity against severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2). In this study, we investigated the clinical benefits and initiation of favipiravir treatment in patients with non-severe coronavirus-disease-2019 (COVID-19). METHODS: This study was a single-center retrospective cohort study. Receiver operating characteristic curves were drawn to calculate the area under the curve, and the optimal cut-off values for the time to initiate favipiravir treatment were calculated to predict defervescence within seven days. Univariate and multivariate Cox regression analyses were performed to identify potential influencing factors of defervescence. This was defined as a body temperature of less than 37 °C for at least 2 days. RESULTS: Data from 41 patients were used for the efficacy assessment. The days from the onset of fever to defervescence showed a positive correlation with the duration from the onset of fever to initiation of favipiravir treatment (r = 0.548, P < 0.001). The optimal cut-off value was the administration of favipiravir on day 4. Patients were assigned to two groups based on the optimal cut-off value from onset to initiation of favipiravir treatment: early treatment group (within 4-days) and late treatment group (more than 4-days). In the multivariate analysis, when adjusted for age, sex, and days from onset to initiation of favipiravir treatment, the significant factors were male sex and days of initiation of the favipiravir treatment. CONCLUSIONS: We recommend that if favipiravir is to be used for treatment, it should be initiated as early as possible.

DOI PubMed

Gender-affirming hormone treatment causes changes in gender phenotype in a 12-lead electrocardiogram.

Nagomi Saito, Daigo Nagahara, Koji Ichihara, Naoya Masumori, Tetsuji Miura, Satoshi Takahashi

Heart rhythm 18 ( 7 ) 1203 - 1209 2021.07 [International journal]

BACKGROUND: Men and women have specific patterns in an electrocardiogram (ECG) differentiated by J-point elevation and ST-segment angle. Although gender-affirming hormone treatment is one of the treatments for gender dysphoria, its influence on an ECG has not been clarified yet. OBJECTIVE: The purpose of this study was to investigate ECG changes induced by gender-affirming hormone treatment. METHODS: The study population consisted of 29 transgender males and 8 transgender females and 37 age- and sex-matched cisgender females and males. Male pattern was defined as J-point elevation > 0.1 mV and ST-segment angle > 20° in precordial leads. RESULTS: In the comparison between 29 transgender males and cisgender females, the prevalence of the male pattern (89.7% vs 6.9%; P < .001), prevalence of the early repolarization pattern (51.7% vs 17.2%; P = .01), J-point elevation (leads V1-V6), T-wave amplitudes (leads V1-V6), QRS amplitudes (leads II, III, V1-V6), and P-wave amplitudes (leads V1-V3) were significantly higher in transgender males. The prevalence of the male pattern was lower in transgender females than in cisgender males (25.0% vs 87.5%; P = .04). In the analysis of transgender males for whom ECGs were available before and after gender-affirming hormone treatment (n = 13), J-point elevation and T-wave amplitudes significantly increased after gender-affirming hormone treatment, leading to a higher prevalence of the male pattern (23.1% vs 92.3%; P < .001). The prevalence of the early repolarization pattern and QRS amplitudes also significantly increased after the treatment, but the augmentation of P-wave amplitudes was modest. CONCLUSION: Gender-affirming hormone treatment for gender dysphoria is accompanied by a change in ECG phenotype toward affirming gender, in which change in androgen level may be involved.

DOI PubMed

Invasive pneumococcal disease affected the fatal outcome in a COVID-19 patient.

Koji Kuronuma, Naofumi Bunya, Bin Chang, Yoshihiro Fujiya, Kazunori Oishi, Eichi Narimatsu, Satoshi Takahashi, Hirofumi Chiba

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 7 ) 1108 - 1111 2021.07 [International journal]

A 68-year-old man experienced fever and cough and was referred to a hospital for day 4. He had a positive reverse transcription-polymerase chain reaction result for severe acute respiratory syndrome coronavirus-2. On day 12, his PaO2/FiO2 ratio worsened to 120 and he was transferred to Sapporo Medical University Hospital for treatment using extracorporeal membrane oxygenation. Venous blood cultures were positive for Streptococcus pneumoniae, which were serotype 3, mucoid-type, and penicillin susceptible. Coinfections with coronavirus disease-2019 and invasive pneumococcal disease are rare; however, they are associated with a higher case fatality than either of the conditions manifesting alone.

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Evaluation of two commercial molecular diagnostic assays: The Xpert Norovirus and the TRCReady NV.

Yuki Sato, Shinya Nirasawa, Masachika Saeki, Yuki Yakuwa, Mayumi Ono, Nozomi Yanagihara, Yoshihiro Fujiya, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 7 ) 1115 - 1118 2021.07 [International journal]

INTRODUCTION: Norovirus is highly contagious, and a few particles of this virus are sufficient to make people sick. It is desirable to develop quick and accurate laboratory methods to detect norovirus. METHODS: We evaluated two commercial molecular diagnostic assays, the Xpert Norovirus and the TRCReady NV, using clinical fecal samples. A reference method was performed using in-house real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR). RESULTS: The results of the real-time RT-PCR analysis of 60 suspected cases of norovirus infection showed 5 cases of Genogroup I (GI) positives and 21 cases of GII positives, among which was 1 GI and GII coinfection. The viral titers of the norovirus-positive samples ranged from 1.54 × 101 to 3.14 × 108 copies/μL. Norovirus GII.17 (12 cases, 48%) was the most frequently detected genotype in this study, followed by GII.4 (6 cases, 24%), GII.13 (2 cases, 8%), GI.2 (2 cases, 8%), GI.3 (2 cases, 8%), GI.1 (1 case, 4%), and GII.2 (1 case, 4%). The kappa coefficient was 1.000 (95% CI: 1.000-1.000) for Xpert Norovirus and 0.966 (95% CI: 0.896-1.000) for TRCReady NV, indicating a strong agreement. CONCLUSIONS: Norovirus detection using Xpert Norovirus and TRCReady NV is highly useful for diagnosis and infection control because these assays are easy to operate, quick, and exhibit almost the same performance as that of real-time RT-PCR.

DOI PubMed

Luteinizing hormone (LH) formed a complex with an immunoglobulin G caused abnormally high levels of LH: A case report.

Yoshifumi Umemori, Ryosei Murai, Koichi Asanuma, Yusuke Takahashi, Yoshika Kuno, Tsuyoshi Saito, Satoshi Takahashi

Clinical biochemistry 93 33 - 35 2021.07 [International journal]

We encountered a 30-year-old woman with remarkably elevated luteinizing hormone (LH) levels, as measured by electrochemiluminescent immunoassay (ECLIA), and no specific symptoms. We performed the following investigations: dilution linearity test, polyethylene glycol (PEG) precipitation test, immunoprecipitation test, protein G addition test, and high-performance liquid chromatography (HPLC) analysis. The linearity of patient's serum was similar to that of a standard LH preparation, and non-specific reactions were not observed. The recovery rate of LH shown by the PEG precipitation test, immunoprecipitation test, and protein G addition test was low. Moreover, an abnormal peak in HPLC was located at a slightly larger molecular weight position than that of IgG. These results showed the presence of macro-LH, LH, and anti-LH-IgG autoantibody complex and suggested that the clearance of LH from the blood was delayed due to IgG binding, and therefore, the LH value was falsely high. We should keep the possibility of macro-LH in mind in cases of unexpectedly high LH values.

DOI PubMed

Evaluating a novel, highly sensitive, and quantitative reagent for detecting SARS-CoV-2 antigen.

Ryo Kobayashi, Ryosei Murai, Koichi Asanuma, Yoshihiro Fujiya, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 6 ) 800 - 807 2021.06 [International journal]

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is rapidly spreading all over the world. A new quantifying reagent for detecting SARS-CoV-2 antigen was developed for early and accurate detection. We evaluated the novel quantitative reagent for detecting SARS-CoV-2 antigen using an automated laboratory device. METHODS: One-hundred nasopharyngeal samples were collected from 47 SARS-CoV-2-infected patients, and 200 samples were collected from healthy donners. We measured the SARS-CoV-2 antigen and nucleic acid using Lumipulse Presto SARS-CoV-2 Ag and the 2019 Novel Coronavirus Detection Kit, respectively. RESULTS: The sensitivity and specificity of the SARS-CoV-2 antigen test were 75.7% (56/74) and 96.0% (192/200), respectively. The concordance rate in the positive group between the antigen and nucleic acid tests was 66% (66/100). In addition, the correlation coefficient between the concentration of SARS-CoV-2 antigen and the level of SARS-CoV-2 RNA was 0.74. There were 19 discrepant samples in which SARS-CoV-2 RNA was detected without SARS-CoV-2 antigen. There was significant difference between the discrepant and matched samples in terms of the time since symptom onset: the 19 discrepant samples were collected a median of 33 days after onset, while the 55 matched samples were collected a median of 19 days after onset. In addition, the 19 discrepant samples were collected from patients who were immune against SARS-CoV-2. CONCLUSIONS: This novel SARS-CoV-2 antigen detection assay is highly sensitive, rapid, accurate, easily diagnostic. It may be useful in both clinical diagnosis and in screening because it does not require special methods such as PCR.

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The JAID/JSC guidelines to Clinical Management of Infectious Disease 2017 concerning male urethritis and related disorders.

Ryoichi Hamasuna, Mitsuru Yasuda, Satoshi Takahashi, Shinya Uehara, Yasuhiro Kawai, Isao Miyairi, Soichi Arakawa, Hiroshi Kiyota

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 27 ( 4 ) 546 - 554 2021.04 [International journal]

DOI PubMed

A Clinical Trial Evaluating the Usefulness of Tailored Antimicrobial Prophylaxis Using Rectal-culture Screening Media Prior to Transrectal Prostate Biopsy: A Multicenter, Randomized Controlled Trial.

Takuya Sadahira, Yuki Maruyama, Yoshiki Hiyama, Hiroyuki Kitano, Hiroki Yamada, Takayuki Goto, Tsubasa Kondo, Katsumi Shigemura, Yosuke Mitsui, Takehiro Iwata, Kohei Edamura, Motoo Araki, Masami Watanabe, Tadasu Takenaka, Jun Teishima, Yasuyoshi Miyata, Kiyohito Ishikawa, Ei-Ichiro Takaoka, Jun Miyazaki, Satoshi Takahashi, Naoya Masumori, Hiroshi Kiyota, Masato Fujisawa, Shingo Yamamoto, Takafumi Sakuma, Norihiro Kusumi, Takaharu Ichikawa, Toyohiko Watanabe, Yoshitsugu Nasu, Masaya Tsugawa, Yasutomo Nasu, Koichiro Wada

Acta medica Okayama 75 ( 5 ) 663 - 667 2021 [Domestic journal]

The aim of this report is to introduce an on-going, multicenter, randomized controlled trial to evaluate whether tailored antimicrobial prophylaxis guided by rectal culture screening prevents acute bacterial prostatitis following transrectal prostate biopsy (TRPB). Patients will be randomized into an intervention or non-intervention group; tazobactam-piperacillin or levofloxacin will be prophylactically administered according to the results of rectal culture prior to TRPB in the intervention group whereas levofloxacin will be routinely given in the non-intervention group. The primary endpoint is the occurrence rate of acute bacterial prostatitis after TRPB. Recruitment begins in April, 2021 and the target total sample size is 5,100 participants.

DOI PubMed

Emergence of the Novel Aminoglycoside Acetyltransferase Variant aac(6')-Ib-D179Y and Acquisition of Colistin Heteroresistance in Carbapenem-Resistant Klebsiella pneumoniae Due to a Disrupting Mutation in the DNA Repair Enzyme MutS.

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

mBio 11 ( 6 ) 2020.12 [International journal]

Amikacin and colistin are effective against carbapenem-resistant Klebsiella pneumoniae In 2017, we successively isolated three carbapenem-resistant K. pneumoniae isolates (ST967) from a patient with chronic renal failure in Japan. The first (SMKP01, sputum, day 0) and second (SMKP02, blood, day 14) strains were resistant to most antimicrobials tested but still susceptible to amikacin (MICs of 4 and 0.5 mg/liter, respectively) and colistin (MIC of 0.5 mg/liter for both). The third strain (SMKP03, blood, day 51) was not susceptible to amikacin (MIC, 32 mg/liter), and its MIC for colistin varied (0.5 to 8 mg/liter). Whole-genome sequencing of SMKP01 revealed that 17 of 20 antimicrobial resistance genes, including qnrB91 (a novel qnrB2 variant) and aac(6')-Ib-cr, were located on an 86.9-kb IncFII-IncQ plasmid. The qnrB91 conferred greater fluoroquinolone resistance than qnrB2 SMKP03 aac(6')-Ib-cr that possessed a gene mutation that resulted in an R102W substitution, namely, aac(6')-Ib-D179Y, made a greater contribution to amikacin resistance than did aac(6')-Ib-cr SMKP03 harbored a nonsense mutation in mutS, which encodes a DNA repair enzyme. Introduction of this mutation into SMKP01 (SMKP01mutSA307T) resulted in a dramatic increase (>58-fold) in the frequency of spontaneous amikacin-resistant mutants relative to SMKP01, and the substantial mutants possessed aac(6')-Ib-D179Y SMKP01mutSA307T exhibited an unstable MIC for colistin (0.5 to 8 mg/liter). The results demonstrate that a disruptive mutation in MutS, arising during the clinical course of an infection, created a platform for the acquisition of amikacin nonsusceptibility and colistin heteroresistance in multidrug-resistant K. pneumoniae, mediated by the elevated frequency of spontaneous mutations.IMPORTANCE The emergence of multidrug resistance in pathogens such as Klebsiella pneumoniae is of great clinical concern. Antimicrobial resistance sometimes arises during the course of an infection. Although many studies have reported the emergence of antimicrobial resistance and novel antimicrobial resistance genes in the clinical isolates, the identity of the bacterial factor(s) that generate this emergence is still unclear. We report that a disruptive mutation in MutS, arising during the clinical course of an infection, created a context for the acquisition of colistin resistance and the emergence of a novel variant of the amikacin resistance gene in multidrug-resistant K. pneumoniae via an increase in the frequency of spontaneous mutation. This observation is important for understanding how K. pneumoniae develops multidrug resistance during infection and could potentially lead to new antimicrobial treatments for high-risk pathological microbes.

DOI PubMed

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.

DOI PubMed

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.

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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.

DOI PubMed

[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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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 ).

DOI PubMed

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]

DOI PubMed

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.

DOI PubMed

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.

DOI PubMed

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]

DOI PubMed

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.

DOI PubMed

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.

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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.

DOI PubMed

Evaluation of new algorithm using TPLA as an initial syphilis screening test.

Ryosei Murai, Koji Yamada, Hitoshi Yonezawa, Nozomi Yanagihara, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 25 ( 1 ) 68 - 70 2019.01 [International journal]

We retrospectively compared the performance of an existing syphilis diagnostic algorithm with a new algorithm that analyzes the results of Treponema pallidum latex agglutination (TPLA) tests. Of the 100 clinical blood samples, 51 were classified as positive through both Mediace TPLA and ESPLINE TP; 2/51 were classified as negative by Architect Syphilis TP, whereas 1/51 was negative as per LUMIPULSE Presto TP. The false positive rate when the results of Mediace TPLA and ESPLINE TP were combined was 1.96% versus 0% for both Architect Syphilis TP and LUMIPULSE Presto TP. The sensitivity of Mediace TPLA (98%) was comparable to that of Architect Syphilis TP (98%) but lower than that of LUMIPULSE Presto TP (100%). The specificity of Mediace TPLA was 98.0% versus 100% for Architect Syphilis TP, and versus 100% for LUMIPULSE Presto TP. We conclude that the performance of Mediace TPLA in combination with a reverse algorithm is nearly equal to that of enzyme immunoassay (EIA) or chemiluminescence immunoassay (CIA). Because TPLA is low cost, highly sensitive method for IgM detection, and is easy to operate, we have recommended its adoption for initial syphilis screening tests.

DOI PubMed

Contribution of Novel Amino Acid Alterations in PmrA or PmrB to Colistin Resistance in mcr-Negative Escherichia coli Clinical Isolates, Including Major Multidrug-Resistant Lineages O25b:H4-ST131-H30Rx and Non-x.

Toyotaka Sato, Tsukasa Shiraishi, Yoshiki Hiyama, Hiroyuki Honda, Masaaki Shinagawa, Masaru Usui, Koji Kuronuma, Naoya Masumori, Satoshi Takahashi, Yutaka Tamura, Shin-Ichi Yokota

Antimicrobial agents and chemotherapy 62 ( 9 ) 2018.09 [International journal]

Colistin is a last-line drug for multidrug-resistant Gram-negative bacteria. We previously reported four plasmid-mediated colistin resistance (mcr) gene-negative colistin-resistant Escherichia coli clinical isolates, including the major pathogenic and fluoroquinolone-resistant strains O25b:H4-ST131-H30Rx (isolates SRE34 and SRE44; MIC for colistin = 16 mg/liter), non-x (SME296; MIC = 8 mg/liter), and O18-ST416 (SME222; MIC = 4 mg/liter). In this study, we investigated the colistin resistance mechanism and identified novel amino acid substitutions or deletions in the PmrAB two-component system that activates eptA (encoding a phosphoethanolamine transferase) and arnT (encoding an undecaprenyl phosphate-alpha-4-amino-4-deoxy-l-arabinose arabinosyl transferase) in all colistin-resistant isolates. SRE34 possessed deletion Δ27-45 (LISVFWLWHESTEQIQLFE) in PmrB, SRE44 possessed substitution L105P in PmrA, and both SME222 and SME296 included substitution G206D in PmrB. Matrix-assisted laser desorption ionization-time of flight mass spectrometry revealed that lipid A is modified with phosphoethanolamine in all four isolates. Deletion of pmrAB decreased colistin MICs to 0.5 mg/liter and lowered eptA and arnT expression. Chromosomal replacement of mutated pmrA or pmrB in colistin-susceptible O25b:H4-ST131 strain SME98 (colistin MIC = 0.5 mg/liter) increased the colistin MIC to that of the respective parent colistin-resistant isolate. In addition, SME98 mutants in which pmrAB was replaced with mutated pmrAB showed no significant differences in bacterial growth and competition culture from the parent strain, except for the mutant with L105P in PmrA, whose growth was significantly suppressed in the presence of the parent strain. In conclusion, some O25b:H4-ST131 strains appear to acquire colistin resistance via phosphoethanolamine modification of lipid A through amino acid changes in PmrAB, and the amino acid changes in PmrB do not influence bacterial growth.

DOI PubMed

Multiclonal Expansion and High Prevalence of β-Lactamase-Negative Haemophilus influenzae with High-Level Ampicillin Resistance in Japan and Susceptibility to Quinolones.

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

Antimicrobial agents and chemotherapy 62 ( 9 ) 2018.09 [International journal]

β-Lactam-resistant Haemophilus influenzae is a clinical concern. A high prevalence (>40%) of β-lactamase-negative high-level ampicillin-resistant H. influenzae (high-BLNAR) isolates in Japan has been reported. However, the reasons for the expansion are unknown. High-BLNAR strains possess an amino acid substitution, either Asn526Lys (group III) or Arg517His (group III-like) in addition to Ser385Thr, in penicillin-binding protein 3 (PBP3). To determine the current prevalence of high-BLNAR strains and the mechanisms behind their expansion in Japan, their prevalence, PBP3 types, multilocus sequence types, and susceptibilities to quinolones approved in Japan as alternatives were determined. Sixty percent of H. influenzae clinical isolates (62/104 isolates) were β-lactamase-negative ampicillin-resistant H. influenzae (BLNAR) strains. Among BLNAR isolates, 92% (57/62 isolates) were high-BLNAR strains. Most isolates were classified as belonging to group III, which contained many genotypes (11 PBP3 types and 25 sequence types). These results indicated that the expansion of high-BLNAR isolates was multiclonal and such strains are still predominant in Japanese clinical settings. One high-BLNAR isolate harbored the novel amino acid substitution Asn526Met in addition to Ser385Thr in PBP3, suggesting a new group (group IV). No quinolone-resistant H. influenzae isolates were identified. The MICs for the quinolones (moxifloxacin, garenoxacin, and tosufloxacin) were similar to that for levofloxacin, whereas sitafloxacin exhibited a lower MIC. However, we obtained 4 H. influenzae isolates with decreased quinolone susceptibility with the amino acid substitution Ser84Leu in GyrA, and 3 of those isolates were high-BLNAR isolates. In summary, this study shows that multiclonal high-BLNAR strains predominate in a Japanese university hospital. Isolates remain sensitive to quinolones, but vigilance is required to prevent the development of fluoroquinolone resistance in high-BLNAR strains.

DOI PubMed

Release of large amounts of lipopolysaccharides from Pseudomonas aeruginosa cells reduces their susceptibility to colistin.

Shin-Ichi Yokota, Hiroshi Hakamada, Soh Yamamoto, Toyotaka Sato, Tsukasa Shiraishi, Masaaki Shinagawa, Satoshi Takahashi

International journal of antimicrobial agents 51 ( 6 ) 888 - 896 2018.06 [International journal]

Pseudomonas aeruginosa is an important etiological agent of opportunistic infections. Injectable colistin is available as a last-line treatment option for multidrug-resistant P. aeruginosa infections. When cells were inoculated at a high number, colistin-susceptible P. aeruginosa grew on agar medium containing colistin at a concentration 10-fold higher than the minimum inhibitory concentration without acquiring colistin resistance. This study examined the responsible mechanism for growth in the presence of a high concentration of colistin. Cell wash fluid derived from P. aeruginosa efficiently reduced colistin antimicrobial activity. This reduction was mediated by lipopolysaccharide (LPS) in the wash fluid. Extracellular LPS inhibited colistin activity more effectively than cell-bound LPS in fixed cells. Cell wash fluids from Escherichia coli and Acinetobacter baumannii also reduced colistin activity; however, they were less potent than those from P. aeruginosa. The amount of LPS in cell wash fluid from P. aeruginosa was approximately 10-fold higher than that in fluid from E. coli or A. baumannii. In conclusion, cell-free LPS derived from bacterial cells inhibited the antimicrobial activity of colistin, and this effect was greatest for P. aeruginosa. Thus, large amounts of broken and dead cells of P. aeruginosa at infection foci will reduce the effectiveness of colistin, even against cells that have not yet acquired resistance.

DOI PubMed

Isolation of a mcr-1-harbouring Escherichia coli isolate from a human clinical setting in Sapporo, Japan.

Toyotaka Sato, Akira Fukuda, Masaru Usui, Masaaki Shinagawa, Tsukasa Shiraishi, Yutaka Tamura, Satoshi Takahashi, Shin-Ichi Yokota

Journal of global antimicrobial resistance 13 20 - 21 2018.06 [International journal]

DOI PubMed

Management of fungus balls as a result of Candida albicans.

Yoshiki Hiyama, Satoshi Takahashi, Naoya Masumori

International journal of urology : official journal of the Japanese Urological Association 25 ( 6 ) 635 - 636 2018.06 [International journal]

DOI PubMed

Oral administration of cernitin pollen extract (Cernilton® ) for 30 days might be useful to avoid unnecessary biopsy in prostate biopsy candidates: A preliminary study.

Yoshikazu Togo, Daishi Ichioka, Jun Miyazaki, Yoshiko Maeda, Koji Kameyama, Mitsuru Yasuda, Yoshiki Hiyama, Satoshi Takahashi, Hiroshi Nagae, Seiichi Hirota, Shingo Yamamoto

International journal of urology : official journal of the Japanese Urological Association 25 ( 5 ) 479 - 485 2018.05 [International journal]

OBJECTIVES: To assess the effect of cernitin pollen extract on serum prostate-specific antigen level prostate biopsy candidates, and to develop an ideal protocol to avoid an unnecessary biopsy procedure. METHODS: A total of 61 patients were administrated cernitin pollen extract tablets (two tablets t.i.d.) for 30 days, and then underwent a prostate biopsy with ≥12 systematic and targeted biopsy cores obtained. Serum prostate-specific antigen levels were examined before and after administration of the pollen extract, and the change in serum prostate-specific antigen and the rate of change were analyzed in relation to negative and positive biopsy results for cancer. RESULTS: The mean change in serum prostate-specific antigen and rate of change after administration of cernitin pollen extract in all patients were -0.6 ± 1.4 ng/mL and -7.6 ± 16.1%, respectively, which were significantly different from the baseline values (P = 0.0003 and P = 0.0005, respectively). When prostate-specific antigen change values and rates were compared between patients negative and positive for cancer, a significant difference between those groups was observed (P = 0.04 and P = 0.03, respectively). CONCLUSIONS: The present study is the first to show that an ideal protocol using cernitin pollen extract has the potential to avoid an unnecessary prostate biopsy procedure in patients with elevated prostate-specific antigen, possibly caused by inflammation. Additional studies with greater numbers of participants are required to confirm our findings and develop an ideal protocol.

DOI PubMed

A Case of Acquired Hemophilia A: Usefulness of Various Methods for Judging Mixing Test Results for Monitoring the Effect of Immunosuppressive Therapy.

Ryosuke Moriai, Nozomi Yanagihara, Akemi Endoh, Satoru Yamada, Maki Mochizuki, Takashi Kondo, Teruo Endoh, Koichi Asanuma, Satoshi Takahashi

Clinical laboratory 64 ( 4 ) 623 - 626 2018.04 [International journal]

BACKGROUND: Measurement of FVIII inhibitor (FVIII INH) levels is important for determining the effect of immunosuppressive therapy on acquired hemophilia A (AHA). However, FVIII INH can only be measured at a limited number of laboratories, which means that there are delays in obtaining the results at many sites. METHODS: A series of mixing tests were carried out in a case of AHA, followed by comparison of various methods for judging the obtained results in association with a change of FVIII INH. The mixing test results were judged using the visual waveform pattern method and the index of circulating anticoagulant (ICA), as well as the difference between the APTT values of delayed-type and immediate-type waveforms (APTT D-I) as a numerical index. RESULTS: All examined judgment methods reflected the change in FVIII INH, but ICA and APTT D-I were particularly sensitive for capturing this. CONCLUSIONS: Our results suggest that a series of mixing tests are useful for rapid monitoring of the effect of immunosuppressive therapy on AHA.

DOI PubMed

Inoculum effect of high concentrations of methicillin-susceptible Staphylococcus aureus on the efficacy of cefazolin and other beta-lactams.

Masachika Saeki, Masaaki Shinagawa, Yuki Yakuwa, Shinya Nirasawa, Yuki Sato, Nozomi Yanagihara, Satoshi Takahashi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 24 ( 3 ) 212 - 215 2018.03 [International journal]

The existence of a cefazolin inoculum effect (InE) of methicillin-susceptible Staphylococcus aureus (MSSA), which is speculated to be a reason for cefazolin treatment failure in MSSA infections, is controversial. In Japan, although cefazolin is one of the therapeutic choices for patients with MSSA infection, there are few reports of this effect. Additionally, the association between InE and blaZ type in beta-lactams other than cefazolin has not been well documented. In this study, we confirmed an MSSA InE in several beta-lactams, including cefazolin, and its relationship with blaZ, using 52 MSSA isolates from blood cultures. Three isolates (5.8%) that possessed type A blaZ showed a pronounced cefazolin InE. Five isolates (9.6%) showed pronounced InE with sulbactam/ampicillin; four isolates had type C blaZ and one had type A blaZ. However, we confirmed InE in MSSA isolates with blaZ not only type A and C but also B and D. For cefotaxime, ceftriaxone, imipenem, and meropenem, regardless of the presence of blaZ, we did not observe a significant increase in MICs at a high inoculum of MSSA. Hence, our results suggest that the above four beta-lactams are good alternatives to cefazolin if InE leads to treatment failure in a patient.

DOI PubMed

Quantification of Wilms' tumor 1 mRNA by digital polymerase chain reaction.

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

International journal of hematology 107 ( 2 ) 230 - 234 2018.02 [Domestic journal]

Wilms' tumor 1 (WT1) is overexpressed in various hematopoietic tumors and widely used as a marker of minimal residual disease. WT1 mRNA has been analyzed using quantitative real-time polymerase chain reaction (real-time PCR). In the present study, we analyzed 40 peripheral blood and bone marrow samples obtained from cases of acute myeloid leukemia, acute lymphoblastic leukemia, and myelodysplastic syndrome at Sapporo Medical University Hospital from April 2012 to January 2015. We performed quantification of WT1 was performed using QuantStudio 3D Digital PCR System (Thermo Fisher Scientific‎) and compared the results between digital PCR and real-time PCR technology. The correlation between digital PCR and real-time PCR was very strong (R = 0.99), and the detection limits of the two methods were equivalent. Digital PCR was able to accurately detect lower WT levels compared with real-time PCR. Digital PCR technology can thus be utilized to predict WT1/ABL1 expression level accurately and should thus be useful for diagnosis or the evaluation of drug efficiency in patients with leukemia.

DOI PubMed

Contribution of Type II Topoisomerase Mutations to Fluoroquinolone Resistance in Enterococcus faecium from Japanese Clinical Setting.

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

Microbial drug resistance (Larchmont, N.Y.) 24 ( 1 ) 1 - 7 2018 [International journal]

High-level fluoroquinolone resistance is conferred by the mutation of conserved serine and acidic amino acids in the quinolone resistance-determining region (QRDR) of the A subunits of the type II topoisomerases, DNA gyrase (GyrA) and topoisomerase IV (ParC). In Japan, fluoroquinolone-resistant Enterococcus faecium continues to emerge in clinical settings. We analyzed 131 Japanese E. faecium clinical isolates for susceptibility to levofloxacin (LVFX), and QRDR mutational status. The bacterial collection had a high percentage of resistance (79%) and showed elevated drug minimal inhibitory concentrations (MICs). Eighty-three isolates had single or combined mutations in gyrA and/or parC; all were resistant to LVFX. A strong correlation was evident between log-transformed MICs and the total number of QRDR mutations (r = 0.7899), confirming the involvement of QRDR mutations in drug resistance, as previously described. Three-dimensional modeling indicated that the amino acid change(s) in QRDR could disrupt the interaction between the enzymes and drugs: the most common cause of quinolone resistance. Interestingly, eight isolates had a single mutation on gyrA and exhibited significantly reduced susceptibility. These data imply that either DNA gyrase or topoisomerase IV can be the primary target of fluoroquinolones, although topoisomerase IV is commonly thought to be the primary target in gram-positive bacteria.

DOI PubMed

Four Cases of Bacteremia Caused by Helicobacter cinaedi in the Urological Ward at About the Same Time

Yoshiki Hiyama, Satoshi Takahashi, Naotaka Nishiyama, Mami Nakae, Satoshi Fujii, Masaaki Shinagawa, Naoya Masumori

Hinyokika kiyo. Acta urologica Japonica ( 泌尿器科紀要刊行会 ) 63 ( 11 ) 461 - 463 2017.11 [Domestic journal]

Here we report the outbreak of bacteremia caused by Helicobacter cinaedi (H. cinaedi) in the urology ward. Case 1 was a man in his seventies with prostate cancer. Bacteremia caused by H. cinaedi developed 6 days after robot-assisted radical prostatectomy. Case 2 was a man in his sixties with small cell carcinoma of the prostate. Bacteremia developed at 5 days of docetaxel therapy. Case 3 was a man in his fifties with left renal pelvis carcinoma. Bacteremia developed 3 days after laparoscopic left nephroureterectomy. Case 4 was a man in his seventies with right renal pelvic carcinoma and bladder cancer. Bacteremia developed 22 days after laparoscopic right nephroureterectomy and laparoscopic radical cystectomy. Each bacteremia occurred almost simultaneously. Fortunately, all 4 cases were treated by antibiotics successfully and there were no cases of recurrence. Whole environmental inspection of the ward did not reveal H. cinaedi. However, multilocus sequence typing proved the strains in cases 3 and 4 to be the same. Therefore, cross-infection was suspected. H. cinaedi can develop to a pathogen of immunocompromised infection. This report clarified that this pathogen can cause bacteremia in the urology ward.

DOI PubMed CiNii

The discrepancy between serum creatinine and cystatin C can predict renal function after treatment for postrenal acute kidney injury: multicenter study and pooled data analysis.

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

Clinical and experimental nephrology 21 ( 5 ) 852 - 857 2017.10 [Domestic journal]

BACKGROUND: Although serum cystatin C and creatinine are used as practical markers of renal function, the discrepancy between them in postrenal acute kidney injury (AKI) cases was reported. The aim of this study was to determine whether the preoperative serum cystatin C (pre-CysC) level could predict clinical outcomes after treatment in patients with postrenal AKI. METHODS: Patients who underwent urological interventions with postrenal AKI were enrolled in this prospective observational study. Associations among preoperative serum creatinine (pre-sCr), pre-CysC, and nadir postoperative serum creatinine (post-sCr) were evaluated. In addition, based on our results in combination with detailed data from the literature, a predictive equation for postoperative serum creatinine (post-sCr) was developed by simple regression analysis and validated using Bland-Altman plots. RESULTS: Finally, 19 patients were eligible for analysis in this study. The value calculated by subtracting pre-CysC (mg/L) from pre-sCr (mg/dl) had a strong correlation to the decrement of serum creatinine (r = 0.9508, p < 0.0001). We added the data of 16 patients obtained from the literature to our series, which were totally randomized into 2 groups, training set and validation set in a 2:1 ratio (n = 23 and 12, respectively) to develop and validate a predictive equation for post-sCr. The mean difference between the predictive and actual post-sCr, -0.68 mg/dl (95% CI -1.62 to 0.26) in the validation set was within the limits of agreement. CONCLUSION: We showed that the discrepancy between pre-sCr and pre-CysC could predict improvement of renal function after intervention in patients with postrenal AKI.

DOI PubMed

Soleal vein dilatation assessed by ultrasonography is an independent predictor for deep vein thrombosis after major orthopedic surgery.

Kiyoshi Abe, Satoshi Yuda, Kenji Yasui, Ayumi Okubo, Chihiro Kobayashi, Atsuko Muranaka, Hirofumi Ohnishi, Akiyoshi Hashimoto, Atsushi Teramoto, Satoshi Nagoya, Kazufumi Tsuchihashi, Toshihiko Yamashita, Satoshi Takahashi, Tetsuji Miura

Journal of cardiology 69 ( 5 ) 756 - 762 2017.05 [International journal]

BACKGROUND: Deep vein thrombosis (DVT) develops after major orthopedic surgery despite the current use of prophylaxis. DVT frequently develops in the soleal vein (SV) and might develop easily at the site of SV dilatation because of blood flow stasis. However, whether preoperative SV dilatation detected by ultrasonography predicts DVT after major orthopedic surgery remains unknown. OBJECTIVE: We examined whether SV dilatation detected by preoperative ultrasonography predicts DVT after major orthopedic surgery. METHODS: Ultrasonography was performed preoperatively and postoperatively in 243 patients with orthopedic diseases (mean age of 67±13 years, 77% women) who underwent total hip arthroplasty (THA, n=180) or total knee arthroplasty (TKA, n=63). Presence of DVT was diagnosed by ultrasonography and SV diameter ≥10mm was defined as SV dilatation. Patients with preoperative DVT were excluded. RESULTS: Sixty-nine patients (28%) developed postoperative DVT. SV dilatation was found in 24 patients (10%), and 16 (67%) of those patients had postoperative DVT. Multivariate logistic regression analysis showed that female gender [odds ratio (OR): 4.09, p=0.004], TKA (OR: 2.52, p=0.011), and SV dilatation (OR: 6.67, p<0.001), but not presence of comorbidities, medications, or plasma d-dimer value, independently predict postoperative DVT. Subgroup analyses according to the operation site showed that female gender (OR: 3.27, p=0.043) and SV dilatation (OR: 3.72, p=0.022) were independent predictors of postoperative DVT in the THA group. SV dilatation (OR: 12.0, p=0.027) was an independent predictor of postoperative DVT also in the TKA group. CONCLUSIONS: In addition to gender and TKA, SV dilatation detected by ultrasonography is an independent predictor of DVT after major orthopedic surgery. Determination of SV diameter by ultrasonography before major orthopedic surgery is useful for assessing the risk of postoperative DVT.

DOI PubMed

The efficacy of faropenem for patients with acute cystitis caused by extended spectrum β-lactamase producing Escherichia coli.

Keiko Fujino, Yoshiki Hiyama, Teruhisa Uehara, Koji Ichihara, Jiro Hashimoto, Satoshi Fujii, Masaaki Shinagawa, Satoshi Takahashi, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 23 ( 5 ) 336 - 338 2017.05 [International journal]

The number of patients with acute cystitis caused by extended spectrum β lactamase (ESBL)-producing Escherichia coli (E. coli) is increasing gradually. Although it is reported that ESBL-producing E. coli are sensitive to faropenem (FRPM), there are few clinical studies on the efficiency of FRPM against acute cystitis caused by the bacteria. Therefore, we retrospectively reviewed the medical charts of patients with acute cystitis caused by ESBL-producing E. coli who were treated with the oral antimicrobial agent faropenem (FRPM) in our institution from June 2011 to May 2015. Ten patients with acute cystitis caused by ESBL producing E. coli were treated with FRPM. Although clinical cure was achieved in 9 of them, it reoccurred in 3. This study revealed that the treatment regimen with FRPM for patients with acute cystitis caused by ESBL-producing E. coli is promising. However, a non-negligible number of recurrences were caused by ESBL-producing E. coli because of the nature of underlying diseases or pathologies in the urinary tract.

DOI PubMed

Serotype distribution, antimicrobial resistance and prevalence of pilus islets in pneumococci following the use of conjugate vaccines.

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

Journal of medical microbiology 66 ( 5 ) 643 - 650 2017.05 [International journal]

PURPOSE: In Japan, the 7-valent pneumococcal vaccine (PCV7) was introduced in 2010 and, in 2013, the PCV7 was replaced with the 13-valent pneumococcal vaccine (PCV13). This study was conducted to investigate serotypes, antimicrobial resistance and prevalence of pilus islets in pneumococcal isolates from inpatients in a Japanese tertiary hospital. METHODOLOGY: From April 2011 to February 2016, 151 isolates [95 (18 children, 77 adults) and 56 (19 children, 37 adults) in the PCV7 and PCV13 periods, respectively] were collected. All isolates were serotyped using genetic methods and were tested for susceptibility to 18 antimicrobials. Unaltered penicillin-binding protein (PBP) genes, macrolide resistance genes and pilus islets were identified by PCR. RESULTS: Between the two periods, the prevalence of non-PCV13 serotypes was shown to increase from 50.0 to 78.9 % in children, and serotype 3 increased from 14.3 to 24.3 % in adults. Six of seven isolates from invasive diseases were assigned to non-PCV13 serotypes. Overall, multidrug resistance (MDR) was detected in 46.4 % of isolates, which included the dominant non-PCV13 serotypes 6E, 15A and 23A (prevalence≥75.0 %). gPRSP (three altered genes pbp1a, pbp2b and pbp2x) and macrolide resistance genes [erm(B) and/or mef(A/E)] were detected in 35.8 and 93.4 % of all isolates, respectively. Pilus islets [PI-1 (clade I, II and III) and/or PI-2] were found in 22.5 % (34/151) of isolates belonging to six different serotypes (19F, 23F, 19A, 6E, 15B and 35B) and 88.2 % (30/34) of these exhibited MDR. CONCLUSION: This study revealed the spread of MDR in several non-PCV13 serotypes and in isolates with pilus islets.

DOI PubMed

Surfactant Protein A Inhibits Growth and Adherence of Uropathogenic Escherichia coli To Protect the Bladder from Infection

Jiro Hashimoto, Motoko Takahashi, Atsushi Saito, Masaki Murata, Yuichiro Kurimura, Chiaki Nishitani, Rina Takamiya, Yasuaki Uehara, Yoshihiro Hasegawa, Yoshiki Hiyama, Norimasa Sawada, Satoshi Takahashi, Naoya Masumori, Yoshio Kuroki, Shigeru Ariki

JOURNAL OF IMMUNOLOGY ( AMER ASSOC IMMUNOLOGISTS ) 198 ( 7 ) 2898 - 2905 2017.04 [Refereed]

Surfactant protein A (SP-A) is a multifunctional host defense collectin that was first identified as a component of pulmonary surfactant. Although SP-A is also expressed in various tissues, including the urinary tract, its innate immune functions in nonpulmonary tissues are poorly understood. In this study, we demonstrated that adherence of uropathogenic Escherichia coli (UPEC) to the bladder was enhanced in SP-A-deficient mice, which suggests that SP-A plays an important role in innate immunity against UPEC. To understand the innate immune functions of SP-A in detail, we performed in vitro experiments. SP-A directly bound to UPEC in a Ca2+-dependent manner, but it did not agglutinate UPEC. Our results suggest that a bouquet-like arrangement seems unsuitable to agglutinate UPEC. Meanwhile, SP-A inhibited growth of UPEC in human urine. Furthermore, the binding of SP-A to UPEC decreased the adherence of bacteria to urothelial cells. These results indicate that direct action of SP-A on UPEC is important in host defense against UPEC. Additionally, adhesion of UPEC to urothelial cells was decreased when the cells were preincubated with SP-A. Adhesion of UPEC to urothelial cells is achieved via interaction between FimH, an adhesin located at bacterial pili, and uroplakin Ia, a glycoprotein expressed on the urothelium. SP-A directly bound to uroplakin Ia and competed with FimH for uroplakin Ia binding. These results lead us to conclude that SP-A plays important roles in host defense against UPEC.

DOI PubMed

Tigecycline Nonsusceptibility Occurs Exclusively in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates, Including the Major Multidrug-Resistant Lineages O25b:H4-ST131-H30R and O1-ST648.

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

Antimicrobial agents and chemotherapy 61 ( 2 ) 2017.02 [International journal]

Tigecycline (TGC) is a last-line drug for multidrug-resistant Enterobacteriaceae We investigated the mechanism(s) underlying TGC nonsusceptibility (TGC resistant/intermediate) in Escherichia coli clinical isolates. The MIC of TGC was determined for 277 fluoroquinolone-susceptible isolates (ciprofloxacin [CIP] MIC, <0.125 mg/liter) and 194 fluoroquinolone-resistant isolates (CIP MIC, >2 mg/liter). The MIC50 and MIC90 for TGC in fluoroquinolone-resistant isolates were 2-fold higher than those in fluoroquinolone-susceptible isolates (MIC50, 0.5 mg/liter versus 0.25 mg/liter; MIC90, 1 mg/liter versus 0.5 mg/liter, respectively). Two fluoroquinolone-resistant isolates (O25b:H4-ST131-H30R and O125:H37-ST48) were TGC resistant (MICs of 4 and 16 mg/liter, respectively), and four other isolates of O25b:H4-ST131-H30R and an isolate of O1-ST648 showed an intermediate interpretation (MIC, 2 mg/liter). No TGC-resistant/intermediate strains were found among the fluoroquinolone-susceptible isolates. The TGC-resistant/intermediate isolates expressed higher levels of acrA and acrB and had lower intracellular TGC concentrations than susceptible isolates, and they possessed mutations in acrR and/or marR The MICs of acrAB-deficient mutants were markedly lower (0.25 mg/liter) than those of the parental strain. After continuous stepwise exposure to CIP in vitro, six of eight TGC-susceptible isolates had reduced TGC susceptibility. Two of them acquired TGC resistance (TGC MIC, 4 mg/liter) and exhibited expression of acrA and acrB and mutations in acrR and/or marR In conclusion, a population of fluoroquinolone-resistant E. coli isolates, including major extraintestinal pathogenic lineages O25b:H4-ST131-H30R and O1-ST648, showed reduced susceptibility to TGC due to overexpression of the efflux pump AcrAB-TolC, leading to decreased intracellular concentrations of the antibiotics that may be associated with the development of fluoroquinolone resistance.

DOI PubMed

Editorial Comment to Novel algorithm for management of acute epididymitis.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 24 ( 1 ) 87 - 88 2017.01 [International journal]

DOI PubMed

Analysis of the causes of discrepancies in troponin I concentrations as measured by ARCHITECT High-Sensitive Troponin I ST and STACIA CLEIA cTnI.

Takashi Kondo, Daisuke Kobayashi, Maki Mochizuki, Kouichi Asanuma, Satoshi Takahashi

Annals of clinical biochemistry 54 ( 1 ) 121 - 126 2017.01 [International journal]

Background Recently developed reagents for the highly sensitive measurement of cardiac troponin I are useful for early diagnosis of acute coronary syndrome. However, differences in measured values between these new reagents and previously used reagents have not been well studied. In this study, we aimed to compare the values between ARCHITECT High-Sensitive Troponin I ST (newly developed reagents), ARCHITECT Troponin I ST and STACIA CLEIA cardiac troponin I (two previously developed reagent kits). Methods Gel filtration high-performance liquid chromatography was used to analyse the causes of differences in measured values. Results The measured values differed between ARCHITECT High-Sensitive Troponin I ST and STACIA CLEIA cardiac troponin I reagents (r = 0.82). Cross-reactivity tests using plasma with added skeletal-muscle troponin I resulted in higher reactivity (2.17-3.03%) for the STACIA CLEIA cardiac troponin I reagents compared with that for the ARCHITECT High-Sensitive Troponin I ST reagents (less than 0.014%). In addition, analysis of three representative samples using gel filtration high-performance liquid chromatography revealed reagent-specific differences in the reactivity against each cardiac troponin I complex; this could explain the differences in values observed for some of the samples. Conclusion The newly developed ARCHITECT High-Sensitive Troponin I ST reagents were not affected by the presence of skeletal-muscle troponin I in the blood and may be useful for routine examinations.

DOI PubMed

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 2016.12 [International journal]

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 2016.11 [International journal]

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

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 2016.10 [International journal]

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 2016.10 [International journal]

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

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 2016.10 [International journal]

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

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 2016.09 [International journal]

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 2016.08 [International journal]

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 2016.07 [Refereed] [International journal]

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 : official journal of the Japanese Urological Association 23 ( 7 ) 558 - 63 2016.07 [International journal]

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 2016.06 [Domestic journal]

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 ) 2016.03

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.

DOI

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 2015.12 [International journal]

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 ) 2015.10 [International journal]

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 2015.10

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 2015.10 [Domestic journal]

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 2015.09 [International journal]

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 2015.07 [International journal]

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 2015.06 [International journal]

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

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 2015.05

Bladder Neck Rupture and Vesicovaginal Fistula Associated with Pelvic Fracture in Female.

Koji Ichihara, Naoya Masumori, Satoshi Takahashi, Noriomi Miyao, Ryuichi Kato

Lower urinary tract symptoms 7 ( 2 ) 115 - 7 2015.05 [International journal]

CASE: Female urethral injury or bladder neck rupture associated with pelvic fracture is rare. The experience of this injury is limited and the management is still challenging. Here we describe a young female patient with urethral injury and vesicovaginal fistula associated with pelvic fracture due to traffic accident. We discuss the recommendation and management about this problem. OUTCOME: We selected staged surgical management for this case, and fortunately succeeded in the repair of the urethral and vaginal injury and acquired favorable continence. CONCLUSION: Appropriate management should be selected according to the condition in each patient. But it should be taken into consideration that a patient with pelvic fracture is critically ill, and an experienced urologist of this field is not always available at that time.

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 2015.05 [International journal]

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

[Significance of Procalcitonin Measurement in Cases with Febrile Condition during Chemotherapy for Urological Cancer].

Yuichiro Kurimura, Satoshi Takahashi, Yoshiki Hiyama, Teruhisa Uehara, Koji Ichihara, Jiro Hashimoto, Naotaka Nishiyama, Hiroshi Kitamura, Naoya Masumori

Hinyokika kiyo. Acta urologica Japonica 61 ( 4 ) 141 - 5 2015.04 [Domestic journal]

We examined the usefulness of measurement of procalcitonin (PCT) for patients, who developed febrile neutropenia during cancer chemotherapy for urological cancer. Of the Patients who underwent cancer chemotherapy for bladder, renal pelvic or ureteral, and testicular cancer in our department from 2010 to 2013, 51 had febrile events. Their clinical courses and PCT values were retrospectively reviewed and analyzed. PCT was positive in 12 patients and negative in 39. The duration with febrile status was significantly longer in the PCT-positive group than in the PCT-negative group. There was no significant difference between the blood count values in each group, but C-reactive protein (CRP) was significantly higher in the PCT-positive group than in the PCT-negative group. There were no significant differences between the 2 groups in other tests with blood. There were 12 patients with febrile neutropenia (FN) but all were classified into low-risk by the MASCC scoring system. Four of these 12 patients were positive for PCT. Our results suggested that, in patients with a fever of 37.5°C or more during the course of cancer chemotherapy for urologic cancer, bacteremia possibly existed if the patient was positive for PCT. In addition, the duration of fever tended to be longer and the condition was more severe. When the patients with urological cancer undergo cancer chemotherapy manifest high-grade fever, PCT is promising and valuable as an indicator of the severity of infection.

PubMed

Obstructive pyelonephritis as a result of urolithiasis in Japan: diagnosis, treatment and prognosis.

Ryoichi Hamasuna, Satoshi Takahashi, Hiroshi Nagae, Tatsuhiko Kubo, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

International journal of urology : official journal of the Japanese Urological Association 22 ( 3 ) 294 - 300 2015.03 [International journal]

OBJECTIVES: To study the current scenario of diagnosis, treatment and mortality of obstructive pyelonephritis secondary to urolithiasis in Japan. METHODS: The study was a retrospective and multicenter survey for hospitalized patients with obstructive pyelonephritis as a result of urolithiasis in educational facilities for specialists by the Japanese Urological Association. Patients' characteristics including physical or laboratory examinations, treatment and prognosis were recorded, and the risk factors for disease death were analyzed. RESULTS: A total of 1363 patients from 208 hospitals were analyzed. The median age of patients was 68 years, and there were 2.2-fold more female patients than male patients. From 844 patients, 891 species of bacteria or fungi were isolated, and Gram-negative rods accounted for 76.5% of cases. The mortality of patients was 2.3%. The risk factors related to disease death by univariate analysis were identified as older age, solitary kidney, ambulance use to visit hospital, disturbance of consciousness, severe appetite loss, higher performance status, disseminated intravascular coagulation status or systemic inflammatory response syndrome, vasopressors and anti-disseminated intravascular coagulation therapies, increased pulse rates, lower hemoglobin, lower serum albumin, and high blood urea nitrogen values. The predictive risk factors for disease death of patients' status at hospitalization were age over 80 years, systemic inflammatory response syndrome, disseminated intravascular coagulation status, disturbance of consciousness and solitary kidney by multivariate analysis. CONCLUSIONS: Obstructive pyelonephritis as a result of urolithiasis represents an emergent disease in the urological field with relatively high mortality. Patients with older age or poor conditions should be hospitalized, and intervention by a urology specialist is likely to be required.

DOI PubMed

The primary local stage at diagnosis predicts regional symptoms caused by local progression in patients with castration-resistant prostate cancer.

Kohei Hashimoto, Takahiro Mizuno, Hiroshi Kitamura, Tetsuya Shindo, Satoshi Takahashi, Naoya Masumori

Urology 85 ( 2 ) 430 - 5 2015.02 [International journal]

OBJECTIVE: To identify the characteristics that predict occurrence of local progression-related events (LPREs) in patients with castration-resistant prostate cancer (CRPC) to adjust its management. METHODS: We retrospectively reviewed the medical records of 39 patients with CRPC. LPREs were defined as regional symptoms caused by local progression and categorized into urinary events and rectal events. Urinary events were defined as ureteral obstruction, acute urinary retention, or hematuria requiring treatment, and rectal events were rectal obstruction or rectal bleeding caused by tumor invasion. RESULTS: The median prostate-specific antigen level at diagnosis was 185 ng/mL. During the median follow-up period of 4.4 years, 10 patients (25.6%) had LPREs. Urinary events were observed in 8 patients (20.5%) and rectal events in 2 (5.1%). The proportion of T4 in patients with LPREs was higher than in those without LPREs (70.0% vs. 10.3%; P <.001). Stage T4 at diagnosis was an independent factor to predict LPREs in multivariate analysis (hazard ratio, 8.62; P = .004). The 5-year cumulative incidence of LPREs in patients with stage T4 was 70.0%, whereas in those with stage ≤T3, they were 3.6% (P <.001). CONCLUSION: Patients with stage T4 at diagnosis are more likely to have a risk of LPREs than those with stage ≤T3. These results indicate that patients with locally advanced prostate cancer on androgen deprivation therapy need to be closely monitored for early diagnosis of CRPC and treated with the appropriate intervention for LPREs at the appropriate time.

DOI PubMed

How do we understand the disagreement in the frequency of surgical site infection between the CDC and Clavien-Dindo classifications?

Takanobu Yamamoto, Satoshi Takahashi, Koji Ichihara, Yoshiki Hiyama, Teruhisa Uehara, Jiro Hashimoto, Megumi Hirobe, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 2 ) 130 - 3 2015.02 [International journal]

To clarify the discrepancy in the incidence and severity of surgical site infections (SSI) for radical cystectomy between reports based on the CDC guideline and those using the Clavien-Dindo classification we evaluated 449 consecutive patients who underwent radical cystectomy for bladder cancer between 1990 and 2012. Of the 115 (25.6%) patients with SSI defined by the CDC guideline, 89 could be analyzed. We compared the SSI rates and severity defined by the CDC guideline and Clavien-Dindo classifications. There were 58 patients with superficial SSI, 16 with deep SSI, and 15 with organ/space SSI according to the CDC guideline. All patients with organ/space SSI were judged as "not having SSI" by the Clavien-Dindo classification. They were classified as having "intestinal prolapse", "intestinal fistula", "abdominal abscess" and "pelvic abscess." There was a significant association between the treatment duration and depth of SSI based on the CDC guideline by Spearman's rank-correlation coefficient (p < 0.001, r = 0.614) and with the grade of complications (p < 0.001, r = 0.632) in the Clavien-Dindo classification. Multivariate analysis showed that patients with grade III SSI in the Clavien-Dindo classification needed a significantly longer treatment duration. It is necessary to be aware that a discrepancy can occur automatically due to the different natures of the definitions. Using the CDC guideline, we can effectively estimate the future treatment period when SSI occurs. With the Clavien-Dindo classification, grade III SSI requires a longer treatment duration.

DOI PubMed

Do patients who complain of lower urinary tract symptoms frequently have clinically significant pyuria?

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

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 21 ( 1 ) 31 - 3 2015.01 [International journal]

There is still controversy about whether post-void residual (PVR) urine volume affects the onset of urinary tract infection (UTI). In addition, although male patients with lower urinary tract symptoms (LUTS) might potentially have PVR, the association between LUTS and UTI or asymptomatic pyuria with or without bacteriuria remains unclear. We studied the frequency of asymptomatic pyuria, with and without bacteriuria, in patients with LUTS without a previous history of urinary tract manipulation at the first visit and their sequential courses. This retrospective study was done by reviewing medical charts. A total of 453 male patients who complained of LUTS and visited our outpatient clinic in 2008 were included in this study. The frequency of pyuria, with or without bacteriuria, in this study at the first visit was 4.9%. The median PVR volumes at the initial examination were 79 ml in the 22 patients with pyuria and 22 ml in the 431 patients without pyuria. The difference of the PVR volume between the patients with pyuria and those without pyuria was statistically significant (p = 0.0095). Twelve patients were treated with alpha-blockers without antimicrobial chemotherapy and pyuria disappeared in 5 (41.7%) of them. However, the decrease in the rate of PVR was not significantly different between the patients with persisting pyuria and those without pyuria. A not negligible number of patients with LUTS had pyuria at the first visit; however, there was no febrile UTI in their clinical course even if they received no urological manipulation.

DOI PubMed

Nationwide survey of urogenital tuberculosis in Japan.

Keita Nakane, Mitsuru Yasuda, Takashi Deguchi, Satoshi Takahashi, Kazushi Tanaka, Hiroshi Hayami, Ryoichi Hamasuna, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

International journal of urology : official journal of the Japanese Urological Association 21 ( 11 ) 1171 - 7 2014.11 [International journal]

OBJECTIVES: To determine current epidemiology and treatment patterns of urogenital tuberculosis in Japan. METHODS: A questionnaire was sent to the urological departments of 1203 Japanese hospitals. Clinical data was reviewed retrospectively; no time range was specified. RESULTS: Of the 1203 hospitals, 399 returned questionnaires with information about 355 urogenital tuberculosis patients. Of the 399, 153 institutions reported at least one patient, and 201 patients were identified between 2000 and 2007. Infections were located in the kidneys (n = 242), ureter (n = 96), bladder (n = 100), epididymis or testes (n = 81) and prostate (n = 9). CONCLUSIONS: Urogenital tuberculosis is rare in Japan, but patients do exist, and we should not ignore them.

DOI PubMed

Erratum: Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - A multi-center retrospective study (Journal of Infection and Chemotherapy (2014) 20 (232-237))

Yoshikazu Togo, Tatsuhiko Kubo, Rikiya Taoka, Yoshiki Hiyama, Teruhisa Uehara, Jiroh Hashimoto, Yuichiro Kurimura, Satoshi Takahashi, Taiji Tsukamoto, Jun Miyazaki, Hiroyuki Nishiyama, Shinichiro Kira, Hiroshi Kiyota, Satoshi Yazawa, Naoya Niwa, Hiroshi Hongo, Mototsugu Oya, Taku Kato, Mitsuru Yasuda, Takashi Deguchi, Kiyohito Ishikawa, Kiyotaka Hoshinaga, Minori Matsumoto, Katsumi Shigemura, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Koichiro Wada, Shinya Uehara, Toyohiko Watanabe, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Masahiro Matsumoto, Takehiko Sho, Ryoichi Hamasuna, Tetsuro Matsumoto, Hiroshi Hayami, Masayuki Nakagawa, Shingo Yamamoto

Journal of Infection and Chemotherapy ( SPRINGER JAPAN KK ) 20 ( 10 ) 660 - 660 2014.10

DOI

Editorial Comment from Dr Takahashi to Development and validation of a nomogram predicting recurrence risk in women with symptomatic urinary tract infection.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 21 ( 9 ) 934 - 5 2014.09 [International journal]

DOI PubMed

Treatment of acute uncomplicated cystitis with faropenem for 3 days versus 7 days: multicentre, randomized, open-label, controlled trial.

Ryoichi Hamasuna, Kazushi Tanaka, Hiroshi Hayami, Mitsuru Yasuda, Satoshi Takahashi, Kanao Kobayashi, Hiroshi Kiyota, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

The Journal of antimicrobial chemotherapy 69 ( 6 ) 1675 - 80 2014.06 [International journal]

OBJECTIVES: The increasing prevalence of resistant bacteria such as fluoroquinolone-resistant or extended-spectrum β-lactamase-producing strains in pathogens causing acute uncomplicated cystitis has been of concern in Japan. Faropenem sodium is a penem antimicrobial that demonstrates a wide antimicrobial spectrum against both aerobic and anaerobic bacteria. It is stable against a number of β-lactamases. METHODS: We compared 3 and 7 day administration regimens of faropenem in a multicentre, randomized, open-label, controlled study. RESULTS: In total, 200 female patients with cystitis were enrolled and randomized into 3 day (N = 97) or 7 day (N = 103) treatment groups. At the first visit, 161 bacterial strains were isolated from 154 participants, and Escherichia coli accounted for 73.9% (119/161) of bacterial strains. At 5-9 days after the completion of treatment, 73 and 81 patients from the 3 day and 7 day groups, respectively, were evaluated by intention-to-treat analysis; the microbiological efficacies were 58.9% eradication (43/73), 20.5% persistence (15/73) and 8.2% replaced (6/73), and 66.7% eradication (54/81), 6.2% persistence (5/81) and 7.4% replaced (6/81), respectively (P = 0.048). The clinical efficacies were 76.7% (56/73) and 80.2% (65/81), respectively (P = 0.695). Adverse events due to faropenem were reported in 9.5% of participants (19/200), and the most common adverse event was diarrhoea. CONCLUSIONS: The 7 day regimen showed a superior rate of microbiological response. E. coli strains were in general susceptible to faropenem, including fluoroquinolone- and cephalosporin-resistant strains.

DOI PubMed

Investigation of the management and risk of febrile neutropenia associated with chemotherapy in the urological field: A multicenter, retrospective analysis

Koichiro Wada, Ryuta Tanimoto, Hiroyuki Nose, Shinya Uehara, Toyohiko Watanabe, Hiroshi Hayami, Shingo Nagai, Mitsuru Yasuda, Takashi Deguchi, Keisuke Shigeta, Satoshi Yazawa, Eiji Kikuchi, Mototsugu Oya, Jiro Hashimoto, Teruhisa Uehara, Yuichiro Kurimura, Yoshiki Hiyama, Satoshi Takahashi, Taiji Tsukamoto, Takehiko Sho, Ryoichi Hamasuna, Jun Miyazaki, Yoshikazu Togo, Rikiya Taoka, Atsushi Nakao, Shingo Yamamoto, Kanao Kobayashi, Akio Matsubara, Kiyohito Ishikawa, Hiromi Kumon, Tetsuro Matsumoto

Japanese Journal of Chemotherapy 62 ( 3 ) 374 - 381 2014.05

In Japan, chemotherapy for urogenital malignant diseases is commonly performed by urologists and febrile neutropenia (FN) is one of the major adverse events associated with chemotherapy, however, few reports exist from the urological field about FN. In this present study, a total of 883 courses of chemotherapy (326 patients) performed from 2010 to 2011 at 10 University Hospitals were retrospectively reviewed. The regimens were GC (gemcitabine and cisplatin), GCP (gemcitabine, cisplatin and paclitaxel) and M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) for urothelial carcinoma, and EP (etoposide and cisplatin) and BEP (bleomycin, etoposide and cisplatin) for testicular cancer. In 81 courses (9.2%, 66 patients; 20.2%) including FN, antimicrobials and granulocyte-colony stimulating factor (G-CSF) were administered in 69 courses (85.2%) and in 77 courses (95.1%), respectively. The MASCC risk-index score was evaluated in no more than 51 courses (63.0%) and 1 patient with 18 points on the MASCC score died due to myelotoxicity and infections. According to statistical investigations, FN is significantly more frequent in GCP and M-VAC than in GC (p = 0.0073, <0.0001) and in a similar manner in BEP than in EP (p = 0.0405). In patients with afebrile neutropenia (AN), observed in 232 courses (26.3%), antimicrobials and G-CSF were administered in 5 courses (2.2%) and in 144 courses (62.1%), respectively. Further evidence from the urological field is required to investigate the treatment and risk of FN for management of patients with urogenital malignancies.

Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis.

Satoshi Takahashi, Hiroshi Kiyota, Shin Ito, Akihiko Iwasawa, Yoshiki Hiyama, Teruhisa Uehara, Koji Ichihara, Jiro Hashimoto, Naoya Masumori, Kenichi Sunaoshi, Koichi Takeda, Nobukazu Suzuki, Takahide Hosobe, Hirokazu Goto, Hidenori Suzuki, Shoichi Onodera

Antibiotics (Basel, Switzerland) 3 ( 2 ) 109 - 20 2014.04 [International journal]

To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011-2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33). The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43) and 37.2% (16/43), respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50). The microbiological eradication rates for the pathogens were 90.9% (30/33) for Neisseria gonorrhoeae, 91.5% (43/47) for Chlamydia trachomatis, 71.4% (5/7) for Mycoplasma genitalium, and 100% (13/13) for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120). The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.

DOI PubMed

[The Japanese version of the National Institutes of Health Chronic Prostatitis Symptom Index].

Satoshi Takahashi, Koichiro Wada, Hiromi Kumon, Hitoshi Masuda, Yasuyuki Suzuki, Osamu Yokoyama, Yukio Homma, Masayuki Takeda

Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 105 ( 2 ) 62 - 5 2014.04 [Domestic journal]

The National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) is the standard questionnaire that determines the degree of symptoms and efficacy of treatment in patients with chronic prostatitis/chronic pelvic pain syndrome. Because there was no officially approved Japanese version of the NIH-CPSI, the Japanese Urological Association (JUA) formed a committee to develop one chaired by Dr. Masayuki Takeda, who also chairs the special field of voiding function and neurourology in the JUA. Consequently, the committee produced a Japanese version, referring to previous proposals and the Japanese version of the International Prostate Symptom Score. The committee strongly expects that the Japanese version of the NIH-CPSI will be taken full advantage of in future clinical research.

PubMed

Comparison of Laparoscopic, Hand-Assisted, and Open Surgical Nephroureterectomy

Hiroshi Kitamura, Toshihiro Maeda, Toshiaki Tanaka, Fumimasa Fukuta, Ko Kobayashi, Naotaka Nishiyama, Satoshi Takahashi, Naoya Masumori

JSLS-JOURNAL OF THE SOCIETY OF LAPAROENDOSCOPIC SURGEONS ( SOC LAPAROENDOSCOPIC SURGEONS ) 18 ( 2 ) 288 - 293 2014.04 [Refereed] [International journal]

Background and Objectives: The aim of this study was to compare oncologic outcomes after laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy for upper urinary tract urothelial cancer. Methods: Between April 1995 and August 2010, 189 patients underwent laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, or open nephroureterectomy for upper urinary tract urothelial cancer. Of these patients, 110 with no previous or concurrent bladder cancer or any metastatic disease were included in this study. Cancer-specific survival, recurrence-free survival, and intravesical recurrence-free survival rates were analyzed by the Kaplan-Meier method and compared with the log-rank test. The median follow-up period for the cohort was 70 months (range, 6-192 months). Results: The 3 groups were well matched for tumor stage, grade, and the presence of lymphovascular invasion and concomitant carcinoma in situ. The estimated 5-year cancer-specific survival rates were 81.1%, 65.6%, and 65.2% for laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy, respectively (P = .4179). The estimated 5-year recurrence-free survival rates were 33.8%, 10.0%, and 41.2% for laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy, respectively (P = .0245). The estimated 5-year intravesical recurrence-free survival rates were 64.8%, 10.0%, and 76.2% for laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy, respectively (P < .0001). Conclusion: Although there was no significant difference in cancer-specific survival rate among the laparoscopic nephroureterectomy, hand-assisted laparoscopic nephroureterectomy, and open nephroureterectomy groups, hand-assisted laparoscopic nephroureterectomy may be inferior to laparoscopic nephroureterectomy or open nephroureterectomy with regard to recurrence-free survival and intravesical recurrence-free survival rates.

DOI PubMed

Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - a multi-center retrospective study.

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 20 ( 4 ) 232 - 7 2014.04 [International journal]

We retrospectively investigated the incidence of genitourinary tract infection in 5895 patients who underwent transrectal and/or transperineal prostate biopsy procedure between January and December 2011 at 46 institutions belonging to Japanese Research Group for Urinary Tract Infection (JRGU). The total rate of genitourinary tract infection after prostate biopsy was 0.76%, while that following transrectal procedure was 0.83% and following transperineal procedure was 0.57%, which were not significantly different. In contrast, febrile infection associated with a fever (≥38 °C) occurred significantly more frequently after transrectal (0.71%) than transperineal (0.16%) approach (P = 0.04). Notably, in infectious cases, Escherichia coli was most frequently isolated. Of the 9 E. coli strains isolated by urine culture, 6 (66.7%) produced extended spectrum β-lactamase (ESBL) and 7 (77.8%) showed levofloxacin resistance. Similarly, of 6 E. coli strains isolated by blood culture, 4 (66.7%) produced ESBL and 6 (100%) showed levofloxacin resistance. When the efficacy of antimicrobial prophylaxis (AMP) with levofloxacin for the patients undergoing transrectal or transperineal biopsy was compared between a single dose (500 mg) and that given for 2 or more days, no significant difference was observed for the rate of infection (transrectal: 0.82% vs. 1.04%, p = 0.94; transperineal: 0.30% vs. 0.46%, p = 0.68). Although a single dose of levofloxacin for AMP is sufficient to prevent genitourinary infection after transrectal or transperineal prostate biopsy, and recommended in this era of increased multi-drug resistant pathogens, the increase in fluoroquinolone-resistant E. coli and ESBL-producing E. coli has emerged as a profound problem for surveillance.

DOI PubMed

Surgical site infection of scrotal and inguinal lesions after urologic surgery.

Teruhisa Uehara, Satoshi Takahashi, Kohji Ichihara, Yoshiki Hiyama, Jiro Hashimoto, Yuichiro Kurimura, Naoya Masumori

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 20 ( 3 ) 186 - 9 2014.03 [International journal]

To clarify the incidence of surgical site infection (SSI) after urological scrotal and inguinal surgical procedures and the preventive effect of antimicrobial prophylaxis for SSI, retrospective analysis was performed. The patients who underwent scrotal and inguinal operations from 2001 to 2010 were included in this analysis. A first or second generation cephalosporin was administered as antimicrobial prophylaxis just before the start of surgery and no additional prophylaxis was conducted. The surgery was classified into 76 (38%) cases with testicular sperm extraction (TESE), 72 (36%) with radical orchiectomy, 29 (14.5%) with bilateral orchiectomy (surgical castration) and 23 (11.5%) with other scrotal and inguinal operations. The median age and age range were 36 years and 18-81 years, respectively. SSI occurred in 7 (3.5%) cases. The frequencies of SSI were 6.5% in the patients with urological inguinal surgery and 1.6% in those with scrotal surgery. The frequency of SSI in the patients with urological inguinal surgery was not negligible even though it is considered a clean operation, and further analysis is warranted to prevent SSI.

DOI PubMed

Evaluation of long-term outcome for patients with renal cell carcinoma after surgery: analysis of cancer deaths occurring more than 10 years after initial treatment

Yuki Kyoda, Ko Kobayashi, Megumi Hirobe, Tetsuya Shindo, Fumimasa Fukuta, Kohei Hashimoto, Toshiaki Tanaka, Akiko Tonooka, Hiroshi Kitamura, Satoshi Takahashi, Naoya Masumori, Tadashi Hasegawa, Taiji Tsukamoto

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY ( SPRINGER JAPAN KK ) 19 ( 1 ) 146 - 151 2014.02 [Refereed]

Objective We evaluated the outcome of renal cell carcinoma (RCC) after surgery in a long-term follow-up study to elucidate the specific biological behaviors of RCC, such as late recurrence and late cancer-specific death. Materials and methods We retrospectively reviewed the clinical and pathological features of 625 patients who were diagnosed as having renal cell carcinoma at our institution from 1975 to 2006. We analyzed the parameters and outcomes for the patients who had received radical or partial nephrectomy. Pathological staging was reviewed again by two pathologists. Results The median age of the patients was 61 years (range 16-87). The median follow-up was 7.0 years (range 0.1-30.3). Of the 516 patients with localized or locally advanced RCC, 124 (24.0 %) had recurrence after surgery. Lung metastasis was observed most frequently. The 10-year cancer-specific survival rates were 92.4, 91.0, 64.1 and 11.8 % for stages I, II, III and IV, respectively. The late recurrence rates in patients with localized and locally advanced RCC 5 and 10 years after initial surgery were 8.5 and 3.7 %, respectively. Cancer death more than 10 years after initial treatment of the disease occurred in 16 patients. Of the 16 patients, 9 had localized disease at the time of the initial surgery. Specific findings that characterized them were not identified in these patients. Conclusions Late recurrence of RCC is not rare. Cancerspecific death more than 10 years after the initial treatment was observed in 16 patients with localized or advanced disease. No specific findings were identified to characterize these patients with late cancer death.

DOI

Editorial comment to "Differential diagnosis between bacterial infection and neoplastic fever in patients with advanced urological cancer: the role of procalcitonin".

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 21 ( 1 ) 107 - 107 2014.01 [International journal]

DOI PubMed

Clinicopathological Analysis of Patients with Non-muscle-invasive Bladder Cancer: Prognostic Value and Clinical Reliability of the 2004 WHO Classification System

Naotaka Nishiyama, Hiroshi Kitamura, Toshihiro Maeda, Satoshi Takahashi, Naoya Masumori, Tadashi Hasegawa, Taiji Tsukamoto

JAPANESE JOURNAL OF CLINICAL ONCOLOGY ( OXFORD UNIV PRESS ) 43 ( 11 ) 1124 - 1131 2013.11 [Refereed]

Objective: The aim of this study was to clarify the prognostic value and clinical reliability of the 2004 World Health Organization classification system of non-muscle-invasive bladder cancer. Methods: Between January 1995 and November 2010, 153 patients were diagnosed with non-muscle- invasive bladder cancer. We used a substage system that discerns T1-microinvasive (T1m, 42 patients) and T1-extensive-invasive (T1e, 37 patients) cancers. Results: There were 2 (1.3%), 89 (58.2%) and 62 (40.5%) cases of Grade 1-3 urothelial carcinoma, respectively, on the basis of the 1973 World Health Organization classification system. Of these, 37 (24.2%) and 116 (75.8%) were graded as low and high on the basis of the 2004 World Health Organization classification system. All of the cases with progression (15 patients) were diagnosed as high grade at the time of primary transurethral resection of the bladder tumor. Based on the Kaplan-Meier analysis, the 2004World Health Organization classification system accurately predicted tumor recurrence (P = 0.029) and progression (P = 0.031). The 5-year recurrence-free survival rates in patients with low-grade and high-grade tumors were 68.7 and 47.1%, and the 5-year progression-free survival rates were 100 and 89.0%, respectively. In the high-grade T1 cases, the substage (T1m or T1e) was a significant predictor of tumor recurrence (P = 0.001) and progression (P = 0.020). Conclusions: The 2004 World Health Organization classification system accurately predicts the risk of recurrence in primary non-muscle-invasive bladder cancer cases and has the same accuracy when predicting the risk of progression as the 1973 World Health Organization classification. Furthermore, the substaging system for high-grade T1 tumors is useful in predicting both recurrence and progression.

DOI

Editorial comment to on- and post-treatment symptom relief by repeated instillations of heparin and alkalized lidocaine in interstitial cystitis.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 20 ( 11 ) 1123 - 1123 2013.11 [International journal]

DOI PubMed

Clinical efficacy of sitafloxacin 100 mg twice daily for 7 days for patients with non-gonococcal urethritis.

Satoshi Takahashi, Ryoichi Hamasuna, Mitsuru Yasuda, Shin Ito, Kenji Ito, Shuichi Kawai, Takamasa Yamaguchi, Takashi Satoh, Kenichi Sunaoshi, Koichi Takeda, Nobukazu Suzuki, Shinichi Maeda, Hirofumi Nishimura, Souichirou Fukuda, Tetsuro Matsumoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 19 ( 5 ) 941 - 5 2013.10 [International journal]

To clarify the clinical efficacy of STFX for patients with non-gonococcal urethritis (NGU), including chlamydial urethritis and Mycoplasma genitalium-positive urethritis, this study included male patients with NGU who were 20 years old or older. The pathogens, including Chlamydia trachomatis, M. genitalium and Ureaplasma urealyticum, were detected by nucleic acid amplification tests and the patients were treated with sitafloxacin 100 mg twice daily for 7 days. Microbiological and clinical efficacies were assessed for the patients with NGU posttreatment. Among the 208 patients enrolled in this study, data for a total of 118 patients could be analyzed. The median age was 32 (20-61) years. The median duration from the completion of treatment to the second visit was 21 (14-42) days. There were 68 pathogen-positive NGU cases and 50 with NGU without any microbial detection. Microbiological cure was achieved in 95.6% of the pathogen-positive NGU patients. Total clinical cure was achieved in 91.3% (105/115). In this study, STFX was able to eradicate 95.7% of C. trachomatis, 93.8% of M. genitalium and 100% of U. urealyticum. The results of our clinical research indicate that the STFX treatment regimen should become a standard regimen recommended for patients with NGU. In addition, this regimen is recommended for patients with M. genitalium-positive NGU.

DOI PubMed

Significance of anaerobic bacteria in postoperative infection after radical cystectomy and urinary diversion or reconstruction

Yoshiki Hiyama, Satoshi Takahashi, Teruhisa Uehara, Jiro Hashimoto, Yuichiro Kurimura, Toshiaki Tanaka, Naoya Masumori, Taiji Tsukamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK ) 19 ( 5 ) 867 - 870 2013.10 [Refereed]

Radical cystectomy followed by urinary diversion or reconstruction (RC) is a standard treatment for patients with muscle-invasive bladder cancer. In these operations, a high frequency of complications, especially postoperative infection, has been reported. However, there have only been a few studies about postoperative anaerobic bacterial infection. To clarify the significance and role of anaerobic bacteria in postoperative infection, we retrospectively analyzed cases in which postoperative infection by these organisms developed. A total of 126 patients who underwent RC from 2006 to 2010 were included in this study. Various types of postoperative infection occurred in 66 patients. Anaerobic bacterial infections were detected with cultures for urine and blood in one case, for blood in two cases, and for surgical wound pus in four. The frequency of postoperative anaerobic bacterial infection in RC was less than that of colon surgery. However, this study revealed the possible development of a nonnegligible number of postoperative anaerobic bacterial infections. Therefore, we should consider anaerobic bacteria as possible pathogens in postoperative infection after RC.

DOI

Incidence of sexually transmitted diseases in Hokkaido, Japan, 1998 to 2001.

Satoshi Takahashi, Kou Takeyama, Yasuharu Kunishima, Toshiaki Shimizu, Naotaka Nishiyama, Hiroshi Hotta, Masanori Matsukawa, Masumi Minowa, Takeo Tanihata, Yoshiaki Kumamoto, Taiji Tsukamoto

Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 87 ( 5 Suppl 8 ) 24 - 8 2013.09 [Domestic journal]

The objective of this study was to provide precise data on the incidence of sexually transmitted diseases (STDs) in Hokkaido. The goal of this prospective surveillance, study was to clarify the STD incidence between 1998 and 2001 in Hokkaido, Japan. The incidence of gonococcal infection in men was found to be 127-199 per 100000 people per year, which was three or four times higher than that for women. Female genital chlamydial infection had an incidence of 300-400 with a female to male ratio of two or three to one. Younger adults had higher incidences of gonococcal and chlamydial infections than older people. In conclusion, the current study of STDs revealed high incidences of gonococcal and chlamydial infections in the Hokkaido area, and there was no decreasing trend in STD incidence during these 4 years.

PubMed

[Bilateral urolithiasis with zonisamide developed for a short period of time in a 10-year-old girl with intractable epilepsy].

Shunsuke Sato, Kazuyuki Nishinaka, Satoshi Takahashi, Megumi Hirobe, Taiji Tsukamoto

Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 104 ( 5 ) 674 - 7 2013.09 [Domestic journal]

Zonisamide is an antiepileptic drug mainly used in patients with refractory epilepsy. One of the urological adverse effects caused by zonisamide is urinary lithiasis. We reported bilateral urinary lithiasis with zonisamide developed for a short period of time. A 10 year-old girl had been treated with zonisamide for intractable epilepsy for nine years. She progressively developed microscopic hematuria as well as crystalluria while being hospitalized for ventriculoperitoneal shunt infection. A computed tomography (CT) showed bilaterally hydronephrotic kidneys obstructed by multiple ureteral calculi. What was impressive was the fact that any single urinary calculus was not identified in a CT image taken just three weeks prior to this event. Then the diagnosis was made of zonisamide-induced bilateral urinary calculi and zonisamide treatment was discontinued. However, since the deterioration of renal function and left-sided hydronephrosis progressed, we performed the construction of right-sided percutaneous nephrostomy (PNS) and the transurethral placement of a left ureteral stent. Subsequently her condition was stabilized and all of these stones were discharged. The analysis of these stones showed mainly calcium phosphatic calculus. We eventually removed both the right PNS and the left ureteral stent. Since then, there has not been any recurrence thus far. We need to recognize the risk of progressively developing renal calculi during zonisamide treatment for a relatively short period of time in the face of dehydration.

PubMed

Nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan.

Ryoichi Hamasuna, Mitsuru Yasuda, Kiyohito Ishikawa, Shinya Uehara, Satoshi Takahashi, Hiroshi Hayami, Shingo Yamamoto, Tetsuro Matsumoto, Shinichi Minamitani, Akira Watanabe, Aikichi Iwamoto, Kyoichi Totsuka, 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, Katsunori Tatsugami, Shin Ito, Harunori Narita, Mototsugu Kanokogi, Toru Sumii, Kenji Ito, Takahide Hosobe, Shuichi Kawai, Hiromi Kawano, Kazuo Takayama, Takamasa Yamaguchi, Katsuhisa Endo, Takamine Yamauchi, Shinichi Maeda, Mutsumasa Yoh, Masanobu Horie, Masayasu Ito, Hirofumi Chokyu, Hideari Ihara, Kikuo Akiyama, Satoshi Uno, Koichi Monden, Shinichi Kaji, Hirofumi Nishimura, Motoshi Kawahara, Takashi Sato, Takatoshi Konishi, Shohei Nishi, Satoshi Ishihara, Masaru Yoshioka

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 19 ( 4 ) 571 - 8 2013.08 [International journal]

Neisseria gonorrhoeae is one of the most important pathogens causing sexually transmitted infection, and strains that are resistant to several antimicrobials are increasing. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the first nationwide surveillance. The urethral discharge was collected from male patients with urethritis at 51 medical facilities from April 2009 to October 2010. Of the 156 specimens, 83 N. gonorrhoeae strains were tested for susceptibility to 18 antimicrobial agents. The prevalence of β-lactamase-producing strains and chromosomally mediated resistant strains were 7.2 % and 16.5 %, respectively. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) of ceftriaxone for 7 strains (8.4 %) was 0.125 μg/ml. One strain was resistant to cefixime (MIC 0.5 μg/ml). The MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin, and tosufloxacin, showed a bimodal distribution. The MIC of sitafloxacin was lower than those of the three fluoroquinolones listed here, and it was found that the antimicrobial activity of sitafloxacin was stronger than that of the fluoroquinolones. The MIC of azithromycin in 2 strains was 2 μg/ml, but no high-level resistance to macrolides was detected.

DOI PubMed

Coadministration of tenofovir decreased atazanavir plasma concentration after unilateral nephrectomy.

Yusuke Kunimoto, Hiroshi Yasui, Norifumi Touda, Masako Okazaki, Hiromasa Nakata, Norimasa Noda, Hiroshi Ikeda, Toshiaki Hayashi, Satoshi Takahashi, Yasuhisa Shinomura, Tadao Ishida, Atsushi Miyamoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 19 ( 4 ) 750 - 3 2013.08 [International journal]

We report a case in which the atazanavir (ATV) concentration in the plasma decreased after unilateral nephrectomy in a patient receiving tenofovir (TDF). The patient was a 39-year-old man diagnosed with human immunodeficiency virus type 1 infection and was being treated with TDF/emtricitabine, ATV, and ritonavir. Before nephrectomy, ATV and TDF plasma trough concentrations were 810 and 65 ng/ml, respectively. At this time, estimated glomerular filtration rate (eGFR) was 111 ml/min/1.73 m(2). Approximately 5 months after starting antiretroviral therapy (ART), the patient underwent nephrectomy. Plasma concentrations were remeasured 18 weeks after the operation, and the TDF concentration had increased to 109 ng/ml, whereas the ATV concentration decreased to 290 ng/ml. His eGFR decreased to 50 ml/min/1.73 m(2) at the time of the second measurement. The decreased ATV plasma concentration suggested that interactions between ATV and TDF were exacerbated by an increase in TDF plasma concentration caused by renal dysfunction. This case report suggests that it is important to monitor the ATV plasma concentration to ensure that it is no less than the target trough concentration when renal function decline is observed in patients receiving ART including ATV and TDF.

DOI PubMed

[A questionnaire survey of antimicrobial prophylaxis to prevent perioperative infection in urological field in Japan].

Yoshikazu Togo, Rikiya Taoka, Shingo Yamamoto, Yoshiki Hiyama, Teruhisa Uehara, Jiroh Hashimoto, Yuichiro Kurimura, Satoshi Takahashi, Taiji Tsukamoto, Jun Miyazaki, Hiroyuki Nishiyama, Hiroshi Kiyota, Satoshi Yazawa, Mototsugu Oya, Mitsuru Yasuda, Takashi Deguchi, Kiyohito Ishikawa, Kiyotaka Hoshinaga, Minori Matsumoto, Katsumi Shigemura, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Koichiro Wada, Shinya Uehara, Toyohiko Watanabe, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Masahiro Matsumoto, Takehiko Sho, Ryoichi Hamasuna, Tetsuro Matsumoto, Hiroshi Hayami, Takashi Yamane, Masayuki Nakagawa

Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 104 ( 4 ) 579 - 88 2013.07 [Domestic journal]

PURPOSE: To survey the present condition of administration method of the antimicrobial prophylactic (AMP) agents for the perioperative infection in Japan on revising "The Japanese guidelines for prevention of perioperative infections in urologic field (2006)". PATIENTS AND METHODS: With the approval of the Japanese Urological Association (JUA) in 2011, all of the principal urological training institutions certified by JUA (n = 836) were encouraged to participate to survey their adherence to the JUA guidelines (published in 2006) for AMP to prevent perioperative infection in urological field, and 446 (53.3%) institutions responded to the questionnaire. RESULTS: The rates of following the JUA guidelines of, "completely", "mainly", "not too much", and "not at all" were 6.5%, 69.7%, 22.0% and 1.6%, respectively. The guidelines were followed for open clean operations in 48.5%, open clean-contaminated operations in 66.4%, open contaminated operations in 61.8%, laparoscopic clean operations in 54.1%, laparoscopic clean-contaminated operations in 61.2%, transurethral resection of bladder tumor in 71.5%, transurethral resection of prostate in 68.9%, ureteroscopy and transurethral ureterolithotomy in 68.2%, prostate biopsy in 43.2%, and cystoscopy were in 42.2%, respectively. However, in terms of duration of AMP administration, the longer duration than those recommended by the guidelines were observed for clean surgery, transurethral resection of bladder tumor, ureteroscopy and transurethral ureterolithotomy, prostate biopsy, and cystoscopy. CONCLUSIONS: In terms of kinds of AMP, the guidelines were almostly followed in all operative procedures. However, the duration of AMP administration were longer than those recommended by the guidelines. On revision of "Japanese guidelines for prevention of perioperative infections in urologic field (2006)", these data would be taken into consideration to avoid dissociation between the guidelines and the practical side in the urologists.

PubMed

Nationwide surveillance of bacterial pathogens from patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2009 and 2010: antimicrobial susceptibility of Escherichia coli and Staphylococcus saprophyticus.

Hiroshi Hayami, Satoshi Takahashi, Kiyohito Ishikawa, Mitsuru Yasuda, Shingo Yamamoto, Shinya Uehara, Ryoichi Hamasuna, Tetsuro Matsumoto, Shinichi Minamitani, Akira Watanabe, Aikichi Iwamoto, Kyoichi Totsuka, 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, Katsunori Tatsugami, Takamasa Yamaguchi, Shin Ito, Mototsugu Kanokogi, Harunori Narita, Hiromi Kawano, Takahide Hosobe, Kazuo Takayama, Toru Sumii, Akira Fujii, Takashi Sato, Takamine Yamauchi, Masanobu Izumitani, Hirofumi Chokyu, Hideari Ihara, Kikuo Akiyama, Masaru Yoshioka, Satoshi Uno, Koichi Monden, Motonori Kano, Shinichi Kaji, Shuichi Kawai, Kenji Ito, Hisato Inatomi, Hirofumi Nishimura, Toshihiro Ikuyama, Shohei Nishi, Koichi Takahashi, Yukihiro Kawano, Satoshi Ishihara, Kengo Tsuneyoshi, Shinji Matsushita, Takashi Yamane, Takaoki Hirose, Shigeru Fujihiro, Katsuhisa Endo, Yasuhiko Oka, Koh Takeyama, Takahiro Kimura, Tetsuji Uemura

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 19 ( 3 ) 393 - 403 2013.06 [International journal]

The Japanese surveillance committee conducted the first nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for female acute uncomplicated cystitis at 43 hospitals throughout Japan from April 2009 to November 2010. In this study, the causative bacteria (Escherichia coli and Staphylococcus saprophyticus) and their susceptibility to various antimicrobial agents were investigated by isolation and culturing of bacteria from urine samples. In total, 387 strains were isolated from 461 patients, including E. coli (n = 301, 77.8 %), S. saprophyticus (n = 20, 5.2 %), Klebsiella pneumoniae (n = 13, 3.4 %), and Enterococcus faecalis (n = 11, 2.8 %). S. saprophyticus was significantly more common in premenopausal women (P = 0.00095). The minimum inhibitory concentrations of 19 antibacterial agents used for these strains were determined according to the Clinical and Laboratory Standards Institute manual. At least 87 % of E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, and 100 % of S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant E. coli strains and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 13.3 % and 4.7 %, respectively. It is important to confirm the susceptibility of causative bacteria for optimal antimicrobial therapy, and empiric antimicrobial agents should be selected by considering patient characteristics and other factors. However, the number of isolates of fluoroquinolone-resistant or ESBL-producing strains in gram-negative bacilli may be increasing in patients with urinary tract infections (UTIs) in Japan. Therefore, these data present important information for the proper treatment of UTIs and will serve as a useful reference for future surveillance studies.

DOI PubMed

[Prospective multi-institutional analysis according to the "Japanese guidelines for prevention of perioperative infections in urological field"].

Koichiro Wada, Shinya Uehara, Shinichiro Kira, Masahiro Matsumoto, Takehiko Sho, Yuichiro Kurimura, Jiro Hashimoto, Teruhisa Uehara, Takashi Yamane, Sojun Kanamaru, Yoshikazu Togo, Rikiya Taoka, Akira Takahashi, Yusuke Yamada, Akira Yokomizo, Mitsuru Yasuda, Kazushi Tanaka, Ryoichi Hamasuna, Satoshi Takahashi, Hiroshi Hayami, Toyohiko Watanabe, Koichi Monden, Hiroshi Kiyota, Takashi Deguchi, Seiji Naito, Taiji Tsukamoto, Soichi Arakawa, Masato Fujisawa, Shingo Yamamoto, Hiromi Kumon, Tetsuro Matsumoto

Nihon Hinyokika Gakkai zasshi. The japanese journal of urology 104 ( 3 ) 505 - 12 2013.05 [Domestic journal]

OBJECTIVE: The "Japanese guidelines for prevention of perioperative infections in urological field" was edited by the Japanese Urological Association in 2007. They are the first Japanese guidelines for antimicrobial prophylaxis specifically to prevent perioperative infections in the urological field. We report here the results of a multicenter prospective study conducted to examine the validity and usefulness of these guidelines. PATIENTS AND METHODS: The subjects were 513 patients who had undergone urological surgeries between July and September 2008 at 10 nationwide university institutions in the Japanese Society of UTI Cooperative Study Group. These surgeries were transurethral resection of bladder (TURBT), transurethral resection of prostate (TURP), adrenalectomy, nephrectomy, nephroureterectomy, radical prostatectomy and total cystectomy. Analysis was performed on patient information, surgical procedures, types and durations of administration of prophylactic antibiotic agents, and the presence of surgical site infections (SSI) and remote infections (RI). RESULTS: Of 513 patients, 387 (75.4%) were administered prophylactic antibiotic agents according to the guidelines. In these patients, the incidences of SSI and RI were 5.9% and 4.1%, respectively. Multivariate analysis showed that significant factors for SSI were the surgical risk (according to the ASA physical status classification system), diabetes, and operation time, and that the only significant factor for RI was the operation time. CONCLUSIONS: More large-scale study and evidences are necessary in order to demonstrate the validity and usefulness of these guidelines.

PubMed

Antimicrobial susceptibility and penicillin-binding protein 1 and 2 mutations in Neisseria gonorrhoeae isolated from male urethritis in Sapporo, Japan

Satoshi Takahashi, Yuichiro Kurimura, Jiro Hashimoto, Teruhisa Uehara, Yoshiki Hiyama, Akihiko Iwasawa, Masahiro Nishimura, Kenichi Sunaoshi, Koichi Takeda, Nobukazu Suzuki, Taiji Tsukamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK ) 19 ( 1 ) 50 - 56 2013.02 [Refereed]

The spread of antimicrobial-resistant Neisseria gonorrhoeae worldwide is a critical issue in the control of sexually transmitted infections. The purpose of this study was to clarify recent trends in the susceptibility of N. gonorrhoeae to various antimicrobial agents and to compare these data with our previous data. Minimum inhibitory concentrations (MICs) of various antimicrobial agents were determined in N. gonorrhoeae strains clinically isolated from male gonococcal urethritis. In addition, amino acid sequencing of penicillin-binding protein (PBP) 2, encoded by the penA gene, was analyzed so that genetic analysis of mosaic PBP 2 could clarify the susceptibility of the strains to cefixime and other cephalosporins. The susceptibility rate for ceftriaxone, cefodizime, and spectinomycin, agents whose use is recommended by the guideline of the Japanese Society of Sexually Transmitted Infections (JSSTI), was 100 %. The susceptibility rates of the strains to penicillin G and ciprofloxacin were lower than those in previous reports. Mosaic PBP 2 structures were detected in 51.9 % of the strains and the MICs of the strains with the mosaic PBP 2 to cefixime were much higher than those of the strains without the mosaic PBP 2. In the clinical situation, the treatment regimen recommended by the JSSTI remains appropriate; however, the susceptibility to cephalosporins should be intensively surveyed because strains with mosaic PBP 2 were commonly detected.

DOI

A randomized clinical trial to evaluate the preventive effect of cranberry juice (UR65) for patients with recurrent urinary tract infection.

Satoshi Takahashi, Ryoichi Hamasuna, Mitsuru Yasuda, Soichi Arakawa, Kazushi Tanaka, Kiyohito Ishikawa, Hiroshi Kiyota, Hiroshi Hayami, Shingo Yamamoto, Tatsuhiko Kubo, Tetsuro Matsumoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 19 ( 1 ) 112 - 7 2013.02 [International journal]

We examined the rate of relapse, as a variable index, in patients with urinary tract infection (UTI) who suffered from multiple relapses when using cranberry juice (UR65). A randomized, placebo-controlled, double-blind study was conducted from October 2007 to September 2009 in Japan. The subjects were outpatients aged 20 to 79 years who were randomly divided into two groups. One group received cranberry juice (group A) and the other a placebo beverage (group P). To keep the conditions blind, the color and taste of the beverages were adjusted. The subjects drank 1 bottle (125 mL) of cranberry juice or the placebo beverage once daily, before going to sleep, for 24 weeks. The primary endpoint was relapse of UTI. In the group of females aged 50 years or more, there was a significant difference in the rate of relapse of UTI between groups A and P (log-rank test; p = 0.0425). In this subgroup analysis, relapse of UTI was observed in 16 of 55 (29.1 %) patients in group A and 31 of 63 (49.2 %) in group P. In this study, cranberry juice prevented the recurrence of UTI in a limited female population with 24-week intake of the beverage.

DOI PubMed

Impact of vancomycin or linezolid therapy on development of renal dysfunction and thrombocytopenia in Japanese patients.

Satoshi Fujii, Satoshi Takahashi, Shinki Makino, Yusuke Kunimoto, Hiromasa Nakata, Norimasa Noda, Koichi Sakurai, Atsushi Miyamoto

Chemotherapy 59 ( 5 ) 319 - 24 2013 [International journal]

BACKGROUND: Vancomycin and linezolid therapies are associated with renal dysfunction and thrombocytopenia, respectively. METHODS: We retrospectively investigated Japanese patients with renal dysfunction or thrombocytopenia possibly associated with vancomycin and linezolid therapies, including 235 patients treated with parenteral vancomycin and 178 treated with parenteral linezolid. RESULTS: Renal dysfunction occurred more frequently in patients receiving vancomycin (24%) than in those receiving linezolid (13%; p = 0.032), whereas thrombocytopenia occurred more frequently in linezolid-treated patients (41%) than in vancomycin-treated patients (17%; p < 0.001). Controlling trough vancomycin concentrations (<20 μg/ml) protects against renal dysfunction, but thrombocytopenia may occur after >7.5 days of linezolid treatment. CONCLUSION: Controlling trough vancomycin concentrations to <20 μg/ml protects Japanese patients against renal dysfunction. Linezolid is an appropriate initial therapy for severe infections in patients with acute renal dysfunction, but monitoring of platelet counts is essential after initiation of therapy.

DOI PubMed

Surfactant Protein D Inhibits Adherence of Uropathogenic Escherichia coli to the Bladder Epithelial Cells and the Bacterium-induced Cytotoxicity A POSSIBLE FUNCTION IN URINARY TRACT

Yuichiro Kurimura, Chiaki Nishitani, Shigeru Ariki, Atsushi Saito, Yoshihiro Hasegawa, Motoko Takahashi, Jiro Hashimoto, Satoshi Takahashi, Taiji Tsukamoto, Yoshio Kuroki

JOURNAL OF BIOLOGICAL CHEMISTRY ( AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC ) 287 ( 47 ) 39578 - 39588 2012.11 [Refereed]

The adherence of uropathogenic Escherichia coli (UPEC) to the host urothelial surface is the first step for establishing UPEC infection. Uroplakin Ia (UPIa), a glycoprotein expressed on bladder urothelium, serves as a receptor for FimH, a lectin located at bacterial pili, and their interaction initiates UPEC infection. Surfactant protein D (SP-D) is known to be expressed on mucosal surfaces in various tissues besides the lung. However, the functions of SP-D in the non-pulmonary tissues are poorly understood. The purposes of this study were to investigate the possible function of SP-D expressed in the bladder urothelium and the mechanisms by which SP-D functions. SP-D was expressed in human bladder mucosa, and its mRNA was increased in the bladder of the UPEC infection model in mice. SP-D directly bound to UPEC and strongly agglutinated them in a Ca2+-dependent manner. Co-incubation of SP-D with UPEC decreased the bacterial adherence to 5637 cells, the human bladder cell line, and the UPEC-induced cytotoxicity. In addition, preincubation of SP-D with 5637 cells resulted in the decreased adherence of UPEC to the cells and in a reduced number of cells injured by UPEC. SP-D directly bound to UPIa and competed with FimH for UPIa binding. Consistent with the in vitro data, the exogenous administration of SP-D inhibited UPEC adherence to the bladder and dampened UPEC-induced inflammation in mice. These results support the conclusion that SP-D can protect the bladder urothelium against UPEC infection and suggest a possible function of SP-D in urinary tract.

DOI PubMed

下肢静脈瘤を伴う患者における術前深部静脈超音波検査の意義

西田幸代, 北村寛, 高橋聡, 舛森直哉, 塚本泰司

泌尿器外科 ( 医学図書出版(株) ) 25 ( 9 ) 1895 - 1895 2012.09

当科における複数の分子標的薬使用経験

西田幸代, 北村寛, 高橋聡, 舛森直哉, 塚本泰司

泌尿器外科 ( 医学図書出版(株) ) 25 ( 9 ) 1906 - 1906 2012.09

Clinical study of laparoscopic adrenalectomy in Sapporo Medical University

Satoshi Takahashi, Naoya Masumori, Hiroshi Kitamura, Naoki Itoh, Atsushi Takahashi, Masanori Matsukawa, Yasuharu Kunishima, Ryuichi Kato, Noriomi Miyao, Taiji Tsukamoto

Acta Urologica Japonica ( 7 ) 58 ( 7 ) 315 - 318 2012.07 [Refereed]

The purpose of this retrospective study was to identify the surgical outcome and complications of laparoscopic adrenalectomy at Sapporo Medical University Hospital. One hundred fifty-six patients underwent laparoscopic adrenalectomy due to primary aldosteronism in 64 (41.0%), Cushing's syndrome in 34 (21.8%), endocrinological non-functioning tumors in 27 (17.3%), pheochromocytoma in 23 (14.7%) and others. The median time of the surgery was 140 minutes (range 70 to 345) and the median volume of blood loss was 10 ml (0-1, 200). From 1999, the operation time was around the median time of this study and from 2006, it was commonly below the median time of this study. There were 4 cases (2.6%) with complications however, no severe cases occurred. In conclusion, laparoscopic adrenalectomy in our hospital has been performed safely as a standard treatment.

PubMed

Should urologists care for the pharyngeal infection of Neisseria gonorrhoeae or Chlamydia trachomatis when we treat male urethritis?

Ryoichi Hamasuna, Satoshi Takahashi, Shinya Uehara, Tetsuro Matsumoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 18 ( 3 ) 410 - 3 2012.06 [International journal]

Detection of Neisseria gonorrhoeae (NG) or Chlamydia trachomatis (CT) from the pharynx of women or men is not uncommon. However, there is no recommendation how urologists should care for the pharyngeal infection of men with urethritis in Japan. The aim of this study is to clarify the prevalence of NG or CT infection in the pharynx of men and to show a recommendation for urologists. The Japanese reports about the detection of NG or CT from the pharynx or the oral cavity of men in Japan are reviewed in the literature from 1990 to 2011. The prevalence of NG or CT in the pharynx was 4% or 6% in men who attended clinics, and 20% or 6% in men who were positive for NG or CT from genital specimens, respectively. Single 1-g dose ceftriaxone was recommended to treat pharyngeal NG, but no evidence was found for pharyngeal CT. There was not enough evidence for recommendation. However, when men with urethritis only caused by NG or CT are treated through the guideline of the Japanese Society of Sexually Transmitted Infection, we do not think additional tests or treatment for the pharynx are needed when a single 1-g dose ceftriaxone for gonococcal urethritis or a single 1- or 2- g dose azithromycin is prescribed for chlamydial urethritis in Japan.

DOI PubMed

The 7th American Urological Association and the Japanese Urological Association international affiliate society meeting.

Yukio Homma, Hidehiro Kakizaki, Joseph A Smith Jr, Shunichi Namiki, Yoichi Arai, Yoshihiko Tomita, Robert Uzzo, Norihiko Tsuchiya, Masayuki Takahashi, Tomohiko Ichikawa, Marcus L Quek, Hiroji Uemura, Atsushi Mizokami, Hidehiro Kakizaki, William D Steers, Momokazu Gotoh, Takehiko Ogawa, Michael B Chancellor, Shingo Yamamoto, Satoshi Takahashi, Kohji Ichihara

International journal of urology : official journal of the Japanese Urological Association 19 ( 4 ) 374 - 85 2012.04 [International journal]

DOI PubMed

Analysis of isolated bacteria and short-term antimicrobial prophylaxis with tazobactam-piperacillin (1:4 ratio) for prevention of postoperative infections after radical cystectomy.

Kazushi Tanaka, Soichi Arakawa, Tetsuya Miura, Katsumi Shigemura, Yuzo Nakano, Satoshi Takahashi, Taiji Tsukamoto, Tetsuro Matsumoto, Masato Fujisawa

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 18 ( 2 ) 175 - 9 2012.04 [International journal]

Radical cystectomy is associated with the highest morbidity and mortality of all commonly performed urological cancer treatment procedures. Postoperative infection remains a major problem. We herein report the results of an open prospective study involving radical cystectomies, undertaken to evaluate the efficacy of 0.5/2 g tazobactam-piperacillin (TAZ-PIPC) in the prevention of postoperative infectious complications. Antimicrobial prophylaxis was performed using 0.5/2 g TAZ-PIPC (2.5 g i.v.) every 3 h during surgery and then twice a day for 3 days postoperatively. The patients were monitored to detect any postoperative infections. During surgery, irrigation fluid from the total abdominal cavity was taken for bacterial culture just before closing the abdomen. Surveillance cultures of drain discharge and urine from ureteral stents were also performed. Other samples were taken for bacterial culture when an infection was suspected. The total postoperative bacterial infection rate was 20.0% (7/35), and surgical site infection rate was 5.7% (2/35). These rates are lower than those documented in other studies. This study, even though open and noncomparative, showed that a short-interval regimen containing 0.5/2 g TAZ-PIPC provides adequate antimicrobial prophylaxis in patients undergoing radical cystectomy.

DOI PubMed

New technique with combination of felt, Hem-o-lok and Lapra-Ty for suturing the renal parenchyma in laparoscopic partial nephrectomy

Naoya Masumori, Naoki Itoh, Satoshi Takahashi, Hiroshi Kitamura, Sachiyo Nishida, Taiji Tsukamoto

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY-BLACKWELL ) 19 ( 3 ) 273 - 276 2012.03 [Refereed]

We reported a new technique for closure of the renal parenchyma in laparoscopic partial nephrectomy, shortening the suturing time. Between 2009 and 2011, 41 patients with renal masses 4 cm or smaller in diameter underwent transabdominal laparoscopic partial nephrectomy by a single surgeon in a single institution. The sutures were carried out using 2-0 vicryl CT-1 with a 1.2 x 1.2 cm piece of felt, and both sutures were temporarily held using a Hem-o-lok. After all sutures (median 3) were completed, they were sequentially fixed by sliding the Hem-o-lok, and then locked using the Lapra-Ty. The median times for suturing the renal parenchyma and ischemic time were 13 min and 28 min, respectively. The arrangement of the wound and hemostasis were good. No patients developed urinoma or postoperative bleeding.

DOI

Current controversial issues in the decontamination process for urological endoscopes.

Hitoshi Yanaihara, Ryoichi Hamasuna, Satoshi Takahashi, Shingo Yamamoto, Soichi Arakawa, Satoru Ishikawa, Tetsuro Matsumoto

International journal of urology : official journal of the Japanese Urological Association 19 ( 1 ) 5 - 6 2012.01 [International journal]

DOI PubMed

Effect of gatifloxacin against Mycoplasma genitalium-related urethritis: an open clinical trial.

Ryoichi Hamasuna, Satoshi Takahashi, Hiroshi Kiyota, Mitsuru Yasuda, Hiroshi Hayami, Soichi Arakawa, Kazunori Tomono, Tetsuro Matsumoto

Sexually transmitted infections 87 ( 5 ) 389 - 90 2011.08 [International journal]

OBJECTIVES: Mycoplasma genitalium and Chlamydia trachomatis are the primary pathogens detected from non-gonococcal urethritis (NGU). In this study, the efficacy of gatifloxacin was examined against M genitalium-related urethritis. METHODS: The study was an open clinical trial evaluating the effectiveness of gatifloxacin with 200 mg doses twice a day for 7 days against male NGU. RESULTS: Between March and September 2008, 169 male patients were enrolled, and microbiological and clinical cure rates could be evaluated in 86 patients detected with C trachomatis or M genitalium and in 135 with NGU, respectively. Microbiological cure rates of gatifloxacin against C trachomatis and M genitalium were 100% and 83%, respectively, and the total clinical cure rate was 99%. CONCLUSION: Analysis of in-vivo and in-vitro data from the literature of fluoroquinolone efficacies against M genitalium suggests that a MIC90 of 0.125 μg/ml or less may be useful for optimal activity against M genitalium infection.

DOI PubMed

A case with fistula formation between a perinephric retroperitoneal abscess and the duodenum: successful outcome after conservative management.

Masahiro Matsuki, Satoshi Takahashi, Shin-Ichi Hisasue, Takashi Muranaka, Akio Takayanagi, Takeshi Maehana, Teruhisa Uehara, Naoya Masumori, Taiji Tsukamoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 17 ( 4 ) 541 - 3 2011.08 [International journal]

A 67-year-old woman diagnosed with pyonephrosis and perinephric abscess because of an impacted urinary stone in the pelvicoureteric junction was admitted to the hospital with a high-grade fever. Although construction of a right nephrostomy for drainage of the abscess improved her general condition, she had a fever again 2 weeks after the initial treatment. Computed tomography revealed a persistent perinephric retroperitoneal abscess and a second drainage procedure was performed. Then, imaging examination revealed fistula formation between the cavity of the perinephric retroperitoneal abscess and the duodenum. The patient received conservative management including percutaneous drainage, discontinuation of oral intake, and antimicrobial chemotherapy. Three days after the second drainage and discontinuation of oral intake, imaging examination revealed complete closure of the fistula. Fistula formation between a perinephric abscess and the duodenum is very rare but a favorable outcome was obtained by our conservative management.

DOI PubMed

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

Mitsuru Yasuda, Satoshi Takahashi, Hiroshi Kiyota, Kiyohito Ishikawa, Akira Takahashi, Shingo Yamamoto, Soichi Arakawa, Koichi Monden, Tetsuro Muratani, Ryoichi Hamasuna, Hiroshi Hayami, Tetsuro Matsumoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 17 ( 4 ) 579 - 94 2011.08 [International journal]

DOI PubMed

Guideline for the prevention of health care-associated infection in urological practice in Japan.

Ryoichi Hamasuna, Satoshi Takahashi, Shingo Yamamoto, Soichi Arakawa, Hitoshi Yanaihara, Satoru Ishikawa, Tetsuro Matsumoto

International journal of urology : official journal of the Japanese Urological Association 18 ( 7 ) 495 - 502 2011.07 [International journal]

For developing the Japanese guideline for the prevention of health care-associated infection in urological practice, we surveyed the literature including standard precautions, environmental considerations in both the inpatient and outpatient settings, the management of urinary catheters, endoscopy techniques, and the disinfection and sterilization of instruments used in endoscopies and related procedures. The concept of this guideline is to show the minimum precautions that urologists and other medical professionals should observe when they work in the urological field. Standard precautions based on hand hygiene and the use of personal protective equipment should be observed in both the inpatient and outpatient settings. In the inpatient setting, the management of the toilet is important. Collecting urine should be restricted only when it is necessary to determine a patient's urinary output. The management for urinary catheter and infection are created based on the "European and Asian guidelines on management and prevention of catheter-associated urinary tract infections". In addition, we propose that nephrostomy should be carried out after maximum barrier precautions have been taken. Urinary catheters are replaced in the event of an occlusion or if there are signs that an occlusion might occur, but the same catheter cannot be left in place for more than 2 months. Regarding the handling of urine containing Mycobacterium tuberculosis, airborne infection countermeasures are unnecessary, except for the laboratory personnel. For the procedures using urological endoscopes, aseptic techniques are recommended. Endoscopes and related devices should be used by sterilization or high-level disinfection, but formaldehyde gas cannot be used.

DOI PubMed

Clinical efficacy of levofloxacin 500 mg once daily for 7 days for patients with non-gonococcal urethritis

Satoshi Takahashi, Kohji Ichihara, Jiro Hashimoto, Yuichiro Kurimura, Akihiko Iwasawa, Kenji Hayashi, Kenichi Sunaoshi, Koichi Takeda, Nobukazu Suzuki, Takashi Satoh, Taiji Tsukamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO ) 17 ( 3 ) 392 - 396 2011.06 [Refereed]

To confirm the efficacy of the treatment regimen with oral levofloxacin (LVFX) 500 mg once daily for 7 days for patients with non-gonococcal urethritis (NGU), we evaluated the microbiological and clinical outcomes of the regimen in those patients. We finally evaluated 53 patients with symptomatic NGU and 5 patients with asymptomatic NGU. As a result of microbiological examinations, 19 of the symptomatic patients were diagnosed as having non-gonococcal chlamydial urethritis (NGCU); 13 had non-gonococcal non-chlamydial urethritis (NGNCU), and 21 had urethritis without any microbial detection. Five of the asymptomatic patients were diagnosed as having NGCU. Microbiological cure was achieved in 91% of the 32 patients with symptomatic NGU and in 80% of the 5 patients with asymptomatic NGCU. Clinical cure was obtained in 92% of the 53 patients with symptomatic NGU. The microbiological eradication rate for Chlamydia trachomatis was 92% in 24 patients. As for other organisms, the microbiological eradication rate for Mycoplasma genitalium was 60% in 5 patients and that for Ureaplasma urealyticum was 100% in 10. The microbiological and clinical efficacy of oral LVFX 500 mg once daily for 7 days for the patients with NGU was the same for the azithromycin (AZM) 1,000 mg single dose that we previously reported. The eradication rates of C. trachomatis and U. urealyticum in the treatment regimen with LVFX 500 mg were high enough in the clinical setting; however, for M. genitalium, the rate was relatively inferior to that with AZM.

DOI

Management for males whose female partners are diagnosed with genital chlamydial infection

Satoshi Takahashi, Yuichiro Kurimura, Jiro Hashimoto, Kenichi Sunaoshi, Koichi Takeda, Nobukazu Suzuki, Ryoji Furuya, Keisuke Taguchi, Takashi Satoh, Akihiko Iwasawa, Kenji Hayashi, Takaoki Hirose, Taiji Tsukamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO ) 17 ( 1 ) 76 - 79 2011.02 [Refereed]

The purpose of this study was to investigate the infection rate of asymptomatic men whose female sexual partners were diagnosed as having genital chlamydial infection and discuss the management for them. The subjects were asymptomatic men whose female sexual partners were diagnosed with genital chlamydial infection at other obstetric and gynecological clinics. Microscopic findings of urinary sediment and the results of a nucleic acid amplification test of the first-voided urine specimen were retrospectively examined in those men who visited our clinics. A total of 267 men were included and analyzed. The infection rate for urinary Chlamydia trachomatis in asymptomatic men was 36.3% (97 of 267). In the analysis of urinary sediment, 35 of the 267 (13.1%) had pyuria and 82.9% (29 of 35) in the men with pyuria were positive for urinary C. trachomatis in. Even in men without pyuria, the urinary C. trachomatis-positive rate was 29.3% (68 of 232). When such men have pyuria in the clinic, prompt treatment is the appropriate approach. If the men are without pyuria, testing for urinary C. trachomatis should be performed. Prompt treatment before doing any clinical evaluation can be an option in couples with trouble.

DOI

Peritoneal dissemination of prostate cancer due to laparoscopic radical prostatectomy: A case report

Yoshiki Hiyama, Hiroshi Kitamura, Satoshi Takahashi, Naoya Masumori, Tetsuya Shindo, Mitsuhiro Tsujiwaki, Tomoko Mitsuhashi, Tadashi Hasegawa, Taiji Tsukamoto

Journal of Medical Case Reports 5 355 2011 [Refereed]

Introduction. Peritoneal dissemination with no further metastases of prostate cancer is very rare, with only three cases reported in the available literature. We report the first case of iatrogenic peritoneal dissemination due to laparoscopic radical prostatectomy. Case Presentation. A 59-year-old Japanese man underwent laparoscopic radical prostatectomy for clinical T2bN0M0 prostate cancer, and the pathological diagnosis was pT3aN0 Gleason 3+4 adenocarcinoma with a negative surgical margin. Salvage radiation therapy was performed since his serum prostate-specific antigen remained at a measurable value. After the radiation, he underwent castration, followed by combined androgen blockade with estramustine phosphate and dexamethasone as each treatment was effective for only a few months to a year. Nine years after the laparoscopic radical prostatectomy, computed tomography revealed a peritoneal tumor, although no other organ metastasis had been identified until then. He died six months after the appearance of peritoneal metastasis. An autopsy demonstrated peritoneal dissemination of the prostate cancer without any other metastasis. Conclusion: Physicians should take into account metastasis to unexpected sites. Furthermore, we suggest that meticulous care be taken not to disseminate cancer cells to the peritoneum during laparoscopic radical prostatectomy. © 2011 Hiyama et al licensee BioMed Central Ltd.

DOI PubMed

PP-352 鼠径・陰嚢部手術における手術部位感染症(一般演題ポスター発表・討論,一般演題ポスター,第99回日本泌尿器科学会総会)

上原央久, 高橋聡, 栗村雄一郎, 橋本次朗, 桧山佳樹, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 102 ( 2 ) 462 - 462 2011

DOI CiNii

PP-349 泌尿器科準清潔手術において術前に除菌すべき尿細菌培養所見についての検討(一般演題ポスター発表・討論,一般演題ポスター,第99回日本泌尿器科学会総会)

橋本次朗, 高橋聡, 栗村雄一郎, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 102 ( 2 ) 462 - 462 2011

DOI CiNii

Editorial comment to Prevalence of human papillomavirus infection in the urinary tract of men with urethritis.

Satoshi Takahashi

International journal of urology : official journal of the Japanese Urological Association 17 ( 6 ) 568 - 9 2010.06 [International journal]

DOI PubMed

Decrease in incidence of surgical site infections in contemporary series of patients with radical cystectomy

Yuuki Kyoda, Satoshi Takahashi, Koh Takeyama, Naoya Masumori, Taiji Tsukamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO ) 16 ( 2 ) 118 - 122 2010.04 [Refereed]

We previously reported that the incidence of surgical site infection (SSI) after radical cystectomy was 33% between January 1996 and December 2003 at Sapporo Medical University Hospital. Base on that result, we modified perioperative management for surgical wounds after January 2004. The modifications included the method of suturing and standardization of the period for removal of closed drains and surgical dressings. This study compared the incidence of SSI between the former and latter periods, and assessed risk factors for SSI. The study consisted of 109 patients between January 1996 and December 2003 (Group A), and 104 patients between January 2004 and December 2007 (Group B), who underwent radical cystectomy and urinary diversion or reconstruction. The incidence of SSI was reduced from 32.1% in Group A to 18.2% in Group B (p = 0.027). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from SSI wounds in 40.0% of patients in Group A and 42.1% of those in Group B. Preoperative MRSA bacteriuria was the only risk factor for SSI in both groups. The incidences of SSI in patients who had such bacteriuria were 45.4% in Group A and 50.0% in Group B. Modification of perioperative management for the surgical wound was partly responsible for the reduction of the incidence of SSI. In conclusion, MRSA is still the main isolated pathogen of SSI after radical cystectomy and this clinical problem remains a challenge to urologists. Effective countermeasures are needed for MRSA bacteriuria involved in the development of SSI.

DOI

Efficacy of treatment with carbapenems and third-generation cephalosporins for patients with febrile complicated pyelonephritis

Satoshi Takahashi, Yuichiro Kurimura, Koh Takeyama, Kohei Hashimoto, Shintaro Miyamoto, Kohji Ichihara, Manabu Igarashi, Jiro Hashimoto, Ryoji Furuya, Hiroshi Hotta, Kohsuke Uchida, Noriomi Miyao, Masahiro Yanase, Yoshio Takagi, Hitoshi Tachiki, Keisuke Taguchi, Taiji Tsukamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO ) 15 ( 6 ) 390 - 395 2009.12 [Refereed]

The purpose of this study was to clarify the clinical relevance of carbapenem and third-generation cephalosporin treatment for febrile complicated pyelonephritis, which often leads to urosepsis. Parenteral antimicrobial treatment with a carbapenem or third-generation cephalosporin was administered to febrile patients and the treatment was switched to oral antimicrobial agents after they became afebrile. In principle, the duration of the course of antimicrobial chemotherapy was limited to a total of 14 days. Clinically, the success rates were 97.3% in the carbapenem group and 96.0% in the third-generation cephalosporin group. For microbiological efficacy, the success rates were 89.2% in the carbapenem group and 92.0% in the third-generation cephalosporin group. There were no serious adverse events in the course of the study. The treatment regimen with a carbapenem or a third-generation cephalosporin was highly effective for patients with febrile complicated pyelonephritis and was well tolerated. Either of these regimens could become one of the standard treatments for patients with febrile complicated pyelonephritis.

DOI

腹腔鏡下腎・腎尿管手術において開放移行となった症例の臨床的特徴

西田幸代, 舛森直哉, 高橋聡, 伊藤直樹, 塚本泰司

Japanese Journal of Endourology and ESWL ( (一社)日本泌尿器内視鏡学会 ) 22 ( 3 ) 223 - 223 2009.11

Is urethritis accompanied by seminal vesiculitis?

Ryoji Furuya, Satoshi Takahashi, Seiji Furuya, Nobuhito Saitoh, Hiroshi Ogura, Yuichiro Kurimura, Taiji Tsukamoto

International journal of urology : official journal of the Japanese Urological Association 16 ( 7 ) 628 - 31 2009.07 [International journal]

OBJECTIVE: To determine whether urethritis is accompanied by seminal vesiculitis using transrectal ultrasound (TRUS) imaging. METHODS: Fifty-six male patients (mean age 31.6 8.7 years) with urethritis were included in the study. As a control group,we also considered 34 healthy volunteers (mean age 21.3 1.8 years). The two groups were evaluated by the nucleic acid amplification test and imaging studies using TRUS. RESULTS: The nucleic acid amplification test could identify 15 patients (26.8%) with gonococcal urethritis (five had accompanying chlamydial urethritis), 32 (57.1%) with chlamydial urethritis, and nine (16.1%) with nongonococcal and nonchlamydial urethritis. The mean anteroposterior diameter of the bilateral seminal vesicles was significantly longer in the urethritis group than in the controls (12.9 3.3 mm vs 11.0 2.0 mm, P = 0.004). The incidence of dilatation or cystic changes of seminal vesicles was significantly higher in the urethritis group than in the controls (dilatation: 30% vs 9%, P = 0.019; cystic change: 39% vs 12%, P = 0.007). There was no significant difference in the incidence of dilatation or cystic changes of seminal vesicles between gonococcal urethritis and chlamydial urethritis. CONCLUSIONS: Patients with urethritis are likely to have accompanying seminal vesiculitis. This suggests a close interrelationship among urethritis, seminal vesiculitis and epididymitis.

DOI PubMed

Genetic profiles of fluoroquinolone-resistant Escherichia coli isolates obtained from patients with cystitis: phylogeny, virulence factors, PAIusp subtypes, and mutation patterns.

Akira Takahashi, Tetsuro Muratani, Mitsuru Yasuda, Satoshi Takahashi, Koichi Monden, Kiyohito Ishikawa, Hiroshi Kiyota, Soichi Arakawa, Tetsuro Matsumoto, Hiroki Shima, Hisao Kurazono, Shingo Yamamoto

Journal of clinical microbiology 47 ( 3 ) 791 - 5 2009.03 [International journal]

The low virulence of quinolone- and fluoroquinolone-resistant Escherichia coli strains is known, although the reasons for this remain unclear. We surveyed the mutation patterns of quinolone resistance determining regions (QRDRs), phylogenetic distribution, prevalence of 18 urovirulence genes, and PAIusp subtypes in 89 fluoroquinolone-resistant E. coli (FQREC) isolates obtained from patients with cystitis and compared them with those of their fluoroquinolone-susceptible counterparts (FQSEC). Phylogenetic group B2 was significantly less prevalent in FQREC than in FQSEC (49% versus 78%; P=0.0138), but it still dominated, followed by phylogroup D (35%), in FQREC. When the prevalences of virulence factor (VF) genes were compared between FQREC and FQSEC, sfa/foc, cnf1, hly, kpsMT, ompT, ibeA, usp, and iroN showed significantly lower prevalences in FQREC than in FQSEC (1.1% versus 24% [P<0.0001], 0% versus 29% [P<0.0001], 7.9% versus 33% [P<0.0001], 74% versus 90% [P=0.01], 71% versus 87% [P=0.017], 5.6% versus 37% [P<0.0001], 54% versus 82% [P<0.0001], and 7.9% versus 32% [P=0.0001], respectively), whereas aer, iha, and ETTT showed significantly higher prevalences in FQREC (85% versus 36% [P<0.0001], 66% versus 29% [P<0.0001], and 53% versus 16% [P<0.0001], respectively). Furthermore, a similar difference in prevalences of uropathogenic VF genes was seen between FQREC and FQSEC in phylogroup B2. This indicated that the low virulence in FQREC was intimately correlated with a lesser distribution of VFs in phylogroup B2, which dominated in FQREC and FQSEC. It was interesting that the mutation pattern of Ser83Leu and Asp87Asn encoded in gyrA and Ser80Ile and Glu84Val encoded in parC was frequently found in FQREC isolates that belonged to phylogroup B2 and that most of these isolates showed PAIusp subtype 2a. PAIusp subtypes 1a, 1b, and 2b, which were frequently seen in FQSEC, were rarely found in FQREC. These results suggested that the acquisition of fluoroquinolone resistance, e.g., mutations in QRDRs, might be a specific event in limited strains, such as those that possess PAIusp subtype 2a in phylogroup B2.

DOI PubMed

OP-421 BCG膀胱内注入療法の副作用についての検討(膀胱腫瘍/薬物療法1,一般演題口演,第97回日本泌尿器科学会総会)

栗村雄一郎, 高橋聡, 進藤哲也, 橋本次朗, 田口圭介, 島正樹, 五十嵐学, 高橋敦, 高木良雄, 井上隆太, 国島康晴, 舛森直哉, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 100 ( 2 ) 294 - 294 2009

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Pharyngeal Neisseria gonorrhoeae detection in oral-throat wash specimens of male patients with urethritis.

Satoshi Takahashi, Yuichiro Kurimura, Jiro Hashimoto, Koh Takeyama, Mikio Koroku, Hitoshi Tanda, Masahiro Nishimura, Taiji Tsukamoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 14 ( 6 ) 442 - 4 2008.12 [International journal]

Detection of Neisseria gonorrhoeae and Chlamydia trachomatis in the pharynx has been highlighted in the prevention of the unexpected spread of sexually transmitted diseases. We tried to clarify the detection rate of Neisseria gonorrhoeae in the pharynx and the clinical relevance of oral-throat wash specimens to detect the organism in heterosexual men with gonococcal and nongonococcal urethritis. In our cohort of 79 male patients with urethritis, oral throat wash specimens were collected after they had gargled with normal saline for approximately 30 to 60 s. Positive pharyngeal N. gonorrhoeae was defined as a positive result on the strand displacement amplification test for the specimen from the oral-throat wash. N. gonorrhoeae was detected in the oral-throat wash specimens of 13 (31.7%) of the 41 male patients with gonococcal urethritis. Oral-throat wash with a nucleic acid amplification test can detect pharyngeal N. gonorrhoeae easily and efficiently.

DOI PubMed

Septic pulmonary embolism caused by Candida albicans after treatment for urinary multidrug-resistant Pseudomonas aeruginosa.

Satoshi Takahashi, Teruhisa Uehara, Masaki Shima, Shogo Takasugi, Kohei Hashimoto, Naoki Itoh

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 14 ( 6 ) 436 - 8 2008.12 [International journal]

After treatment with antimicrobial chemotherapy for the elimination of urinary multidrug-resistant Pseudomonas aeruginosa (MDRP), a 48-year-old man with recurrence of bladder cancer complained of acute onset of dyspnea, and computed tomography revealed multiple nodular lesions in the lung. Candida albicans was isolated from both urinary and blood samples. He was diagnosed as having a septic pulmonary embolism caused by C. albicans. Fungal septic pulmonary embolism is a rare condition; however, we must be cautious about superinfection as a consequence of strong antimicrobial chemotherapy, and understand that the treatment for urinary MDRP is likely to be difficult.

DOI PubMed

Clinical efficacy of azithromycin for male nongonococcal urethritis.

Satoshi Takahashi, Masanori Matsukawa, Yuichiro Kurimura, Koh Takeyama, Yasuharu Kunishima, Akihiko Iwasawa, Mikio Koroku, Hitoshi Tanda, Nobukazu Suzuki, Yoshio Takagi, Takaoki Hirose, Masahiro Nishimura, Taiji Tsukamoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 14 ( 6 ) 409 - 12 2008.12 [International journal]

The aim of this study was to confirm the clinical efficacy of a single-dose azithromycin (AZM) regimen (1000 mg) for patients with nongonococcal urethritis in real-life practice. The study finally evaluated 55 patients, 42 who were symptomatic and 13 who were asymptomatic, after excluding 40 who visited clinics only once. Sixteen of the symptomatic patients were diagnosed as having nongonococcal chlamydial urethritis, 7 as having nongonococcal nonchlamydial urethritis, and 19 as having urethritis without any microbial detection. Chlamydia trachomatis was detected in 11 asymptomatic patients, Mycoplasma genitalium in 1, and Ureaplasma urealyticum in 1. Of the patients who were microbiologically evaluated before and after single-dose AZM, microbiological cure was achieved in 87% (20/23) of those with symptomatic nongonococcal urethritis and in 100% (13/13) of those with asymptomatic nongonococcal urethritis. The clinical cure rate was 86% for the 42 symptomatic patients with detectable and undetectable pathogens. There were adverse events in 5 (9%) patients but they were commonly mild and self-limited. In conclusion, the single-dose AZM regimen was well tolerated and eradicated the estimated and potential pathogens of nongonococcal urethritis.

DOI PubMed

[Management of specific patients in view of hospital infection management. 3. Patients with indwelling urinary catheters].

Taiji Tsukamoto, Satoshi Takahashi, Yuichiro Kurimura

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 97 ( 11 ) 2737 - 42 2008.11 [Domestic journal]

PubMed

[Case of urinary mycobacterium fortuitum in a patient with urinary tract tuberculosis posttreatment].

Takeshi Maehana, Satoshi Takahashi, Megumi Hirobe, Keisuke Taguchi

Hinyokika kiyo. Acta urologica Japonica 54 ( 11 ) 741 - 3 2008.11 [Domestic journal]

A 70-year-old male who complained of urinary frequency and a feeling of incomplete emptying was admitted to our hospital. Imaging findings showed dilation of the left renal pelvis and ureter. He was diagnosed as having urinary tuberculosis because a positive urinary Mycobacterium tuberculosis result was obtained by polymerase chain reaction (PCR). He was treated with a combination of the antituberculosis agents isoniazid, rifampicin, pyrazinamide and ethambutol for six months. The symptoms and pyuria disappeared and M. tuberculosis was negative by PCR; however, Mycobacterium fortuitum was isolated by culture. Due to asymptomatic urinary tract infection by the multidrug resistant M. fortuitum, he was followed up with observation. Currently, he remains unchanged with regard to symptoms and imaging examination. M. fortuitum is a nontubercular mycobacterium, and clinical relevance between urinary tract infection and M. fortuitum has rarely emerged. However, we should be aware that nontubercular mycobacteria such as M. fortuitum can infect the urinary tract, especially in immunocompromised patients.

PubMed

Fate of seminal vesicles and prostate after medical castration: How long is the optimal duration of neoadjuvant treatment for prostate cancer before radiation?

Ryoji Furuya, Shin-ichi Hisasue, Seiji Furuya, Nobuhito Saitoh, Hiroshi Ogura, Satoshi Takahashi, Taiji Tsukamoto

UROLOGY ( ELSEVIER SCIENCE INC ) 72 ( 2 ) 417 - 421 2008.08 [Refereed]

OBJECTIVES To clarify the morphological alteration of prostate and seminal vesicles (SV) quantitatively after testosterone ablation, we investigated the prostate volume (PV) and the SV volume (SVV) using transrectal ultrasonography. METHODS Between July 2002 and October 2004, we prospectively investigated 29 prostate cancer patients. The medical castration group included 21 patients (42 SV and 21 prostate; Median Gleason sum, 74 years) who were diagnosed as having T1b to T3aN0M0 prostate cancer and underwent androgen ablation with a lutenizing hormone (LH-RH) analogue and chlormadinone acetate. As normal controls, 8 patients (16 SV and 8 prostate; median age, 68.5 years) with T1aN0M0 prostate cancer without any other additional treatment were enrolled in this study. We measured both PV and SVV in these groups with transrectal ultrasonography. RESULTS Both PV and SVV significantly decreased in the medical castration group (PV: 28.4 +/- 9.3 mL to 17.0 +/- 5.3 mL, SVV: 3.5 +/- 1.8 mL to 1.9 +/- 1.0 mL; median, 6 months), whereas those in the control group were maintained (PV: 16.6 +/- 5.7 mL to 16.5 +/- 5.3 mL, SVV: 2.5 +/- 1.0 mL to 2.6 +/- 1.6 mL; median, 12 months). In longitudinal assessment, mean PSA, PV, and SVV were significantly reduced gradually up to 12 months after medical castration. CONCLUSIONS Not only PV but also SVV was significantly reduced after medical castration. Moreover, size reduction continued up to 12 months in SV, with especially marked reduction seen through the first 6 months. These results demonstrated that optimum duration for androgen ablation before radiotherapy is at least 6 months, and up to 12 months for the maximum effect.

DOI

[Case of male accessory urethra with orifice in the scrotal skin].

Tetsuya Shindo, Satoshi Takahashi, Yuuki Kyoda, Shintaro Miyamoto, Kohei Hashimoto, Naoya Masumori, Taiji Tsukamoto

Hinyokika kiyo. Acta urologica Japonica 54 ( 7 ) 505 - 7 2008.07 [Domestic journal]

A 67-year-old male had an innate fistular orifice at the scrotal skin. In spite of occasional pus discharge from the orifice, no treatment had been performed for the fistula because it improved spontaneously. Due to increasing pus discharge, the fistula was resected at a dermatology clinic, but a persistent fistula tract was confirmed postoperatively by MRI. The fistula adjoined the bulbar urethra and was considered an accessory urethra. We performed resection of the fistula to resolve the frequent pus discharge and pain due to infection of the fistula. The isolated fistula did not communicate with the urethra and the proximal edge ended blindly. Pathological examination showed that the proximal end consisted of transitional epithelium and the distal end consisted of stratified squamous epithelium which meant an accessory urethra. Accessory urethra is not a rare condition, but cases like this one with an orifice that opened at the scrotal skin are extremely rare. As the treatment for the fistula, complete resection should be indicated.

PubMed

Glomerulation observed during transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is a common finding but no predictor of clinical outcome

Ryoji Furuya, Naoya Masumori, Sej Furuya, Toshiro Oda, Satoshi Takahashi, Masaya Takeuchi

UROLOGY ( ELSEVIER SCIENCE INC ) 70 ( 5 ) 922 - 926 2007.11 [Refereed]

OBJECTIVES Although glomerulation in the bladder mucosa when the bladder is overdistended is a finding suggestive of interstitial cystitis (10, it is sometimes observed at transurethral resection of the prostate (TURP) for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). We prospectively investigated the incidence and clinical implications of glomerulation found at TURP. METHODS From December 2003 to October 2005, 197 patients aged 50 years or older who were considered to be appropriate candidates to undergo TURP for LUTS/BPH were investigated in this study. just before beginning resection under spinal anesthesia, the bladder was filled to a water pressure of 80 cm and the capacity was measured. After evacuation of the fluid, careful inspection was conducted for glomerulation during refilling. Before TURP, and 3 and 12 months after TURP, the International Prostate Symptom Score and O'Leary-Sant IC Symptom and Problem Index were determined, and uroflowmetry and measurement of residual urine volume were performed. RESULTS Glomerutation was observed in 40 of the 197 patients (20.3%). There was no difference in bladder capacity between the glomerulation and nonglomerulation groups, although the glomerulation group was younger with lighter resected weight and a higher baseline IC problem index than the nonglomerulation group. There were no differences in other parameters before, 3, and 12 months after TURP between the 2 groups. CONCLUSIONS Although glomerulation at TURP is a common finding, the clinical implications related to IC are unknown. Glomerulation itself may not be a predictor of the clinical outcome of TURP. Glomerulation observed during transurethral resection of the prostate for patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is a common finding but no predictor of clinical outcome. UROLOGY 70: 922-926, 2007. (c) 2007 Elsevier Inc.

DOI

Comparison of 1-day, 2-day, and 3-day administration of antimicrobial prophylaxis in radical prostatectomy.

Koh Takeyama, Satoshi Takahashi, Toshihiro Maeda, Masatoshi Mutoh, Yasuharu Kunishima, Masanori Matsukawa, Yoshio Takagi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 13 ( 5 ) 320 - 3 2007.10 [International journal]

An adequate protocol for antimicrobial prophylaxis (AMP) in radical prostatectomy has not been established. We retrospectively compared the incidence and severity of infectious complications after radical prostatectomy with three different protocols for AMP. The study cohort consisted of 67 patients with prostate cancer who underwent radical prostatectomy at Hakodate Goryoukaku Hospital between January 2003 and December 2005. As a prophylactic antimicrobial agent, one of the cephalosporins or penicillins was administered intravenously to all patients. The analyzed protocols were for: (1) a 3-day group: administration of AMP until the second postoperative day (POD 2), (2) a 2-day group: administration of AMP until POD 1, and (3) a 1-day group: administration of AMP only on the operative day. The incidence and severity of infectious complications were retrospectively investigated. Three patients in the 3-day group (9.4%), 2 patients in the 2-day group (12.5%), and 2 patients in the 1-day group (10.5%) developed some infectious complications. The incidence of infectious complications was not significantly different among the three groups. No patients developed severe infectious complications such as sepsis. We conclude that single-day AMP is sufficient in patients with radical prostatectomy.

PubMed

Change in Environment of Medical Equipment after Introduction of the Electronic Chart System : Results of Bacterial Survey of Computer Mice

MASUMORI Naoya, KUNISHIMA Yasuharu, TAKAHASHI Satoshi, ITOH Shiori, ITOH Naoki, TSUKAMOTO Taiji, MATSUKAWA Masanori

Japanese Journal of Infection Prevention and Control ( Japanese Society of Environmental Infections ) 22 ( 2 ) 113 - 117 2007.06

Computers were first installed in the medical environment with the introduction of the electronic chart system. Bacterial contamination of computer mice frequently used by many members of the medical staff was investigated with a microbacteriologic survey by the smear method on February 1, 2006 for 16 computer mice located in the urological ward. The computer mice attached to the 9 desktop-type computers were different to those of the 7 laptop computers. The laptop computers were transported to the patients' bedsides when needed for the dispensing and infusion of drugs. Specimens were collected from 3 locations on the mice, the left click button, the body, and the scroll button. Bacteria were detected on all mice. More bacteria were isolated from the scroll button than from the click button or the body. Two patients with MRSA had been treated during the survey, but no outbreak was found. MRSA was detected on the scroll button of the mouse of one laptop computer. This strain was identical to the MRSAstrain obtained from a patient with surgical site infection. No Pseudomonas aeruginosa was detected. Although random, undirected microbiologic sampling is not necessary, the computer mousemay act as a reservoir for colonizing bacteria.

DOI CiNii

The 6-fluoro-8-methoxy quinolone, gatifloxacin, down-regulates interleukin-8 production in prostate cell line PC-3

Koh Takeyama, Hiroaki Mitsuzawa, Chiaki Nishitani, Takeyuki Shimizu, Hitomi Sano, Yasuharu Kunishima, Satoshi Takahashi, Hiroshi Hotta, Masanori Matsukawa, Ken-ichiro Shibata, Taiji Tsukamoto, Yoshio Kuroki

Antimicrob. Agents Chemother. 51 162 - 168 2007

DOI

Time courses of bacterial density in urine during antibacterial chemotherapy and influential factors in patients having positive bacteriuria with a complicated urinary tract

Masanori Matsukawa, Yasuharu Kunishima, Satoshi Takahashi, Kou Takeyama, Taiji Tsukamoto

Journal of Infection and Chemotherapy ( Springer Japan ) 13 ( 2 ) 99 - 104 2007 [Refereed]

A series of consecutive urine cultures was performed to determine the time points of elimination of bacteria from urine and the factors influencing these time points in patients receiving antimicrobial chemotherapy for positive bacteriuria. Between 1988 and 2000, 110 patients who had positive bacteriuria and received a 5-day regimen of parenteral antibacterials were included in this study. Quantitative urine cultures were performed every 24h throughout the therapy. Bacteria were identified minimum inhibitory concentrations of antibacterial agents for causative bacteria were determined, and the bacteria were categorized as susceptible or nonsusceptible. The complexity of the urinary tract was graded as high or low. A multivariate Cox proportional hazards model was utilized to identify the factors that determined the time course of bacterial density in urine. Two penicillins, seven cephalosporins, five carbapenems and one fluoroquinolone were administered to 110 patients. The overall bacteriurial elimination rate at the end of treatment was 73% (80/110), and the most frequent day of elimination was day 1 (54% 43/80), followed by day 2 (20% 16/80). The significant factors for persistence of bacteriuria after chemotherapy were the presence of an indwelling catheter, a nonsusceptible pathogen, and high complexity of the urinary tract risk ratios were: 2.398 (P = 0.0009), 2.227 (P = 0.0020), and 2.113 (P = 0.0455), respectively, which also influenced the day of elimination. In conclusion, the efficacy of treatment and the time point of bacteriurial elimination were determined by the presence of a urinary catheter, drug susceptibility, and urinary complexity in patients with positive bacteriuria undergoing antibacterial chemotherapy. © 2007 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.

DOI PubMed

APP-081 尿路変向・再建術後症例における尿管ステント抜去時の発熱に関する検討(第95回日本泌尿器科学会総会)

橋本次朗, 高橋聡, 竹山康, 国島康晴, 舛森直哉, 伊藤直樹, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 98 ( 2 ) 281 - 281 2007

DOI CiNii

PP-558 泌尿器科領域の術後感染予防抗菌薬投与における薬物動態的検討(第95回日本泌尿器科学会総会)

高橋聡, 国島康晴, 竹山康, 市原浩司, 高柳明夫, 竹内基, 橋本浩平, 福多史昌, 小林皇, 舛森直哉, 伊藤直樹, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 98 ( 2 ) 536 - 536 2007

DOI CiNii

Modified and bilateral retroperitoneal lymph node dissection for testicular cancer: Peri- and postoperative complications and therapeutic outcome

Toshiaki Tanaka, Hiroshi Kitamura, Yasuharu Kunishima, Satoshi Takahashi, Atsushi Takahashi, Naoya Masumori, Naoki Itoh, Taiji Tsukamoto

JAPANESE JOURNAL OF CLINICAL ONCOLOGY ( OXFORD UNIV PRESS ) 36 ( 6 ) 381 - 386 2006.06 [Refereed]

Objective: To characterize surgical invasiveness and morbidity and to verify therapeutic efficacy, we reviewed perioperative and postoperative courses and therapeutic outcomes of patients who underwent retroperitoneal lymph node dissection (RPLND) for testicular germ cell cancers. Methods: The study included 31 patients who underwent retroperitoneal lymph node dissection. A modified template was used if retroperitoneal metastasis was limited to the areas below the level of the renal hilus and above the level of the inferior mesenteric artery (IMA). Perioperative and postoperative courses and complications were reviewed as well as therapeutic outcomes. Results: Overall, 27 perioperative and postoperative complications were observed in 15 patients (48.4%). Superficial surgical site infection and paralytic ileus were seen most frequently. All of them were resolved without special additional treatments; however, patients who underwent retrocrural dissection had a tendency to have severe symptomatic complications such as chylothorax, phrenic nerve palsy and orthostatic hypotension. Antegrade ejaculation was preserved in 94.1% of patients with modified template dissection, whereas no patients with additional dissection below the level of the IMA had the function preserved. One patient (3.2%) developed a postoperative recurrent disease in the retroperitoneum, which was outside the dissection field, as well as in the mediastinum. Conclusions: Although RLND had high morbidity, most peri- and postoperative complications were manageable conservatively. Modified template dissection enabled patients to preserve antegrade ejaculation without compromising its therapeutic efficacy, if the disease extension allowed us to use the template.

DOI

Chlamydial seminal vesiculitis without symptomatic urethritis and epididymitis

R Furuya, S Takahashi, S Furuya, K Takeyama, N Masumori, T Tsukamoto

INTERNATIONAL JOURNAL OF UROLOGY ( BLACKWELL PUBLISHING ) 13 ( 4 ) 466 - 467 2006.04 [Refereed]

We previously reported that seminal vesiculitis was associated with acute epididymitis, and that Chlamydia trachomatis was the major causative pathogen for infection of the seminal vesicle, suggesting that seminal vesiculitis was a discrete disease entity. In this paper, we report two patients with bacteriologically and cytologically proven seminal vesiculitis who had asymptomatic urethritis but not epididymitis. The clinical courses of these patients suggest that chlamydial seminal vesiculitis may be a cause of asymptomatic infection of the urethra or subsequent development of acute epididymitis.

[Male genital herpes].

Satoshi Takahashi, Takaoki Hirose

Nihon rinsho. Japanese journal of clinical medicine 64 Suppl 3 77 - 80 2006.03 [Domestic journal]

PubMed

S13-4 The efficacy of antimicrobial agents for chronic prostatitis and prospects for the future(Symposium 13「Diagnosis and Treatment of Chronic Prostatitis」)

Takahashi Satoshi, Kunishima Yasuharu, Takeyama Koh, Tsukamoto Taiji

The Japanese Journal of Urology ( THE JAPANESE UROLOGICAL ASSOCIATION ) 97 ( 2 ) 173 - 173 2006

DOI CiNii

MP-126 慢性前立腺炎に対する抗菌薬(GFLX)投与の有用性に関する検討(一般演題ポスター,第94回日本泌尿器科学会総会)

国島康晴, 高橋聡, 塚本泰司, 丹田均, 小六幹夫, 廣瀬崇興, 岩澤晶彦, 西村昌宏, 横尾彰文, 松川雅則, 鈴木伸和, 竹田孝一, 堀田浩貴

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 97 ( 2 ) 398 - 398 2006

DOI CiNii

OP-209 男子尿道炎に対するアジスロマイシンの臨床効果に関する多施設共同研究(一般演題口演,第94回日本泌尿器科学会総会)

松川雅則, 国島康晴, 高橋聡, 塚本泰司, 岩澤晶彦, 丹田均, 小六幹夫, 鈴木伸和, 高木良雄, 廣瀬崇興, 西村昌宏

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 97 ( 2 ) 333 - 333 2006

DOI CiNii

[Application of real-time polymerase chain reaction for the detection of prostatic bacteria in patients with chronic prostatitis/chronic pelvic pain syndrome].

Satoshi Takahashi

The Japanese journal of antibiotics 58 ( 2 ) 187 - 92 2005.04 [Domestic journal]

PubMed

OP2-035 抗菌薬による前立腺癌細胞株のサイトカイン産生抑制(一般演題(口演))

竹山康, 国島康晴, 高橋聡, 西山直隆, 堀田裕, 松川雅則, 塚本泰司, 黒木由夫

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 95 ( 2 ) 359 - 359 2004

DOI CiNii

PP3-191 経直腸的前立腺針生検における抗菌薬予防投与に関するprospective study(一般演題(ポスター))

国島康晴, 竹山康, 高橋聡, 松川雅則, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 95 ( 2 ) 521 - 521 2004

DOI CiNii

[Application of real-time polymerase chain reaction technology to detect prostatic bacteria in patients with chronic prostatitis/chronic pelvic pain syndrome].

Satoshi Takahashi

The Japanese journal of antibiotics 56 ( 4 ) 338 - 9 2003.08 [Domestic journal]

PubMed

[Comparative studies on activities on antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2000). III. Secular changes in susceptibility].

Yoshiaki Kumamoto, Taiji Tsukamoto, Takaoki Hirose, Masanori Matsukawa, Satoshi Takahashi, Yasuharu Kunishima, Makoto Fujime, Kazuhiko Fujita, Masahiko Ogihara, Kei Ishibashi, Jun Igari, Shiro Shigeta, Toyoko Oguri, Keizo Yamaguchi, Tetsuya Matsumoto, Fusako Kashitani, Hiroshi Yoshida, Yuuji Imafuku, Masaru Murai, Hiroshi Ooe, Mineko Nishikawa, Kiyoaki Watanabe, Yoshio Kobayashi, Hiroshi Uchida, Toshitsugu Oka, Masaya Kitamura, Yuuji Takano, Yasuhiro Matsuoka, Seiji Matsuda, Shinichi Sato, Toshinari Furuhama, Hiromi Kumon, Koichi Monden, Shigeru Kohno, Yoshitsugu Miyazaki, Kazunori Tomono, Siho Aoki, Chikako Mochida, Yoichi Hirakata

The Japanese journal of antibiotics 55 ( 5 ) 568 - 655 2002.10 [Refereed] [Domestic journal]

The bacteria (Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as having urinary tract infections (UTIs) in 10 institutions in Japan were supplied between August 2000 and July 2001. Then, the susceptibilities of these bacteria to various antimicrobial agents were examined, and the results were compared with those obtained between 1992 and 1999. Comparison was made by classifying strains isolated from patients into those in uncomplicated UTIs and those in complicated UTIs (including with or without indwelling catheter). E. faecalis showed good susceptibility to ampicillin (ABPC) and imipenem (IPM), and the MIC90s were 2 micrograms/ml. Also, E. faecalis showed good susceptibility to vancomycin (VCM). However, the MIC90, which was 2 micrograms/ml between 1992 and 1999, rose to 4 micrograms/ml in patients with complicated UTIs because the strains inhibited at 4 micrograms/ml increased more than before. The low susceptibility of S. aureus to arbekacin (ABK) in complicated UTIs, as shown in 1998 and 1999, recovered in 2000, and no strains inhibited at > or = 4 micrograms/ml were detected. E. coli showed good susceptibility to CTM (MIC90: 0.25-0.5 microgram/ml) and CZOP (MIC90: < or = 0.125 microgram/ml) and was not resistant to those. E. coli also showed good susceptibility to the other drugs except to penicillins. Decreases in susceptibility of E. coli to quinolones, ciprofloxacin (CPFX), and sparfloxacin (SPFX) were observed in the patients with complicated UTIs. The susceptibility of Klebsiella spp. to all drugs did not significantly change in 2000 and was generally good except to penicillins. Although the susceptibility of P. aeruginosa to carbapenems was notable, the MIC90 went up from 4 micrograms/ml to 16 micrograms/ml in complicated UTIs compared with those observed in the previous year.

PubMed

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2000). I. Susceptibility distribution].

Yoshiaki Kumamoto, Taiji Tsukamoto, Makoto Fujime, Kazuhiko Fujita, Takaoki Hirose, Masanori Matsukawa, Satoshi Takahashi, Yasuharu Kunishima, Jun Igari, Masahiko Ogihara, Kei Ishibashi, Toyoko Oguri, Shiro Shigeta, Keizo Yamaguchi, Tetsuya Matsumoto, Fusako Kashitani, Hiroshi Yoshida, Yuuji Imafuku, Masaru Murai, Hiroshi Ooe, Mineko Nishikawa, Kiyoaki Watanabe, Yoshio Kobayashi, Hiroshi Uchida, Toshitsugu Oka, Masaya Kitamura, Yuuji Takano, Yasuhiro Matsuoka, Seiji Matsuda, Shinichi Sato, Toshinari Furuhama, Hiromi Kumon, Koichi Monden, Siho Aoki, Chikako Mochida, Yoichi Hirakata, Shigeru Kohno, Yoshitsugu Miyazaki, Kazunori Tomono

The Japanese journal of antibiotics 55 ( 4 ) 370 - 98 2002.08 [Refereed] [Domestic journal]

The bacterial strains isolated from patients diagnosed as having urinary tract infections (UTIs) in 10 institutions in Japan were supplied between the period of August 2000 and July 2001. Then, the susceptibilities of them to many kinds of antimicrobial agents were investigated. The number of them were 511 strains. The breakdown of these strains was Gram-positive bacteria as 29.0% and Gram-negative bacteria as 71.0%. Susceptibilities of these bacteria to antimicrobial agents were as follows; vancomycin (VCM), ampicillin (ABPC) and imipenem (IPM) showed strong activities against Enterococcus faecalis. No increase in low-susceptible strains of E. faecalis observed against these antimicrobial agents. VCM showed a strong activity against MRSA preventing growth of all strains with 1 microgram/ml. In addition, the activity of arbekacin (ABK) was strong with the MIC90 of 2 micrograms/ml against MRSA and prevented growth of all strains with 4 micrograms/ml. ABK showed a strong activity against Staphylococcus epidermidis preventing growth of all strains with 0.5 microgram/ml. ABPC, cefotiam (CTM) and cefozopran (CZOP) also showed a relatively strong activity against S. epidermidis (MIC90: 4 to 8 micrograms/ml). Against Escherichia coli, carbapenems showed high activities: meropenem (MEPM) prevented growth of all strains within 0.125 microgram/ml; IPM prevented growth of all strains with 0.25 microgram/ml. CZOP and CTM also showed strong activities against E. coli: MIC90 of CZOP was within 0.125 microgram/ml; MIC80 and MIC90 of CTM were 0.25 and 0.5 microgram/ml, respectively. Quinolone resistant E. coli was detected at frequency of 14.0%, which was significantly higher than that in the last year. Almost all drugs showed strong activities against Klebsiella pneumoniae and Proteus mirabilis, and MEPM prevented growth of all strains within 0.125 microgram/ml. Against Pseudomonas aeruginosa, almost drugs were not so active. The MIC90 of carbapenems and gentamicin (GM) were 16 micrograms/ml and those of all other drugs were more than 32 micrograms/ml. Against Serratia marcescens, the MIC90 of IPM and GM were the lowest value being 2 micrograms/ml, and that of MEPM was 4 micrograms/ml.

PubMed

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2000). II. Background of patients].

The Japanese journal of antibiotics 55 ( 4 ) 399 - 411 2002.08 [Refereed] [Domestic journal]

Five-hundred eighty eight bacterial strains isolated from 435 patients diagnosed as having urinary tract infections (UTIs) in 10 institutions in Japan were supplied between August 2000 and July 2001. Then, the clinical background of patients were investigated such as sex, age, and type of infections, infections and kind of bacteria, frequency of bacteria isolation by age and infections, bacteria and infections by timing of antibiotics administration, and bacteria and infections by surgical procedures. About the relationship between age and sex of patients and type of infections, the number of male patients aged less than 50 years was few, and complicated UTIs without indwelling catheter was the most frequent. In females, the number of patients aged less than 20 years was few. The majority of female patients aged 40 years and over had complicated UTIs while uncomplicated UTIs was most frequent in the patients being twenties. As for type of infections and kind of bacteria, Escherichia coli decreased when the infections became complicated, and pseudomonas aeruginosa increased when the infection became complicated. Enterococcus faecalis was isolated more frequently in complicated UTIs than in uncomplicated UTIs. Considering this result by age of patients, isolated frequency of E. coli was gradually decreased with aging in patients aged 20 years and over with uncomplicated UTIs or complicated UTIs without indwelling catheter. The isolated frequencies of Klebsiella spp., P. aeruginosa, and E. faecalis were high in the patients with complicated UTIs without indwelling catheter. In the patients aged 70 years and over with complicated UTIs with indwelling catheter, P. aeruginosa and E. faecalis were frequently isolated. As for type of causative organisms in UTIs before and after the administration of antibiotics, the isolation of bacteria was remarkably decreased after administration in the patients with uncomplicated UTIs and complicated UTIs without indwelling catheter. E. coli decreased after administration of antibiotics, and P. aeruginosa increased after administration in the patients with all types of infections. As for type of causative organisms in UTIs and surgical procedures, E. coli was frequently isolated in the patients without surgery in all types of infections, while P. aeruginosa was frequently isolated in the patients who underwent surgery. In uncomplicated UTIs, Proteus spp. and E. faecalis were frequently isolated in the patients with surgery. In complicated UTIs without indwelling catheter, Klebsiella spp. was frequently isolated in the patients without surgery and E. faecalis was frequently isolated in the patients with surgery. In complicated UTIs with indwelling catheter, most of organisms except P. aeruginosa and S. aureus were frequently isolated in the patients without surgery.

PubMed

NIH慢性前立腺炎symptom index(NIH-CPSI)の有用性に関する検討

国島康晴, 松川稚則, 西山直隆, 竹山康, 清水俊明, 高橋聡, 堀田裕, 廣瀬崇興, 古屋聖兒, 小椋啓, 高塚慶次, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 92 ( 2 ) 397 - 397 2001

DOI CiNii

泌尿器科手術侵襲とSIRS

西山直隆, 国島康晴, 松川雅則, 竹山康, 本間一也, 清水俊明, 高橋聡, 堀田裕, 横尾彰文, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 91 ( 3 ) 246 - 246 2000

DOI CiNii

透析施行者の前立腺癌に対する内分泌(Total Androgen Blockade)療法時の薬物血中濃度に関する検討

高橋聡, 加藤隆一, 久末伸一, 高木誠次, 伊藤直樹, 塚本泰司

日本泌尿器科学会雑誌 ( 一般社団法人日本泌尿器科学会 ) 91 ( 3 ) 419 - 419 2000

DOI CiNii

Expression of intercellular adhesion molecule-1 in mice with Pseudomonas-induced pyelonephritis

A Yokoo, T Hirose, M Matsukawa, H Hotta, Y Kunishima, S Takahashi

JOURNAL OF UROLOGY ( LIPPINCOTT WILLIAMS & WILKINS ) 160 ( 2 ) 592 - 596 1998.08 [Refereed]

Purpose: To investigate the role of intercellular adhesion molecule-1 (ICAM-1) in the renal inflammatory process, we studied the time-course fluctuation of ICAM-1 expression on inflammatory lesions in mice with experimentally induced bacterial pyelonephritis and the effect of in vivo administration of an anti-ICAM-1 monoclonal antibody (mAb) on leukocytic migration. Materials and Methods: Ascending pyelonephritis was induced by transurethral instillation of Pseudomonas aeruginosa, and the expression of ICAM-1 in the pyelonephritic lesions was studied by immunohistochemical methods. Results: The expression of ICAM-1 on the pyelonephritic lesions closely paralleled the degree of infiltration of neutrophils and macrophages until 3 days after infection. At 7 days after infection, though the degree of infiltration of these cells was quite high, expression of ICAM-1 was reduced. Treatment with the anti-ICAM-1 mAb in mice with bacterial pyelonephritis resulted in suppression of influx of neutrophils and macrophages in the infected sites until 3 days after infection. However, at 7 days after infection inhibition of the influx of these cells was not seen. Conclusions: These results suggest that ICAM-1 expression is transient and plays a key role in the influx of neutrophils and macrophages associated with the early-phase response, and that in the late phase ICAM-1 independent adhesion molecules may be more predominant.

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