Misc - TAKAHASHI Satoshi

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

S Takahashi, DE Riley, JN Krieger

WORLD JOURNAL OF UROLOGY ( SPRINGER-VERLAG )  21 ( 2 ) 100 - 104  2003.04

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To investigate the potential association between prostate infection and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), we used molecular approaches described in previous reports. These methods employed standard polymerase chain (PCR) reaction assays to provide a qualitative evaluation of prostatic bacterial species. Here, we report on the detection of prostatic bacteria using a real-time PCR. Template DNAs were examined from prostatic tissue samples from patients with CP/CPPS. Two PCR primer sets were used: one that amplifies a portion of all known bacterial ribosomal DNAs (16S rDNAs) and one that is specific for Escherichia coli as opposed to related, E. coli-like bacteria. The 16S rDNA real-time PCR assay detected bacterial DNAs in eight (26%) of 31 samples from patients with CP/CPPS, including three samples (10%) that were also positive by the E. coli real-time PCR assay. These E. coli positives were quantified at approximately 10(3) cfu/ml of tissue digested. Quantification, speed and specificity make real-time PCR a promising approach for the quantitative detection and identification of prostatic bacteria from CP/CPPS patients.

DOI

Is seminal vesiculitis a disease entity? Its association of acute epididymitis

R Furuya, S Furuya, H Shinichi, T Shimizu, S Takahashi, A Takahashi, N Masumori, N Itoh, T Tsukamoto

JOURNAL OF UROLOGY ( LIPPINCOTT WILLIAMS & WILKINS )  169 ( 4 ) 30 - 30  2003.04

Research paper, summary (international conference)  

Chronic prostatitis: Role of uncommon organisms

JN Krieger, S Takahashi, DE Riley

EUROPEAN UROLOGY SUPPLEMENTS ( ELSEVIER SCIENCE BV )  2 ( 2 ) 19 - 22  2003.03

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Only a small subset of patients presenting with chronic prostatitis are found to have evidence of infection with recognized uropathogens. Recent studies suggest that uncommon organisms, i.e. those not culturable on standard media but detectable using molecular techniques, may be implicated in chronic prostatitis. (C) 2003 Elsevier Science B.V. All rights reserved.

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Efficacy of an RNA detection test kit in the diagnosis of genital chlamydial infection

Satoshi Takahashi, Toshiaki Shimizu, Kou Takeyama, Ryouji Furuya, Mikio Koroku, Hitoshi Tanda, Masahiro Nishimura, Akihiko Iwasawa, Hiroshi Yoshio, Naoki Itoh, Taiji Tsukamoto

Journal of Infection and Chemotherapy ( Springer Japan )  9 ( 1 ) 90 - 92  2003

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A nucleic acid amplification method based on DNA detection, the current standard method for the diagnosis of genital infection by Chlamydia trachomatis, has been shown to potentially yield false-positive results after treatment in the clinical setting. RNA detection methods are more appropriate because viable organisms have multiple RNA copies that are surely detected by the method. In this study, we evaluated the efficacy of a new RNA detection test kit, the VIDAS PROBE CT test, in the diagnosis of genital chlamydial infection. For comparison, the standard DNA detection method, Amplicor STD-I, was also used in the study. First voided-urine samples and urethral smears from male patients with urethritis, and first voided-urine samples and cervical smears from female patients with cervicitis served as samples for the detection of C. trachomatis. Of the 60 first voided-urine samples from male patients, 21 were positive and 39 negative with the VIDAS PROBE CT test. Amplicor STD-I achieved exactly the same result. In female patients with cervicitis, the two test kits produced the same result, with 2 positive cervical smears and 38 negative. These results suggest that the VIDAS PROBE CT test is as efficient as Amplicor STD-I in the detection of C. trachomatis. While studies including a greater number of patients will be needed for revealing the unique advantages of the new RNA detection test kit, VIDAS PROBE CT, we concluded from the current study that the test may be clinically useful in the diagnosis of genital chlamydial infection.

DOI PubMed

National Institutes of Health Chronic Prostatitis Symptom Index for Japanese men

Y Kunishima, M Matsukawa, S Takahashi, N Itoh, T Hirose, S Furuya, K Takatsuka, M Mori, T Tsukamoto

UROLOGY ( ELSEVIER SCIENCE INC )  60 ( 1 ) 74 - 77  2002.07

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Objectives. To establish a Japanese version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and to determine its validity and applicability in patients with chronic prostatitis, comparing the results with those from patients with benign prostatic hyperplasia (BPH) and normal men. Methods. The study included 103 patients with chronic prostatitis, 60 with BPH, and 87 normal men who agreed to respond to a self-administered questionnaire of the Japanese version of the NIH-CPSI (JPN-NIH-CPSI). Testing-retesting was done to confirm the reliability of the index in 23 patients with chronic prostatitis, with a 2-week interval between tests. Results. Pain or discomfort was more prominent in the prostatitis group than in the BPH and normal groups. Overall, quality of life in the prostatitis group was impaired more severely than that in the other two groups. The scores of three domains (pain, urinary symptoms, and quality-of-life impact) in the prostatitis group were clearly higher than those in the BPH and normal groups, except for those of urinary symptoms in the BPH group. The test-retest analysis showed good reliability and internal consistency for the JPN-NIH-CPSI, with a Cronbach's alpha coefficient of more than 0.8. Conclusions. The JPN-NIH-CPSI can be reliably used for evaluation of Japanese patients with prostatitis, as is the NIH-CPSI for English-speaking men. (C) 2002, Elsevier Science Inc.

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Multidrug-resistant Pseudomonas aeruginosa isolated from the urine of patients with urinary tract infection

K. Takeyama, Y. Kunishima, M. Matsukawa, S. Takahashi, T. Hirose, N. Kobayashi, I. Kobayashi, T. Tsukamoto

Journal of Infection and Chemotherapy ( Springer Japan )  8 ( 1 ) 59 - 63  2002

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We report the clinical courses of 3 patients with urinary obstruction who developed acute pyelonephritis caused by multidrug-resistant (MDR) Pseudomonas aeruginosa. Genome fingerprinting was performed to clarify the route of cross-infection, and an imipenem-resistance gene was detected by the polymerase chain reaction (PCR) method. The study included 17 patients at our institute who had urinary tract infections caused by P. aeruginosa between January and December 1997. MDR was defined as that when all the minimum inhibitory concentrations (MICs) were determined to show resistance according to the breakpoints recommended by the National Committee for Clinical Laboratory Standards (NCCLS) for P. aeruginosa. Pulse-field gel electrophoresis (PFGE) was carried out for genome fingerprinting. PCR was used to detect the metallo-β-lactamase gene (blaIMP). Three strains were revealed for MDR. The strains were isolated from the 3 patients with urinary tract obstruction who developed acute pyelonephritis. The treatment consisted of urinary drainage for the obstructed urinary tract and parenterally administered antimicrobials. Although none of the strains was susceptible to any antimicrobials, all patients had favorable outcomes. PFGE revealed that two strains had an identical genotype, implying cross-infection between the patients. The blaIMP gene was not detected in any of the three strains. In febrile patients with urinary tract infection caused by MDR P. aeruginosa, treatment for urinary obstruction is strongly recommended. Initial empirical chemotherapy with antimicrobials to which the organism is not susceptible is often inevitable. Because there was epidemiological evidence of cross-infection with MDR P. aeruginosa, countermeasures against nosocominal infection are warranted.

DOI PubMed

Complications of Stamey needle suspension for female stress urinary incontinence

S Takahashi, N Miyao, T Hisataki, M Matsukawa, S Takagi, T Sasao, H Adachi, M Miyake, T Tsukamoto

UROLOGIA INTERNATIONALIS ( KARGER )  68 ( 3 ) 148 - 151  2002

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Introduction: The Stamey bladder neck suspension for stress urinary incontinence in females is thought to be an excellent procedure. However, recent studies revealed that complications of this procedure have not been negligible. In this retrospective study, complications of the Stamey needle bladder neck suspension were examined. Materials and Methods: The Stamey procedure was performed either alone or in combination with anterior colporrhaphy for 86 female patients with stress urinary incontinence between 1989 and 1999. The mean follow-up period was 37.6 months and the mean age was 59.1 years. We studied the complications postoperatively pointed out by patients' complaint and image examination. Results: The overall incidence of complications was 37.2%. Voiding difficulties and lower abdominal pain were present in 15 cases, respectively. We experienced 2 unusual cases in whom suspensory stitches had to be removed due to abdominal pain. Conclusions: Although the Stamey bladder neck suspension is thought to be an excellent procedure for stress urinary incontinence, surgeons should beware of possible complications and be alert of the symptoms, such as abdominal pain and bladder irritation. Copyright (C) 2002 S. Karger AG, Basel.

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Epidemiological Survey of Sexually Transmitted Diseases Prevalence in Hokkaido

NISHIYAMA Naotaka, TAKAHASHI Satoshi, FURUYA Ryouji, TAKEYAMA Koh, SHIMIZU Toshiaki, KUNISHIMA Yasuharu, MATSUKAWA Masanori, KUMAMOTO Yoshiaki, MINOWA Masumi, TSUKAMOTO Taiji

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases   12 ( 1 ) 117 - 122  2001.07

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Staphylococcus aureus bacteriuria and surgical site infections by methicillin-resistant Staphylococcus aureus

M Matsukawa, Y Kunishima, S Takahashi, K Takeyama, T Tsukamoto

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV )  17 ( 4 ) 327 - 330  2001.04

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Surgical site infection (SSI) remains an important cause of morbidity among hospitalized patients. We reviewed 421 patients who underwent open urological operations between January 1993 and December 1997 in our institute. Group I consisted of 259 patients who received uncontrolled antimicrobial prophylaxis (AMP) between 1993 and 1995. Group II consisted of 162 patients who received controlled AMP between 1996 and 1997. In group II, penicillins or first to second-generation cephalosporins was used and the duration of use for these agents regulated according to the wound class of each operation. The operations with clean wounds showed the lowest rate of SSI in both groups; the operations with contaminated wounds showed the highest rate of SSI (32.0% in group I and 33.3%, in group II). There was no significant difference in the total rates of SSI between the two groups (P = 0.216). The most frequently isolated bacterial species was methicillin-resistant Staphylococcus aureus (MRSA), isolated in 73.3% of the cases in group I and in 93.3%, in group II. There was no significant difference in the incidence of MRSA isolation between the two groups (P = 0.114). The controlled AMP could not lower the incidence of MRSA-induced SSls. In SSI patients, 22.7% of group I and 35.7% in group II. had MRSA bacteriuria before operation, The prohibition of third-generation cephalosporins and shorter duration of AMP did not reduce the incidence of SSI induced by MRSA because MRSA was not the emerging microorganism but rather a resident in the urological ward. On the other hand, the total incidence of SSI did not increase after regulation of AMP. This finding suggests that older antibacterial agents can prevent infection, except those caused by resistant microorganisms such as MRSA. The effective counter-measure for the prevention of MRSA-induced SSI is needed. (C) 2001 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.

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Efficacy of a 14-day course of oral ciprofloxacin therapy for acute uncomplicated pyelonephritis

S. Takahashi, T. Hirose, T. Satoh, R. Kato, S. Hisasue, S. Takagi, T. Shimizu, Y. Kunishima, M. Matsukawa, N. Itoh, T. Tsukamoto

Journal of Infection and Chemotherapy ( Springer Japan )  7 ( 4 ) 255 - 257  2001

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This study aimed to evaluate the efficacy and safety of oral antibacterial treatment with fluoroquinilone for acute uncomplicated pyelonephritis Thirteen female patients with acute uncomplicated pyelonephritis were treated with oral fluoroquinilone (ciprofloxacin CPFX). They received 200mg of the drug three times a day while febrile (3-5 days). Once they become afebrile, the same dose of the drug, given twice a day, was given for another 9-11 days. The mean duration of the course of CPFX was 14 days. Symptoms were evaluated, and laboratory examinations, including urine culture and measurement of the minimal inhibitory concentration (MIC) of CPFX were conducted before treatment, and 3, 7, 14, 21, and/or 28 days after the initiation of the treatment. Of the 13 patients, only 5 needed to be hospitalized, and the period of hospitalization was only a few days. On the 14th day after the commencement of treatment, bacteriologic and clinical cure rates were 100%. Escherichia coli was the most common uropathogen, being isolated from the urine of 8 patients. No clinical relapse of the disease was found during a follow-up period of up to 4 weeks. The patients tolerated the drug well without developing any serious adverse effects. Oral antimicrobial chemotherapy with fluoroquinolone, given on an outpatient or short-term hospitalization basis, achieved satisfactory bacteriological and clinical outcomes in the treatment of acute uncomplicated pyelonephritis. This treatment regimen is indicated for patients with this disease who are not in a serious condition with complications such as shock.

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Efficacy of prophylactic single intravenous administration of antimicrobials for patients receiving systematic transrectal prostate biopsy

Hiroshi Hotta, Masanori Matsukawa, Yasuharu Kunishima, Naotaka Nishiyama, Toshiaki Shimizu, Satoshi Takahashi, Taiji Tsukamoto

Japanese Journal of Chemotherapy   49 ( 11 ) 642 - 644  2001

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Efficacy of prophylactic single intravenous administration of antimicrobials for patients receiving systematic transrectal prostate biopsy

HOTTA Hiroshi, MATSUKAWA Masanori, KUNISHIMA Yasuharu, NISHIYAMA Naotaka, SHIMIZU Toshiaki, TAKAHASHI Satoshi, TSUKAMOTO Taiji

日本化学療法学会雑誌   49 ( 11 ) 642 - 644  2001

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Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1999) I. Susceptibility distribution

Y. Kumamoto, T. Tsukamoto, T. Hirose, M. Matsukawa, S. Takahashi, Y. Kunishima, M. Ogihara, K. Ishibashi, S. Shigeta, H. Yoshida, Y. Imafuku, M. Murai, K. Watanabe, Y. Kobayashi, H. Uchida, S. Matsuda, S. Sato, M. Fujime, K. Fujita, J. Igari, T. Oguri, K. Yamaguchi, T. Matsumoto, F. Kashitani, H. Ooe, M. Nishikawa, T. Oka, M. Kitamura, Y. Takano, Y. Matsuoka, T. Furuhama, H. Kumon, K. Monden, S. Kohno, Y. Miyazaki, K. Izumikawa, T. Yamaguchi, C. Mochida

Japanese Journal of Antibiotics   54 ( 5 ) 185 - 216  2001

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The bacterial strains isolated from patients diagnosed as having urinary tract infections (UTIs) in 9 institutions in Japan were supplied between the period of August 1999 to July 2000. Then, the susceptibilities of them to many kinds of antimicrobial agents were investigated. The number of them were 499 strains. The breakdown of these strains was Gram-positive bacteria as 31.3% and Gram-negative bacteria as 68.7%. Susceptibilities of these bacteria to antimicrobial agents were as follows vancomycin (VCM), ampicillin (ABPC) and imipenem (IPM) showed strong activities against Enterococcus faecalis. The increase of low-susceptible strains which was noticed in the former year showed a slight recovery in this year. VCM showed a strong activity against MRSA preventing growth of all strains with 1 μg/ml. In addition, the activity of arbekacin (ABK) was also strong with the MIC90 of 2 μg/ml against MRSA. However, MSSA and MRSA showing low susceptibilities were detected in one strain each (MIC: 16 μg/ml and 32 μg/ml, respectively). Carbapenems showed high activities against Citrobacter freundii and Escherichia coli. Meropenem (MEPM) prevented growth of all strains within 0.125 μg/ml. Quinolone resistant E. coli decreased in this year compared with those in the last year, that percentage was less than 5%. Almost all drugs showed strong activities against Klebsiella pneumoniae and Proteus mirabilis. MEPM and carumonam (CRMN) prevented growth of all strains within 0.125 μg/ml. On the other hand, one strain of K. pneumoniae showing resistance to cefaclor (CCL) and one strain of P mirabilis showing low susceptibility to most of cephems were detected. Against Pseudomonas aeruginosa, almost drugs were not so active. The MIC90s of carbapenems were 8 μg/ml and those of all other drugs were more than 16 μg/ml.

DOI PubMed

In vitro analysis of the change in resistance of Chlamydia trachomatis under exposure to sub-MIC levofloxacin for a therapeutic term

S Takahashi, T Hagiwara, S Shiga, T Hirose, T Tsukamoto

CHEMOTHERAPY ( KARGER )  46 ( 6 ) 402 - 407  2000.11

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Background: While fluoroquinolone-resistant Chlamydia trachomatis strains have not been clinically isolated, they were isolated in an in vitro study recently. Methods: To determine whether C, trachomatis strains develop resistance under sub-MIG antibacterial exposure in a clinical therapeutic term, C, trachomatis strains were exposed to sub-MIG levofloxacin (LVFX) for about 2 weeks. The MIG of LVFX was measured and DNA fingerprinting was performed every 72 h by PCR using random primers. Results: There was almost no change in the MIG under exposure to 0.125 mug/ml LVFX. However, some mutation-al changes in DNA fingerprints developed. Conclusions: In clinical therapeutic terms, resistant strains of C, trachomatis will probably not develop, even if sub-MIG LVFX is employed, Copyright (C) 2000 S. Karger AG, Basel.

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Changes in susceptibility of Pseudomonas aeruginosa to gatifloxacin and carbapenem in an in vitro urinary bladder model

S Takahashi, T Hirose, M Sano, M Nishimura, M Matsukawa, M Mikami, T Tsukamoto

CHEMOTHERAPY ( KARGER )  46 ( 3 ) 204 - 208  2000.05

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To study the changes of bacterial susceptibility during exposure to antimicrobials, the respective minimal inhibitory concentrations (MICs) of 50 colonies from each of various bacterial test strains were determined in an experimental system using an in vitro urinary bladder model. The MICs of gatifloxacin and meropenem for Pseudomonas aeruginosa strains were not homogeneous before exposure to the drugs. The MICs of the strains examined reflected only that of their dominant population. When starting from 10(7) CFU/ml, the bacterial count was determined serially during exposure to gatifloxacin or meropenem in therapeutic urinary concentrations. The MIC of the less susceptible population of each strain was changed serially to a higher one. The more susceptible strains were eradicated before the change of the MIC. The bacteria originally consisted of strains having heterogeneous susceptibility to drugs, in which major strains had susceptibility expressed by the MIC and minor ones had a higher or lower MIC. This heterogeneity may be responsible for the change of susceptibility in strains after exposure to the drugs. Copyright (C) 2000 S. Karger AG, Basel.

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Bactericidal activity of gatifloxacin (AM-1155) against Pseudomonas aeruginosa and Enterococcus faecalis in an in vitro bladder model simulating human urinary concentrations after oral administration

S Takahashi, H Ebisu, T Hirose, M Sano, M Nishimura, K Hirai, T Tsukamoto, M Hosaka

CHEMOTHERAPY ( KARGER )  46 ( 2 ) 122 - 128  2000.03

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The bactericidal activity of gatifloxacin, a new 6-fluoro-8-methoxy quinolone, was determined in a dynamic in vitro model mimicking complicated lower urinary tract infection. Strains of Pseudomonas aeruginosa and Enterococcus faecalis with different susceptibility were exposed to changing gatifloxacin concentrations, simulating human urinary concentrations afer oral treatment with 200 mg twice daily for 3 consecutive days. Bacterial numbers of P. aeruginosa (minimal inhibitory concentrations, MIG: less than or equal to 32 mu g/ml) and of E. faecalis (MIC: 16 mu g/ml) were reduced to undetectable levels during exposure. For the strains with lower susceptibility, gatifloxacin showed bactericidal activity, but eradication was not complete. Thus, in a complicated urinary tract infection model, breakpoint MICs of gatifloxacin for uropathogenic organisms were presumed to range from 16 to 32 mu g/ml. At least 86% of recent clinical isolates of P. aeruginosa and E. faecalis were inhibited at its breakpoint MIG. These results suggest that gatifloxacin may be useful in the treatment of urinary tract infections. Copyright (C) 2000 S.Karger AG, Basel.

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Detection of antimicrobial-treated Chlamydia trachomatis with Amplicor PCR test kit

S. Takahashi, T. Hagiwara, S. Shiga, T. Hirose, T. Tsukamoto

Journal of Infection and Chemotherapy ( Springer Japan )  6 ( 4 ) 211 - 215  2000

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A polymerase chain reaction (PCR) method for the detection of Chlamydia trachomatis has been developed and is now available in the clinical setting. However, one of the major problems with this method is possible false-positive detection posttreatment. Nonviable C. trachomatis was established by in-vitro exposure to an antimicrobial agent, and we tried to detect the nonviable cells (NVCs) of C. trachomatis by PCR with variant primer sets. C. trachomatis strains (D/UW-3/Cx) were cultured in a medium containing the antimicrobial agent, at 8×MIC (minimal inhibitory concentration) 15 to 20h postinfection. Amplicor and two sets of PCR primers were used to detect the DNA of NVCs. Serial passages of NVCs were done five times. All samples were positive on Amplicor, and all except the fourth passage were positive for the two sets of primers. Although the PCR test appears to be valuable, NVCs may possibly be detected by this method, and this may be clinically responsible for the false detection of C. trachomatis after appropriate antimicrobial chemotherapy.

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Biofilm in complicated urinary tract infection

T Tsukamoto, M Matsukawa, M Sano, S Takahashi, H Hotta, N Itoh, T Hirose, Y Kumamoto

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV )  11 ( 3-4 ) 233 - 236  1999.05

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We studied the clinical efficacy of oral treatment with ciprofloxacin (CPFX) alone and combined with clarithromycin (CAM) in patients with complicated urinary tract infection with or without an indwelling catheter. Patients were randomly allocated to 600 mg CPFX (CPFX group) or to 600 mg CPFX plus 600 mg CAM (combination group) for 14 days. Evaluation was done on day 14 according to the criteria advocated by the Japanese Urinary Tract Infection Committee. In patients with a urinary catheter, the combination achieved a higher complete bacterial elimination rate (50.0%) and clinical efficacy rate (83.9%) than CPFX alone (30.0 and 61.5%, respectively). While no significant difference was found in the bacterial elimination rate between the two groups, the clinical efficacy of the combination (40.0%) was superior to that of CPFX alone (23.3%) in patients with an indwelling catheter. The better clinical efficacy of the combination may partly be attributed to the antibiofilm effect of CAM in the clinical setting. The results also indicate that difficulties still remain in the treatment of complicated urinary tract infections in patients with an indwelling catheter. (C) 1999 Elsevier Science B.V. All rights reserved.

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Inhibitory action of clarithromycin on glycocalyx produced by MRSA

Masato Sano, Takaoki Hirose, Masahiro Nishimura, Satoshi Takahashi, Masanori Matsukawa, Taiji Tsukamoto

Journal of Infection and Chemotherapy ( Springer Japan )  5 ( 1 ) 10 - 15  1999

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We determined whether clarithromycin (CAM) had the ability to eliminate glycocalyx and biofilm produced by methicillin-resistant Staphylococcus aureus (MRSA) using an in-vitro experimental system (consisting of a bladder model and a kidney model) simulating complicated urinary tract infection (UTI). We also examined whether a combination of CAM and vancomycin (VCM) was effective for eliminating the MRSA biofilm. VCM (urinary concentration simulating drip infusion of 500 mg twice a day for 5 days minimum inhibitory concentration (MIC) 0.5 μg/ml) eliminated MRSA from the bladder model medium at 48h, but reproliferation occurred immediately after withdrawal of the agent. No disappearance of MRSA biofilm was noted, and this appeared to be the cause of the bacterial regrowth. CAM (urinary concentration simulating oral administration of 200 mg twice a day for 5 days MIC, 128 μg/ml) allowed microbial recovery to the initial level within 48 h, but led to the disappearance of the glycocalyx-forming biofilm. A combination of VCM and CAM caused microbial elimination from the bladder model medium at 46h with no regrowth after withdrawal of the antimicrobial agents. Scanning electron microscopy confirmed that the MRSA biofilm disappeared completely and no microbial adhesion was noted. These results suggest that CAM has an inhibitory action on glycocalyx and biofilm of MRSA, and that the combined use of VCM and CAM may be efficacious for the treatment of MRSA UTI.

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Analysis of cross infection using genomic fingerprinting in nosocomial urinary tract infection caused by Enterococcus faecalis

Satoshi Takahashi, Takaoki Hirose, Masanori Matsukawa, Toshiaki Shimizu, Yasuharu Kunishima, Koh Takeyama, Akifumi Yokoo, Hiroshi Hotta, Midori Mikami, Taiji Tsukamoto

Journal of Infection and Chemotherapy ( Springer Japan )  5 ( 1 ) 46 - 48  1999

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To evaluate cross infection and a possible outbreak of Enterococcus faecalis urinary tract infection (UTI) in our urology ward, we studied the DNA fingerprinting of E. faecalis strains isolated from nosocomial UTI patients, in the period 1982-1996, using arbitrarily primed polymerase chain reaction (AP-PCR) analysis. The serovar and amplified products of DNA extracted from clinically isolated urinary E. faecalis strains by the AP-PCR method were analyzed, and the respective isolation periods of E. faecalis- positive UTI patients were investigated. There were nine patients with E. faecalis UTI between March and May 1994 and all strains isolated from their urine specimens were serovar type 7. AP-PCR revealed that five of the nine isolates had the same pattern. It appeared that these strains had caused the outbreak of E. faecalis UTI. Cross-infection between patients with E. faecalis UTI was demonstrated by genomic fingerprinting, suggesting that cross infection had occurred via urinary catheters or by hand contact in our ward. We may, therefore, reasonably conclude that we should beware of the transmission of urinary E. faecalis and take counter-measures against its dissemination.

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