研究者詳細 - 安田　満

論文 - 安田　満

分割表示 149 件中 1 - 20 件目／全件表示 >>

Detection of Novel US <i>Neisseria meningitidis</i> Urethritis Clade Subtypes in Japan

Hideyuki Takahashi, Masatomo Morita, Mitsuru Yasuda, Yuki Ohama, Yoshitomo Kobori, Munekado Kojima, Ken Shimuta, Yukihiro Akeda, Makoto Ohnishi

Emerging Infectious Diseases ( Centers for Disease Control and Prevention (CDC) ) 29 ( 11 ) 2023年11月

DOI

The third nationwide surveillance of antimicrobial susceptibility against Neisseria gonorrhoeae from male urethritis in Japan, 2016-2017.

Mitsuru Yasuda, Satoshi Takahashi, Jun Miyazaki, Koichiro Wada, Kanao Kobayashi, Masahiro Matsumoto, Hiroshi Hayami, Shingo Yamamoto, Hiroshi Kiyota, Junko Sato, Tetsuya Matsumoto, Hiroshi Yotsuyanagi, Hideaki Hanaki, Naoya Masumori, Yoshiki Hiyama, Hiroyuki Nishiyama, Takahiro Kimura, Hiroki Yamada, Kazumasa Matsumoto, Kiyohito Ishikawa, Yoshikazu Togo, Kazushi Tanaka, Takuya Sadahira, Junichi Inokuchi, Ryoichi Hamasuna, Kenji Ito, Hideo Hirayama, Kenji Hayashi, Yuichiro Kurimura, Hitoshi Kadena, Shin Ito, Yutaka Shiono, Takahiro Maruyama, Masayasu Ito, Koichi Hatano, Hirofumi Chokyu, Hideari Ihara, Satoshi Uno, Koichi Monden, Teruhiko Yokoyama, Motonori Kano, Shinichi Kaji, Motoshi Kawahara, Toru Sumii, Takanori Tojo, Takahide Hosobe, Kazuhiko Naito, Shuichi Kawai, Hirofumi Nishimura, Masanobu Izumitani, Mutsumasa Yoh, Masaru Matsumura, Ryuji Fujita, Kazuo Takayama, Makoto Hara, Shohei Nishi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 29 ( 11 ) 1011 - 1016 2023年08月 [国際誌]

Neisseria gonorrhoeae is one of the important pathogens of sexually transmitted infections. N. gonorrhoeae is rapidly becoming antimicrobial resistant, and there are few drugs that are effective in the initial treatment of gonorrhea. To understand the trends of antimicrobial susceptibility of N. gonorrhoeae, the Surveillance Committee of the Japanese Society of Infectious Diseases, the Japanese Society for Chemotherapy, and the Japanese Society of Clinical Microbiology conducted the third nationwide antimicrobial susceptibility surveillance of N. gonorrhoeae isolated from male urethritis. The specimens were collected from male patients with urethritis at 30 facilities from May 2016 to July 2017. From the 159 specimens collected, 87 N. gonorrhoeae strains were isolated, and 85 were tested for susceptibility to 21 antimicrobial agents. All strains were non-susceptible to penicillin G. Seven strains (8.2%) were β-lactamase-producing strains. The rates of susceptibility to cefixime and cefpodoxime were 96.5% and 52.9%, respectively. Three strains were non-susceptible with a minimum inhibitory concentration (MIC) of 0.5 mg/L for cefixime. None of the strains were resistant to ceftriaxone or spectinomycin. The susceptibility rate for ciprofloxacin was 23.5% (20 strains), and no strains showed intermediate susceptibility. The susceptibility rate against azithromycin was 81.2%, with one strain isolated with a MIC of 8 mg/L against azithromycin. The results of this surveillance indicate that ceftriaxone and spectinomycin, which are currently recommended for gonococcal infections in Japan, appear to be effective. It will be necessary to further expand the scale of the next surveillance to understand the current status of drug-resistant N. gonorrhoeae in Japan.

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年02月 [国際誌]

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 2021年09月 [国際誌]

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

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年09月 [国際誌]

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

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年08月 [国際誌]

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

2019年にわが国で分離された淋菌の薬剤感受性報告

安田満, 志牟田健, 中山周一, 高橋英之, 小林寅哲, 大澤佳代, 陳内理生, 三宅啓文, 大西真

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 31 ( 2 ) 93 - 93 2020年11月

Human Adenovirus B7d-Associated Urethritis after Suspected Sexual Transmission, Japan.

Nozomu Hanaoka, Shin Ito, Naomi Nojiri, Masami Konagaya, Mitsuru Yasuda, Takashi Deguchi, Tsuguto Fujimoto

Emerging infectious diseases 26 ( 10 ) 2444 - 2447 2020年10月 [国際誌]

DOI PubMed

Characterization of two Neisseria gonorrhoeae strains with high-level azithromycin resistance isolated in 2015 and 2018 in Japan

Ken Shimuta, Kenichi Lee, Mitsuru Yasuda, Keiichi Furubayashi, Chiaki Uchida, Shu-ichi Nakayama, Hideyuki Takahashi, Makoto Ohnishi

Sexually Transmitted Diseases ( Ovid Technologies (Wolters Kluwer Health) ) Publish Ahead of Print ( 7 ) e85 - e87 2020年09月

DOI

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年05月 [国際誌]

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

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

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER ) 26 ( 5 ) 418 - 428 2020年05月

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 mu g/mL) increased to 14.7% from 5.5%.Bacterial strains that produced extended-spectrum beta-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 beta-lactamase producing E. coli and K. pneumoniae strains increased from previous surveillance reports. (c) 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI

Update on the treatment of sexually transmitted infections diseases-significance of a single 1 g dose of ceftriaxone and single 2 g dose of azithromycin for urethritis in Japan and comparison with guidelines from western countries

Mitsuru Yasuda, Katsumi Shigemura, Shin Ito

Japanese Journal of Chemotherapy ( Japan Society of Chemotherapy ) 68 ( 2 ) 186 - 197 2020年03月

Antimicrobial resistance has become a serious problem in the treatment of sexually transmitted infections. It is of particular concern in regard to the causative pathogens of urethritis. We investigated the position of ceftriaxone (CTRX) and azithromycin (AZM) for the treatment of urethritis, and compared the Japanese guidelines with the European Association of Urology (EAU) guideline and Centers for Diseases Control and Prevention (CDC) guideline. In Japan, isolates of Neisseria gonorrhoeae with decreased susceptibilities to CTRX have nearly not been isolated. Even using "Therapeutic time", one of the methods for predicting clinical efficacy, single-dose administration of CTRX 1 g is considered to be effective for the treatment of gonococcal urethritis, and has also been reported to be effective in clinical practice. Although there have been no reports of strain like a CTRX-resistant N. gonorrhoeae isolated, a few strains with an MIC of CTRX of 05 mg/L have been isolated. On the other hand, the isolation rates of AZM-resistant N. gonorrhoeae have been increasing, and the efficacy rates of AZM against gonococcal urethritis are actually decreasing. Moreover, isolation of AZM-highly resistant isolates has also been reported from around the world, and single-dose AZM-ER is not recommended as the initial therapy for gonococcal urethritis. However, there have been no reports of isolation of AZM-resistant strains of Chlamydia trachomatis which is one of causative pathogeh for nongonococcal. Therefore, AZM is recommended as the regimen of choice for the treatment of chlamydial urethritis. However, the efficacy rates of AZM therapy against Mycoplasma genitalium-urethritis are actually decreasing. It has also been reported that 70% of Af. genitalium strains have a mutation 'in the 23S rRNA gene associated with macrolide resistance in Japan, and the position of a macrolide as first-line therapy for non-gonococcal non-chlamydial urethritis remains questionable. Comparison of Japanese and Western guidelines revealed almost no difference in the recommended treatment of non-gonococcal urethritis. However, for the case of gonococcal urethritis, a single administration of a high dose of CTRX is recommended in Japan, whereas in the US and Europe, dual therapy with low doses of CTRX + AZM is recommended. Low doses of CTRX may be less pharmacologically effective and may promote the development of resistance. In addition, no synergistic effect of dual therapy has been observed with the CTRX + AZM regimen, and it is essential for each of the drugs to be individually is effective however, the frequency of AZM-resistant N. gonorrhoeae is increasing. Therefore, single administration of CTRX at a high dose may be desirable, as recommended in Japan. From this point of view, in the case of gonococcal urethritis, the dose of CTRX in Japan is the light in the sense that it is the highest dose in the world, but rather it may be said that Western guidelines are a lower dose and a shadow.

Comparison of single- and multiple-dose cefazolin as prophylaxis for transurethral enucleation of prostate: A multicenter, prospective, randomized controlled trial by the Japanese Research Group for Urinary Tract Infection

Yoshikazu Togo, Koji Fukui, Yasuo Ueda, Sojun Kanamaru, Yosuke Shimizu, Koichiro Wada, Takuya Sadahira, Yusuke Yamada, Masahiro Matsumoto, Ryoichi Hamasuna, Kiyohito Ishikawa, Manabu Takai, Yuka Maekawa, Mitsuru Yasuda, Koji Kokura, Nobuyuki Kondoh, Hidekazu Takiuchi, Shingo Yamamoto

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY ) 27 ( 3 ) 244 - 248 2020年03月

Objectives To compare the optimal administration period of antimicrobial prophylaxis in patients undergoing transurethral enucleation of the prostate for benign prostatic hyperplasia. Methods We carried out a randomized controlled trial to compare the differences in incidence of perioperative genitourinary tract infection between single and multiple (3 days) administrations of cefazolin for transurethral enucleation of the prostate in benign prostatic hyperplasia patients without pyuria or bacteriuria between January 2015 and December 2018. Results This multicenter randomized controlled trial included 203 patients who underwent a transurethral enucleation of the prostate procedure. All received antimicrobial prophylaxis, and were randomized into those who received single-dose (n = 101) or multiple-dose (n = 102) therapy. The rate of genitourinary tract infection after transurethral enucleation of the prostate for all patients was 1.5%, whereas that in the single-dose group was 1.0% and in the multiple-dose group was 2.0%, which were not significantly different (P = 1.00). Conclusions A single dose of antimicrobial prophylaxis as a prophylactic antibacterial drug is sufficient for patients undergoing transurethral enucleation of the prostate who do not have presurgical pyuria or bacteriuria.

DOI

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年12月 [査読有り] [国際誌]

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

2018年にわが国で分離された淋菌の薬剤感受性報告

安田満, 志牟田健, 中山周一, 高橋英之, 小林寅哲, 大澤佳代, 陳内理生, 三宅啓文, 大西真

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 30 ( 2 ) 228 - 228 2019年10月

本邦のAPTIMA Combo2クラミジア偽陰性株の解析

伊藤晋, 花岡希, 高梨真樹, 高橋聡, 伊藤貴子, 安田満, 出口隆

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 30 ( 2 ) 257 - 257 2019年10月

クラミジア診断における3つの核酸増幅キット(APTIMA Combo2、Cobas4800、ProbeTec)の比較

伊藤晋, 高橋聡, 花岡希, 高梨真樹, 桧山佳樹, 安田満, 出口隆

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 30 ( 2 ) 258 - 258 2019年10月

アデノウイルス・単純ヘルペスウイルス性尿道炎診断における迅速免疫クロマトキットの有用性に関する検討（第２報） - 尿沈湾検体ではアデノウイルスを高感度・高特異度に検出可能－

花岡希, 伊藤晋, 藤本嗣人, 安田満, 出口隆

日本性感染症誌 30 ( 1 ) 1 - 5 2019年10月 [査読有り] [招待有り]

J-GLOBAL

アデノウイルス・単純ヘルペスウイルス性尿道炎診断における迅速免疫クロマトキットの有用性に関する検討(第2報) 尿沈渣検体ではアデノウイルスを高感度・高特異度に検出可能

花岡希, 伊藤晋, 藤本嗣人, 安田満, 出口隆

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 30 ( 1 ) 45 - 49 2019年09月

ウイルス性尿道炎診断におけるアデノウイルス(HAdV)迅速免疫クロマトキット(ICキット)の有用性を高めるため、感度上昇を期待し検体を初尿から尿沈渣に変更した。また単純ヘルペスウイルス(HSV)用ICキットも追加して検討を行った。既知のHAdV陽性、HSV陽性初尿と同一初尿由来沈渣を用いて、Real-time PCR法により検体中のウイルスcopy数を測定・比較した。次に、ウイルス性尿道炎が疑われる男子尿道炎46例の初尿沈渣を用いて、アルソニックアデノ(AA)、プライムチェックアデノ(PA)、プライムチェックHSV(PH)の結果を、Real-time PCR法の結果を正診とし評価した。その結果、HAdVは初尿より尿沈渣で核酸量が多く、AAおよびPAは感度100%(8/8)、特異度100%(38/38)であった。HSVは尿沈渣による核酸増加はわずかで、PHの感度は46.2%(6/13)、特異度は100%(33/33)であった。症例数は少ないがAAおよびPAはPCR法に劣らずHAdV尿道炎の診断に有用であり、PHの感度は高いとは言えないが特異度は高く有用と考えられた。

Urinary exosome as a potential biomarker for urinary tract infection.

Mizutani K, Kawakami K, Horie K, Fujita Y, Kameyama K, Kato T, Nakane K, Tsuchiya T, Yasuda M, Masunaga K, Kasuya Y, Masuda Y, Deguchi T, Koie T, Ito M

Cellular microbiology 21 ( 7 ) e13020 2019年07月 [査読有り] [国際誌]

Unlike urinary tract infection (UTI), asymptomatic bacteriuria (ABU) should not be treated, with some exceptions such as pregnant women and patients who will undergo traumatic urologic interventions. However, there has been no clinically available marker for their differential diagnosis. Exosomes or small extracellular vesicles carry proteins contained in cells from which they are derived, thus having the potential as a biomarker of several diseases. On the basis of the hypothesis that the molecular signature of exosomes in urine may differ between UTI and ABU patients, we examined if urinary exosomes could serve as a marker for their differential diagnosis. Exosomes were isolated by ultracentrifugation or affinity-based method from cell culture medium of monocytic THP-1 and uroepithelial SV-HUC-1 cells and human urine. Protein expression was examined by Western blot analysis, ELISA, and CLEIA. The results showed that the levels of intracellular signalling molecules Akt and ERK and transcription factor NF-κB increased in exosomes isolated from THP-1 and SV-HUC-1 cells cocultured with Escherichia coli and/or treated with lipopolysaccharide. In urinary exosomes of UTI patients, Akt significantly diminished, and an exosomal marker CD9 showed a trend to decrease after treatment with antimicrobial agents. More importantly, Akt and CD9 levels in urinary exosomes were higher in UTI patients than in ABU patients, which was also observed after correction by urine creatinine. Collectively, these results suggest that Akt and CD9 in urinary exosomes could be useful markers for differential diagnosis of UTI and ABU.

DOI PubMed

　前のページ - 次のページ　

<安田 満>

論文 - 安田 満

<安田　満>

論文 - 安田　満