研究者詳細 - 安田　満

論文 - 安田　満

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Clinical courses of herpes simplex virus-induced urethritis in men

Shin Ito, Mitsuru Yasuda, Hiromi Kondo, Yoshiteru Yamada, Keita Nakane, Kosuke Mizutani, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV ) 23 ( 10 ) 717 - 719 2017年10月 [査読有り]

We retrieved clinical data of 13 men having herpes simplex virus (HSV)-induced non-gonococcal urethritis (NGU) without visible herpetic lesions. They visited a clinic in Sendai, Japan, between April 2013 and December 2015. All the men complained of dysuria. Meatitis was observed in 9 of the 13 men. Mononuclear cells were observed in the urethral smears from 9 men. The 13 men were treated with azithromycin or sitafloxacin regimen. First-voided urine (FVU) specimens became negative for HSV in 8 of the 10 men who returned to the clinic after antibacterial treatment, and urethritis symptoms were alleviated. However, herpetic lesions were observed at the follow-up visits in 3 men, and 2 of them were still positive for HSV in their FVU. HSV could be a cause of acute urethritis without causing visible herpetic lesions. The shedding of HSV from the urethra would spontaneously cease with alleviation of urethritis symptoms in most cases of HSV-induced NGU without antiviral therapy. However, new herpetic lesions could be developed in some cases. Early antiviral therapy is beneficial for patients with HSV infections. The development of meatitis and the mononuclear cell response in the urethral smear could be helpful to diagnose HSV-induced NGU. Therefore, we should presumptively initiate anti-HSV therapy for patients with signs and symptoms suggestive of HSV-induced NGU at their first presentation. (C) 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

陰茎癌におけるHPV感染の役割と発癌のメカニズムについての検討

坂本次郎, 重原一慶, 中嶋一史, 川口昌平, 中嶋孝夫, 島村正喜, 安田満, 長谷川徹, 小堀善友, 岡田弘, 出口隆, 並木幹夫, 溝上敦

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 28 ( 1 ) 85 - 91 2017年09月

当院および関連施設で外科的治療を行った陰茎癌患者17例(平均年齢72.5歳)を対象に、HPV感染の役割と発癌メカニズムについて検討した。その結果、HPVは7例から検出され、その内訳は16型が5例、33型が1例、68型が1例であった。ISH法では、HPV陽性7検体のうち6検体で腫瘍細胞核内に、びまん性にHPV-DNAのシグナルが確認された。ISHの染色パターンは、ドット状にシグナルを呈しているものが多かった。p16-INK4aの発現に関しては、HPV陽性例では5例に発現を認め、強陽性が2例、中等度陽性が1例、軽度陽性が2例であった。一方、HPV陰性例ではp16-INK4aの発現は弱かった。また、HPV-L1の発現はHPV陽性例、陰性例に関わらず、全ての症例でみられなかった。今回の検討から、陰茎癌患者の41%からHPVが検出されたことからも、HPV感染が発癌に関連している可能性が示唆された。

Emergence of Mycoplasma genitalium with clinically significant fluoroquinolone resistance conferred by amino acid changes both in GyrA and ParC in Japan

Takashi Deguchi, Shin Ito, Mitsuru Yasuda, Hiromi Kondo, Yoshiteru Yamada, Keita Nakane, Kosuke Mizutani, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV ) 23 ( 9 ) 648 - 650 2017年09月 [査読有り]

We observed fluoroquinolone treatment failures in 2 men with Mycoplasma genitalium-positive non-gonococcal urethritis in Japan. A fluoroquinolone regimen of sitafloxacin 100 mg twice daily for 7 days failed to eradicate M. genitalium. In both cases, M. genitalium had fluoroquinolone resistance-associated amino acid changes both in GyrA and ParC and a macrolide resistance-associated mutation in the 23S rRNA gene. The emergence of such multi-drug resistant strains can threaten antimicrobial chemotherapy for M. genitalium infections in Japan, because we will lose the first- (azithromycin) and second-line (sitafloxacin) antimicrobial agents to treat M. genitalium infections. We prescribed an extended minocycline regimen of minocycline 100 mg twice daily for 14 days for our patients, and the regimen was successful in eradicating the M. genitalium. The extended minocycline regimen might be an option that we can try when treating multi-drug resistant M. genitalium infections in clinical practice. (C) 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Haemophilus influenzae Isolated From Men With Acute Urethritis: Its Pathogenic Roles, Responses to Antimicrobial Chemotherapies, and Antimicrobial Susceptibilities

Shin Ito, Kyoko Hatazaki, Ken Shimuta, Hiromi Kondo, Kosuke Mizutani, Mitsuru Yasuda, Keita Nakane, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Makoto Ohinishi, Takashi Deguchi

SEXUALLY TRANSMITTED DISEASES ( LIPPINCOTT WILLIAMS & WILKINS ) 44 ( 4 ) 205 - 210 2017年04月 [査読有り]

Background: There have been few comprehensive studies on Haemophilus influenza-positive urethritis. Methods: In this retrospective study, we enrolled 68 men with H. influenzae-positive urethritis, including coinfections with Neisseria gonorrhoeae, Chlamydia trachomatis, and/or genital mycoplasmas: 2, 3, 20, and 43 treated with ceftriaxone, levofloxacin, sitafloxacin, and extended-release azithromycin (azithromycin-SR), respectively. We assessed microbiological outcomes in 54 men and clinical outcomes in 46 with H. influenzae-positive monomicrobial nongonococcal urethritis. We determined minimum inhibitory concentrations (MICs) of 6 antimicrobial agents for 59 pretreatment isolates. Results: H. influenzae was eradicated from the men treated with ceftriaxone, levofloxacin, or sitafloxacin. The eradication rate with azithromycin-SR was 85.3%. The disappearance or alleviation of urethritis symptoms and the decreases in leukocyte counts in first-voided urine were significantly associated with the eradication of H. influenzae after treatment. For the isolates, ceftriaxone, levofloxacin, sitafloxacin, azithromycin, tetracycline, and doxycycline MICs were <= 0.008-0.25, 0.008-0.5, 0.001-0.008, 0.12-1, 0.25-16, and 0.25-2 mu g/mL, respectively. The azithromycin MICs for 3 of 4 strains persisting after azithromycin-SR administration were 1 mu g/mL. H. influenzae with an azithromycin MIC of 1 mu g/mL increased chronologically. Conclusions: H. influenzae showed good responses to the chemotherapies for urethritis. The significant associations of the clinical outcomes of the chemotherapies with their microbiological outcomes suggested that H. influenzae could play pathogenic roles in urethritis. All isolates, except for one with decreased susceptibility to tetracyclines, were susceptible to the examined agents. However, the increase in H. influenzae with an azithromycin MIC of 1 mu g/mL might threaten efficacies of azithromycin regimens on H. influenzae-positive urethritis.

DOI PubMed

Antimicrobial Susceptibility of Neisseria gonorrhoeae in Japan from 2000 to 2015

Mitsuru Yasuda, Kyoko Hatazaki, Shin Ito, Masataka Kitanohara, Mutsumasa Yoh, Munekado Kojima, Harunori Narita, Akira Kido, Kazutoyo Miyata, Takashi Deguch

SEXUALLY TRANSMITTED DISEASES ( LIPPINCOTT WILLIAMS & WILKINS ) 44 ( 3 ) 149 - 153 2017年03月 [査読有り]

Background: Gonococcal infections are difficult to treat because of their multidrug antimicrobial resistance. The outbreak of antimicrobial-resistant Neisseria gonorrhoeae has begun in Asia and particularly in Japan. Therefore, it is very important that we understand the trend of antimicrobial resistance of N. gonorrhoeae in Asia including Japan. Our surveillance of the antimicrobial susceptibility of N. gonorrhoeae began in 2000 under the guidance of the Department of Urology, Gifu University. We report our surveillance data from 2000 to 2015. Methods: We collected N. gonorrhoeae strains isolated from patients with gonococcal infections who visited our cooperating medical institutions in Japan from 2000 to 2015. MICs of penicillin G, cefixime, ceftriaxone, tetracycline, spectinomycin, azithromycin, and levofloxacin were determined by the agar dilution method approved by the Clinical and Laboratory Standards Institute. Results: From 2000 to 2015, 2471 isolates of N. gonorrhoeae were collected in Japan. High rates of nonsusceptibility to penicillin, tetracycline, levofloxacin, cefixime, and azithromycin were shown. Around 5% to 10% of the strains isolated had a 0.25-mg/L MIC of ceftriaxone in each year, and 6 strains (0.24%) with a 0.5-mg/L MIC of ceftriaxone were isolated throughout the study period. Approximately 5% to 10% of the strains were resistant to each of ceftriaxone, azithromycin, and levofloxacin according to European Committee on Antimicrobial Susceptibility Testing breakpoints, and the rate has not increased significantly. Conclusions: From this study and previous pharmacodynamic analyses, a single 1-g dose of ceftriaxone is recommended to treat gonorrhea. As strains with high-level ceftriaxone resistance continue to spread, higher doses of ceftriaxone in monotherapy or multiple doses of ceftriaxone should be considered.

DOI

Remarkable increase of Neisseria gonorrhoeae with decreased susceptibility of azithromycin and increase in the failure of azithromycin therapy in male gonococcal urethritis in Sendai in 2015

Mitsuru Yasuda, Shin Ito, Kyoko Hatazaki, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV ) 22 ( 12 ) 841 - 843 2016年12月 [査読有り]

The antimicrobial resistance of Neisseria gonorrhoeae is a serious problem worldwide. In this study, we examined the susceptibility of N. gonorrhoeae isolated from male gonococcal urethritis in Sendai in 2014 and 2015. Furthermore, of all cases, we investigated the clinical efficacy of a single 2-g dose of extended-release azithromycin (AZM-SR) in the treatment of male gonococcal urethritis retrospectively. Sixty N. gonorrhoeae strains in 2014 and 54 strains in 2015 were isolated from male gonococcal urethritis and stored each year. The MIC of AZM was >= 1 mg/L in 4 strains (6.7%) in 2014 and in 13 strains (24.1%) in 2015 and the number of strains having >= 1 mg/L MIC increased significantly (P = 0.016). Microbiological efficacy was evaluated in 32 and 29 of these patients, and the rates of treatment success were 93.8% and 79.3%, respectively. All of the treatment failures were caused by strains having a MIC of AZM of >= 0.5 mg/L. In particular, the increase in the isolates having a MIC of AZM of >= 1 mg/L was remarkable. Therefore, it was thought that the increase in these strains was the reason for the increase in treatment failures in 2015. Because no other drug is effective, it is currently necessary to use AZM-SR to treat gonococcal infections caused by ceftriaxone-resistant strains or patients allergic to ceftriaxone. To prevent a further increase in resistance to AZM, we should not use AZM-SR to treat normal cases of gonococcal infection. (C) 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI

単純ヘルペスウイルスが原因と考えられ症状が遷延した後淋菌性尿道炎の2例

伊藤晋, 伊藤貴子, 花岡希, 山田壮一, 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 ) 27 ( 2 ) 259 - 259 2016年11月

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 ( WILEY ) 23 ( 10 ) 814 - 824 2016年10月

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

単純ヘルペスウイルス1型が原因と考えられ症状が遷延した後淋菌性尿道炎の1例

伊藤晋, 花岡希, 山田壮一, 安田満, 出口隆

泌尿器外科 ( 医学図書出版(株) ) 29 ( 9 ) 1499 - 1499 2016年09月

Postoperative infectious complications in patients undergoing holmium laser enucleation of the prostate: Risk factors and microbiological analysis

Mina Kikuchi, Koji Kameyama, Mitsuru Yasuda, Shigeaki Yokoi, Takashi Deguchi, Kosei Miwa

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY-BLACKWELL ) 23 ( 9 ) 791 - 796 2016年09月 [査読有り]

ObjectivesTo examine the incidence of postoperative bacteriuria and febrile complications, and to investigate bacterial strains in the urine of patients undergoing holmium laser enucleation of the prostate. MethodsWe retrospectively analyzed 190 evaluable patients treated with holmium laser enucleation of the prostate at the Gifu University Hospital, Gifu, Japan, between September 2005 and May 2014. All patients presented with lower urinary tract symptoms as a result of benign prostatic hyperplasia. We also evaluated the causative bacteria and compared the findings with the results of preoperative urine cultures. We analyzed the relationship between the emergence of postoperative febrile complications, antibiotic prophylaxis, patient background and surgical procedure. ResultsThe frequency of bacterial isolation in preoperative and postoperative urine cultures was 41% and 23%, respectively. Preoperatively, Enterococcus faecalis was the most frequently cultured bacteria, second was methicillin-resistant Staphylococcus epidermidis, and third was Escherichia coli. Postoperatively, Enterococcus faecalis was still the most frequently cultured bacteria, whereas the second was Escherichia coli. Risk factors for postoperative bacteriuria were evaluated. Multivariate analysis showed that the rate of postoperative bacteriuria in patients who had taken dutasteride preoperatively was significantly lower than that in the other patients. Risk factors for febrile complications could not be identified. ConclusionsThe use of perioperative prophylactic antibacterial agents for holmium laser enucleation of the prostate keeps the rate of postoperative infectious complications low. Dutasteride treatment administered before surgery might reduce the risk of postoperative bacteriuria.

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Microbiological efficacy and tolerability of a single-dose regimen of 1 g of ceftriaxone in men with gonococcal urethritis.

Ito S, Yasuda M, Hatazaki K, Mizutani K, Tsuchiya T, Yokoi S, Nakano M, Deguchi T

The Journal of antimicrobial chemotherapy 71 ( 9 ) 2559 - 2562 2016年09月 [査読有り]

DOI PubMed

Novel penA mutations identified in Neisseria gonorrhoeae with decreased susceptibility to ceftriaxone isolated between 2000 and 2014 in Japan.

Seike K, Yasuda M, Hatazaki K, Mizutani K, Yuhara K, Ito Y, Fujimoto Y, Ito S, Tsuchiya T, Yokoi S, Nakano M, Deguchi T

The Journal of antimicrobial chemotherapy 71 ( 9 ) 2466 - 2470 2016年09月 [査読有り]

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 ( ELSEVIER SCIENCE BV ) 22 ( 9-10 ) 651 - 661 2016年09月 [査読有り]

DOI PubMed

尿路性器感染症に関する臨床試験実施のためのガイドライン(第2版) ガイドラインの改訂にあたって

荒川創一, 石川清仁, 清田浩, 坂田宏, 重村克巳, 高橋聡, 濱砂良一, 速見浩士, 三鴨廣繁, 村谷哲郎, 安田満, 山本新吾, 渡邉豊彦, 公益社団法人日本化学療法学会尿路性器感染症に関する臨床試験実施のためのガイドライン改訂委員会

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 64 ( 3 ) 479 - 493 2016年05月

2014年に収集された複雑性尿路感染症分離菌の薬剤感受性について

安田満, 亀山紘司, 山田佳輝, 江原英俊, 原田吉将, 小出卓也, 小林覚, 米田尚生, 高橋義人, 林秀治, 篠田育男, 石原哲, 武田明久, 岡野学, 伊藤康久, 藤本佳則, 藤広茂, 出口隆, 旗崎恭子, 増栄孝子, 藤本祥太, 中井千愛, 川瀬紘太

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 64 ( 2 ) 360 - 360 2016年03月

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

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

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV ) 22 ( 9-10 ) 581 - 586 2016年 [査読有り] [国際誌]

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

DOI PubMed

MLVAによって見出されたNG-MAST ST1407型淋菌の遺伝学的特徴

中西典子, 田中忍, 志牟田健, 石原朋子, 中山周一, 大澤佳代, 吉田弘之, 重村克巳, 荒川創一, 安田満, 出口隆, 岩本朋忠, 大西真

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 26 ( 2 ) 72 - 72 2015年10月

男性性器感染症に対する治療を考える前立腺生検に伴う尿路性器感染症の発生頻度の検討後ろ向き多施設共同研究 UTI共同研究会

東郷容和, 安田満, 宮崎淳, 高橋聡, 速見浩士, 田中一志, 石川清仁, 濱砂良一, 山本新吾, 清田浩, 荒川創一, 松本哲朗

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 63 ( 1 ) 76 - 77 2015年01月

男性性器感染症に対する治療を考える前立腺生検に伴う尿路性器感染症の発生頻度の検討後ろ向き多施設共同研究 UTI共同研究会

東郷容和, 安田満, 宮崎淳, 高橋聡, 速見浩士, 田中一志, 石川清仁, 濱砂良一, 山本新吾, 清田浩, 荒川創一, 松本哲朗

感染症学雑誌 ( (一社)日本感染症学会 ) 89 ( 1 ) 123 - 123 2015年01月

泌尿器科領域 2012年における淋菌の薬剤感受性サーベイランス

安田満, 濱砂良一, 上原慎也, 高橋聡, 速見浩士, 石川清仁, 山本新吾, 松本哲朗, 門田淳一, 渡辺彰, 三学会合同抗菌薬感受性サーベイランス委員会

日本臨床微生物学雑誌 ( (一社)日本臨床微生物学会 ) 25 ( Suppl.1 ) 150 - 150 2014年12月

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