Details of a Researcher - YASUDA Mitsuru

Papers - YASUDA Mitsuru

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Detection of Novel US Neisseria meningitidis 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 ) 2023.11

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 2023.08 [International journal]

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 2022.02 [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 2021.09 [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

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 2021.09 [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

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

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 2020.11

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 2020.10 [International journal]

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 2020.09

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 2020.05 [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

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 2020.05

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.

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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 2020.03

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 2020.03

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.

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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 [Refereed] [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

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 2019.10

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 2019.10

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 2019.10

Evaluation of rapid immunochromatographic tests for adenovirs and herpe simplex virus ｗith urinary sediment from male urethritis

Nozomu Hanaoka, Shin Ito, Tsuguto Fujimoto, Mitsuru Yasuda, Takashi Deguchi

Japanese Journal of Sexually Transmitted Infections 30 ( 1 ) 1 - 5 2019.10 [Refereed] [Invited]

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 2019.09

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 2019.07 [Refereed] [International journal]

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

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

Hayami H, Takahashi S, Ishikawa K, Yasuda M, Yamamoto S, Wada K, Kobayashi K, Hamasuna R, Minamitani S, Matsumoto T, Kiyota H, Tateda K, Sato J, Hanaki H, Masumori N, Nishiyama H, Miyazaki J, Fujimoto K, Tanaka K, Uehara S, Matsubara A, Ito K, Hayashi K, Kurimura Y, Ito S, Takeuchi T, Narita H, Izumitani M, Nishimura H, Kawahara M, Hara M, Hosobe T, Takashima K, Chokyu H, Matsumura M, Ihara H, Uno S, Monden K, Sumii T, Kawai S, Kariya S, Sato T, Yoshioka M, Kadena H, Matsushita S, Nishi S, Hosokawa Y, Shirane T, Yoh M, Watanabe S, Makinose S, Uemura T, Goto H

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 25 ( 6 ) 413 - 422 2019.06 [Refereed]

DOI PubMed

非淋菌性尿道炎の治療効果判定における初尿白血球濃度の有用性

伊藤晋, 安田満, 花岡希, 出口隆

日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 107回 AOP - 037 2019.04

2015〜2017年にわが国で分離された淋菌の薬剤感受性について

安田満, 籏崎恭子, 小林寅哲, 大澤佳代, 濱砂良一, 荒川創一, 志牟田健, 中山周一, 大西真, 陳内理生, 三宅啓文

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 67 ( Suppl.A ) 240 - 240 2019.03

2017年に男子淋菌性尿道炎患者より分離された淋菌の薬剤感受性について

安田満, 伊東晋, 楊睦正, 伊藤雅康, 西村昌宏, 川原元司, 平山英雄, 宮田和豊, 出口隆, 田中香お里, 村上啓雄, 旗崎恭子, 鷺山和幸, 小島宗門, 松木孝和, 成田晴紀, 木戸雅人, 伊東健治, 川井修一, 上床典康, 花井俊典, 重原一慶, 中嶋一史, 沼崎進, 内田千秋, 竹内敏視, 佐藤嘉一, 楠山弘之, 岩澤晶彦, 野口武俊, 土屋博, 川野尚, 小林峰男, 山田拓己, 内島豊, 宮村隆三, 米田尚生, 久保田恵章, 伊藤康久, 岡野学, 濱野公成, 増栄成泰

感染症学雑誌 ( (一社)日本感染症学会 ) 93 ( 2 ) 235 - 236 2019.03 [Refereed]

A real-time PCR assay for detecting a penA mutation associated with ceftriaxone resistance in Neisseria gonorrhoeae.

Shimuta K, Igawa G, Yasuda M, Deguchi T, Nakayama SI, Ohnishi M

Journal of global antimicrobial resistance ( Elsevier BV ) 19 46 - 49 2019.02 [Refereed]

DOI PubMed

Etiological role of human papillomavirus infection in the development of penile cancer.

Jiro Sakamoto, Kazuyoshi Shigehara, Kazufumi Nakashima, Shohei Kawaguchi, Takao Nakashima, Masayoshi Shimamura, Mitsuru Yasuda, Taku Kato, Toru Hasegawa, Yoshitomo Kobori, Hiroshi Okada, Takashi Deguchi, Kouji Izumi, Yoshifumi Kadono, Atsushi Mizokami

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 78 148 - 154 2019.01 [International journal]

OBJECTIVE: To examine the association between human papillomavirus (HPV) infection and penile cancer among Japanese patients. METHODS: Thirty-four patients with penile cancer were enrolled in this study. DNA was extracted from paraffin-embedded tumor tissue samples, and HPV-DNA tests and genotyping were performed. For all of the samples, in situ hybridization (ISH) was performed to locate HPV-DNA in tumor tissue. Furthermore, expression levels of p16-INK4a, mini-chromosome maintenance protein 7(mcm-7), HPV-L1, and Ki-67 were analyzed using immunohistochemical methods. RESULTS: HPV and high-risk (HR)-HPV were detected in 14 (41.1%; 95% confidence interval (CI) 24.6-57.7%) and 12 (35.2%; 95% CI 19.2-51.4%) cases, respectively. HPV16 was the most frequently detected HPV type. Among the HR-HPV-positive cases, a punctate HR-HPV-DNA signal pattern was detected by ISH in tumor cell nuclei. P16-INK4a was expressed in 66.7% (95% CI 42.8-90.1%) of HR-HPV-positive cases and was significantly more frequent and stronger in HR-HPV-positive cases than in HPV-negative cases. There was no significant difference in the occurrence or distribution of mcm-7 or Ki-67 expression between HPV-positive and HPV-negative cases. HPV-L1 expression was not observed in any of the cases examined. CONCLUSIONS: HPV infection may have had an etiological role in 41% of the examined cases of penile cancer in Japan.

DOI PubMed

Infectious human adenoviruses are shed in urine even after disappearance of urethral symptoms.

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

PloS one 14 ( 3 ) e0212434 2019 [International journal]

BACKGROUND: Urethritis is a common sexually transmitted disease, and human adenoviruses (HAdVs) have been found to be associated with nonchlamydial nongonococcal urethritis. However, the level and viability of HAdV in the urine of patients with urethritis remain unclear. METHODS: Male patients with urethritis and an asymptomatic group were screened using their First-void urine (FVU) for urethritis-related pathogens to identify those with HAdV DNA. FVU and gargle fluid were collected from all patients including from those in the asymptomatic group. A swab of eye discharge was also collected from patients with eye symptoms. The pharyngeal and/ or ocular fluid was also screened only in cases in which FVU was positive for HAdV DNA. HAdVs were isolated using A549 cell lines and typed by sequencing, and viral shedding during 2 years was quantified using real-time PCR. The prevalence of HAdV was assessed in the urethritis and asymptomatic groups, and viral load, isolated HAdV types, and urethral symptoms were compared between the groups. RESULTS: The positive detection rate of HAdV DNA was significantly higher in the urethritis group than in the asymptomatic group. Of 398 patients with urethritis, HAdV was isolated in all 32 cases (23 cases in which only HAdV DNA was detected with a mean of 2 × 109 copies/mL in urine samples). Of 124 control cases, one had HAdV monoinfection. The most frequently detected HAdV type was 56, followed by types 37 and 64. Regarding the relationship between symptoms and isolated HAdVs, the virus was isolated for up to 12 days after urethritis symptoms disappeared. CONCLUSIONS: HAdVs were significantly detected and isolated from the FVU of patients with urethritis. Furthermore, high levels of infectious HAdVs are excreted in urine for a long period even after urethritis symptoms disappear.

DOI PubMed

Surveillance of the prevalence of macrolide and/or fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in Japan

Takashi Deguchi, Shin Ito, Mitsuru Yasuda, Yuko Sato, Chiaki Uchida, Masayuki Sawamura, Kazushi Manda, Masaki Takanashi, Hiroshi Kiyota

Journal of Infection and Chemotherapy ( Elsevier B.V. ) 24 ( 11 ) 861 - 867 2018.11

To clarify the status of macrolide and fluoroquinolone resistance of clinical strains of Mycoplasma genitalium in Japan, we amplified portions of the gyrA, parC, and 23S rRNA genes from DNAs in 627 first-voided urine specimens collected from men with M. genitalium-positive urethritis who visited clinics mainly in Sendai, Tokyo, and Osaka, Japan, from 2013 to 2017, by PCR and sequenced. The incidence of single amino acid changes at Met95 or Asp99 in GyrA increased chronologically and was approximately 10% from 2015 onward. The incidence of amino acid changes at Ser83 or Asp87 in ParC was approximately 50% in 2013 but increased to 60–70% from 2014 to 2017. The incidence of mutations at A2071 or A2072 in the 23S rRNA gene increased chronologically and reached over 70% in 2017. The prevalence of M. genitalium harboring alterations in ParC and mutations in the 23S rRNA gene increased and was approximately 50% in 2016 and 2017. The prevalence of M. genitalium with alterations in both GyrA and ParC and mutations in the 23S rRNA gene, which could be associated with treatment failures with the sitafloxacin and azithromycin regimens, were approximately 15% and 10% in 2016 and 2017, respectively. The prevalence of M. genitalium with genetic alterations associated with resistance to fluoroquinolones and/or macrolides is increasing rapidly in Japan. We must prevent the further selection of multi-drug-resistant M. genitalium so that M. genitalium infections will not become untreatable.

DOI PubMed

2015〜2017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, 小林寅哲, 大澤佳代, 陣内理生, 三宅啓文, 濱砂良一, 荒川創一, 大西真

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 29 ( 2 ) 239 - 239 2018.10

尿道炎原因微生物の診断に関する検討迅速免疫クロマトキットを用いたヒトアデノウイルスおよび単純ヘルペスウイルスの検出

伊藤晋, 花岡希, 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 ) 29 ( 2 ) 241 - 241 2018.10

尿道炎原因微生物の診断に関する検討原因微生物と排尿痛の程度

伊藤晋, 伊藤貴子, 花岡希, 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 ) 29 ( 2 ) 240 - 240 2018.10

尿道炎原因微生物の診断に関する検討原因微生物と潜伏期間

伊藤晋, 伊藤貴子, 花岡希, 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 ) 29 ( 2 ) 240 - 240 2018.10

Corrigendum: Genomic surveillance of Neisseria gonorrhoeae to investigate the distribution and evolution of antimicrobial-resistance determinants and lineages.

Koji Yahara, Shu-Ichi Nakayama, Ken Shimuta, Ken-Ichi Lee, Masatomo Morita, Takuya Kawahata, Toshiro Kuroki, Yuko Watanabe, Hitomi Ohya, Mitsuru Yasuda, Takashi Deguchi, Xavier Didelot, Makoto Ohnishi

Microbial genomics 4 ( 9 ) 2018.09 [International journal]

DOI PubMed

Macrolide and fluoroquinolone resistance is uncommon in clinical strains of Chlamydia trachomatis.

Deguchi T, Hatazaki K, Ito S, Kondo H, Horie K, Nakane K, Mizutani K, Tsuchiya T, Yasuda M, Yokoi S, Nakano M

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 24 ( 8 ) 610 - 614 2018.08 [Refereed]

DOI PubMed

Genomic surveillance of Neisseria gonorrhoeae to investigate the distribution and evolution of antimicrobial-resistance determinants and lineages.

Microbial genomics 4 ( 8 ) 2018.08 [Refereed] [International journal]

The first extensively drug resistant (XDR) Neisseria gonorrhoeae strain with high resistance to the extended-spectrum cephalosporin ceftriaxone was identified in 2009 in Japan, but no other strain with this antimicrobial-resistance profile has been reported since. However, surveillance to date has been based on phenotypic methods and sequence typing, not genome sequencing. Therefore, little is known about the local population structure at the genomic level, and how resistance determinants and lineages are distributed and evolve. We analysed the whole-genome sequence data and the antimicrobial-susceptibility testing results of 204 strains sampled in a region where the first XDR ceftriaxone-resistant N. gonorrhoeae was isolated, complemented with 67 additional genomes from other time frames and locations within Japan. Strains resistant to ceftriaxone were not found, but we discovered a sequence type (ST)7363 sub-lineage susceptible to ceftriaxone and cefixime in which the mosaic penA allele responsible for reduced susceptibility had reverted to a susceptible allele by recombination. Approximately 85 % of isolates showed resistance to fluoroquinolones (ciprofloxacin) explained by linked amino acid substitutions at positions 91 and 95 of GyrA with 99 % sensitivity and 100 % specificity. Approximately 10 % showed resistance to macrolides (azithromycin), for which genetic determinants are less clear. Furthermore, we revealed different evolutionary paths of the two major lineages: single acquisition of penA X in the ST7363-associated lineage, followed by multiple independent acquisitions of the penA X and XXXIV in the ST1901-associated lineage. Our study provides a detailed picture of the distribution of resistance determinants and disentangles the evolution of the two major lineages spreading worldwide.

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.

Togo Y, Ichioka D, Miyazaki J, Maeda Y, Kameyama K, Yasuda M, Hiyama Y, Takahashi S, Nagae H, Hirota S, Yamamoto S, Japanese Research Group for Urinary Tract Infection (JRG

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

GyrA and/or ParC alterations of Haemophilus influenzae strains isolated from the urethra of men with acute urethritis.

Kondo H, Ito S, Hatazaki K, Horie K, Nakane K, Mizutani K, Tsuchiya T, Yasuda M, Yokoi S, Nakano M, Deguchi T

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 24 ( 3 ) 232 - 235 2018.03 [Refereed]

DOI PubMed

Evaluation of the Microbiological Efficacy of a Single 2-Gram Dose of Extended-Release Azithromycin by Population Pharmacokinetics and Simulation in Japanese Patients with Gonococcal Urethritis.

Soda M, Ito S, Matsumaru N, Nakamura S, Nagase I, Takahashi H, Ohno Y, Yasuda M, Yamamoto M, Tsukamoto K, Itoh Y, Deguchi T, Kitaichi K

Antimicrobial agents and chemotherapy 62 ( 1 ) 2018.01 [Refereed] [International journal]

The objective of this study was to analyze the relationship between the pharmacokinetic (PK)/pharmacodynamic (PD) parameters of a single 2-g dose of extended-release formulation of azithromycin (AZM-SR) and its microbiological efficacy against gonococcal urethritis. Fifty male patients with gonococcal urethritis were enrolled in this study. In 36 patients, the plasma AZM concentrations were measured using liquid chromatography-tandem mass spectrometry, the AZM MIC values for the Neisseria gonorrhoeae isolates were determined, and the microbiological outcomes were assessed. AZM-SR monotherapy eradicated N. gonorrhoeae in 30 (83%) of the 36 patients. AZM MICs ranged from 0.03 to 2 mg/liter. The mean value of the area under the concentration-time curve (AUC), estimated by population PK analysis using a two-compartment model, was 20.8 mg · h/liter. Logistic regression analysis showed that the PK/PD target value required to predict an N. gonorrhoeae eradication rate of ≥95% was a calculated AUC/MIC of ≥59.5. The AUC/MIC value was significantly higher in patients who achieved microbiological cure than in patients who achieved microbiological failure. Monte Carlo simulation using this MIC distribution revealed that the probability that AZM-SR monotherapy would produce an AUC/MIC exceeding the AUC/MIC target of 59.5 was 47%. Furthermore, the MIC distribution for strains isolated in this study was mostly consistent with that for strains currently circulating in Japan. In conclusion, in Japan, AZM-SR monotherapy may not be effective against gonococcal urethritis. Therefore, use of a single 2-g dose of AZM-SR either with or without other antibiotics could be an option to treat gonococcal urethritis if patients are allergic to ceftriaxone and spectinomycin or are diagnosed to be infected with an AZM-sensitive strain.

DOI PubMed

'Haemophilus quentini' in the urethra of men complaining of urethritis symptoms

Kengo Horie, Shin Ito, Kyoko Hatazaki, Mitsuru Yasuda, Masahiro Nakano, Kyojiro Kawakami, Yasunori Fujita, Masafumi Ito, Takayuki Ezaki, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV ) 24 ( 1 ) 71 - 74 2018.01 [Refereed]

We isolated a cryptic genospecies of Haemophilus influenzae referred to as 'Haemophilus quentini' in the urethra of 3 men complaining of urethritis symptoms. H. influenzae strains, which had been isolated from the urethra in 77 of 1518 men complaining of urethritis symptoms, identified by the conventional test, and stored, were re-cultured for this study. Sixty-seven strains surviving storage were screened by a PCR-based assay specific for the cryptic genital Haemophilus genospecies. Three strains (HI09003, HI11006, and HI14016) were screened by PCR and identified as 'H. quentini' by 16S rRNA sequencing. The men positive for HI09003 and HI11006 were diagnosed as having non-chlamydial non-gonococcal urethritis (NGU), and their demographic and clinical features were similar to those of NGU caused by other pathogens. The man positive for HI14016 was ultimately diagnosed as having condyloma acuminatum on the glans. The 3 strains of 'H. quentini' produced no b-lactamase and were susceptible to ampicillin and other antimicrobial agents, including cephalosporins, fluoroquinolones, tetracyclines, and macrolides, recommended for treatment for urethritis. 'H. quentini' would be an uncommon pathogen in men with urogenital infections. Based on the clinical features of the two patients with 'H. quentini'-positive NGU, it would be difficult to predict the presence of 'H. quentini' in the urethra. The 3 strains of 'H. quentini' were susceptible to a variety of antimicrobial agents. Further accumulation of data regarding 'H. quentini' infections is needed to characterize the pathogenic roles of this genospecies in urogenital infections and to establish appropriate management of 'H. quentini' infections. (C) 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Antimicrobial susceptibility of Haemophilus influenzae strains isolated from the urethra of men with acute urethritis and/or epididymitis

Takashi Deguchi, Shin Ito, Kyoko Hatazaki, Kengo Horie, Mitsuru Yasuda, Keita Nakane, Kosuke Mizutani, Tomohiro Tsuchiya, Shigeaki Yokoi, Nozomu Hanaoka, Ken Shimuta, Makoto Ohnishi, Tetsuro Muratani, Masahiro Nakano

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV ) 23 ( 11 ) 804 - 807 2017.11 [Refereed]

We determined minimum inhibitory concentrations (MICs) of 41 antimicrobial agents for 73 clinical strains of Haemophilus influenzae isolated from the urethra of men with acute urethritis and/or epididymitis and examined the strains for the production of beta-lactamase. We also compared their antimicrobial susceptibilities with those of H. influenzae strains from respiratory tract or otorhinolaryngological infections that were reported in Japan. The proportion of beta-lactamase-nonproducing ampicillin-resistant strains from acute urethritis and/or epididymitis appeared to be lower, but that of beta-lactamase-producing ampicillin-resistant strains appeared to be higher, compared with those from respiratory tract or otorhinolaryngological infections. However, their antimicrobial susceptibilities to a variety of other antimicrobial agents would be similar to those from respiratory tract or otorhinolaryngological infections. Almost all of the strains of H. influenzae from acute urethritis and/or epididymitis were susceptible to the agents, including ceftriaxone, quinolones, macrolides, and tetracyclines, commonly prescribed for treatment of acute urethritis based on the MIC breakpoints recommended by the Clinical and Laboratory Standards Institute. Ceftriaxone and quinolones could be effective on H. influenzae-induced urethritis. However, azithromycin treatment failures were reported in acute urethritis caused by H. influenzae strains considered susceptible to azithromycin. Further studies will be needed to determine MIC breakpoints of antimicrobial agents, which are recommended for treatment of urogenital infections, for H. influenzae strains causing these infections. Nevertheless, this study provides useful data regarding antimicrobial susceptibilities of H. influenzae strains isolated from the urogenital tract, which have rarely been studied. (C) 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

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 2017.10 [Refereed]

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 2017.09

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 2017.09 [Refereed]

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 2017.04 [Refereed]

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 2017.03 [Refereed]

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.

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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 2016.12 [Refereed]

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.

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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 2016.11

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 2016.10

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 2016.09

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 2016.09 [Refereed]

DOI PubMed

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 2016.09 [Refereed]

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 2016.09 [Refereed]

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 2016.09 [Refereed]

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 2016.05

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 2016.03

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 [Refereed] [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 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 2015.10

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 2015.01

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 2015.01

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 2014.12

尿道炎におけるアデノウイルスについて

花岡希, 伊藤晋, 高梨真樹, 安田満, 出口隆, 山岸拓也, 藤本嗣人

日本性感染症学会誌 ( (一社)日本性感染症学会 ) 25 ( 2 ) 64 - 64 2014.10

集学的治療にて比較的長期予後を得られている前立腺小細胞癌の1例

堀江憲吾, 亀山紘司, 水谷晃輔, 菅原崇, 清家健作, 土屋朋大, 安田満, 横井繁明, 仲野正博, 出口隆, 酒々井夏子, 広瀬善信

泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 60 ( 10 ) 517 - 521 2014.10

72歳男。尿閉を主訴とした。MRIのT2強調像で前立腺右葉を中心として両葉に低信号を示す腫瘤を認め、拡散強調像で同部位に異常信号を認めた。腫瘍は直腸、尿道および右閉鎖筋に浸潤していた。経直腸式前立腺生検で前立腺癌と診断し、CTや骨シンチグラフィーで遠隔転移を認めず、前立腺癌T4N0M0と診断した。LH-RH agonistを開始するも病変の増大を認め、前立腺生検標本を再検討した結果、前立腺小細胞癌の診断に至った。化学療法(IP療法:CTP-11 60mg/m2、CDDP 60mg/m2)を開始し、1コース目に骨髄抑制grade 3以上の副作用が出現したため、2コース目からは20%減量で投与した。2コース終了時のMRIで尖部レベルの腫瘤は縮小し、拡散強調像で高信号は消失しており、また自排尿が可能となった。4コース終了後も高信号は消失したままであり、評価目的の経直腸的前立腺生検で悪性像は認めず、線維増生を伴う瘢痕組織であった。化学療法後の補助療法として、10MV-X線を用いて40Gy/20回の全骨盤照射を4門のBOX照射にて行った。更に、前立腺と精嚢に7門の固定多門原体照射24Gy/12回のブーストを行った。診断から18ヵ月後の現在、再発は認めていない。

2012年における淋菌の薬剤感受性サーベイランス(3学会合同サーベイランス報告)

濱砂良一, 安田満, 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, 3学会合同サーベイランス委員会

感染症学雑誌 ( (一社)日本感染症学会 ) 88 ( 5 ) 735 - 735 2014.09

2012年における淋菌の薬剤感受性サーベイランス(3学会合同サーベイランス報告)

濱砂良一, 安田満, 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, 3学会合同サーベイランス委員会

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 62 ( Suppl.A ) 227 - 227 2014.05

泌尿器科領域における抗癌化学療法に伴う発熱性好中球減少症に関する多施設共同調査

和田耕一郎, 谷本竜太, 能勢宏幸, 上原慎也, 渡辺豊彦, 速見浩士, 永井真吾, 安田満, 出口隆, 茂田啓介, 矢澤聰, 菊地栄次, 大家基嗣, 橋本次朗, 上原央久, 栗村雄一郎, 桧山佳樹, 高橋聡, 塚本泰司, 庄武彦, 濱砂良一, 宮崎淳, 東郷容和, 田岡利宜也, 中尾篤, 山本新吾, 小林加直, 松原昭郎, 石川清仁, 公文裕巳, 松本哲朗

日本化学療法学会雑誌 ( (公社)日本化学療法学会 ) 62 ( 3 ) 374 - 381 2014.05

泌尿器科領域における精巣腫瘍、尿路上皮癌に対する抗癌化学療法は高頻度に行われているが、発熱性好中球減少症(febrile neutropenia:FN)に関する泌尿器科領域に特化した検討は少ない。今回、泌尿器癌に対する抗癌化学療法に伴うFNについて、後ろ向きに多施設共同調査を施行した。対象はUTI共同研究会に所属する泌尿器科メンバーの所属する10大学病院で、2010年1月から2011年12月に尿路上皮癌および精巣腫瘍に対して抗癌化学療法が開始された326症例、883コースとした。FNは326例中66例(20.2%)、883コース中81コース(9.2%)に認められ、治療として抗菌薬と顆粒球コロニー刺激因子(granulocyte-colony stimulating factor:G-CSF)の投与はそれぞれ69コース(85.2%)、77コース(95.1%)で投与されていた。一方、発熱を伴わない好中球減少症に対して抗菌薬とG-CSFはそれぞれ5コース(2.2%)、144コース(62.1%)で投与され、予防的投与として抗菌薬よりもG-CSFが頻用されていた。統計学的な検討では、尿路上皮癌において単変量・多変量解析ともに化学療法レジメンの種類のみ有意差がみられ(GC vs GCP;p=0.0073、GC vs M-VAC;p<0.0001)、精巣腫瘍における単変量・多変量解析ではEPよりBEPで有意にFNの発症率が高かった。泌尿器科領域においても、さらに大規模で前向きなエビデンスを蓄積していくことでFNに対して適切なマネジメントを行っていくことが可能であると考えられる。(著者抄録)

陰茎-尿道海綿体シャント術で勃起機能を温存しえたLow-flow型持続勃起症の1例

亀山紘司, 清家健作, 堀江憲吾, 菊地美奈, 水谷晃輔, 菅原崇, 土屋朋大, 安田満, 横井繁明, 仲野正博, 出口隆, 加藤博基, 近藤浩史, 小林覚

泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 60 ( 4 ) 202 - 202 2014.04

複雑性尿路感染症由来株の抗菌薬感受性サーベイランス報告

石川清仁, 山本新吾, 上原慎也, 高橋聡, 浜砂良一, 安田満, 速見浩士, 松本哲朗, 門田淳一

日本泌尿器科学会総会 ( (一社)日本泌尿器科学会総会事務局 ) 102回 553 - 553 2014.04

尿管ステントの長期留置に関するアンケート調査

和田耕一郎, 山本新吾, 松崎純一, 麦谷荘一, 山田仁, 安田満, 宮崎淳, 高橋聡, 山口秋人, 奴田原紀久雄

Japanese Journal of Endourology ( Japanese Society of Endourology ) 27 ( 1 ) 79 - 83 2014

<YASUDA Mitsuru>

Papers - YASUDA Mitsuru