論文 - 安田　満

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

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

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

DOI

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

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

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

　概要を見る

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

DOI PubMed

AAUS guideline for chlamydial urethritis.

Yoshiki Hiyama, Satoshi Takahashi, Mitsuru Yasuda

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy   28 ( 2 ) 142 - 145  2022年02月  [国際誌]

　概要を見る

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

DOI PubMed

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

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

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy   28 ( 1 ) 1 - 5  2021年09月  [国際誌]

　概要を見る

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

DOI PubMed

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

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

International journal of urology : official journal of the Japanese Urological Association   28 ( 12 ) 1198 - 1211  2021年09月  [国際誌]

　概要を見る

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

DOI PubMed

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

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

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy   27 ( 8 ) 1169 - 1180  2021年08月  [国際誌]

　概要を見る

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

DOI PubMed

2019年にわが国で分離された淋菌の薬剤感受性報告

安田 満, 志牟田 健, 中山 周一, 高橋 英之, 小林 寅哲, 大澤 佳代, 陳内 理生, 三宅 啓文, 大西 真

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

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

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

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

　概要を見る

Outbreaks of acute respiratory disease associated with human adenovirus (HAdV) B7d have been reported, including fatal cases in the United States. In 2018, we detected HAdV-B7d in a patient with urethritis, probably transmitted through sexual contact. Infectious HAdV-B7d was excreted in urine and gargle for >10 days after the disappearance of symptoms.

DOI PubMed

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

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

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

　概要を見る

Abstract We identified and characterized the first 2 Neisseria gonorrhoeae strains with high-level azithromycin resistance isolated in Japan. These were in the clade of ceftriaxone- and azithromycin-resistant strains isolated in Australia and the United Kingdom. The multilocus sequence typing, N. gonorrhoeae multiantigen sequence typing, and N. gonorrhoeae sequence typing for antimicrobial resistance types of these strains were found in gonococci from eastern Asia.

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

Kanao Kobayashi, Shingo Yamamoto, Satoshi Takahashi, Kiyohito Ishikawa, Mitsuru Yasuda, Koichiro Wada, Ryoichi Hamasuna, Hiroshi Hayami, Shinichi Minamitani, Tetsuya Matsumoto, Hiroshi Kiyota, Kazuhiro Tateda, Junko Sato, Hideaki Hanaki, Naoya Masumori, Yoshiki Hiyama, Hiroki Yamada, Shin Egawa, Takahiro Kimura, Hiroyuki Nishiyama, Jun Miyazaki, Kazumasa Matsumoto, Yukio Homma, Jun Kamei, Kiyohide Fujimoto, Kazumasa Torimoto, Kazushi Tanaka, Yoshikazu Togo, Shinya Uehara, Akio Matsubara, Koichi Shoji, Hirokazu Goto, Hisao Komeda, Toru Ito, Katsuhisa Mori, Koji Mita, Masao Kato, Yoshinori Fujimoto, Takako Masue, Hisato Inatomi, Yoshito Takahashi, Satoshi Ishihara, Kazuo Nishimura, Kenji Mitsumori, Noriyuki Ito, Sojun Kanamaru, Daisuke Yamada, Maeda Hiroshi, Masuo Yamashita, Masaya Tsugawa, Tadasu Takenaka, Koichi Takahashi, Yasuhiko Oka, Tomihiko Yasufuku, Shuji Watanabe, Yoshitomo Chihara, Kazuhiro Okumura, Hiroaki Kawanishi, Masanori Matsukawa, Masanobu Shigeta, Shuntaro Koda

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy   26 ( 5 ) 418 - 428  2020年05月  [国際誌]

　概要を見る

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

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 ( ELSEVIER )  26 ( 5 ) 418 - 428  2020年05月

　概要を見る

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年03月

　概要を見る

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

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

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

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

　概要を見る

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年12月  [査読有り]  [国際誌]

　概要を見る

BACKGROUND: To study the outcomes and experiences of using metallic stents in treating patients with malignant ureteral obstruction (MUO), we examined the effects of metallic ureteral stenting using the Cook Resonance® stent in the treatment of MUO. METHODS: All patients who had a Resonance metallic stent inserted between April 2015 and March 2018 at one of multiple facilities were prospectively observed with a 1-year follow-up. The primary outcome was the patency rate of the metallic ureteral stent. The secondary outcomes included the complications (e.g., infection and fever). RESULTS: Although stent insertion was attempted in 50 patients, the stent could not be inserted as a ureteral stent in three patients due to severe ureteral stricture, and one ureteral cancer patient was excluded from the analysis. The remaining 46 patients' median age was 67 years (range 28-85 years) (16 males, 30 females). Twenty-four patients died during the study; their median survival time was 226 days. The median follow-up period for the censored patients was 355 days (range 16-372 days), and just seven patients were still alive without Resonance failure > 1 year later. The women's IPSS scores tended to be lower than those of the men. Regarding the OABSS score, although the women's total score tended to be low, the difference between the men's and women's scores was nonsignificant. The bacteria detected from urine culture after stent insertion were more gram-positive than gram-negative. CONCLUSION: Metallic ureteric stenting using the Resonance stent is safe and effective for treating MUO. Subjective symptoms were relatively less in the female patients.

DOI PubMed

2018年にわが国で分離された淋菌の薬剤感受性報告

安田 満, 志牟田 健, 中山 周一, 高橋 英之, 小林 寅哲, 大澤 佳代, 陳内 理生, 三宅 啓文, 大西 真

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

本邦のAPTIMA Combo2クラミジア偽陰性株の解析

伊藤 晋, 花岡 希, 高梨 真樹, 高橋 聡, 伊藤 貴子, 安田 満, 出口 隆

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

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

伊藤 晋, 高橋 聡, 花岡 希, 高梨 真樹, 桧山 佳樹, 安田 満, 出口 隆

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

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

花岡希, 伊藤晋, 藤本嗣人, 安田満, 出口隆

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

J-GLOBAL

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

花岡 希, 伊藤 晋, 藤本 嗣人, 安田 満, 出口 隆

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

　概要を見る

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

Urinary exosome as a potential biomarker for urinary tract infection.

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

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

　概要を見る

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年06月  [査読有り]

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年04月

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年03月

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年03月  [査読有り]

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年02月  [査読有り]

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年01月  [国際誌]

　概要を見る

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年  [国際誌]

　概要を見る

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年11月

　概要を見る

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年10月

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年10月

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年10月

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年10月

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年09月  [国際誌]

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年08月  [査読有り]

DOI PubMed

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 ( 8 )  2018年08月  [査読有り]  [国際誌]

　概要を見る

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年05月  [査読有り]  [国際誌]

　概要を見る

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年03月  [査読有り]

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年01月  [査読有り]  [国際誌]

　概要を見る

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年01月  [査読有り]

　概要を見る

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年11月  [査読有り]

　概要を見る

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年10月  [査読有り]

　概要を見る

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

　概要を見る

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]

　概要を見る

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]

　概要を見る

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]

　概要を見る

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年12月  [査読有り]

　概要を見る

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

　概要を見る

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]

　概要を見る

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]

　概要を見る

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

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年10月

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年10月

　概要を見る

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年09月

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年05月

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年05月

　概要を見る

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年04月

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年04月

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年

DOI CiNii

三学会合同抗菌薬感受性サーベイランス委員会報告 泌尿器科領域 複雑性尿路感染症

石川 清仁, 山本 新吾, 上原 慎也, 高橋 聡, 濱砂 良一, 安田 満, 速見 浩士, 松本 哲朗, 門田 淳一

感染症学雑誌 ( (一社)日本感染症学会 )  87 ( 4 ) 532 - 532  2013年07月

「泌尿器科領域における周術期感染予防ガイドライン」に関する多施設共同研究

和田 耕一郎, 上原 慎也, 吉良 慎一郎, 松本 正広, 庄 武彦, 栗村 雄一郎, 橋本 次朗, 上原 央久, 山根 隆史, 金丸 聰淳, 東郷 容和, 田岡 利宜也, 高橋 彰, 山田 祐介, 横溝 晃, 安田 満, 田中 一志, 濱砂 良一, 高橋 聡, 速見 浩士, 渡邉 豊彦, 門田 晃一, 清田 浩, 出口 隆, 内藤 誠二, 塚本 泰司, 荒川 創一, 藤澤 正人, 山本 新吾, 公文 裕巳, 松本 哲朗, UTI共同研究会

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  104 ( 3 ) 505 - 512  2013年05月

　概要を見る

(目的)2007年に日本泌尿器科学会が編集した「泌尿器科領域における周術期感染予防ガイドライン」は我が国初の泌尿器科、周術期に特化した感染予防ガイドラインである。今回、その妥当性、有用性を検証するため多施設で前向きに調査、解析を行った。(方法)対象は2008年7月から9月に全国の10施設において泌尿器科領域の手術を受けた513例。手術の内訳は経尿道的膀胱腫瘍切除術、経尿道的前立腺切除術、副腎摘除術、腎摘除術、腎尿管全摘除術、前立腺全摘除術、膀胱全摘除術である。患者背景、術式、予防投与した抗菌薬の種類と投与期間、SSI(Surgical Site Infection:手術部位感染)とRI(Remote Infection:遠隔感染)の有無を解析した。(結果)513例のガイドライン遵守率は75.4%であった。ガイドラインを遵守していた387例におけるSSI、RIの発生率はそれぞれ5.9、4.1%であった。SSIについてはASA(American Society of Anesthesiologists)手術リスク、糖尿病と手術時間が、RIについては手術時間が発生に寄与していた。(結語)同ガイドラインの妥当性、有用性の検証にはさらなる大規模な調査やエビデンスの蓄積が必要と考えられた。(著者抄録)

再発を繰り返す尿路感染症患者に対するクランベリー果汁飲料の再発予防効果

高橋 聡, 濱砂 良一, 安田 満, 荒川 創一, 田中 一志, 石川 清仁, 清田 浩, 速見 浩士, 山本 新吾, 松本 哲朗, UTI共同研究会

日本化学療法学会雑誌 ( (公社)日本化学療法学会 )  60 ( Suppl.A ) 272 - 272  2012年03月

OP-109 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(感染症1,一般演題口演,第99回日本泌尿器科学会総会)

安田 満, 中根 慶太, 清家 健作, 楊 睦正, 原田 吉将, 石原 哲, 斉藤 昭弘, 藤本 佳則, 前田 真一, 藤広 茂, 堀江 正宣, 伊藤 晋, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  102 ( 2 ) 359 - 359  2011年

DOI CiNii

PP-949 急性精巣上体炎におけるMycoplasma genitaliumの起炎菌としての意義は明白ではない(発表・討論,一般演題ポスター,第99回日本泌尿器科学会総会)

伊藤 晋, 安田 満, 前田 真一, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  102 ( 2 ) 563 - 563  2011年

DOI CiNii

VP-015 腹腔鏡下左副腎摘除術 : 当院における工夫(副腎・尿管・腹部,一般演題ビデオ,第99回日本泌尿器科学会総会)

横井 繁明, 三輪 好生, 中根 慶太, 佐藤 啓美, 加藤 卓, 清家 健作, 石田 健一郎, 安田 満, 伊藤 慎一, 仲野 正博, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  102 ( 2 ) 397 - 397  2011年

DOI CiNii

めざせ3 座長のメッセージ(研究のすゝめ-研究で世界一になる必要があるんでしょうか?臨床だけじゃダメなんでしょうか?-,めざせ!泌尿器科の星3,第99回日本泌尿器科学会総会)

安田 満, 高橋 聡, 山本 新吾

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  102 ( 2 ) 271 - 271  2011年

DOI CiNii

OP-133 岐阜大学病院における腹腔鏡下ドナー腎採取術の経験(腎移植2,一般演題口演,第99回日本泌尿器科学会総会)

伊藤 慎一, 横井 繁明, 石田 健一郎, 三輪 好生, 中根 慶太, 佐藤 啓美, 清家 健作, 安田 満, 仲野 正博, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  102 ( 2 ) 363 - 363  2011年

DOI CiNii

小児泌尿器科周術期感染予防のための抗菌薬投与に関するアンケート調査結果について

石川 清仁, 松本 哲朗, 村谷 哲郎, 山田 陽司, 塚本 泰司, 松川 雅則, 小野寺 昭一, 清田 浩, 安田 満, 石原 哲, 出口 隆, 山本 新吾, 荒川 創一, 田中 一志, 門田 晃一, 上原 慎也, 公文 裕巳, 江頭 稔久, 野村 博之

尿路感染症研究会記録集 ( 尿路感染症研究会 )  21回   35 - 35  2010年10月

尿路感染症主要原因菌の各種抗菌薬に対する感受性

松本 哲朗, 濱砂 良一, 石川 清仁, 高橋 聡, 安田 満, 速見 浩士, 田中 一志, 清田 浩, 村谷 哲郎, 門田 晃一, 荒川 創一, 山本 新吾

日本化学療法学会雑誌 ( (公社)日本化学療法学会 )  58 ( 4 ) 466 - 482  2010年07月

　概要を見る

急性単純性膀胱炎、複雑性膀胱炎患者の患者背景調査を実施するとともに、各疾患別の原因菌の種類・分布と各種抗菌薬に対する感受性を検討した。さらに、キノロン耐性大腸菌が検出されるリスク因子を検討した。急性単純性膀胱炎患者1317例から1699株、複雑性膀胱炎患者643例から880株を分離した。急性単純性膀胱炎由来のE.coliのフルオロキノロン系薬(FQ)、セフェム系薬(CEP)に対する感性率はいずれも90%以上で、複雑性膀胱炎由来のE.coliのFQに対する感性率は67.5〜86.9%、CEPに対する感性率は83.9〜88.5%であった。キノロン耐性大腸菌が検出されるリスク因子を検討し、1年以内の膀胱炎の罹患回数が2回以上の症例、今回の膀胱炎に対してキノロン薬が無効であった症例、複雑性膀胱炎の症例、1ヵ月以内にキノロン薬の投与歴のある症例、75歳以上の症例の5項目であった。

尿路性器結核症の全国的調査

中根 慶太, 安田 満, 石原 哲, 出口 隆, 高橋 聡, 田中 一志, 速見 浩士, 石川 清仁, 門田 晃一, 濱砂 良一, 山本 新吾, 荒川 創一, 松本 哲朗

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  101 ( 2 ) 237 - 237  2010年02月

PP-624 非クラミジア性非淋菌性尿道炎の起炎菌に関する検討(発表・討論,一般演題ポスター,第98回日本泌尿器科学総会)

伊藤 晋, 安田 満, 前田 真一, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  101 ( 2 ) 524 - 524  2010年

DOI CiNii

OP-373 当院における新規生体腎移植患者におけるグラセプターの使用経験 : 1日用量はプログラフと々でいいのか?(腎移植3,一般演題口演,第98回日本泌尿器科学会総会)

石田 健一郎, 佐藤 啓美, 菊地 美奈, 中根 慶太, 土屋 朋大, 三輪 好生, 南舘 譲, 安田 満, 横井 繁明, 伊藤 慎一, 仲野 正博, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  101 ( 2 ) 326 - 326  2010年

DOI CiNii

OP-014 ヨウ素125密封小線源永久挿入療法における抗菌剤の予防投与に関する検討(感染症2,一般演題口演,第98回日本泌尿器科学会総会)

仲野 正博, 南館 謙, 佐藤 啓美, 輪 好生, 安田 満, 横井 繁明, 出口 隆, 大宝 和博, 林 真也, 宇野 裕己

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  101 ( 2 ) 236 - 236  2010年

DOI CiNii

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1版)

松本 哲朗, 高橋 聡, 清田 浩, 安田 満, 石川 清仁, 高橋 彰, 山本 新吾, 荒川 創一, 門田 晃一, 村谷 哲郎, 濱砂 良一, 速水 浩士, 公文 裕巳, 渡辺 豊彦, 上原 慎也, 川原 元司, 中川 昌之, 山根 隆史, 石原 哲, 出口 隆, 菊池 達也, 内藤 誠二, 野村 博之, 平賀 紀行, 金丸 聰淳, 小川 修, 守殿 貞夫, 重村 克巳, 田中 一志, 中野 雄造, 藤澤 正人, 三浦 徹也, 国島 康晴, 塚本 泰司, 松川 雅則, 山田 陽司, 赤坂 聡一郎, 小野寺 昭一, 島 博基, 繁田 正信, 星長 清隆, 長田 幸夫, 和田 耕一郎, 日本化学療法学会UTI薬効評価基準見直しのための委員会

日本化学療法学会雑誌 ( (公社)日本化学療法学会 )  57 ( 6 ) 511 - 525  2009年11月

膀胱炎由来キノロン耐性大腸菌株のキノロン耐性決定領域変異と系統分類・病原因子の相関

高橋 彰, 山本 新吾, 村谷 哲郎, 石川 清仁, 安田 満, 高橋 聡, 門田 晃一, 清田 浩, 荒川 創一, 松本 哲朗

尿路感染症研究会記録集 ( 尿路感染症研究会 )  19回   66 - 66  2009年10月

Retrospective cohort chart review study of factors associated with the development of thrombocytopenia in adult Japanesepatients who received intravenous linezolid therapy.

Niwa Takashi, Suzuki Akio, Sakakibara Seiji, Kasahara Senji, Yasuda Mitsuru, Fukao Ayumi, Matsuura Katsuhiko, Goto Chitoshi, Murakami Nobuo, Itoh Yoshinori

Clinical therapeutics   31 ( 10 ) 2126 - 33  2009年10月  [査読有り]

　概要を見る

Linezolid is an oxazolidinone antibiotic agent active against Gram-positive bacteria. It has been associated with hematologic adverse effects such as thrombocytopenia. Little is known about the mechanism underlying thrombocytopenia in patients who receive intravenous linezolid.

DOI PubMed

泌尿器科領域における感染制御ガイドライン

松本 哲朗, 荒川 創一, 高橋 聡, 濱砂 良一, 山本 新吾, 矢内原 仁, 石川 悟, 石川 清仁, 石原 哲, 上原 慎也, 江田 晋一, 小野寺 昭一, 金丸 聰淳, 守殿 貞夫, 菊池 達也, 清田 浩, 公文 裕巳, 栗村 雄一郎, 島 博基, 高橋 彰, 田中 一志, 谷村 正信, 塚本 泰司, 出口 隆, 内藤 誠二, 中野 雄造, 速見 浩士, 平賀 紀行, 藤澤 正人, 三浦 徹也, 村谷 哲郎, 門田 晃一, 安田 満, 安福 富彦, 渡辺 豊彦, 和田 耕一郎, 日本泌尿器科学会泌尿器科領域における感染制御ガイドライン作成委員会

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  100 ( 4 ) np1,np2,1 - 27  2009年05月

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1版 最終案

松本 哲朗, 荒川 創一, 村谷 哲郎, 安田 満, 高橋 彰, 公文 裕巳, 門田 晃一, 渡辺 豊彦, 上原 慎也, 川原 元司, 中川 昌之, 速見 浩士, 山根 隆史, 石原 哲, 出口 隆, 菊池 達也, 内藤 誠二, 野村 博之, 平賀 紀行, 金丸 聰淳, 小川 修, 守殿 貞夫, 重村 克巳, 田中 一志, 中野 雄造, 藤澤 正人, 三浦 徹也, 国島 康晴, 高橋 聡, 塚本 泰司, 松川 雅則, 山田 陽司, 赤坂 聡一郎, 小野寺 昭一, 清田 浩, 島 博基, 山本 新吾, 繁田 正信, 石川 清仁, 星長 清隆, 濱砂 良一, 長田 幸夫, 日本化学療法学会臨床評価法制定委員会

日本化学療法学会雑誌 ( (公社)日本化学療法学会 )  57 ( 2 ) np1 - 20  2009年03月

PP-320 非淋菌性尿道炎治療後のMycoplasma genitalium除菌は初尿白血球数で推定可能か?(感染症2,一般演題ポスター,第97回日本泌尿器科学会総会)

伊藤 晋, 前田 真一, 安田 満, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  100 ( 2 ) 396 - 396  2009年

DOI CiNii

尿路由来キノロン耐性大腸菌株の系統分類、保有病原因子検討

高橋 彰, 山本 新吾, 石川 清仁, 安田 満, 高橋 聡, 門田 晃一, 村谷 哲郎, 清田 浩, 荒川 創一, 松本 哲朗

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  99 ( 2 ) 460 - 460  2008年02月

尿路由来キノロン耐性大腸菌株の系統分類、保有病原因子検討

高橋 彰, 山本 新吾, 石川 清仁, 安田 満, 高橋 聡, 門田 晃一, 村谷 哲郎, 清田 浩, 荒川 創一, 松本 哲朗

尿路感染症研究会記録集 ( 尿路感染症研究会 )  ( 16 ) 22 - 24  2008年02月

PP-332 尿道分泌物を認める男子症例における初尿白血球数と淋菌、クラミジア、マイコプラズマの検出率について(感染症/基礎/尿道、前立腺、性器1,一般演題ポスター,第96回日本泌尿器科学会総会)

伊藤 晋, 前田 真一, 安田 満, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  99 ( 2 ) 460 - 460  2008年

DOI CiNii

PP-274 前立腺肥大症にともなう pelvic pain syndrome に対するエビプロスタットの有効性の検討(第95回日本泌尿器科学会総会)

三輪 好生, 守山 洋司, 増栄 孝子, 西野 好則, 加藤 成一, 安田 満, 宇野 雅博, 米田 尚生, 岡野 学, 竹内 敏視, 藤本 佳則, 坂 義人, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  98 ( 2 ) 465 - 465  2007年

DOI CiNii

PP-220 夜間頻尿は睡眠時無呼吸症候群の治療で改善するのか(第95回日本泌尿器科学会総会)

守山 洋司, 三輪 好生, 安田 満, 出口 隆, 藤広 茂, 西野 好則

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  98 ( 2 ) 451 - 451  2007年

DOI CiNii

泌尿器科領域における周術期感染予防ガイドライン

松本 哲朗, 村谷 哲郎, 山田 陽司, 塚本 泰司, 松川 雅則, 小野寺 昭一, 清田 浩, 頴川 晋, 星長 清隆, 石川 清仁, 出口 隆, 安田 満, 石原 哲, 小川 修, 山本 新吾, 藤澤 正人, 荒川 創一, 田中 一志, 公文 裕巳, 門田 晃一, 上原 慎也, 内藤 誠二, 江頭 稔久, 野村 博之, UTI共同研究会周術期感染予防ガイドライン作成ワーキンググループ

日本泌尿器科学会雑誌 ( (一社)日本泌尿器科学会 )  97 ( 6 ) np1,1 - 35  2006年09月

MP-194 当科における最近5年間の腎移植の臨床的検討(一般演題ポスター,第94回日本泌尿器科学会総会)

土屋 朋大, 伊藤 慎一, 萩原 徳康, 久保田 恵章, 亀井 信吾, 安田 満, 横井 繁明, 仲野 正博, 山田 徹, 江原 英俊, 高橋 義人, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  97 ( 2 ) 415 - 415  2006年

DOI CiNii

S3-4 男子尿道炎におけるマイコプラズマ感染症について(シンポジウム3「性感染症の現状と対策」,第94回日本泌尿器科学会総会)

出口 隆, 安田 満, 横井 繁明, 仲野 正博, 伊藤 慎一, 江原 英俊, 高橋 義人, 久保田 恵章, 前田 慎一

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  97 ( 2 ) 136 - 136  2006年

DOI CiNii

APP-018 免疫組織化学的手法による腎細胞癌(clear cell carcinoma)の予後因子の検討(総会賞応募ポスター,第94回日本泌尿器科学会総会)

ウェン フック・バ, 江原 英俊, 萩原 徳康, 安田 満, 横井 繁明, 伊藤 慎一, 仲野 正博, 山本 直樹, 高橋 義人, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  97 ( 2 ) 231 - 231  2006年

DOI CiNii

In vitro activity of fluoroquinolones against Mycoplasma genitalium and their bacteriological efficacy for treatment of m. genitalium-positive nongonococcal urethritis in men

M. Yasuda, S. Maeda, Takashi Deguchi

Clinical Infectious Diseases   41 ( 9 ) 1357 - 1359  2005年11月

　概要を見る

We investigated the minimum inhibitory concentrations of some fluoroquinolones for Mycoplasma genitalium and their bacteriological efficacy in the treatment of M. genitalium-positive nongonococcal urethritis. In vitro, levofloxacin was less active than gatifloxacin, tosufloxacin, and sparfloxacin. In vivo, the bacteriological efficacy of gatifloxacin was superior to that of levofloxacin or tosufloxacin. © 2005 by the Infectious Diseases Society of America. All rights reserved.

DOI PubMed

Efficacy of 1-day prophylaxis medication with fluoroquinolone for prostate biopsy

K Shigemura, K Tanaka, M Yasuda, S Ishihara, T Muratani, T Deguchi, T Matsumoto, S Kamidono, Y Nakano, S Arakawa, M Fujisawa

WORLD JOURNAL OF UROLOGY ( SPRINGER )  23 ( 5 ) 356 - 360  2005年11月

　概要を見る

A prospective, randomized trial in which 236 patients received oral levofloxacin, either at 600 mg/day for 1 day (n=124) or 300 mg/day for 3 days (n=112). Urinalysis, plasma white blood cell count (WBC) (per mm(3)), and C reactive protein (CRP) (mg/dl) levels were checked before prostate biopsy (PBX), on the day after PBX, and on the seventh day after PBX. Two patients (1.61%) who received 600 mg for 1 day and 2 patients (1.79%) who received 300 mg for 3 days had febrile infectious complications. There was no statistically significant difference between levofloxacin at 600 mg for 1 day and levofloxacin at 300 mg for 3 days regarding the elevation of WBC and CRP. We can perform PBX safely with levofloxacin at 600 mg for 1 day as prophylaxis and recommend this method from the point of view of the decrease of antibiotic-resistant strains.

DOI

髄膜炎菌が分離された男子尿道炎の1例

林 美佳, 萩原 徳康, 安田 満, 山羽 正義, 堀江 正宣, 大楠 清文, 江崎 孝行, 出口 隆

日本性感染症学会誌 ( (一社)日本性感染症学会 )  16 ( 2 ) 51 - 51  2005年11月

Cultivation of Neisseria gonorrhoeae in liquid media and determination of its in vitro susceptibilities to quinolones

M Takei, Y Yamaguchi, H Fukuda, M Yasuda, T Deguchi

JOURNAL OF CLINICAL MICROBIOLOGY ( AMER SOC MICROBIOLOGY )  43 ( 9 ) 4321 - 4327  2005年09月

　概要を見る

The cultivation of Neisseria gonorrhoeae by use of fastidious broth (FB) was evaluated. FB was found to be able to support the growth of all N. gonorrhoeae strains tested in this study without a rapid decrease in the viable count after exponential growth. After 24 h of incubation at 35 degrees C with 5% CO2, viable counts of all strains reached over 10(8) CFU/ml in FB. Similar growth of the wild-type strain and its target-altered quinolone-resistant derivatives was observed. The susceptibilities of laboratory-adapted strains and clinical isolates to quinolones were tested by the microdilution method using FB. The MICs determined by microdilution were not significantly different from those determined by the agar dilution method recommended by the CLS1 (formerly National Committee for Clinical Laboratory Standards). Moreover, the concentration-dependent time-kill of quinolones such as gatifloxacin and ciprotioxacin was observed in FB. At 2 to 4 times the MIC, gatifloxacin and ciprofloxacin were predominantly bactericidal against N. gonorrhoeae WHO A. At the MIC, the activities of both quinolones ranged from bactericidal to bacteriostatic. At 0.25 to 0.5 times the MIC, gonococcal growth was comparable to that of the growth control. These results suggest that the cultivation of N. gonorrhoeae by use of FB may be useful for evaluation of the antibacterial effects of quinolones.

DOI

Neisseria meningitidis(髄膜炎菌)Y群による男子尿道炎の1例

大楠 清文, 安田 満, 大塚 喜人, 河村 好章, 江崎 孝行, 出口 隆

感染症学雑誌 ( (一社)日本感染症学会 )  79 ( 9 ) 797 - 797  2005年09月

Polymerase chain reaction-based subtyping of Ureaplasma parvum and Ureaplasma urealyticum in first-pass urine samples from men with or without urethritis

T Yoshida, H Ishiko, M Yasuda, Y Takahashi, Y Nomura, Y Kubota, M Tamaki, S Maeda, T Deguchi

SEXUALLY TRANSMITTED DISEASES ( LIPPINCOTT WILLIAMS & WILKINS )  32 ( 7 ) 454 - 457  2005年07月

　概要を見る

Background: Our previous study suggested a significant association between Ureaplasma urealyticum and nongonococcal urethritis (NGU). However, association of the serovars of U. urealyticum with NGU remains unclear. A polymerase chain reaction (PCR)-based assay can distinguish 4 serovars of Ureoplasma parvum from each other and categorize 10 serovars of U. urealyticum into 3 subtypes: subtype 1 (serovars 2, 5, 8, and 9), subtype 2 (serovars 4, 10, 12, and 13), and subtype 3 (serovars 7 and 11). Goal: The goal of this study was to determine which subtypes of U. urealyticum are associated with NGU as determined by PCR-based assay. Study: The prevalence of U. urealyticum subtypes in 106 ureaplasma-positive men with urethritis was compared with that in 30 ureaplasma-positive men without urethritis. Results: In men with nonchlamydial NGU and men with Mycoplasma genitalium-negative nonchlamydial NGU, only U. urealyticum subtype 1 (serovars 2, 5, 8, and 9) was detected significantly more often than in men without urethritis. Conclusion: This study suggests that subtype 1 of U. urealyticum (serovars 2, 5, 8, and 9) is associated with NGU independently of Chlamydia trachomatis or M. genitalium.

DOI

Neisseria meningitidis(髄膜炎菌)Y群による男子尿道炎の1例

大楠 清文, 安田 満, 大塚 喜人, 河村 好章, 江崎 孝行, 出口 隆

感染症学雑誌 ( (一社)日本感染症学会 )  79 ( 臨増 ) 307 - 307  2005年03月

腎盂腎炎患者の尿より分離されたLeclercia adecarboxylata

澤村 治樹, 河村 好章, 安田 満, 大楠 清文, 高橋 義人, 石原 哲, 出口 隆, 江崎 孝行

日本感染症学雑誌 ( The Japanese Association for Infectious Diseases )  79 ( 10 ) 831 - 835  2005年01月

DOI CiNii

尿膜管臍瘻に対する腹腔鏡下手術

高橋 義人, 横井 繁明, 安田 満, 出口 隆

手術   59   1591 - 1597  2005年01月

泌尿器科系感染症Neisseria meningitidis（髄膜炎菌）Serogroup Yによる男子尿道炎の一例

大楠 清文, 萩原 徳康, 河村 好章, 安田 満, 大塚 喜人, 江崎 孝行, 出口 隆

症例から学ぶ感染症診療のポイント     137 - 142  2005年01月

Emergence and spread of Neisseria gonorrhoeae clinical isolates harboring mosaic-like structure of penicillin-binding protein 2 in central Japan

M Ito, T Deguchi, KS Mizutani, M Yasuda, S Yokoi, SI Ito, Y Takahashi, S Ishihara, Y Kawamura, T Ezaki

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  49 ( 1 ) 137 - 143  2005年01月

　概要を見る

Of 150 clinical isolates of Neisseria gonorrhoeae recovered in 2001, we examined 55 clinical isolates of N. gonorrhoeae for which cefixime MICs were greater than or equal to0.125 mug/ml and randomly selected 15 isolates for which cefixime MICs were less than or equal to0.06 mug/ml for analysis of alterations in the penicillin-binding protein 2 (PBP 2) gene. We found insertion of an extra codon (Asp-345a) in the transpeptidase domain of PBP 2, and this insertion occurred alone or in conjunction with other amino acid substitutions. We also found a mosaic PBP 2 that was composed of fragments of the PBP 2 proteins from Neisseria cinera and Neisseria perflava. This mosaic PBP 2 was significantly associated with decreased susceptibilities to penicillin and cephalosporins, especially oral cephalosporins. For most of the isolates with a mosaic PBP 2, the cefixime MICs were greater than or equal to0.5 mug/ml and the cefdinir MICs were greater than or equal to1 mug/ml. Analysis of chromosomal DNA restriction patterns by pulsed-field gel electrophoresis revealed that most isolates with the mosaic PBP 2 were genetically similar. The recombination events that generated the mosaic PBP 2 would likely have contributed to the decreased sensitivities to cephalosporins. Isolates with the mosaic PBP 2 appear to threaten the efficacy of the currently recommended regimen with cefixime. The emergence of such strains may be the result of the in vivo generation of clones in which interspecies recombination occurred between the penA genes of N. gonorrhoeae and commensal Neisseria species.

DOI

腎不全症例に対する鏡視下腎摘除術の経験(第93回日本泌尿器科学会総会)

横井 繁明, 中根 慶太, 加藤 卓, 水谷 晃輔, 萩原 徳康, 安田 満, 仲野 正博, 伊藤 慎一, 江原 英俊, 高橋 義人, 石原 哲, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  96 ( 2 ) 348 - 348  2005年

DOI CiNii

Mycoplasma genitalium urethritis in men

S Ishihara, M Yasuda, S Ito, S Maeda, T Deguchi

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV )  24   S23 - S27  2004年09月

　概要を見る

Mycoplasma genitalium was first isolated from two men with non-gonococcal urethritis (NGU) and thereafter shown to produce urethritis in subhuman primates, inoculated intraurethrally. This mycoplasma has been detected significantly more often in patients with acute NGU, particularly in patients with non-chlamydial NGU, than in subjects without urethritis. The prevalence of M. genitalium-positive non-chlarnydial NGU ranges from 18 to 46% of all non-chlamydial NGU cases. In addition, the persistence of M. genitalium in the urethra after antimicrobial chemotherapy is associated with persistence or recurrence of NGU. The various results reported to date tend to support the proposition that M. genitalium is a pathogen of NGU. M. genitalium is highly susceptible to tetracyclines, macrolides, and some new fluoroquinol ones, but the clinical data on the chemotherapy in M. genitalium-positive NGU is extremely limited. Because of the possible association between the post-treatment presence of M. genitalium in the urethra and persistent or recurrent NGU, the eradication of this mycoplasma from the urethra is essential in the management of patients with M. genitalium-positive NGU. Further studies are required to establish the optimal chemotherapy for M. genitalium-positive NGU. (C) 2004 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

DOI

Remarkable increase in central Japan in 2001-2002 of Neisseria gnorrrhoeae isolated with decreased susceptibility to penicillin,tetracycline oral cephalosporins，and fluoroquinolones.

Yasuda M, Yokoi S(Urology, Ito S(Urology, Deguchi T

Amtimicrob Agent Chemother. ( AMER SOC MICROBIOLOGY )  48 ( 8 ) 3185 - 3187  2004年08月

　概要を見る

Four hundred sixty-two clinical isolates of Neisseria gonorrhoeae recovered from 1999 through 2002 in central Japan were examined for MICs of antimicrobial agents. The majority was sensitive to ceftriaxone and spectinomycin, but a remarkable increase in isolates with decreased susceptibility to penicillin, tetracycline, oral cephalosporins, and fluoroquinolones was observed from 2001 through 2002.

DOI

Association of Ureaplasma urealyticum (Biovar 2) with nongonococcal urethritis

T Deguchi, T Yoshida, T Miyazawa, M Yasuda, M Tamaki, H Ishiko, SI Maeda

SEXUALLY TRANSMITTED DISEASES ( LIPPINCOTT WILLIAMS & WILKINS )  31 ( 3 ) 192 - 195  2004年03月

　概要を見る

Background: The tiny (T)-strain mycoplasmas, designated in 1974 as Ureaplasma urealyticum, have been divided into 2 species, Ureaplasma parvum (biovar 1) and U. urealyticum (biovar 2), but association of each of these species with nongonococcal urethritis (NGU) remains unclear. Goal: The goal of this study was to determine whether U. parvum (biovar 1) or U. urealyticum (biovar 2) is associated with NGU. Study Design: The prevalences of U. parpum (biovar 1) and U. urealyticum (biovar 2) in 572 patients with urethritis were compared with those in 141 men without urethritis. Results: The prevalence of U. urealyticum (biovar 2) in men with NGU (15.8%) or with nonchlamydial NGU (18.0%) was significantly higher than that in men without urethritis (7.8%). The prevalence of U. parvum (biovar 1) in men with NGU (8.5%) or with nonchlamydial NGU (11.1%) did not differ significantly from that in men without urethritis (13.5%). Conclusion: Our results showed a significant association between U. urealyticum (biovar 2) and NGU. They also suggest that the presence of U. parvum (biovar 1) in the male urethra might be the result of colonization.

DOI

非淋菌性尿道炎難治例におけるマイコプラズマの関与

前田 真一, 久保田 恵章, 玉木 正義, 安田 満, 出口 隆, 吉田 隆史, 石古 博昭

日本性感染症学会誌   15   139 - 143  2004年01月

マイコプラズマ

出口 隆, 安田 満, 前田 真一

性感染症 STD     160 - 168  2004年01月

血清CA19とCAEが異常高値を示した尿管癌の1例

加藤 成一, 安田 満, 仲野 正博, 江原 英俊, 石原 哲, 出口 隆, 坂田 佳子, 森, 秀樹, 下川 邦泰

泌尿器科紀要   50   99 - 102  2004年01月

泌尿器科周術期における抗菌薬の使用方法についてのアンケート報告

山本 新吾, 竹山 康, 塚本 泰司, 清田 浩, 小野寺 昭一, 頴川 晋, 門田 晃一, 公文 裕巳, 江頭 稔久, 内藤 誠二, 田中 一志, 金丸 聰淳, 荒川 創一, 守殿 貞夫, 安田 満, 石原 哲, 出口 隆, 山田 陽司, 村谷 哲郎, 松本 哲朗, 小川 修, 石川 清仁, 星長 清隆, 岩村 正嗣, 斉藤 威文, 馬場 志郎, 松川 雅則

泌尿器科紀要   50   779 - 786  2004年01月

PP3-185 複雑性尿路感染症起因菌の耐性率の変化(一般演題(ポスター))

石原 哲, 水谷 晃輔, 亀井 信吾, 増栄 成泰, 後藤 高広, 萩原 徳康, 安田 満, 横井 繁明, 仲野 正博, 伊藤 慎一, 江原 英俊, 高橋 義人, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  95 ( 2 ) 520 - 520  2004年

DOI CiNii

APP-114 ペニシリン結合蛋白2のモザイク様構造変化を有する淋菌臨床分離株の出現(総会賞応募(ポスター))

安田 満, 水谷 晃輔, 石原 哲, 篠田 育男, 林 秀治, 斉藤 昭弘, 藤本 佳則, 前田 真一, 藤広 茂, 蟹本 雄右, 堀江 正宣, 説田 修, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  95 ( 2 ) 343 - 343  2004年

DOI CiNii

PP4-016 タクロリムス,バシリキシマブ併用療法におけるCD25陽性細胞数の推移に関する検討(一般演題(ポスター))

伊藤 慎一, 萩原 徳康, 増栄 成泰, 水谷 晃輔, 安田 満, 横井 繁明, 江原 英俊, 高橋 義人, 石原 哲, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  95 ( 2 ) 534 - 534  2004年

DOI CiNii

PP3-217 腹腔鏡手術の開腹移行例の検討(一般演題(ポスター))

高橋 義人, 横井 繁明, 安田 満, 亀井 信吾, 伊藤 慎一, 江原 英俊, 水谷 晃輔, 中根 慶太, 加藤 卓, 宇野 裕巳, 玉木 正義, 前田 真一, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  95 ( 2 ) 528 - 528  2004年

DOI CiNii

尿路感染症の薬物治療 細菌感染症のトピックス

安田 満, 出口 隆

MEDICAMENT NEWS   1764   1 - 3  2003年01月

外来診療のすべて改訂第3版

安田 満, 出口 隆

    124 - 125  2003年01月

男子淋菌性尿道炎に対するセフィキシム400mg，分2，3日間投与の細菌学的効果の検討

前田 真一, 久保田 恵章, 玉木 正義, 安田 満, 出口 隆

日本性感染症学会誌   14   121 - 124  2003年01月

Mycoplasma genitaliumと尿道炎

安田 満, 出口 隆

日本マイコプラズマ学会誌   30   52 - 55  2003年01月

Grade3表在性膀胱癌の臨床的検討

楊 睦正, 土屋 朋大, 亀井 信吾, 山田 徹, 安田 満, 西野 好則, 西田 泰幸, 谷口 光宏, 永井 司, 竹内 敏視, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  94 ( 2 ) 266 - 266  2003年

DOI CiNii

膀胱全摘除症例における術前化学療法の有用性の検討

土屋 朋大, 亀井 信吾, 山田 徹, 安田 満, 楊 睦正, 西野 好則, 西田 泰幸, 谷口 光宏, 永井 司, 竹内 敏視, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  94 ( 2 ) 213 - 213  2003年

DOI CiNii

Treatment of uncomplicated gonococcal urethritis by double-dosing of 200mg cefixime at a 6-h interval

Takashi Deguchi, Mitsuru Yasuda, Shigeaki Yokoi, Ken-Ichiro Ishida, Masayasu Ito, Satoshi Ishihara, Ken Minamidate, Yoshimasa Harada, Kanhin Tei, Kentaro Kojima, Masayoshi Tamaki, Shin-Ichi Maeda

Journal of Infection and Chemotherapy ( Springer Japan )  9 ( 1 ) 35 - 39  2003年

　概要を見る

The efficacy of antimicrobial regimens for the treatment of uncomplicated gonococcal urethritis depends partially upon the period of time (therapeutic time) during which the drug concentration in the blood after the concentration peak is greater than four times the minimum inhibitory concentration for 90% of clinical isolates of Neisseria gonorrhoeae (MIC90). A therapeutic time of at least 10h is suggested as an important determinant for elimination of 95% or more of the infection. In this study, therapeutic times for a single 400-mg dose of cefixime at various MIC90s were calculated, and pharmacokinetic profiles of double-dosing of 200mg cefixime at various intervals were simulated. Subsequently, a dosing interval of 6h was tested in 6 healthy Japanese men, and then 93 Japanese men with gonococcal urethritis were treated with a regimen of two 200-mg doses of cefixime given at a 6-h interval. For a single dose of 400mg cefixime, therapeutic times were calculated to be 12.8, 9.1, 5.4, and 1.7h for MIC90s of 0.06, 0.125, 0.25, and 0.5 μg/ml, respectively. In the simulation study of double-dosing of 200mg cefixime at a 6-h interval, the therapeutic times for the MIC90s of ≤0.125 μg/ml were longer than 10h. Of the 93 patients, 68 were evaluated for microbiological outcome, and N. gonorrhoeae was eradicated in 60 (88.2%). The MIC90 of cefixime for the 61 isolates tested was 0.125 μg/ml. All strains with MICs of ≤0.06 μg/ml were eradicated, whereas 8 of 16 strains with MICs of ≥0.125 μg/ml persisted after treatment. This regimen would not be effective against infection by strains exhibiting cefixime MIC90s of ≥0.125 μg/ml. For such strains, a different regimen with a higher dose of cefixime would be required.

DOI PubMed

Association of mycoplasma genitalium persistence in the urethra with recurrence of nongonococcal urethritis

S Maeda, M Tamaki, K Kojima, T Yoshida, H Ishiko, M Yasuda, T Deguchi

SEXUALLY TRANSMITTED DISEASES ( LIPPINCOTT WILLIAMS & WILKINS )  28 ( 8 ) 472 - 476  2001年08月  [査読有り]

　概要を見る

Background. Most patients with recurrent symptomatic nongonococcal urethritis receive negative test results for Chlamydia trachomatis and Ureaplasma urealyticum, and the cause of such recurrence usually is unknown. Goal: To assess the association of Mycoplasma genitalium with recurrent nongonococcal urethritis. Study Design: In this study, 72 men with nongonococcal urethritis were treated with levofloxacin. Before and after treatment. symptoms and signs were assessed and first-pass urine was examined for C trachomatis, M genitalium, U urealyticum, and Mycoplasma hominis by polymerase chain reaction- based assays. Results: In 6 of 45 men who had no symptoms and no evidence of inflammation after treatment, nongonococcal urethritis recurred. Of these 6 men, 5 had positive test results for M genitalium before levofloxacin treatment, which remained positive afterward. After the second treatment for recurrent nongonococcal urethritis, one man was still had a positive test result for the mycoplasma and experienced a subsequent recurrence. Conclusions: This study suggests that the persistence of M genitalium in the urethra may be associated with recurrence of nongonococcal urethritis.

腎細胞癌におけるcentrosomal kinase AIK1およびAIK3発現の免疫組織化学的検討

江原 英俊, 横井 繁明, 山田 徹, 玉木 正義, 安田 満, 西野 好則, 山本 直樹, 高橋 義人, 石原 哲, 出口 隆, 木村 正志, 岡野 幸雄

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  91 ( 3 ) 395 - 395  2000年

DOI CiNii

1998年に当科で分離された尿路由来緑膿菌の抗菌剤耐性関連遺伝子の状況について

石原 哲, 安田 満, 横井 繁明, 西野 好則, 江原 英俊, 山本 直樹, 高橋 義人, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  91 ( 3 ) 198 - 198  2000年

DOI CiNii

上部尿路上皮内癌におけるBCG灌流療法の検討

西野 好則, 安田 満, 横井 繁明, 江原 英俊, 山本 直樹, 原田 吉將, 米田 尚生, 高橋 義人, 石原 哲, 竹内 敏視, 酒井 俊助, 鄭 漢彬, 出口 隆

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  91 ( 3 ) 400 - 400  2000年

DOI CiNii

Improved antimicrobial activity of DU-6859a, a new fluoroquinolone, against quinolone-resistant Klebsiella pneumoniae and Enterobacter cloacae isolates with alterations in GyrA and ParC proteins

T Deguchi, M Yasuda, T Kawamura, M Nakano, S Ozeki, E Kanematsu, Y Nishino, Y Kawada

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  41 ( 11 ) 2544 - 2546  1997年11月  [査読有り]

　概要を見る

MICs of DU-6859a, a novel fluoroquinolone, for 18 Klebsiella pneumoniae isolates and 21 Enterobacter cloacae isolates with altered GyrA or altered GyrA and ParC ranged from less than or equal to 0.025 to 6.25 mu g/ml and from 0.1 to 3.13 mu g/ml respectively. Based on the MICs at which 90% of the isolates were inhibited for these strains of K. pneumoniae and E. cloacae, DU-6859a exhibited 16- to 256-fold-greater activity than currently available fluoroquinolones.

Detection of mutations in the gyrA and parC genes in quinolone-resistant clinical isolates of Enterobacter cloacae

T Deguchi, M Yasuda, M Nakano, S Ozeki, E Kanematsu, Y Nishino, S Ishihara, Y Kawada

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  40 ( 4 ) 543 - 549  1997年10月  [査読有り]

　概要を見る

We have determined partial sequences of the gyrA and parC genes of Enterobacter cloacae type strain including the regions analogous to the quinolone resistance-determining region of the Escherichia coli gyrA gene. The deduced 65- and 49-amino acid sequences of the determined regions of the E. cloacae gyrA and parC genes were identical to the corresponding regions of the E. coli GyrA and ParC proteins, respectively. We examined 40 clinical strains of E. cloacae isolated from patients with urinary tract infection for susceptibilities to nalidixic acid and ciprofloxacin. Based on the nalidixic acid and ciprofloxacin MICs, these isolates were divided into 19 quinolone-susceptible strains (MICs of nalidixic acid, 3.13-25 mg/L; MICs of ciprofloxacin, less than or equal to 0.025 mg/L) and 21 quinolone-resistant strains (MICs of nalidixic acid, 400 to >800 mg/L; MICs of ciprofloxacin, 0.39-100 mg/L). We analysed five quinolone-susceptible and 21 quinolone-resistant strains for alterations in GyrA and ParC. The five quinolone-susceptible strains had amino acid sequences in GyrA and ParC identical to those of type strain. Of the 21 quinolone-resistant isolates, three (MICs of nalidixic acid, 400 to >800 mg/L; MICs of ciprofloxacin, 0.39-3.13 mg/L) had a single amino acid change at the position equivalent to Ser-83 in the E. coli GyrA protein and no alterations in ParC; one (MIG of nalidixic acid, >800 mg/L; MIC of ciprofloxacin, 3.13 mg/L) had a single amino acid change at Ser-83 in GyrA and a single amino acid change at the position equivalent to Glu-84 in the E. coli ParC protein; two (MIG of nalidixic acid, >800 mg/L; MIC of ciprofloxacin, 25 mg/L) had double amino acid changes at Ser-83 and Asp-87 in GyrA and no alterations in ParC; and 15 (MICs of nalidixic acid, >800 mg/L; MICs of ciprofloxacin, 25-100 mg/L) had double amino acid changes at Ser-83 and Asp-87 in GyrA and a single amino acid change at Ser-80 or Glu-84 in ParC. This study suggests, that in clinical isolates of E. cloacae, DNA gyrase is a primary target of quinolones, that only a single amino acid change at Ser-83 in GyrA is sufficient to generate high-level resistance to nalidixic acid and to decrease susceptibility to ciprofloxacin, and that the accumulation of amino acid changes in GyrA and the simultaneous presence of the ParC alterations play a central role in developing high-level resistance to ciprofloxacin.

In-vitro antimicrobial activity of HSR-903, a new fluoroquinolone, against clinical isolates of Neisseria gonorrhoeae with quinolone resistance-associated alterations in GyrA and ParC

T Deguchi, M Yasuda, S Ishihara, Y Takahashi, E Okezaki, O Nagata, Saito, I, Y Kawada

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  40 ( 3 ) 437 - 439  1997年09月  [査読有り]

　概要を見る

The in-vitro antimicrobial activity of HSR-903, a new fluoroquinolone, was tested against 51 clinical Neisseria gonorrhoeae isolates in comparison with ciprofloxacin, levofloxacin and sparfloxacin. The MICs of HSR-903 for 11 isolates with alterations in both GyrA and ParC, for 19 isolates with alterations only in GyrA and for 21 isolates without alterations in either GyrA or ParC ranged from 0.03 mg/L to 1.0 mg/L (MIC90 = 0.25 mg/L), from 0.03 mg/L to 0.5 mg/L (MIC90 = 0.125 mg/L) and from less than or equal to 0.001 mg/L to 0.008 mg/L (MIC90 = 0.004 mg/L), respectively. Levofloxacin and ciprofloxacin were the least active of the four quinolones tested, particularly against the mutant strains. Sparfloxacin was more active, but HSR-903 exhibited the most potent in-vitro activity against the clinical N. gonorrhoeae isolates, including those harbouring quinolone-resistance-associated alterations in GyrA and ParC.

Mutations in the gyrA and parC genes associated with fluoroquinolone resistance in clinical isolates of Citrobacter freundii

Y Nishino, T Deguchi, M Yasuda, T Kawamura, M Nakano, E Kanematsu, S Ozeki, Y Kawada

FEMS MICROBIOLOGY LETTERS ( ELSEVIER SCIENCE BV )  154 ( 2 ) 409 - 414  1997年09月  [査読有り]

　概要を見る

We determined partial sequences of the gyrA and parC genes of Citrobacter freundii type strain, and then examined 38 C. freundii clinical strains isolated from patients with urinary tract infections for the association of alterations in GyrA and ParC with susceptibility to fluoroquinolones. Our results suggest that in C. freundii DNA gyrase may be a primary target of quinolones, that an amino acid change at Thr-83 or Asp-87 in GyrA is sufficient to decrease susceptibility to fluoroquinolones, and that accumulation of changes in GyrA with the simultaneous presence of an alteration at Ser-80 or Glu-84 in ParC may be associated with the development of high-level fluoroquinolone resistance in C. freundii clinical isolates.

Development of a rapid assay for detecting gyrA mutations in Escherichia coli and determination of incidence of gyrA mutations in clinical strains isolated from patients with complicated urinary tract infections

S Ozeki, T Deguchi, M Yasuda, M Nakano, T Kawamura, Y Nishino, Y Kawada

JOURNAL OF CLINICAL MICROBIOLOGY ( AMER SOC MICROBIOLOGY )  35 ( 9 ) 2315 - 2319  1997年09月  [査読有り]

　概要を見る

The MICs of ofloxacin for 743 strains of Escherichia coli isolated from 1988 to 1994 were determined by testing, The strains were from patients with urinary tract infections complicated by functional or anatomical disorders of the urinary tract, Those determined to be ofloxacin resistant (MIG, greater than or equal to 12.5 mu g/ml) comprised 3 of 395 strains (1.3%) from the 1988 to 1990 group, 2 of 166 strains (1.2%) from the 1991 to 1992 group, and 7 of 182 strains (3.8%) from the 1993 to 1994 group, The incidence of resistant strains increased significantly during this period, The percentage of isolates with moderately decreased susceptibilities to ofloxacin (MIG, 0.39 to 3.13 mu g/ml) also rose during the same period, To determine the incidence of gyrA mutations in urinary-tract-derived strains of E, coli, we developed a simple and rapid assay based on PCR amplification of the region of the gyrA gene containing the mutation sites followed by digestion of the PCR product with a restriction enzyme, Using this assay, we examined all 182 strains isolated in 1993 and 1994 for the presence of mutations at Ser-83 and Asp-87 in the gyrA gene, Of these strains, 33 (18.1%) had mutations in the gyrA gene, The incidences of mutations at Ser-83, at Asp-87, and at both codons were 10.4 (19 strains), 4.4 (8 strains), and 3.3% (6 strains), respectively, To determine the correlation of the mutations in the gyrA gene with susceptibilities to quinolones (nalidixic acid, ofloxacin, norfloxacin, and ciprofloxacin), we further examined 116 strains for which the MICs of ofloxacin were greater than or equal to 0.2 mu g/ml that were chosen from the isolates in the 1988 to 1992 group, The MICs of nalidixic acid for the strains without mutations at either Ser-83 or Asp-87 were less than or equal to 25 mu g/ml, whereas those for the strains with single mutations or double mutations were from 50 to >800 mu g/ml. For the fluoroquinolones, significant differences in the distributions of the MICs were observed among the strains without mutations, with single mutations, and with double mutations, The accumulation of mutations in the gvrA gene was associated with an increase in fluoroquinolone resistance, Ofloxacin MICs for the majority of the strains with single and double mutations were 0.39 to 3.13 and 6.25 to 100 mu g/ml, respectively, This study demonstrates a chronological increase in the percentage of not only highly fluoroquinolone-resistant strains, corresponding to those with double mutations in the gyrA gene, but also strains with moderately decreased susceptibilities to fluoroquinolones, corresponding to those with single mutations, This increase in the incidence of strains with a single mutation in the gyrA gene portends a further increase in the incidence of strains with clinically significant resistance to fluoroquinolones.

Comparison of in vitro antimicrobial activity of AM-1155 with those of tosufloxacin and fleroxacin against clinical isolates of Neisseria gonorrhoeae harboring quinolone resistance alterations in GyrA and ParC

T Deguchi, M Yasuda, M Nakano, S Ozeki, E Kanematsu, H Fukuda, S Maeda, Saito, I, Y Kawada

CHEMOTHERAPY ( KARGER )  43 ( 4 ) 239 - 244  1997年07月  [査読有り]

　概要を見る

The in vitro antimicrobial activities of AM-1155, a new fluoroquinolone, tosufloxacin and fleroxacin were tested against 55 clinical isolates of Neisseria gonorrhoeae using the agar dilution method. In our previous study, all the strains had been examined for mutations in the region corresponding to the quinolone-resistance determining region of the Escherichia cell gyrA gene and the analogous region of the parC gene, and tested for susceptibility to ciprofloxacin. In this study, the 55 isolates of N. gonorrhoeae were assigned to one of three categories based on the presence or absence of alterations in GyrA and ParC. In each category, the antimicrobial activity of AM-1155 against the isolates was compared with those of tosufloxacin and fleroxacin. The MICs of AM-1155 for 11 highly fluoroquinolone-resistant isolates with alterations in both GyrA and ParC ranged from 0.06 to 1.0 mu g/ml. The MICs inhibiting 50% (MIC50) and 90% (MIC90) of these isolates were 0.125 and 1.0 mu g/ml, respectively. The MICs of AM-1155 for 20 moderately fluoroquinolone-resistant isolates with alterations only in GyrA ranged from 0.03 to 0.25 mu g/ ml (MIC50, 0.06 mu g/ml; MIC90, 0.125 mu g/ml). The MICs of AM-1155 for 24 of the quinolone-susceptible isolates without alterations in either GyrA or ParC ranged from 0.004 to 0.03 mu g/ml (MIC50, 0.008 mu g/ml; MIC50, 0.015 mu g/ml). There were significant differences between the MIC distribution of AM-1155 and each corresponding MIC distribution of tosufloxacin and fleroxacin in these three categories to which the 55 isolates were assigned (p < 0.05). Based on the MIC(90)s of the tested fluoroquinolones, AM-1155 was two- and eightfold more active against the highly fluoroquinolone-resistant isolates than tosufloxacin and fleroxacin, respectively. Against the moderately fluoroquinolone-resistant isolates, AM-1155 was four- and sixteenfold more active than tosufloxacin and fleroxacin, respectively. Against the quinolone-susceptible strains, AM-1155 was also two- to fourfold more active than the other fluoroquinolones. Overall, AM-1155 exhibited more potent in vitro activity against both quinolone-resistant and quinolone-susceptible isolates of N. gonorhoeae than tosufloxacin and fleroxacin. In ciprofloxacin treatment failures of gonorrhea at single doses of 500 mg. MICs for the causative organisms have ranged from 1.0 to 16.0 mu g/ml. The MICs of AM-1155 for the isolates harboring quinolone resistance-associated genetic alterations, including strains exhibiting ciprofloxacin MICs of 2.0 and 8.0 mu g/ml, still ranged from 0.03 to 1.0 mu g/ml. A single-dose study in humans has demonstrated higher peak serum concentrations and longer half-lives of AM-1155, resulting in the AUC(O-infinity) values of AM-1155, which are threefold greater than those of ciprofloxacin at the single doses of 400 and 600 mg. Because of its potent in vitro antimicrobial activity and advantageous pharmacokinetic behavior, AM-1155 may be a clinically useful agent for treating gonorrhea including that caused by quinolone-resistant strains.

In vivo selection of Klebsiella pneumoniae strains with enhanced quinolone resistance during fluoroquinolone treatment of urinary tract infections

T Deguchi, T Kawamura, M Yasuda, M Nakano, H Fukuda, H Kato, N Kato, Y Okano, Y Kawada

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  41 ( 7 ) 1609 - 1611  1997年07月  [査読有り]

　概要を見る

We report two cases of failure of fluoroquinolone treatment of urinary tract infections with Klebsiella pneumoniae strains harboring quinolone resistance-associated alterations in GyrA and ParC and in vivo selection of posttreatment isolates with enhanced fluoroquinolone resistance. Active efflux leading to decreased accumulation of a drug enhanced fluoroquinolone resistance in one posttreatment isolate, and an additional mutation in parC resulting in an additional amino acid change in ParC was associated with increased resistance in the other.

Fluoroquinolone treatment failure in gonorrhea - Emergence of a Neisseria gonorrhoeae strain with enhanced resistance to fluoroquinolones

T Deguchi, Saito, I, M Tanaka, K Sato, K Deguchi, M Yasuda, M Nakano, Y Nishino, E Kanematsu, S Ozeki, Y Kawada

SEXUALLY TRANSMITTED DISEASES ( LIPPINCOTT-RAVEN PUBL )  24 ( 5 ) 247 - 250  1997年05月  [査読有り]

　概要を見る

Background and Objectives: Although emergence of clinical isolates of Neisseria gonorrhoeae with decreased susceptibilities to fluoroquinolones and treatment failures in gonorrhea have been reported, there have been no clinical reports that fluoroquinolone treatments actually select quinolone-resistant strains, nor have isolates that exhibited clinically significant resistance been analyzed for resistance mechanisms, Goals: To report a case of fluoroquinolone treatment failure in gonorrhea and emergence of a posttreatment isolate with enhanced resistance to fluoroquinolones; and to study mechanisms of quinolone resistance in the isolates from this patient, Study Design: A patient with gonococcal urethritis treated with ofloxacin, 200 mg, three times daily for 5 days is described, Pretreatment and posttreatment isolates were tested for minimum inhibitory concentrations (MICs) of antimicrobial agents and analyzed for alterations in DNA gyrase and topoisomerase IV, They were also examined for ofloxacin uptake, Results: Treatment failure with multiple doses of ofloxacin was observed in this case of gonorrhea, The pretreatment isolate showed decreased susceptibilities to fluoroquinolones (IMC of ofloxacin, 1.0 mg/l; MIC of ciprofloxacin, 0.25 mg/l), and had amino acid changes of Ser-91 --> Phe in GyrA and Ser-87 --> Ile in ParC. The posttreatment isolate exhibited an increase in resistance to fluoroquinolones (MIC of ofloxacin, 8.0 mg/l; MIC of ciprofloxacin, 1.0 mg/l), This isolate had identical alterations in GyrA and ParC, but exhibited significantly reduced uptake of ofloxacin. This isolate also showed a small decrease in susceptibilities to cephalosporins. Conclusions: Alterations in DNA gyrase and topoisomerase IV confer clinically significant resistance to fluoroquinolones in N. gonorrhoeae strains, Treatment with multiple doses of fluoroquinolones is likely to bring about selection of more fluoroquinolone-resistant strains of N, gonorrhoeae and to influence susceptibilities to cephalosporins.

Rapid screening of point mutations of the Neisseria gonorrhoeae parC gene associated with resistance to quinolones

T Deguchi, M Yasuda, M Nakano, E Kanematsu, S Ozeki, Y Nishino, T Ezaki, S Maeda, Saito, I, W Kawada

JOURNAL OF CLINICAL MICROBIOLOGY ( AMER SOC MICROBIOLOGY )  35 ( 4 ) 948 - 950  1997年04月  [査読有り]

　概要を見る

To detect quinolone resistance-associated mutations within the Asp-86, Ser-87, Ser-88, and Glu-91 codons of the Neisseria gonorrhoeae parC gene, we developed a rapid and simple assay based on amplification of the regions of the parC gene containing the mutation sites by PCR and digestion of the PCR products with restriction enzymes, By using the method of primer-specified restriction site modification, artificial SalI, PstI, EcoRI, and HinfI restriction sites were created in the regions containing the Asp-86, Ser-87, Ser-88, and Glu-91 codons, respectively, The mutations generating alterations at Asp-86, Ser-87, Ser-88, and Glu-91 were detected as failures of SalI, PstI, EcoRI, and Hinfl to digest the respective PCR products, Fifty-five clinical strains of N. gonorrhoeae were examined for mutations in the parC gene by this assay, Appropriate mutations at either the Asp-86, Ser-87, Ser-88, or Glu-91 codon were detected in each of 11 strains in which a mutation had previously been observed by DNA sequencing, This rapid and simple assay could be a useful device for screening genetic alterations in the parC gene associated with resistance to quinolones in N. gonorrhoeae.

Prevalence of Mycoplasma genitalium in asymptomatic men in Japan

M Uno, T Deguchi, A Saito, M Yasuda, H Komeda, Y Kawada

INTERNATIONAL JOURNAL OF STD & AIDS ( ROYAL SOC MEDICINE PRESS LTD )  8 ( 4 ) 259 - 260  1997年04月  [査読有り]

　概要を見る

We aim to clarify the prevalence of Mycoplasma genitalium in asymptomatic men in Japan. First-catch urine specimens were obtained from 187 asymptomatic Japanese men and examined for the presence of M. genitalium using a polymerase chain reaction (PCR)-based assay. Two (1.1%) of 187 first-catch urine specimens were positive for M. genitalium. The prevalence of M. genitalium in wine specimens of asymptomatic men in Japan is lower than that in asymptomatic men in the UK (6%) and Denmark (9%).

Alterations in the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV in quinolone-resistant clinical isolates of Klebsiella pneumoniae

T Deguchi, A Fukuoka, M Yasuda, M Nakano, S Ozeki, E Kanematsu, Y Nishino, S Ishihara, Y Ban, Y Kawada

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  41 ( 3 ) 699 - 701  1997年03月  [査読有り]

　概要を見る

We determined a partial sequence of the Klebsiella pneumoniae parC gene, including the region analogous to the quinolone resistance-determining region of the Escherichia coli gyrA gene, and examined 26 clinical strains of K. pneumoniae for an association of alterations in GyrA and ParC with susceptibilities to quinolones; The study suggests that in K. pneumoniae DNA gyrase is a primary target of quinolones and that ParC alterations play a complementary role in the development of higher-level fluoroquinolone resistance.

Antimicrobial activity of a new fluoroquinolone, DU-6859a, against quinolone-resistant clinical isolates of Neisseria gonorrhoeae with genetic alterations in the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV

T Deguchi, M Yasuda, M Nakano, E Kanematsu, S Ozeki, S Ishihara, Saito, I, Y Kawada

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  39 ( 2 ) 247 - 249  1997年02月  [査読有り]

　概要を見る

The in-vitro antimicrobial activity of DU-6859a, a new fluoroquinolone, was tested against 55 clinical isolates of Neisseria gonorrhoeae. The MIC of DU-6859a inhibiting 90% (MIC90) of the isolates with genetic alterations of both the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV was 0.125 mg/L. The MIC90, for isolates with alterations of GyrA alone or without alterations of GyrA or ParC was 0.03 mg/L and 0.004 mg/L, respectively. The potency of DU-6859a against clinical isolates bearing genetic alterations associated with quinolone resistance was significantly greater than that of currently available fluoroquinolones.

Prevalence of Mycoplasma genitalium in men with gonococcal urethritis

M Uno, T Deguchi, H Komeda, M Yasuda, M Tamaki, S Maeda, Saito, I, Y Kawada

INTERNATIONAL JOURNAL OF STD & AIDS ( ROYAL SOC MEDICINE SERVICES LTD )  7 ( 6 ) 443 - 444  1996年10月  [査読有り]

　概要を見る

A significant association of Mycoplasma genitalium with non-gonococcal urethritis has been reported, but the prevalence of this mycoplasma in men with gonococcal urethritis has not been so well studied. Ln this study, we examined urethral swab specimens from 45 Japanese male patients with gonococcal urethritis for the presence of M. genitalium by using a polymerase chain reaction-based assay. We also sought Chlamydia trachomatis by an enzyme immunoassay (Chlamydiazyme). Of the 45 specimens, 2 (4.4%) were positive for the mycoplasma and 12 (26.7%) were positive for C. trachomatis. The findings suggest that M. genitalium may be a cause not only of non-gonococcal urethritis but also of postgonococcal urethritis.

Rapid detection of point mutations of the Neisseria gonorrhoeae gyrA gene associated with decreased susceptibilities to quinolones

T Deguchi, M Yasuda, M Nakano, S Ozeki, T Ezaki, SI Maeda, Saito, I, Y Kawada

JOURNAL OF CLINICAL MICROBIOLOGY ( AMER SOC MICROBIOLOGY )  34 ( 9 ) 2255 - 2258  1996年09月  [査読有り]

　概要を見る

Mutations in the gyrA gene resulting in amino acid changes at Ser-91 and Asp-95 are significantly associated with decreased susceptibilities to quinolones in Neisseria gonorrhoeae. To detect these mutations, we developed a rapid and simple assay based on amplification of the region of the gyrA gene containing the mutation sites by PCR and digestion of the PCR product with a restriction enzyme. A naturally occurring HinfI restriction site was present in the region containing the Ser-91 codon, and an artificial HinfI restriction site was created in the region containing the Asp-95 codon by the method of primer-specified restriction site modification. The mutations generating alterations at Ser-91 and Asp-95 were detected as restriction fragment length polymorphisms of the PCR products digested with HinfI. Fifty-five clinical strains of N. gonorrhoeae were examined for mutations in the gyrA gene by this method. Mutations at Ser-91 and/or Asp-95 were detected in all the 31 strains in which the mutations had been confirmed by DNA sequencing. Our method allows simultaneous testing of a large number of Strains and provides results within 8 h. This rapid and simple assay could be a useful screening device for genetic alterations associated with decreased susceptibilities to quinolones in N. gonorrhoeae and could facilitate epidemiological studies on clinical isolates of N. gonorrhoeae with decreased susceptibilities to quinolones.

Comparison among performances of a ligase chain reaction-based assay and two enzyme immunoassays in detecting Chlamydia trachomatis in urine specimens from men with nongonococcal urethritis

T Deguchi, M Yasuda, M Uno, K Tada, H Iwata, H Komeda, S Maeda, Latila, V, Saito, I, Y Kawada

JOURNAL OF CLINICAL MICROBIOLOGY ( AMER SOC MICROBIOLOGY )  34 ( 7 ) 1708 - 1710  1996年07月  [査読有り]

　概要を見る

We evaluated the performances of a ligase chain reaction (LCR)-based assay and two enzyme immunoassays (Chlamydiazyme and IDEIA) in the detection of Chlamydia trachomatis in urine specimens. We compared the results of testing urine specimens by these assays with those of urethral swab culture by examining samples from 131 men with nongonococcal urethritis. Discrepant results were analyzed by testing urethral swab specimens for C. trachomatis by a PCR-based assay. After the resolution of discrepant results, the sensitivity of urethral swab culture was 85.3%, whereas those of the LCR assay, Chlamydiazyme, and IDEIA with urine specimens were 93.1, 82.4, and 94.1%, respectively. The LCR assay and IDEIA were more sensitive than was urethral swab culture. In addition, the LCR assay, with a sensitivity equal to that of IDEIA, was more specific. Overall, the LCR assay proved to be superior to the enzyme immunoassays in detecting C. trachomatis in urine specimens. Testing urine specimens by LCR assay should be a helpful alternative method for diagnosing C. trachomatis urethral infection in men with nongonococcal urethritis.

Quinolone-resistant Neisseria gonorrhoeae: Correlation of alterations in the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV with antimicrobial susceptibility profiles

T Deguchi, M Yasuda, M Nakano, S Ozeki, T Ezaki, Saito, I, Y Kawada

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  40 ( 4 ) 1020 - 1023  1996年04月  [査読有り]

　概要を見る

Fifty-five clinical strains of Neisseria gonorrhoeae were examined for mutations in the gyrA and parC genes and for antimicrobial susceptibility profiles. The MICs of quinolones for 31 strains with alterations in GyrA were significantly higher than the MICs for 24 strains without such alterations. Eleven strains with alterations in both GyrA and ParC were significantly more resistant to fluoroquinolones than those with alterations in GyrA alone. The MICs of cephalosporins for these strains were also significantly higher than those for other strains.

腎細胞癌におけるProgesterone receptorの発現に関する免疫組織学的検討

楊 睦正, 江原 英俊, 出口 隆, 仲野 正博, 安田 満, 土屋 博, 河田 幸道

日本泌尿器科学会雑誌 ( 一般社団法人 日本泌尿器科学会 )  87 ( 2 ) 390 - 390  1996年

DOI CiNii

Polymerase chain reaction法による男子非淋菌性尿道炎患者からの<I>Mycoplasma genitalium</I>の検出

米田 尚生, 出口 隆, 安田 満, 多田 晃司, 岩田 英樹, 石原 哲, 坂 義人, 河田 幸道, 江崎 孝行, 斉藤 功

感染症学雑誌 ( The Japanese Association for Infectious Diseases )  68 ( 11 ) 1376 - 1380  1994年

　概要を見る

Mycoplasma genitaliumは非淋菌性尿道炎患者から分離されるが, 分離培養が困難なため, ヒトの尿道炎の起炎菌であるか, 否かの検討は進んでいない. われわれはpolymerase chain reaction (PCR) 法を用いて, 非淋菌性尿炎患者におけるM. genitaliumの役割を検討した. PCRによるM.genitalium 検出のためのプライマーとして, M.genitaliumの140-KDaadhesingeneの一部の塩基配列に相補的なoligonucleotideを用いた. 本PCM法はMycoplasma hominis, Mycoplasma pneumoniaeを含め, 他の菌種ではDNAの増幅を認めず. M.genitaliumに特異的であった. 非淋菌性尿道炎患者および健常男子の尿道擦過物から本PCR法にて, M.genitaliumDNAの検出を行った. 非淋菌性クラミジア性尿道炎患者33例中3例 (9.1%) および非淋菌性非クラミジア性尿道炎患者81例中14例 (17.3%) からM.genitaliumDNAが検出され, 非淋菌性尿道炎患者全体では114例中14.9%の検出率であったが, 健常男子29例からは1例も検出されなかった. M. genitaliumは非淋菌性クラミジア性尿道炎患者からの検出率が健常男子と比較して有意に高く, 非淋菌性尿道炎の起炎菌であると示唆された.

DOI CiNii