Misc - 安田　満

マイコプラズマ、アデノウイルス、単純ヘルペスウイルス、腟トリコモナスを含む尿道炎起炎微生物の検討

伊藤 晋, 安田 満, 高梨 真樹, 伊藤 貴子, 花岡 希, 前田 真一, 出口 隆

日本性感染症学会誌 ( (一社)日本性感染症学会 )  25 ( 2 ) 63 - 63  2014年10月

Clinical effectiveness and safety of tazobactam/piperacillin 4.5 g for the prevention of febrile infectious complication after prostate biopsy

Mitsuru Yasuda, Keita Nakane, Yoshiteru Yamada, Masahiro Matsumoto, Takehiko Sho, Minori Matsumoto, Kanao Kobayashi, Katsumi Shigemura, Yuzo Nakano, Kazushi Tanaka, Ryoichi Hamasuna, Satoshi Ishihara, Soichi Arakawa, Shingo Yamamoto, Akio Matsubara, Masato Fujisawa, Takashi Deguchi, Tetsuro Matsumoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  20 ( 9-10 ) 631 - 634  2014年09月

　概要を見る

We investigated the clinical effectiveness and safety of tazobactam/piperacillin (TAZ/PIPC) in a 1:8 ratio, a beta-lactamase inhibitor with penicillin antibiotic, for the prevention of febrile infectious complication after prostate biopsy. Each patient received a single dose of TAZ/PIPC 4.5 g, 30 min before the biopsy in Group 1 or TAZ/PIPC 4.5 g twice, once 30 min before and once after the biopsy (just before discharge or 5 h after the biopsy), in Group 2. Estimation of efficacy was performed within 1-month after prostate biopsy. Clinical diagnosis of febrile infectious complication was based on a body temperature elevation greater than 38 C. Infectious complication after prostate biopsy was detected in 2.5% (4/160 patients) in Group 1 and in 0.45% (2/442 patients) in Group 2. All of the patients with febrile infectious complication had risk factors: 5 patients had voiding disturbance, 2 patients had diabetes mellitus and 1 patient had steroid dosing. In group 1, 88 patients had at least one risk factor and 72 patients had no risk factors. Of the patients with a risk factor, 4 had febrile infectious complication after prostate biopsy, but there was no significant difference between the two groups. In group 2, 87 patients had at least one risk factor and 255 patients had no risk factors. The patients with a risk factor had febrile infectious complication significantly more frequently than did patients without a risk factor (P = 0.038). Therefore, TAZ/PIPC appears to be effective as preoperative prophylaxis against the occurrence of febrile infectious complication after prostate biopsy. (C) 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Remarkable increase in fluoroquinolone-resistant Mycoplasma genitalium in Japan

Mina Kikuchi, Shin Ito, Mitsuru Yasuda, Tomohiro Tsuchiya, Kyoko Hatazaki, Masaki Takanashi, Takayuki Ezaki, Takashi Deguchi

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  69 ( 9 ) 2376 - 2382  2014年09月

　概要を見る

Objectives: We determined the prevalence of macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium DNA specimens from men with non-gonococcal urethritis (NGU) and analysed their effects on antibiotic treatments of M. genitalium infections. Methods: In this retrospective study, we examined antibiotic resistance-associated mutations in the 23S rRNA, gyrA and parC genes of M. genitalium and the association of the mutations with microbiological outcomes of antibiotic treatments in men with M. genitalium-positive NGU. Results: No macrolide resistance-associated mutations in the 23S rRNA gene were observed in 27 M. genitalium DNA specimens in 2011 and in 24 in 2012. However, 5 of 17 in 2013 had 23S rRNA mutations. Three of 15 in 2011, 6 of 19 in 2012 and 8 of 17 in 2013 had fluoroquinolone resistance-associated alterations in ParC. Three in 2013 had both the antibiotic resistance-associated alterations coincidentally. In two men with M. genitalium harbouring 23S rRNA mutations, the mycoplasma persisted after treatment with a regimen of 2 g of extended-release azithromycin (AZM-SR) once daily for 1 day. All nine men with mycoplasma harbouring ParC alterations were microbiologically cured with a regimen of 100 mg of sitafloxacin twice daily for 7 days. Conclusions: Macrolide-or fluoroquinolone-resistant M. genitalium appears to be increasing, and the increase in fluoroquinolone-resistant mycoplasmas is especially remarkable in Japan. Mycoplasmas harbouring 23S rRNA mutations would be resistant to the AZM-SR regimen, but those harbouring ParC alterations would still be susceptible to the sitafloxacin regimen.

DOI PubMed

前立腺神経内分泌癌の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, 宮崎 龍彦

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  60 ( 8 ) 408 - 408  2014年08月

Treatment of acute uncomplicated cystitis with faropenem for 3 days versus 7 days: multicentre, randomized, open-label, controlled trial

Ryoichi Hamasuna, Kazushi Tanaka, Hiroshi Hayami, Mitsuru Yasuda, Satoshi Takahashi, Kanao Kobayashi, Hiroshi Kiyota, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  69 ( 6 ) 1675 - 1680  2014年06月

　概要を見る

The increasing prevalence of resistant bacteria such as fluoroquinolone-resistant or extended-spectrum beta-lactamase-producing strains in pathogens causing acute uncomplicated cystitis has been of concern in Japan. Faropenem sodium is a penem antimicrobial that demonstrates a wide antimicrobial spectrum against both aerobic and anaerobic bacteria. It is stable against a number of beta-lactamases. We compared 3 and 7 day administration regimens of faropenem in a multicentre, randomized, open-label, controlled study. In total, 200 female patients with cystitis were enrolled and randomized into 3 day (NaEuroS=aEuroS97) or 7 day (NaEuroS=aEuroS103) treatment groups. At the first visit, 161 bacterial strains were isolated from 154 participants, and Escherichia coli accounted for 73.9% (119/161) of bacterial strains. At 5-9 days after the completion of treatment, 73 and 81 patients from the 3 day and 7 day groups, respectively, were evaluated by intention-to-treat analysis; the microbiological efficacies were 58.9% eradication (43/73), 20.5% persistence (15/73) and 8.2% replaced (6/73), and 66.7% eradication (54/81), 6.2% persistence (5/81) and 7.4% replaced (6/81), respectively (PaEuroS=aEuroS0.048). The clinical efficacies were 76.7% (56/73) and 80.2% (65/81), respectively (PaEuroS=aEuroS0.695). Adverse events due to faropenem were reported in 9.5% of participants (19/200), and the most common adverse event was diarrhoea. The 7 day regimen showed a superior rate of microbiological response. E. coli strains were in general susceptible to faropenem, including fluoroquinolone- and cephalosporin-resistant strains.

DOI PubMed

Prediction of the persistence of Mycoplasma genitalium after antimicrobial chemotherapy by quantification of leukocytes in first-void urine from patients with non-gonococcal urethritis

Shin Ito, Kohsuke Mizutani, Kensaku Seike, Takashi Sugawara, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yokoi, Masahiro Nakano, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  20 ( 5-6 ) 298 - 302  2014年05月

　概要を見る

Mycoplasma genitalium is regarded as another pathogen of male non-gonococcal urethritis (NGU). Failure to eradicate this mycoplasma is associated with persistent or recurrent NGU, but this mycoplasma is not routinely examined in clinical practice. In cases of M. genitalium-positive NGU, therefore, some criteria are needed to assess the success or failure of antimicrobial chemotherapy other than microbiological outcomes. We enrolled 49 men with M. genitalium-positive non-chlamydial NGU. At successive visits after treatment, we inquired about their symptoms, observed their urethral meatus for urethral discharge, and examined their first-void urine (FVU) for quantification of leukocytes and for the persistence of M. genitalium. M. genitalium was eradicated in 34 patients after treatment, whereas the mycoplasma persisted in 15. Urethritis symptoms and urethral discharges were not found to be predictors of the persistence of M. genitalium up to the 25th day after the start of treatment. Leukocyte counts in FVU from the patients with persistence of M. genitalium were significantly higher than those from the patients with eradication of the mycoplasma. Leukocyte counts of 10 leukocytes/mu l or more between the 18th and 24th day after the start of treatment were most significantly associated with the persistence of M. genitalium. Quantification of leukocytes in FVU would appear to be crucial to judge the outcome of treatment in patients with non-chlamydial NGU and could be helpful to predict the persistence of M. genitalium after treatment when M. genitalium is not routinely examined in clinical specimens in clinical practice. (C) 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Occurrence of infection following prostate biopsy procedures in Japan Japanese Research Group for Urinary Tract Infection (JRGU) - A multi-center retrospective study

Yoshikazu Togo, Tatsuhiko Kubo, Rikiya Taoka, Yoshiki Hiyama, Teruhisa Uehara, Jiroh Hashimoto, Yuichiro Kurimura, Satoshi Takahashi, Taiji Tsukamoto, Jun Miyazaki, Hiroyuki Nishiyama, Shinichiro Kira, Hiroshi Kiyota, Satoshi Yazawa, Naoya Niwa, Hiroshi Hongo, Mototsugu Oya, Taku Kato, Mitsuru Yasuda, Takashi Deguchi, Kiyohito Ishikawa, Kiyotaka Hoshinaga, Minort Matsumoto, Katsumi Shigemura, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Koichiro Wada, Shinya Uehara, Toyohiko Watanabe, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Masahiro Matsumoto, Takehiko Sho, Ryoichi Hamasuna, Tetsuro Matsumoto, Hiroshi Hayami, Masayuki Nakagawa, Shingo Yamamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  20 ( 3-4 ) 232 - 237  2014年03月

　概要を見る

We retrospectively investigated the incidence of genitourinary tract infection in 5895 patients who underwent transrectal and/or transperineal prostate biopsy procedure between January and December 2011 at 46 institutions belonging to Japanese Research Group for Urinary Tract Infection (JRGU). The total rate of genitourinary tract infection after prostate biopsy was 0.76%, while that following transrectal procedure was 0.83% and following transperineal procedure was 0.57%, which were not significantly different. In contrast, febrile infection associated with a fever (>= 38 degrees C) occurred significantly more frequently after transrectal (0.71%) than transperineal (0.16%) approach (P = 0.04). Notably, in infectious cases, Escherichia coli was most frequently isolated. Of the 9 E. coli strains isolated by urine culture, 6 (66.7%) produced extended spectrum B-lactamase (ESBL) and 7 (77.8%) showed levofloxacin resistance. Similarly, of 6 E. coli strains isolated by blood culture, 4 (66.7%) produced ESBL and 6 (100%) showed levofloxacin resistance. When the efficacy of antimicrobial prophylaxis (AMP) with levofloxacin for the patients undergoing transrectal or transperineal biopsy was compared between a single dose (500 mg) and that given for 2 or more days, no significant difference was observed for the rate of infection (transrectal: 0.82% vs. 1.04%, p = 0.94; transperineal: 0.30% vs. 0.46%, p = 0.68). Although a single dose of levofloxacin for AMP is sufficient to prevent genitourinary infection after transrectal or transperineal prostate biopsy, and recommended in this era of increased multi-drug resistant pathogens, the increase in fluoroquinolone-resistant E. coli and ESBL-producing E. coli has emerged as a profound problem for surveillance. (C) 2013, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Bacterial loads of Ureaplasma urealyticum contribute to development of urethritis in men

Y. Shimada, S. Ito, K. Mizutani, T. Sugawara, K. Seike, T. Tsuchiya, S. Yokoi, M. Nakano, M. Yasuda, T. Deguchi

INTERNATIONAL JOURNAL OF STD & AIDS ( SAGE PUBLICATIONS LTD )  25 ( 4 ) 294 - 298  2014年03月

　概要を見る

Ureaplasma urealyticum could be a pathogen of non-gonococcal urethritis (NGU) in men. However, ureaplasma is often detected in men without NGU, and the proportion of cases possibly attributable to this pathogen is still undefined. We attempted to determine the bacterial loads of U. urealyticum significantly associated with NGU. The 16S rRNA genes of U. urealyticum were quantified by a real-time polymerase chain reaction-based assay in first-void urine (FVU) from 26 asymptomatic and 25 symptomatic men positive for U. urealyticum. The leucocyte counts in first-void urine (FVU) were determined as an objective measure of inflammatory response to ureaplasma in the hosts by automated quantitative urine particle analysis. Positive correlations were observed between copies of the 16S rRNA genes of U. urealyticum per ml and the leucocyte counts per mu l in FVU (r = 0.49, p = 0.0003). Loads of >= 10(4) copies of the 16S rRNA gene of U. urealyticum/ml, corresponding to >= 5 x 10(3) cells of U. urealyticum/ml in FVU, were significantly associated with the presence of urethritis symptoms (p < 0.0001) and with higher leukocyte counts in FVU (p < 0.0001). The bacterial load of U. urealyticum, possibly of >= 5 x 10(3) cells of U. urealyticum/ml in FVU, could be significantly associated with the development of symptomatic NGU.

DOI PubMed

Decreased susceptibility to cephalosporins among gonococci?

Takashi Deguchi, Mitsuru Yasuda, Tomohiro Tsuchiya, Shigeaki Yokoi, Shin Ito

LANCET INFECTIOUS DISEASES ( ELSEVIER SCIENCE INC )  14 ( 3 ) 185 - 186  2014年03月

速報，短報，研究ノート等（学術雑誌）  

DOI PubMed

Investigation of the management and risk of febrile neutropenia associated with chemotherapy in the urological field: A multicenter, retrospective analysis

Koichiro Wada, Koichiro Wada, Ryuta Tanimoto, Hiroyuki Nose, Hiroyuki Nose, Shinya Uehara, Shinya Uehara, Toyohiko Watanabe, Toyohiko Watanabe, Hiroshi Hayami, Hiroshi Hayami, Shingo Nagai, Shingo Nagai, Mitsuru Yasuda, Mitsuru Yasuda, Takashi Deguchi, Takashi Deguchi, Keisuke Shigeta, Satoshi Yazawa, Satoshi Yazawa, Eiji Kikuchi, Mototsugu Oya, Mototsugu Oya, Jiro Hashimoto, Jiro Hashimoto, Teruhisa Uehara, Teruhisa Uehara, Yuichiro Kurimura, Yuichiro Kurimura, Yoshiki Hiyama, Yoshiki Hiyama, Satoshi Takahashi, Satoshi Takahashi, Taiji Tsukamoto, Taiji Tsukamoto, Takehiko Sho, Takehiko Sho, Ryoichi Hamasuna, Ryoichi Hamasuna, Jun Miyazaki, Jun Miyazaki, Yoshikazu Togo, Yoshikazu Togo, Rikiya Taoka, Rikiya Taoka, Atsushi Nakao, Atsushi Nakao, Shingo Yamamoto, Shingo Yamamoto, Kanao Kobayashi, Kanao Kobayashi, Akio Matsubara, Akio Matsubara, Kiyohito Ishikawa, Kiyohito Ishikawa, Hiromi Kumon, Hiromi Kumon, Tetsuro Matsumoto, Tetsuro Matsumoto

Japanese Journal of Chemotherapy   62   374 - 381  2014年01月

　概要を見る

In Japan, chemotherapy for urogenital malignant diseases is commonly performed by urologists and febrile neutropenia (FN) is one of the major adverse events associated with chemotherapy, however, few reports exist from the urological field about FN. In this present study, a total of 883 courses of chemotherapy (326 patients) performed from 2010 to 2011 at 10 University Hospitals were retrospectively reviewed. The regimens were GC (gemcitabine and cisplatin), GCP (gemcitabine, cisplatin and paclitaxel) and M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) for urothelial carcinoma, and EP (etoposide and cisplatin) and BEP (bleomycin, etoposide and cisplatin) for testicular cancer. In 81 courses (9.2%, 66 patients; 20.2%) including FN, antimicrobials and granulocyte-colony stimulating factor (G-CSF) were administered in 69 courses (85.2%) and in 77 courses (95.1%), respectively. The MASCC risk-index score was evaluated in no more than 51 courses (63.0%) and 1 patient with 18 points on the MASCC score died due to myelotoxicity and infections. According to statistical investigations, FN is significantly more frequent in GCP and M-VAC than in GC (p = 0.0073, <0.0001) and in a sim

Prevalence of genital mycoplasmas in asymptomatic male partners of women diagnosed as having chlamydial infections

Shin Ito, Mina Kikuchi, Kensaku Seike, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yokoi, Masahiro Nakano, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV )  20 ( 1-2 ) 143 - 145  2014年01月

　概要を見る

We examined 209 asymptomatic male partners of women diagnosed as having chlamydial infections for the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum in their first-voided urine (FVU) by nucleic acid amplification tests. Quantification of leukocytes in FVU was performed by automated urine particle analyzers. Two (1.0%) men were positive for N. gonorrhoeae, and 92 (44.0%) were positive for C trachomatis. In men negative for these pathogens, prevalences of M. genitalium, M. hominis, U. urealyticum, and U. parvum were 0.9%, 29.6%, 27.8%, and 20.1%, respectively, and 58.3% were positive for at least one species of the genital mycoplasmas. Leukocyte counts in FVU from 92 men positive for C trachomatis were significantly greater than those from 115 men negative for C trachomatis (p < 0.0001). However, there was no significant difference in leukocyte counts between 66 men positive for at least one species of M. hominis, U. urealyticum, and U. parvum and 48 men negative for all the species (p = 0.1657). The present population of asymptomatic male partners of women diagnosed as having chlamydial infections showed a low prevalence of M. genitalium infections but would be at high risk of being infected by the other genital mycoplasmas. However, it was still unclear whether these genital mycoplasmas would contribute to the development of inflammation of the male urethra. When these partners are negative for C trachomatis and N. gonorrhoeae, the recommendation to presumptively treat them to disrupt transmission networks of the genital mycoplasmas would seem premature. (C) 2013, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Assessment of antimicrobial prophylaxis to prevent perioperative infection in patients undergoing prostate brachytherapy: multicenter cohort study

Rikiya Taoka, Yoshikazu Togo, Tatsuhiko Kubo, Masahito Kido, Kenta Miki, Hiroshi Kiyota, Shin Egawa, Takashi Sugawara, Mitsuru Yasuda, Masahiro Nakano, Takashi Deguchi, Masashi Nishino, Kiyohito Ishikawa, Ryoichi Shiroki, Minori Matsumoto, Katsumi Shigemura, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Koichiro Wada, Toyohiko Watanabe, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Takehiko Sho, Ryoichi Hamasuna, Tetsuro Matsumoto, Hiroshi Hayami, Masayuki Nakagawa, Shingo Yamamoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  19 ( 5 ) 926 - 930  2013年10月

　概要を見る

To propose an appropriate prophylactic antimicrobial therapy for patients undergoing brachytherapy, we evaluated the relationships between various antimicrobial prophylaxis (AMP) protocols and the incidence of postimplant infections in a multicenter cohort study conducted in Japan. The records of 826 patients with localized prostate cancer who underwent a transperineal I-125 brachytherapy procedure between January 2009 and December 2010 were retrospectively reviewed. Perioperative infections, including surgical site and remote infections, were recorded up to postoperative day 30. A total of 6 (0.73 %) patients had a perioperative infection following seed implantation, of whom all received AMP for 1 or more days. None of the patients who received a single-dose protocol of AMP using fluoroquinolone p.o. or penicillin with a beta-lactamase inhibitor i.v. developed a perioperative infection. Statistical analysis showed that a single-dose protocol was more significantly related to a lower risk of perioperative infection as compared to the other AMP protocols examined (p = 0.045). Furthermore, our results indicated that bacteriuria and preoperative hair removal were risk factors of perioperative infection with statistical significance (p = 0.007, p = 0.004). Analysis of patient clinical parameters, including age, American Society of Anesthesiologists score, diabetes mellitus, prostate volume, numbers of implanted seeds and needle punctures, operation time, and indwelling duration time of the Foley catheter, did not reveal significant differences in terms of perioperative infection. Our results indicated that a single-dose AMP protocol is sufficient to prevent perioperative infections following seed implantation. On the other hand, AMP is only one of several measures to prevent perioperative infectious complications. It is necessary to know that the patient must have no bacteriuria and that preoperative hair removal should be avoided.

DOI PubMed

Prevalence and morbidity of urethral Trichomonas vaginalis in Japanese men with or without urethritis

Kensaku Seike, Shin-Ichi Maeda, Yasuaki Kubota, Masayoshi Tamaki, Mitsuru Yasuda, Takashi Deguchi

SEXUALLY TRANSMITTED INFECTIONS ( BMJ PUBLISHING GROUP )  89 ( 6 ) 528 - 530  2013年09月

　概要を見る

Objectives Trichomonas vaginalis is one of the pathogens causing sexually transmitted infections. This microorganism is a common pathogen among women, but its significance as a cause of morbidity among men remains uncertain. We sought to determine the prevalence and morbidity of T. vaginalis infection in Japanese men with and without urethritis. Methods We examined urine specimens from 215 men with urethritis and 98 men without urethritis for the presence of urethral T. vaginalis by PCR assay. Results Only four patients-one with gonococcal urethritis, one with non-gonococcal chlamydial urethritis, one with non-gonococcal non-chlamydial urethritis and one without urethritis-were positive for T. vaginalis. The prevalence of T. vaginalis was 1.4% in men with urethritis and 1.0% in men without urethritis. A possible relation between the appearance of T. vaginalis and clinical symptoms was not confirmed. Conclusions In the present study, the incidence of urethral T. vaginalis infection appears to be rare in Japanese men with or without urethritis, and T. vaginalis may be an uncommon pathogen in male urethritis in Japan.

DOI PubMed

Nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan

Ryoichi Hamasuna, Mitsuru Yasuda, Kiyohito Ishikawa, Shinya Uehara, Satoshi Takahashi, Hiroshi Hayami, Shingo Yamamoto, Tetsuro Matsumoto, Shinichi Minamitani, Akira Watanabe, Aikichi Iwamoto, Kyoichi Totsuka, Junichi Kadota, Keisuke Sunakawa, Junko Sato, Hideaki Hanaki, Taiji Tsukamoto, Hiroshi Kiyota, Shin Egawa, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Seiji Naito, Katsunori Tatsugami, Shin Ito, Harunori Narita, Mototsugu Kanokogi, Toru Sumii, Kenji Ito, Takahide Hosobe, Shuichi Kawai, Hiromi Kawano, Kazuo Takayama, Takamasa Yamaguchi, Katsuhisa Endo, Takamine Yamauchi, Shinichi Maeda, Mutsumasa Yoh, Masanobu Horie, Masayasu Ito, Hirofumi Chokyu, Hideari Ihara, Kikuo Akiyama, Satoshi Uno, Koichi Monden, Shinichi Kaji, Hirofumi Nishimura, Motoshi Kawahara, Takashi Sato, Takatoshi Konishi, Shohei Nishi, Satoshi Ishihara, Masaru Yoshioka

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  19 ( 4 ) 571 - 578  2013年08月

　概要を見る

Neisseria gonorrhoeae is one of the most important pathogens causing sexually transmitted infection, and strains that are resistant to several antimicrobials are increasing. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the first nationwide surveillance. The urethral discharge was collected from male patients with urethritis at 51 medical facilities from April 2009 to October 2010. Of the 156 specimens, 83 N. gonorrhoeae strains were tested for susceptibility to 18 antimicrobial agents. The prevalence of beta-lactamase-producing strains and chromosomally mediated resistant strains were 7.2 % and 16.5 %, respectively. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) of ceftriaxone for 7 strains (8.4 %) was 0.125 mu g/ml. One strain was resistant to cefixime (MIC 0.5 mu g/ml). The MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin, and tosufloxacin, showed a bimodal distribution. The MIC of sitafloxacin was lower than those of the three fluoroquinolones listed here, and it was found that the antimicrobial activity of sitafloxacin was stronger than that of the fluoroquinolones. The MIC of azithromycin in 2 strains was 2 mu g/ml, but no high-level resistance to macrolides was detected.

DOI PubMed

泌尿器科領域における周術期感染症予防抗菌薬の使用状況についてのアンケート調査報告

東郷 容和, 田岡 利宜也, 山本 新吾, 桧山 佳樹, 上原 央久, 橋本 次朗, 栗村 雄一郎, 高橋 聡, 塚本 泰司, 宮崎 淳, 西山 博之, 清田 浩, 矢澤 聰, 大家 基嗣, 安田 満, 出口 隆, 石川 清仁, 星長 清隆, 松本 穣, 重村 克巳, 田中 一志, 荒川 創一, 藤澤 正人, 和田 耕一郎, 上原 慎也, 渡辺 豊彦, 公文 裕巳, 小林 加直, 松原 昭郎, 松本 正広, 庄 武彦, 濱砂 良一, 松本 哲朗, 速見 浩士, 山根 隆史, 中川 昌之, UTI共同研究会ガイドライン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 )  104 ( 4 ) 579 - 588  2013年07月

　概要を見る

(目的)「泌尿器科領域における周術期感染予防ガイドライン(2006)」の改訂にあたり、日本における周術期感染症に対しての予防抗菌薬の投与方法の現状を把握する。(対象と方法)日本泌尿器科学会の承認を得て、2011年に各施設において周術期感染症予防抗菌薬の投与方法についてのアンケート調査を専門医基幹教育施設836施設に依頼し、446施設(回答率53.3%)から回答を得た。(結果)周術期感染予防ガイドラインの遵守について、遵守している6.5%、おおむね遵守している69.7%、あまり遵守していない22.0%、まったく遵守していない1.6%、であった。術式・検査別の遵守率では、開腹清潔手術48.5%、開腹準清潔手術66.4%、開腹消化管利用手術61.8%、腹腔鏡清潔手術54.1%、腹腔鏡準清潔手術61.2%、TURBT71.5%、TURP68.9%、経尿道的尿管検査・手術68.2%、前立腺生検43.2%、膀胱尿道鏡検査42.2%、であった。投与日数においては、清潔手術、TURBT、経尿道的尿管検査・手術、前立腺生検、膀胱尿道鏡検査でガイドラインよりも長期に設定している施設が多くみられた。(結論)使用抗菌薬の種類に関しては、いずれの術式においても概ね遵守されていたが、抗菌薬の投与期間が長期に設定されている施設もみられた。(著者抄録)

Susceptibilities of Neisseria gonorrhoeae to antimicrobial agents from 2000 to 2011 in Japan

M. Yasuda, S. Ito, K. Miyata, S. Ishihara, S. Maeda, T. Deguchi

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV )  42   S76 - S76  2013年06月

研究発表ペーパー・要旨（国際会議）  

Case of endogenous endophthalmitis caused by Klebsiella pneumoniae with magA and rmpA genes in an immunocompetent patient

Akira Sawada, Shinya Komori, Kazunari Udo, Shinsuke Suemori, Kiyofumi Mochizuki, Mitsuru Yasuda, Kiyofumi Ohkusu

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  19 ( 2 ) 326 - 329  2013年04月

　概要を見る

We report a case of endogenous endophthalmitis caused by Klebsiella pneumoniae in an immunocompetent patient. A 73-year-old man with acute epididymitis who had no history of diabetes mellitus developed endogenous endophthalmitis. The patient underwent anterior vitrectomy and intracapsular cataract extraction with intravitreal injections of both vancomycin and ceftazidime. After the surgery, he was treated with topical and intravenous antibiotics; however, the left eye perforated and was enucleated. Culture from vitreous biopsy specimens grew as K. pneumoniae, which was positive for both magA and rmpA. K. pneumoniae should be considered as a pathogen that can cause severe endogenous endophthalmitis in patients with urinary tract infection. The severity of the disease may be related to the virulence genes.

DOI PubMed

Contribution of Topoisomerase IV Mutation to Quinolone Resistance in Mycoplasma genitalium

Yuko Yamaguchi, Masaya Takei, Ryuta Kishii, Mitsuru Yasuda, Takashi Deguchi

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  57 ( 4 ) 1772 - 1776  2013年04月

　概要を見る

The mechanism of quinolone resistance in Mycoplasma genitalium remains poorly understood due to difficulties with in vitro culture, especially of clinical isolates. In this study, to confirm the association between mutations in topoisomerases and antimicrobial susceptibilities to quinolones, ciprofloxacin-resistant mutant strains were selected using the cultivable type strain ATCC 33530. Sequence analysis revealed that the mutant strains harbored mutations in topoisomerase IV: Gly81Cys in ParC, Pro261Thr in ParC, or Asn466Lys in ParE. The MICs of all quinolones tested against the mutant strains were 2- to 16-fold higher than those against the wild-type strain. No cross-resistance was observed with macrolides or tetracyclines. We determined the inhibitory activities of quinolones against DNA gyrase and topoisomerase IV in order to investigate the correlation between antimicrobial susceptibility and inhibitory activity against the target enzymes, considered the primary targets of quinolones. Furthermore, using enzymatic analysis, we confirmed that Gly81Cys in the ParC quinolone resistance-determining region (QRDR) contributed to quinolone resistance. This is the first study to isolate quinolone-resistant mutant strains of M. genitalium harboring substitutions in the parC or parE gene in vitro and to measure the inhibitory activities against the purified topoisomerases of M. genitalium.

DOI PubMed

A randomized clinical trial to evaluate the preventive effect of cranberry juice (UR65) for patients with recurrent urinary tract infection

Satoshi Takahashi, Ryoichi Hamasuna, Mitsuru Yasuda, Soichi Arakawa, Kazushi Tanaka, Kiyohito Ishikawa, Hiroshi Kiyota, Hiroshi Hayami, Shingo Yamamoto, Tatsuhiko Kubo, Tetsuro Matsumoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  19 ( 1 ) 112 - 117  2013年02月

　概要を見る

We examined the rate of relapse, as a variable index, in patients with urinary tract infection (UTI) who suffered from multiple relapses when using cranberry juice (UR65). A randomized, placebo-controlled, double-blind study was conducted from October 2007 to September 2009 in Japan. The subjects were outpatients aged 20 to 79 years who were randomly divided into two groups. One group received cranberry juice (group A) and the other a placebo beverage (group P). To keep the conditions blind, the color and taste of the beverages were adjusted. The subjects drank 1 bottle (125 mL) of cranberry juice or the placebo beverage once daily, before going to sleep, for 24 weeks. The primary endpoint was relapse of UTI. In the group of females aged 50 years or more, there was a significant difference in the rate of relapse of UTI between groups A and P (log-rank test; p = 0.0425). In this subgroup analysis, relapse of UTI was observed in 16 of 55 (29.1 %) patients in group A and 31 of 63 (49.2 %) in group P. In this study, cranberry juice prevented the recurrence of UTI in a limited female population with 24-week intake of the beverage.

DOI PubMed

Analysis of the quinolone-resistance determining region of the gyrA gene and the analogous region of the parC gene in Ureaplasma parvum and Ureaplasma urealyticum detected in first-void urine of men with non-gonococcal urethritis

Yasuyoshi Kamiya, Yasushi Shimada, Shin Ito, Mina Kikuchi, Mitsuru Yasuda, Yoshiaki Kawamura, Takashi Deguchi

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  68 ( 2 ) 480 - 482  2013年02月

速報，短報，研究ノート等（学術雑誌）  

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