研究者詳細 - 安田　満

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The nationwide study of bacterial pathogens associated with urinary tract infections conducted by the Japanese Society of Chemotherapy

Kiyohito Ishikawa, Tetsuro Matsumoto, Mitsuru Yasuda, Shinya Uehara, Tetsuro Muratani, Morimasa Yagisawa, Junko Sato, Yoshihito Niki, Kyoichi Totsuka, Keisuke Sunakawa, Hideaki Hanaki, Rikizo Hattori, Michinori Terada, Tsuneo Kozuki, Akinori Maruo, Kohei Morita, Kazuhiko Ogasawara, Yoshisaburo Takahashi, Kenji Matsuda, Takaoki Hirose, Noriomi Miyao, Tasuku Hayashi, Koh Takeyama, Hiroshi Kiyota, Masayuki Tomita, Hisashi Yusu, Haruhisa Koide, Shoji Kimura, Masanori Yanaoka, Hajime Sato, Toru Ito, Takashi Deguchi, Yoshinori Fujimoto, Hisao Komeda, Yuko Asano, Yoshito Takahashi, Satoshi Ishihara, Soichi Arakawa, Yuzo Nakano, Kazushi Tanaka, Masato Fujisawa, Takashi Matsui, Akira Fujii, Shingo Yamamoto, Michio Nojima, Yoshihide Higuchi, Yasuo Ueda, Sojun Kanamaru, Koichi Monden, Tomoyasu Tsushima, Yuko Seno, Masaya Tsugawa, Tadasu Takenaka, Ryoichi Hamasuna, Naohiro Fujimoto, Takehiko Sho, Koichi Takahashi, Hisato Inatomi, Naoya Takahashi, Yoshihiko Ikei, Hiroshi Hayami, Takashi Yamane, Masayuki Nakagawa, Satoru Kariya, Takashi Arima

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO ) 17 ( 1 ) 126 - 138 2011年02月

This study was conducted by the Japanese Society of Chemotherapy and is the first nationwide study on bacterial pathogens isolated from patients with urinary tract infections at 28 hospitals throughout Japan between January 2008 and June 2008. A total of 688 bacterial strains were isolated from adult patients with urinary tract infections. The strains investigated in this study are as follows: Enterococcus faecalis (n = 140), Escherichia coli (n = 255), Klebsiella pneumoniae (n = 93), Proteus mirabilis (n = 42), Serratia marcescens (n = 44), and Pseudomonas aeruginosa (n = 114). The minimum inhibitory concentrations of 39 antibacterial agents used for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. All Enterococcus faecalis strains were susceptible to ampicillin and vancomycin. Although a majority of the E. faecalis strains were susceptible to linezolid, 11 strains (7.8%) were found to be intermediately resistant. The proportions of fluoroquinolone-resistant Enterococcus faecalis, Escherichia coli, Proteus mirabilis, and S. marcescens strains were 35.7%, 29.3%, 18.3%, and 15.2%, respectively. The proportions of E. coli, P. mirabilis, K. pneumoniae, and S. marcescens strains producing extended-spectrum beta-lactamase were 5.1%, 11.9%, 0%, and 0%, respectively. The proportions of Pseudomonas aeruginosa strains resistant to carbapenems, aminoglycosides, and fluoroquinolones were 9.2%, 4.4%, and 34.8%, respectively, and among them, 2 strains (1.8%) were found to be multidrug resistant. These data present important information for the proper treatment of urinary tract infections and will serve as a useful reference for periodic surveillance studies in the future.

DOI PubMed

右心房内に転移を来たした腎細胞癌の1例

中根慶太, 佐藤啓美, 菊地美奈, 清家健作, 石田健一郎, 小島圭太郎, 三輪好生, 安田満, 横井繁明, 仲野正博, 出口隆, 石田成吏洋, 竹村博文

泌尿器科紀要 ( 泌尿器科紀要刊行会 ) 56 ( 12 ) 722 - 722 2010年12月

gyrB and parE mutations in urinary Mycoplasma genitalium DNA from men with non-gonococcal urethritis

Takashi Deguchi, Yuko Yamaguchi, Mitsuru Yasuda, Keita Nakane, Shigeaki Yokoi, Shin-ichi Ito, Masahiro Nakano, Shin Ito, Hiroaki Ishiko

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV ) 36 ( 5 ) 477 - 478 2010年11月

速報，短報，研究ノート等（学術雑誌）

DOI PubMed

Emergence and Spread of Drug Resistant Neisseria gonorrhoeae

Takashi Deguchi, Keita Nakane, Mitsuru Yasuda, Shin-ichi Maeda

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC ) 184 ( 3 ) 851 - 858 2010年09月

Purpose: The emergence and spread of Neisseria gonorrhoeae with resistance to oral antibiotics have led to difficulty in treating gonorrhea. We review drug resistance in N. gonorrhoeae with a particular emphasis on resistance to fluoroquinolones, cefixime and azithromycin. Materials and Methods: Literature selected from peer reviewed journals listed in MEDLINE (R)/PubMed (R) from 1943 to 2009 and from resources cited in those articles was reviewed comprehensively. Results: Due to the spread of fluoroquinolone resistant N. gonorrhoeae fluoroquinolones are no longer recommended for the treatment of gonorrhea. The emergence of N. gonorrhoeae with a mosaic penicillin-binding protein 2 associated with oral cephalosporin resistance has threatened cefixime treatment for gonorrhea. Emergence of N. gonorrhoeae with high level resistance to azithromycin has also been documented. However, injectable antibiotics (sepctinomycin and ceftriaxone) retain their activity against N. gonorrhoeae. To monitor drug resistance in N. gonorrhoeae several national and international programs have become functional. Conclusions: Oral regimens for the treatment of gonorrhea are limited. At present to our knowledge ceftriaxone is the most reliable and available agent for the treatment of gonorrhea. To prevent the further emergence and international spread of drug resistance, and allow for the selection of appropriate treatments, a comprehensive global program is needed including surveillance for drug resistance in N. gonorrhoeae and collection of patient epidemiological data. Clinicians should effectively treat patients with gonorrhea, always being conscious of local trends of drug resistance in N. gonorrhoeae, and should perform culture and antimicrobial susceptibility testing in those with persistent gonorrhea after treatment.

DOI PubMed

Emergence of clinical strains of Mycoplasma genitalium harbouring alterations in ParC associated with fluoroquinolone resistance

Yasushi Shimada, Takashi Deguchi, Keita Nakane, Takako Masue, Mitsuru Yasuda, Shigeaki Yokoi, Shin-ichi Ito, Masahiro Nakano, Shin Ito, Hiroaki Ishiko

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV ) 36 ( 3 ) 255 - 258 2010年09月

Surveillance for antimicrobial resistance in Mycoplasma genitalium clinical strains is extremely limited as culturing of strains from clinical specimens is still difficult. We therefore conducted a non-cultural assessment of fluoroquinolone resistance of M. genitalium clinical strains by analysing the quinolone-resistance determining regions (QRDRs) of the gyrA and parC genes. The QRDRs amplified from M. genitalium DNA taken from urine specimens of 28 men with non-gonococcal urethritis positive for M. genitalium by polymerase chain reaction were sequenced. An amino acid change (Phe-108 -> Iso) in GyrA was found in one specimen, and the same change was accompanied by an amino acid change (Lys-97 -> Arg) in ParC in another specimen. A single amino acid change (Ser-83 -> Asn, Asp-87 -> Tyr or Asp-87 -> Val) in ParC was also found in three other respective specimens without alterations in GyrA. No alterations in GyrA and ParC were found in the remaining 23 specimens. The alterations of Ser-83 -> Asn, Asp-87 -> Tyr and Asp-87 -> Val in ParC found in 3 (10.7%) of 28 specimens were analogous to those commonly observed in fluoroquinolone-resistant mutants of other Mycoplasma and Ureaplasma spp. M. genitalium harbouring mutations associated with fluoroquinolone resistance in the parC gene may have emerged clinically and the prevalence may be ca. 10% in Japan. (C) 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

DOI PubMed

Sensitivity of major causative urinary tract infection bacteria to various antimicrobial agents

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

Japanese Journal of Chemotherapy 58 466 - 482 2010年07月

We studied causative bacteria type and distribution by disease and sensitivity to antimicrobial agents, and risk factors for detecting quinolone-resistant Escherichia coli in case of acute uncomplicated cystitis or complicated cystitis and urine-sample bacteria isolation and cultivation. We isolated 1,699 strains from 1,317 subjects with acute uncomplicated cystitis, including E. coli (58.9%), Enterococcus faecalis (13.4%), Streptococcus agalactiae (4.6%), Klebsiella pneumoniae (3.6%), and Staphylococcus epidermidis (3.4%). We also isolated 880 from 643 with complicated cystitis, including E. coli (34.7%), E. faecalis (19.9%), Pseudomonas aeruginosa (4.9%), K. pneumoniae (4.9%), and S. agalactiae (4.5%). The sensitivity of E. coli isolated from acute uncomplicated cystitis for fluoroquinolone (FQs) and cephem (CEPs) agents was ≥90%. The sensitivity of E. coli isolated from complicated cystitis for FQs was 67.5-86.9%, showing the highest sensitivity for STFX. The sensitivity for CEPs was 83.9-88.5%. A study of risk factors for detecting quinolone-resistant E. coli (MIC of LVFX ≥4 μg/mL), significant differences were observed for cases involving the following 5 items: ≥2 cysti

男子性器感染症における役割

安田満

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases 21 ( 1 ) 22 - 27 2010年06月

CiNii

オーラルセックスにより男子マイコプラズマ性尿道炎およびウレアプラズマ性尿道炎は引き起こされるか?

前田真一, 清家健作, 久保田恵章, 安田満, 出口隆

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases 21 ( 1 ) 115 - 119 2010年06月

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Microbiological outcome of complicated urinary tract infections treated with levofloxacin: a pharmacokinetic/pharmacodynamic analysis

Takashi Deguchi, Keita Nakane, Mitsuru Yasuda, Takako Shimizu, Koichi Monden, Soichi Arakawa, Tetsuro Matsumoto

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV ) 35 ( 6 ) 573 - 577 2010年06月

The pharmacodynamic targets representing 90% probability thresholds for bacterial eradication were determined in patients with complicated urinary tract infections (UTIs) treated with 500 mg of levofloxacin every 24 h for 7-14 days. Of 241 pre-treatment strains from 156 patients, 21 strains persisted after treatment. In each patient, plasma concentrations of levofloxacin were simulated based on population pharmacokinetic parameters and patient-specific data. Minimum inhibitory concentrations (MICs) of levofloxacin for the pre-treatment strains determined in our previous study were used. The pharmacodynamic targets representing 90% probability thresholds for bacterial eradication were determined by logistic regression analyses. For all the isolates, Gram-negative bacilli, Gram-positive cocci, Escherichia coli and Enterococcus faecalis, the target values of the area under the concentration-time curve (AUC)/MIC were 14.65, 31.46, 4.85, 43.00 and 3.06, respectively, and the targets of the maximum plasma concentration (C(max))/MIC were 1.22, 2.74, 0.39, 3.61 and 0.25, respectively. Such thresholds of AUC/MIC and C(max)/MIC in complicated UTIs would be lower than those in infections of other sites. In particular, the C(max)/MIC thresholds for Gram-positive cocci and E. faecalis were < 1. These findings suggested that, in addition to its plasma concentration, the high concentration of levofloxacin in the urine might play a role in eradicating bacteria. (C) 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

DOI PubMed

Drug resistant bacteria on urinary tract infection and sexually transmitted infection

Mitsuru Yasuda

Japanese Journal of Clinical Urology ( 医学書院 ) 64 ( 5 ) 289 - 295 2010年04月

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Failure to detect Mycoplasma genitalium in the pharynges of female sex workers in Japan

Takashi Deguchi, Mitsuru Yasuda, Shigeaki Yokoi, Masahiro Nakano, Shin-Ichi Ito, Kiyofumi Ohkusu, Takayuki Ezaki, Shinji Hoshina

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV ) 15 ( 6 ) 410 - 413 2009年12月

To determine the prevalence of genital mycoplasmas and ureaplasmas in the pharynges of Japanese female sex workers practicing fellatio on their clients, vaginal swabs and throat washings were collected from 403 female sex workers attending a clinic in Kyoto, Japan, for regular screening of gonococcal and chlamydial infections. Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum in vaginal and throat specimens were tested by nucleic acid amplification tests. The prevalence of N. gonorrhoeae, C. trachomatis, M. genitalium, M. hominis, U. parvum, and U. urealyticum in the genitals was 1.7%, 7.2%, 1.7%, 19.6%, 40.4%, and 10.2%, respectively, whereas their prevalence in the pharynges was 4.0%, 2.0%, 0%, 1.2%, 0.2%, and 0.7%, respectively. Gonococcal infection in the pharynx was significantly associated with gonococcal infection in the genitals. Chlamydial infection in the pharynx was also significantly associated with chlamydial infection in the genitals. M. hominis, U. parvum, and U. urealyticum were all detected in vaginal swabs and in throat washings; however, M. genitalium was detected in vaginal swabs but not in throat washings. For each of these genital mycoplasmas and ureaplasmas, a positive test result in the pharynx was not significantly associated with a positive result in the genitals. M. hominis, U. parvum, and U. urealyticum were detected in throat washings, but M. genitalium was not. These findings do not necessarily rule out the transmission of M. genitalium from the pharynx to the urethra by orogenital sex.

DOI PubMed

Retrospective Cohort Chart Review Study of Factors Associated With the Development of Thrombocytopenia in Adult Japanese Patients Who Received Intravenous Linezolid Therapy

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

CLINICAL THERAPEUTICS ( ELSEVIER ) 31 ( 10 ) 2126 - 2133 2009年10月

Background: 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. Objective: The aim of the present study was to investigate the risk factors associated with the development of thrombocytopenia in adult Japanese patients who received intravenous linezolid therapy. Methods: This was a retrospective review of the medical charts of patients who were treated with linezolid 600 mg IV BID (q12h) between June 2006 and March 2008 at Gifu University Hospital in Gifu, Japan. Data were extracted from the electronic medical records obtained from a central database in the hospital. Thrombocytopenia was defined as a decrease in platelet count of >= 25% and a final platelet count of <100 X 10(3)/mm(3). Risk factors associated with thrombocytopenia in patients who received linezolid were identified via logistic regression analysis. Results: In total, 42 patients (31 men and 11 women; mean [SD] age, 59.6 [12.8] years [range, 33-85 years]) were included in the study. The mean duration of linezolid therapy was 13.6 (10.1) days, with a range of 3 to 48 days. Seven patients with renal insufficiency received hemodialysis before linezolid infusion. Thrombocytopenia occurred in 7 patients (16.7%). Among the 7 patients with renal insufficiency, 2 patients (28.6%) developed severe thrombocytopenia, requiring platelet transfusion. In univariate analysis, a high daily dose of >= 22 mg/kg (odds ratio [OR] = 20.25; 9.5% CI, 2.115-193.9; P = 0.009), low baseline platelet count of <200 x 10(3)/mm(3) (OR = 8.437; 95% CI, 1.367-52.06), and lowered creatinine clearance of <30 mL/min (OR = 6.444; 95% CI, 1.136-36.57) were significant factors for thrombocytopenia associated with linezolid therapy; however, in multivariate analysis, only daily dose (>= 22 mg/kg) was a significant risk factor for thrombocytopenia associated with linezolid therapy. Conclusions: The daily dose of >= 22 mg/kg was a significant risk factor associated with thrombocytopenia in patients who received linezolid therapy. Prospective studies comparing the efficacy and safety profile of linezolid in patients receiving a conventional dose (600 mg q12h) and those receiving a weight-adjusted dose are needed to determine an adequate dose of linezolid, particularly in patients with renal insufficiency or low baseline platelet count. (Clin Ther. 2009;31:2126-2133) (C) 2009 Excerpta Medica Inc.

DOI PubMed

男子初尿からの淋菌、Chlamydia trachomatis 検出における APTIMA Combo 2 とAMPLICOR STD-1の比較

伊藤晋, 前田真一, 安田満, 出口隆

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases 20 ( 1 ) 122 - 126 2009年07月

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Ureaplasma urealyticum (biovar 2) の男子非淋菌性尿道炎への関与は一定ではない

伊藤晋, 島田康司, 落合晋, 前田真一, 安田満, 出口隆

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases 20 ( 1 ) 140 - 146 2009年07月

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Genetic Profiles of Fluoroquinolone-Resistant Escherichia coli Isolates Obtained from Patients with Cystitis: Phylogeny, Virulence Factors, PAIusp Subtypes, and Mutation Patterns

Akira Takahashi, Tetsuro Muratani, Mitsuru Yasuda, Satoshi Takahashi, Koichi Monden, Kiyohito Ishikawa, Hiroshi Kiyota, Soichi Arakawa, Tetsuro Matsumoto, Hiroki Shima, Hisao Kurazono, Shingo Yamamoto

JOURNAL OF CLINICAL MICROBIOLOGY ( AMER SOC MICROBIOLOGY ) 47 ( 3 ) 791 - 795 2009年03月

The low virulence of quinolone- and fluoroquinolone-resistant Escherichia coli strains is known, although the reasons for this remain unclear. We surveyed the mutation patterns of quinolone resistance determining regions (QRDRs), phylogenetic distribution, prevalence of 18 urovirulence genes, and PAIusp subtypes in 89 fluoroquinolone-resistant E. coli (FQREC) isolates obtained from patients with cystitis and compared them with those of their fluoroquinolone-susceptible counterparts (FQSEC). Phylogenetic group B2 was significantly less prevalent in FQREC than in FQSEC (49% versus 78%; P = 0.0138), but it still dominated, followed by phylogroup D (35%), in FQREC. When the prevalences of virulence factor (VF) genes were compared between FQREC and FQSEC, sfa/foc, cnf1, hly, kpsMT, ompT, ibeA, usp, and iroN showed significantly lower prevalences in FQREC than in FQSEC (1.1% versus 24% [P < 0.0001], 0% versus 29% [P < 0.0001], 7.9% versus 33% [P < 0.0001], 74% versus 90% [P = 0.01], 71% versus 87% [P = 0.017], 5.6% versus 37% [P < 0.0001], 54% versus 82% [P < 0.0001], and 7.9% versus 32% [P = 0.0001], respectively), whereas aer, iha, and ETTT showed significantly higher prevalences in FQREC (85% versus 36% [P < 0.0001], 66% versus 29% [P < 0.0001], and 53% versus 16% [P < 0.0001], respectively). Furthermore, a similar difference in prevalences of uropathogenic VF genes was seen between FQREC and FQSEC in phylogroup B2. This indicated that the low virulence in FQREC was intimately correlated with a lesser distribution of VFs in phylogroup B2, which dominated in FQREC and FQSEC. It was interesting that the mutation pattern of Ser83Leu and Asp87Asn encoded in gyrA and Ser80Ile and Glu84Val encoded in parC was frequently found in FQREC isolates that belonged to phylogroup B2 and that most of these isolates showed PAIusp subtype 2a. PAIusp subtypes 1a, 1b, and 2b, which were frequently seen in FQSEC, were rarely found in FQREC. These results suggested that the acquisition of fluoroquinolone resistance, e. g., mutations in QRDRs, might be a specific event in limited strains, such as those that possess PAIusp subtype 2a in phylogroup B2.

DOI PubMed

Azithromycin treatment for nongonococcal urethritis negative for Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum

Shin-ichi Maeda, Mitsuru Yasuda, Shin Ito, Kensaku Seike, Shin-ichi Ito, Takashi Deguchi

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY ) 16 ( 2 ) 215 - 216 2009年02月

Some patients with nongonococcal urethritis (NGU) are negative for Chlamydia trachomatis, mycoplasmas, and ureaplasmas. The optimal antimicrobial chemotherapy for such NGU has not fully been clarified. We assessed the efficacy of azithromycin for treatment of nonmycoplasmal, nonureaplasmal, nonchlamydial NGU (NMNUNCNGU). Thirty-eight men whose first-pass urine was negative for Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum were treated with a single dose of 1 g azithromycin. Urethritis symptoms and polymorphonuclear leukocytes in urethral smears or in first-pass urine were assessed before and after treatment with azithromycin. Thirty-two (84.2%) of the 38 men with NMNUNCNGU showed no signs of urethral inflammation after treatment. The efficacy of this azithromycin regimen was comparable to that of the 7-day regimen of levofloxacin, gatifloxacin, minocycline, or clarithromycin reported previously. A single dose of 1 g azithromycin, which is effective not only for NGU due to specific pathogens but also for NMNUNCNGU, is an appropriate treatment for NGU.

DOI PubMed

Non-chlamydial non-gonococcal urethritis

Takashi Deguchi, Mitsuru Yasuda, Shin ichi Maeda

Nippon rinsho. Japanese journal of clinical medicine ( 日本臨床社 ) 67 ( 1 ) 167 - 171 2009年01月

Besides Chlamydia trachomatis, various microorganisms could cause non-gonococcal urethritis (NGU). Recently, Mycoplasma genitalium and Ureaplasma urealyticum (biovar 2) have been suggested to be other pathogens of NGU independent of C. trachomatis. Clinical findings of non-chlamydial NGU, including M. genitalium--or U. urealyticum-postive NGU, are not different from those of chlamydial NGU. M. genitalium and U. urealyticum (biovar 2) are susceptible to tetracyclines, macrolides, and fluoroquinolones. However, the post-treatment presence of M. genitalium in the urethra is significantly associated with persistent or recurrent urethritis. Eradication of this mycoplasma from the urethra is essential for managing M. genitalium-positive NGU. In treatment of non-chlamydial NGU, therefore, the antimicrobial agents that are active against M. genitalium should be chosen.

PubMed CiNii

Acute renal failure due to bilateral ureteral stone impaction in an HIV-positive patient

Yoji Moriyama, Yuzuru Minamidate, Mitsuru Yasuda, Hidetoshi Ehara, Mina Kikuchi, Tomohiro Tsuchiya, Takashi Deguchi, Hisashi Tsurumi

UROLOGICAL RESEARCH ( SPRINGER ) 36 ( 5 ) 275 - 277 2008年10月

A 51-year-old HIV-positive man treated with atazanavir for 9 months presented with anuria following right flank pain. Laboratory examination indicated renal insufficiency, and abdominopelvic computed tomography scanning showed bilateral hydroureteronephrosis, but no stones were visualized. Endoscopic procedures were performed to investigate the causes of ureteral obstruction and, if possible, to insert Double-J stents in the ureters. A yellowish stone composed of pure atazanavir was found at the right ureteral orifice, and retrograde pyelography revealed a filling defect in the left ureter found to be caused by an atazanavir stone. The patient's renal function recovered after removal of these stones.

DOI PubMed

Lack of nationwide surveillance of antimicrobial resistance of Neisseria gonorrhoeae in Japan

Takashi Deguchi, Mitsuru Yasuda, Shin-Ichi Maeda

Annals of Internal Medicine ( American College of Physicians ) 149 ( 5 ) 363 - 364 2008年09月

速報，短報，研究ノート等（学術雑誌）

DOI PubMed

非クラミジア・非淋菌感染,その他--HB,赤痢アメーバ,梅毒など (特集性感染症) -- (おもな性感染症)

安田満, 出口隆

小児科診療 ( 診断と治療社 ) 71 ( 8 ) 1301 - 1310 2008年08月

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