Misc - 安田　満

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

Shin Ichi Maeda, Masayoshi Tamaki, Keitaro Kojima, Takashi Yoshida, Hiroaki Ishiko, Mitsuru Yasuda, Takashi Deguchi, Takashi Deguchi

Sexually Transmitted Diseases   28   472 - 476  2026年

　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.

PubMed

致死的な重症呼吸器感染症を引き起こすアデノウイルスB7dによる尿道炎症例

花岡希, 野尻直未, 小長谷昌未, 藤本嗣人, 伊藤晋, 安田満, 安田満, 出口隆

IASR (Web)   42 ( 4 )  2021年

J-GLOBAL

膀胱Nephrogenic adenomaの1例

大澤 華織, 竹内 慎一, 飯沼 光司, 前川 由佳, 堀江 憲吾, 加藤 卓, 山田 佳輝, 中根 慶太, 水谷 晃輔, 土屋 朋大, 安田 満, 仲野 正博, 酒々井 夏子

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  64 ( 12 ) 524 - 524  2018年12月

陰茎癌におけるHPV感染の役割と発癌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, 小堀 善友, 出口 隆, 溝上 敦

日本性感染症学会誌 ( (一社)日本性感染症学会 )  29 ( 2 ) 255 - 255  2018年10月

女子尿道憩室に発生したAdenocarcinomaの1例

竹内 慎一, 中井 千愛, 高井 学, 亀山 紘司, 山田 佳輝, 中根 慶太, 水谷 晃輔, 土屋 朋大, 安田 満, 横井 繁明, 仲野 正博, 出口 隆, 酒々井 夏子

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  64 ( 10 ) 421 - 421  2018年10月

女子尿道憩室に発生したAdenocarcinomaの1例

竹内 慎一, 中井 千愛, 高井 学, 亀山 紘司, 山田 佳輝, 中根 慶太, 水谷 晃輔, 土屋 朋大, 安田 満, 横井 繁明, 仲野 正博, 出口 隆, 酒々井 夏子

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  64 ( 10 ) 421 - 421  2018年10月

陰茎癌におけるHPV感染の役割と発癌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, 小堀 善友, 出口 隆, 溝上 敦

日本性感染症学会誌 ( (一社)日本性感染症学会 )  29 ( 2 ) 255 - 255  2018年10月

淋菌性尿道炎患者における徐放性アジスロマイシンの有効性の評価 母集団薬物動態解析とシミュレーションによる有効性予測

曽田 翠, 松丸 直樹, 長瀬 泉, 伊藤 晋, 安田 満, 塚本 桂, 出口 隆, 北市 清幸

TDM研究 ( (一社)日本TDM学会 )  35 ( 2 ) 118 - 118  2018年05月

淋菌に対する各種抗菌薬感受性の変化・現況 セフトリアキソン、スペクチノマイシンは有効だが、ほとんどの使用薬剤に耐性を獲得

安田 満, 重原 一慶

日本医事新報 ( (株)日本医事新報社 )  ( 4895 ) 53 - 54  2018年02月

Human mastadenovirusにおける尿道炎発症に関わるサイトの探索

飯田 雅, 花岡 希, 藤本 嗣人, 伊藤 晋, 出口 隆, 安田 満, 小柳 香奈子, 渡邉 日出海

日本性感染症学会誌 ( (一社)日本性感染症学会 )  28 ( 2 ) 202 - 202  2017年11月

2016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報告

安田 満, 伊藤 晋, 小島 宗門, 楊 睦正, 成田 晴紀, 木戸 晃, 岩澤 晶彦, 松木 孝和, 宮田 和豊, 出口 隆, 旗崎 恭子, 伊藤 雅康, 竹内 敏視, 上床 典康, 土屋 博, 藤本 佳則, 澤村 治樹, 楠山 弘之, 花井 俊典, 内島 豊, 宮村 隆三, 沼崎 進, 重原 一慶, 濱野 公成, 米田 尚生, 岡野 学, 長谷川 徹, 伊藤 康久, 林 秀治, 高橋 義人, 小出 卓也, 池田 直弥, 原田 吉将

日本性感染症学会誌 ( (一社)日本性感染症学会 )  28 ( 2 ) 206 - 206  2017年11月

膀胱Inflammatory myofibroblastic tumorの1例

高木 公暁, 高井 学, 河田 啓, 堀江 憲吾, 菊地 美奈, 加藤 卓, 水谷 晃輔, 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, 石原 哲, 亀井 信吾

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  62 ( 11 ) 610 - 610  2016年11月

陰茎癌とHPV感染との関連性についての検討

坂本 次郎, 重原 一慶, 中嶋 一史, 安田 満, 中嶋 孝夫, 島村 正喜, 小堀 義友, 出口 隆, 笹川 寿之, 溝上 敦

日本性感染症学会誌 ( (一社)日本性感染症学会 )  27 ( 2 ) 263 - 263  2016年11月

Male non-gonococcal urethritis: From microbiological etiologies to demographic and clinical features

Shin Ito, Nozomu Hanaoka, Ken Shimuta, Kensaku Seike, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yokoi, Masahiro Nakano, Makoto Ohnishi, Takashi Deguchi

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY-BLACKWELL )  23 ( 4 ) 325 - 331  2016年04月

　概要を見る

Objectives: To detect microorganisms responsible for male acute urethritis and to define the microbiology of non-gonococcal urethritis. Methods: The present study comprised 424 men with symptoms and signs compatible with acute urethritis. Their urethral swabs and first-voided urine underwent detection of the microorganisms. Demographic characteristics and clinical features of Mycoplasma genitalium-, Ureaplasma urealyticum-, Haemophilus influenza-, adenovirus- or Herpes simplex virus-positive monomicrobial non-gonococcal urethritis, or all-examined microorganism-negative urethritis in heterosexual men were compared with urethritis positive only for Chlamydia trachomatis. Results: Neisseria gonorrhoeae was detected in 127 men (30.0%). In 297 men with non-gonococcal urethritis, C. trachomatis was detected in 143 (48.1%). In 154 men with non-chlamydial non-gonococcal urethritis, M. genitalium (22.7%), M. hominis (5.8%), Ureaplasma parvum (9.1%), U. urealyticum (19.5%), H. influenzae (14.3%), Neisseria meningitidis (3.9%), Trichomonas vaginalis (1.3%), human adenovirus (16.2%), and Herpes simplex virus types 1 (7.1%) and 2 (2.6%) were detected. Although some features of monomicrobial non-chlamydial non-gonococcal urethritis or all-examined microorganism-negative urethritis were significantly different from those of monomicrobial chlamydial nongonococcal urethritis, most features were superimposed. Conclusions: Predicting causative microorganisms in men with non-gonococcal urethritis based on demographic and clinical features is difficult. However, the present study provides useful information to better understand the microbiological diversity in non-gonococcal urethritis, and to manage patients with non-gonococcal urethritis appropriately.

DOI

ヒトアデノウイルス陽性男子尿道炎の臨床的特徴

伊藤 晋, 安田 満, 花岡 希, 高梨 真樹, 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 )  104回   OP - 028  2016年04月

Multidrug-Resistant Mycoplasma genitalium Is Increasing

Takashi Deguchi, Mina Kikuchi, Mitsuru Yasuda, Shin Ito

CLINICAL INFECTIOUS DISEASES ( OXFORD UNIV PRESS INC )  62 ( 3 ) 405 - 406  2016年02月

速報，短報，研究ノート等（学術雑誌）  

DOI

New Clinical Strain of Neisseria gonorrhoeae with Decreased Susceptibility to Ceftriaxone, Japan

Takashi Deguchi, Mitsuru Yasuda, Kyoko Hatazaki, Koji Kameyama, Kengo Horie, Taku Kato, Kohsuke Mizutani, Kensaku Seike, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Mutsumasa Yoh

EMERGING INFECTIOUS DISEASES ( CENTERS DISEASE CONTROL )  22 ( 1 ) 142 - 144  2016年01月

速報，短報，研究ノート等（学術雑誌）  

DOI

Bacterial loads of Ureaplasma parvum contribute to the development of inflammatory responses in the male urethra

Takashi Deguchi, Yasushi Shimada, Kengo Horie, Kohsuke Mizutani, Kensaku Seike, Tomohiro Tsuchiya, Shigeaki Yokoi, Mitsuru Yasuda, Shin Ito

INTERNATIONAL JOURNAL OF STD & AIDS ( SAGE PUBLICATIONS LTD )  26 ( 14 ) 1035 - 1039  2015年12月

　概要を見る

Ureaplasma parvum, which has been recognised as a coloniser in the male urethra, is detected in some men with non-gonococcal urethritis. In this study, we quantified the 16S rRNA genes of U. parvum by a real-time polymerase chain reaction-based assay in first-voided urine from 15 symptomatic and 38 asymptomatic men who were positive only for U. parvum. We also determined the leukocyte counts by automated quantitative urine particle analysis in their first-voided urine. Positive correlations were observed between copies of the 16S rRNA genes of U. parvum/ml and the leukocyte counts/mu l in first-voided urine (p = 0.0019). The loads of >= 10(4) copies of the 16 S rRNA gene/ml, corresponding to >= 5 x 10(3) cells of U. parvum/ml, were significantly associated with the presence of >= 12.5 leukocytes/mu l in first-voided urine that might document the presence of inflammatory responses in the urethra. However, a large portion of the subjects (83.0%) had bacterial loads of < 5 x 10(3) cells of U. parvum/ml, and 79.5% of them showed < 12.5 leukocytes/ml. The ambiguity of the pathogenic role of U. parvum in non-gonococcal urethritis could, in part, be due to its low bacterial loads, which might not give rise to inflammatory responses in the male urethra.

DOI

アデノウイルス性尿道炎患者変遷と市中アデノウイルス流行状況との関連性

花岡 希, 伊藤 晋, 安田 満, 高梨 真樹, 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 )  26 ( 2 ) 87 - 87  2015年10月

うがい液淋菌検査におけるAPTIMA Combo2とCOBAS4800不一致例の増加

伊藤 晋, 安田 満, 高橋 聡, 花岡 希, 伊藤 貴子, 出口 隆

日本性感染症学会誌 ( (一社)日本性感染症学会 )  26 ( 2 ) 61 - 61  2015年10月

ヒトアデノウイルス陽性男子尿道炎の臨床的特徴

伊藤 晋, 花岡 希, 安田 満, 高梨 真樹, 伊藤 貴子, 出口 隆

日本性感染症学会誌 ( (一社)日本性感染症学会 )  26 ( 2 ) 80 - 80  2015年10月

ALK Gene Translocation in Inflammatory Myofibroblastic Tumor of the Urinary Bladder: A Case Report

Kimiaki Takagi, Manabu Takai, Koji Kameyama, Kengo Horie, Mina Kikuchi, Taku Kato, Kosuke Mizutani, Kensaku Seike, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yokoi, Natsuko Suzui, Masahiro Nakano, Takashi Deguchi

Urology Case Reports ( Elsevier Inc. )  3 ( 5 ) 138 - 140  2015年09月

　概要を見る

A 26-year-old woman with gross hematuria was seen in a previous hospital. Magnetic resonance imaging (MRI) showed a tumor at the dome of the urinary bladder with invasion outside of the bladder wall. The patient underwent transurethral resection of the bladder tumor (TUR-BT). From the result of the pathological examination, the tumor was suggested to be carcinosarcoma of the bladder. The patient was then referred to our hospital for treatment. We performed radical cystectomy and ileal conduit diversion. Pathological examination of the excised specimen revealed an inflammatory myofibroblastic tumor as the basis for immunostaining of anaplastic lymphoma kinase (ALK).

DOI

Three patients with acute myocardial infarction associated with targeted therapy of sorafenib for metastatic renal cell carcinoma: Case report

Kimiaki Takagi, Manabu Takai, Kei Kawata, Kengo Horie, Mina Kikuchi, Taku Kato, Kosuke Mizutani, Kensaku Seike, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yokoi, Masahiro Nakano, Hiroaki Ushikoshi, Tatsuhiko Miyazaki, Takashi Deguchi

Acta Urologica Japonica ( Editorial Board of Acta Urologica Japonica )  61 ( 9 ) 347 - 351  2015年09月

　概要を見る

Sorafenib is a tyrosine kinase inhibitor (TKI) of the vascular endothelial growth factor receptor (VEGFR) used for advanced renal cell carcinoma. Treatment with sorafenib prolongs progression-free survival in patients with advanced clear-cell renal cell carcinoma. However, in spite of its therapeutic efficacy, sorafenib causes a wide range of adverse events. Cardiovascular adverse events have been observed when sorafenib was used with targeted agents. Although these adverse events like hypertension, reduced left ventricular ejection fraction, cardiac ischemia or infarction were manageable with standard medical therapies in most cases, some had a poor clinical outcome. We report three cases of acute myocardial infarction associated with sorafenib in patients with metastatic renal cell carcinoma.

PubMed

Japanese nationwide surveillance in 2011 of antibacterial susceptibility patterns of clinical isolates from complicated urinary tract infection cases

Kiyohito Ishikawa, Ryoichi Hamasuna, Shinya Uehara, Mitsuru Yasuda, Shingo Yamamoto, Hiroshi Hayami, Satoshi Takahashi, Tetsuro Matsumoto, Shinichi Minamitani, Jun-ichi Kadota, Satoshi Iwata, Mitsuo Kaku, Akira Watanabe, Keisuke Sunakawa, Junko Sato, Hideaki Hanaki, Taiji Tsukamoto, Hiroshi Kiyota, Shin Egawa, Takashi Deguchi, Minori Matsumoto, Kazushi Tanaka, Soichi Arakawa, Masato Fujisawa, Hiromi Kumon, Kanao Kobayashi, Akio Matsubara, Hironobu Wakeda, Yoshinosuke Amemoto, Shoichi Onodera, Hirokazu Goto, Hisao Komeda, Masuo Yamashita, Tadasu Takenaka, Yoshinori Fujimoto, Masaya Tsugawa, Yoshito Takahashi, Hiroshi Maeda, Hiroyuki Onishi, Satoshi Ishitoya, Kazuo Nishimura, Kenji Mitsumori, Toru Ito, Yoshikazu Togo, Ichiro Nakamura, Noriyuki Ito, Sojun Kanamaru, Takaoki Hirose, Takashi Muranaka, Daisuke Yamada, Satoshi Ishihara, Hiroya Oka, Hisato Inatomi, Takashi Matsui, Makoto Kobuke, Yasuharu Kunishima, Takahiro Kimura, Takaharu Ichikawa, Ichiro Kagara, Masanori Matsukawa, Koichi Takahashi, Koji Mita, Masao Kato, Kazuhiro Okumura, Hiroaki Kawanishi, Takayuki Hashimura, Teruyoshi Aoyama, Masanobu Shigeta, Shuntaro Koda, Keisuke Taguchi, Yohei Matsuda

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV )  21 ( 9 ) 623 - 633  2015年09月

　概要を見る

To investigate antimicrobial susceptibility patterns of various bacterial pathogens isolated from complicated urinary tract infection (UTI) cases, the Japanese Society of Chemotherapy, the Japanese Association of Infectious Disease, and the Japanese Society of Clinical Microbiology conducted the second nationwide surveillance from January to September 2011. With the cooperation of 42 medical institutions throughout Japan, 1036 strains belonging to 8 clinically relevant bacterial species were collected. Among methicillin-resistant Staphylococcus aureus (MRSA) strain, the vancomycin (VCM) MIC for 5.5% (3/55) of the strains was 2 mu g/mL. Ampicillin, VCM, and linezolid were relatively active against 209 Enterococcus faecalis strains. The proportion of fluoroquinolone (FQ)-resistant strains was >20%. The MIC90 of FQs against the 382 Escherichia coli strains was 2-64 mg/L and the proportion resistant to FQs was approximately 30%. However, susceptibility of E. coli to sitafloxacin was still high (MIC90 = 2 mg/L). Fifty-eight (15.2%) of 382 E. coli, 6 (4.5%) of 132 Klebsiella pneumoniae, 1 (2.4%) of 41 Klebsiella oxytoca and 4 (6.8%) of 59 Proteus mirabilis strains were suspected of producing extended-spectrum beta-lactamase. Of 93 Pseudomonas aeruginosa strains, the proportions resistant to imipenem, amikacin, and ciprofloxacin were 21.5%, 4.3%, and 20.4%, respectively. Four strains (4.3%) were found to be multidrug-resistant. In complicated UTI cases, all of MRSA and E. faecalis were susceptible to all anti-MRSA agents. Sitafloxacin was active against other FQ-resistant E. coli strains. The isolation of extended-spectrum betalactamase-producing and multidrug-resistant strains increased. (C) 2015, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI

Re: Adrian Pilatz, Hamid Hossain, Rolf Kaiser, et al. Acute Epididymitis Revisited: Impact of Molecular Diagnostics on Etiology and Contemporary Guideline Recommendations. Eur Urol 2015;68:428-35

Takashi Deguchi, Mitsuru Yasuda, Shin Ito

EUROPEAN UROLOGY ( ELSEVIER SCIENCE BV )  68 ( 3 ) E59 - E60  2015年09月

速報，短報，研究ノート等（学術雑誌）  

DOI

転移性腎細胞癌に対してソラフェニブ内服治療中に心筋梗塞を発症した3例

高木 公暁, 高井 学, 河田 啓, 堀江 憲吾, 菊地 美奈, 加藤 卓, 水谷 晃輔, 清家 健作, 土屋 朋大, 安田 満, 横井 繁明, 仲野 正博, 牛越 博昭, 宮崎 龍彦, 出口 隆

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  61 ( 9 ) 347 - 351  2015年09月

　概要を見る

症例1は69歳男で、左腎癌に対する左腎摘除術後、局所再発、骨・肝・肺転移出現のためソラフェニブ内服を開始した。転移巣の完全消失(CR)後も継続したが、心筋梗塞を発症し、左冠動脈回旋枝と右冠動脈に経皮的冠動脈ステントを留置した。ソラフェニブ内服は中止し、1年8ヵ月経過して腎癌はCRを維持している。症例2は69歳男で、右腎癌に対し右腎摘除術後、多発肺転移を認め、ソラフェニブを10ヵ月継続したが、急性心筋梗塞を発症した。右冠動脈および左冠動脈前下行枝に対しカテーテル治療を行ったが、心不全が進行し第10病日に死亡した。症例3は59歳男で、右腎癌に対し右腎摘除術後、肺転移を認め、ソラフェニブを8ヵ月間継続したが、心筋梗塞を発症した。右冠動脈および左冠動脈前下行枝に冠動脈ステントを留置した。ソラフェニブを中止しtemsirolimus投与を開始したが、副作用のため中止となり、その後緩和治療へ移行した。

Development and clinical application of an InvaderPlus® assay for the detection of genital mycoplasmas

Masaki Takanashi, Shin Ito, Hiroyuki Kaneto, Yoshikatsu Tanahashi, Masataka Kitanohara, Akira Yanagihara, Haruhiko Nakazima, Mitsuru Yasuda

Journal of Infection and Chemotherapy ( ELSEVIER SCIENCE BV )  21 ( 7 ) 516 - 519  2015年07月

　概要を見る

© 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. We developed a PCR-based assay involving Invader® technology for detection of the genital mycoplasmas of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. We compared its performance with that of a PCR-microtiter plate hybridization assay, which we developed previously, in detecting genital mycoplasmas in first-voided urine (FVU) specimens from men with non-gonococcal urethritis. The tests targeting each of the genital mycoplasmas were specific for the respective species and could detect as few as 10 copies of the plasmids containing the target genes of each of the genital mycoplasmas per reaction. The assay using the InvaderPlus® method (InvaderPlus® assay) showed very similar performance to that of the PCR-microtiter plate hybridization assay for detecting the genital mycoplasmas in the FVU specimens. In addition, the PCR and endonuclease reaction in the InvaderPlus® assay were carried out simultaneously in one procedure, thus simplifying the assay, leading to time- and labor-savings and a decrease in the risk of specimen contamination. The In

DOI PubMed

Drug Resistance-Associated Mutations in Mycoplasma genitalium in Female Sex Workers, Japan

Takashi Deguchi, Mitsuru Yasuda, Kengo Horie, Kensaku Seike, Mina Kikuchi, Kohsuke Mizutani, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Shinji Hoshina

EMERGING INFECTIOUS DISEASES ( CENTERS DISEASE CONTROL )  21 ( 6 ) 1062 - 1064  2015年06月

　概要を見る

Mycoplasma genitalium was detected in 21(14.1%) of 149 vaginal swab samples and in 1 (0.7%) of 149 throat washing samples from female sex workers during 2013-2014 in Japan. Prevalences of M. genitalium with macrolide resistance associated 23S rRNA mutations and fluoroquinolone resistance associated parC alterations were 47.1% and 36.8%, respectively.

DOI

The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013

Ryoichi Hamasuna, Mitsuru Yasuda, Kiyohito Ishikawa, Shinya Uehara, Hiroshi Hayami, Satoshi Takahashi, Tetsuro Matsumoto, Shingo Yamamoto, Shinichi Minamitani, Akira Watanabe, Satoshi Iwata, Mitsuo Kaku, 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, Kentaro Kuroiwa, Hideo Hirayama, Harunori Narita, Takahide Hosobe, Shin Ito, Kenji Ito, Shuichi Kawai, Masayasu Ito, Hirofumi Chokyu, Masaru Matsumura, Masaru Yoshioka, Satoshi Uno, Koichi Monden, Kazuo Takayama, Shinichi Kaji, Motoshi Kawahara, Toru Sumii, Hitoshi Kadena, Takamasa Yamaguchi, Shinichi Maeda, Shohei Nishi, Hirofumi Nishimura, Takeshi Shirane, Mutsumasa Yoh, Kikuo Akiyama, Toshio Imai, Motonori Kano

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV )  21 ( 5-6 ) 340 - 345  2015年05月

　概要を見る

Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 mu g/ml, and 11(10.7%) strains were considered less susceptible with an MIC of 0.125 mu g/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 mu g/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 mu g/ml. (C) 2015, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI

The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013

Ryoichi Hamasuna, Mitsuru Yasuda, Kiyohito Ishikawa, Shinya Uehara, Hiroshi Hayami, Satoshi Takahashi, Tetsuro Matsumoto, Shingo Yamamoto, Shinichi Minamitani, Akira Watanabe, Satoshi Iwata, Mitsuo Kaku, 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, Kentaro Kuroiwa, Hideo Hirayama, Harunori Narita, Takahide Hosobe, Shin Ito, Kenji Ito, Shuichi Kawai, Masayasu Ito, Hirofumi Chokyu, Masaru Matsumura, Masaru Yoshioka, Satoshi Uno, Koichi Monden, Kazuo Takayama, Shinichi Kaji, Motoshi Kawahara, Toru Sumii, Hitoshi Kadena, Takamasa Yamaguchi, Shinichi Maeda, Shohei Nishi, Hirofumi Nishimura, Takeshi Shirane, Mutsumasa Yoh, Kikuo Akiyama, Toshio Imai, Motonori Kano

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV )  21 ( 5-6 ) 340 - 345  2015年05月

　概要を見る

Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 mu g/ml, and 11(10.7%) strains were considered less susceptible with an MIC of 0.125 mu g/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 mu g/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 mu g/ml. (C) 2015, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI

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, 花岡 希, 前田 真一, 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 )  103回   524 - 524  2015年04月

Sitafloxacin: Antimicrobial activity against ciprofloxacin-selected laboratory mutants of Mycoplasma genitalium and inhibitory activity against its DNA gyrase and topoisomerase IV

Takashi Deguchi, Mina Kikuchi, Mitsuru Yasuda, Shin Ito

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  21 ( 1-2 ) 74 - 75  2015年01月

　概要を見る

A sitafloxacin regimen is highly effective on Myco plasma genitalium infections, including those caused by the mycoplasmas harboring mutant topoisomerase IV with a quinolone resistance-associated amino acid change in ParC. In this study, we evaluated sitafloxacin antimicrobial activities against M. genitalium, including the mycolasmas with decreased susceptibilities to quinolones, by determining minimum inhibitory concentrations (MICs) for the strain ATCC 33530 and its 3 ciprofloxacin-selected mutants, for which ciprofloxacin MICs were 8-16 times higher than that for their parent strain. We also evaluated inhibitory activities against the target enzymes of M. genitalium by determining concentrations required to inhibit 50% (IC50) of the supercoiling activity of the recombinant wild-type DNA gyrase and the decatenating activities of the recombinant wild-type topoisomerase IV and the 2 types of mutant topoisomerase IV with a single amino acid change in ParC. Sitafloxacin MICs were 0.125 for the parent strain and 0.125-0.25 mu g/ml for the mutants. Sitafloxacin IC50s were 3.12 for the supercoiling activity of the wild-type DNA gyrase and 2.98 mu g/ml for the decatenating activity of the wild-type topoisomerase IV. Its IC50s for the decatenating activity of the mutant topoisomerase IV harboring an amino acid change in ParC were 15.1 for Gly-81 -> Cys and 7.92 mu g/ml for Asp-87 -> Tyr. Sitafloxacin was highly active against ciprofloxacin-selected mutants of M. genitalium and possessed intense inhibitory activities not only against wild-type DNA gyrase and topoisomerase IV but also against mutant topoisomerase IV containing ParC with a quinolone resistance-associated amino acid change. Sitafloxacin could be a promising agent for M. genitalium infections. (C) 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Atazanavir-Induced Urine Crystals Demonstrated by Infrared Spectroscopic Analysis

Isao Inagaki, Mariko Adachi, Hiroyasu Ito, Mitsuru Yasuda, Hisashi Tsurumi, Takashi Deguchi, Mitsuru Seishima

UROLOGIA INTERNATIONALIS ( KARGER )  94 ( 1 ) 121 - 124  2015年

　概要を見る

Atazanavir sulfate, an azapeptide inhibitor of HIV protease, has been associated with urolithiasis. A 60-year-old man with atazanavir-induced urinary sediment crystals verified by infrared spectroscopic analysis is described. He had been receiving highly active antiretroviral therapy (HAART) for HIV infection and also had a history of urinary lithiasis and been undergoing urinalysis once every month. Needle-shaped crystals were seen in his urine sediment and infrared spectroscopic analysis revealed that these were atazanavir crystals. Because the presence of the crystals in urine do not always reveal an abnormality in the urinary test strip analysis, the urinary sediment needed to be observed microscopically in order to prevent future urolithiasis and renal failure in this HIV patient receiving atazanavir. (C) 2013 S. Karger AG, Basel

DOI PubMed

[Conservative management of symptomatic or asymptomatic urinoma after grade III blunt renal trauma: a report of three cases].

Mina Kikuchi, Koji Kameyama, Kengo Horie, Kosuke Mizutani, Kensaku Seike, Taku Kato, Takashi Sugawara, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yokoi, Masahiro Nakano, Takashi Deguchi, Hiroshi Kondo, Yoji Moriyama, Hidetoshi Ehara

Hinyokika kiyo. Acta urologica Japonica   60 ( 12 ) 615 - 20  2014年12月   [ 国内誌 ]

　概要を見る

The management of urinoma after blunt renal trauma is still controversial, ranging from percutaneous drainage or ureteral stent placement for the symptomatic urinoma and waiting for spontaneous vanishment of the asymptomatic urinoma. We present two cases of symptomatic urinoma and a case of asymptomatic urinoma after renal laceration. All patients underwent selective renal arterial embolization for vascular complications, including active bleeding, pseudoaneurysm and arteriovenous fistula. Urinomas, which had been observed in all cases gradually reduced and vanished 1-24 months later. All cases were successfully managed without catheterization or percutaneous drainage for urinoma.

PubMed

Usefulness of quantifying leukocytes in first-voided urine to predict positivity for Chlamydia trachomatis in asymptomatic men at high risk for chlamydial infection

Shin Ito, Kengo Horie, Kensaku Seike, Mitsuru Yasuda, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  20 ( 12 ) 748 - 751  2014年12月

　概要を見る

Chlamydia trachomatis causes acute non-gonococcal urethritis, but some infected men are asymptomatic. We examined leukocytes in uncentrifuged first-voided urine (FVU) from asymptomatic men at high risk for chlamydial infection by automated urine particle analyzers to assess whether the quantification of urinary leukocytes could predict chlamydial infection in these men. We enrolled 209 asymptomatic men, whose female sexual partners had been diagnosed as having a genital chlamydial infection. Their FVU specimens were examined for quantification of leukocytes with automated urine particle analyzers and tested for Neisseria gonorrhoeae, C. trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum by nucleotide acid amplification tests. Eleven men positive for N. gonorrhoeae or M. genitalium were excluded from further analysis. In the remaining 198 men, 84 positive for C. trachomatis (42.4%) had 1.8-1666.9 white blood cells (WBCs)/mu l (median, 43.3 WBCs/mu l) in their FVU, whereas 114 negative for C. trachomatis had 0.1-1378 WBCs/mu l (median, 4.8 WBCs/mu l). A receiver operating characteristic (ROC) curve was constructed to examine the sensitivity and specificity of leukocytes counts for predicting chlamydial infection. A cut-off point of leukocyte counts of 12.5 WBCs/mu l was determined from the ROC curve, resulting in a sensitivity of 86.9% and specificity of 88.6% for predicting chlamydial infection. Leukocyte quantification in FVU by automated urine particle analyzers showed good performance in predicting the positivity and negativity for chlamydial infection in asymptomatic men. This test could potentially develop into a relevant tool for preselecting asymptomatic men prior to C. trachomatis screening. (C) 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI PubMed

Usefulness of quantifying leukocytes in first-voided urine to predict positivity for Chlamydia trachomatis in asymptomatic men at high risk for chlamydial infection

Shin Ito, Kengo Horie, Kensaku Seike, Mitsuru Yasuda, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  20 ( 12 ) 748 - 751  2014年12月

　概要を見る

Chlamydia trachomatis causes acute non-gonococcal urethritis, but some infected men are asymptomatic. We examined leukocytes in uncentrifuged first-voided urine (FVU) from asymptomatic men at high risk for chlamydial infection by automated urine particle analyzers to assess whether the quantification of urinary leukocytes could predict chlamydial infection in these men. We enrolled 209 asymptomatic men, whose female sexual partners had been diagnosed as having a genital chlamydial infection. Their FVU specimens were examined for quantification of leukocytes with automated urine particle analyzers and tested for Neisseria gonorrhoeae, C. trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum by nucleotide acid amplification tests. Eleven men positive for N. gonorrhoeae or M. genitalium were excluded from further analysis. In the remaining 198 men, 84 positive for C. trachomatis (42.4%) had 1.8-1666.9 white blood cells (WBCs)/mu l (median, 43.3 WBCs/mu l) in their FVU, whereas 114 negative for C. trachomatis had 0.1-1378 WBCs/mu l (median, 4.8 WBCs/mu l). A receiver operating characteristic (ROC) curve was constructed to examine the sensitivity and specificity of leukocytes counts for predicting chlamydial infection. A cut-off point of leukocyte counts of 12.5 WBCs/mu l was determined from the ROC curve, resulting in a sensitivity of 86.9% and specificity of 88.6% for predicting chlamydial infection. Leukocyte quantification in FVU by automated urine particle analyzers showed good performance in predicting the positivity and negativity for chlamydial infection in asymptomatic men. This test could potentially develop into a relevant tool for preselecting asymptomatic men prior to C. trachomatis screening. (C) 2014, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI

Nationwide survey of urogenital tuberculosis in Japan

Keita Nakane, Mitsuru Yasuda, Takashi Deguchi, Satoshi Takahashi, Kazushi Tanaka, Hiroshi Hayami, Ryoichi Hamasuna, Shingo Yamamoto, Soichi Arakawa, Tetsuro Matsumoto

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY-BLACKWELL )  21 ( 11 ) 1171 - 1177  2014年11月

　概要を見る

ObjectivesTo determine current epidemiology and treatment patterns of urogenital tuberculosis in Japan. MethodsA questionnaire was sent to the urological departments of 1203 Japanese hospitals. Clinical data was reviewed retrospectively; no time range was specified. ResultsOf the 1203 hospitals, 399 returned questionnaires with information about 355 urogenital tuberculosis patients. Of the 399, 153 institutions reported at least one patient, and 201 patients were identified between 2000 and 2007. Infections were located in the kidneys (n=242), ureter (n=96), bladder (n=100), epididymis or testes (n=81) and prostate (n=9). ConclusionsUrogenital tuberculosis is rare in Japan, but patients do exist, and we should not ignore them.

DOI

A single 2 g oral dose of extended-release azithromycin for treatment of gonococcal urethritis

Mitsuru Yasuda, Shin Ito, Akira Kido, Kiminari Hamano, Yutaka Uchijima, Noriyasu Uwatoko, Hiroyuki Kusuyama, Akiko Watanabe, Ryuzou Miyamura, Kazutoyo Miyata, Takashi Deguchi

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  69 ( 11 ) 3116 - 3118  2014年11月

　概要を見る

We treated gonococcal urethritis in men with a single 2 g dose of azithromycin extended-release formulation (azithromycin-SR) to determine its microbiological outcomes and tolerability. We enrolled 189 Japanese men with gonococcal urethritis between April 2009 and December 2013. The patients were given a single 2 g dose of azithromycin-SR. Microbiological efficacy was evaluated by the results of the post-treatment molecular testing of Neisseria gonorrhoeae. MIC testing was performed only for pretreatment isolates of N. gonorrhoeae collected from the patients. We evaluated 130 patients for microbiological outcomes. Of these patients, 122 (93.8%) were judged to be microbiologically cured on the basis of negative test results. All isolates for which the azithromycin MICs were a parts per thousand currency sign0.25 mg/L were eradicated, whereas 5 of 12 isolates for which the MICs were 1 mg/L persisted after the treatment. Forty-six adverse events occurred in 41 patients. However, all adverse events were classified as mild. The eradication rate of N. gonorrhoeae was 93.8% in men with gonococcal urethritis treated with a single 2 g dose of azithromycin-SR. The breakpoint MIC of a 2 g dose of azithromycin-SR for gonococcal urethritis associated with clinical treatment failures appeared to be 1 mg/L. With regard to side effects of higher doses of azithromycin, the 2 g dose of azithromycin-SR appeared to improve tolerability. However, the widespread use of a high-dose regimen of azithromycin might lead to the development of further resistance to azithromycin.

DOI PubMed

Small cell carcinoma of the prostate effectively treated for relatively long term: A case report

Kengo Horie, Koji Kameyama, Kosuke Mizutani, Takashi Sugawara, Kensaku Seike, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yokoi, Masahiro Nakano, Takashi Deguchi, Natsuko Suzui, Yoshinobu Hirose

Acta Urologica Japonica ( Editorial Board of Acta Urologica Japonica )  60 ( 10 ) 517 - 521  2014年10月

　概要を見る

A 72-year-old Japanese man was referred to a hospital because of urinary retention. Digital rectal examination revealed a stony, hard nodule in the prostate. A high level of serum PSA was not detected. Prostatic biopsy was performed, and pathological examination indicated adenocarcinoma of the prostate. He was referred to our hospital for treatment. Imaging examinations revealed no metastases (T4N0M0), so we re-evaluated the biopsy specimens. Immunohistochemical examination revealed prostatic small cell carcinoma. His levels of neuron-specific enolase (NSE) and pro-gastrin-releasing peptide (Pro-GRP) were high. We treated him with combination chemotherapy comprising irinotecan and cisplatin, and the treatment was effective. After four courses of the chemotherapy, levels of NSE and Pro-GRP had decreased, and the prostatic mass had decreased in size. Needle rebiopsy of the prostate demonstrated no evidence of malignancy. Adjuvant external beam radiation therapy was also performed. The patient is still alive at 18 month after diagnosis with no evidence of relapse or metastasis of the disease. Key word: Prostatic small cell carcinoma.

PubMed

Erratum: Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - A multi-center retrospective study (Journal of Infection and Chemotherapy (2014) 20 (232-237))

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, Minori 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 ( Japanese Society for Cancer Chemotherapy )  20 ( 10 ) 660  2014年10月

DOI

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.

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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）  

DOI PubMed

Clinical efficacy of sitafloxacin 100 mg twice daily for 7 days for patients with non-gonococcal urethritis

Satoshi Takahashi, Ryoichi Hamasuna, Mitsuru Yasuda, Shin Ito, Kenji Ito, Shuichi Kawai, Takamasa Yamaguchi, Takashi Satoh, Kenichi Sunaoshi, Koichi Takeda, Nobukazu Suzuki, Shinichi Maeda, Hirofumi Nishimura, Souichirou Fukuda, Tetsuro Matsumoto

Journal of Infection and Chemotherapy ( Japanese Society for Cancer Chemotherapy )  19 ( 5 ) 941 - 945  2013年

　概要を見る

To clarify the clinical efficacy of STFX for patients with non-gonococcal urethritis (NGU), including chlamydial urethritis and Mycoplasma genitalium-positive urethritis, this study included male patients with NGU who were 20 years old or older. The pathogens, including Chlamydia trachomatis, M. genitalium and Ureaplasma urealyticum, were detected by nucleic acid amplification tests and the patients were treated with sitafloxacin 100 mg twice daily for 7 days. Microbiological and clinical efficacies were assessed for the patients with NGU posttreatment. Among the 208 patients enrolled in this study, data for a total of 118 patients could be analyzed. The median age was 32 (20-61) years. The median duration from the completion of treatment to the second visit was 21 (14-42) days. There were 68 pathogen-positive NGU cases and 50 with NGU without any microbial detection. Microbiological cure was achieved in 95.6 % of the pathogen-positive NGU patients. Total clinical cure was achieved in 91.3 % (105/115). In this study, STFX was able to eradicate 95.7 % of C. trachomatis, 93.8 % of M. genitalium and 100 % of U. urealyticum. The results of our clinical research indicate that the STFX treatment regimen should become a standard regimen recommended for patients with NGU. In addition, this regimen is recommended for patients with M. genitalium-positive NGU. © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.

DOI PubMed

Nationwide surveillance of bacterial pathogens from patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2009 and 2010: Antimicrobial susceptibility of Escherichia coli and Staphylococcus saprophyticus

Hiroshi Hayami, Satoshi Takahashi, Kiyohito Ishikawa, Mitsuru Yasuda, Shingo Yamamoto, Shinya Uehara, Ryoichi Hamasuna, 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, Takamasa Yamaguchi, Shin Ito, Mototsugu Kanokogi, Harunori Narita, Hiromi Kawano, Takahide Hosobe, Kazuo Takayama, Toru Sumii, Akira Fujii, Takashi Sato, Takamine Yamauchi, Masanobu Izumitani, Hirofumi Chokyu, Hideari Ihara, Kikuo Akiyama, Masaru Yoshioka, Satoshi Uno, Koichi Monden, Motonori Kano, Shinichi Kaji, Shuichi Kawai, Kenji Ito, Hisato Inatomi, Hirofumi Nishimura, Toshihiro Ikuyama, Shohei Nishi, Koichi Takahashi, Yukihiro Kawano, Satoshi Ishihara, Kengo Tsuneyoshi, Shinji Matsushita, Takashi Yamane, Takaoki Hirose, Shigeru Fujihiro, Katsuhisa Endo, Yasuhiko Oka, Koh Takeyama, Takahiro Kimura, Tetsuji Uemura

Journal of Infection and Chemotherapy ( Japanese Society for Cancer Chemotherapy )  19 ( 3 ) 393 - 403  2013年

　概要を見る

The Japanese surveillance committee conducted the first nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for female acute uncomplicated cystitis at 43 hospitals throughout Japan from April 2009 to November 2010. In this study, the causative bacteria (Escherichia coli and Staphylococcus saprophyticus) and their susceptibility to various antimicrobial agents were investigated by isolation and culturing of bacteria from urine samples. In total, 387 strains were isolated from 461 patients, including E. coli (n = 301, 77.8 %), S. saprophyticus (n = 20, 5.2 %), Klebsiella pneumoniae (n = 13, 3.4 %), and Enterococcus faecalis (n = 11, 2.8 %). S. saprophyticus was significantly more common in premenopausal women (P = 0.00095). The minimum inhibitory concentrations of 19 antibacterial agents used for these strains were determined according to the Clinical and Laboratory Standards Institute manual. At least 87 % of E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, and 100 % of S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant E. coli strains and extended-spectrum β-lactamase (ESBL)-producing E. coli strains were 13.3 % and 4.7 %, respectively. It is important to confirm the susceptibility of causative bacteria for optimal antimicrobial therapy, and empiric antimicrobial agents should be selected by considering patient characteristics and other factors. However, the number of isolates of fluoroquinolone-resistant or ESBL-producing strains in gram-negative bacilli may be increasing in patients with urinary tract infections (UTIs) in Japan. Therefore, these data present important information for the proper treatment of UTIs and will serve as a useful reference for future surveillance studies. © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases.

DOI PubMed

A questionnaire survey of antimicrobial prophylaxis to prevent perioperative infection in urological field in Japan

Yoshikazu Togo, Rikiya Taoka, Shingo Yamamoto, Yoshiki Hiyama, Teruhisa Uehara, Jiroh Hashimoto, Yuichiro Kurimura, Satoshi Takahashi, Taiji Tsukamoto, Jun Miyazaki, Hiroyuki Nishiyama, Hiroshi Kiyota, Satoshi Yazawa, Mototsugu Oya, Mitsuru Yasuda, Takashi Deguchi, Kiyohito Ishikawa, Kiyotaka Hoshinaga, Minori 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, Takashi Yamane, Masayuki Nakagawa

Japanese Journal of Urology ( Japanese Urological Association )  104 ( 4 ) 579 - 588  2013年

　概要を見る

(Purpose): To survey the present condition of administration method of the antimicrobial prophylactic (AMP) agents for the perioperative infection in Japan on revising "The Japanese guidelines for prevention of perioperative infections in urologic field (2006)". (Patients and methods): With the approval of the Japanese Urological Association (JUA) in 2011, all of the principal urological training institutions certified by JUA (n = 836) were encouraged to participate to survey their adherence to the JUA guidelines (published in 2006) for AMP to prevent perioperative infection in urological field, and 446 (53.3%) institutions responded to the questionnaire. (Results): The rates of following the JUA guidelines of, "completely", "mainly", "not too much", and "not at all" were 6.5%, 69.7%, 22.0% and 1.6%, respectively. The guidelines were followed for open clean operations in 48.5%, open clean-contaminated operations in 66.4%, open contaminated operations in 61.8%, laparoscopic clean operations in 54.1%, laparoscopic clean-contaminated operations in 61.2%, transurethral resection of bladder tumor in 71.5%, transurethral resection of prostate in 68.9%, ureteroscopy and transurethral ureterolithotomy in 68.2%, prostate biopsy in 43.2%, and cystoscopy were in 42.2%, respectively. However, in terms of duration of AMP administration, the longer duration than those recommended by the guidelines were observed for clean surgery, transurethral resection of bladder tumor, ureteroscopy and transurethral ureterolithotomy, prostate biopsy, and cystoscopy. (Conclusions): In terms of kinds of AMP, the guidelines were almostly followed in all operative procedures. However, the duration of AMP administration were longer than those recommended by the guidelines. On revision of "Japanese guidelines for prevention of perioperative infections in urologie field (2006)", these data would be taken into consideration to avoid dissociation between the guidelines and the practical side in the urologists. © 2013 The Japanese Urological Association.

DOI PubMed

A prospective multi-institutional analysis according to the "Japanese guidelines for prevention of perioperative infections in urological field"

Koichiro Wada, Shinya Uehara, Shinichiro Kira, Masahiro Matsumoto, Takehiko Sho, Yuichiro Kurimura, Jiro Hashimoto, Teruhisa Uehara, Takashi Yamane, Sojun Kanamaru, Yoshikazu Togo, Rikiya Taoka, Akira Takahashi, Yusuke Yamada, Akira Yokomizo, Mitsuru Yasuda, Kazushi Tanaka, Ryoichi Hamasuna, Satoshi Takahashi, Hiroshi Hayami, Toyohiko Watanabe, Koichi Monden, Hiroshi Kiyota, Takashi Deguchi, Seiji Naito, Taiji Tsukamoto, Soichi Arakawa, Masato Fujisawa, Shingo Yamamoto, Hiromi Kumon, Tetsuro Matsumoto

Japanese Journal of Urology ( Japanese Urological Association )  104 ( 3 ) 505 - 512  2013年

　概要を見る

(Objective) The "Japanese guidelines for prevention of perioperative infections in urological field" was edited by the Japanese Urological Association in 2007. They are the first Japanese guidelines for antimicrobial prophylaxis specifically to prevent perioperative infections in the urological field. We report here the results of a multicenter prospective study conducted to examine the validity and usefulness of these guidelines. (Patients and methods) The subjects were 513 patients who had undergone urological surgeries between July and September 2008 at 10 nationwide university institutions in the Japanese Society of UTI Cooperative Study Group. These surgeries were transurethral resection of bladder (TURBT), transurethral resection of prostate (TURP), adrenalectomy, nephrectomy, nephroureterectomy, radical prostatectomy and total cystectomy. Analysis was performed on patient information, surgical procedures, types and durations of administration of prophylactic antibiotic agents, and the presence of surgical site infections (SSI) and remote infections (RI). (Results) Of 513 patients, 387 (75.4%) were administered prophylactic antibiotic agents according to the guidelines. In these patients, the incidences of SSI and RI were 5.9% and 4.1%, respectively. Multivariate analysis showed that significant factors for SSI were the surgical risk (according to the ASA physical status classification system), diabetes, and operation time, and that the only significant factor for RI was the operation time. (Conclusions) More large-scale study and evidences are necessary in order to demonstrate the validity and usefulness of these guidelines.© 2013 The Japanese Urological Association.

DOI PubMed

Outcome measurement of extensive implementation of antimicrobial stewardship in patients receiving intravenous antibiotics in a Japanese university hospital

T. Niwa, Y. Shinoda, A. Suzuki, T. Ohmori, M. Yasuda, H. Ohta, A. Fukao, K. Kitaichi, K. Matsuura, T. Sugiyama, N. Murakami, Y. Itoh

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE ( WILEY-BLACKWELL )  66 ( 10 ) 999 - 1008  2012年10月

　概要を見る

Background: Antimicrobial stewardship has not always prevailed in a wide variety of medical institutions in Japan. Methods: The infection control team was involved in the review of individual use of antibiotics in all inpatients (6348 and 6507 patients/year during the first and second annual interventions, respectively) receiving intravenous antibiotics, according to the published guidelines, consultation with physicians before prescription of antimicrobial agents and organisation of education programme on infection control for all medical staff. The outcomes of extensive implementation of antimicrobial stewardship were evaluated from the standpoint of antimicrobial use density, treatment duration, duration of hospital stay, occurrence of antimicrobial-resistant bacteria and medical expenses. Results: Prolonged use of antibiotics over 2 weeks was significantly reduced after active implementation of antimicrobial stewardship (2.9% vs. 5.2%, p < 0.001). Significant reduction in the antimicrobial consumption was observed in the second-generation cephalosporins (p = 0.03), carbapenems (p = 0.003), aminoglycosides (p < 0.001), leading to a reduction in the cost of antibiotics by 11.7%. The appearance of methicillin-resistant Staphylococcus aureus and the proportion of Serratia marcescens to Gram-negative bacteria decreased significantly from 47.6% to 39.5% (p = 0.026) and from 3.7% to 2.0% (p = 0.026), respectively. Moreover, the mean hospital stay was shortened by 2.9 days after active implementation of antimicrobial stewardship. Conclusion: Extensive implementation of antimicrobial stewardship led to a decrease in the inappropriate use of antibiotics, saving in medical expenses, reduction in the development of antimicrobial resistance and shortening of hospital stay.

DOI PubMed

Sensitivities of major causative organisms isolated from patients with acute uncomplicated cystitis against various antibacterial agents: results of subanalysis based on the presence of menopause

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

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER JAPAN KK )  18 ( 4 ) 597 - 607  2012年08月

　概要を見る

We investigated whether the presence of menopause influenced the species and distribution of causative bacteria isolated from patients with acute uncomplicated cystitis (the most common urinary tract infection), and we also investigated the sensitivity of the isolated species to antibacterial agents. Using multivariate analysis, we also investigated risk factors for infection with quinolone-resistant Escherichia coli, because its frequency has increased and it is now a clinical problem in Japan. Six hundred and thirty-four strains were isolated from 489 premenopausal patients (mean age 32.3 +/- A 10.1 years). Major causative bacteria detected were Escherichia coli (65.0 %), Enterococcus faecalis (12.0 %), Streptococcus agalactiae (5.5 %), and Klebsiella pneumoniae (1.6 %). From 501 postmenopausal patients (mean age 68.7 +/- A 10.29 years), 657 strains were isolated, and the major causative bacteria detected were E. coli (61.5 %), E. faecalis (13.7 %), K. pneumoniae (5.2 %), and S. agalactiae (4.0 %). The sensitivities to fluoroquinolones (FQs) and cephems of E. coli isolated from premenopausal patients were both a parts per thousand yen90 %, while the sensitivities to FQs of E. coli isolated from postmenopausal patients were about 5 % lower. In regard to infection with quinolone-resistant E. coli (minimal inhibitory concentration of levofloxacin [LVFX] a parts per thousand yen4 mu g/mL), significant risk factors were observed in patients with more than two episodes of cystitis within a year (p = 0.0002), patients to whom antibacterial agents were used previously for this episode of cystitis (p = 0.0175), and patients who had a history of FQ administration within 1 month. Although the species and distribution of causative bacteria of acute uncomplicated cystitis were the same regardless of the presence of menopause, the sensitivities to FQs of E. coli detected in postmenopausal patients were significantly lower than those in the premenopausal women. The major risk factors for infection with quinolone-resistant E. coli were a history of FQ administration and the morbidity of cystitis rather than the menopausal status. It was considered that taking an appropriate history including the morbidity of cystitis and history of FQ administration, and the appropriate selection of an antibacterial agent, would be important when empirical therapy is required.

DOI PubMed

Management of Pharyngeal Gonorrhea Is Crucial To Prevent the Emergence and Spread of Antibiotic-Resistant Neisseria gonorrhoeae

Takashi Deguchi, Mitsuru Yasuda, Shin Ito

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  56 ( 7 ) 4039 - 4040  2012年07月

速報，短報，研究ノート等（学術雑誌）  

DOI PubMed

Antimicrobial chemotherapy of Mycoplasma genitalium-positive non-gonococcal urethritis

Takashi Deguchi, Shin Ito, Noriyasu Hagiwara, Mitsuru Yasuda, Shin-ichi Maeda

EXPERT REVIEW OF ANTI-INFECTIVE THERAPY ( TAYLOR & FRANCIS LTD )  10 ( 7 ) 791 - 803  2012年07月

書評論文，書評，文献紹介等  

　概要を見る

Mycoplasma genitalium is an important pathogen of acute non-gonococcal urethritis (NGU) in men and plays a significant role in persistent or recurrent NGU. In the management of patients with M. genitalium-positive NGU, eradication of the mycoplasma from the urethra is necessary to prevent persistent or recurrent NGU. Therefore, M. genitalium should be considered for antimicrobial chemotherapy of NGU. This article reviews the in vitro antimicrobial activities of antibiotics against M. genitalium and the efficacies of various antibiotic regimens against M. genitalium-positive NGU, including the doxycycline and azithromycin regimens recommended as first-line treatments for NGU in the guidelines. Selection of macrolide-resistant M. genitalium by treatment with the single-dose regimen of 1-g azithromycin and mechanisms of macrolide resistance in M. genitalium are discussed. The effectiveness of the moxifloxacin regimen against persistent or recurrent NGU, unsuccessfully treated with azithromycin and/or doxycycline regimens, is emphasized.

DOI PubMed

Clinical and microbiological outcomes in treatment of men with non-gonococcal urethritis with a 100-mg twice-daily dose regimen of sitafloxacin

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

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO )  18 ( 3 ) 414 - 418  2012年06月

　概要を見る

Several microorganisms cause non-gonococcal urethritis (NGU). Failure to eradicate Mycoplasma genitalium from the urethra could be associated with persistent or recurrent urethritis; thus, the choice of antibiotics with activities potent enough to eradicate M. genitalium is crucial in the treatment of NGU. In in vitro studies, sitafloxacin has been shown to be highly active against Chlamydia trachomatis and M. genitalium. We treated 89 males with NGU, including 15 patients with persistent or recurrent NGU and 1 patient with post-gonococcal urethritis, with a 100-mg twice-daily dose regimen of sitafloxacin to assess its efficacy against NGU. We examined first-void urine samples for the presence of C. trachomatis, M. genitalium, Ureaplasma parvum, and Ureaplasma urealyticum. After treatment, we evaluated 73 patients for clinical outcomes and 44 for microbiological outcomes. Symptoms were alleviated in 62 (84.9%) patients, who were judged clinically cured. Microorganisms detected before treatment were eradicated in 42 (95.5%) patients, who were judged microbiologically cured. Regarding microbiological outcomes of specific microorganisms, eradication rates of C. trachomatis (n = 33), M. genitalium (n = 11), and U. urealyticum (n = 10) were 100%, 100%, and 80.0%, respectively. In all 5 patients with M. genitalium-positive persistent or recurrent NGU who had experienced treatment failures with antibiotics, the mycoplasma was eradicated. These results suggested that the sitafloxacin regimen used, which was effective on both M. genitalium and C. trachomatis infections, could be useful as an appropriate option as first- and second-line treatment of NGU.

DOI PubMed

Uncommon occurrence of mutations in the gyrB gene associated with quinolone resistance in clinical isolates of Neisseria gonorrhoeae [1]

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

Antimicrobial Agents and Chemotherapy   40   2437 - 2438  2012年03月

PubMed

Prevalence of genital mycoplasmas and ureaplasmas in men younger than 40 years-of-age with acute epididymitis

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

INTERNATIONAL JOURNAL OF UROLOGY ( WILEY-BLACKWELL )  19 ( 3 ) 234 - 238  2012年03月

　概要を見る

Objectives: Acute epididymitis is often associated with urethritis. Mycoplasma genitalium and Ureaplasma urealyticum have been considered as pathogens of urethritis. The aim of the present study was to determine the prevalence of these microorganisms in men with acute epididymitis. Method: A total of 56 men younger than 40 years-of-age with acute epididymitis were enrolled in the present study between January 2006 and June 2010. First-void urine specimens were subjected to culture of aerobic bacterial species, and examined for the presence of Chlamydia trachomatis, M. genitalium, M. hominis, U. parvum and U. urealyticum by polymerase chain reaction-based assays. Urethral swabs were cultured for Neisseria gonorrhoeae. Results: The number and percentage of patients positive for each microorganism were as follows: Gram-negative bacilli, 2% and 3.6%; Gram-positive cocci, 23% and 41.1%; N. gonorrhoeae, 3% and 5.4%; C. trachomatis, 28% and 50.0%; M. genitalium, 5% and 8.9%; M. hominis, 6% and 10.7%; U. parvum, 6% and 10.7%; and U. urealyticum, 5% and 8.9%. Among 25 men with non-chlamydial non-gonococcal epididymitis, who were negative for Gram-negative bacilli, M. genitalium or U. urealyticum was detected in one man each (4.0%), and M. hominis and/or U. parvum was detected in five (20.0%). Conclusion: In men younger than 40 years-of-age with acute epididymitis, C. trachomatis is a major pathogen. The prevalence of genital mycoplasmas and ureaplasmas are lower, and the role of genital mycoplasmas and ureaplasmas in the development of acute epididymitis remains to be determined.

DOI PubMed

Solitary fibrous tumor of the urinary bladder: A case report

Kensaku Seike, Koji Kameyama, Taku Kato, Tomohiro Tsuchiya, Mitsuru Yasuda, Shigeaki Yoko, Masahiro Nakano, Syuji Hayashi, Takashi Deguchi, Yoshinobu Hirose

Acta Urologica Japonica   58 ( 2 ) 105 - 108  2012年02月

　概要を見る

A 41-year-old woman with an incidental tumor of the urinary bladder was referred to our hospital. Computed tomography and magnetic resonance imaging showed a tumor in the urinary bladder wall with expansive growth. Under the suspicion of leiomyoma, we performed transurethral resection of the tumor. Pathological examination of tumor specimens revealed pattcrnless arrangements of spindle cells. Immunochemical analysis revealed tumor cells positive for CD34 and bcl-2. The final diagnosis was a solitary fibrous tumor.

PubMed

In vitro activity of azithromycin against Mycoplasma genitalium and its efficacy in the treatment of male Mycoplasma genitalium-positive nongonococcal urethritis

Noriyasu Hagiwara, Mitsuru Yasuda, Shin-ichi Maeda, Takashi Deguchi

JOURNAL OF INFECTION AND CHEMOTHERAPY ( ELSEVIER SCIENCE BV )  17 ( 6 ) 821 - 824  2011年12月

　概要を見る

Many recent studies have shown that Mycoplasma genitalium is among the pathogens responsible for Chlamydia trachomatis-negative nongonococcal urethritis (NGU). A single 1-g dose of azithromycin (AZM) has been recommended for the treatment of NGU, including M. genitalium-positive NGU, irrespective of whether it is positive or negative for Chlamydia trachomatis. The purpose of this study was to determine the minimal inhibitory concentrations of AZM against Mycoplasma genitalium strains, and to assess its clinical efficacy against Mycoplasma genitalium-positive NGU. Seven Mycoplasma genitalium strains were obtained from the American Type Culture Collection, and susceptibility testing of seven antimicrobial agents was performed using a broth microdilution method. Thirty men with M. genitalium-positive NGU were enrolled in this study and treated with a single 1-g dose of AZM. AZM and clarithromycin (CAM) were highly active against M. genitalium strains. Fluoroquinolone activities were moderate, and of the three fluoroquinolones tested, gatifloxacin (GFLX) and sparfloxacin (SPFX) were more active than levofloxacin (LVFX). In 25 of 30 (83.3%) men treated with a single 1-g dose of AZM, M. genitalium was eradicated from first-void urine samples, as determined by polymerase chain reaction. AZM was highly active against M. genitalium, and a single 1-g dose of AZM for M. genitalium-positive NGU was tolerated in Japan. These findings may be helpful in establishing optimal treatment for M. genitalium-positive NGU.

DOI PubMed

Evaluation by Monte Carlo simulation of levofloxacin dosing for complicated urinary tract infections caused by Escherichia coli or Pseudomonas aeruginosa

Takashi Deguchi, Kensaku Seike, Mitsuru Yasuda, Tetsuro Matsumoto

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO )  17 ( 5 ) 726 - 730  2011年10月

　概要を見る

We evaluated, by Monte Carlo simulation, 500-mg once-daily, 100-mg thrice-daily, 200-mg twice-daily, and 200-mg thrice-daily dose regimens of levofloxacin (LVFX), for the ratio of area under the concentration-time curve for 24 h (AUC(0-24)) to minimum inhibitory concentration (MIC) (AUC(0-24)/MIC) and the ratio of maximum plasma concentration (C(max)) to MIC (C(max)/MIC), which predict microbiological outcomes, and the C(max)/MIC, which inhibits fluoroquinolone resistance selection, in complicated urinary tract infections (UTIs) with Escherichia coli or Pseudomonas aeruginosa. Monte Carlo simulation was performed for 10000 cases using the pharmacokinetic data of patients with complicated UTIs and the LVFX MIC distributions for E. coli or P. aeruginosa clinical strains. The probabilities of achieving the AUC(0-24)/MIC target (66.2-67.9%) and the C(max)/MIC target (64.5-67.5%) to eradicate E. coli were similar among the 4 regimens. In eradication of P. aeruginosa, the 200-mg thrice-daily and the once-daily dose regimens produced higher probabilities of achieving the AUC(0-24)/MIC target (57.5%) and C(max)/MIC target (55.1%), respectively. For the probabilities of achieving the C(max)/MIC targets that prevent the emergence of fluoroquinolone resistance, the once-daily dose regimen (66.8%) did not differ from the other multiple-dose regimens (62.3-66.2%) in E. coli, whereas the former regimen (44.2%) was superior to the latter regimens (10.8-31.7%) in P. aeruginosa. The 500-mg once-daily dose regimen of LVFX, which produced the larger AUC(0-24) and higher C(max), could ensure the efficacy of eradication of uropathogens and reduce the risk of fluoroquinolone resistance selection in complicated UTIs.

DOI PubMed

Infected solitary renal cyst of the graft in a renal transplant recipient: A case report

Kenichiro Ishida, Tomohiro Tsuchiya, Hiromi Kondo, Keita Nakane, Taku Kato, Kensaku Seike, Kousei Miwa, Mitsuru Yasuda, Sigeaki Yokoi, Masahiro Nakano, Takashi Deguchi

Acta Urologica Japonica   57 ( 9 ) 501 - 504  2011年09月

　概要を見る

A 59-year-old woman with end-stage renal disease of diabetic nephropathy who had been on maintenance hemodialisis for 4 years, underwent a living-unrelated renal transplantation 6 years ago. She was admitted to our hospital, because of a low grade fever and edema. Ultrasonography revealed the cyst with heterogeneity structure in the upper pole of the transplanted kidney. Magnetic resonance imaging showed a high-intensity cystic mass measuring 68 × 53 mm. As fever and laboratory data did not improve sufficiently by the treatment with antibiotics, echo-guided puncture and drainage were performed for the abnormal structure in the upper pole of the transplanted kidney. In the culture of the purulent aspirate drained from renal cyst, Escherichia coli was isolated. To our knowledge, this is the first report of infected renal cyst of the graft in a renal transplant recipient in the world.

PubMed

Effect of gatifloxacin against Mycoplasma genitalium-related urethritis: an open clinical trial

Ryoichi Hamasuna, Satoshi Takahashi, Hiroshi Kiyota, Mitsuru Yasuda, Hiroshi Hayami, Soichi Arakawa, Kazunori Tomono, Tetsuro Matsumoto

SEXUALLY TRANSMITTED INFECTIONS ( B M J PUBLISHING GROUP )  87 ( 5 ) 389 - 390  2011年08月

　概要を見る

Objectives Mycoplasma genitalium and Chlamydia trachomatis are the primary pathogens detected from non-gonococcal urethritis (NGU). In this study, the efficacy of gatifloxacin was examined against M genitalium-related urethritis. Methods The study was an open clinical trial evaluating the effectiveness of gatifloxacin with 200 mg doses twice a day for 7 days against male NGU. Results Between March and September 2008, 169 male patients were enrolled, and microbiological and clinical cure rates could be evaluated in 86 patients detected with C trachomatis or M genitalium and in 135 with NGU, respectively. Microbiological cure rates of gatifloxacin against C trachomatis and M genitalium were 100% and 83%, respectively, and the total clinical cure rate was 99%. Conclusion Analysis of in-vivo and in-vitro data from the literature of fluoroquinolone efficacies against M genitalium suggests that a MIC90 of 0.125 mu g/ml or less may be useful for optimal activity against M genitalium infection.

DOI PubMed

Selection of Mycoplasma genitalium strains harbouring macrolide resistance-associated 23S rRNA mutations by treatment with a single 1 g dose of azithromycin

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

SEXUALLY TRANSMITTED INFECTIONS ( B M J PUBLISHING GROUP )  87 ( 5 ) 412 - 414  2011年08月

　概要を見る

Objective A single 1 g dose regimen of azithromycin has been recommended for the treatment of Mycoplasma genitalium infections. The authors evaluated whether this regimen could select M genitalium strains with macrolide resistance after treatment for M genitalium-positive non-gonococcal urethritis. Methods In seven men with non-gonococcal urethritis, who were infected with M genitalium without macrolide resistance-associated mutations but experienced microbiological azithromycin treatment failure, M genitalium DNAs in their post-treatment urine specimens were examined for mutations in the 23S rRNA gene and the ribosomal protein genes of L4 and L22. To assess the relatedness of M genitalium strains before and after treatment, their DNAs in pretreatment and post-treatment urine were genotyped by analysing short tandem repeats of an AGT/AAT unit in the MG309 gene and single nucleotide polymorphisms in the MG191 gene. Results In four of seven patients, M genitalium in post-treatment urine had an A-to-G transition at nucleotide position 2071 or 2072, corresponding to 2058 or 2059 in the 23S rRNA gene of Escherichia coli. In one of the four strains, Pro81Ser in the ribosomal protein L4 accompanied the mutation in the 23S rRNA gene. The genotyping of M genitalium DNAs suggested that these four post-treatment strains were selected from the respective closely related or identical pretreatment strains without macrolide resistance-associated mutations by the treatment. Conclusions The single 1 g dose treatment of azithromycin could select M genitalium strains harbouring macrolide resistance-associated mutations. For M genitalium, this regimen might increase the risk of macrolide resistance selection after treatment.

DOI PubMed

Japanese guideline for clinical research of antimicrobial agents on urogenital infections: the first edition

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

JOURNAL OF INFECTION AND CHEMOTHERAPY ( SPRINGER TOKYO )  17 ( 4 ) 579 - 594  2011年08月

その他  

DOI PubMed

Macrolide Resistance-associated 23S rRNA Mutation in Mycoplasma genitalium, Japan

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

EMERGING INFECTIOUS DISEASES ( CENTERS DISEASE CONTROL )  17 ( 6 ) 1148 - 1150  2011年06月

速報，短報，研究ノート等（学術雑誌）  

DOI

Nationwide survey of antibacterial activity against clinical isolates from urinary tract infections in Japan (2008)

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

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV )  37 ( 3 ) 210 - 218  2011年03月

　概要を見る

In this study, the causative bacteria and their sensitivity to various antimicrobial agents as well as risk factors for quinolone-resistant Escherichia coli were investigated in patients with acute uncomplicated cystitis or complicated cystitis by isolation and culture of bacteria from urine samples. In total, 1312 strains were isolated from 1009 patients with acute uncomplicated cystitis, including E. coli (63.3%), Enterococcus faecalis (12.8%) and Streptococcus agalactiae (4.6%). In addition, 994 strains were isolated from 725 patients with complicated cystitis, including E. coli (36.4%), E. faecalis (19.2%), Klebsiella pneumoniae (5.0%), S. agalactiae (4.7%) and Pseudomonas aeruginosa (4.5%). At least 90% of E. coli isolates from acute uncomplicated cystitis showed sensitivity to fluoroquinolones and cephems, whilst 70.4-88.4% of E. coli isolates from complicated cystitis were sensitive to fluoroquinolones and 85.4-89.5% were sensitive to cephems. Factors associated with quinolone-resistant E. coli included two or more episodes of cystitis within 1 year, failure of quinolone therapy, underlying urinary tract disease, prior quinolone treatment within 1 month and age >= 75 years. It is important to confirm the sensitivity of causative bacteria for optimal antimicrobial therapy, and empirical antimicrobial agents should be selected by considering patient characteristics and other factors. (C) 2011 Published by Elsevier B.V. and the International Society of Chemotherapy.

DOI PubMed

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

　概要を見る

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

　概要を見る

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

　概要を見る

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

　概要を見る

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

　概要を見る

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

CiNii

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

　概要を見る

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

　概要を見る

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

CiNii

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

　概要を見る

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

　概要を見る

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

　概要を見る

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

　概要を見る

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

CiNii

Rapid detection of the mosaic structure of the Neisseria gonorrhoeae penA gene, which is associated with decreased susceptibilities to oral cephalosporins

Susumu Ochiai, Hiroaki Ishiko, Mitsuru Yasuda, Takashi Deguchi

JOURNAL OF CLINICAL MICROBIOLOGY ( AMER SOC MICROBIOLOGY )  46 ( 5 ) 1804 - 1810  2008年05月

　概要を見る

In Neisseria gonorrhoeae, the mosaic structure of the penA gene (encoding penicillin-binding protein 2 [PBP 2]), which is composed of fragments of the penA genes from Neisseria cinerea and Neisseria perflava, has been significantly associated with decreased susceptibility to cephalosporins, particularly oral cephalosporins. The aim of this study was to develop a rapid assay for the detection of mosaic PBP 2 of N. gonorrhoeae by real-time PCR. This assay successfully detected the mosaic penA gene of N. gonorrhoeae, and its sensitivity was >= 10(1) copies/reaction. Six hundred twenty-one clinical strains were examined by this assay for the presence of mosaic PBP 2, which was detected in 85 (39.4%) of 216 strains from 2002, 69 (40.6%) of 170 strains from 2003, 71 (44.4%) of 160 strains from 2004, and 31 (41.3%) of 75 strains from 2005. The MICs of cephalosporins for strains with the mosaic PBP 2 detected by the assay were statistically higher than those for strains without the mosaic PBP 2. One hundred sixty-six (64.8%) of 256 strains with the mosaic PBP 2 exhibited cefixime MICs of >= 0.5 mu g/ml. The emergence and spread of strains with mosaic PBP 2 could be a threat to the cefixime treatment of gonorrhea. This real-time PCR assay for the detection of mosaic PBP 2 of N. gonorrhoeae is thus useful in the prediction of decreased susceptibilities to oral cephalosporins.

DOI PubMed

The phylogenetic and virulence profiles of quinolone-resistant escherichia coli isolated from cystitis are different from quinolone-susceptible counterparts

Akira Takahashi, Shingo Yamamoto, Kiyohito Ishikawa, Mitsuru Yasuda, Satoshi Takahashi, Koichi Morlden, Tetsuro Muratani, Hiroshi Kiyota, Soichi Arakawa, Tetsuro Matsumoto

JOURNAL OF UROLOGY ( ELSEVIER SCIENCE INC )  179 ( 4 ) 83 - 83  2008年04月

研究発表ペーパー・要旨（国際会議）  

DOI

T-even-related bacteriophages as candidates for treatment of Escherichia coli urinary tract infections

H. Nishikawa, M. Yasuda, J. Uchiyama, M. Rashel, Y. Maeda, I. Takemura, S. Sugihara, T. Ujihara, Y. Shimizu, T. Shuin, S. Matsuzaki

ARCHIVES OF VIROLOGY ( SPRINGER WIEN )  153 ( 3 ) 507 - 515  2008年03月

　概要を見る

Multidrug-resistant uropathogenic Escherichia coli (UPEC) is increasing gradually on a worldwide scale. We therefore examined the possibility of bacteriophage (phage) therapy for urinary tract infections (UTIs) caused by the UPEC strains as an alternative to chemotherapy. In addition to the well-known T4 phage, KEP10, which was newly isolated, was used as a therapeutic phage candidate. KEP10 showed a broader bacteriolytic spectrum (67%) for UPEC strains than T4 (14%). Morphological and genetic analyses showed that KEP10 resembles phage T4. Phages T4 and KEP10 injected into the peritoneal cavity of mice were distributed immediately to all organs examined and maintained a high titer for at least 24 h. They were stable in the urine of both mice and humans for 24 h at 37 degrees C. Administration of these phages into the peritoneal cavity caused a marked decrease in the mortality of mice inoculated transurethrally with a UPEC strain, whereas most of the control mice died within a few days of bacterial infection. Inoculation with phage alone produced no adverse effects attributable to the phage per se. The present study experimentally demonstrated the therapeutic potential of phage for E. coli-induced UTIs, and T-even-related phages may be suitable candidates with which to treat them.

DOI PubMed

The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis

Shigeaki Yokoi, Shin-ichi Maeda, Yasuaki Kubota, Masayoshi Tamaki, Kohsuke Mizutani, Mitsuru Yasuda, Shin-ichi Ito, Masahiro Nakano, Hidetoshi Ehara, Takashi Deguchi

CLINICAL INFECTIOUS DISEASES ( UNIV CHICAGO PRESS )  45 ( 7 ) 866 - 871  2007年10月

　概要を見る

Background. There are few studies on coinfection with genital mycoplasmas and ureaplasmas in men with gonococcal urethritis (GU). The role of these species in postgonococcal urethritis (PGU) is poorly understood. Thus, we conducted a study to determine the prevalence of coinfection with genital mycoplasmas and ureaplasmas among men with GU and to assess the role of these pathogens in PGU. Methods. Three hundred ninety men infected with culture-confirmed Neisseria gonorrhoeae participated in the study. Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum biovar 1, and Ureaplasma urealyticum biovar 2 in first-voided urine samples were detected by polymerase chain reaction-based assay at the patients' initial visits. PGU was judged to be present if the urethral smear was positive for polymorphonuclear leucocytes 7-14 days after treatment for gonorrhea. The association between each microorganism and PGU, measured by the odds ratio, was estimated by multivariate logistic regression analysis. Results. C. trachomatis, M. genitalium, M. hominis, U. parvum biovar 1, and U. urealytiucm biovar 2 were detected in 85 (21.8%), 16 (4.1%), 8 (2.1%), and 33 men (8.5%), respectively. In patients with chlamydia-negative GU, coinfection with M. genitalium was associated with a 14.54-fold greater risk of PGU (95% confidence interval, 2.91-72.74), and coinfection with U. urealyticum biovar 2 was associated with a 3.64-fold greater risk of PGU ( 95% confidence interval, 1.24-10.63). Conclusions. Coinfection with M. genitalium or U. ureaplasma biovar 2 in men with GU was significantly associated with PGU, independent of C. trachoamtis. Men with GU should be treated presumptively with antibiotics that are active against C. trachomatis, M. genitalium, and U. urealyticum biovar 2.

DOI PubMed

Japanese guidelines for prevention of perioperative infections in urological field

Tetsuro Matsumoto, Hiroshi Kiyota, Masanori Matsukawa, Mitsuru Yasuda, Soichi Arakawa, Koichi Monden

INTERNATIONAL JOURNAL OF UROLOGY ( BLACKWELL PUBLISHING )  14 ( 10 ) 890 - 909  2007年10月

書評論文，書評，文献紹介等  

　概要を見る

For urologists, it is very important to master surgical indications and surgical techniques. On the other hand, the knowledge of the prevention of perioperative infections and the improvement of surgical techniques should always be considered. Although the prevention of perioperative infections in each surgical field is a very important issue, the evidence and the number of guidelines are limited. Among them, the preparation of guidelines has progressed, especially in gastrointestinal surgery. The Center for Disease Control and Prevention (CDC) proposed guidelines for the prevention of surgical site infections, which have been used worldwide. In urology, the original guidelines were different from those of general surgery, due to many endourological procedures and urine exposure in the surgical field. The Japanese Society of UTI Cooperative Study Group has thus framed these guidelines supported by The Japanese Urological Association. The guidelines consist of the following nine techniques: open surgeries, laparoscopic surgeries, transurethral resection of bladder tumor, ureterorenoscope and transurethral lithotripsy, transurethral resection of the prostate, prostate biopsy, cystourethroscope, pediatric surgeries in the urological field, and extracorporeal shock wave lithotripsy and febrile neutropenia. These are the first guidelines for the prevention of perioperative infections in the urological field in Japan. Although most of these guidelines were made using reliable evidence, there are parts without enough evidence. Therefore, if new reliable data is reported, it will be necessary for these guidelines to be revised in the future.

DOI PubMed

Threat to Cefixime treatment for Gonorrhea

Shigeaki Yokoi, Takashi Deguchi, Tomorni Ozawa, Mitsuru Yasuda, Shin-ichi Ito, Yasuaki Kubota, Masayoshi Tamaki, Shin-ichi Maeda

EMERGING INFECTIOUS DISEASES ( CENTER DISEASE CONTROL )  13 ( 8 ) 1275 - 1277  2007年08月

速報，短報，研究ノート等（学術雑誌）  

PubMed

Decreased affinity of mosaic-structure recombinant penicillin-binding protein 2 for oral cephalosporins in Neisseria gonorrhoeae

Susumu Ochiai, Satomi Sekiguchi, Akio Hayashi, Mitsunobu Shimadzu, Hiroaki Ishiko

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  60 ( 1 ) 54 - 60  2007年07月

　概要を見る

Objectives: In Neisseria gonorrhoeae, the mosaic structure of penicillin-binding protein 2 (PBP 2), composed of fragments of, PBP 2 from Neisseria cinerea and Neisseria perflava, was significantly associated with decreased susceptibility to cephalosporins, particularly oral cephalosporins. The aim of this study was to determine the affinity of mosaic PBP 2 for cephalosporins in N. gonorrhoeae. Methods: Two types of non-mosaic PBP 2 from the type strain of N. gonorrhoeae (ATCC 19424) and a clinical strain (GU01-29), as well as the mosaic PBP 2 from a clinical strain (GU01-89), were expressed in insect cells, and recombinant PBP 2s were purified. ATCC 19424 and GU01-29 were susceptible to cephalosporins. GU01-, 89 showed decreased susceptibility to cephalosporins. Bindings of fluorescent penicillin to PBP 2 were characterized by the Scatchard plot analysis. The affinity of the recombinant PBP 2s for cefdinir, cefixime and ceftriaxone was determined by PBP 2 competition assays with fluorescent penicillin. Results: The Kd value of mosaic PBP 2 for fluorescent penicillin was higher than that of non-mosaic PBP 2s. The affinity of mosaic PBP 2 for cefdinir or cefixime was lower than that of the non-mosaic PBP 2s. The affinity of the mosaic PBP 2 for ceftriaxone was not changed, compared with that of the non-mosaic PBP 2s. Conclusions: Other mechanisms may be involved in clinical isolates with decreased susceptibility to cephalosporins, but this study suggests that the decreased affinity of mosaic-structure recombinant PBP 2 for oral cephalosporins may contribute to decreased susceptibility to these antibiotics in N. gonorrhoeae.

DOI PubMed

Quantitative detection of Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in urine specimens from men with and without urethritis by real-time polymerase chain reaction

Takashi Yoshida, Takashi Deguchi, Shin-Ichi Meda, Yasuaki Kubota, Masayoshi Tamaki, Shigeaki Yokoi, Mitsuru Yasuda, Hiroaki Ishiko

SEXUALLY TRANSMITTED DISEASES ( LIPPINCOTT WILLIAMS & WILKINS )  34 ( 6 ) 416 - 419  2007年06月

　概要を見る

Background: We previously reported a significant association between Ureaplasma urealyticum (biovar 2) and nongonococcal urethritis (NGU). We also found that the presence of Ureaplasma parvum (biovar 1) in the male urethra might be the result of colonization. Objective: The objective of this study was to clarify the pathogenic role of human Ureaplasma in NGU by assessing the association of bacterial loads with clinical findings and inflammatory responses in the urethra. Study Design: The 16S rRNA gene of Ureaplasma was quantified by a TaqMan-based real-time polymerase chain reaction assay in first-pass urine from 37 men with Ureaplasma-positive nonmycoplasmal nonchlamydial NGU (NMNCNGU) and 30 Ureaplasma-positive men without urethritis. Results: U. urealyticum (biovar 2) loads in 23 men with NMNCNGU were significantly higher than those in 14 men without urethritis. However, U. parvum (biovar 1) loads did not differ significantly between 14 men with NMNCNGU and 20 men without urethritis. Conclusion: The association of increased U. urealyticum (biovar 2) loads with symptomatic urethritis suggests that U. urealyticum (biovar 2) may be a pathogen of NGU. Our results also suggest that the presence of U. parvum (biovar 1) may not be significant in the development of NGU.

DOI PubMed

Treatment of men with urethritis negative for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum

Shin-Ichi Maeda, Masayoshi Tamaki, Yasuaki Kubota, Phuoc Ba Nguyen, Mitsuru Yasuda, Takashi Deguchi

INTERNATIONAL JOURNAL OF UROLOGY ( BLACKWELL PUBLISHING )  14 ( 5 ) 422 - 425  2007年05月

　概要を見る

Objective: Some patients with symptomatic non-gonococcal urethritis (NGU) are negative for Chlamydia trachomatis, mycoplasmas and ureaplasmas. The optimal antimicrobial chemotherapy for such NGU has not fully been elucidated, though many studies of antimicrobial chemotherapies for C. trachomatis-positive NGU have been performed. We assessed the efficacy of antimicrobial agents that are active against C. trachomatis on non-mycoplasmal, non-ureaplasmal and non-chlamydial NGU (NMNUNCNGU). Methods: One hundred men whose first-pass urine samples were negative for C. trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum were treated with levofloxacin, gatifloxacin, minocycline, or clarithromycin for 7 days. Urethritis symptoms and the presence of polymorphonuclear leukocytes (PMNL) in urethral smears were assessed before and after treatment. Results: Eighty-eight (88.0%) of 100 men with NMNUNCNGU showed no signs of urethral inflammation after treatment, but two men complained of some symptoms of urethritis. Twelve (12.0%) of 100 men had significant numbers of PMNL in urethral smears, but five of these 12 men had no symptoms of urethritis. The efficacy for normalization of urethral smears was 90.7% for clarithromycin, 89.7% for levofloxacin, 87.5% for gatifloxacin, and 75.0% for minocycline. The 12 men who showed signs of urethral inflammation were retreated with levofloxacin, gatifloxacin, minocycline or clarithromycin for an additional 7 days. The 10 men who returned after the second treatment had negative urethral smears. Conclusion: Our present findings suggest that antimicrobial agents active against C. trachomatis are effective against NMNUNCNGU and that a 7-day treatment regimen with an appropriate antimicrobial agent may be sufficient to manage patients with NMNUNCNGU.

DOI PubMed

性感染症 診断・治療 非クラミジア性非淋菌性尿道炎 (特集 性感染症--今,なにが問題か)

出口 隆, 萩原 徳康, 安田 満

臨牀と研究 ( 大道学館出版部 )  84 ( 5 ) 673 - 676  2007年05月

CiNii

In vitro antimicrobial activity of azithromycin against Mycoplasma genitalium and the bacteriological efficacy in male M-genitalium-positive non-gonococcal urethritis

M. Yasuda, N. Hagiwara, M. Ito, S. Ishihara, S. Maeda, S. Ito, H. Narita, T. Deguchi

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV )  29   S305 - S305  2007年03月

研究発表ペーパー・要旨（国際会議）  

Coinfection of genital mycoplasmas among men with gonococcal urethritis and their roles in post-gonococcal urethritis

T. Deguchi, M. Yasuda, S. Maeda, M. Tamaki, S. Ito, M. Nakano, S. Yokoi

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS ( ELSEVIER SCIENCE BV )  29   S369 - S369  2007年03月

研究発表ペーパー・要旨（国際会議）  

Failure to detect urethral Trichomonas vaginalis in Japanese men with or without urethritis

Shin-Ichi Maeda, Yasuaki Kubota, Yuri Senda, Masayoshi Tamaki, Mitsuru Yasuda, Takashi Deguchi

INTERNATIONAL JOURNAL OF UROLOGY ( BLACKWELL PUBLISHING )  13 ( 11 ) 1418 - 1420  2006年11月

　概要を見る

Aim: Trichomonas vaginalis may cause symptomatic or asymptomatic urethritis in men. There are few recent studies on the prevalence of T. vaginalis infection in Japanese men, and quantification of the number of cases of urethritis attributable to this pathogen has not been performed in Japan. The aim of this study was to determine the prevalence and morbidity of T. vaginalis infection in Japanese men. Methods: One hundred subjects with or without urethritis were examined for the presence of urethral T. vaginalis using culture swabs. Results: Urethral swabs from all subjects were negative for T. vaginalis. Conclusion: These results indicate Japanese men, including those with urethritis, have a low incidence of urethral T. vaginalis infection or colonization. T. vaginalis appears to be an uncommon pathogen for male urethritis in Japan.

DOI PubMed

髄膜炎菌による男子尿道炎の一例

林 美佳, 安田 満, 出口 隆

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases   17 ( 1 ) 78 - 81  2006年06月

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 PubMed

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 PubMed

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 PubMed

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 PubMed

A questionnaire survey on the theory of antimicrobial prophylaxis in urologic surgery

Shingo Yamamoto, Sojun Kanamaru, Osamu Ogawa, Kiyohito Ishikawa, Kiyotaka Hoshinaga, Masatsugu Iwamura, Takefumi Satoh, Shiro Baba, Masanori Matsukawa, Koh Takeyama, Taiji Tsukamoto, Hiroshi Kiyota, Shoichi Onodera, Shin Egawa, Koichi Monden, Hiromi Kumon, Toshihisa Egashira, Seiji Naito, Kazushi Tanaka, Soichi Arakawa, Sadao Kamidono, Mitsuru Yasuda, Satoshi Ishihara, Takashi Deguchi, Yoji Yamada, Tetsuro Muratani, Tetsuro Matsumoto

Acta Urologica Japonica   50 ( 11 ) 779 - 786  2004年11月

　概要を見る

In order to establish an acceptable guideline for prevention of perioperative infection following urologic surgery, a questionnaire survey on the theory of antimicrobial prophylaxis (AMP) was conducted among urologists in Japan in February 2004. A reply was obtained from 149 urologists working for institutes located all over Japan from Hokkaido to Kyushu areas. Ninety-two percent of the urologists agreed that AMP should be administered 30 min before an incision, and 44% replied that an additional dose of AMP is required in the case of prolonged intervention. Penicillins or the 1st or 2nd generation cephems were used by 89 to 93% of the urologists in operations not including bowel segments, while 78% preferred such AMP agents in the procedures including bowel segments. AMP was terminated within 3 days in 87% for genital operations, in 70 to 76% for laparoscopic operations, in 54 to 65% for other clean or clean-contaminated operations, and in 24% for operations without the bowel segments. Especially, 58% of the urologists continued AMP for more than 5 days after operations with urinary diversion using the intestine. When compared with the previous questionnaire survey by Shinagawa et al, our survey demonstrated that standard consensus of AMP has spread widely among urologists in Japan, although the recommendations published in Europe and United States are still controversial in Japan. Thus, further well-designed clinical trials are required to establish original guidelines in Japan.

PubMed

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 PubMed

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

M Ito, M Yasuda, S Yokoi, SI Ito, Y Takahashi, S Ishihara, SI Maeda, T Deguchi

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( 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 PubMed

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 PubMed

Nationwide survey of urogenital tuberculosis in Japan

Keita Nakane, Keita Nakane, Mitsuru Yasuda, Mitsuru Yasuda, Takashi Deguchi, Takashi Deguchi, Satoshi Takahashi, Satoshi Takahashi, Kazushi Tanaka, Kazushi Tanaka, Hiroshi Hayami, Hiroshi Hayami, Ryoichi Hamasuna, Ryoichi Hamasuna, Shingo Yamamoto, Shingo Yamamoto, Soichi Arakawa, Soichi Arakawa, Tetsuro Matsumoto, Tetsuro Matsumoto

International Journal of Urology   21 ( 11 ) 1171 - 1177  2004年01月   [ 国際誌 ]

　概要を見る

© 2014 The Japanese Urological Association. Objectives: To determine current epidemiology and treatment patterns of urogenital tuberculosis in Japan. Methods: A questionnaire was sent to the urological departments of 1203 Japanese hospitals. Clinical data was reviewed retrospectively; no time range was specified. Results: Of the 1203 hospitals, 399 returned questionnaires with information about 355 urogenital tuberculosis patients. Of the 399, 153 institutions reported at least one patient, and 201 patients were identified between 2000 and 2007. Infections were located in the kidneys (n=242), ureter (n=96), bladder (n=100), epididymis or testes (n=81) and prostate (n=9). Conclusions: Urogenital tuberculosis is rare in Japan, but patients do exist, and we should not ignore them.

DOI PubMed

Uncommon occurrence of fluoroquinolone resistance-associated alterations in GyrA and ParC in clinical strains of Chlamydia trachomatis

Shigeaki Yokoi, Mitsuru Yasuda, Shin-Ichi Ito, Yoshihito Takahashi, Satoshi Ishihara, Takashi Deguchi, Shin-Ichi Maeda, Yasuaki Kubota, Masayoshi Tamaki, Hideto Fukushi

Journal of Infection and Chemotherapy ( Springer Japan )  10 ( 5 ) 262 - 267  2004年

　概要を見る

Twenty-three clinical strains of Chlamydia trachomatis were isolated from men with chlamydial nongonococcal urethritis and examined for the presence of fluoroquinolone resistance-associated alterations in GyrA and ParC. The minimum inhibitory concentrations (MICs) of fluoroquinolones, erythromycin, and tetracycline were determined for 6 of the 23 isolates. In 12 of the 23 isolates, a single amino-acid change was found in GyrA, and in 1 isolate, two amino acids were changed. In all 23 isolates, an Arg-83-to-Gly substitution was observed in ParC, and in 3 isolates, an additional amino-acid change was found. Some changes occurred within the quinolone resistance-determining regions (QRDRs) of GyrA and ParC, but not at positions critical for fluoroquinolone resistance. Of the 6 isolates for which MICs of the agents were determined, 1 isolate had a Cys-66 → Arg substitution in GyrA, and all had the Arg-83 → Gly substitution in ParC. However, all 6 isolates were susceptible to fluoroquinolones. First-pass urine specimens were obtained from two men who were positive for C. trachomatis after levofloxacin treatment, and the gyrA and parC genes of C. trachomatis were amplified by polymerase chain reaction (PCR) and examined for fluoroquinolone resistance-associated mutations. Pre- and post-treatment C. trachomatis persisting in each of them had identical amino-acid sequences in the QRDR of GyrA and ParC. Further, the substitutions found in GyrA and ParC were not located at positions critical for fluoroquinolone resistance. The present study suggests that fluoroquinolone resistance-associated alterations in GyrA and ParC may be uncommon in clinical strains of C. trachomatis.

DOI PubMed

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

Urinary tract-derived Escherichia coli resistant to co-trimoxazole in Japan, where the drug is seldom used for treating acute urinary tract infections

S Ishihara, S Yokoi, N Masue, T Yamada, Y Minamidate, M Yasuda, M Nakano, T Deguchi

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  49 ( 5 ) A881 - 882  2002年05月

速報，短報，研究ノート等（学術雑誌）  

DOI PubMed

Antimicrobial activity of imipenem against isolates from complicated urinary tract infections

Satoshi Ishihara, Toru Yamada, Shigeaki Yokoi, Masayasu Ito, Mitsuru Yasuda, Masahiro Nakano, Yukimichi Kawada, Takashi Deguchi

International Journal of Antimicrobial Agents   19 ( 6 ) 565 - 569  2002年

　概要を見る

Antimicrobial activity of imipenem was measured using 4725 strains isolated from patients with complicated urinary tract infections (CUTIs) between 1988 and 2000. Imipenem was inactive against methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis, Enterococcus faecium and some non-fermenting Gram-negative rods. Resistant strains (MIC> 16 mg/l) were observed in Staphylococcus haemolyticus (22%), Enterococcus faecalis (4%), Enterococcus avium (8%), Serratia marcescens (5%) and Pseudomonas aeruginosa (7%). Although the prevalence of imipenem-resistant strains of S. aureus, S. epidermidis and P. aeruginosa was sporadically high in some years, no steady increase was seen over the period. Resistant strains were rare in other major uropathogenic species. These results suggest that imipenem is still one of the most reliable antimicrobial drugs. © 2002 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.

DOI PubMed

In vivo selection of Pseudomonas aeruginosa with decreased susceptibilities to fluoroquinolones during fluoroquinolone treatment of urinary tract infection

Masahiro Nakano, Mitsuru Yasuda, Shigeaki Yokoi, Yoshihito Takahashi, Satoshi Ishihara, Takashi Deguchi

Urology   58 ( 1 ) 125 - 128  2001年

　概要を見る

Objectives. To present a case of fluoroquinolone treatment failure in urinary tract infection caused by Pseudomonas aeruginosa, accompanied by in vivo selection of the post-treatment isolate that showed decreased susceptibilities to fluoroquinolones, and to report fluoroquinolone resistance mechanisms in the post-treatment isolate. Methods. A patient with urinary tract infection was treated with a suboptimal dose of a fluorinated quinolone, gatifloxacin. P. aeruginosa strains were isolated before and after fluoroquinolone treatment. The pretreatment and post-treatment isolates were examined for relatedness by arbitrarily primed polymerase chain reaction. For these isolates, the minimum inhibitory concentration of antimicrobial agents was determined and mutations in the target genes (gyrA and parC) and regulatory genes (mexR and nfxB) for drug efflux pumps were analyzed. Results. Failure of fluoroquinolone treatment of urinary tract infection was observed. The post-treatment isolate, which was assumed to be isogenic to the pretreatment isolate, exhibited fourfold to 16-fold increases in the MIC of fluoroquinolones. In this isolate, a new mutation, not observed in the pretreatment isolate, was found only in the gyrA gene, resulting in an amino acid change of aspartic acid to asparagine in codon 87 of GyrA. Conclusions. The P. aeruginosa isolate that was initially susceptible to fluoroquinolones showed decreased susceptibility to fluoroquinolones after treatment with a suboptimal dose of one fluoroquinolone. In the post-treatment isolate, the alteration of GyrA would be responsible for the decreased susceptibility to fluoroquinolones. We should be aware that inappropriate use of fluoroquinolones could select such a strain harboring a quinolone resistance-associated alteration of DNA gyrase. Copyright © 2001 Elsevier Science Inc.

DOI PubMed

A clinical study on active vitamin D pulse therapy in hemodialysis patients with secondary hyperparathyroidism

Hidetoshi Ehara, Shin-Ichi Nezasa, Noriyasu Hagiwara, Tohru Yamada, Mitsuru Yasuda, Yoshinori Nishino, Yasuyuki Nishida, Yoshito Takahashi, Satoshi Ishihara, Takashi Degughi

Acta Urologica Japonica   46 ( 3 ) 165 - 168  2000年03月

　概要を見る

The oral active vitamin D pulse therapy was performed for 20 chronic hemodialysis patients with secondary hyperparathyroidism (2°HPT). Before pulse therapy, all patients showed high-turnover bone diseases, elevated serum alkaline phosphatase (Alp) and elevated serum parathyroid hormone (PTH). They had at least one parathyroid gland detected by ultrasonography. In one patient, serum PTH level did not decrease during three months. In five patients, hypercalcemia was observed so that the pulse therapy was withdrawn. Another patient was resistant to the second pulse therapy for recurrence of 2°HPT. Total parathyroidectomy and autotransplantation was performed in these seven patients. The size of parathyroid gland in patients undergoing surgical treatment was significantly larger than those estimated by ultrasonography in patients successfully treated with pulse therapy (p< 0.005). In all patients with surgical treatment, the conventional oral active vitamin D therapy was performed with caution to hypercalcemia preoperatively. The preoperative Alp levels decreased compared with those of at the beginning of the pulse therapy. Postoperatively, the total amount of intravenous administered calcium decreased, and serum calcium levels were easily controlled.

PubMed

In vitro selection of fluoroquinolone-resistant Neisseria gonorrhoeae harboring alterations in DNA gyrase and topoisomerase IV

Mitsuru Yasuda, Hideyuki Fukuda, Shigeaki Yokoi, Satoshi Ishihara, Yukimichi Kawada, Takashi Deguchi

Journal of Urology ( Lippincott Williams and Wilkins )  164 ( 3 I ) 847 - 851  2000年

　概要を見る

Purpose: We attempted to select increasingly fluoroquinolone-resistant strains of Neisseria gonorrhoeae in vitro and to assess whether selected mutants harbored alterations in the GyrA subunit of DNA gyrase and the ParC subunit of DNA topoisomerase IV, which were analogous to those in fluoroquinolone-resistant clinical isolates. Materials and Methods: A fluoroquinolone-susceptible strain was exposed to norfloxacin in vitro. Selected mutants were sequentially exposed to norfloxacin, and this procedure was repeated. For 11 mutants, minimum inhibitory concentrations (MICs) of antimicrobial agents were determined, and mutations in the region corresponding to the quinolone resistance-determining region (QRDR) of the Escherichia coli gyrA gene and the analogous region of the parC gene were analyzed. Results: Mutants obtained in one step exhibited significantly increased MICs of norfloxacin, ofloxacin and ciprofloxacin and had a single amino acid change in GyrA. Two- step mutants exhibited significantly higher norfloxacin MICs. Three of four two-step selected strains had single amino acid changes in both GyrA and ParC. Three-step mutants exhibited further increases in fluoroquinolone MICs and were assigned to the ciprofloxacin-resistant category. Two had a double amino acid change in GyrA, and one had a double GyrA change and a single amino acid change in ParC. Conclusion: We selected fluoroquinolone-resistant strains that carried GyrA and ParC alterations analogous to those in clinical isolates. The serial accumulation of changes in the QRDR of GyrA and the analogous region of ParC was associated with a stepwise increase in fluoroquinolone resistance, although the development of additional alterations in other regions of GyrA and ParC or other mechanisms of fiuoroquinolone resistance also might contribute to the enhancement in fluoroquinolone resistance. The clinical emergence of fluoroquinolone-resistant strains may be due to in- vivo stepwise selection of strains with genetic alterations in GyrA and ParC, as observed here in the in-vitro selection of fluoroquinolone-resistant mutants.

PubMed

Development of a rapid assay for screening point mutations associated with quinolone resistance in the Pseudomonas aeruginosa parC gene

Takashi Deguchi, Masayoshi Yamaha, Masahiro Nakano, Mitsuru Yasuda, Yoshinori Nishino, Satoshi Ishihara, Yukimichi Kawada

Journal of Infection and Chemotherapy ( Springer Japan )  6 ( 1 ) 26 - 29  2000年

　概要を見る

To detect quinolone resistance-associated mutations within the Ser-80 and Glu-84 codons of the Pseudomonas aeruginosa parC gene, we developed a rapid and simple assay based on polymerase chain reaction (PCR) amplification of the region of the parc gene containing the mutation sites and digestion of the PCR products with a restriction enzyme. The mutations generating alterations at Ser-80 and Glu-84 were detected as restriction fragment length polymorphisms of the PCR products digested with HinfI. Among 22 clinical isolates tested by this assay, mutations at the Ser-80 and Glu-84 codons were detected in all 10 isolates in which the presence of the mutations had been confirmed previously by DNA sequencing. This rapid and simple assay could be a useful screening device for genetic alterations associated with resistance to quinolones in the P. aeruginosa parc gene.

DOI PubMed

Clinical study of gatifloxacin in the treatment of male urethritis

Y. Kawada, T. Deguchi, M. Yasuda, I. Saito, M. Yoshida, S. Maeda, K. Tei, Y. Harada, S. Matsuda, Y. Nagatani, H. Kojima, T. Tahara, Y. Hosoi, T. Kawamura, Y. Kunisawa, R. Miyamura

Japanese Journal of Chemotherapy   47   786 - 793  1999年12月

　概要を見る

The clinical efficacies of gatifloxacin (GFLX), a new 8- methoxyquinolone, on male urethritis were investigated. The subjects were 45 patients with gonococcal urethritis, 7 with gonococcal-chlamydial urethritis, 75 with chlamydial urethritis and 44 with nongonococcal-nonchlamydial urethritis. GFLX was administered orally at a dose of 200 mg twice a day for 3 days to the patients with gonococcal urethritis, and for 7 to 14 days to those with chlamydial urethritis and nongonococcal-nonchlamydial urethritis. Thirty-six patients with gonococcal urethritis, 33 patients with chlamydial urethritis and 20 patients with nongonococcal-nonchlamydial urethritis were assessable according to the criteria of the Japanese UTI Committee. The overall clinical responses were excellent in 30 cases and moderate in 6 cases with gonococcal urethritis, excellent in 25 cases, moderate in 7 cases and poor in i case with chlamydial urethritis, and excellent in all cases with nongonococcal-nonchlamydial urethritis, showing an overall efficacy rate of 100%, 97.0%, and 100%, respectively. MIC90 of GFLX against 36 strains of Neisseria gonorrhoeae isolated in this study, was 0.063 μg/mL, and its activity was 4-

DOI

膀胱癌・前立腺癌に対するリザーバー動注化学療法の経験

高橋 義人, 山本 直樹, 出口 隆, 栗山 学, 楊 睦正, 安田 満, 仲野 正博, 河田 幸道, 竹内 敏視, 篠田 育男

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  45 ( 2 ) 159 - 161  1999年02月

　概要を見る

他臓器の合併症を初めとしてなんらかの理由で手術施行が不可能であった進行性膀胱癌15例,膀胱全摘除術試行後の骨盤内再発10例に対しSeldinger法に準じて皮下埋没型リザーバーシステムを設置し動注化学療法を施行.局所再燃前立腺癌23例,内分泌療法不応性局所進行型前立腺癌5例に対してリザーバーを動注化学療法を施行.使用薬剤は,methotrexate,cis-platinum,adriamycinを用いた動注化学療法を入院で施行,外来通院中で可能な症例には5-FUもしくはcarboplatinを維持化学療法として施行.膀胱癌で平均6回,前立腺癌で平均4回施行.局所が制癌されている期間には,遠隔部位での増悪は認めなかった.膀胱癌でPR18例NC7例,前立腺癌でPR11例,NC14例.奏効期間は,膀胱癌で最大46ヵ月,中央値23ヵ月,前立腺癌で最大32ヵ月,中央値12ヵ月.副作用は,全身化学療法に比較して軽度であったA clinical study was performed on the efficacy of intra-arterial chemotherapy using a reservoir system for advanced urological malignancies. The reservoir system was indwelted in the femoral subcutaneous layer by Seldinger's method. Fifteen cases of inoperable complicated advanced bladder cancer and 10 cases of postoperative local recurrent bladder cancer were administered intra-arterial chemotherapy using a reservoir system. Then, 23 cases of local relapsed prostate cancer and two cases of endpocrine-resistant prostate cancer were administered the chemotherapy. The administered anti-cancerous agents were methotraxate, cis-platinum and adriamycin, then 5-FU or carboplatin was administered as maintenance therapy. The mean number of courses of chemotherapy was six for bladder cancer and four for prostate cancer. During stabilization of the local lesion, no distant deterioration was recognized. The overall clinical efficacy was a positive response (PR) and no change (NC): for 18 and 7 cases of bladder cancer, and 11 and 14 cases of prostate cancer, respectively. The median duration of stabilization was 23 months for bladder cancer and 12 months for prostate cancer. The adverse effects were fever than those with systemic chemotherapy.

CiNii

尿路性器感染症における mycoplasma の病原的意義

安田 満, 宇野 雅博, 出口 隆

日本マイコプラズマ学会雑誌 = Japanese Journal of Mycoplasmology   25   1 - 8  1998年12月

CiNii

Alteration in the GyrA subunit of DNA gyrase and the ParC subunit of DNA topoisomerase IV in quinolone-resistant clinical isolates of Staphylococcus epidermidis

Zhiyu Li, Takashi Deguchi, Mitsuru Yasuda, Takeshi Kawamura, Emiko Kanematsu, Yoshinori Nishino, Satoshi Ishihara, Yukimichi Kawada

Antimicrobial Agents and Chemotherapy   42 ( 12 ) 3293 - 3295  1998年12月

　概要を見る

We examined 22 clinical isolates of Staphylococcus epidermidis to analyze the association of alterations in GyrA and Parc with fluoroquinolone resistance. The simultaneous presence of GyrA and Parc alterations was associated with a high level of fluoroquinolone resistance in the clinical isolates of S. epidermidis.

PubMed

In-vitro antimicrobial activity of HSR-903, a new fluoroquinolone, against clinical isolates of Klebsiella pneumoniae and Enterobacter cloacae with fluoroquinolone resistance-associated amino acid alterations in GyrA and ParC (vol 40, pg 907, 1997)

T Deguchi, M Yasuda, T Kawamura, Y Takahashi, E Okezaki, O Nagata, H Kato, Y Kawada

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  41 ( 6 ) 672 - 673  1998年06月

その他  

Alterations in the GyrA subunit of DNA gyrase and the ParC subunit of DNA topoisomerase IV associated with quinolone resistance in Enterococcus faecalis

Emiko Kanematsu, Takashi Deguchi, Mitsuru Yasuda, Takeshi Kawamura, Yoshinori Nishino, Yukimichi Kawada

Antimicrobial Agents and Chemotherapy   42 ( 2 ) 433 - 435  1998年02月

　概要を見る

The gyrA and parC genes of 31 clinical isolates of Enterococcus faecalis, including fluoroquinolone-resistant isolates, were partially sequenced and analyzed for target alterations. Topoisomerase IV may be a primary target in E. faecalis, but high-level fluoroquinolone resistance was associated with simultaneous alterations in both GyrA and ParC.

PubMed

Erratum: In-vitro antimicrobial activity of HSR-903, a new fluoroquinolone, against clinical isolates of Klebsiella pneumoniae and Enterobacter cloacae with fluoroquinolone resistance-associated amino acid alterations in GyrA and ParC (Journal of Antimicr

T. Deguchi, M. Yasuda, T. Kawamura, Y. Takahashi, E. Okezaki, O. Nagata, H. Kato, Y. Kawada

Journal of Antimicrobial Chemotherapy   41   672 - 673  1998年01月

Significance of Stenotrophomonas maltophilia in urinary tract infections

Satoshi Ishihara, Mitsuru Yasuda, Masahiro Nakano, Shigehiko Ozeki, Takashi Deguchi, Yoshihito Ban, Yukimichi Kawada

Journal of Infection and Chemotherapy ( Springer Japan )  4 ( 1 ) 20 - 23  1998年

　概要を見る

Bacteriuria of Stenotrophomonas maltophilia, a new name for Xanthomonas maltophilia, is not common. During a 7-year study period, the medical records of 26 patients were retrospectively analyzed. All patients had several underlying diseases and previous antimicrobial treatments. S. maltophilia spontaneously regressed and was thought to be colonized in most of our patients. This organism is resistant to most broad-spectrum antibiotics, except for minocycline and latamoxef. Although S. maltophilia is thought to be a colonizer in the urinary tract, it should be viewed with special concern because of its resistance to antibiotics. © JSC/CLJ 1998.

DOI

Serotyping of quinolone-resistant neisseria gonorrhoeae isolates with alterations in GyrA and ParC [2]

T. Deguchi, M. Yasuda, S. I. Maeda, I. Saito, Y. Kawada

Journal of Antimicrobial Chemotherapy   41 ( 3 ) 418 - 420  1998年

速報，短報，研究ノート等（学術雑誌）  

DOI PubMed

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

Masahiro Nakano, Takashi Deguchi, Mitsuru Yasuda, Shigehiko Ozeki, Yoshinori Nishino, Satoshi Ishihara, Yukimichi Kawada

Journal of Infection and Chemotherapy ( Springer Japan )  4 ( 3 ) 142 - 144  1998年

　概要を見る

The in vitro antimicrobial activity of DU-6859a, a new fluoroquinolone, was tested against 22 clinical isolates of Pseudomonas aeruginosa, including strains with fluoroquinolone resistance-associated alterations in the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV. The MICs of DU-6859a for 10 isolates with both altered GyrA and ParC and for 7 isolates with altered GyrA alone ranged from 1.56 to 25 μg/mL and from 0.78 to 6.25 μg/mL, respectively. The MIC of DU-6859a at which 90% of the strains were inhibited (MIC90) of these 17 isolates was 12.5 μg/mL. However, there was no significant difference between DU-6859a and the other quinolones tested against 5 strains which did not have any alterations of either GyrA or ParC. Based on the MIC90s, DU-6859a exhibited 8- to 32-fold greater activity than the currently available fluoroquinolones against strains having alterations in DNA gyrase and topoisomerase IV. © JSC/CLJ 1998.

DOI

尿路性器感染症における Mycoplasma genitalium の病原的意義

出口 隆, 安田 満, 宇野 雅博

日本マイコプラズマ学会雑誌 = Japanese Journal of Mycoplasmology   24   37 - 40  1997年12月

CiNii

In-vitro antimicrobial activity of HSR-903, a new fluoroquinolone, against clinical isolates of Klebsiella pneumoniae and Enterobacter cloacae with fluoroquinolone resistance-associated amino acid alterations in GyrA and ParC

T Deguchi, M Yasuda, T Kawamura, Y Takahashi, E Okezaki, O Nagata, H Kato, Y Kawada

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY ( OXFORD UNIV PRESS )  40 ( 6 ) 907 - 909  1997年12月

速報，短報，研究ノート等（学術雑誌）  

尿由来緑膿菌におけるgyrA遺伝子変異の臨床的意義に関する研究

河田 幸道, 出口 隆, 仲野 正博, 安田 満

日本化学療法学会雜誌 = Japanese journal of chemotherapy   45 ( 9 ) 750 - 756  1997年09月

CiNii

Quinolone-Resistant Neisseria gonorrhoeae

DEGUCHI Takashi, YASUDA Mitsuru, SAITO Isao, KAWADA Yukimichi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy   3 ( 2 ) 73 - 84  1997年06月

CiNii

Uncommon occurrence of mutations in the gyrB gene associated with quinolone resistance in clinical isolates of Neisseria gonorrhoeae

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

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  40 ( 10 ) 2437 - 2438  1996年10月

速報，短報，研究ノート等（学術雑誌）  

陰嚢内平滑筋肉腫の1例

尾関 茂彦, 安田 満, 仲野 正博, 石原 哲, 出口 隆, 坂 義人, 河田 幸道, 武田 明久

泌尿器科紀要 ( 泌尿器科紀要刊行会 )  42 ( 3 ) 229 - 231  1996年03月

　概要を見る

A case of leiomyosarcoma of the scrotum is reported. A 44-year-old man referred to our hospital with the complaint of swelling of the left scrotal contents. The lesion was about 3 cm in diameter, isolated from testis, epididymis and spermatic cord. Ultrasonography revealed hypoechoic and slightly heterogenic area in the lesion. Surgical resection was easily done. Histological examination showed leiomyosarcoma. Adjuvant therapy was not performed. Three years after the resection, he is alive without any sign of recurrence or metastasis.

CiNii

淋菌におけるキノロン耐性遺伝子変異の簡易検査法

出口 隆, 安田 満, 宇野 雅博, 仲野 正博, 尾関 茂彦, 河田 幸道

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases   6 ( 2 ) 77 - 77  1995年11月

CiNii

男子尿道炎の7年間の臨床統計

前田 真一, 玉木 正義, 安田 満, 仲野 正博, 出口 隆, 坂 義人, 河田 幸道

日本性感染症学会誌 = Japanese archives of sexually transmitted diseases   6 ( 2 ) 28 - 28  1995年11月

CiNii

PCR法による男子非淋菌性尿道炎患者からの Mycoplasma genitalium の検出

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

日本マイコプラズマ学会雑誌 = Japanese Journal of Mycoplasmology   21   73 - 74  1995年10月

CiNii

複雑性尿路感染症由来Enterococcus faecalisの臨床的検討と薬剤感受性について

石原 哲, 安田 満, 多田 晃司, 米田 尚生, 伊藤 康久, 斉藤 昭弘, 出口 隆, 栗山 学, 坂 義人, 河田 幸道

日本化学療法学会雜誌 = Japanese journal of chemotherapy   43 ( 4 ) 451 - 456  1995年04月

CiNii

DNA GYRASE MUTATIONS IN QUINOLONE-RESISTANT CLINICAL ISOLATES OF NEISSERIA-GONORRHOEAE

T DEGUCHI, M YASUDA, M ASANO, K TADA, H IWATA, H KOMEDA, T EZAKI, SAITO, I, Y KAWADA

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY ( AMER SOC MICROBIOLOGY )  39 ( 2 ) 561 - 563  1995年02月

記事・総説・解説・論説等（学術雑誌）  

　概要を見る

Eight quinolone-resistant clinical isolates of Neisseria gonorrhoeae were shown to carry mutations in their GyrA proteins. Six isolates had a single amino acid change of serine to phenylalanine at the position corresponding to Ser-83 in Escherichia coli. In addition to the change of serine to phenylalanine, two isolates had another change of aspartic acid to asparagine at the position corresponding to Asp-87 in E. coli.

Mycoplasma genitalium in non-gonococcal urethritis [2]

T. Deguchi, H. Komeda, M. Yasuda, K. Tada, H. Iwata, M. Asano, T. Ezaki, Y. Kawada

International Journal of STD and AIDS   6   144 - 145  1995年01月

PubMed

Macrolide resistance-associated 23s rRNA mutation in Mycoplasma Genitalium, Japan

Yasushi Shimada, Yasushi Shimada, Takashi Deguchi, Keita Nakane, Mitsuru Yasuda, Shigeaki Yokoi, Shin Ichi Ito, Masahiro Nakano, Shin Ito, Hiroaki Ishiko

Emerging Infectious Diseases   17   1148 - 1149  1978年

DOI PubMed