著者
Hiroki Namikawa Koichi Yamada Hiroki Fujimoto Ken-Ichi Oinuma Yoshihiro Tochino Yasuhiko Takemoto Yukihiro Kaneko Taichi Shuto Hiroshi Kakeya
出版者
一般社団法人 日本内科学会
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.56, no.14, pp.1807-1815, 2017-07-15 (Released:2017-07-15)
参考文献数
37

Objective In recent years, infection caused by extended-spectrum beta-lactamase (ESBL)-producing organisms has become an important issue. However, comparative studies of the bacteremia caused by ESBL Enterobacteriaceae and non-ESBL Enterobacteriaceae are extremely rare in Japan. This study aimed to assess the risk factors and prognosis of patients with bacteremia due to ESBL Escherichia coli (E. coli). Methods The medical records of 31 patients with ESBL E. coli bacteremia and 98 patients with non-ESBL E. coli bacteremia who had been admitted to Osaka City University Hospital between January 2011 and June 2015 were retrospectively reviewed. The patient backgrounds, risk factors for infection, and prognosis were evaluated. Results The male-to-female ratio, mean age, underlying disease, leukocyte count, and C-reactive protein (CRP) level did not differ between the patients in the ESBL E. coli bacteremia and non-ESBL E. coli bacteremia groups. The mean Sequential Organ Failure Assessment (SOFA) score for patients with ESBL and non-ESBL E. coli bacteremia were 3.6 and 3.8, respectively. Further, the mortality did not differ between the two groups (9.7% vs 9.2%). However, the independent predictors associated with ESBL E. coli bacteremia according to a multivariate analysis were the use of immunosuppressive drugs or corticosteroids (p=0.048) and quinolones (p=0.005) prior to isolation. The mortality did not differ between the carbapenem and tazobactam/piperacillin (TAZ/PIPC) or cefmetazole (CMZ) groups for the patients with ESBL E. coli bacteremia. Conclusion Whenever we encountered patients with a history of immunosuppressive drug, corticosteroid, quinolone administration, it was necessary to perform antibiotic therapy while keeping the risk of ESBL E. coli in mind.
著者
Koichi Yamada Hiroki Namikawa Hiroki Fujimoto Kiyotaka Nakaie Etsuko Takizawa Yasuyo Okada Akiko Fujita Hiroyoshi Kawaguchi Yasutaka Nakamura Junko Abe Yukihiro Kaneko Hiroshi Kakeya
出版者
一般社団法人 日本内科学会
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.56, no.7, pp.781-785, 2017-04-01 (Released:2017-04-01)
参考文献数
27
被引用文献数
1

Objective Coagulase-negative staphylococci are among the most frequently isolated microorganisms in blood cultures. The aim of this study was to assess [1] the clinical characteristics of methicillin-resistant, coagulase-negative staphylococci bacteremia and [2] the susceptibility of the isolated bacteria to glycopeptides. Methods We retrospectively reviewed the medical records of 70 patients from whom methicillin-resistant coagulase-negative staphylococci had been isolated at Osaka City University Hospital between January 2010 and December 2013. We evaluated the patients' background, severity and prognosis of the disease, and the susceptibility of the isolated methicillin-resistant coagulase-negative staphylococci to glycopeptides. Results Out of the 70 patients tested, 28 (40.0%) had leukemia, and 36 (51.4%) had been treated for febrile neutropenia. Infection with Staphylococcus epidermidis accounted for 78.6% of patients. Thirty-nine cases (55.7%) were related to intravascular catheters, and 39 (55.7%) were treated using teicoplanin as a first-line therapy. The 30-day mortality rate was 4.3%. Regarding susceptibility, 20% of all isolates were non-susceptible to teicoplanin. According to multivariate analyses, it was observed that premedication using glycopeptides was independently associated with teicoplanin non-susceptibility (p=0.03; hazard ratio = 5.64; 95% confidence interval, 1.16-26.76). Conclusion Our results suggest that clinicians must use glycopeptides appropriately to prevent the development of further antibiotic resistance in methicillin-resistant coagulase-negative staphylococci.
著者
Yohei Migiyama Katsunori Yanagihara Norihito Kaku Yosuke Harada Koichi Yamada Kentaro Nagaoka Yoshitomo Morinaga Norihiko Akamatsu Junichi Matsuda Koichi Izumikawa Hirotsugu Kohrogi Shigeru Kohno
出版者
国立感染症研究所 Japanese Journal of Infectious Diseases 編集委員会
雑誌
Japanese Journal of Infectious Diseases (ISSN:13446304)
巻号頁・発行日
vol.69, no.2, pp.91-96, 2016 (Released:2016-03-23)
参考文献数
31
被引用文献数
2

Pseudomonas aeruginosa bacteremia occurs mainly in immunocompromised patients. However, P. aeruginosa bacteremia in immunocompetent patients has also been reported. The aim of this study was to evaluate the clinical characteristics of P. aeruginosa bacteremia in relation to the immune status of the patients. The medical records of 126 adult patients with P. aeruginosa bacteremia in Nagasaki University Hospital were retrospectively reviewed between January 2003 and December 2012. Of 126 patients with P. aeruginosa bacteremia, 60 patients (47.6%) were classified as immunocompetent. Mortality in immunocompetent patients tended to be lower than in immunocompromised patients (7-day mortality, 8% vs. 30%, P < 0.01; 30-day mortality, 23% vs. 39%, P = 0.053). Multivariate analysis showed that a higher sequential organ failure assessment score (hazard ratio [HR]: 1.27, P < 0.01) and underlying malignancies (HR: 3.33, P < 0.01) were independently associated with 30-day mortality. Initial antibiotic therapy (HR: 0.21, P < 0.01) and patients' immune status (HR: 0.29, P = 0.02) also had a significant impact on survival. However, there was a significant interaction between these 2 variables (P = 0.03 for interaction). A subgroup analysis showed that in immunocompromised, but not immunocompetent patients, initial appropriate antibiotic therapy was associated with lower mortality (30-day mortality 20.5% vs. 66.7%, P < 0.01 by log-rank test).
著者
Yukuo Abe Masahiko Taniguchi Hideki Suganuma Masahiro Saito Toshinori Kojima Yasuyuki Egashira Yukiyo Yamamoto Koichi Yamada
出版者
公益社団法人 化学工学会
雑誌
JOURNAL OF CHEMICAL ENGINEERING OF JAPAN (ISSN:00219592)
巻号頁・発行日
vol.36, no.4, pp.376-382, 2003 (Released:2004-02-21)
参考文献数
13
被引用文献数
2 2 2

Global warming is a serious problem requiring immediate countermeasures. Large-scale afforestation in arid areas for the aim of absorbing CO2 is considered to be one of these measures and the research activities for it have been carried out in Leonora, Western Australia. In this study, the relationship between the biomass distribution and topographic features was examined in order to collect basic information for the selection of suitable afforestation regions in the research area using a biomass distribution map and some topographic elements. The results were as follows.(1) Plant growth is related to the movement of and the volume of runoff water derived from inequality of the ground, which leads to a biased distribution of nutrient accumulation and of surface soil thickness.(2) The total potential biomass estimated from the present topography is greater than the present biomass in the 30 km × 50 km research area. A mass of 319 kt-C could be absorbed in the research area without any improvements in the landform.(3) A substantial improvement on the environment utilizing vast arid areas by afforestation is necessary to fix enough carbon deterring global warming.