研究者詳細 - 大塚　文男

論文 - 大塚　文男

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Detection of Enterobacter cloacae complex strain with a blaNDM-1-harboring plasmid from an elderly resident at a long-term care facility in Okayama, Japan 査読国際誌

Kazuyoshi Gotoh, Hideharu Hagiya, Koji Iio, Haruto Yamada, Osamu Matsushita, Fumio Otsuka

Journal of Infection and Chemotherapy 28 ( 12 ) 1697 - 1699 2022年12月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Elsevier BV

Amidst the global spread of antimicrobial resistance, New Delhi metallo-β-lactamase (NDM)-type carbapenemase-producing Enterobacterales (CPE) remain uncommon in Japan, and the detection of such highly drug-resistant organisms is limited to inbound cases. There is little evidence regarding the prevalence of NDM β-lactamase gene (blaNDM)-harboring CPE in the domestic community, especially in the provincial cities of Japan. Herein, we report the isolation of a blaNDM-1-harboring plasmid in Enterobacter cloacae complex strain isolated from an elderly woman without a history of traveling abroad who had resided in a long-term care facility in Okayama, Japan. The multidrug-resistant blaNDM-harboring CPE isolate was detected in a stool sample of the patient during routine screening at admission. We performed whole-genome sequencing analysis of the isolate using MiSeq (Illumina) and MinION (Oxford Nanopore Technologies) platforms. The isolate was identified as sequence type 171, which has predominantly been reported in the United States and China. The blaNDM-1 gene was encoded on the 46,161 bp IncX3 plasmid, with sequence similarity to plasmids of similar size isolated from individuals in China. Collectively, the genomic data suggest that an imported CPE isolate may have spread among healthy individuals in the regional area of Japan.

DOI： 10.1016/j.jiac.2022.08.019

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Rhinogenic optic neuropathy with hemianopia caused by ethmoidal sinus mucocele. 査読国際誌

Kosuke Oka, Wataru Ando, Hideharu Hagiya, Takaya Higaki, Fumio Otsuka

Clinical case reports 10 ( 12 ) e6696 2022年12月

医療系学部教育でのIPE(Inter-professional Education:多職種連携教育)の実践を通した患者中心の医療の経験

三好智子, 岩室雅也, 花山宜久, 小川弘子, 小比賀美香子, 名倉弘哲, 大塚文男

医学教育 53 ( 6 ) 531 - 536 2022年12月

記述言語：日本語出版者・発行元：(一社)日本医学教育学会

本研究では,医療系学生が小グループのIPEの実践を通して,患者中心のチーム医療を実践したと考えることができたかを検証した.医学科,薬学科,保健学科の臨床実習中の学部学生に対し,小グループで症例基盤型の臨床推論と治療・看護計画立案を行い,IPEに対するアンケートを行った.医学科生は臨床推論と治療計画立案が,薬学科生は治療の副作用対策を提案することが,看護学生は医療チームに必要な情報提供をすることが,医療チームとともに患者中心の医療が実践できたと感じていた.学部毎にチーム医療を実践したと考える項目が異なり,多学部合同IPEにはそれぞれの要素を組み込むことが重要である.(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J00050&link_issn=&doc_id=20230117110006&doc_link_id=%2Fed9jmded%2F2022%2F005306%2F007%2F0531-0536%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fed9jmded%2F2022%2F005306%2F007%2F0531-0536%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Early-stage antibody kinetics after the third dose of BNT162b2 mRNA COVID-19 vaccination measured by a point-of-care fingertip whole blood testing 査読

Hideharu Hagiya, Yasuhiro Nakano, Masanori Furukawa, Naruhiko Sunada, Toru Hasegawa, Yasue Sakurada, Kou Hasegawa, Koichiro Yamamoto, Hiroko Ogawa, Takafumi Obara, Kouhei Ageta, Naomi Matsumoto, Rumi Matsuo, Tomoka Kadowaki, Akihito Higashikage, Takao Hikita, Takashi Yorifuji, Shinichi Toyooka, Yoshinobu Maeda, Yoshinori Yokokura, Fumio Otsuka, Masanori Nakayama

Scientific Reports 12 ( 1 ) 2022年11月

掲載種別：研究論文（学術雑誌）出版者・発行元：Springer Science and Business Media LLC

Abstract

Amid the Coronavirus Disease 2019 pandemic, we aimed to demonstrate the accuracy of the fingertip whole blood sampling test (FWT) in measuring the antibody titer and uncovering its dynamics shortly after booster vaccination. Mokobio SARS-CoV-2 IgM & IgG Quantum Dot immunoassay (Mokobio Biotechnology R&D Center Inc., MD, USA) was used as a point-of-care FWT in 226 health care workers (HCWs) who had received two doses of the BNT162b2 mRNA vaccine (Pfizer-BioNTech) at least 8 months prior. Each participant tested their antibody titers before and after the third-dose booster up to 14-days. The effect of the booster was observed as early as the fourth day after vaccination, which exceeded the detection limit (> 30,000 U/mL) by 2.3% on the fifth day, 12.2% on the sixth day, and 22.5% after the seventh day. Significant positive correlations were observed between the pre- and post-vaccination (the seventh and eighth days) antibody titers (correlation coefficient, 0.405; p < 0.001). FWT is useful for examining antibody titers as a point-of-care test. Rapid response of antibody titer started as early as the fourth day post-vaccination, while the presence of weak responders to BNT162b2 vaccine was indicated.

DOI： 10.1038/s41598-022-24464-3

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その他リンク： https://www.nature.com/articles/s41598-022-24464-3

Letter to the Editor From Yamamoto et al: “Whole Body, Whole Life, Whole Family: Patients’ Perspectives on X-Linked Hypophosphatemia” 査読

Koichiro Yamamoto, Daisuke Omura, Keiji Soga, Mikako Obika, Fumio Otsuka

Journal of the Endocrine Society 7 ( 1 ) 2022年11月

Right-sided infective endocarditis with odontogenic infections 査読国際誌

S Fukushima, K Fujita, H Hagiya, F Otsuka

QJM: An International Journal of Medicine 115 ( 11 ) 753 - 753 2022年11月

A Wolff–Parkinson–White syndrome revealed by the event of heat stroke 査読国際誌

S Tanaka, H Hagiya, F Otsuka

QJM: An International Journal of Medicine 115 ( 11 ) 760 - 761 2022年11月

High frequency of extended-spectrum beta-lactamase-producing Enterobacteriaceae carriers at a Japanese long-term care hospital 査読国際誌

Hideharu Hagiya, Yuji Onishi, Natsumi Shinohara, Mayumi Tokuyasu, Aki Imanishi, Shinnosuke Fukushima, Lutfun Nahar, Koji Iio, Fumio Otsuka

Journal of Infection and Chemotherapy 28 ( 11 ) 1578 - 1581 2022年11月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Elsevier BV

INTRODUCTION: Long-term care hospitals (LTCHs) are at a high risk for the inflow and spread of antimicrobial resistance (AMR) pathogens. However, owing to limited laboratory resources, little is known about the extent to which AMR organisms are endemic. METHODS: We performed active surveillance for carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in newly admitted patients at Marugame Medical Center, a nearly 200-bedded LTCH located in Kagawa, Japan. From August to December 2021, we tested stool samples from patients wearing diapers and confirmed the genetic variants using specific PCR assays. We also collected clinical variables and compared them between AMR carriers and non-carriers. RESULTS: Stool samples were collected from 75 patients, with a median age of 84 years. CRE strain was not detected, but 37 strains of ESBL-E were isolated from 32 patients (42.7%). During the study period, 4.9% of in-hospital patients (37 per 756 patients) were identified to be ESBL-E carriers in the routine microbiological processing, suggesting that active surveillance detected approximately 9-fold more ESBL-E carriers. The blaCTX-M-9 group was the most common (38.5%), followed by the blaTEM (26.9%). The clinical backgrounds of the ESBL-E non-carriers and carriers were not significantly different. CONCLUSION: Our active screening demonstrated that nearly half of the patients hospitalized or transferred to a Japanese LTCH were colonized with ESBL-E. We highlight the enforcement of universal basic infection prevention techniques at LTCHs where patients carrying AMR pathogens gather.

DOI： 10.1016/j.jiac.2022.07.014

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Trends in the incidence of syphilis in the middle‐aged and older adults in Japan: A nationwide observational study, 2009–2019 査読

Misa Takahashi, Hideharu Hagiya, Toshihiro Koyama, Fumio Otsuka

Geriatrics and Gerontology International 2022年11月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Wiley

AIM: Sexually transmitted infections remain a neglected area of research in geriatrics. However, in the global aging societies, sexual health among the middle-aged and older adults is an emerging public concern. High-income countries are facing a resurgence of syphilis cases among young generations, but little is known about its prevalence in older populations. We aimed to investigate the national trend of syphilis cases in Japan. METHODS: This nationwide observational study used the publicly-available database (2009-2019) to calculate crude and age-adjusted incidence rates of syphilis per 100 000 population by age, sex and clinical stage. We collected data from patients aged ≥50 years and performed joinpoint regression analysis to estimate long-term trends and average annual percentage changes (AAPCs). RESULTS: The total number of patients with syphilis increased about 8-fold from 165 in 2009 to 1280 in 2019. AAPCs of crude incidence rates significantly increased in every age category; 33.2% in 50-59 years, 23.8% in 60-69 years and 20.9% in ≥70 years. Age-adjusted incidence rates have surged at AAPCs of 28.7% in men and 23.1% in women, reaching 4.09 in men and 0.71 in women in 2019. By clinical stage, marked increases were observed in primary (AAPCs, 42.3% in men and 41.6% in women) and secondary syphilis (AAPCs, 24.9% in men and 24.2% in women). CONCLUSIONS: An up-toward trend of syphilis among people aged ≥50 years was observed. The importance of sexual health among older people should be highlighted in this aging Japanese society. Geriatr Gerontol Int 2022; ••: ••-••.

DOI： 10.1111/ggi.14500

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ggi.14500

Isolated unilateral absence of adult pulmonary artery 査読

Koichiro Yamamoto, Yasuhiro Nakano, Fumio Otsuka

Clinical Case Reports 10 ( 11 ) 2022年11月

Increased CCR4+ and Decreased Central Memory CD4+ T Lymphocytes in the Background Gastric Mucosa of Patients Developing Gastric Cancer After Helicobacter pylori Eradication: An Exploratory Study. 査読国際誌

Masaya Iwamuro, Takahide Takahashi, Araki Hirabata, Takehiro Tanaka, Fumio Otsuka, Horoyuki Okada

Cureus 14 ( 11 ) e31713 2022年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

The composition of lymphocytes in the gastric mucosa following the eradication of Helicobacter pylori (H. pylori) in patients with and without gastric cancer has not been compared. This study performed a single spot analysis of gastric mucosal lymphocytes after H. pylori eradication in patients with (n = 13) and without (n = 20) gastric cancer. Our comprehensive analysis of lymphocyte composition in the gastric mucosa revealed that: i) the proportion of CD8+/CD3+ cells was relatively higher in the peri-tumor mucosa than in the background mucosa; ii) the proportion of CCR4+/CD3+ cells was higher, and the ratio of CD62L+/CD3+CD4+ cells was relatively lower in the gastric mucosa of cancer patients than in non-cancer patients; and iii) the proportion of CD45RA-CD62L+/CD3+CD4+ cells, namely, the central memory CD4+ T-cell fraction, was lower in the gastric mucosa of cancer patients than in non-cancer patients. Although the exact mechanism of the altered proportions of CCR4+/CD3+ and central memory CD4+ cells in the gastric mucosa of patients with cancer is unknown, focusing on lymphocytes in the gastric mucosa might help improve our understanding of gastric cancer development after H. pylori eradication.

DOI： 10.7759/cureus.31713

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男性2型糖尿病患者における血中アンドロゲン値とその意義

浜原潤, 本多寛之, 山本絋一郎, 中野靖浩, 徳増一樹, 花山宜久, 萩谷英大, 小比賀美香子, 植田圭吾, 岸田雅之, 大塚文男

糖尿病 65 ( 11 ) 633 - 633 2022年11月

Postprandial reactive hypoglycemia detected with premature ventricular contraction 査読

H Honda, S Tanaka, H Hagiya, F Otsuka

QJM: An International Journal of Medicine 115 ( 10 ) 675 - 676 2022年10月

投稿 GM Report 専攻医から見た新専門医制度における総合診療専攻医の育成

大塚勇輝, 小比賀美香子, 大塚文男

総合診療 32 ( 10 ) 1274 - 1275 2022年10月

Transitional Changes in Fatigue-Related Symptoms Due to Long COVID: A Single-Center Retrospective Observational Study in Japan 査読国際誌

Yasuhiro Nakano, Yuki Otsuka, Hiroyuki Honda, Naruhiko Sunada, Kazuki Tokumasu, Yasue Sakurada, Yui Matsuda, Toru Hasegawa, Kanako Ochi, Hideharu Hagiya, Hitomi Kataoka, Keigo Ueda, Fumio Otsuka

Medicina 58 ( 10 ) 1393 - 1393 2022年10月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：MDPI AG

Background and Objectives: Changes in post COVID-19 condition (PCC) characteristics caused by viral variants have yet to be clarified. We aimed to characterize the differences between clinical backgrounds and manifestations in long COVID patients who were infected with the Delta variant and those who were infected with the Omicron variants. Materials and Methods: This study was a single-center retrospective observational study for patients who visited our COVID-19 aftercare outpatient clinic (CAC) established in Okayama University Hospital (Japan) during the period from 15 February 2021 to 15 July 2022. We classified the onset of COVID-19 in the patients into three groups, the preceding, Delta-dominant, and Omicron-dominant periods, based on the prevalent periods of the variants in our prefecture. Results: In a total of 353 patients, after excluding 8 patients, 110, 130, and 113 patients were classified into the preceding, Delta-dominant, and Omicron-dominant periods, respectively. Patients infected in the Omicron-dominant period had significantly fewer hospitalizations, milder illnesses, more vaccinations and earlier visit to the CAC than did patients infected in the Delta-dominant period. Patients infected in the Omicron-dominant period had significantly lower frequencies of dysosmia (12% vs. 45%, ** p < 0.01), dysgeusia (14% vs. 40%, ** p < 0.01) and hair loss (7% vs. 28%, ** p < 0.01) but had higher frequencies of fatigue (65% vs. 50%, * p < 0.05), insomnia (26% vs. 13%, * p < 0.05) and cough (20% vs. 7%, ** p < 0.01) than did patients infected in the Delta-dominant period. Conclusions: The transitional changes in long COVID symptoms caused by the two variants were characterized.

DOI： 10.3390/medicina58101393

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Clinical and microbiological characteristics of polymicrobial bacteremia: a retrospective, multicenter study. 査読国際誌

Shinnosuke Fukushima, Hideharu Hagiya, Koji Fujita, Shinya Kamiyama, Haruto Yamada, Masayuki Kishida, Fumio Otsuka

Infection 50 ( 5 ) 1233 - 1242 2022年10月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To clarify the clinical and microbial characteristics of polymicrobial bacteremia (PMB) to contribute to improvements in clinical diagnosis and effective early treatment. METHODS: This retrospective multicenter study used data from three acute-care hospitals in Okayama Prefecture, Japan, collected between January 2014 and March 2019. We reviewed the demographics, comorbidities, organisms isolated, infectious focus, and 30-day mortality of patients with PMB. RESULTS: Of the 7233 positive blood cultures, 808 (11.2%) were positive for more than one organism. Of the patients with bacteremia, 507 (7.0%) had PMB, of whom 65.3% were male. Infectious foci were identified in 78.3% of the cases, of which intra-abdominal infections accounted for 47.1%. A combination of Gram-positive cocci (GPC) (chain form) and Gram-negative rods (GNR) accounted for 32.9% of the cases, and GPC/GNR and GNR/GNR patterns were significantly associated with intra-abdominal infections. The 30-day mortality rate of patients with PMB was 18.1%, with a median of 7.5 days from diagnosis to death. The mortality in patients with an infectious focus identified was significantly lower than that in patients with an unknown focus (16.3% vs. 24.5%; p = 0.031). CONCLUSIONS: Intra-abdominal infections were the most common source of PMB, and were strongly associated with a Gram-staining combination pattern of GPC (chain form)/GNR. PMB cases with an unknown focus had a poorer prognosis, highlighting the importance of early diagnosis and appropriate treatment.

DOI： 10.1007/s15010-022-01799-7

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新規PHEXバリアントを伴うXLHにブロスマブが奏効した1例

山本紘一郎, 本多寛之, 中野靖浩, 徳増一樹, 長谷川功, 長谷川高誠, 大塚文男

日本内分泌学会雑誌 98 ( 2 ) 591 - 591 2022年10月

COVID-19罹患後症状における内分泌機能に関する検討

砂田匠彦, 本多寛之, 中野靖浩, 山本絋一郎, 徳増一樹, 櫻田泰江, 松田祐依, 長谷川徹, 大塚勇輝, 小比賀美香子, 花山宜久, 萩谷英大, 植田圭吾, 片岡仁美, 大塚文男

日本内分泌学会雑誌 98 ( 2 ) 628 - 628 2022年10月

Kikuchi–Fujimoto disease manifesting bilateral lymphadenopathy 査読国際誌

Akihiro Kawatsuki, Kosuke Oka, Hideharu Hagiya, Fumio Otsuka

Clinical Case Reports 10 ( 10 ) e6494 2022年10月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Wiley

Physicians should keep in mind that Kikuchi-Fujimoto disease can show bilateral lymphadenopathy like the present case.

DOI： 10.1002/ccr3.6494

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その他リンク： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccr3.6494

Candida dubliniensis fungemia in a patient with severe COVID-19: A case report 査読国際誌

Ayaka Kakehi, Hideharu Hagiya, Koji Iio, Yasuhiro Nakano, Hiromi Ihoriya, Yuki Taira, Kenta Nakamoto, Kou Hasegawa, Akihito Higashikage, Fumio Otsuka

Journal of Infection and Chemotherapy 28 ( 10 ) 1433 - 1435 2022年10月

担当区分：最終著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Elsevier BV

Candida dubliniensis phenotypically mimics Candida albicans in its microbiological features; thus, its clinical characteristics have yet to be fully elucidated. Here we report the case of a 68-year-old Japanese man who developed C. dubliniensis fungemia during treatment for severe coronavirus disease 2019 (COVID-19). The patient was intubated and received a combination of immunosuppressants, including high-dose methylprednisolone and two doses of tocilizumab, as well as remdesivir, intravenous heparin, and ceftriaxone. A blood culture on admission day 11 revealed Candida species, which was confirmed as C. dubliniensis by mass spectrometry. An additional sequencing analysis of the 26S rDNA and ITS regions confirmed that the organism was 100% identical to the reference strain of C. dubliniensis (ATCC MYA-646). Considering the simultaneous isolation of C. dubliniensis from a sputum sample, the lower respiratory tract could be an entry point for candidemia. Although treatment with micafungin successfully eradicated the C. dubliniensis fungemia, the patient died of COVID-19 progression. In this case, aggressive immunosuppressive therapy could have caused the C. dubliniensis fungemia. Due to insufficient clinical reports on C. dubliniensis infection based on definitive diagnosis, the whole picture of the cryptic organism is still unknown. Further accumulation of clinical and microbiological data of the pathogen is needed to elucidate their clinical significance.

DOI： 10.1016/j.jiac.2022.07.007

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