Faculty Profiles - HAGIYA Hideharu

Genomic reorganization by IS26 in a blaNDM-5-bearing FII plasmid of Klebsiella pneumoniae isolated from a patient in Japan. Reviewed International journal

Takeuchi D, Akeda Y, Yoshida H, Hagiya H, Yamamoto N, Nishi I, Yoshioka N, Sugawara Y, Sakamoto N, Shanmugakani RK, Deguchi M, Tomono K, Hamada S

Journal of medical microbiology 67 ( 9 ) 1221 - 1224 2018.9

Language：English Publishing type：Research paper (scientific journal)

An NDM-5-producing Klebsiella pneumoniae ST147 strain was isolated from a Japanese patient who had not travelled abroad in at least 5 years. Whole-genome sequencing revealed a genomic rearrangement in an FII plasmid harbouring bla due to the replicative transposition of IS26. A hypothetical structure was proposed for its ancestral plasmid, and comparative genomic analysis of the plasmid suggested the dissemination of structurally similar plasmids harbouring bla in Asian and Middle Eastern countries. NDM-5 NDM-5

DOI： 10.1099/jmm.0.000817

Genomic reorganization by IS26 in a blaNDM-5-bearing FII plasmid of Klebsiella pneumoniae isolated from a patient in Japan Reviewed

akeuchi D, Akeda Y, Yoshida H, Hagiya H, Yamamoto N, Nishi I, Yoshioka N, Sugawara Y, Sakamoto N, Shanmugakani RK, Deguchi M, Tomono K, Hamada S

J Med Microbio 67 ( 9 ) 1221 - 1224 2018.8

Liver abscess caused by Gram-negative spiral bacilli. Reviewed International journal

Hagiya H, Kimura K, Nishi I, Tomono K

JMM case reports 5 ( 7 ) e005155 2018.7

Vaccination strategy for epidemic viral diseases in healthcare workers: Cut-off for optimal immunization. Reviewed International journal

Yoshioka N, Deguchi M, Hagiya H, Kagita M, Tsukamoto H, Takao M, Tomono K

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 25 ( 1 ) 78 - 81 2018.7

Language：English Publishing type：Research paper (scientific journal)

Healthcare workers (HCWs) are at an increased risk of being exposed to epidemic viral diseases (EVDs), such as measles, rubella, mumps, and varicella-zoster. Currently, in case of the absence of written records on previous immunizations, the Japanese Society for Infection Prevention and Control guidelines require HCWs to have antibody titers higher than laboratory thresholds, possibly leading to over-immunization. We report our vaccination strategy and the consequent incidences of EVDs at the Osaka University Hospital between 2000 and 2016. In 2001, we initiated an annual serology check of antibody titers against EVDs and immunization for newly employed HCWs. As an additional vaccination program, all HCWs with low antibody titers were vaccinated in 2005 and 2010. Antibody titers were determined by an enzyme immunoassay (EIA), with a positive range of >2.0 cut-off index. After implementing the vaccination strategy to keep the laboratory threshold, there were only sporadic cases of EVDs among HCWs. More than 99% of individuals who had positive titers in 2005 remained the positive antibody titers in 2010, indicating that a minimum interval of 5 years is enough to measure immunity. Unprotected workers can, even silently, transmit the contagious viruses to patients and coworkers, possibly resulting in a nosocomial outbreak. However, over-vaccination may yield adverse effects and financial burdens. Our observational data indicate that the laboratory cut-off index of >2.0 by EIA may provide a sufficient herd immunity to prevent EVDs among HCWs.

DOI： 10.1016/j.jiac.2018.07.008

Spread of blaNDM-carrying plasmids among clinical and wastewater isolates of Enterobacteriaceae in Myanmar

Sugawara Y, Akeda Y, Sakamoto N, Takeuchi D, Yamamoto N, Hagiya H, Tomono K, Hamada S

2018.6

Persistent methicillin-resistant Staphylococcus aureus bacteremia owing to placental abscess. Reviewed

Maeda N, Hagiya H, Takiuchi T, Kusakabe S, Maeda T, Kimura K, Iwai S, Kawasaki K, Hori Y, Morii E, Kanakura Y, Kimura T, Tomono K

J Infect Chemother 18 30125 - 30129 2018.5

Helicobacter cinaedi-associated Carotid Arteritis. Reviewed

Shinichiro Nakao, Hideharu Hagiya, Keigo Kimura, Tomomi Mitsui, Akane Oyama, Kazuhiro Hongyo, Yusuke Takahashi, Futoshi Nakagami, Kazunori Tomono, Hiromi Rakugi

Acta medica Okayama 72 ( 2 ) 189 - 192 2018.4

Language：English Publishing type：Research paper (scientific journal)

A 65-year-old Japanese man with bilateral carotid atherosclerosis presented with right neck pain and fever. Contrast-enhanced computed tomography suggested carotid arteritis, and carotid ultrasonography showed an unstable plaque. The patient developed a cerebral embolism, causing a transient ischemic attack. Helicobacter cinaedi was detected in blood culture, and H. cinaedi-associated carotid arteritis was diagnosed. Empirical antibiotic therapy was administered for 6 weeks. After readmission for recurrent fever, he was treated another 8 weeks. Although the relationship between H. cinaedi infection and atherosclerosis development remains unclear, the atherosclerotic changes in our patient's carotid artery might have been attributable to H. cinaedi infection.

DOI： 10.18926/AMO/55861

Silent Native-valve Endocarditis Caused by Propionibacterium acnes. Reviewed

Yamamoto R, Miyagawa S, Hagiya H, Kimura K, Nishi I, Yamamoto N, Yoshida H, Akeda Y, Tomono K, Toda K, Sawa Y

Internal medicine (Tokyo, Japan) 57 ( 16 ) 2417 - 2420 2018.3

Language：English Publishing type：Research paper (scientific journal)

We describe a rare case of Propionibacterium acnes native-valve endocarditis that silently progressed in a 67-year-old man with hybrid dialysis. The patient was scheduled for kidney transplantation, and pre-operative investigation incidentally detected a vegetative structure at his native mitral valve that had increased in size. He underwent cardiac surgery and P. acnes was detected in cultures of a resected cardiac valve specimen and blood. This case highlights that P. acnes can silently cause infective endocarditis in a native-valve, and that physicians should consider the possibility of infection when P. acnes is isolated in blood cultures.

DOI： 10.2169/internalmedicine.9833-17

ミャンマー連邦共和国の臨床及び環境由来町内細菌科細菌におけるNDM搭載プラスミドの伝播

菅原庸, 明田幸宏, 萩谷英大, 坂本典子, 竹内壇, 山本倫久, 岡田和久, 朝野和典, 浜田茂幸

2018.3

Desulfovibrio desulfuricans bacteremia: A case report and literature review Reviewed International journal

Hideharu Hagiya, Keigo Kimura, Isao Nishi, Norihisa Yamamoto, Hisao Yoshida, Yukihiro Akeda, Kazunori Tomono

Anaerobe 49 112 - 115 2018.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Academic Press

Desulfovibrio spp. are sulfate-reducing, anaerobic bacteria that are ubiquitously found in the environment. These organisms infrequently cause human infections, and the clinical characteristics of infection with Desulfovibrio spp. remain unclear. Here, we describe a case of Desulfovibrio desulfuricans bacteremia in an 88-year-old Japanese man with a past medical history of thoracic endovascular aortic repair (TEVAR). His chief complaint was hemoptysis for 2 weeks. A chest contrast-enhanced computed tomography demonstrated an enlarged thoracic aortic aneurysm surrounded by a ring-enhanced lesion, recognized as mediastinal abscess. Gram-negative spiral bacilli were detected in anaerobic blood culture. These bacteria could not be identified using conventional methods, but by analyzing a full base sequence of 16S rDNA, they were identified as D. desulfuricans subsp. desulfuricans. The patient underwent an emergent re-TEVAR, and the infection subsided after being treated with tazobactam/piperacillin and clindamycin, followed by metronidazole. A literature review of previous cases of D. desulfuricans bacteremia suggested that the pathogen was derived from bacterial translocation from the intestine in most cases. Desulfovibrio infection is presumably underestimated due to its infrequency, indolent growth, and difficulty in identification. Desulfovibrio spp. should be suspected when spiral rods are observed in anaerobic culture, and molecular analysis is required for accurate species-level differentiation of the pathogens. To better understand the pathogenicity of these fastidious organisms, further cases based on the exact bacterial identification should be investigated.

DOI： 10.1016/j.anaerobe.2017.12.013

Emergence of Carbapenem Non-susceptible Campylobacter coli after Long-term Treatment against Recurrent Bacteremia in a Patient with X-linked Agammaglobulinemia. Reviewed

Hagiya H, Kimura K, Nishi I, Yoshida H, Yamamoto N, Akeda Y, Tomono K

Internal medicine (Tokyo, Japan) 57 ( 14 ) 2077 - 2080 2018.2

Language：English Publishing type：Research paper (scientific journal)

We herein report a case of recurrent Campylobacter coli bacteremia in a 37-year-old Japanese man with X-linked agammaglobulinemia (XLA). The patient experienced seven episodes of C. coli bacteremia over one year, with an erythematous rash intermittently emerged on the lower limbs. Although hospitalization for intravenous treatment was repeatedly recommended, he obstinately declined it. Following long-term oral antibiotic treatment with tebipenem and faropenem for the persistent infection, C. coli showed elevated minimum inhibitory concentrations to meropenem, a key drug for severe campylobacteriosis. Physicians should note that the overuse of antibiotics can lead to the emergence of carbapenem-non-susceptible Campylobacter strains.

DOI： 10.2169/internalmedicine.0312-17

Emergence of Carbapenem Non-susceptible Campylobacter coli after Long-term Treatment against Recurrent Bacteremia in a Patient with X-linked Agammaglobulinemia. Reviewed

Hagiya H, Kimura K, Nishi I, Yoshida H, Yamamoto N, Akeda Y, Tomono K

Internal Medicine 2018.2

Available, Bed-sided, Comprehensive (ABC) score to a diagnosis of Methicillin-resistant Staphylococcus aureus infection: A derivation and validation study Reviewed International journal

Nori Yoshioka, Matsuo Deguchi, Hideharu Hagiya, Hisao Yoshida, Norihisa Yamamoto, Shoji Hashimoto, Yukihiro Akeda, Kazunori Tomono

BMC Infectious Diseases 18 ( 1 ) 19 - 19 2018.1

Language：English Publishing type：Research paper (scientific journal) Publisher：BioMed Central Ltd.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infections continue to be a leading problem in health care facilities worldwide. Methods: This single-center retrospective cohort study consisted of a derivation phase and a validation phase. The derivation phase included all patients admitted to Osaka University Hospital between May 2010 and April 2011. We proposed a provisional available, bed-sided, comprehensive (ABC) score, and evaluated its accuracy using the clinical diagnosis as a reference. We subsequently revised ABC scores based on k coefficient scores of each variable this revision was validated by applying it to another patient population. Results: A total of 172 patients and 154 cases were enrolled in the derivation and validation studies, respectively. The revised ABC score consisted of four simple variables: type of clinical specimen (1 to 3 points), Gram-staining result (1 point), presence of local inflammation (2 points), and a systemic inflammatory response (2 points). A revised score of ≥5 points was sensitive (93.8%) and specific (90.6%), and the area under the receiver-operating curve was 0.969 (95% CI
0.957-1). Conclusions: We developed a simple and comprehensive scoring system for diagnosis of nosocomial MRSA infections
this system is applicable in a wide variety of situations.

File：研究業績書　萩谷 (20180413).docx

DOI： 10.1186/s12879-017-2919-2

Available, Bed-sided, Comprehensive (ABC) score to a diagnosis of Methicillin-resistant Staphylococcus aureus infection: A derivation and validation study Reviewed

Nori Yoshioka, Matsuo Deguchi, Hideharu Hagiya, Hisao Yoshida, Norihisa Yamamoto, Shoji Hashimoto, Yukihiro Akeda, Kazunori Tomono

BMC Infectious Diseases 18 ( 1 ) 19 2018.1

Language：English Publishing type：Research paper (scientific journal) Publisher：BioMed Central Ltd.

DOI： 10.1186/s12879-017-2919-2

Clinical characteristics and outcome of critically ill patients with bacteremia caused by extended-spectrum β-lactamase-producing and non-producing Escherichia coli Reviewed International journal

Yuto Haruki, Hideharu Hagiya, Mai Haruki, Tetsuhiro Sugiyama

Journal of Infection and Chemotherapy 24 ( 11 ) 944 - 947 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier B.V.

The number of patients infected with extended-spectrum beta-lactamase (ESBL)-producing organisms has increased dramatically worldwide, and high mortality rates are seen in severely ill patients. This study retrospectively compared the clinical characteristics and outcomes of critically ill patients in an intensive care unit (ICU) at the Tsuyama Chuo Hospital (Okayama, Japan) who were hospitalized for bacteremia caused by ESBL-producing Escherichia coli (ESBL-EC) or non-ESBL-producing E. coli (non-ESBL-EC) between January 2006 and December 2016 (11 years). We analyzed the patients' age, sex, underlying disease(s), sequential organ failure assessment scores, primary focus of bacteremia, empiric antibiotics, rate of appropriateness of empiric antibiotics, and treatment duration, with 28-day mortality being the primary outcome. The study included 24 patients with ESBL-EC bacteremia and 77 with non-ESBL-EC bacteremia. The rate of appropriate initial antibiotic treatment was significantly lower (54.2% vs. 96.1%, respectively
P &lt
0.01) and the mortality due to bacteremia significantly higher (37.5% vs. 15.6%, respectively
P = 0.04) in the ESBL-EC than in the non-ESBL-EC bacteremia group. A subgroup analysis focusing on patients who were administered appropriate empiric antibiotics showed that the 28-day mortality rate did not differ significantly between the two groups (P = 0.23). To our knowledge, this is the first study to compare the outcomes of patients with ESBL-EC and non-ESBL-EC bacteremia in a Japanese ICU setting. Initial empiric antibiotic therapy covering ESBL-producing pathogens should be considered for critically ill patients in the ICU.

DOI： 10.1016/j.jiac.2018.04.016

Far east scarlet-like fever masquerading as adult-onset Kawasaki disease Reviewed

Kazuki Ocho, Masaya Iwamuro, Kou Hasegawa, Hideharu Hagiya, Kammei Rai, Tetsuya Yumoto, Fumio Otsuka

Internal Medicine 57 ( 3 ) 437 - 440 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Japanese Society of Internal Medicine

A previously healthy 31-year-old man was referred to us with refractory septic shock accompanied by bilateral conjunctival congestion and erythema of his right lower limb. Nine days after admission, he had bilateral desquamation of the fingertips, and his presentation satisfied the criteria for Kawasaki disease. A serological examination was positive for Yersinia pseudotuberculosis, and he was diagnosed with Far East scarlet-like fever (FESLF). Interestingly, his 11-month-old baby boy had similar symptoms around the same time, indicating the intrafamilial transmission of the pathogen. We should consider FESLF when we encounter a familial occurrence of systemic manifestations of Kawasaki disease.

DOI： 10.2169/internalmedicine.9250-17

Risk factors for fecal carriage of IMP-6-producing Enterobacteriaceae at a long-term care hospital in Japan: A follow-up report from the northern Osaka multicentre study group Reviewed International journal

Hideharu Hagiya, Norihisa Yamamoto, Ryuji Kawahara, Yukihiro Akeda, Rathina Kumar Shanmugakani, Akiko Ueda, Isao Nishi, Rumiko Asada, Hisao Yoshida, Kazunori Tomono

Journal of Infection and Chemotherapy 24 ( 9 ) 769 - 772 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier B.V.

The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing at medical institutions in Japan without even noticing. Recently, we performed a point prevalence survey for CRE carriage at a medical facility in northern Osaka that demonstrated an unexpectedly high prevalence of blaIMP-6-positive CRE, particularly at long-term care hospitals (LTCH). To identify the risk factors for CRE carriage, we collected clinical data of patients at a representative LTCH. Of 140 patients who were included in this study, 27 (19.3%) were colonized with metallo-beta-lactamase (IMP-6) producers. Pulsed-field gel electrophoresis of the IMP-6 producing Enterobacteriaceae suggested a non-clonal transmission of Escherichia coli, while a clonal spread was shown for Klebsiella pneumoniae. Risk factors for CRE colonization were a longer stay at the hospital stay and a lower independence state, as measured by Norton scales. We propose that a paradigm shift in infection control, inciting a coordinated regional effort to involve LTCHs, should be discussed in the aging society of Japan.

DOI： 10.1016/j.jiac.2018.03.009

Comparison of the temperature influence on the activity of currently available Procalcitonin reagents Reviewed International journal

Nori Yoshioka, Matsuo Deguchi, Hideharu Hagiya, Masanori Kagita, Satomi Yukawa, Yoh Hidaka, Kazunori Tomono

Clinical Laboratory 64 ( 1-2 ) 201 - 204 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Verlag Klinisches Labor GmbH

Background: Procalcitonin (PCT) is a stable biomarker for bacterial infections
however, limited data is available on new trivalent reagents. We evaluated temperature influence on the activity of PCT reagents. Methods: Using both conventional and trivalent reagents, we measured PCT levels of 30 clinical samples, stored residuum at refrigerator (4°C) and room temperature (24°C), and reexamined it after 24 hours. We defined a reduction rate as a percentage of PCT level at 24 hours compared to that after defrost and evaluated a ratio of reduction rate in 4°C to that in 24°C. Results: The reduction rate at room temperature decreased significantly compared to that in the refrigerated condition for all the reagents examined (p &lt
0.001). In addition, the ratio of reduction rate between the conventional and trivalent reagents showed a significant difference (p &lt
0.001) Conclusions: The serum PCT levels significantly decrease at room temperature, particularly when using newer trivalent reagents.

DOI： 10.7754/Clin.Lab.2017.170510