研究者詳細 - 萩谷　英大

Novel and Simple Approach to Estimating the Actual Incidence of Blood and Body Fluid Exposure 査読国際誌

Nori Yoshioka, Matsuo Deguchi, Hideharu Hagiya, Masanori Kagita, Satomi Yukawa, Hiroko Tsukamoto, Hisao Yoshida, Norihisa Yamamoto, Yukihiro Akeda, Yoshiko Nabetani, Ikuhiro Maeda, Yoh Hidaka, Kazunori Tomono

CLINICAL LABORATORY 63 ( 9 ) 1481 - 1486 2017年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：CLIN LAB PUBL

Background: There is no current way to determine the actual blood and body fluid exposure (BBFE) incidence in hospitals. We propose a simple, reliable, and widely available method for the accurate estimation of BBFE.
Methods: Data for BBFE for healthcare workers between 2006 and 2015 at Osaka University Hospital were retrospectively extracted from the electronic records. Annual positivity of hepatitis C virus (HCV) antibody in the source individuals and overall patient population were calculated over time. We created an estimation formula focusing on the difference in HCV positivity between the source individuals and overall patient population for the actual number of BBFEs. A linear regression model was used to evaluate the temporal change in the reported and estimated BBFEs.
Results: During the study period, 937 BBFEs were reported. HCV positivity between the post-BBFE cohort and overall patient population greatly differed; the incidence ratio ranged from 2.1 to 5.7. The linear regression model revealed that the reported BBFEs did not significantly change during the study period (the slope, 1.315 [95% confidence interval (C.I.): -0.849 to 3.480, p = 0.199]). The annual incidence ratio of the estimated and reported BBFEs significantly reduced over time (the slope, -0.287 [95% C.I.: -0.488 to -0.086, p = 0.011]), indicating that, although the reported number of BBFEs seemed unchanged, the estimated incidence decreased.
Conclusions: We propose a novel and simple approach to estimating the actual incidence of BBFEs in hospitals using the difference in HCV positivity between the post-BBFE cohort and overall patient population.

DOI： 10.7754/Clin.Lab.2017.170340

Herpes zoster laryngitis in a patient treated with fingolimod 査読国際誌

Hideharu Hagiya, Hisao Yoshida, Mikito Shimizu, Daisuke Motooka, Shota Nakamura, Tetsuya Iida, Norihisa Yamamoto, Yukihiro Akeda, Kazunori Tomono

JOURNAL OF INFECTION AND CHEMOTHERAPY 22 ( 12 ) 830 - 832 2016年12月

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 SCIENCE BV

Development of treatment with immunomodulatory agents has improved prognosis of various autoimmune-related diseases. A sphingosin-1-phosphate receptor modulator, or fingolimod, is the first licensed oral drug for relapsing-remitting multiple sclerosis. The agent reduces circulating lymphocytes by trapping T cells in lymph nodes, possibly leading to reactivation of latent viruses. A 41-year-old Japanese woman who had been treated with fingolimod for 2 years presented with unilateral sore throat. Laryngoscopy revealed exudates unilaterally emerging on the left side of her supraglottic region. Serum level of the varicella zoster virus (VZV)-specific IgG was markedly elevated, and a result of genome sequence using the exudates demonstrated VZV as a possible causative pathogen. Fingolimod therapy was discontinued and the patient was successfully treated with intravenous acyclovir. This is the first reported case of fingolimod-associated herpes zoster laryngitis, in which the local VZV reactivation was demonstrated by next-generation sequencing technology. The present case highlights that the occurrence of VZV reactivation should be recalled in any patients undergoing fingolimod therapy. (C) 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jiac.2016.07.011

Kikuchi-Fujimoto Disease Complicated with Reactive Hemophagocytic Lymphohistiocytosis 査読

Masatake Nishiwaki, Hideharu Hagiya, Toru Kamiya

ACTA MEDICA OKAYAMA 70 ( 5 ) 383 - 388 2016年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

Kikuchi-Fujimoto disease (KFD) is a benign cause of self-limiting subacute necrotizing lymphadenitis. KFD is rarely complicated with reactive hemophagocytic lymphohistiocytosis (HLH), and the clinical features of the simultaneous occurrence of these conditions are uncertain. A 30-year-old Japanese man with a persistent fever and sore throat presented to our hospital for treatment. Laboratory analysis showed bicytopenia, and radiological studies showed systemic lymphadenopathy accompanied by splenomegaly. A bone marrow examination showed hemophagocytic macrophages, suggesting HLH. Malignant lymphoma was suspected as a possible underlying disease, but the histology of the lymph nodes led to a final diagnosis of KFD and treatment with prednisolone (1 mg/kg/day), resulting in clinical improvement. This case highlighted the importance and difficulty of differentiating KFD from malignant lymphoma as an underlying condition of HLH. The literature review showed that patients with HLH-associated KFD may have higher serum ferritin and lactate dehydrogenase levels compared to typical KFD cases. Definite diagnosis based on pathological examination is essential for a better understanding of this rare disease. The presence of systemic lymphadenopathy does not exclude the possibility of KFD. This case serves to remind physicians that KFD is a potential etiology of HLH.

DOI： 10.18926/AMO/54597

Non-nosocomial healthcare-associated left-sided Pseudomonas aeruginosa endocarditis: a case report and literature review 査読国際誌

Hideharu Hagiya, Takeshi Tanaka, Kohei Takimoto, Hisao Yoshida, Norihisa Yamamoto, Yukihiro Akeda, Kazunori Tomono

BMC INFECTIOUS DISEASES 16 ( 1 ) 431 - 431 2016年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：BIOMED CENTRAL LTD

Background: With the development of invasive medical procedures, an increasing number of healthcare-associated infective endocarditis cases have been reported. In particular, non-nosocomial healthcare-associated infective endocarditis in outpatients with recent medical intervention has been increasingly identified.
Case presentation: A 66-year-old man with diabetes mellitus and a recent history of intermittent urethral self-catheterization was admitted due to a high fever. Repeated blood cultures identified Pseudomonas aeruginosa, and transesophageal echocardiography uncovered a new-onset severe aortic regurgitation along with a vegetative valvular structure. The patient underwent emergency aortic valve replacement surgery and was successfully treated with 6 weeks of high-dose meropenem and tobramycin. Historically, most cases of P. aeruginosa endocarditis have occurred in the right side of the heart and in outpatients with a history of intravenous drug abuse. In the case presented, the repeated manipulations of the urethra may have triggered the infection. Our literature review for left-sided P. aeruginosa endocarditis showed that non-nosocomial infection accounted for nearly half of the cases and resulted in fatal outcomes as often as nosocomial cases. A combination therapy with anti-pseudomonal beta-lactams or carbapenems and aminoglycosides may be the preferable treatment. Medical treatment alone may be effective, and surgical treatment should be carefully considered.
Conclusions: We presented a rare case of native aortic valve endocarditis caused by P. aeruginosa. This case illustrates the importance of identifying the causative pathogen(s), especially for outpatients with a recent history of medical procedures.

DOI： 10.1186/s12879-016-1757-y

Necrotizing soft tissue infection caused by Serratia marcescens: A case report and literature review 査読国際誌

Hideharu Hagiya, Masahiro Ojima, Takeshi Yoshida, Takahiro Matsui, Eiichi Morii, Kazuaki Sato, Shinichiro Tahara, Hisao Yoshida, Kazunori Tomono

JOURNAL OF INFECTION AND CHEMOTHERAPY 22 ( 5 ) 335 - 338 2016年5月

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 SCIENCE BV

A 64-year-old man with advanced liver cirrhosis was transferred to an emergency center due to septic shock and markedly inflamed left leg. Under a clinical diagnosis of necrotizing soft tissue infection (NSTI), the patient undertook intensive therapy but died 25 h after arrival. The pathogenic organism, Serratia marcescens, was later isolated from blood and soft tissue cultures. NSTI is very rarely associated with S. marcescens. A literature review showed that only 16 such cases, including our case, have been reported to date. Our case is the first evidence of an S. marcescens NSTI in a patient with liver cirrhosis. S. marcescens NSTI has an extremely high mortality rate; total mortality and mortality in cases involving the extremities were 75% (12 of 16 cases) and 83.3% (10 of 12 cases), respectively. Physicians need to be aware that S. marcescens can induce fatal infections in community patients. (C) 2015, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jiac.2015.11.013

Capnocytophaga ochracea-related Bacterium Bacteremia in a Hypertrophic Cardiomyopathy Patient without Neutropenia 査読

Shimpei Ito, Hideharu Hagiya, Keigo Kimura, Isao Nishi, Hisao Yoshida, Hidetaka Kioka, Tomohito Ohtani, Osamu Yamaguchi, Kazuaki Tanabe, Kazunori Tomono, Yasushi Sakata

INTERNAL MEDICINE 55 ( 18 ) 2731 - 2735 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

Gram-negative fusiform rods were detected in a blood culture obtained from a 63-year-old man who had been hospitalized for a long duration for severe heart failure. Although the organism could not be identified using a conventional method, it was finally identified as a bacterium of the Capnocytophaga ochracea group based on the results of biochemical testing, 16S rRNA sequencing and a matrix-assisted laser desorption ionization time-of-flight mass spectrometry analysis. Although neutropenic patients with poor oral hygiene are exclusively vulnerable to Capnocytophaga bacteremia, this case was unique because such predisposing conditions were not noted. A multi-centered investigation is warranted for a better understanding of this clinically rare, but potentially pathogenic organism.

DOI： 10.2169/internalmedicine.55.6593

Emergence of Daptomycin-Resistant Staphylococcus aureus during Treatment 査読

Hideharu Hagiya, Yuto Haruki, Taeko Uchida, Tomoko Wada, Sumiko Shiota, Tomoharu Ishida, Hiroko Ogawa, Tomoko Murase, Fumio Otsuka

INTERNAL MEDICINE 55 ( 1 ) 73 - 78 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

A 68-year-old man with persistent bacteremia accompanying a large iliopsoas abscess, vertebral osteomyelitis, discitis and central venous port infection caused by methicillin-resistant Staphylococcus aureus (MRSA) was admitted to our hospital. During the course of treatment, the emergence of a daptomycin (DAP)-resistant MRSA strain was confirmed; the minimum inhibitory concentration was 1 to 2 mu g/mL for vancomycin and more than 1 mu g/mL for DAP. Although the bacterial cell wall was not significantly thickened, an increased positive surface charge and single-nucleotide polymorphism within mprF have been confirmed in DAP-resistant strains. Still rare, but clinicians need to be cautious of the emergence of DAP-resistant MRSA during treatment.

DOI： 10.2169/internalmedicine.55.4763

Hypoparathyroidism Solely Manifesting Otological Symptoms 査読

Tokiko Urabe, Hideharu Hagiya, Eri Nakamura, Fumio Otsuka

INTERNAL MEDICINE 55 ( 2 ) 211 - 212 2016年

Reactivation of Human Herpes Virus-6 in the Renal Tissue of a Patient with Drug-induced Hypersensitivity Syndrome/Drug Rash with Eosinophilia and Systemic Symptoms (DIHS/DRESS) 査読

Hideharu Hagiya, Masaya Iwamuro, Takehiro Tanaka, Kou Hasegawa, Yoshihisa Hanayama, Maya Kimura, Fumio Otsuka

INTERNAL MEDICINE 55 ( 13 ) 1769 - 1774 2016年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

A 74-year-old man who had been administered trimethoprim-sulfamethoxazole for three weeks suffered from drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms (DIHS/DRESS). In the early stage of the clinical course, he developed renal dysfunction. A renal biopsy showed granulomatous tubulointerstitial nephritis accompanying the proliferation of human herpes virus ( HHV)-6 in tubular epithelial cells. With corticosteroid therapy, the systemic rash and renal function gradually improved. The present patient is the second case of DIHS/DRESS demonstrating a possible reactivation of HHV-6 in the renal tissue. The clinical role of viral reactivation in DIHS/DRESS must be further elucidated.

DOI： 10.2169/internalmedicine.55.6287

Olecranon Osteomyelitis Caused by Mycobacterium chelonae 査読

Hideharu Hagiya, Misa Hayashi, Ichiro Katayama, Kazunori Tomono

INTERNAL MEDICINE 55 ( 13 ) 1825 - 1825 2016年

A Necrotized Eyelid 査読

Hideharu Hagiya, Ekkachai Thiansukhon, Yukihiro Akeda, Kazunori Tomono

INTERNAL MEDICINE 55 ( 15 ) 2121 - 2121 2016年

Refractory chyluria due to filariasis 査読国際誌

Hideharu Hagiya, Fumio Otsuka

INFECTION 43 ( 6 ) 785 - 786 2015年12月

Pheochromocytoma Manifesting Persistent Right Shoulder Pain and Hypochondralgia

Hideharu Hagiya, Eri Nakamura, Tomohiro Terasaka, Kou Hasegawa, Kikuko Asano, Takahiro Nada, Kosuke Kimura, Koichi Waseda, Yoshihisa Hanayama, Fumio Otsuka

JOURNAL OF GENERAL AND FAMILY MEDICINE 16 ( 4 ) 292 - 296 2015年12月

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

We report a 42-year-old female who initially complained of sub-acute onset of right upper quadrant abdominal pain with right shoulder pain. A CT scan incidentally revealed an adrenal tumor, and a final diagnosis of pheochromocytoma was made on the basis of endocrinological examinations. Symptomatically, the pheochromocytoma in our patient mimicked a hepato-biliary disease by presenting abdominal pain accompanying right shoulder pain that was assumed to be referred pain via the right phrenic nerve. Physicians may need to consider the possibility of pheochromocytoma in patients with abdominal symptoms.

DOI： 10.14442/jgfm.16.4_292

Cytomegalovirus as an Insidious Pathogen Causing Duodenitis 査読

Hideharu Hagiya, Masaya Iwamuro, Takehiro Tanaka, Yoshihisa Hanayama, Fumio Otsuka

ACTA MEDICA OKAYAMA 69 ( 5 ) 319 - 323 2015年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：OKAYAMA UNIV MED SCHOOL

A 60-year-old woman with rheumatoid arthritis treated with methotrexate for a decade complained of slight epigastric discomfort. A positive cytomegalovirus (CMV) antigenemia test indicated the probability of CMV-related gastrointestinal infection, for which esophagogastroduodenoscopy was performed. Endoscopic findings showed a non-specific duodenal mucosal lesion; however, pathological investigation revealed evidence of CMV duodenitis. There is scarce information on the clinical and pathological features of CMV-related duodenitis, likely due to its low prevalence. CMV infection in the upper gastrointestinal tract should be considered as a differential diagnosis in high-risk individuals, particularly those with symptoms relating to the digestive system. Biopsy examinations are preferable for the definitive diagnosis of CMV gastrointestinal infection, even without specific endoscopic features.

DOI： 10.18926/AMO/53679

Predominance of PCR-ribotypes, 018 (smz) and 369 (trf) of Clostridium difficile in Japan: a potential relationship with other global circulating strains? 査読国際誌

Mitsutoshi Senoh, Haru Kato, Tadashi Fukuda, Akiko Niikawa, Yoshiko Hori, Hideharu Hagiya, Yoichiro Ito, Hiroshi Miki, Yoshifumi Abe, Kiyoshi Furuta, Hideki Takeuchi, Hirokazu Tajima, Harumi Tominaga, Hideyuki Satomura, Hideaki Kato, Sayuri Morita, Ai Tanada, Toshinori Hara, Miki Kawada, Yuka Sato, Masahiko Takahashi, Akiko Higuchi, Tomoko Nakajima, Yukiko Wakamatsu, Masahiro Toyokawa, Akiko Ueda, Paul Roberts, Fabio Miyajima, Keigo Shibayamal

JOURNAL OF MEDICAL MICROBIOLOGY 64 ( 10 ) 1226 - 1236 2015年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：SOC GENERAL MICROBIOLOGY

Global spread and evolutionary links of an epidemic Clostridium difficile strain (PCR-ribotype 027) have been noted in recent decades. However, in Japan, no outbreaks caused by type 027 have been reported to date. A total of 120 C. difficile isolates from patients at 15 hospitals during non-outbreak seasons between 2011 and 2013 as well as 18 and 21 isolates collected from two hospitals in 2010 and 2009, respectively, in outbreak periods in Japan, were examined. Among these 120 isolates, Japan-ribotypes smz and ysmz (subtype variant of smz) were the most predominant (39.2 %) followed by Japan-ribotype trf (15.8 %). Types smz/ysmz and trf were also concurrently predominant at two hospitals in the outbreak settings. Out of the five binary toxin-positive isolates observed, only one was PCR-ribotype 027 and another PCR-ribotype 078. Type smz was later found to correspond to PCR-ribotype 018. High rates of resistance against gatifloxacin, moxifloxacin, erythromycin and clindamycin were observed in the PCR-ribotype 018 isolates. Interestingly, all trf isolates were toxin A-negative, toxin B-positive, but they did not correspond to PCR-ribotype 017, thus being assigned a new ribotype (PCR-ribotype 369). In conclusion, PCR-ribotypes 018 (smz) and 369 (trf) were identified as major circulating strains in both outbreak and non-outbreak settings in Japan. Given their epidemiological relevance, molecular investigations are warranted to clarify potential evolutionary links with related strains found elsewhere, such as PCR-ribotypes 018 and 017 from Europe and North America.

DOI： 10.1099/jmm.0.000149

集中治療室患者におけるアジスロマイシン静注製剤投与時の希釈輸液量制限の安全性に関する検討査読

春木祐人, 萩谷英大, 佐久間晶子, 春木麻衣, 岡泰江, 杉山哲大, 川上恭弘, 近藤祥代

薬学雑誌 135 ( 8 ) 987 - 990 2015年8月

記述言語：日本語出版者・発行元：(公社)日本薬学会

2011年12月～2014年8月の33ヵ月間に集中治療室でアジスロマイシン(AZM)製剤を投与された患者情報をカルテより後方視的に検討した。対象期間内にAZM静注製剤を使用された患者は194例であった。そのうち集中治療室で投与された患者は65例(男性53例、女性12例)であった。入院時死亡した2例、入院後すぐに転院した1例は除外した。投与量は全投与量で500mg/回/日で、コントロールグループ(CG)は500mL、レデュースグループ(RG)は250mLまたは100mLの溶解液量で希釈されていた。対象患者の平均年齢は73.5±13.9(35～95)歳であった。診療科は内科45例(69.2%)、救命救急センター17例(26.2%)、外科系診療科2例(3.1%)、循環器内科1例(1.5%)であった。対象疾患は呼吸器感染症64例、感染性腹部大動脈瘤1例であった。入院後48時間以上経過してから発症した院内発症症例が11例であった。平均投与期間は4.78±1.89(1～11)日であった。対象患者中CGは52例(80%)、RGは合計13例(20%)であった。投与速度はCG中41例が2時間かけて投与され、RGにおいて全例で輸液ポンプなど用い2時間以上かけ投与された。63例(96.9%)において他の抗菌薬が併用され、ペニシリン系抗菌薬との併用が最も多く、次いでセフェム系であった。静脈炎の出現例はCG、RGいずれの群においても認められなかった。

DOI： 10.1248/yakushi.15-00003

その他リンク： https://search.jamas.or.jp/default/link?pub_year=2015&ichushi_jid=J01459&link_issn=&doc_id=20150813380009&doc_link_id=1390001206126826880&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390001206126826880&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_3.gif

How can you manage your patients without 'breakpoint'? 査読国際誌

Hideharu Hagiya

JOURNAL OF CHEMOTHERAPY 27 ( 3 ) 193 - 194 2015年6月

Atypical Onset of Eosinophilic Granulomatosis with Polyangitis in a Patient with Long-term Well-controlled Bronchial Asthma

Satoshi Akao, Hideharu Hagiya, Kou Hasegawa, Takahiro Nada, Eri Nakamura, Kosuke Kimura, Koichi Waseda, Yoshihisa Hanayama, Kentaro Deguchi, Fumio Otsuka

JOURNAL OF GENERAL AND FAMILY MEDICINE 16 ( 2 ) 99 - 102 2015年6月

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

Eosinophillic glanuromatosis with polyangitis (EGPA) usually occurs in patients with a recent history (usually less than 10 years) of uncontrolled bronchial asthma. Here we describe a case of EGPA that occurred in a 68-year-old female who had well-controlled bronchial asthma for 17 years. A leukotriene receptor antagonist that had been prescribed one week before onset might have triggered the disease. Our case shows that there is a wide spectrum of clinical characteristics of EGPA, making diagnosis difficult in a primary care setting.