研究者詳細 - 萩谷　英大

論文 - 萩谷　英大

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Cryptococcal prostatitis in an immunocompromised patient with tocilizumab and glucocorticoid therapy: A case report. 査読国際誌

Kohei Oguni, Shinnosuke Fukushima, Hideharu Hagiya, Atsushi Kato, Atsuhito Suyama, Takehiro Iwata, Yoshia Miyawaki, Sawako Ono, Koji Iio, Fumio Otsuka

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2024年8月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

Cryptococcus prostatitis is an uncommon manifestation of cryptococcal infection that occurs mostly in immunocompromised patients. Tocilizumab, an anti-interleukin-6 receptor monoclonal antibody, has been associated with an increased risk of cryptococcal infections. However, there have been no documented cases of cryptococcal prostatitis in patients receiving tocilizumab therapy. We report a case of cryptococcal prostatitis in a 72-year-old man treated with glucocorticoids and tocilizumab for giant cell arteritis and granulomatosis with polyangiitis. The patient presented dysuria and his serum level of prostate-specific antigen was elevated. Magnetic resonance imaging revealed a prostate mass, and a prostate biopsy was performed, leading to a pathologic diagnosis of cryptococcal prostatitis. Fungal cultures for blood and urine were negative, while the cryptococcal antigen for both serum and urine showed positive results. There were no particular findings in the pulmonary and central nervous systems. The patient was successfully treated with oral fluconazole (400 mg/day) and was discharged. Although cryptococcal prostatitis is a rare entity, clinicians should note that an immunosuppressed patient may develop such a difficult-to-diagnose disease.

DOI： 10.1016/j.jiac.2024.08.009

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Ghost in blood culture. 査読国際誌

Shinnosuke Fukushima, Hideharu Hagiya, Mami Okura, Koji Iio

Internal and emergency medicine 2024年8月

Effectiveness of Sensing Gloves-Applied Virtual Reality Education System on Hand Hygiene Practice: A Randomised Controlled Trial. 査読国際誌

Mahiro Izumi, Hideharu Hagiya, Yuki Otsuka, Yoshiaki Soejima, Shinnosuke Fukushima, Mitsunobu Shibata, Satoshi Hirota, Toshihiro Koyama, Fumio Otsuka, Akio Gofuku

American journal of infection control 2024年8月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

INTRODUCTION: We developed a virtual reality (VR) education system and evaluated its clinical utility for promoting hand hygiene practices. METHODS: This prospective, two-week, randomised controlled study conducted at Okayama University Hospital, Japan, from November 2023 to January 2024, involved 22 participants (18 medical students and four residents). A fully immersive 360° VR system (VIVE Pro Eye) using a head-mounted display and sensing gloves was used to develop three healthcare tasks in a virtual patient room-Environmental Cleaning, Gauze Exchange, and Urine Collection. After monitoring all participants' baseline usage data of portable hand-rubbing alcohol in the first week, we randomly assigned them into 1:1 groups (VR training and video lecture groups). The primary outcome was differences in hand-rubbed alcohol use before and after intervention. RESULTS: Before the intervention, alcohol use did not significantly differ between both groups. After the intervention, a significant increase in alcohol use was observed in the VR training group (median: 8.2 g vs. 16.2 g; p=0.019) but not in the video lecture group. CONCLUSION: Our immersive 360° VR education system enhanced hand hygiene practices. Infection prevention and control practitioners and digital technology experts must collaborate to advance the development of superior educational devices and content.

DOI： 10.1016/j.ajic.2024.08.003

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Narrower-Spectrum Therapeutic Approaches Are Warranted for Aspiration Pneumonia. 査読国際誌

Hideharu Hagiya, Shinnosuke Fukushima

Chest 166 ( 2 ) e71-e72 2024年8月

Increased Oxidative Stress and Decreased Citrulline in Blood Associated with Severe Novel Coronavirus Pneumonia in Adult Patients. 査読国際誌

Mitsuru Tsuge, Eiki Ichihara, Kou Hasegawa, Kenichiro Kudo, Yasushi Tanimoto, Kazuhiro Nouso, Naohiro Oda, Sho Mitsumune, Goro Kimura, Haruto Yamada, Ichiro Takata, Toshiharu Mitsuhashi, Akihiko Taniguchi, Kohei Tsukahara, Toshiyuki Aokage, Hideharu Hagiya, Shinichi Toyooka, Hirokazu Tsukahara, Yoshinobu Maeda

International journal of molecular sciences 25 ( 15 ) 2024年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

This study investigated the correlation between oxidative stress and blood amino acids associated with nitric oxide metabolism in adult patients with coronavirus disease (COVID-19) pneumonia. Clinical data and serum samples were prospectively collected from 100 adult patients hospitalized for COVID-19 between July 2020 and August 2021. Patients with COVID-19 were categorized into three groups for analysis based on lung infiltrates, oxygen inhalation upon admission, and the initiation of oxygen therapy after admission. Blood data, oxidative stress-related biomarkers, and serum amino acid levels upon admission were compared in these groups. Patients with lung infiltrations requiring oxygen therapy upon admission or starting oxygen post-admission exhibited higher serum levels of hydroperoxides and lower levels of citrulline compared to the control group. No remarkable differences were observed in nitrite/nitrate, asymmetric dimethylarginine, and arginine levels. Serum citrulline levels correlated significantly with serum lactate dehydrogenase and C-reactive protein levels. A significant negative correlation was found between serum levels of citrulline and hydroperoxides. Levels of hydroperoxides decreased, and citrulline levels increased during the recovery period compared to admission. Patients with COVID-19 with extensive pneumonia or poor oxygenation showed increased oxidative stress and reduced citrulline levels in the blood compared to those with fewer pulmonary complications. These findings suggest that combined oxidative stress and abnormal citrulline metabolism may play a role in the pathogenesis of COVID-19 pneumonia.

DOI： 10.3390/ijms25158370

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New Delhi Metallo-Beta-Lactamase Inhibitors: A Systematic Scoping Review. 査読国際誌

Lutfun Nahar, Hideharu Hagiya, Kazuyoshi Gotoh, Md Asaduzzaman, Fumio Otsuka

Journal of clinical medicine 13 ( 14 ) 2024年7月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

Background/Objectives: Among various carbapenemases, New Delhi metallo-beta-lactamases (NDMs) are recognized as the most powerful type capable of hydrolyzing all beta-lactam antibiotics, often conferring multi-drug resistance to the microorganism. The objective of this review is to synthesize current scientific data on NDM inhibitors to facilitate the development of future therapeutics for challenging-to-treat pathogens. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews, we conducted a MEDLINE search for articles with relevant keywords from the beginning of 2009 to December 2022. We employed various generic terms to encompass all the literature ever published on potential NDM inhibitors. Results: Out of the 1760 articles identified through the database search, 91 met the eligibility criteria and were included in our analysis. The fractional inhibitory concentration index was assessed using the checkerboard assay for 47 compounds in 37 articles, which included 8 compounds already approved by the Food and Drug Administration (FDA) of the United States. Time-killing curve assays (14 studies, 25%), kinetic assays (15 studies, 40.5%), molecular investigations (25 studies, 67.6%), in vivo studies (14 studies, 37.8%), and toxicity assays (13 studies, 35.1%) were also conducted to strengthen the laboratory-level evidence of the potential inhibitors. None of them appeared to have been applied to human infections. Conclusions: Ongoing research efforts have identified several potential NDM inhibitors; however, there are currently no clinically applicable drugs. To address this, we must foster interdisciplinary and multifaceted collaborations by broadening our own horizons.

DOI： 10.3390/jcm13144199

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Rapid diagnostic testing for GAS necrotizing fasciitis. 査読国際誌

Shinnosuke Fukushima, Hideharu Hagiya, Mami Okura, Koji Iio

Internal and emergency medicine 19 ( 6 ) 1773 - 1774 2024年7月

抗ブドウ球菌エンドライシンのリンカー領域が機能に与える影響(Functional impact by shorting a linker region of a staphylococcal endolysin)

宗友荘介, 内山淳平, 内山伊代, Thamonwan Wanganuttara, 津久井利広, 萩谷英大, 山本由弥子, 神田秀幸, 松下治

日本細菌学雑誌 79 ( 2 ) 265 - 265 2024年7月

Mimicker of Gram-positive Staphylococci. 査読国際誌

Shinnosuke Fukushima, Takumi Fujimori, Hideharu Hagiya

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 146 107145 - 107145 2024年6月

Disseminated septic arthritis caused by Ureaplasma urealyticum in an immunocompromised patient with hypogammaglobulinemia after rituximab therapy. 査読国際誌

Kohei Oguni, Shinnosuke Fukushima, Yuki Otsuka, Yoshiaki Soejima, Marina Kawaguchi, Yosuke Sazumi, Takumi Fujimori, Koji Iio, Noriyuki Umakoshi, Kazuki Yamada, Hideharu Hagiya, Fumio Otsuka

Infection 52 ( 6 ) 2495 - 2499 2024年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: Ureaplasma urealyticum is a rare pathogen associated with septic arthritis that predominantly affects patients with hypogammaglobulinemia. Bacterial identification of fastidious organisms is challenging because they are undetectable by routine culture testing. To the best of our knowledge, this is the first report of septic arthritis induced by U. urealyticum infection in Japan. CASE DESCRIPTION: We describe the case of a 23-year-old Japanese female with secondary hypogammaglobulinemia (serum immunoglobulin level < 500 mg/dL), identified 8 years after treatment with rituximab. The patient presented with persistent fever and polyarthritis that were unresponsive to ceftriaxone and prednisolone. Contrast-enhanced computed tomography and gallium-67 scintigraphy revealed effusion and inflammation in the left sternoclavicular, hip, wrist, knee, and ankle joints. Although Gram staining and bacterial culture of the drainage fluid from the left hip joint were negative, the condition exhibited characteristics of purulent bacterial infection. The patient underwent empirical treatment with doxycycline, and her symptoms promptly resolved. Subsequent 16S ribosomal RNA (rRNA) gene sequencing of the joint fluid confirmed the presence of U. urealyticum, leading to the diagnosis of septic arthritis. Combination therapy with doxycycline and azithromycin yielded a favorable recovery from the inflammatory status and severe arthritic pain. CONCLUSION: This case highlights U. urealyticum as a potential causative agent of disseminated septic arthritis, particularly in patients with hypogammaglobulinaemia. The 16S rRNA gene analysis proved beneficial for identifying pathogens in culture-negative specimens, such as synovial fluid, in suspected bacterial infections.

DOI： 10.1007/s15010-024-02301-1

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抗ブドウ球菌エンドライシンのリンカー領域が機能に与える影響

宗友荘介, 内山淳平, 内山伊代, Thamonwan Wanganuttara, 津久井利広, 萩谷英大, 山本由弥子, 神田秀幸, 松下治

日本細菌学雑誌 79 ( 2 ) 119 - 119 2024年6月

Thoughts on and Proposal for the Education, Training, and Recruitment of Infectious Disease Specialists. 査読

Hideharu Hagiya

Acta medica Okayama 78 ( 3 ) 205 - 213 2024年6月

担当区分：筆頭著者,　最終著者,　責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

The global pandemic of COVID-19 has underscored the significance of establishing and sustaining a practical and efficient infection control system for the benefit and welfare of society. Infectious disease (ID) specialists are expected to take on leadership roles in enhancing organizational infrastructures for infection prevention and control (IPC) at the hospital, community, and national levels. However, due to an absolute shortage and an uneven distribution, many core hospitals currently lack the ID specialists. Given the escalating global risk of emerging and re-emerging infectious diseases as well as antimicrobial resistance pathogens, the education and training of ID specialists constitutes an imperative concern. As demonstrated by historical changes in the healthcare reimbursement system, the establishment and enhancement of IPC measures is pivotal to ensuring medical safety. The existing structure of academic society-driven certification and training initiatives for ID specialists, contingent upon the discretionary decisions of individual physicians, possesses both quantitative and qualitative shortcomings. In this article, I first address the present situations and challenges related to ID specialists and then introduce my idea of securing ID specialists based on the new concepts and platforms; (i) ID Specialists as National Credentials, (ii) Establishment of the Department of Infectious Diseases in Medical and Graduate Schools, (iii) Endowed ID Educative Courses Funded by Local Government and Pharmaceutical Companies, and (iv) Recruitment of Young Physicians Engaged in Healthcare Services in Remote Areas. As clarified by the COVID-19 pandemic, ID specialists play a crucial role in safeguarding public health. Hopefully, this article will advance the discussion and organizational reform for the education and training of ID specialists.

DOI： 10.18926/AMO/67195

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「感染制御チームや微生物検査室がない地域医療機関」で内科専攻医が取り組んだ血液培養のコンタミネーション低減活動に関する報告査読

福島伸乃介, 萩谷英大, 辻健太郎, 平岩千尋, 大江啓史, 喜多真也, 太田茂, 多田龍平, 宮阪英, 角南博, 表静馬, 大塚文男

感染症学雑誌 98 ( 3 ) 306 - 310 2024年5月

Adherence to and clinical utility of "quality indicators" for Staphylococcus aureus bacteremia: a retrospective, multicenter study. 査読国際誌

Shinnosuke Fukushima, Hideharu Hagiya, Naoki Kuninaga, Yuto Haruki, Haruto Yamada, Yoshitaka Iwamoto, Masayo Yoshida, Kota Sato, Yoshihisa Hanayama, Shuichi Tanaka, Tomoko Miyoshi, Yuki Otsuka, Keigo Ueda, Fumio Otsuka

Infection 52 ( 4 ) 1527 - 1538 2024年5月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: We aimed to improve the prognosis, treatment, and management of Staphylococcus aureus bacteremia (SAB) by evaluating the association between adherence to quality indicators (QIs) and clinical outcomes in patients with their clinical outcomes. METHODS: We retrospectively collected clinical and microbiological data on hospitalized patients with SAB from 14 hospitals (three with > 600, two with 401-600, five with 201-400, and four with ≤ 200 beds) in Japan from January to December 2022. The SAB management quality was evaluated using the SAB-QI score (ranging from 0 to 13 points), which consists of 13 QIs (grouped into five categories) based on previous literature. RESULTS: Of the 4,448 positive blood culture episodes, 289 patients with SAB (6.5%) were enrolled. The SAB-QI scores ranged from 3 to 13, with a median score of 9 points. The SAB-QI score was highest in middle-sized hospitals with 401-600 beds. Adherence to each of the four QI categories (blood culture, echocardiography, source control, and antibiotic treatment) was significantly higher in survived cases than in fatal cases. Kaplan-Meier curves with log-rank tests demonstrated that higher adherence to SAB-QIs indicated a better prognosis. Logistic regression analysis revealed that age, methicillin resistance, multiple comorbidities (≥ 2), and low SAB-QI score were significantly associated with 30-day mortality in patients with SAB. CONCLUSIONS: Our study highlights that greater adherence to the SAB-QIs correlates with improved patient outcomes. Management of patients with SAB should follow these recommended indicators to maintain the quality of care, especially for patients with poor prognosticators.

DOI： 10.1007/s15010-024-02284-z

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Evidence Still Pending: Post-Exposure Prophylactic Measures Against Varicella Zoster Virus. 査読国際誌

Hideharu Hagiya, Shinnosuke Fukushima

Journal of the Pediatric Infectious Diseases Society 13 ( 6 ) 336 - 336 2024年5月