Faculty Profiles - MORIOKA Hiroshi

Active surveillance in response to the identification of a single carbapenemase-producing Escherichia coli at a Japanese university hospital. International journal

Daizo Kato, Hiroshi Morioka, Yuka Tomita, Mitsutaka Iguchi, Aki Hirabayashi, Noriyuki Tetsuka, Takuya Sadomoto, Miyuki Hyodo, Mariko Mochizuki, Yukari Osada, Masato Yamamoto, Yoshiaki Kato, Takayuki Inagaki, Kazuya Ichikawa, Tetsuya Yagi

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 24 ( 12 ) page： 1013 - 1015 2018.12

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

This report described the experience of active surveillance culture implemented in response to the identification of a single carbapenemase-producing Escherichia coli in a Japanese university hospital. It revealed a horizontal transmission event and an additional asymptomatic carrier of carbapenemase-producing Escherichia coli with unique drug susceptibility and resistance gene profiles. Early implementation of active surveillance culture as a part of multifaceted infection control measures appeared to be useful to control further transmission of carbapenemase-producing Escherichia coli even in the low endemic facility. Further investigations on the timing and usefulness of active surveillance culture in the control of carbapenemase-producing Enterobacteriaceae would be warranted.

DOI： 10.1016/j.jiac.2018.05.013

A case of sepsis caused by intra abdominal infection with Mycoplasma hominis after Caesarean section

Risk factors for and role of OprD protein in increasing minimal inhibitory concentrations of carbapenems in clinical isolates of Pseudomonas aeruginosa

Hirabayashi Aki, Kato Daizo, Tomita Yuka, Iguchi Mitsutaka, Yamada Keiko, Kouyama Yuichi, Morioka Hiroshi, Tetsuka Nobuyuki, Yagi Tetsuya

JOURNAL OF MEDICAL MICROBIOLOGY Vol. 66 ( 11 ) page： 1562 - 1572 2017.11

Appropriateness of surgical prophylaxis contributed to significant reduction of oral cephalosporins in a Japanese university hospital

Hiroshi Morioka, Yoshiaki Kato, Takayuki Inagaki, Nobuyuki Tetsuka, Mitsutaka Iguchi, Yuka Tomita, Tetsuya Yagi

INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS Vol. 50 page： S42 - S43 2017.11

Recurrent bacteremia and liver abscess caused by Clostridium difficile A case report

Morioka Hiroshi, Iguchi Mitsutaka, Kuzuya Teiji, Mikamo Hiroshige, Yagi Tetsuya

MEDICINE Vol. 96 ( 35 ) page： e7969 2017.9

Pneumococcal biliary tract infections - How rare are they?

Morioka Hiroshi, Iguchi Mitsutaka, Oodate Mitsuru, Yoneda Masaki, Ushijima Futoshi, Hirabayashi Aid, Tetsuka Nobuyuki, Tomita Yuka, Kato Daizo, Yagi Tetsuya

JOURNAL OF INFECTION AND CHEMOTHERAPY Vol. 23 ( 6 ) page： 415 - 418 2017.6

Vol. 27 ( 1 ) page： 23 - 28 2017

森岡悠, 井口光孝

内科 Vol. 118 ( 5 ) page： 885 - 889 2016.11

The first point prevalence survey of health care-associated infection and antimicrobial use in a Japanese university hospital: A pilot study. International journal

Hiroshi Morioka, Aki Hirabayashi, Mitsutaka Iguchi, Yuka Tomita, Daizo Kato, Naokazu Sato, Miyuki Hyodo, Naoko Kawamura, Takuya Sadomoto, Kazuya Ichikawa, Takayuki Inagaki, Yoshiaki Kato, Yuichi Kouyama, Yoshinori Ito, Tetsuya Yagi

American journal of infection control Vol. 44 ( 7 ) page： E119 - E123 2016.7

Language：English Publishing type：Research paper (scientific journal) Publisher：MOSBY-ELSEVIER

BACKGROUND: Point prevalence surveys (PPSs) in Japanese hospitals have not yet been reported. The purpose of this pilot PPS study was to evaluate the epidemiology of health care-associated infections (HAIs) and antimicrobial use in a Japanese tertiary university hospital. METHODS: A 1-day, cross-sectional PPS was performed at a Japanese university hospital. Data on demographics, active HAIs, and antimicrobial use of all inpatients were collected using a data collection form. RESULTS: Of 841 patients, 85 (10.1%) had 90 active HAIs, and 308 patients (36.6%) were administered 494 antimicrobials. Among the 90 HAIs and 58 pathogens, the most frequent infection and isolated pathogen were pneumonia (20.0%) and Enterobacteriaceae (27.6%), respectively. Of the 118 antimicrobials used for treatment of HAIs, carbapenems were the most frequently administered category of antimicrobials (22.9%). In regard to antimicrobials for surgical prophylaxis, 37 of 119 (31.1%) were administered to patients on postoperative day 3 or later, and 48 of 119 (40.3%) were administered orally. CONCLUSIONS: The incidence of HAIs is higher than in other developed countries. The social and medical situation in Japan may affect patient demographics, active HAIs, and antimicrobial use. Multicenter PPSs are necessary to uncover the real epidemiology of HAIs and antimicrobial use in Japan.

DOI： 10.1016/j.ajic.2016.03.045

CD8 Encephalitis Caused by Persistently Detectable Drug-resistant HIV.

Hiroshi Morioka, Naoki Yanagisawa, Shugo Sasaki, Noritaka Sekiya, Akihiko Suganuma, Akifumi Imamura, Atsushi Ajisawa, Shuji Kishida

Internal medicine (Tokyo, Japan) Vol. 55 ( 10 ) page： 1383 - 1386 2016

Publishing type：Research paper (scientific journal)

We herein report a 52-year-old man infected with human immunodeficiency virus (HIV) who was referred to our hospital due to the development of severe neurocognitive disorders and bilateral leukoencephalopathy. He has been treated with antiretroviral agents for 17 years, but low-level viremia has been detected consistently prior to admission. Drug resistant testing of the serum and the cerebrospinal fluid (CSF) both demonstrated a M184V mutation. A brain biopsy revealed perivascular CD8(+) T-lymphocyte infiltration, leading to the diagnosis of CD8 encephalitis. The clinical symptoms improved drastically after changing to a nucleoside reverse transcriptase inhibitor sparing regimen, which subsequently decreased the HIV viral load to an undetectable level in both the serum and CSF.

DOI： 10.2169/internalmedicine.55.5783

Laryngeal Kaposi's Sarcoma Complicated by the Immune Reconstitution Inflammatory Syndrome in an HIV-infected Patient.

Hirofumi Kato, Naoki Yanagisawa, Hiroshi Morioka, Shugo Sasaki, Noritaka Sekiya, Akihiko Suganuma, Akifumi Imamura, Atsushi Ajisawa

Internal medicine (Tokyo, Japan) Vol. 55 ( 8 ) page： 1001 - 1005 2016

Publishing type：Research paper (scientific journal)

We herein report a case of laryngeal Kaposi's sarcoma (KS) complicated by immune reconstitution inflammatory syndrome in a human immunodeficiency virus (HIV)-infected patient. The patient initially presented with KS involving the larynx, which was successfully treated with pegylated liposomal doxorubicin (PLD) and antiretroviral therapy (ART). PLD was discontinued after 2 courses because of a marked clinical improvement; however, the patient experienced progressive odynophagia and dyspnea 2 months after the initiation of ART. Laryngoscopy revealed a severely swollen, inflamed epiglottis. The readministration of PLD was successful, and the patient was thereafter discharged without any subsequent complications.

DOI： 10.2169/internalmedicine.55.5813

Disseminated Mycobacterium abscessus Infection Following Septic Arthritis: A Case Report and Review of the Literature. International journal

Shoichi Fukui, Noritaka Sekiya, Yasunobu Takizawa, Hiroshi Morioka, Hirofumi Kato, Akio Aono, Kinuyo Chikamatsu, Satoshi Mitarai, Satomi Kobayashi, Satoshi Kamei, Keigo Setoguchi

Medicine Vol. 94 ( 21 ) page： e861 2015.5

Publishing type：Research paper (scientific journal)

Mycobacterium abscessus is a rapidly growing mycobacterium found mainly in patients with respiratory or cutaneous infections, but it rarely causes disseminated infections. Little is known about the clinical characteristics, treatment, and prognosis of disseminated M abscessus infection. A 75-year-old Japanese woman who had been treated for 17 years with a corticosteroid for antisynthetase syndrome with antithreonyl-tRNA synthetase antibody developed swelling of her right elbow. X-ray of her right elbow joint showed osteolysis, and magnetic resonance imaging revealed fluid in her right elbow joint. M abscessus grew in joint fluid and blood cultures. She was diagnosed with a disseminated M abscessus infection following septic arthritis. Antimicrobial treatment by clarithromycin, amikacin, and imipenem/cilastatin combined with surgical debridement was administered. Although blood and joint fluid cultures became negative 1 week later, the patient died at 6 weeks from starting antimicrobial treatment. We reviewed 34 cases of disseminated M abscessus infections from the literature. Most of the patients had immunosuppressive backgrounds such as transplantation, use of immunosuppressive agents, hematological malignancy, and end stage renal disease. The duration from onset of symptoms to diagnosis was over 3 months in half of the cases. All fatal cases had positive blood cultures or use of immunosuppressive agents. Clinicians should bear in mind that mycobacterial infections including M abscessus are one of the differential diagnoses in patients with subacute arthritis and soft tissue infections.

DOI： 10.1097/MD.0000000000000861

A型肝炎ワクチン(エイムゲンとHavrix)接種後の抗体価と互換性に関する検討

菊池均, 宮津光伸, 永田俊人, 後藤泰浩, 山本悦子, 森岡悠, 佐藤好隆

日本渡航医学会誌 = Journal of the Japanese Society of Travel and Health Vol. 9 ( 1 ) page： 48 - 50 2015

P0578-22-AM 注射用抗菌薬届出システムの構築と適正使用に向けた介入方法の検討(感染制御(その他)1,ポスター発表,一般演題,医療薬学の進歩と未来-次の四半世紀に向けて-)

加藤善章, 八木哲也, 山田清文, 山本雅人, 稲垣孝行, 手塚宜行, 森岡悠, 平林亜希, 井口光孝, 加藤大三, 冨田ゆうか

日本医療薬学会年会講演要旨集 Vol. 25 ( 0 ) 2015

Evaluation of HIV-infected Patients Suspected as Having HIV-associated Neurocognitive Disorders

MORIOKA Hiroshi, KISHIDA Shuji, IMAMURA Akifumi, SEKIYA Noritaka, YANAGISAWA Naoki, SUGANUMA Akihiko, AJISAWA Atsushi

Kansenshogaku Zasshi Vol. 88 ( 2 ) page： 141 - 8 2014.3

Publishing type：Research paper (scientific journal) Publisher：The Japanese Association for Infectious Diseases

Background：HIV-associated neurocognitive disorders (HAND) have emerged as a problem among HIV-infected individuals in the era of antiretroviral therapy. However, there are insufficient data on HAND regarding its prevalence and clinical features in Japan. Methods：A test battery composed of eight neuropsycological tests proposed by the Ministry of Health,Labour and Welfare (MHLW test battery) was applied to assess 30 subjects at Tokyo Metropolitan Komagome Hospital. Among them, 5 subjects were excluded due to central nervous system complications. The background of each patient along with the results of head magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis and neuropsychological tests were compared to each HAND category. In addition, the clinical utility of a combination of neuropsychological tests as an abbreviated test battery of HAND was evaluated. Results：A total of 19 (76％) subjects were diagnosed as having a HAND. Among them, HIV-associated dementia, mild neurocognitive disorders and asymptomatic neurocognitive disorders were diagnosed in 7, 8,and 4 subjects, respectively. Neither the patientʼs background nor the results of the head MRI and CSF analysis showed relevance to disease severity. The conventional International HIV Dementia Scale with the Digit Symbol Substitute Test was capable of detecting 94.7％cases of HAND. Conclusions：Most HIV-infected subjects clinically suspected as having neurocognitive disorders were diagnosed as having a HAND. Neuropsychological tests of the MHLW test battery were in some part useful to diagnose HAND. However, more precise neuropsychological tests are warranted to screen and diagnose HAND, based on the current criteria.

DOI： 10.11150/kansenshogakuzasshi.88.141

Bilateral Facial Nerve Palsy and Appendicitis Occurring during Acute Retroviral Syndrome

Morioka Hiroshi, Sakamoto Naoya, Iwabuchi Sentaro, Ohnishi Kenji

INTERNAL MEDICINE Vol. 53 ( 2 ) page： 155 - 158 2014

Publishing type：Research paper (scientific journal) Publisher：Internal Medicine

We herein report the case of 41-year-old homosexual man who presented to our hospital with typical acute retroviral syndrome. Complications of bilateral facial nerve palsy and appendicitis appeared eight days after admission. The bilateral facial nerve palsy spontaneously recovered one month later; however, the appendicitis required surgical intervention. To our knowledge, this is the first reported case of appendicitis related to acute retroviral syndrome.

DOI： 10.2169/internalmedicine.53.0636

神経心理検査で改善が示唆されたHIV-associated dementiaの1例

森岡悠, 今村顕史

HIV感染症とAIDSの治療 Vol. 5 ( 1 ) page： 46 - 48 2014

Necrotizing Fasciitis after a Cat Bite : A Case Report

HOSODA Tomohiro, YANAGISAWA Naoki, MORIOKA Hiroshi, SUGANUMA Akihiko, IMAMURA Akifumi, AJISAWA Atsushi

Kansenshogaku Zasshi Vol. 87 ( 2 ) page： 211 - 4 2013.3

Publishing type：Research paper (scientific journal) Publisher：The Japanese Association for Infectious Diseases

We report on a previously healthy 56-year-old woman who was referred to our hospital with fever and progressive left foot pain. She had been bitten by a cat 7 days previously, and cephalosporins had been prescribed for treatment. However, her clinical symptoms deteriorated, and physical examination on admission was compatible with necrotizing fasciitis. Treatment with ampicillin-sulbactam and clindamycin was initiated. In addition, immediate surgical debridement was performed, resulting in therapeutic success. Culture of the necrotizing tissue grew multiple organisms, including Pasteurella multocida and Bacteroides caccae. Administration of appropriate antibiotics after a cat bite is essential for the prevention of potentially fatal complications.

DOI： 10.11150/kansenshogakuzasshi.87.211

Re-expansion pulmonary edema: evaluation of risk factors in 173 episodes of spontaneous pneumothorax. International journal

Hiroshi Morioka, Kazuto Takada, Shuuichi Matsumoto, Eiji Kojima, Susumu Iwata, Shoutaro Okachi

Respiratory investigation Vol. 51 ( 1 ) page： 35 - 9 2013.3

Publishing type：Research paper (scientific journal)

BACKGROUND: The precise incidence and clinical features of re-expansion pulmonary edema (RPE) are unclear, and they vary among reports. In this study, we assessed the incidence, risk factors, and outcomes of patients with RPE over a 3-yr period in a general hospital, with the goal of proposing a primary intervention for pneumothorax. METHODS: We retrospectively reviewed records of inpatients with spontaneous pneumothorax treated by tube thoracostomy between October 2007 and December 2010. RESULTS: A total of 173 episodes of spontaneous pneumothorax occurred in 156 patients. The incidence of RPE was 27/173 (15.6%). Symptom duration and pneumothorax size were significant risk factors for RPE, and the occurrence of RPE was independent of primary treatment of spontaneous pneumothorax. Among the patients with RPE, 18 (67%) were symptomatic. Five patients (18.5%) were treated with temporary oxygen, however, 21 patients (78%) did not need any treatment. All patients survived and none required mechanical ventilation. The occurrence of RPE did not influence the clinical outcome. CONCLUSIONS: The risk of developing RPE increases with an increased duration or size of pneumothorax. Our results suggest that the methods of primary intervention, including prompt suction, do not affect the onset of RPE. Close observation is always required regardless of the intervention because of the potentially fatal complications.

DOI： 10.1016/j.resinv.2012.09.003

Bilateral Emphysematous Pyelonephritis with a Splenic Abscess

Morioka Hiroshi, Yanagisawa Naoki, Suganuma Akihiko, Imamura Akifumi, Ajisawa Atsushi

INTERNAL MEDICINE Vol. 52 ( 1 ) page： 147 - 150 2013

Publishing type：Research paper (scientific journal) Publisher：一般社団法人日本内科学会

The case of a 66-year-old woman with untreated diabetes mellitus who was admitted to our hospital with a fever, hypotension and an altered mental status is herein reported. Computed tomography revealed bilateral emphysematous pyelonephritis along with a splenic abscess. Blood and urine cultures grew Escherichia coli. Treatment with systemic antibiotics combined with the insertion of percutaneous and renoureteral catheters was successful. The patient was discharged and completed treatment without developing any subsequent complications.

DOI： 10.2169/internalmedicine.52.8302