2024/02/29 更新

写真a

オカ ケイスケ
岡 圭輔
OKA Keisuke
所属
医学部附属病院 中央感染制御部 病院助教
職名
病院助教
外部リンク

学位 1

  1. 博士(医学) ( 2022年9月   名古屋大学 ) 

研究キーワード 6

  1. 薬剤耐性菌

  2. 結核菌

  3. 細菌

  4. 分子疫学

  5. ワクチン

  6. Infection Control

研究分野 3

  1. ライフサイエンス / 衛生学、公衆衛生学分野:実験系を含む

  2. ライフサイエンス / 細菌学

  3. ライフサイエンス / 内科学一般

経歴 1

  1. 名古屋大学   医学部附属病院 中央感染制御部   病院助教

    2021年8月 - 現在

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所属学協会 7

  1. 日本内科学会

  2. 日本感染症学会

  3. 日本化学療法学会

  4. 日本呼吸器学会

  5. 日本結核・非結核性抗酸菌症学会

  6. 日本臨床微生物学会

  7. 日本環境感染学会

▼全件表示

受賞 1

  1. The 19th Asia Pacific Congress of Clinical Microbiology and Infection Best Poster Presentation Awards

    2023年7月   Asia Pacific Society of Clinical Microbiology and Infection   Analysis of Enterobacter cloacae complex producing IMI-type carbapenemase

    Keisuke Oka, Kazumitsu Kawamura, Tetsuya Yagi

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    受賞区分:国際学会・会議・シンポジウム等の賞  受賞国:大韓民国

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論文 23

  1. Clinical characteristics and treatment outcomes of carbapenem-resistant Enterobacterales infections in Japan 査読有り 国際誌

    Oka, K; Matsumoto, A; Tetsuka, N; Morioka, H; Iguchi, M; Ishiguro, N; Nagamori, T; Takahashi, S; Saito, N; Tokuda, K; Igari, H; Fujikura, Y; Kato, H; Kanai, S; Kusama, F; Iwasaki, H; Furuhashi, K; Baba, H; Nagao, M; Nakanishi, M; Kasahara, K; Kakeya, H; Chikumi, H; Ohge, H; Azuma, M; Tauchi, H; Shimono, N; Hamada, Y; Takajo, I; Nakata, H; Kawamura, H; Fujita, J; Yagi, T

    JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE   29 巻   頁: 247 - 252   2022年6月

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    担当区分:筆頭著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Global Antimicrobial Resistance  

    Objectives: The dissemination of difficult-to-treat carbapenem-resistant Enterobacterales (CRE) is of great concern. We clarified the risk factors underlying CRE infection mortality in Japan. Methods: We conducted a retrospective, multicentre, observational cohort study of patients with CRE infections at 28 university hospitals from September 2014 to December 2016, using the Japanese National Surveillance criteria. Clinical information, including patient background, type of infection, antibiotic treatment, and treatment outcome, was collected. The carbapenemase genotype was determined using PCR sequencing. Multivariate analysis was performed to identify the risk factors for 28-day mortality. Results: Among the 179 patients enrolled, 65 patients (36.3%) had bloodstream infections, with 37 (20.7%) infections occurring due to carbapenemase-producing Enterobacterales (CPE); all carbapenemases were of IMP-type (IMP-1: 32, IMP-6: 5). Two-thirds of CPE were identified as Enterobacter cloacae complex. Combination therapy was administered only in 46 patients (25.7%), and the 28-day mortality rate was 14.3%. Univariate analysis showed that solid metastatic cancer, Charlson Comorbidity Index ≥3, bloodstream infection, pneumonia, or empyema, central venous catheters, mechanical ventilation, and prior use of quinolones were significant risk factors for mortality. Multivariate analysis revealed that mechanical ventilation (OR: 6.71 [1.42–31.6], P = 0.016), solid metastatic cancers (OR: 5.63 [1.38–23.0], P = 0.016), and bloodstream infections (OR: 3.49 [1.02–12.0], P = 0.046) were independent risk factors for 28-day mortality. Conclusion: The significant risk factors for 28-day mortality in patients with CRE infections in Japan are mechanical ventilation, solid metastatic cancers, and bloodstream infections.

    DOI: 10.1016/j.jgar.2022.04.004

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  2. Genetic and epidemiological analysis of ESBL-producing<i> Klebsiella</i><i> pneumoniae</i> in three Japanese university hospitals 査読有り 国際誌

    Oka, K; Tetsuka, N; Morioka, H; Iguchi, M; Kawamura, K; Hayashi, K; Yanagiya, T; Morokuma, Y; Watari, T; Kiyosuke, M; Yagi, T

    JOURNAL OF INFECTION AND CHEMOTHERAPY   28 巻 ( 9 ) 頁: 1286 - 1294   2022年9月

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    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Infection and Chemotherapy  

    Introduction: We aimed to clarify the genetic background and molecular epidemiology of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae (K. pneumoniae) at three geographically separated university hospitals in Japan. Methods: From January 2014 to December 2016, 118 ESBL-producing K. pneumoniae (EPKP) strains that were detected and stored at three university hospitals were collected. Molecular epidemiological analysis was performed using enterobacterial repetitive intergenic consensus (ERIC)-polymerase chain reaction (PCR) and multi-locus sequence typing (MLST). The ESBL type was determined using the PCR-sequence method. The presence of plasmid-mediated fluoroquinolone resistance (PMQR) genes was analyzed by PCR. We compared the relationships between PMQR gene possession/quinolone resistance-determining region (QRDR) mutation and levofloxacin (LVFX)/ciprofloxacin (CPFX) susceptibility. Results: The detection rate of EPKP was 4.8% (144/2987 patients). MLST analysis revealed 62 distinct sequence types (STs). The distribution of STs was diverse, and only some EPKP strains had the same STs. ERIC-PCR showed discriminatory power similar to that of MLST. The major ESBL genotypes were CTX-M-15-, CTX-M-14-, and SHV-types, which were detected in 47, 30, and 27 strains, respectively. Ninety-one out of 118 strains had PMQR genes and 14 out of 65 strains which were not susceptible to CPFX had QRDR mutations, and the accumulation of PMQR genes and QRDR mutations tended to lead to higher minimum inhibitory concentrations (MICs) of LVFX. Conclusions: At three geographically separated university hospitals in Japan, the epidemiology of EPKP was quite diverse, and no epidemic strains were found, whereas CTX-M-14 and CTX-M-15 were predominant.

    DOI: 10.1016/j.jiac.2022.05.013

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  3. <i>Mycobacterium obuense</i> bacteremia: A case report and literature review 査読有り

    Oka, K; Sahara, S; Kuramae, H; Osada, Y

    INTERNATIONAL JOURNAL OF MYCOBACTERIOLOGY   12 巻 ( 3 ) 頁: 357 - 359   2023年7月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:International journal of mycobacteriology  

    An 84-year-old man visited our hospital with a high fever. He had cut his right index finger 7 days previously. Blood culture became positive on day 3. Gram staining was negative, and acid-fast staining was positive. The organism was subsequently identified as Mycobacterium obuense using a MALDI Biotyper. M. obuense was also detected in the soil at the patient's house, suggesting that it had entered his bloodstream through the cut on his finger. He was treated with a combination of imipenem/cilastatin, amikacin, and clarithromycin for 2 weeks. His clinical condition improved, and he was discharged after 2 weeks and was prescribed clarithromycin and levofloxacin therapy. Only two cases of human infection with M. obuense have been reported previously.

    DOI: 10.4103/ijmy.ijmy_148_23

    DOI: 10.4103/ijmy.ijmy_148_23

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    その他リンク: https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=iroffice_5964&SrcAuth=WosAPI&KeyUT=WOS:001087774300021&DestLinkType=FullRecord&DestApp=WOS

  4. Bursitis, Bacteremia, and Disseminated Infection of <i>Mycobacteroides</i> <i>(Mycobacterium) abscessus</i> subsp. <i>massiliense</i>

    Oka, K; Morioka, H; Eguchi, M; Sato, Y; Tetsuka, N; Iguchi, M; Kanematsu, T; Fukano, H; Hoshino, Y; Kiyoi, H; Yagi, T

    INTERNAL MEDICINE   60 巻 ( 18 ) 頁: 3041 - 3045   2021年9月

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    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:一般社団法人 日本内科学会  

    We herein report a 59-year-old woman with a 2-year history of chronic bursitis of the hand who took 50 mg/day prednisolone for several autoimmune diseases. Mycobacteroides abscessus subsp. massiliense was isolated from the abscess and blood culture. Combination therapy (imipenem/cilastatin, amikacin, and clarithromycin) was administered for a month. Two months later, M. massiliense was detected from a blood culture again, and disseminated lesions were found. Clarithromycin and sitafloxacin were administered following eight weeks of the same regimen. Six months after the diagnosis, M. massiliense was isolated from a blood culture, and she expired due to multiple organ failure.

    DOI: 10.2169/internalmedicine.6189-20

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  5. Catheter-related bloodstream infection caused by Lacticaseibacillus paracasei: A case report and literature review.

    Fukuda Y, Morioka H, Yamamoto S, Iguchi M, Umeda S, Asahara T, Kanda K, Oka K, Nakayama G, Yagi T

    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy     2024年1月

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    記述言語:英語   出版者・発行元:Journal of Infection and Chemotherapy  

    Catheter-related bloodstream infections (CRBSIs) caused by Lactobacillus spp. and Lacticaseibacillus spp. are rare, and their clinical course and optimal treatment remain uncertain. In this report, we present a 46-year-old male patient who experienced clinically diagnosed Lacticaseibacillus paracasei CRBSI on four separate occasions, despite receiving systemic administration of antibiotics and antimicrobial lock therapy. The patient did not develop L. paracasei bacteremia after catheter removal. This case report furthers our knowledge of CRBSI caused by Lactobacillus and related genera and highlights the need for further research.

    DOI: 10.1016/j.jiac.2023.12.015

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  6. Surgical antimicrobial prophylaxis in Japanese hospitals: Real status and challenges.

    Morioka H, Koizumi Y, Watariguchi T, Oka K, Tomita Y, Kojima Y, Okudaira M, Ito Y, Shimizu J, Watamoto K, Kato H, Nagaoka M, Yokota M, Hasegawa C, Tsuji T, Shimizu S, Ito K, Kawasaki S, Akita K, Kitagawa Y, Mutoh Y, Ishihara M, Iwata S, Nozaki Y, Nozawa M, Kato M, Katayama M, Yagi T, Research Group, of Aichi Poin, Prevalence Survey

    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy     2024年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Infection and Chemotherapy  

    Background: Information regarding the status of surgical antimicrobial prophylaxis (SAP) in Japanese hospitals is lacking. This study aimed to explore the status of SAP prescriptions for surgeries and adherence to Japanese SAP guidelines. Methods: From February to July 2020, a 1-day multicentre point prevalent survey was conducted at 27 hospitals in Aichi Prefecture, Japan. Patients prescribed SAP were included in this study. The appropriateness of the SAP was evaluated based on the guidelines for selection of antimicrobials and their duration. Surgery was defined as appropriate when all the items were appropriate. Results: A total of 728 patients (7.1 %; 728/10,199) received antimicrobials for SAP. Among them, 557 patients (76.5 %, 557/728) underwent the surgeries described in the guidelines. The overall appropriateness of all surgeries was 33.9 % (189/557). The appropriate selection of antimicrobial before/during and after surgery and their durations were 67.5 % (376/557), 67.5 % (376/557), and 43.3 % (241/557), respectively. The overall appropriateness ranged from 0 % (0/37, oral and maxillofacial surgery) to 58.7 % (88/150, orthopaedic surgery) and 27.7 % (36/130, community hospitals with 400–599 beds) to 47.2 % (17/36, specific hospitals). Cefazolin was the most prevalent antimicrobial prescribed before/during (55.5 %, 299/539), and after (45.1 %, 249/552) surgery. In total, 101 oral antimicrobials were prescribed postoperatively. Conclusions: SAP adherence by specific surgical fields and hospitals was shown in this study. Intensive intervention and repeated surveillance are necessary to improve SAP prescriptions in Japanese hospitals.

    DOI: 10.1016/j.jiac.2024.01.013

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  7. Methicillin-resistant <i>Staphylococcus aureus</i>-induced staphylococcal scalded skin syndrome in a preterm infant, and subsequent toxigenic analysis 国際誌

    Fukaura, R; Terashima-Murase, C; Ota, M; Noda, H; Oka, K; Ishihara, Y; Shibayama, K; Akiyama, M

    JOURNAL OF DERMATOLOGY   50 巻 ( 12 ) 頁: e422 - e423   2023年12月

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    記述言語:英語   出版者・発行元:Journal of Dermatology  

    DOI: 10.1111/1346-8138.16929

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  8. First Case Report of Peritoneal Dialysis-associated Peritonitis Caused by <i>Lysinibacillus sphaericus</i>

    Kinoshita, T; Sahara, S; Amano, T; Ito, M; Sakakibara, T; Takimoto, N; Osada, Y; Oka, K

    INTERNAL MEDICINE   62 巻 ( 19 ) 頁: 2919 - 2922   2023年10月

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    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:一般社団法人 日本内科学会  

    We herein report a case of peritoneal dialysis-associated peritonitis caused by Lysinibacillus sphaericus in a 40s-year-old patient. Treatment was initiated with intermittent intraperitoneal cefazolin and ceftazidime. Later, both peritoneal dialysate and blood cultures detected L. sphaericus, so the antibiotic was changed to ampicillin (ABPC). The patient was treated with a combination of intraperitoneal intermittent and intravenous ABPC for 7 days, followed by 14 days of amoxicillin. The patient experienced no adverse events and no recurrence for 30 days. The patient had four dogs, and the infection was deemed likely to have been caused by environmental contamination and inadequate catheter replacement.

    DOI: 10.2169/internalmedicine.1141-22

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  9. 外来の急性下痢症に対する経口抗菌薬の適正使用に向けた医師への教育効果 査読有り

    佐原 祥子, 木下 照常, 柴田 大地, 石原 歩実, 國遠 孝斗, 正木 猛史, 滝本 典夫, 岡 圭輔

    日本化学療法学会雑誌   70 巻 ( 6 ) 頁: 460 - 465   2023年

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    担当区分:最終著者   記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  10. Time course of skin rash, computed tomography findings, and viral load in a rheumatoid arthritis patient with severe varicella pneumonia 国際誌

    Kobayashi, H; Takeuchi, S; Torii, Y; Ikenouchi, T; Kawada, J; Oka, K; Kato, S; Ogawa, M

    IDCASES   33 巻   頁: e01866   2023年

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    記述言語:英語   出版者・発行元:IDCases  

    Varicella-zoster virus (VZV) infection in adults or immunocompromised patients has a more severe presentation compared to the mild disease in children. To the best of our knowledge, no reports have described the clinical course of VZV pneumonia focusing on time course of skin rash, chest computed tomography (CT) findings, and viral load. Furthermore, no reports have described the reactivation of human herpes virus 6 (HHV-6) in VZV pneumonia. Here, we report a case of severe VZV pneumonia that resulted in reactivation of HHV-6 in a patient with rheumatoid arthritis (RA). A 66-year-old female treated for RA was admitted to our hospital with papules. Her chest CT showed granular infiltrates, micronodules, and ground-glass opacities. The day after admission, because the typical skin rashes and chest CT findings were observed, she was diagnosed with VZV pneumonia and treated with acyclovir. Her skin rash then crusted over five days and entered the healing process, whereas it took approximately two weeks for her respiratory condition and chest CT findings to improve. In addition, VZV deoxyribonucleic acid (DNA) gradually decreased with treatment. On the 34th day of admission, VZV DNA was not found in the serum sample but remained in the sputum sample. Furthermore, although reactivation of HHV-6 was observed, viremia resolved without treatment. Clinicians should be able to recognize the differences in the improvement of skin rashes, respiratory status, and chest CT findings. In addition, treatment for HHV-6 reactivation should be carefully determined for each case.

    DOI: 10.1016/j.idcr.2023.e01866

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  11. Multicenter survey for carbapenemase-producing Enterobacterales in central Japan 査読有り

    Hara, Y; Iguchi, M; Tetsuka, N; Morioka, H; Hirabayashi, A; Suzuki, M; Tomita, Y; Oka, K; Yagi, T

    NAGOYA JOURNAL OF MEDICAL SCIENCE   84 巻 ( 3 ) 頁: 630 - 639   2022年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nagoya Journal of Medical Science  

    Carbapenemase-producing Enterobacterales (CPE) raise concerns about the treatment options for infectious diseases and infection control. We conducted a multicenter study to clarify the molecular epidemiology of CPE in the Aichi Prefecture during the first 3-month period from 2015 to 2019. Carbapenemase production was screened using a modified carbapenem inactivation method, and the genotypes of the carbapenemase genes were determined by polymerase chain reaction sequencing. Genetic relatedness was analyzed using multilocus sequence typing (MLST). Twenty-four hospitals participated in this study. Of the 56,494 Enterobacterales strains detected during the study period, 341 (0.6%) that met the susceptibility criteria were analyzed. Sixty-five of the 341 strains were determined to be CPE, with an incidence rate of 0.12% (65/56,494). The bacterial species responsible for CPE were Klebsiella pneumoniae (n = 24), Enterobacter cloacae complex (n = 23), Klebsiella oxytoca (n = 10), and Escherichia coli (n = 8). Most of the carbapenemase genotypes were IMP-1 (58/65), and only three were IMP-6 types. Three E. coli strains that produced NDM-5 were detected. MLST analysis showed that Sequence type (ST) 78 was predominant in E. cloacae complex CPE (14/23, 60.9%). Meanwhile, various STs were detected in carbapenemase-producing (CP) K. pneumoniae, of which ST37 and ST517 were the most common. The incidence rate of CPE in this region was comparable to national data. This 3-month surveillance revealed the spread of ST78 of CP E. cloacae complex and ST517 and ST592 of CP K. pneumoniae across hospitals, indicating the need to strengthen regional infection control programs.

    DOI: 10.18999/nagjms.84.3.630

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  12. <i>Mycobacteroides abscessus</i> complexによる頸髄硬膜外膿瘍のため呼吸停止に至った一例 査読有り

    安藤 真帆, 清水 綾子, 岸田 帆乃か, 榊原 千紘, 染谷 友紀, 藏前 仁, 中村 清忠, 岡 圭輔

    医学検査   71 巻 ( 3 ) 頁: 599 - 605   2022年7月

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    担当区分:最終著者   記述言語:日本語   出版者・発行元:一般社団法人 日本臨床衛生検査技師会  

    <p>血液培養より<i>Mycobacteroides abscessus</i> complexを分離した頸髄硬膜外膿瘍の1症例を経験した。患者は67歳男性で,糖尿病性腎症,末期腎不全のため血液透析を実施していた。当院受診3週間以上前から右前腕皮下動静脈瘻部の感染徴候があり,近医で3回培養検査を実施していたがいずれも陰性だった。血液透析中に頸部痛が出現し,当院に救急搬送された。救急外来で頸部CT撮影後に心肺停止となり心肺蘇生実施した。頸部CTにて発見された硬膜外占拠性病変により頸髄が圧迫され,呼吸停止に至ったと診断された。本例では神経学的予後不良のため手術や抗菌薬治療に至らなかった。第1病日に原因精査目的に採取した血液培養が第6病日に陽性化し,<i>Mycobacteroides abscessus</i> complexと同定された。迅速発育抗酸菌は一般細菌と比較して発育までに時間を要し,鑑別にあげて検査を実施しなければ検出することが困難であり,また硬膜外膿瘍は急激に脊髄圧迫に伴う不可逆的な症状が出現することもあるため適切かつ迅速な対応が重要と考えられた。一般細菌を検出する目的で実施された創部培養で菌が検出されないが感染兆候が持続する場合は,同菌を鑑別にあげ,適切な同定,感受性検査の実施と臨床側への情報提供が重要であると認識した一例であった。</p>

    DOI: 10.14932/jamt.21-126

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  13. Difficulties in diagnosing Malassezia furfur bloodstream infection and possibility of spontaneous resolution in a patient undergoing chemotherapy for neuroblastoma: A case report 査読有り 国際誌

    Tetsuka, N; Muramatsu, H; Iguchi, M; Oka, K; Morioka, H; Takahashi, Y; Yagi, T

    JOURNAL OF INFECTION AND CHEMOTHERAPY   28 巻 ( 7 ) 頁: 987 - 990   2022年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Infection and Chemotherapy  

    Malassezia furfur is a lipophilic, yeast-like fungus that forms part of the normal human skin microflora and is associated with a wide range of infections, such as pityriasis versicolor, folliculitis, and systemic infections in immunocompromised patients. Although matrix-assisted laser desorption/ionization time-of-flight mass spectrometry has enabled rapid identification of Malassezia species, it is still a challenge to diagnose systemic infections because Malassezia fungemia can often be missed by automated blood culture systems. We report a case in which M. furfur in blood was detected by the presence of yeast-like fungi in blood smears. Yeast-like organisms were observed in the blood smears of a 3-year-old boy, taken over 2 weeks without any symptoms. He had undergone several courses of chemotherapy for neuroblastoma via an indwelling central venous catheter (CVC) that was placed in his right anterior chest for 11 months. Although the blood cultures obtained from an automated blood culture system were negative, M. furfur growth was detected in the subcultured blood taken from the CVC. The CVC was removed, and the scheduled chemotherapy was postponed. No systemic M. furfur bloodstream infection occurred; the infection resolved spontaneously without any specific treatment; only prophylactic fluconazole was administered. M. furfur fungemia may not be diagnosable by an automated blood culture system. Further, M. furfur may not cause infections in humans even when administered intravenously. This report may lead to the discovery of factors related to human infectivity of this disease in the future.

    DOI: 10.1016/j.jiac.2022.02.026

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  14. Epidemiology and molecular characterization of fecal carriage of third-generation cephalosporin-resistant Enterobacterales among elderly residents in Japan 査読有り 国際誌

    Nakai, M; Oka, K; Watanabe, G; Kamei, K; Tsukada, N; Mori, R; Nagaya, M; Ukai, Y; Morioka, H; Tetsuka, N; Iguchi, M; Yagi, T

    JOURNAL OF INFECTION AND CHEMOTHERAPY   28 巻 ( 4 ) 頁: 569 - 575   2022年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Infection and Chemotherapy  

    Introduction: The spread of third-generation cephalosporin-resistant Gram-negative bacteria is a serious concern in acute and post-acute care settings. This study aimed to understand the epidemiology and molecular background of fecal colonization of resistant Enterobacterales in elderly people. Methods: In December 2015–December 2017, stool or rectal swab samples were collected from 101 elderly patients receiving home care, using long-term care facilities (LTCF), and living in nursing homes repeatedly at 3−9-month intervals. Patient clinical background data were collected from medical records. After phenotypic screening for extended-spectrum β-lactamase (ESBL), AmpC-type β-lactamase or carbapenemase production, drug resistance genes of isolates were analyzed using polymerase chain reaction (PCR). ESBL-producing Escherichia coli isolates obtained from the same patients in repetitive screenings were analyzed using PCR-based ORF typing. Risk factors for persistent carriage of resistant Enterobacterales were analyzed using multivariate analysis. Results: Resistant Enterobacterales isolates were detected in 37 of 101 (36.6%) and 29 of 80 (36.3%) residents in first and second screenings, respectively. ESBL-producing E. coli accounted for 80% isolates, the most common being CTX-M-9-group β-lactamase producers. Molecular epidemiological analysis revealed probable transmissions of ESBL-producing E. coli; 58% of ESBL-producing E. coli colonizers were persistent colonizers at least after 3 -month intervals. Age > 87 years and LTCF residence were independent risk factors for persistent carriage of ESBL-producing E. coli. Conclusions: We showed, for the first time, high persistent colonization rate of ESBL-producing E. coli among elderly people in post-acute care settings with probable horizontal transmission. We also identified significant risk factors for persistent colonization.

    DOI: 10.1016/j.jiac.2021.12.033

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  15. <i>Lysinibacillus fusiformis</i> bacteremia: Case report and literature review 査読有り 国際誌

    Morioka, H; Oka, K; Yamada, Y; Nakane, Y; Komiya, H; Murase, C; Iguchi, M; Yagi, T

    JOURNAL OF INFECTION AND CHEMOTHERAPY   28 巻 ( 2 ) 頁: 315 - 318   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Journal of Infection and Chemotherapy  

    A 93-year-old woman was diagnosed with Lysinibacillus fusiformis bacteremia complicated with coma blisters. Initial gram staining for L. fusiformis indicated the presence of gram-negative rods; however, subsequent staining of colonies from Mueller-Hinton agar revealed the presence of gram-positive and gram-negative rods with spherical endospores, and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (VITEK ® MS and microflex® LT/SH) definitively identified the organism as L. fusiformis. The two-week administration of piperacillin/tazobactam and ampicillin resulted in an improvement of the patient's general condition, and the skin lesions gradually improved.

    DOI: 10.1016/j.jiac.2021.10.030

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  16. A case of acute focal bacterial nephritis caused by methicillin-resistant<i> Staphylococcus</i><i> saprophyticus</i> in a 13-year-old adolescent girl treated with daptomycin 査読有り

    Kinoshita, T; Sahara, S; Mihara, Y; Asai, Y; Sato, H; Sakakibara, T; Takimoto, N; Oka, K

    IDCASES   29 巻   頁: e01594 - e01594   2022年

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    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:IDCases  

    Staphylococcus saprophyticus is a gram-positive, coagulase-negative member of the Staphylococcus genus and is second only to Escherichia coli as a cause of urinary tract infections in the young female population. S. saprophyticus usually has good susceptibility to drugs commonly used to treat urinary tract infections, but it is often methicillin-resistant. Here we report a case of acute focal bacterial nephritis in a 13-year-old female patient caused by methicillin-resistant S. saprophyticus and treated with daptomycin (DAP). The patient had a history of unilateral hearing loss and presented to her previous physician with a 3-day history of fever, right-sided abdominal pain, and diarrhea. Cefotaxime antimicrobial chemotherapy was initiated as an empiric therapy targeting E. coli, the most frequent cause of community-onset pyelonephritis. Vancomycin (VCM) was started for acute focal bacterial nephritis caused by methicillin-resistant S. saprophyticus but was stopped due to allergy and replaced with DAP. After 13 days of treatment with DAP, the patient received 17 days of treatment with sulfamethoxazole-trimethoprim combination therapy. The patient experienced no adverse events and did not relapse. DAP is a relatively new anti-methicillin-resistant Staphylococcus aureus drug used to treat gram-positive cocci infections. It is primarily excreted by the kidneys, which may be desirable in treating urinary tract infections. For children who cannot receive VCM for any reason, DAP may be a viable alternative.

    DOI: 10.1016/j.idcr.2022.e01594

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  17. Five-year point prevalence survey of healthcare- associated infections and antimicrobial use in a Japanese university hospital 査読有り

    Morioka, H; Iguchi, M; Tetsuka, N; Kinoshita, F; Tomita, Y; Kato, D; Hirabayashi, A; Matsumoto, A; Oka, K; Kato, H; Inagaki, T; Kato, Y; Kitagawa, K; Ichikawa, K; Kouyama, Y; Kawamura, N; Toyodome, Y; Adachi, N; Ito, Y; Yagi, T

    INFECTION PREVENTION IN PRACTICE   3 巻 ( 3 ) 頁: 100151 - 100151   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Infection Prevention in Practice  

    Background: Periodic point prevalence surveys (PPSs) provide a method for assessing changes in healthcare-associated infections (HAIs) and antimicrobial use over time. Following the introduction of an antimicrobial stewardship programme at Nagoya University Hospital (Aichi, Japan) a five-year PPS study was performed to highlight any epidemiological changes. Methods: One-day PPSs were performed annually in July at Nagoya University Hospital. Data on patient characteristics, medical devices, active HAIs and antimicrobial use were collected using a standard data-collection form. Results: A total of 4339 patients were included. Over the five-year study period the median patient age was 62 years, median duration of hospital admission was nine days, 9% of patients had an HAI and 35.2% received at least one antimicrobial. Overall there were 406 HAIs (95% confidence interval, 369–447) with surgical site infection, pneumonia and febrile neutropenia occurring most frequently. Enterobacterales were the most common pathogens (N = 78, 28.6%) and 32.1% were third-generation cephalosporin-resistant. Meropenem was the most frequently prescribed antimicrobial for HAIs. Surgical antimicrobial prophylaxis changed drastically, with shorter durations and a marked reduction in oral cephalosporin use. However, antimicrobials for medical prophylaxis gradually increased. Conclusions: This five-year PPS study shows consistent data for patient background, HAIs and causative pathogens and highlights changes in antimicrobial use during the era of the National Action Plan on Antimicrobial Resistance. To describe the epidemiology of Japanese hospitals by PPS, multicentre PPSs including in community hospitals should be performed annually.

    DOI: 10.1016/j.infpip.2021.100151

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  18. Weekly point-prevalence surveillanceを用いた医療関連感染対策の有効性評価

    豊留 有香, 西田 一貴, 井口 光孝, 森岡 悠, 手塚 宜行, 岡 圭輔, 矢田 吉城, 長田 ゆかり, 安立 なぎさ, 八木 哲也

    日本環境感染学会総会プログラム・抄録集   36回 巻   頁: 274 - 274   2021年9月

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    記述言語:日本語   出版者・発行元:(一社)日本環境感染学会  

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  19. 対症療法のみで軽快した新型コロナウイルス感染症(COVID-19)の1例 査読有り

    武田 直也,加藤 早紀,岡 圭輔,浅野 元世,中島 国也,鈴木 嘉洋,吉田 憲生

    日本病院総合診療医学会雑誌   16 巻 ( 臨時増刊号2 ) 頁: 289 - 291   2020年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  20. Molecular epidemiological analysis and risk factors for acquisition of carbapenemase-producing <i>Enterobacter cloacae</i> complex in a Japanese university hospital 招待有り 査読有り 国際誌

    Tetsuka, N; Hirabayashi, A; Matsumoto, A; Oka, K; Hara, Y; Morioka, H; Iguchi, M; Tomita, Y; Suzuki, M; Shibayama, K; Yagi, T

    ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL   8 巻 ( 8 ) 頁: 126 - 126   2019年7月

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    記述言語:日本語   掲載種別:学位論文(博士)   出版者・発行元:Antimicrobial resistance and infection control  

    Background: To clarify the molecular epidemiology of carbapenem-resistant Enterobacter cloacae complex (CREC) and the risk factors for acquisition of carbapenemase-producing E. cloacae complex (CPEC). Methods: Using clinical CREC isolates detected in a Japanese university hospital over 4 years, carbapenemase production was screened with phenotypic methods. Carbapenemase genes were analysed by PCR and sequencing. Molecular epidemiological analyses were conducted with repetitive extragenic palindromic (REP)-PCR and multilocus sequence typing (MLST). CRECs were identified to the subspecies level by hsp60 sequencing. Whole-genome sequencing of plasmids was conducted. A case-control study was performed to identify risk factors for acquisition of CPEC among patients with CREC. Results: Thirty-nine CRECs including 20 CPECs carrying blaIMP-1 were identified. Patients with CPEC had longer hospital stay before detection (26.5 days vs. 12 days, p = 0.008), a urinary catheter (odds ratio [OR], 5.36; 95% confidence interval [CI], 1.14-30.9; p = 0.023), or intubation (OR, 7.53; 95% CI, 1.47-53.8; p = 0.008) compared to patients without CPEC. Four genetically closely related CPEC clusters were observed, which showed that three of four CPEC clusters corresponded to E. asburiae (ST 53), E. hormaechei subsp. steigerwaltii (ST 113 and ST 1047) and E. cloacae subsp. cloacae (ST 513) by MLST and hsp60 sequencing. Seven representative plasmids shared structures with class I integron containing blaIMP-1 and IncHI2A replicon type. Conclusions: A longer hospital stay, presence of a urinary catheter, and intubation are risk factors for CPEC acquisition. In addition to horizontal transmission of genetically indistinguishable CPECs, IncHI2A plasmid carrying blaIMP-1 appeared to be transferred among genetically different ECs.

    DOI: 10.1186/s13756-019-0578-3

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  21. フライングディスク練習会の実施と運営 ―自施設内での新規立ち上げと他施設との交流― 査読有り

    加藤 聡之, 武田 直也, 岡 圭輔, 柴田 寛史, 酒井 元生, 河野 純子, 崎尾 百合子

    日本呼吸ケア・リハビリテーション学会誌   16 巻 ( 2 ) 頁: 313 - 317   2016年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

  22. 局所麻酔下胸腔鏡検査後に対側に発症した再膨張性肺水腫の1例 査読有り

    鈴木 嘉洋, 武田 直也, 柴田 寛史, 岡 圭輔, 北川 弘祥, 松井 彰, 馬嶋 俊, 宮沢 亜矢子, 吉田 憲生, 加藤 聡之, 岩田 勝

    気管支学   35 巻 ( 2 ) 頁: 178 - 182   2015年3月

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    記述言語:日本語  

  23. 今月の症例 若年男性に発症した肺硬化性血管腫の1例 招待有り 査読有り

    久我 祐介, 武田 直也, 岡 圭輔, 柴田 寛史, 北川 弘祥, 松井 彰, 吉田 憲生, 加藤 聡之, 岩田 勝, 山田 健

    日本内科学会雑誌   104 巻 ( 1 ) 頁: 103 - 106   2015年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

▼全件表示

MISC 1

  1. Mycobacterium abscessus subsp.abscessusによる播種性皮膚抗酸菌症の1例

    黒田 ケイ, 村瀬 千晶, 村瀬 友哉, 柴田 寛史, 阪本 考司, 岡 圭輔, 秋山 真志, 深野 華子, 星野 仁彦  

    日本皮膚科学会雑誌130 巻 ( 2 ) 頁: 255 - 255   2020年2月

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    記述言語:日本語   出版者・発行元:(公社)日本皮膚科学会  

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