論文 - 宮崎 泰可
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Whole-Genome Sequencing and Comparative Genomic Analysis of Three Clinical Bloodstream Infection Isolates of Trichosporon austroamericanum. 査読あり
Horiguchi T, Umeyama T, Tomuro H, Otani A, Shinohara T, Abe M, Takatsuka S, Miyazawa K, Nagi M, Muraosa Y, Hoshino Y, Sakoh T, Araoka H, Uchida N, Kaneko T, Nagano Y, Tsukada H, Miyazaki T, Miyazaki Y.
J Fungi (Basel). 11 ( 5 ) 401 2025年5月
掲載種別：研究論文（学術雑誌）
DOI： 10.3390/jof11050401.
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Pitt candidaemia score as an assessment tool for mortality in patients with candidaemia caused by Candida tropicalis and other Candida species: a multicentre study conducted in Japan. 査読あり
Ueda T, Kakeya H, Yoshida K, Hisato A, Ukimura A, Ogawa T, Nakajima K, Iijima K, Nagao M, Tsuchido Y, Kawamura H, Shigemi A, Hotomi M, Kono M, Kasahara K, Imakita N, Kaneko Y, Niki M, Yamada K, Kakuno S, Miyazaki T, Sumiyoshi M, Murakami Y, Doi M, Yoshioka M, Miyazaki Y, Takesue Y.
JAC Antimicrob Resist. 7 ( 3 ) dlaf078 2025年5月
掲載種別：研究論文（学術雑誌）
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Analysis of risk factors for long COVID after mild COVID-19 during the Omicron wave in Japan 査読あり
Namie H., Takazono T., Kawasaki R., Yano H., Ito Y., Nakada N., Hirayama T., Yoshida M., Takeda K., Ide S., Takemoto S., Iwanaga N., Tashiro M., Hosogaya N., Ishimoto H., Sakamoto N., Obase Y., Sawai T., Hashiguchi K., Fukuda Y., Kobayashi T., Matsumoto N., Norimura D., Kawano T., Hanaka T., Watanabe T., Komiya K., Miyazaki T., Ishii H., Yatera K., Yanagihara K., Nishino T., Mukae H., Izumikawa K.
Respiratory Investigation 63 ( 3 ) 303 - 310 2025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：Respiratory Investigation
Background: Post-COVID-19 syndrome, referred to as “long COVID,” is characterized by persistent symptoms that develop during or after SRAS-CoV-2 infection lasting for ≥12 weeks, which cannot be explained by factors other than COVID-19. Previous studies before the Omicron pandemic have identified female sex, older age (≥50 years), severity of illness, obesity, diabetes, and smoking as risk factors for long COVID. However, data on long COVID following the emergence of the Omicron variants are limited. Methods: An online survey was conducted among outpatients diagnosed with mild COVID-19 at 14 participating institutions in Japan between July 30, 2022, and December 31, 2023. Results: Of the included 246 cases, 76 (35.5%) experienced at least one long COVID symptom 12 weeks after onset. Logistic regression analysis revealed that age ≥40 years was significantly associated with an increased risk of respiratory (odds ratio [OR]: 3.80, 95% confidence interval [CI]: 1.67–8.65) and neurologic symptoms (OR: 4.53, 95% CI: 1.84–11.13). Conversely, antiviral drug use was associated with a decreased risk of respiratory symptoms (OR: 0.31, 95% CI: 0.11–0.93). Conclusion: Caution is warranted when treating patients over 40 years of age with mild COVID-19 due to their higher susceptibility to developing long COVID. Antiviral drugs may be beneficial in managing respiratory symptoms and mitigating disease severity.
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Volume Rendering画像支援により塞栓に成功した 肺動脈仮性動脈瘤の一例 査読あり
久保田瑠璃、原卓也、新地康規、増田梨絵、古小路英二、榮建文、末原照大、坪内拡伸、宮崎泰可、東美菜子
宮崎県医師会医学会誌 49 ( 1 ) 29 - 33 2025年3月
掲載種別：研究論文（学術雑誌）
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Hirayama T., Miyazaki T., Tanaka R., Kitahori N., Yoshida M., Takeda K., Ide S., Iwanaga N., Tashiro M., Takazono T., Izumikawa K., Yanagihara K., Makimura K., Tsukamoto K., Mukae H.
Antimicrobial Agents and Chemotherapy 69 ( 2 ) e0150824 2025年2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：Antimicrobial Agents and Chemotherapy
Candida auris is an emerging pathogenic fungus that is highly resistant to existing antifungal drugs. Manogepix is a novel antifungal agent that exerts antifungal activity by inhibiting glycosylphosphatidylinositol anchor biosynthesis. Although the mechanisms of resistance of Candida species to manogepix have been reported previously, those of C. auris are yet to be studied. To investigate the resistance mechanisms of C. auris, we exposed a clinical isolate (clade I) to manogepix in vitro and generated strains with reduced susceptibility to manogepix. A search for gain-of-function mutations that upregulate efflux pump expression confirmed the presence of the D865N amino acid mutation in TAC1b. We used the clustered regularly interspaced short palindromic repeats-Cas9 system to create a recovery strain (N865D) in which only this single nucleotide mutation was returned to the wild-type sequence. We generated a mutant strain by introducing only the D865N mutation into the parent strain and a different clade strain (clade III). The D865N mutant strains were clearly less susceptible to manogepix than the parental strains and exhibited high CDR1 expression. Moreover, we generated a strain deficient in CDR1 and confirmed that this strain had significantly increased susceptibility to manogepix. Thus, the present study demonstrated that the TAC1b mutation in C. auris upregulates CDR1 expression and decreases its susceptibility to manogepix.
DOI： 10.1128/aac.01508-24
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Mechanisms of multidrug resistance caused by an Ipi1 mutation in the fungal pathogen Candida glabrata. 査読あり
Miyazaki T, Shimamura S, Nagayoshi Y, Nakayama H, Morita A, Tanaka Y, Matsumoto Y, Inamine T, Nishikawa H, Nakada N, Sumiyoshi M, Hirayama T, Kohno S, Mukae H.
Nat Commun. 16 ( 1 ) 1023 2025年1月
掲載種別：研究論文（学術雑誌）
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Mitsutome E., Yanagi S., Uchida T., Horiguchi T., Tsubouchi H., Sumiyoshi M., Kitamura A., Oda Y., Ueno H., Yamaguchi H., Miyazaki T.
Journal of Infection and Chemotherapy 31 ( 1 ) 102482 2025年1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：Journal of Infection and Chemotherapy
Most cases of nontuberculous mycobacterial pulmonary disease (NTM-PD) have a progressive clinical course, and initiation of treatment is recommended rather than watchful waiting. The NTM-PD medications are frequently associated with adverse reactions, occasionally serious. Optimization of the methods for monitoring and managing adverse events in NTM-PD treatment is thus an important medical issue. Here we report a first case of postprandial hypoglycemia caused by the combination of clarithromycin (CAM) and rifampicin (RFP) in a patient with NTM-PD. A 73-year-old Japanese woman with NTM-PD was hospitalized for treatment with a combination of oral CAM, RFP, and ethambutol. She took the first doses of antibiotics before breakfast, and 3 h later went into a hypoglycemic state. Postprandial hypoglycemia occurred with high reproducibility and was accompanied by relative insulin excess. Continuous glucose monitoring with or without food and in combination with various patterns of medication revealed that the combination of CAM and RFP specifically induced postprandial hypoglycemia. Shifting the timing of administration of the CAM and RFP combination from morning to before sleep corrected the hypoglycemia and enabled continuation of the antimicrobial treatment. In conclusion, our report suggests the importance of introducing NTM-PD medication under inpatient management in order to closely monitor and early detect postprandial hypoglycemia and other serious adverse events.
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Kawaguchi T., Kitamura A., Kimura M., Rikitake Y., Iwao C., Iwao K., Sumiyoshi M., Kariya Y., Matsuda M., Umekita K., Takajo I., Moriguchi-Goto S., Yamashita A., Matsumoto K., Miyazaki T.
Journal of Infection and Chemotherapy 31 ( 1 ) 102534 2025年1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：Journal of Infection and Chemotherapy
Treating disseminated cryptococcosis in people with human immunodeficiency virus (HIV) is challenging due to the limited availability of effective antifungals. Although isavuconazole has antifungal activity against Cryptococcus neoformans, clinical evidence is sparse because this new drug has not been approved for the treatment of cryptococcosis in the US or Europe. Here, we report a case of HIV-associated cryptococcal meningitis that relapsed during maintenance therapy with fluconazole. A Japanese man in his 20s was diagnosed with HIV-1 infection and cryptococcal meningitis. The patient was intolerant to flucytosine and was treated with liposomal amphotericin B monotherapy for 2 weeks as induction therapy, followed by fluconazole (400 mg/day) for 3 months as consolidation therapy. Four months after starting maintenance therapy with fluconazole (200 mg/day), the patient presented with fever and cough, leading to readmission to our hospital. Biopsies of a nodule in the left lung and a left cervical lymph node led to the diagnosis of disseminated cryptococcosis (pulmonary cryptococcosis and cryptococcal lymphadenitis). Although a combination of fluconazole and liposomal amphotericin B was ineffective, the patient was successfully treated with an induction therapy combining isavuconazole and liposomal amphotericin B, followed by a maintenance therapy with isavuconazole. The patient received isavuconazole orally except for loading doses, achieving stable blood concentration levels. Moreover, we observed that blood levels of amphotericin B increased gradually with repeated administration. Therefore, isavuconazole may have a potential role in the treatment of cryptococcosis, and clinical trials involving larger numbers of cases are needed to confirm its efficacy and safety.
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Successful treatment of disseminated cryptococcosis with liposomal amphotericin B and isavuconazole in an adult living with HIV. 査読あり
Kawaguchi T, Kitamura A, Kimura M, Rikitake Y, Iwao C, Iwao K, Sumiyoshi M, Kariya Y, Matsuda M, Umekita K, Takajo T, Moriguchi-Goto S, Yamashita A, Matsumoto K, Miyazaki T.:
J Infect Chemother. 31 ( 1 ) 102534. 2025年1月
掲載種別：症例報告
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Human granulocytic anaplasmosis with rash and rhabdomyolysis: A case report 査読あり
Kawaguchi T., Rikitake Y., Rikitake M., Kimura M., Iwao C., Iwao K., Aizawa A., Sumiyoshi M., Kariya Y., Matsuda M., Miyauchi S., Umekita K., Takajo I., Ohashi N., Miyazaki T.
Journal of Infection and Chemotherapy 30 ( 12 ) 1309 - 1314 2024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：Journal of Infection and Chemotherapy
Human granulocytic anaplasmosis (HGA) is a tick-borne infection caused by Anaplasma phagocytophilum. Only seven cases of HGA have been reported in Japan to date. We report the case of a 61-year-old female farmer who developed HGA with rash and rhabdomyolysis. The patient had fever and erythema covering the entire body, including the palms. An induration with an eschar was observed on the right leg, indicating that the patient had been bitten by a tick. Elevated serum creatinine and creatinine kinase levels and hematuria indicated rhabdomyolysis. We suspected Japanese spotted fever, a tick-borne illness caused by Rickettsia Japonica, and administered minocycline and ciprofloxacin for a week. Transient neutropenia and thrombocytopenia were observed, but the symptoms improved. Polymerase chain reaction (PCR) and antibody tests for R. japonica and Orientia tsutsugamushi, which causes scrub typhus, were both negative. The PCR test for severe fever with thrombocytopenia syndrome virus was also negative. Antibodies against A. phagocytophilum–related proteins were detected by western blotting, indicating seroconversion of IgG with paired serum samples, and the patient was diagnosed with HGA. HGA should be suspected in acute febrile patients with a history of outdoor activity and cytopenia, with or without a rash. A testing system and the accumulation of cases in Japan are necessary for the early diagnosis and appropriate treatment of HGA.
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Human granulocytic anaplasmosis with rash and rhabdomyolysis: A case report. 査読あり
Kawaguchi T, Rikitake Y, Rikitake M, Kimura M, Iwao C, Iwao K, Aizawa A, Sumiyoshi M, Kariya Y, Matsuda M, Miyauchi S, Umekita K, Takajo I, Ohashi N, Miyazaki T.
J Infect Chemother. 30 ( 12 ) 1309 - 1314 2024年12月
掲載種別：症例報告
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Takazono T., Namie H., Nagayoshi Y., Imamura Y., Ito Y., Sumiyoshi M., Ashizawa N., Yoshida M., Takeda K., Iwanaga N., Ide S., Harada Y., Hosogaya N., Takemoto S., Fukuda Y., Yamamoto K., Miyazaki T., Sakamoto N., Obase Y., Sawai T., Higashiyama Y., Hashiguchi K., Funakoshi S., Suyama N., Tanaka H., Yanagihara K., Izumikawa K., Mukae H.
Respirology 29 ( 8 ) 722 - 730 2024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：Respirology
Background and Objective: The identification of factors associated with long-term prognosis after community-onset pneumonia in elderly patients should be considered when initiating advance care planning (ACP). We aimed to identify these factors and develop a prediction score model. Methods: Patients aged 65 years and older, who were hospitalized for pneumonia at nine collaborating institutions, were included. The prognosis of patients 180 days after the completion of antimicrobial treatment for pneumonia was prospectively collected. Results: The total number of analysable cases was 399, excluding 7 outliers and 42 cases with missing data or unknown prognosis. These cases were randomly divided in an 8:2 ratio for score development and testing. The median age was 82 years, and there were 68 (17%) deaths. A multivariate analysis showed that significant factors were performance status (PS) ≥2 (Odds ratio [OR], 11.78), hypoalbuminemia ≤2.5 g/dL (OR, 5.28) and dementia (OR, 3.15), while age and detection of antimicrobial-resistant bacteria were not associated with prognosis. A scoring model was then developed with PS ≥2, Alb ≤2.5, and dementia providing scores of 2, 1 and 1 each, respectively, for a total of 4. The area under the curve was 0.8504, and the sensitivity and specificity were 94.6% and 61.7% at the cutoff of 2, respectively. In the test cases, the sensitivity and specificity were 91.7% and 63.1%, respectively, at a cutoff value of 2. Conclusion: Patients meeting this score should be considered near the end of life, and the initiation of ACP practices should be considered.
DOI： 10.1111/resp.14752
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Kawaguchi T., Matsuda M., Umekita K., Miyazaki T.
Respirology Case Reports 12 ( 7 ) e01428 2024年7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：Respirology Case Reports
Nintedanib has been demonstrated to inhibit the rate of forced vital capacity decline in patients with progressive fibrosing interstitial lung diseases (PF-ILD) at a dose of 200 or 300 mg/day in the INBUILD trial. Although concomitant use of nintedanib with P-glycoprotein inhibitors reportedly increases the plasma concentrations of the former, tacrolimus, a P-glycoprotein inhibitor, is often used to treat connective tissue diseases-related interstitial lung diseases. The optimal dose of nintedanib in combination with tacrolimus for the treatment of PF-ILD with connective tissue disease is unknown. We herein present two patients with PF-ILD with anti-aminoacyl-tRNA synthetase antibody-positive dermatomyositis who were successfully treated with low-dose nintedanib (<200 mg/day) in combination with tacrolimus.
DOI： 10.1002/rcr2.1428
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Resolvin D4 mitigates lipopolysaccharide-induced lung injury in mice 査読あり
Inomata R., Tsubouchi H., Takao T., Kurokawa M., Yanagi S., Sakai K., Miyazaki T.
Prostaglandins Leukotrienes and Essential Fatty Acids 203 102652 2024年4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：Prostaglandins Leukotrienes and Essential Fatty Acids
Acute respiratory distress syndrome (ARDS) is a life-threatening condition involving severe lung inflammation. The excessive oxidative stress and persistent inflammation that occur in ARDS lead to decreased epithelial integrity and hypoxemia due to pulmonary edema via increased vascular permeability. Resolvin D4 (RvD4) is one of the lipid mediators that is biosynthesized from omega-3 polyunsaturated fatty acids. It plays a role in the resolution of inflammation and reduces oxidative stress and cell death. We investigated the therapeutic potential of the administration of RvD4 in a murine model of lipopolysaccharide (LPS)-induced ARDS. Concurrent with the intratracheal administration of LPS, RvD4 or saline was administered to mice via the caudal vein every 12 h. This treatment with RvD4 alleviated the LPS-induced infiltration of inflammatory cells in lungs, inhibited increased pulmonary vascular permeability, decreased the levels of IL-1β, IL-6, and TNF-α in bronchoalveolar lavage fluid (BALF), and suppressed the reduction of the expression levels of the tight junction protein, Zonula occludens-1 (Zo-1) and the NAD+-dependent deacetylase, Sirtuin-3 (Sirt3). In vitro experiments revealed that in LPS-stimulated BEAS-2B cells, treatment with RvD4 suppressed the increases in the expressions of pro-inflammatory cytokines and maintained the epithelial cell barrier function and cell viability. The silencing of SIRT3 abolished both the anti-inflammatory effect and the retention of cell integrity in BEAS-2B cells. Together these results indicate that treatment with RvD4 can (i) protect against LPS-induced lung injury by inhibiting inflammation, and (ii) maintain epithelial barrier function via a reduction in the downregulation of SIRT3.
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Miyazaki T., van der Linden M., Hirano K., Maeda T., Kohno S., Gonzalez E.N., Zhang P., Isturiz R.E., Gray S.L., Grant L.R., Pride M.W., Gessner B.D., Jodar L., Arguedas A.G.
Frontiers in Microbiology 15 1458307 2024年
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：Frontiers in Microbiology
Streptococcus pneumoniae is an important cause of community-acquired pneumonia (CAP) in Japan. Here, we report the serotype distribution and antimicrobial susceptibility of cultured pneumococcal isolates from Japanese adults aged ≥18 years with CAP. This was a prospective, population-based, active surveillance study conducted in Goto City, Japan from December 2015 to November 2020. Pneumococcal isolates from sterile sites (blood and pleural fluid) and non-sterile sites (sputum and bronchoalveolar lavage) were cultured as part of the standard of care. S. pneumoniae were serotyped using the Quellung reaction. Antimicrobial susceptibility was tested using microdilution and interpreted according to the Clinical and Laboratory Standards Institute criteria. Isolates resistant to erythromycin were phenotyped using the triple-risk test and genotyped by polymerase chain reaction. A total of 156 pneumococcal isolates were collected (138 from sputum, 15 from blood, and 3 from bronchoalveolar lavage) from 1992 patients. Of these, 142 were non-duplicate isolates from unique patients and were included in the analyses. Serotypes contained within the 13-valent pneumococcal conjugate vaccine (PCV13) (including 6C), PCV15 (including 6C), and PCV20 (including 6C and 15C) were detected in 39 (27%), 45 (32%), and 80 (56%) of 142 isolates, respectively. The most common serotypes were 35B (12%), 11A (11%), and 3 (11%). Multidrug resistance (MDR) was detected in 96/142 (68%) isolates. Of the 96 MDR isolates, 31, 32, and 59% were PCV13, PCV15, and PCV20 serotypes, respectively; the most common MDR serotypes were 35B (16%), 6C, 10A, and 15A (9% each), and 3 and 11A (8% each). A total of 119 isolates were resistant to macrolides; 41 (35%) had an M phenotype, 53 (45%) had an iMcLS phenotype, and 25 (21%) had a cMLS phenotype. In conclusion, pneumococcal serotypes 35B, 11A and 3 were most frequently associated with pneumonia and antimicrobial resistance was common among pneumococcal isolates from adults with CAP in Goto City, Japan. Implementing higher-valency PCVs May help reduce vaccine-type CAP among Japanese adults.
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EL3-1 侵襲性カンジダ症の病態と治療
宮崎 泰可
日本医真菌学会総会プログラム・抄録集 65.Suppl1 ( 0 ) 71 2024年
担当区分：筆頭著者 記述言語：日本語 掲載種別：研究論文（その他学術会議資料等） 出版者・発行元：日本医真菌学会
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Kimura M., Umekita K., Iwao C., Kawano K., Hashikura Y., Hashiba Y., Hidaka T., Sugata K., Satou Y., Miyazaki T.
Frontiers in Immunology 15 1480506 2024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：Frontiers in Immunology
Background: T-SPOT.TB®, one of the screening tests for latent tuberculosis infection (LTBI), yields invalid results in human T-cell leukemia virus type 1 (HTLV-1)-positive patients with rheumatoid arthritis. However, the detailed mechanisms behind this invalidation are unclear. Additionally, it remains unclear whether T-SPOT.TB® or QuantiFERON-TB (QFT) is more useful in HTLV-1-positive patients with rheumatic disease (RD). Method: Among all of the HTLV-1-positive RD patients who visited our department between August 2012 and December 2022, 44 patients who were screened using T-SPOT.TB® were included in the analysis. QFT testing was performed in 33 of the 44 patients, and the results were compared with that of T-SPOT.TB®. Furthermore, we performed a culture experiment mimicking T-SPOT.TB® using peripheral blood mononuclear cells (PBMCs) obtained from HTLV-1-positive patients with RD. Additionally, T-cell subsets with autonomous product IFN-γ were analyzed using a flow cytometer. Results: Of the included patients, 13 (29.5%) were invalid for T-SPOT.TB® because of the increased number of negative control spots. The median HTLV-1 proviral load in the invalid group was higher than that in the valid group (2.45 vs. 0.49 copies/100 PBMCs, respectively, p = 0.002). QFT was performed in all 33 patients, including 13 patients who were invalid in T-SPOT.TB®. The main source of IFN-γ production was CD8+ T-cells in the T-SPOT.TB® mimic experiment. Furthermore, Tax-expressing CD4+ T-cells and Tax-specific cytotoxic CD8+ T-cells were more frequently observed in patients with invalid results than in patients with valid results. CD4+ T-cell depletion in the T-SPOT.TB® mimic experiment reduced the population of IFN-γ producing CD8+ T cells. Conclusion: T-SPOT.TB® may be invalidated by the interaction between Tax-expressing CD4+ T-cells and cytotoxic CD8+ T-cells. Moreover, HTLV-1-associated immune reactions due to contact between these cells may be unlikely to occur in QFT using whole blood. Therefore, our results reveal the superiority of QFT over T-SPOT.TB® as a screening test for LTBI in HTLV-1-positive patients with RD.
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Kitamura A., Yanagi S., Shide K., Sato Y., Kamiunten A., Yamanari Y., Kitamura A., Sumiyoshi M., Oda Y., Tsubouchi H., Shimoda K., Miyazaki T.
American Journal of Case Reports 25 e945804 2024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：American Journal of Case Reports
Patient: Male, 32-year-old Final Diagnosis: B-acute lymphoblastic leukemia Symptoms: Dyspnea • face swelling Clinical Procedure: — Specialty: Oncology Objective: Unknown etiology Background: Fibrosing mediastinitis (FM) is a rare, fibroproliferative disorder within the mediastinum. It is extremely rare for hematologic malignancies to develop as FM. Case Report: A 32-year-old Japanese man with a 1-month history of headache and 2-week history of facial swelling underwent chest computed tomography (CT); a diffuse mass-like lesion was revealed in the anterior mediastinum with severe stenosis of vital mediastinal organs. After a surgical biopsy, an initial diagnosis of idiopathic FM was made. The FM lesions responded mildly to corticosteroids but recurred repeatedly. Sixteen months after the treatment initiation, blasts appeared in the peripheral blood (PB), and the patient was diagnosed with B-acute lymphoblastic leukemia/lymphoblastic lymphoma (B-ALL/LBL). Chemotherapy led to complete remission of the B-ALL/LBL and almost complete disappearance of FM-like lesions. Immunohistochemistry of the mediastinal biopsy specimen taken before the blasts’ appearance in PB demonstrated a CD34/CD7/terminal deoxynucleotidyl transferase-positive population, an identical pattern of expression common to the blasts in the patient’s PB and bone marrow. Conclusions: This is the first case report of B-ALL/LBL presenting as FM. This case underscores the importance of considering the possibility of latent hematologic malignancy even in the absence of new symptoms other than those caused by FM lesions for a long period of time. This is the first demonstration that leukemia cells may be present in the FM lesions from the initial stage of disease onset. Even if a diagnosis of idiopathic FM is confirmed, continued suspicion of the presence of hematologic malignancy is vital for improving patient outcomes.
DOI： 10.12659/AJCR.945804
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Luteibacter jiangsuensis blood stream infection: a first case report 査読あり
Horiguchi T., Sumiyoshi M., Nagatomo E., Sakamoto K., Ogawa S., Ichinari N., Yamada A., Rikitake Y., Iwao C., Kawaguchi T., Umekita K., Takajo I., Yamamoto S., Miyazaki T.
BMC Infectious Diseases 23 ( 1 ) 863 2023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：BMC Infectious Diseases
Background: Luteibacter jiangsuensis is a gram-negative aerobic bacillus that was first isolated from soil samples at a pesticide factory in China and reported in 2011. Here, we describe the first case of L. jiangsuensis infection in human. Case presentation: A 59-year-old Japanese woman undergoing treatment for Crohn’s disease was admitted to our hospital with fever. Clinical examination indicated catheter-related bloodstream infection. The catheter was removed and meropenem was initiated. Morphologically identical glucose non-fermentative gram-negative bacilli were detected from two sets of aerobic blood culture and catheter-tip cultures. MALDI-TOF mass spectrometry failed to identify the bacterium, which was later identified as L. jiangsuensis by 16 S rRNA gene sequencing. Antimicrobial susceptibility test revealed that the isolate was resistant to carbapenem, therefore meropenem was switched to intravenous levofloxacin (500 mg/day). After 14 days of treatment with levofloxacin, the patient was discharged. Conclusions: This is the first case of L. jiangsuensis infection in human. The strain was identified by 16 S rRNA gene sequence analysis.
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住吉 誠, 宮崎 泰可
日本内科学会雑誌 112 ( 11 ) 2053 - 2058 2023年11月
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：一般社団法人 日本内科学会
市中肺炎の診療において重要な5ステップは，①患者背景と臨床経過，重症度および重症化リスクを的確に評価する，②抗菌薬投与前に適切な検体を採取して原因微生物の同定に努める，③主要な原因菌（感受性菌）を対象とした標準的なエンピリック治療を行う，④微生物学的検査結果を基に標的治療に移行する，⑤病態や合併症，治療効果を基に，適切な治療期間を設定することである．本稿では各ステップにおけるポイントを概説する．