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Inappropriate antimicrobial therapy for surgical site infections (SSIs) can lead to poor outcomes and an increased risk of antibiotic resistance. A nationwide survey was conducted in Japan from 2018 to 2019 to investigate the antimicrobial susceptibility of pathogens isolated from SSIs. The data were compared with those obtained in 2010 and 2014–2015 surveillance studies. Although the rate of detection of extended-spectrum β-lactamase producing strains of Escherichia coli was increased from 9.5% in 2010 to 23% in 2014–2015, the incidence decreased to 8.7% in 2018–2019. Although high susceptibility rates were detected to piperacillin/tazobactam (TAZ), the geometric mean MICs were substantially higher than to meropenem (2.67 vs 0.08 μg/mL). By contrast, relatively low geometric mean MICs (0.397 μg/mL) were demonstrated for ceftolozane/TAZ. Although the MRSA incidence rate decreased from 72% in the first surveillance to 53% in the second, no further decrease was detected in 2018–2019. For the Bacteroides fragilis group species, low levels of susceptibility were observed for moxifloxacin (65.3%), cefoxitin (65.3%), and clindamycin (CLDM) (38.9%). In particular, low susceptibility against cefoxitin was demonstrated in non-fragilis Bacteroides, especially B. thetaiotaomicron. By contrast, low susceptibility rates against CLDM were demonstrated in both B. fragilis and non-fragilis Bacteroides species, and a steady decrease in susceptibility throughout was observed (59.3% in 2010, 46.9% in 2014–2015, and 38.9% in 2018–2019). In conclusion, Japanese surveillance data revealed no significant lowering of antibiotic susceptibility over the past decade in organisms commonly associated from SSIs, with the exception of the B. fragilis group.
Takashi Ueda; Yoshio Takesue; Tetsuya Matsumoto; Kazuhiro Tateda; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Hideaki Hanaki; Toru Mizuguchi; Keita Morikane; Minako Kobayashi; Yasushi Harihara; Shiko Seki; Yuichi Ishida; Ryoji Fukushima; Masahiro Hada; Yoichi Matsuo; Shoji Kubo; Yutaka Kimura; Hiroaki Hata; Kazuhiko Nakajima; Hiroki Ohge; Shinji Akagi; Shigeru Takeda; Yasuo Fukui; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara; Hideki Kawamura. Change in antimicrobial susceptibility of pathogens isolated from surgical site infections over the past decade in Japanese nation-wide surveillance study. Journal of Infection and Chemotherapy 2021, 27, 931 -939.
AMA StyleTakashi Ueda, Yoshio Takesue, Tetsuya Matsumoto, Kazuhiro Tateda, Shinya Kusachi, Hiroshige Mikamo, Junko Sato, Hideaki Hanaki, Toru Mizuguchi, Keita Morikane, Minako Kobayashi, Yasushi Harihara, Shiko Seki, Yuichi Ishida, Ryoji Fukushima, Masahiro Hada, Yoichi Matsuo, Shoji Kubo, Yutaka Kimura, Hiroaki Hata, Kazuhiko Nakajima, Hiroki Ohge, Shinji Akagi, Shigeru Takeda, Yasuo Fukui, Katsunori Suzuki, Kohji Okamoto, Katsunori Yanagihara, Hideki Kawamura. Change in antimicrobial susceptibility of pathogens isolated from surgical site infections over the past decade in Japanese nation-wide surveillance study. Journal of Infection and Chemotherapy. 2021; 27 (7):931-939.
Chicago/Turabian StyleTakashi Ueda; Yoshio Takesue; Tetsuya Matsumoto; Kazuhiro Tateda; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Hideaki Hanaki; Toru Mizuguchi; Keita Morikane; Minako Kobayashi; Yasushi Harihara; Shiko Seki; Yuichi Ishida; Ryoji Fukushima; Masahiro Hada; Yoichi Matsuo; Shoji Kubo; Yutaka Kimura; Hiroaki Hata; Kazuhiko Nakajima; Hiroki Ohge; Shinji Akagi; Shigeru Takeda; Yasuo Fukui; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara; Hideki Kawamura. 2021. "Change in antimicrobial susceptibility of pathogens isolated from surgical site infections over the past decade in Japanese nation-wide surveillance study." Journal of Infection and Chemotherapy 27, no. 7: 931-939.
Interferon gamma (IFN-γ) is considered a key moderator of cell-mediated immunity. However, little is known about its association with granzyme B, which plays an important role in the effector function of cytotoxic T lymphocytes (CTLs). In the present study, we collected blood samples from 32 healthy adults before and after vaccination with inactivated influenza vaccine in 2017/18 to measure the levels of IFN-γ and granzyme B, which play roles in cell-mediated immunity, and hemagglutination inhibition (HAI) antibody, which plays a role in humoral immunity. The levels of IFN-γ and granzyme B were significantly correlated both before and after vaccination. Furthermore, the post-vaccine fold increases in the IFN-γ and granzyme B levels were significantly correlated. The levels of IFN-γ and granzyme B decreased five months after vaccination in more than half of the subjects who exhibited an increase in IFN-γ and granzyme B at two weeks post-vaccination. This is the first study to investigate the correlation between IFN-γ and granzyme B levels following influenza vaccination. Our study suggests that both IFN-γ and granzyme B can be used as markers of cell-mediated immunity.
Naruhito Otani; Kazuhiko Nakajima; Kaori Ishikawa; Kaoru Ichiki; Takashi Ueda; Yoshio Takesue; Takuma Yamamoto; Susumu Tanimura; Masayuki Shima; Toshiomi Okuno. Changes in Cell-Mediated Immunity (IFN-γ and Granzyme B) Following Influenza Vaccination. Viruses 2021, 13, 1137 .
AMA StyleNaruhito Otani, Kazuhiko Nakajima, Kaori Ishikawa, Kaoru Ichiki, Takashi Ueda, Yoshio Takesue, Takuma Yamamoto, Susumu Tanimura, Masayuki Shima, Toshiomi Okuno. Changes in Cell-Mediated Immunity (IFN-γ and Granzyme B) Following Influenza Vaccination. Viruses. 2021; 13 (6):1137.
Chicago/Turabian StyleNaruhito Otani; Kazuhiko Nakajima; Kaori Ishikawa; Kaoru Ichiki; Takashi Ueda; Yoshio Takesue; Takuma Yamamoto; Susumu Tanimura; Masayuki Shima; Toshiomi Okuno. 2021. "Changes in Cell-Mediated Immunity (IFN-γ and Granzyme B) Following Influenza Vaccination." Viruses 13, no. 6: 1137.
This systematic review and meta-analysis examined the optimal trough concentration of voriconazole for adult patients with invasive fungal infections. We used stepwise cutoffs of 0.5–2.0 μg/mL for efficacy and 3.0–6.0 μg/mL for safety. Studies were included if they reported the rates of all-cause mortality and/or treatment success, hepatotoxicity, and nephrotoxicity according to the trough concentration. Twenty-five studies involving 2554 patients were included. The probability of mortality was significantly decreased using a cutoff of ≥1.0 μg/mL (odds ratio (OR) = 0.34, 95% confidence interval (CI) = 0.15–0.80). Cutoffs of 0.5 (OR = 3.48, 95% CI = 1.45–8.34) and 1.0 μg/mL (OR = 3.35, 95% CI = 1.52–7.38) also increased the treatment success rate. Concerning safety, significantly higher risks of hepatotoxicity and neurotoxicity were demonstrated at higher concentrations for all cutoffs, and the highest ORs were recorded at 4.0 μg/mL (OR = 7.39, 95% CI = 3.81–14.36; OR = 5.76, 95% CI 3.14–10.57, respectively). Although further high-quality trials are needed, our findings suggest that the proper trough concentration for increasing clinical success while minimizing toxicity is 1.0–4.0 μg/mL for adult patients receiving voriconazole therapy.
Yuki Hanai; Yukihiro Hamada; Toshimi Kimura; Kazuaki Matsumoto; Yoshiko Takahashi; Satoshi Fujii; Kenji Nishizawa; Yoshitsugu Miyazaki; Yoshio Takesue. Favorable Effects of Voriconazole Trough Concentrations Exceeding 1 μg/mL on Treatment Success and All-Cause Mortality: A Systematic Review and Meta-Analysis. Journal of Fungi 2021, 7, 306 .
AMA StyleYuki Hanai, Yukihiro Hamada, Toshimi Kimura, Kazuaki Matsumoto, Yoshiko Takahashi, Satoshi Fujii, Kenji Nishizawa, Yoshitsugu Miyazaki, Yoshio Takesue. Favorable Effects of Voriconazole Trough Concentrations Exceeding 1 μg/mL on Treatment Success and All-Cause Mortality: A Systematic Review and Meta-Analysis. Journal of Fungi. 2021; 7 (4):306.
Chicago/Turabian StyleYuki Hanai; Yukihiro Hamada; Toshimi Kimura; Kazuaki Matsumoto; Yoshiko Takahashi; Satoshi Fujii; Kenji Nishizawa; Yoshitsugu Miyazaki; Yoshio Takesue. 2021. "Favorable Effects of Voriconazole Trough Concentrations Exceeding 1 μg/mL on Treatment Success and All-Cause Mortality: A Systematic Review and Meta-Analysis." Journal of Fungi 7, no. 4: 306.
Bacterial endophthalmitis is an intraocular infection that causes rapid vison loss. Pathogens can infect the intraocular space directly (exogenous endophthalmitis (ExE)) or indirectly (endogenous endophthalmitis (EnE)). To identify predictive factors for the visual prognosis of Japanese patients with bacterial endophthalmitis, we retrospectively examined the bacterial endophthalmitis characteristics of 314 Japanese patients and performed statistics using these clinical data. Older patients, with significantly more severe clinical symptoms, were prevalent in the ExE group compared with the EnE group. However, the final best-corrected visual acuity (BCVA) was not significantly different between the ExE and EnE groups. Bacteria isolated from patients were not associated with age, sex, or presence of eye symptoms. Genus Streptococcus, Streptococcus pneumoniae, and Enterococcus were more prevalent in ExE patients than EnE patients and contributed to poor final BCVA. The presence of eye pain, bacterial identification, and poor BCVA at baseline were risk factors for final visual impairment.
Hiroto Ishikawa; Kazutaka Uchida; Yoshio Takesue; Junya Mori; Takamasa Kinoshita; Shohei Morikawa; Fumiki Okamoto; Tomoko Sawada; Masahito Ohji; Takayuki Kanda; Masaru Takeuchi; Akiko Miki; Sentaro Kusuhara; Tetsuo Ueda; Nahoko Ogata; Masahiko Sugimoto; Mineo Kondo; Shigeo Yoshida; Tadahiko Ogata; Kazuhiro Kimura; Yoshinori Mitamura; Tatsuya Jujo; Hitoshi Takagi; Hiroto Terasaki; Taiji Sakamoto; Takaaki Sugisawa; Yuki Komuku; Fumi Gomi. Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST. Pathogens 2021, 10, 390 .
AMA StyleHiroto Ishikawa, Kazutaka Uchida, Yoshio Takesue, Junya Mori, Takamasa Kinoshita, Shohei Morikawa, Fumiki Okamoto, Tomoko Sawada, Masahito Ohji, Takayuki Kanda, Masaru Takeuchi, Akiko Miki, Sentaro Kusuhara, Tetsuo Ueda, Nahoko Ogata, Masahiko Sugimoto, Mineo Kondo, Shigeo Yoshida, Tadahiko Ogata, Kazuhiro Kimura, Yoshinori Mitamura, Tatsuya Jujo, Hitoshi Takagi, Hiroto Terasaki, Taiji Sakamoto, Takaaki Sugisawa, Yuki Komuku, Fumi Gomi. Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST. Pathogens. 2021; 10 (4):390.
Chicago/Turabian StyleHiroto Ishikawa; Kazutaka Uchida; Yoshio Takesue; Junya Mori; Takamasa Kinoshita; Shohei Morikawa; Fumiki Okamoto; Tomoko Sawada; Masahito Ohji; Takayuki Kanda; Masaru Takeuchi; Akiko Miki; Sentaro Kusuhara; Tetsuo Ueda; Nahoko Ogata; Masahiko Sugimoto; Mineo Kondo; Shigeo Yoshida; Tadahiko Ogata; Kazuhiro Kimura; Yoshinori Mitamura; Tatsuya Jujo; Hitoshi Takagi; Hiroto Terasaki; Taiji Sakamoto; Takaaki Sugisawa; Yuki Komuku; Fumi Gomi. 2021. "Clinical Characteristics and Outcomes in 314 Japanese Patients with Bacterial Endophthalmitis: A Multicenter Cohort Study from J-CREST." Pathogens 10, no. 4: 390.
Introduction Antimicrobial resistance is one of the biggest threats to public health systems worldwide, and aminoglycosides are key drugs for treating drug-resistant infections. Because of the nephrotoxicity of aminoglycosides, therapeutic drug monitoring is recommended, but few studies of the target trough concentration (Cmin) have been reported. To address the problem, we performed a meta-analysis to confirm the target Cmin of aminoglycosides for minimizing the risk of nephrotoxicity. Methods We conducted a literature search using MEDLINE, the Cochrane Library, and Ichushi-Web. In the meta-analysis, nephrotoxicity was compared between the Cmin ≥2 mg/L and Cmin Results No randomized controlled trials were reported for any of the drugs. Five observational studies involving 615 patients were reported for gentamicin, and two observational studies involving 159 patients were identified for amikacin. For gentamicin, Cmin Conclusions Although further well-controlled studies with a low risk of bias are needed, the current meta-analysis demonstrated that Cmin
Tomoyuki Yamada; Satoshi Fujii; Akari Shigemi; Yoshio Takesue. A meta-analysis of the target trough concentration of gentamicin and amikacin for reducing the risk of nephrotoxicity. Journal of Infection and Chemotherapy 2020, 27, 256 -261.
AMA StyleTomoyuki Yamada, Satoshi Fujii, Akari Shigemi, Yoshio Takesue. A meta-analysis of the target trough concentration of gentamicin and amikacin for reducing the risk of nephrotoxicity. Journal of Infection and Chemotherapy. 2020; 27 (2):256-261.
Chicago/Turabian StyleTomoyuki Yamada; Satoshi Fujii; Akari Shigemi; Yoshio Takesue. 2020. "A meta-analysis of the target trough concentration of gentamicin and amikacin for reducing the risk of nephrotoxicity." Journal of Infection and Chemotherapy 27, no. 2: 256-261.
IntroductionArbekacin is the first aminoglycoside antibacterial agent approved for treating methicillin-resistant Staphylococcus aureus infection in Japan. Although therapeutic drug monitoring (TDM) is recommended during arbekacin treatment, little evidence for the target exposure and once-daily dosing has been reported. This study aimed to clarify the target peak/trough concentrations and the effectiveness of once-daily dosing of arbekacin against nephrotoxicity or treatment failure via meta-analysis.MethodsA literature search was performed using MEDLINE, Cochrane Library, and Ichushi-Web.ResultsNine observational cohort studies met the inclusion criteria. A peak arbekacin concentration of ≥15–16 μg/mL did not exhibit a statistically significant lower risk of treatment failure (risk ratio [RR] = 0.61, 95% confidence interval [CI] = 0.30–1.24). A trough arbekacin concentration of ConclusionsOnce-daily dosing can improve the therapeutic efficacy of arbekacin, and a trough arbekacin concentration of
Kazutaka Oda; Satoshi Fujii; Takehito Yamamoto; Toshihiko Mayumi; Yoshio Takesue. Evaluation of once-daily dosing and target concentrations in therapeutic drug monitoring for arbekacin: A meta-analysis. Journal of Infection and Chemotherapy 2020, 27, 26 -31.
AMA StyleKazutaka Oda, Satoshi Fujii, Takehito Yamamoto, Toshihiko Mayumi, Yoshio Takesue. Evaluation of once-daily dosing and target concentrations in therapeutic drug monitoring for arbekacin: A meta-analysis. Journal of Infection and Chemotherapy. 2020; 27 (1):26-31.
Chicago/Turabian StyleKazutaka Oda; Satoshi Fujii; Takehito Yamamoto; Toshihiko Mayumi; Yoshio Takesue. 2020. "Evaluation of once-daily dosing and target concentrations in therapeutic drug monitoring for arbekacin: A meta-analysis." Journal of Infection and Chemotherapy 27, no. 1: 26-31.
Empirical antifungal therapy is recommended in high-risk patients who have persistent febrile neutropenia (FN) despite broad-spectrum antibiotic therapy. Based on high-quality evidence, most guidelines recommend caspofungin. The aim of this study was to clarify whether echinocandins, including micafungin, are associated with improved clinical outcomes in patients with persistent FN. We conducted a meta-analysis of randomized controlled trials (RCTs) of empirical therapy with echinocandins and non-echinocandins for FN in patients with hematological disease. The primary outcome was all-cause mortality within 7 days after completion of therapy. Secondary outcomes included treatment success, and discontinuation of therapy because of adverse events. For subgroup analysis, we compared RCTs of echinocandins with liposomal amphotericin B. Six RCTs (four that evaluated caspofungin and two that evaluated micafungin) were included in the meta-analysis. Mortality and adverse events in echinocandin-treated patients were significantly lower than in those treated with non-echinocandins [risk ratio (RR) 0.70, 95% confidence interval (CI) 0.49-0.99; RR 0.48, 95% CI 0.33-0.71, respectively]. There was no significant difference in treatment success (RR 1.09, 95% CI 0.87-1.36). Mortality and adverse events in echinocandin-treated patients were significantly lower than in those treated with liposomal amphotericin B (RR 0.68, 95% CI 0.46-0.99; RR 0.53, 95% CI 0.37-0.74, respectively). In conclusion, patients with persistent FN treated with echinocandins had decreased risk of death and adverse events. Both caspofungin and micafungin may be recommended as first-line empirical antifungal therapy in these patients. However, the small number of enrolled patients and the lack of RCTs involving pediatric patients should be considered when using micafungin.
Chizuru Yamashita; Yoshio Takesue; Kazuaki Matsumoto; Kazuhiro Ikegame; Yuki Enoki; Motoi Uchino; Taiga Miyazaki; Koichi Izumikawa; Tohru Takada; Keiji Okinaka; Takashi Ueda; Yoshitsugu Miyazaki; Toshihiko Mayumi. Echinocandins versus non-echinocandins for empirical antifungal therapy in patients with hematological disease with febrile neutropenia: A systematic review and meta-analysis. Journal of Infection and Chemotherapy 2020, 26, 596 -603.
AMA StyleChizuru Yamashita, Yoshio Takesue, Kazuaki Matsumoto, Kazuhiro Ikegame, Yuki Enoki, Motoi Uchino, Taiga Miyazaki, Koichi Izumikawa, Tohru Takada, Keiji Okinaka, Takashi Ueda, Yoshitsugu Miyazaki, Toshihiko Mayumi. Echinocandins versus non-echinocandins for empirical antifungal therapy in patients with hematological disease with febrile neutropenia: A systematic review and meta-analysis. Journal of Infection and Chemotherapy. 2020; 26 (6):596-603.
Chicago/Turabian StyleChizuru Yamashita; Yoshio Takesue; Kazuaki Matsumoto; Kazuhiro Ikegame; Yuki Enoki; Motoi Uchino; Taiga Miyazaki; Koichi Izumikawa; Tohru Takada; Keiji Okinaka; Takashi Ueda; Yoshitsugu Miyazaki; Toshihiko Mayumi. 2020. "Echinocandins versus non-echinocandins for empirical antifungal therapy in patients with hematological disease with febrile neutropenia: A systematic review and meta-analysis." Journal of Infection and Chemotherapy 26, no. 6: 596-603.
Background Intensive glycemic control is recommended to prevent surgical site infections (SSI). Our aim was to evaluate retrospectively the effect of improvement in hyperglycemia irrespective of insulin use on the incidence of SSI in non-diabetic patients. Methods The highest blood glucose (BG) concentration within 12 h (early peak BG) and the final BG from 12 to 24 h after surgery were evaluated in patients who underwent gastrointestinal surgery. Patients with an early peak BG of ≥150 mg/dL were divided into those with persistent (final BG of ≥150 mg/dL) and improved hyperglycemia (final BG of Results Overall, 1612 patients were studied (diabetes, n = 293). Although hyperglycemia increased the SSI rates in non-diabetic patients, no correlation was demonstrated in patients with diabetes at any cutoff final BG defining htperglycemia except for 180 mg/dL. Hyperglycemia improved without insulin therapy in 283 of 512 non-diabetic patients who had early hyperglycemia. The adjusted standardized residual for those with SSI and persistent hyperglycemia was 5.2 (P < 0.05). In contrast, the absence of hyperglycemia was a significant preventive factor for SSI. In the multivariate analyses, persistent hyperglycemia was an independent risk factor for SSI (odds ratio 1.54; 95% confidence interval 1.03–2.31). Conclusions Remission of hyperglycemia within 24 h after surgery prevented SSI in non-diabetic patients. Considering that hyperglycemia improved in approximately half of patients without insulin therapy, commencement of insulin dosing after two consecutive BGs of ≥150 mg/dL might be reasonable, especially in general wards.
Ayami Yoneda; Yoshio Takesue; Yoshiko Takahashi; Kaoru Ichiki; Toshie Tsuchida; Hiroki Ikeuchi; Motoi Uchino; Etsuro Hatano; Hisashi Shinohara; Naohiro Tomita. Improvement in Hyperglycemia Prevents Surgical Site Infection Irrespective of Insulin Therapy in Non-diabetic Patients Undergoing Gastrointestinal Surgery. World Journal of Surgery 2020, 44, 1450 -1458.
AMA StyleAyami Yoneda, Yoshio Takesue, Yoshiko Takahashi, Kaoru Ichiki, Toshie Tsuchida, Hiroki Ikeuchi, Motoi Uchino, Etsuro Hatano, Hisashi Shinohara, Naohiro Tomita. Improvement in Hyperglycemia Prevents Surgical Site Infection Irrespective of Insulin Therapy in Non-diabetic Patients Undergoing Gastrointestinal Surgery. World Journal of Surgery. 2020; 44 (5):1450-1458.
Chicago/Turabian StyleAyami Yoneda; Yoshio Takesue; Yoshiko Takahashi; Kaoru Ichiki; Toshie Tsuchida; Hiroki Ikeuchi; Motoi Uchino; Etsuro Hatano; Hisashi Shinohara; Naohiro Tomita. 2020. "Improvement in Hyperglycemia Prevents Surgical Site Infection Irrespective of Insulin Therapy in Non-diabetic Patients Undergoing Gastrointestinal Surgery." World Journal of Surgery 44, no. 5: 1450-1458.
Empirical combination therapy with β-lactams and glycopeptides is recommended for patients with presumed staphylococcal bloodstream infection (BSI). While coagulase-negative staphylococci (CNS) remain susceptible to vancomycin, such isolates have become less susceptible to teicoplanin. The aim of this retrospective study was to evaluate the clinical efficacy of teicoplanin in the treatment of BSI caused by methicillin-resistant CNS according to teicoplanin susceptibility. Inclusion criteria were patients with intravascular-catheter related BSIs caused by methicillin-resistant CNS (positive for two or more specimens); teicoplanin therapy; and at least one of the signs or symptoms caused by BSI. Antimicrobial resistance was defined as minimum inhibitory concentration (MIC) ≥8 μg/mL. The primary efficacy endpoint was clinical success evaluated 2 weeks after the completion of teicoplanin therapy [test of cure (TOC)]. Resistant rate of CNS was 0% for vancomycin and 22.9% for teicoplanin, and geometric mean MICs were 1.31 μg/mL and 3.41 μg/mL, respectively (p < 0.001). The catheter was removed in all patients except one, and high early clinical response at 72 h after starting therapy was obtained irrespective of teicoplanin susceptibility. The clinical success rate at TOC was 60% in patients with BSIs caused by teicoplanin-resistant strains, while 90% in patients with BSIs caused by susceptible strains (p = 0.052). In multivariate analyses, teicoplanin resistance was significant factor for decreased clinical success at TOC (adjusted odds ratio 0.138, 95% confidence interval 0.020–0.961, p = 0.045). Because of the poor clinical efficacy of teicoplanin against teicoplanin-resistant CNS, combination therapy comprising vancomycin and β-lactam antibiotics should be considered in presumed staphylococci BSI.
Kumiko Yamada; Takashi Ueda; Kazuhiko Nakajima; Kaoru Ichiki; Toshie Tsuchida; Naruhito Otani; Yoshiko Takahashi; Hiroki Ikeuchi; Motoi Uchino; Masahiro Koshiba; Yoshio Takesue. Clinical efficacy of teicoplanin in the treatment of bloodstream infection caused by methicillin-resistant coagulase-negative staphylococci. Journal of Infection and Chemotherapy 2019, 26, 459 -464.
AMA StyleKumiko Yamada, Takashi Ueda, Kazuhiko Nakajima, Kaoru Ichiki, Toshie Tsuchida, Naruhito Otani, Yoshiko Takahashi, Hiroki Ikeuchi, Motoi Uchino, Masahiro Koshiba, Yoshio Takesue. Clinical efficacy of teicoplanin in the treatment of bloodstream infection caused by methicillin-resistant coagulase-negative staphylococci. Journal of Infection and Chemotherapy. 2019; 26 (5):459-464.
Chicago/Turabian StyleKumiko Yamada; Takashi Ueda; Kazuhiko Nakajima; Kaoru Ichiki; Toshie Tsuchida; Naruhito Otani; Yoshiko Takahashi; Hiroki Ikeuchi; Motoi Uchino; Masahiro Koshiba; Yoshio Takesue. 2019. "Clinical efficacy of teicoplanin in the treatment of bloodstream infection caused by methicillin-resistant coagulase-negative staphylococci." Journal of Infection and Chemotherapy 26, no. 5: 459-464.
A long-course antibiotic therapy increases the risk of antibiotic resistance. A 7- to 14-day duration of therapy has been traditionally adopted in patients with intra-abdominal infections (IAIs). Prophylactic antibiotic use is warranted in uncomplicated IAIs, in which the infection involves a single organ, and the source of the infection is completely eradicated by a surgical procedure. A large, randomized clinical trial of the treatment of complicated IAIs recently demonstrated that a fixed 4-day course of antibiotic therapy was as effective as a long-course therapy in patients who underwent adequate source control. Considering the poor prognosis and lack of clear evidence available for shortening the duration of antibiotic therapy in patients who are critically ill or those with ongoing signs of sepsis, the duration of therapy for complicated IAIs should be individually determined according to the clinical course. Limiting therapy to no more than 7 days seems to be warranted in patients who are critically ill with a good clinical response.
Yoshio Takesue; Motoi Uchino; Hiroki Ikeuchi; Takashi Ueda; Kazuhiko Nakajima. Is fixed short-course antimicrobial therapy justified for patients who are critically ill with intra-abdominal infections? Journal of the Anus, Rectum and Colon 2019, 3, 53 -59.
AMA StyleYoshio Takesue, Motoi Uchino, Hiroki Ikeuchi, Takashi Ueda, Kazuhiko Nakajima. Is fixed short-course antimicrobial therapy justified for patients who are critically ill with intra-abdominal infections? Journal of the Anus, Rectum and Colon. 2019; 3 (2):53-59.
Chicago/Turabian StyleYoshio Takesue; Motoi Uchino; Hiroki Ikeuchi; Takashi Ueda; Kazuhiko Nakajima. 2019. "Is fixed short-course antimicrobial therapy justified for patients who are critically ill with intra-abdominal infections?" Journal of the Anus, Rectum and Colon 3, no. 2: 53-59.
The aim of the present study was to develop a risk calculator predictive of postoperative pneumonia in patients undergoing gastroenterological surgery. We analyzed data from 382 124 patients undergoing eight main gastroenterological surgeries between 2011 and 2013 using the National Clinical Database in Japan. A risk model was developed using multivariate logistic regression analysis with patient data from 2011 to 2012 (n = 247 604) and validated using data from 2013 (n = 134 520). Pneumonia was observed in 11 105 patients (2.9%). After the input of significant primary disease and surgical procedures, 18 patient characteristics including gender, chronic obstructive pulmonary disease, sepsis, and need for any assistance in the activities of daily living, six laboratory parameters, and two intraoperative factors were used for risk calculation. Area under the receiver-operating characteristic curve was 0.822 (95% confidence interval, 0.817-0.826) in the derivation group and 0.826 (0.819-0.832) in the validation group. The risk calculator accurately predicted the occurrence of pneumonia following gastroenterological surgery.
Yoshio Takesue; Hiroaki Miyata; Mitsukazu Gotoh; Go Wakabayashi; Hiroyuki Konno; Masaki Mori; Hiraku Kumamaru; Takashi Ueda; Kazuhiko Nakajima; Motoi Uchino; Yasuyuki Seto. Risk calculator for predicting postoperative pneumonia after gastroenterological surgery based on a national Japanese database. Annals of Gastroenterological Surgery 2019, 3, 405 -415.
AMA StyleYoshio Takesue, Hiroaki Miyata, Mitsukazu Gotoh, Go Wakabayashi, Hiroyuki Konno, Masaki Mori, Hiraku Kumamaru, Takashi Ueda, Kazuhiko Nakajima, Motoi Uchino, Yasuyuki Seto. Risk calculator for predicting postoperative pneumonia after gastroenterological surgery based on a national Japanese database. Annals of Gastroenterological Surgery. 2019; 3 (4):405-415.
Chicago/Turabian StyleYoshio Takesue; Hiroaki Miyata; Mitsukazu Gotoh; Go Wakabayashi; Hiroyuki Konno; Masaki Mori; Hiraku Kumamaru; Takashi Ueda; Kazuhiko Nakajima; Motoi Uchino; Yasuyuki Seto. 2019. "Risk calculator for predicting postoperative pneumonia after gastroenterological surgery based on a national Japanese database." Annals of Gastroenterological Surgery 3, no. 4: 405-415.
Aim To survey postoperative infections (PI) after digestive surgery. Methods This survey, conducted by the Japan Society of Surgical Infection, included patients undergoing digestive surgery at 28 centers between September 2015 and March 2016. Data collected included patient background characteristics, type of surgery, contamination status, and type of PI, including surgical site infection (SSI), remote infection (RI), and antimicrobial‐resistant (AMR) bacterial infections and colonization. Results Postoperative infections occurred in 10.7% of 6582 patients who underwent digestive surgery (6.8% for endoscopic surgery and 18.7% for open surgery). SSI and RI, including respiratory tract infection, urinary tract infection, antibiotic‐associated diarrhea, drain infection, and catheter‐related bloodstream infection, occurred in 8.9% and 3.7% of patients, respectively. Among all PI, 13.2% were overlapping infections. The most common overlapping infections were incisional and organ/space SSI, which occurred in 4.2% of patients. AMR bacterial infections occurred in 1.2% of patients after digestive surgery and comprised 11.5% of all PI. Rate of AMR bacterial colonization after digestive surgery was only 0.3%. Conclusion Periodic surveillance of PI, including AMR bacteria, is necessary for a detailed evaluation of nosocomial infections.
Toru Niitsuma; Shinya Kusachi; Yoshio Takesue; Hiroshige Mikamo; Koji Asai; Manabu Watanabe. Current status of postoperative infections after digestive surgery in Japan: The Japan Postoperative Infectious Complications Survey in 2015. Annals of Gastroenterological Surgery 2019, 3, 276 -284.
AMA StyleToru Niitsuma, Shinya Kusachi, Yoshio Takesue, Hiroshige Mikamo, Koji Asai, Manabu Watanabe. Current status of postoperative infections after digestive surgery in Japan: The Japan Postoperative Infectious Complications Survey in 2015. Annals of Gastroenterological Surgery. 2019; 3 (3):276-284.
Chicago/Turabian StyleToru Niitsuma; Shinya Kusachi; Yoshio Takesue; Hiroshige Mikamo; Koji Asai; Manabu Watanabe. 2019. "Current status of postoperative infections after digestive surgery in Japan: The Japan Postoperative Infectious Complications Survey in 2015." Annals of Gastroenterological Surgery 3, no. 3: 276-284.
This communication is in regards to Results section and Tables 3, 4, 5, 7 and 8 of Takesue et al. (2018), which has been found to contain errors.
Yoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Kazuhiko Nakajima; Takashi Ueda; Motoi Uchino; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. Corrigendum to “Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan” [J Infect Chemother 24 (2018) 330–340]. Journal of Infection and Chemotherapy 2018, 24, 592 -595.
AMA StyleYoshio Takesue, Shinya Kusachi, Hiroshige Mikamo, Junko Sato, Akira Watanabe, Hiroshi Kiyota, Satoshi Iwata, Mitsuo Kaku, Hideaki Hanaki, Yoshinobu Sumiyama, Yuko Kitagawa, Kazuhiko Nakajima, Takashi Ueda, Motoi Uchino, Toru Mizuguchi, Yoshiyasu Ambo, Masafumi Konosu, Keiichiro Ishibashi, Akihisa Matsuda, Kazuo Hase, Yasushi Harihara, Koji Okabayashi, Shiko Seki, Takuo Hara, Koshi Matsui, Yoichi Matsuo, Minako Kobayashi, Shoji Kubo, Kazuhisa Uchiyama, Junzo Shimizu, Ryohei Kawabata, Hiroki Ohge, Shinji Akagi, Masaaki Oka, Toshiro Wakatsuki, Katsunori Suzuki, Kohji Okamoto, Katsunori Yanagihara. Corrigendum to “Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan” [J Infect Chemother 24 (2018) 330–340]. Journal of Infection and Chemotherapy. 2018; 24 (7):592-595.
Chicago/Turabian StyleYoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Kazuhiko Nakajima; Takashi Ueda; Motoi Uchino; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. 2018. "Corrigendum to “Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan” [J Infect Chemother 24 (2018) 330–340]." Journal of Infection and Chemotherapy 24, no. 7: 592-595.
The principle of empirical therapy for patients with intra-abdominal infections (IAI) should include antibiotics with activity against Enterobacteriaceae and Bacteroides fragilis group species. Coverage of Pseudomonas aeruginosa, Enterobacter cloacae, and Enterococcus faecalis is also recommended for hospital-associated IAI. A nationwide survey was conducted to investigate the antimicrobial susceptibility of pathogens isolated from postoperative IAI. All 504 isolates were collected at 26 institutions and referred to a central laboratory for susceptibility testing. Lower susceptibility rates to ciprofloxacin and cefepime were demonstrated in Escherichia coli. Among E. coli, 24.1% of strains produced extended-spectrum β-lactamase (ESBL). Carbapenems, piperacillin/tazobactam, cephamycins/oxacephem, aminoglycosides, and tigecycline had high activity against E. coli, including ESBL-producing isolates. Among E. cloacae, low susceptibility rates to ceftazidime were demonstrated, whereas cefepime retained its activity. P. aeruginosa revealed high susceptibility rates to all antimicrobials tested except for imipenem. Among B. fragilis group species, low levels of susceptibility were observed for cefoxitin, moxifloxacin, and clindamycin, and high susceptibility rates were observed for piperacillin/tazobactam, meropenem, and metronidazole. Ampicillin, piperacillin, and glycopeptides had good activity against E. faecalis. Imipenem had the highest activity against E. faecalis among carbapenems. In conclusion, we suggested the empirical use of antimicrobials with the specific intent of covering the main organisms isolated from postoperative IAI. Piperacillin/tazobactam, meropenem, or doripenem, are appropriate in critically ill patients. Combination therapy of cefepime (aztreonam in patients with β-lactam allergy) plus metronidazole plus glycopeptides, imipenem/cilastatin or cephamycins/oxacephem plus ciprofloxacin plus metronidazole are potential therapeutic options.
Yoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Kazuhiko Nakajima; Takashi Ueda; Motoi Uchino; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan. Journal of Infection and Chemotherapy 2018, 24, 330 -340.
AMA StyleYoshio Takesue, Shinya Kusachi, Hiroshige Mikamo, Junko Sato, Akira Watanabe, Hiroshi Kiyota, Satoshi Iwata, Mitsuo Kaku, Hideaki Hanaki, Yoshinobu Sumiyama, Yuko Kitagawa, Kazuhiko Nakajima, Takashi Ueda, Motoi Uchino, Toru Mizuguchi, Yoshiyasu Ambo, Masafumi Konosu, Keiichiro Ishibashi, Akihisa Matsuda, Kazuo Hase, Yasushi Harihara, Koji Okabayashi, Shiko Seki, Takuo Hara, Koshi Matsui, Yoichi Matsuo, Minako Kobayashi, Shoji Kubo, Kazuhisa Uchiyama, Junzo Shimizu, Ryohei Kawabata, Hiroki Ohge, Shinji Akagi, Masaaki Oka, Toshiro Wakatsuki, Katsunori Suzuki, Kohji Okamoto, Katsunori Yanagihara. Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan. Journal of Infection and Chemotherapy. 2018; 24 (5):330-340.
Chicago/Turabian StyleYoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Kazuhiko Nakajima; Takashi Ueda; Motoi Uchino; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. 2018. "Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan." Journal of Infection and Chemotherapy 24, no. 5: 330-340.
Introduction Fistula formation around the ostomy site is a stoma-related complication often requiring surgical intervention. This complication may be caused by sutures or may develop as a complication of inflammatory bowel disease. Before conducting a clinical trial, we set out to investigate the safety of ostomy creation with fewer sutures using tissue adhesives in this pilot study. Methods Patients with inflammatory bowel disease who required surgery with ostomy creation at the Hyogo College of Medicine between January 2014 and December 2015 were enrolled. Safety was assessed by evaluating the incidence of stoma-related complications. Ostomy was restricted to loop ileostomy and was created with two sutures and tissue adhesives. Results A total of 14 patients were enrolled. Mean body mass index was 18.9 ± 2.0 kg/m2. There were no cases of ostomy retraction and no severe adverse events were observed. Conclusions This pilot study demonstrates that ostomy creation using tissue adhesives is safe. Although retraction and adverse events were not observed, even in patients with inflammatory bowel disease who generally exhibit delayed wound healing, the body mass index was extremely low in this series. This study does not strongly recommend ostomy creation with tissue adhesives; further studies are needed to clarify the efficacy and safety of the procedure.
M Uchino; H Ikeuchi; T Bando; H Sasaki; T Chohno; Y Horio; Y Takesue. Ostomy creation with fewer sutures using tissue adhesives (cyanoacrylates) in inflammatory bowel disease: a pilot study. The Annals of The Royal College of Surgeons of England 2018, 100, 190 -193.
AMA StyleM Uchino, H Ikeuchi, T Bando, H Sasaki, T Chohno, Y Horio, Y Takesue. Ostomy creation with fewer sutures using tissue adhesives (cyanoacrylates) in inflammatory bowel disease: a pilot study. The Annals of The Royal College of Surgeons of England. 2018; 100 (3):190-193.
Chicago/Turabian StyleM Uchino; H Ikeuchi; T Bando; H Sasaki; T Chohno; Y Horio; Y Takesue. 2018. "Ostomy creation with fewer sutures using tissue adhesives (cyanoacrylates) in inflammatory bowel disease: a pilot study." The Annals of The Royal College of Surgeons of England 100, no. 3: 190-193.
Yoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. Corrigendum to ‘Antimicrobial susceptibility of pathogens isolated from surgical site infections in Japan: Comparison of data from nationwide surveillance studies conducted in 2010 and 2014–2015’ [J Infect Chemother 23 (2017) 339–348]. Journal of Infection and Chemotherapy 2018, 24, 156 -157.
AMA StyleYoshio Takesue, Shinya Kusachi, Hiroshige Mikamo, Junko Sato, Akira Watanabe, Hiroshi Kiyota, Satoshi Iwata, Mitsuo Kaku, Hideaki Hanaki, Yoshinobu Sumiyama, Yuko Kitagawa, Toru Mizuguchi, Yoshiyasu Ambo, Masafumi Konosu, Keiichiro Ishibashi, Akihisa Matsuda, Kazuo Hase, Yasushi Harihara, Koji Okabayashi, Shiko Seki, Takuo Hara, Koshi Matsui, Yoichi Matsuo, Minako Kobayashi, Shoji Kubo, Kazuhisa Uchiyama, Junzo Shimizu, Ryohei Kawabata, Hiroki Ohge, Shinji Akagi, Masaaki Oka, Toshiro Wakatsuki, Katsunori Suzuki, Kohji Okamoto, Katsunori Yanagihara. Corrigendum to ‘Antimicrobial susceptibility of pathogens isolated from surgical site infections in Japan: Comparison of data from nationwide surveillance studies conducted in 2010 and 2014–2015’ [J Infect Chemother 23 (2017) 339–348]. Journal of Infection and Chemotherapy. 2018; 24 (2):156-157.
Chicago/Turabian StyleYoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. 2018. "Corrigendum to ‘Antimicrobial susceptibility of pathogens isolated from surgical site infections in Japan: Comparison of data from nationwide surveillance studies conducted in 2010 and 2014–2015’ [J Infect Chemother 23 (2017) 339–348]." Journal of Infection and Chemotherapy 24, no. 2: 156-157.
Ulcerative colitis (UC) is well known as a gut immune disorder and is often treated with immunosuppressive therapies. Significant associations between increasing age, the presence of comorbid disease and mortality were found in a previous study, although disease-specific factors such as the severity or extent of colitis were associated with emergent colectomy but not mortality. Currently, besides the patient’s background information and the above risk factors, which cannot be avoided in the clinical course and especially in urgent/emergent surgery, we have no other predicting factor for mortality and morbidity with a definite index. Onodera’s Prognostic Nutritional Index (O-PNI) is a well-known predictor for the prognosis of several surgeries. The aim of this study was to evaluate the association between O-PNI and surgical outcome during surgery for ulcerative colitis. This was a single-institutional retrospective cohort study conducted in the Department of inflammatory bowel disease at Hyogo College of Medicine, Japan. All patients who underwent surgery for UC at our institution between January and 2000 December 2015 were included. The pre-operative predictive factors that were associated with mortality, morbidity and pouch-related complications (PRC) were examined distinct from surgical procedure. PRCs were defined as pelvic bleeding or pelvic sepsis, including anastomotic leakage or pelvic abscess. A total of 1,151 patients were included. Total colectomy (TC) alone, ileal-pouch anal anastomosis (IPAA) with ileostomy, and IPAA without ileostomy were performed in 254 patients, 736 patients and 161 patients, respectively. Mortality and morbidity were found in 9 (0.8%) and 320 (27.8%) patients, respectively. The median O-PNI score was 22.6 in patients with mortality and 35.6 in patients without mortality among TC alone (p < 0.01). The significant predicting factors for mortality among TC alone were elder patients (p = 0.03, odds ratio (OR) 6.8), higher C-reactive protein (CRP) (p = 0.02, OR14.5), and O-PNI<24.9 (p = 0.04, OR5.6). Among IPAA with ileostomy, American society of anaesthesiologist score ≥3 (p = 0.01, OR = 2.3), PSL dose just before surgery ≥14 mg/day (p = 0.04, OR1.8), and O-PNI <35.5 (p < 0.01, OR = 2.1) were selected as predictors for PRC. O-PNI could not predict the PRC among IPAA without ileostomy. Lower O-PNI may predict the prognosis in patients with UC. O-PNI may be useful indicator for decision making for surgical timing and procedure. In addition, in patients with O-PNI below 35, total colectomy alone without pouch reconstruction may be better for avoiding from PRC.
T Chohno; M Uchino; T Minagawa; R Kuwahara; Y Horio; H Sasaki; T Bando; Y Takesue; H Ikeuchi. P291 Can the prognostic index be a predicting factor for mortality and morbidity in intestinal resection of patients with ulcerative colitis? Journal of Crohn's and Colitis 2018, 12, S247 -S248.
AMA StyleT Chohno, M Uchino, T Minagawa, R Kuwahara, Y Horio, H Sasaki, T Bando, Y Takesue, H Ikeuchi. P291 Can the prognostic index be a predicting factor for mortality and morbidity in intestinal resection of patients with ulcerative colitis? Journal of Crohn's and Colitis. 2018; 12 (supplement):S247-S248.
Chicago/Turabian StyleT Chohno; M Uchino; T Minagawa; R Kuwahara; Y Horio; H Sasaki; T Bando; Y Takesue; H Ikeuchi. 2018. "P291 Can the prognostic index be a predicting factor for mortality and morbidity in intestinal resection of patients with ulcerative colitis?" Journal of Crohn's and Colitis 12, no. supplement: S247-S248.
Ulcerative colitis (UC) is known as an immune disorder of the colon that generally involves the rectum, but an atypical distribution of inflamed mucosa has previously been noted in certain subtypes of UC, such as the rectal-sparing type (RST). As noted in a previous report, patients with the RST may be at elevated risk for disease refractoriness, but the clinical significance of RST remains unknown. UC patients who underwent surgery between January 2010 and April 2015 were included. Patients were classified as having the RST or a non-RST based on colectomy specimens or a pre-operative endoscopy. Possible risk factors for urgent/emergent surgery were analyzed. We specifically determined whether the RST is a significant predictor for urgent/emergent surgery. In total, 46/482 patients were classified as having the RST. Disease severity was significantly worse in patients with the RST than in other patients (p = 0.02). Urgent/emergent surgery was required for 24/46 patients with the RST, compared with 107/436 non-RST patients (p < 0.01). The overall incidence of urgent/emergent surgery was 131/482. Disease duration < 70.2 months [odds ratio (OR) 2.45], severe disease (OR 87.1), total administered steroid dose < 5000 mg (OR 3.02), daily pre-operative steroid dose ≥ 9 mg (OR 2.59), and the RST (OR 5.59) were identified as independent risk factors for urgent/emergent surgery. The RST was an independent risk factor for urgent/emergent surgery in our analysis of surgically treated patients with UC.
Yuki Horio; Motoi Uchino; Toshihiro Bando; Teruhiro Chohno; Hirofumi Sasaki; Akihiro Hirata; Yoshio Takesue; Hiroki Ikeuchi. Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies. BMC Surgery 2017, 17, 59 .
AMA StyleYuki Horio, Motoi Uchino, Toshihiro Bando, Teruhiro Chohno, Hirofumi Sasaki, Akihiro Hirata, Yoshio Takesue, Hiroki Ikeuchi. Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies. BMC Surgery. 2017; 17 (1):59.
Chicago/Turabian StyleYuki Horio; Motoi Uchino; Toshihiro Bando; Teruhiro Chohno; Hirofumi Sasaki; Akihiro Hirata; Yoshio Takesue; Hiroki Ikeuchi. 2017. "Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies." BMC Surgery 17, no. 1: 59.
Perioperative hyperglycemia is a risk factor for surgical site infections (SSI). Although the recommended target blood glucose level (BG) is 140–180 mg/dL for critically ill patients, recent studies conducted in patients undergoing surgery showed a significant benefit of intensive insulin therapy for the management of perioperative hyperglycemia. The aim of the present review is to evaluate the benefits of strict glycemic control for reducing SSI in gastroenterological surgery. We carried out a post‐hoc analysis of the previously published data from research on the risk factors for SSI. The highest BG within 24 hours after surgery was evaluated. A total of 1555 patients were enrolled in the study. In multivariate analysis, a dose–response relationship between the level of hyperglycemia and the odds of SSI was demonstrated when compared with the reference group (≤150 mg/dL) (odds ratio [OR] = 1.68, 95% confidence interval [CI] 1.14–2.49 for 150–200 mg/dL; and OR = 2.15, 95% CI 1.40–3.29 for >200 mg/dL). Unexpectedly, hyperglycemia was not a significant risk factor for SSI among diabetes patients. By contrast, non‐diabetes patients with a BG of >150 mg/dL were found to have increased odds of SSI. In conclusion, a target BG of ≤150 mg/dL is recommended in patients without diabetes who undergo gastroenterological surgery. Additional study is required to determine an optimal target BG in diabetes patients. Because of the risk of hypoglycemia, a conventional protocol is indicated for patients admitted to the general ward where frequent glucose measurement is not assured.
Yoshio Takesue; Toshie Tsuchida. Strict glycemic control to prevent surgical site infections in gastroenterological surgery. Annals of Gastroenterological Surgery 2017, 1, 52 -59.
AMA StyleYoshio Takesue, Toshie Tsuchida. Strict glycemic control to prevent surgical site infections in gastroenterological surgery. Annals of Gastroenterological Surgery. 2017; 1 (1):52-59.
Chicago/Turabian StyleYoshio Takesue; Toshie Tsuchida. 2017. "Strict glycemic control to prevent surgical site infections in gastroenterological surgery." Annals of Gastroenterological Surgery 1, no. 1: 52-59.
A nationwide survey was conducted in Japan from 2014 to 2015 to investigate the antimicrobial susceptibility of pathogens isolated from surgical site infections (SSI). The resulting data were compared with that obtained in an earlier survey, conducted in 2010. Seven main organisms were collected, and 883 isolates were studied. A significant reduction in methicillin resistance was observed among Staphylococcus aureus isolates, dropping from 72.5% in 2010 to 53.8% in 2014–2015 (p < 0.001). MRSA isolates with a vancomycin minimum inhibitory concentration (MIC) of 2 μg/mL accounted for 1.2% of all MRSA isolates, which was significantly lower than in 2010 (9.7%, p = 0.029). Of the Escherichia coli isolates, 23.0% produced an extended spectrum β-lactamase (ESBL) in the 2014–2015 survey, which was a significant increase from 9.5% in 2010 (p = 0.011). The geometric mean MICs for ESBL-producing isolates were 0.07 μg/mL for meropenem, 9.51 μg/mL for tazobactam/piperacillin, 0.15 μg/mL for flomoxef, and 1.56 μg/mL for gentamycin. There was a significant increase in the isolation rate of non-fragilis Bacteroides among Bacteroides fragilis group species between the two study periods (35.2% vs. 53.1%, p = 0.007). More than 90% of isolates belonging to the B. fragilis group remained susceptible to tazobactam/piperacillin, meropenem, and metronidazole. In contrast, lower levels of susceptibility were observed for cefmetazole (49.6%), moxifloxacin (61.9%), and clindamycin (46.9%). Non-fragilis Bacteroides isolates had lower rates of antibiotic susceptibility compared with B. fragilis. Overall, the surveillance data clarified trends in antimicrobial susceptibility for organisms commonly associated with SSI.
Yoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. Antimicrobial susceptibility of pathogens isolated from surgical site infections in Japan: Comparison of data from nationwide surveillance studies conducted in 2010 and 2014–2015. Journal of Infection and Chemotherapy 2017, 23, 339 -348.
AMA StyleYoshio Takesue, Shinya Kusachi, Hiroshige Mikamo, Junko Sato, Akira Watanabe, Hiroshi Kiyota, Satoshi Iwata, Mitsuo Kaku, Hideaki Hanaki, Yoshinobu Sumiyama, Yuko Kitagawa, Toru Mizuguchi, Yoshiyasu Ambo, Masafumi Konosu, Keiichiro Ishibashi, Akihisa Matsuda, Kazuo Hase, Yasushi Harihara, Koji Okabayashi, Shiko Seki, Takuo Hara, Koshi Matsui, Yoichi Matsuo, Minako Kobayashi, Shoji Kubo, Kazuhisa Uchiyama, Junzo Shimizu, Ryohei Kawabata, Hiroki Ohge, Shinji Akagi, Masaaki Oka, Toshiro Wakatsuki, Katsunori Suzuki, Kohji Okamoto, Katsunori Yanagihara. Antimicrobial susceptibility of pathogens isolated from surgical site infections in Japan: Comparison of data from nationwide surveillance studies conducted in 2010 and 2014–2015. Journal of Infection and Chemotherapy. 2017; 23 (6):339-348.
Chicago/Turabian StyleYoshio Takesue; Shinya Kusachi; Hiroshige Mikamo; Junko Sato; Akira Watanabe; Hiroshi Kiyota; Satoshi Iwata; Mitsuo Kaku; Hideaki Hanaki; Yoshinobu Sumiyama; Yuko Kitagawa; Toru Mizuguchi; Yoshiyasu Ambo; Masafumi Konosu; Keiichiro Ishibashi; Akihisa Matsuda; Kazuo Hase; Yasushi Harihara; Koji Okabayashi; Shiko Seki; Takuo Hara; Koshi Matsui; Yoichi Matsuo; Minako Kobayashi; Shoji Kubo; Kazuhisa Uchiyama; Junzo Shimizu; Ryohei Kawabata; Hiroki Ohge; Shinji Akagi; Masaaki Oka; Toshiro Wakatsuki; Katsunori Suzuki; Kohji Okamoto; Katsunori Yanagihara. 2017. "Antimicrobial susceptibility of pathogens isolated from surgical site infections in Japan: Comparison of data from nationwide surveillance studies conducted in 2010 and 2014–2015." Journal of Infection and Chemotherapy 23, no. 6: 339-348.