論文 - 南宮　湖

綜説 高齢者に対する肺炎球菌感染症予防戦略-23 価肺炎球菌多糖体ワクチンと 13 価肺炎球菌結合型ワクチン

南宮湖， 長谷川直樹

呼吸と循環 63 (8), 754-761 2015年

The Critical Roles Of Tumor Necrosis Factor α-Converting Enzyme During Influenza Virus And Streptococcus Pneumoniae Infection In Vivo And In Vitro

S Suzuki, M Ishii, H Namkoong, K Yagi, T Asakura, S Tasaka, T Kamo, ...

A32. MICROBIAL INTERACTIONS AND HOST DEFENSE, A1297-A1297 2015年

Successful resumption of tocilizumab for rheumatoid arthritis after resection of a

H Namkoong, S Tasaka, M Akiyama, K Yagi, M Ishii, K Suzuki, M Kohno, ...

2015年

Pulmonary nocardiosis caused by Nocardia cyriacigeorgica in patients with Mycobacterium aviumcomplex lung disease: two case reports

K Yagi, M Ishii, H Namkoong, T Asami, H Fujiwara, T Nishimura, F Saito, ...

BMC infectious diseases 14 (1), 1-5 14   684 - 684 2014年12月

査読有り

　概要を見る

BACKGROUND: Pulmonary nocardiosis frequently occurs in immunocompromised hosts and in some immunocompetent hosts with chronic lung disease; however, few reports have described pulmonary nocardiosis with nontuberculous mycobacterial lung infection. Here we report for the first time two cases of pulmonary nocardiosis caused by Nocardia cyriacigeorgica associated with Mycobacterium avium complex (MAC) lung disease caused by M. avium. CASE PRESENTATION: Case 1 is that of a 72-year-old Japanese man with untreated MAC lung disease, who was diagnosed with rheumatoid arthritis and initiated on methotrexate. After 3 years of methotrexate therapy, the patient remained smear-negative and culture-positive for MAC, but also became smear-positive for Nocardia species. He received trimethoprim/sulfamethoxazole, and his symptoms and lung infiltrates improved. Case 2 is that of an immunocompetent 53-year-old Japanese woman with MAC lung disease, who was treated with a combined therapy of clarithromycin, rifampicin, ethambutol, and levofloxacin. MAC sputum culture was negative after 1 year of combined treatment, which was maintained for 2 years. After four treatment-free years, Nocardia species were occasionally isolated from her sputum, although MAC was rarely isolated from sputum cultures over the same period. In both cases, the Nocardia species were identified as the recently defined N. cyriacigeorgica by 16S ribosomal RNA gene sequencing. CONCLUSION: We report two cases of pulmonary nocardiosis caused by N. cyriacigeorgica associated with MAC lung disease caused by M. avium and suggest that N. cyriacigeorgica may be a major infective agent associated with MAC lung disease.

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Serum (1→ 3) β-D-glucan assay for discrimination between Pneumocystis jirovecii pneumonia and colonization

S Tasaka, S Kobayashi, K Yagi, T Asami, H Namkoong, W Yamasawa, ...

Journal of Infection and Chemotherapy 20 (11), 678-681 20 （ 11 ） 678 - 81 2014年11月

査読有り

　概要を見る

Polymerase chain reaction (PCR) technique is being increasingly used for the microbiological diagnosis of Pneumocystis pneumonia (PCP). As PCR is highly sensitive, it can be positive even in a patient with Pneumocystis colonization. In this study, we evaluated whether the β-d-glucan assay could be used to differentiate between PCP and Pneumocystis jirovecii colonization in immunocompromised patients with pulmonary infiltrates. We retrospectively evaluated data from 166 consecutive patients who underwent bronchoalveolar lavage for the diagnosis of PCP. Serum levels of β-d-glucan in the negative, colonization, probable PCP, and definite PCP groups were 20.2 ± 6.3, 48.8 ± 15.9, 89.9 ± 20.2, 224.9 ± 25.9 pg/mL, respectively. The β-D-glucan levels in the definite PCP group were significantly higher than those in the other 3 groups (p < 0.001). Serum β-d-glucan levels in patients with either definite or probable PCP (173.1 ± 18.8 pg/mL) were significantly greater than those in patients with colonization who had positive PCR results but improved without anti-PCP treatment (p < 0.002). The cut-off level for discrimination was estimated to be 33.5 pg/mL, with which the positive predictive value was 0.925. These results indicate that β-D-glucan is a useful marker to differentiate between PCP and Pneumocystis colonization. A positive β-D-glucan assay result might be a good indication to begin anti-PCP treatment.

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Pharmacokinetics of arbekacin in bronchial epithelial lining fluid of healthy volunteers

Y Funatsu, N Hasegawa, H Fujiwara, H Namkoong, T Asami, S Tasaka, ...

Journal of Infection and Chemotherapy 20 (10), 607-611 20 （ 10 ） 607 - 11 2014年10月

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INTRODUCTION: Arbekacin is a unique aminoglycoside antibiotic with anti-methicillin-resistant Staphylococcus aureus activity. The efficacy of aminoglycosides is related to their serum maximum concentration. Local concentration of antibiotics in pulmonary epithelial lining fluid, rather than its serum concentration, can help determine its clinical efficacy more precisely for treatment of respiratory infectious disease. The objective of this study was to sequentially measure arbekacin concentration in epithelial lining fluid after infusion of a single clinically available dose. METHOD: After the initial blood sampling, arbekacin was intravenously infused into 6 healthy volunteers over 1 h. Epithelial lining fluid and serum samples were collected by bronchoscopic microsampling 1, 1.5, 2, 2.5, 3, 4, 5, and 6 h after the start of 200 mg arbekacin infusion. RESULTS: Each probe sampled 10.1 ± 5.2 μl bronchial epithelial lining fluid. The sample dilution factor was 266.7 ± 157.1. Drug concentration was successfully measured in all but 2 of the epithelial lining fluid samples. The maximum concentration of arbekacin in epithelial lining fluid and serum was 10.4 ± 1.9 μg/ml and 26.0 ± 12.2 μg/ml, respectively. The ratio of the maximum drug concentration in the epithelial lining fluid to that in the serum was 0.47 ± 0.19. CONCLUSIONS: The maximum concentration of epithelial lining fluid reached levels that would effectively treat most clinical strains of methicillin-resistant S. aureus.

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The efficacy, safety, and pharmacokinetics of biapenem administered thrice daily for the treatment of pneumonia in the elderly

H Namkoong, Y Kameyama, H Yasuda, S Nakayama, H Kaneko, ...

Journal of Infection and Chemotherapy 20 (6), 356-360 20 （ 6 ） 356 - 60 2014年06月

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Biapenem has been widely used to treat bacterial pneumonia; however, there is little information concerning its efficacy and safety in elderly patients. Based on pharmacokinetic-pharmacodynamic theory, administration of biapenem thrice rather than twice daily would be expected to be more effective because of longer time above the minimum inhibitory concentration. In this study, we aimed to evaluate the efficacy, safety, and pharmacokinetics of biapenem (300 mg) administered thrice daily in pneumonic patients aged 65 years or older. Biapenem was effective in 22 of 25 patients, as assessed by the improvement in clinical symptoms and/or the eradication of the causative organisms, and caused no serious adverse events. The pharmacokinetic profile was established based on simulations using a modeling program. Among 17 patients whose causative organisms were detected, time above the minimum inhibitory concentration was estimated to be 100% in 16 patients, all of whom showed clinical improvement. The results of this study confirmed the efficacy and safety of 300 mg of biapenem administered thrice daily for the treatment of pneumonia in elderly patients.

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A51 NEW INSIGHTS INTO PATHOGENS AND HOST DEFENSE: Obesity Worsens The Outcome Of Influenza Virus Infection Via Impaired Ifn-Beta Induction In Mice

H Namkoong, M Ishii, H Fujii, T Asami, K Yagi, F Saito, H Fujiwara, ...

American Journal of Respiratory and Critical Care Medicine 189, 1 2014年

B60 POTPOURRI OF INJ-OURRI: NON-EPITHELIAL CONTRIBUTIONS TO LUNG INJURY AND REPAIR: Critical Roles Of Enhancer Of Zeste Homolog 2 (ezh2) During Influenza A Virus Infection

K Yagi, M Ishii, H Namkoong, T Asami, H Fujiwara, T Nishimura, F Saito, ...

American Journal of Respiratory and Critical Care Medicine 189, 1 2014年

Critical Roles Of Enhancer Of Zeste Homolog 2 (ezh2) During Influenza A Virus Infection

K Yagi, M Ishii, H Namkoong, T Asami, H Fujiwara, T Nishimura, F Saito, ...

B60. POTPOURRI OF INJ-OURRI: NON-EPITHELIAL CONTRIBUTIONS TO LUNG INJURY AND … 2014年

Clinical And Bacteriological Evaluations During Observation Of Mycobacterium Avium Complex Lung Disease Without Treatment

Y Kimizuka, M Ishii, Y Hoshino, T Asami, T Nishimura, S Maeda, S Tasaka, ...

C30. LATE BREAKING ABSTRACTS IN DISEASE TREATMENT AND CLINICAL OUTCOMES … 2014年

CLARITHROMYCIN EXPANDS CD11B+ GR-1+ CELLS TO PROTECT AGAINST LPS-INDUCED LETHAL SHOCK

H Namkoong, M Ishii, H Fujii, T Asami, K Yagi, H Fujiwara, F Saitoh, ...

SHOCK 41, 18-18 2014年

C30 LATE BREAKING ABSTRACTS IN DISEASE TREATMENT AND CLINICAL OUTCOMES: Clinical And Bacteriological Evaluations During Observation Of Mycobacterium Avium Complex Lung Disease …

Y Kimizuka, M Ishii, Y Hoshino, T Asami, T Nishimura, S Maeda, S Tasaka, ...

American Journal of Respiratory and Critical Care Medicine 189, 1 2014年

Obesity Worsens The Outcome Of Influenza Virus Infection Via Impaired Ifn-Beta Induction In Mice

H Namkoong, M Ishii, H Fujii, T Asami, K Yagi, F Saito, H Fujiwara, ...

A51. NEW INSIGHTS INTO PATHOGENS AND HOST DEFENSE, A1713-A1713 2014年

SHOCK SOCIETY THIRTY-SEVENTH ANNUAL CONFERENCE ON SHOCK

G Promenade, G ABC, M West, J Cuschieri, J Pessin, C Kolka, ...

2014年

[Case report; A case of acute respiratory failure following influenza virus infection successfully treated by direct hemoperfusion using a polymyxin B immobilized fiber column].

Daisuke Arai, Koichi Fukunaga, Kentaro Fujii, Ho Namkoong, Mizuha Haraguchi, Yohei Funatsu, Katsuhiko Naoki, Sadatomo Tasaka, Tomoko Betsuyaku

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 102 （ 2 ） 429 - 32 2013年02月

査読有り,  ISSN  0021-5384

Case report; A case of acute respiratory failure following influenza virus infection successfully treated by direct hemoperfusion using a polymyxin B immobilized fiber column

D Arai, K Fukunaga, K Fujii, H Namkoong, M Haraguchi, Y Funatsu, ...

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal … 2013年

Diet-Induced Obesity Modulates The Macrophage Response To Influenza Virus Infection

T Nakagawa, M Ishii, H Namkoong, H Fujii, T Asami, K Yagi, F Saito, ...

A50. ADVANCES IN UNDERSTANDING OF INFECTIOUS IMMUNOLOGY IN VIRAL DISEASES … 2013年

Clarithromycin Expands CD11b+ Gr-1+ Cells To Protect Against LPS-Induced Lethal Shock And Polymicrobial Sepsis

H Namkoong, M Ishii, H Fujii, T Asami, K Yagi, Y Funatsu, H Fujiwara, ...

C22. NEW INSIGHTS INTO ACUTE LUNG INJURY, A3856-A3856 2013年

Effects Of Histone Deacetylase Inhibitor Trichostatin A During Influenza A Virus Infection In Vivo And In Vitro

K Yagi, M Ishii, H Fujii, K Mizoguchi, H Namkoong, T Asami, Y Funatsu, ...

D31. RESPIRATORY TRACT INFECTION AND INFLAMMATION: FROM ANIMAL MODELS TO … 2013年