Details of a Researcher - Uwamino, Yoshifumi

Papers - Uwamino, Yoshifumi

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全自動多項目遺伝子検査FilmArray血液培養パネルが抗菌薬選択に及ぼす影響

上蓑義典, 宇野俊介, 池谷修, 長谷川直樹, 村田満

日本化学療法学会雑誌 ((公社)日本化学療法学会) 67 ( Suppl.A ) 236 - 236 2019.03

ISSN 1340-7007

リネゾリド血中濃度上昇に伴い低ナトリウム血症が発現した症例

田口和明, 榎木裕紀, 松元一明, 池谷修, 宇野俊介, 上蓑義典, 長谷川直樹

日本化学療法学会雑誌 ((公社)日本化学療法学会) 67 ( Suppl.A ) 292 - 292 2019.03

ISSN 1340-7007

Campylobacter fetusによる右内腸骨動脈感染性動脈瘤の1例

猪瀬里夏, 上蓑義典, 永田美香, 上遠野保裕, 柴田綾子, 宇野俊介, 藤原宏, 松原健太郎, 尾原秀明, 長谷川直樹, 村田満

日本臨床微生物学会雑誌 ((一社)日本臨床微生物学会) 29 ( 1 ) 17 - 20 2018.12

ISSN 2434-866X

Campylobacter fetusはグラム陰性らせん状小桿菌である。ヒトでは妊婦や基礎疾患をもつ易感染性患者における菌血症、感染性動脈瘤などの起因菌として知られているが、免疫不全のない宿主における感染性動脈瘤の報告は少ない。60代男性、20年前にC型肝炎治療歴がある以外には著患なし。38℃台の発熱と持続する右側腹部痛にて受診し、造影CT検査にて右内腸骨動脈瘤を指摘され手術目的で入院した。入院5日目に入院時に採取した血液培養よりグラム陰性らせん状桿菌を検出した。また、切除された動脈瘤壁の組織培養からもグラム陰性らせん状桿菌を検出し、C.fetusと同定された。文献検索では、C.fetusによる感染性動脈瘤は腹部大動脈が多く、免疫不全を認めない例における内腸骨動脈感染性動脈瘤の報告例は限られていた。(著者抄録)

全自動遺伝子検査装置ELITe InGeniusによる便検体からのClostridioides difficileトキシン遺伝子検出性能評価

香坂亜沙美, 宮下雪子, 上蓑義典, 石原治, 猪狩嘉孝, 永田美香, 猪瀬里夏, 宇野俊介, 村田満, 長谷川直樹

日本臨床微生物学会雑誌 ((一社)日本臨床微生物学会) 29 ( Suppl.1 ) 392 - 392 2018.12

ISSN 2434-866X

Stability of benzylpenicillin potassium and ampicillin in an elastomeric infusion pump.

Tomomi Nakamura, Yuki Enoki, Shunsuke Uno, Yoshifumi Uwamino, Osamu Iketani, Naoki Hasegawa, Kazuaki Matsumoto

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (Elsevier B.V.) 24 ( 10 ) 856 - 859 2018.10

ISSN 1341321X

Some infectious diseases, such as infective endocarditis, osteomyelitis, and abscesses, require treatment with long-term intravenous antimicrobial treatment. Therefore, the patient is required to stay in the hospital to receive therapy, which lowers their quality of life. Establishing an outpatient parenteral antimicrobial therapy (OPAT) by continuous infusion pump is desired in Japan to overcome these issues. However, the 24-h stability of antimicrobial agents dissolved in infusion solutions is unclear. Thus, we investigated the stability of antimicrobial agents in five different infusion solutions in a clinical setting. Benzylpenicillin potassium (PCG) and ampicillin (ABPC) were dissolved separately in five different infusion solutions and kept at 25 or 31.1 °C for 24 h. The residual ratios were determined by high-performance liquid chromatography (HPLC). Dissolved PCG in acetate ringer solution remained stable for 24 h at temperatures of 25 and 31.1 °C (101.7 ± 1.4% and 92.9 ± 1.3%, respectively). In addition, the PCG solution did not adsorb onto the elastomeric infusion pump after 24 h at 31.1 °C. PCG dissolved in acetate ringer solution was also stable for 10 days after being kept in an elastomeric infusion pump at 4 °C (99.7 ± 0.5%). ABPC was unstable in all of the tested infusion solutions and temperatures. Based on our results, PCG in acetate ringer solution can be used in OPAT with continuous infusion pumps.

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16S rRNA解析により起因菌を確認し得た肺放線菌症の1例

江田はるか, 南宮湖, 上蓑義典, 大畠孝則, 阪口真之, 斎藤史武, 大塚喜人, 長谷川直樹, 結城秀樹

日本内科学会雑誌 ((一社)日本内科学会) 107 ( 10 ) 2162 - 2167 2018.10

ISSN 0021-5384

40代女性。健診の胸部X線で異常陰影を指摘された。胸部X線、胸部CT所見にて右肺尖部の空洞病変と右上肺野の粒状影が認められた。胸部CTで右上葉に空洞病変を認め、周囲に粒状影・浸潤影を伴う限局性の薄い胸膜肥厚を有していた。気管支洗浄液一般細菌培養でコロニーを認めたが少数であったため、菌種同定目的に16SrRNA解析を行った。その結果、Actinomyces odontolyticusで肺放線菌症と診断された。ペニシリン系抗菌薬の静注を行ったところ、浸潤影は縮小し改善傾向となった。

基準範囲とパニック値パニック値

上蓑義典, 村田満

臨床病理 (日本臨床検査医学会) 66 ( 9 ) 986 - 992 2018.09

ISSN 0047-1860

チーム医療における臨床検査異常データ・パニック値の検査室対応慶應義塾大学病院におけるパニック値報告制度改善の取り組み

上蓑義典, 柴田綾子, 村田満

臨床病理 (日本臨床検査医学会) 66 ( 7 ) 777 - 782 2018.07

ISSN 0047-1860

Aspergillus precipitating antibody in patients with Mycobacterium avium complex lung disease: A cross-sectional study

Suzuki, S, Asakura, T, Namkoong, H, Okamori, S, Yagi, K, Kamata, H, Uwamino, Y, Funatsu, Y, Nakano, Y, Nishimura, T, Ishii, M, Ebihara, T, Betsuyaku, T, Hasegawa, N

Respir Med (Respiratory Medicine) 138 1 - 6 2018.05

ISSN 09546111

RATIONALE: Little is known about the role of Aspergillus precipitating antibody (APAb) in patients with Mycobacterium avium complex lung disease (MAC-LD). OBJECTIVES: We investigated the clinical characteristics of patients with MAC-LD positive for APAb. METHODS: We conducted a cross-sectional study targeting patients with MAC-LD. APAb was checked in all participants. Clinical variables included laboratory data, pulmonary function, high-resolution computed tomography findings, and health-related quality of life. RESULTS: We analyzed 109 consecutive patients. Their median age was 68 years, and the median duration of MAC-LD was 4.8 years. Twenty (18.3%) patients tested positive for APAb. APAb-positive patients had significantly longer duration of MAC-LD (9.4 vs. 4.0 years, P=0.017), more severe bronchiectasis evaluated by modified Reiff score (6.5 vs. 4, P=0.0049), and lower forced expiratory volume in 1s (%FEV1) (75.1% vs. 86.2%, P=0.013) than APAb-negative patients. Analysis of covariance adjusted for background factors and underlying pulmonary disease revealed that %FEV1 was also significantly lower in patients with APAb (P=0.045). Ten patients were newly diagnosed with chronic pu

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Clinical characteristics of pulmonary Mycobacterium lentiflavum disease in adult patients

Yagi, K, Morimoto, K, Ishii, M, Namkoong, H, Okamori, S, Asakura, T, Suzuki, S, Asami, T, Uwamino, Y, Funatsu, Y, Fujiwara, H, Kamata, H, Nishimura, T, Betsuyaku, T, Kurashima, A, Hasegawa, N

Int J Infect Dis (International Journal of Infectious Diseases) 67 65 - 69 2018.02

ISSN 12019712

BACKGROUND: Mycobacterium lentiflavum organisms are slow-growing nontuberculous mycobacteria often associated with immunocompromised state and cervical lymphadenitis in young children. However, little is known about the clinical importance of pulmonary infection with M. lentiflavum in adults. METHODS: We reviewed the medical records of all adults who met the diagnostic criteria of pulmonary M. lentiflavum disease at Keio University Hospital and Fukujuji Hospital from 2001 to 2015. We also reviewed literature in the PubMed database to identify reported cases in non-human immunodeficiency virus (HIV) adults. RESULTS: Our study presented five cases, and a literature review identified 11 additional cases of pulmonary M. lentiflavum disease. Eleven of 16 cases, including a literature review, were female, and 15 of 16 cases showed a nodular/bronchiectatic (NB) pattern on the chest CT images. Although one patient died of exacerbation of underlying vasculitis and bacterial pneumonia, no cases showed an aggressive clinical course of pulmonary M. lentiflavum disease. CONCLUSIONS: We have identified the clinical characteristics of pulmonary M. lentiflavum disease in adult patients, which main

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AMR専門検討会を通じた当院におけるAMR対策の取り組み

上蓑義典, 高野八百子, 池谷修, 猪瀬里夏, 宇野俊介, 藤原宏, 新庄正宜, 長谷川直樹

日本環境感染学会総会プログラム・抄録集 ((一社)日本環境感染学会) 33回 239 - 239 2018.02

イエローカードを用いた介入が手指衛生遵守率に及ぼす効果の検証

河西貴子, 高野八百子, 宇野俊介, 上蓑義典, 藤原宏, 新庄正宜, 長谷川直樹

日本環境感染学会総会プログラム・抄録集 ((一社)日本環境感染学会) 33回 428 - 429 2018.02

FRI-4 carbapenemase-producing Enterobacter cloacae complex isolated in Tokyo, Japan

Kubota, H, Uwamino, Y, Matsui, M, Sekizuka, T, Suzuki, Y, Okuno, R, Uchitani, Y, Ariyoshi, T, Aoki, W, Suzuki, S, Kuroda, M, Shinkai, T, Yokoyama, K, Sadamasu, K, Funakoshi, T, Murata, M, Hasegawa, N, Iwata, S

J Antimicrob Chemother (Journal of Antimicrobial Chemotherapy) 73 ( 11 ) 2969 - 2972 2018

ISSN 03057453

A carbapenem-resistant Enterobacter cloacae complex isolated in Tokyo, Japan, produced a carbapenemase that was detected by a Carba NP test and a modified carbapenem inactivation method, but none of the 'Big Five' carbapenemase genes was detected by PCR. This study aimed to identify the carbapenemase.|Carbapenemase genes were screened by WGS. Next, we generated a recombinant plasmid in which the carbapenemase gene was inserted. We also extracted the carbapenemase gene-carrying plasmid from the E. cloacae complex. The effects of both plasmids on the antibiotic susceptibility of Escherichia coli were then tested. The carbapenemase gene-carrying plasmid in the E. cloacae complex was completely sequenced.|A novel carbapenemase gene, blaFRI-4, encoded an amino acid sequence that was 93.2% identical to French imipenemase (FRI-1). E. coli transformed with blaFRI-4 showed reduced carbapenem susceptibility. A complete sequence of the blaFRI-4-carrying 98 508 bp IncFII/IncR plasmid (pTMTA61661) showed that blaFRI-4 and the surrounding region (18.7 kb) were duplicated.|The FRI-4-producing E. cloacae complex was isolated in Japan, whereas all other FRI variants have been found in Europe,

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Impact of chronic Pseudomonas aeruginosa infection on health-related quality of life in Mycobacterium avium complex lung disease.

Hirofumi Kamata, Takanori Asakura, Shoji Suzuki, Ho Namkoong, Kazuma Yagi, Yohei Funatsu, Satoshi Okamori, Shunsuke Uno, Yoshifumi Uwamino, Hiroshi Fujiwara, Tomoyasu Nishimura, Makoto Ishii, Tomoko Betsuyaku, Naoki Hasegawa

BMC pulmonary medicine (BIOMED CENTRAL LTD) 17 ( 1 ) 198 - 198 2017.12

ISSN 1471-2466

BACKGROUND: In bronchiectasis patients, chronic Pseudomonas aeruginosa (PA) infection has been associated with worse health-related quality of life (HRQL), but little is known about Mycobacterium avium complex lung disease (MACLD) patients in this context. This study aimed to evaluate HRQL and investigate the impact of chronic PA infection in MACLD patients. METHODS: This cross-sectional study was conducted using the Registry of Prospective Cohort Study including MACLD patients. The 36-item Short-Form health survey (SF-36) and St. George's Respiratory Questionnaire (SGRQ) were administered to assess clinical outcomes. Clinical variables included treatment and sputum culture status, pulmonary function tests, cavitary lesions, and modified Reiff scores on high-resolution computed tomography. RESULTS: The study included 244 MACLD patients (median age, 68 years; 196 women), 19 of whom had chronic PA infection. Modified Reiff score was higher in patients with chronic infection than in those without (P = 0.028). Regarding SF-36 scores, physical functioning subscale scores were significantly lower in patients with chronic infection (P = 0.029). Additionally, SGRQ symptoms, impact, and total scores were significantly higher in patients with chronic infection. During analysis of covariance comparisons, SGRQ symptoms and impact scores were significantly higher for patients with chronic infection (P = 0.043 and 0.021, respectively). CONCLUSIONS: MACLD patients with chronic PA infection exhibited significantly higher SGRQ scores, indicating impaired HRQL. Chronic PA infection was significantly associated with the severity of bronchiectasis.

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全自動遺伝子検査装置ELITe InGeniusによる菌液からのESBL遺伝子検出性能評価

香坂亜沙美, 上蓑義典, 鈴木武尊, 猪瀬里夏, 昆亜紀子, 永田美香, 柴田綾子, 宇野俊介, 藤原宏, 村田満, 長谷川直樹

日本臨床微生物学雑誌 ((一社)日本臨床微生物学会) 28 ( Suppl.1 ) 430 - 430 2017.12

ISSN 0917-5059

hsa-miR-346 is a potential serum biomarker of Mycobacterium avium complex pulmonary disease activity.

Tomoyasu Nishimura, Eiko Tamizu, Shunsuke Uno, Yoshifumi Uwamino, Hiroshi Fujiwara, Kazumi Nishio, Yasushi Nakano, Hirofumi Shiono, Ho Namkoong, Yoshihiko Hoshino, Satoshi Iwata, Naoki Hasegawa

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (ELSEVIER SCIENCE BV) 23 ( 10 ) 703 - 708 2017.10

ISSN 1341-321X

MicroRNA (miRNA) has been recently recognized as a biomarker of various diseases; however, there are no known miRNAs associated with Mycobacterium avium complex (MAC) pulmonary disease. In addition, there are no known biomarkers to precisely reflect disease activity after the diagnosis of MAC pulmonary disease. Thus, we sought to identify a miRNA which is a candidate biomarker of MAC pulmonary disease activity. Serum hsa-miR-346 concentrations of 16 patients with M. avium pulmonary disease were significantly higher than those of 16 healthy controls (p = 0.047). The secretion of hsa-miR-346 increased in a multiplicity of infection-dependent manner in M. avium-infected macrophages. Serum hsa-miR-346 levels of 5 patients with bacterial conversion at the end of follow-up were significantly lower than those at the beginning of the follow-up (p = 0.043). In addition, the longitudinal change in serum hsa-miR-346 concentration correlated with bacterial load in 2 patients with M. avium pulmonary disease. Based on our results, it is supposed that MAC-infected macrophages in pulmonary lesions produce hsa-miR-346, which is then secreted into the bloodstream. The magnitude of this process could be quantitatively controlled by the bacterial load, suggesting that serum hsa-miR-346 is a potentially useful biomarker of MAC pulmonary disease activity.

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The efficacy, safety, and feasibility of inhaled amikacin for the treatment of difficult-to-treat non-tuberculous mycobacterial lung diseases.

Kazuma Yagi, Makoto Ishii, Ho Namkoong, Takahiro Asami, Osamu Iketani, Takanori Asakura, Shoji Suzuki, Hiroaki Sugiura, Yoshitake Yamada, Tomoyasu Nishimura, Hiroshi Fujiwara, Yohei Funatsu, Yoshifumi Uwamino, Tetsuro Kamo, Sadatomo Tasaka, Tomoko Betsuyaku, Naoki Hasegawa

BMC infectious diseases (BIOMED CENTRAL LTD) 17 ( 1 ) 558 - 558 2017.08

ISSN 1471-2334

BACKGROUND: In multidrug regimens, including an intravenous aminoglycoside (e.g. amikacin [AMK]) is recommended for difficult-to-treat non-tuberculous mycobacterial (NTM) lung diseases. We aimed to evaluate the efficacy, safety, and feasibility of inhaled AMK therapy in patients with difficult-to-treat NTM lung diseases in a retrospective chart review. METHODS: The study population consisted of patients with NTM lung diseases who received combination therapy, including inhaled AMK therapy, at Keio University Hospital (Tokyo, Japan), from January 2014 through May 2016. A total of 26 cases, consisting of 23 Mycobacterium avium complex (MAC) and three Mycobacterium abscessus complex (MABC) infections cases, were included in this study. The efficacy, safety, and feasibility of inhaled AMK therapy were retrospectively investigated. The Research Ethics Committee of Keio University Hospital approved this study, and informed consent was obtained from all patients. RESULTS: All 26 patients were culture-positive at enrolment. Twenty-three of the 26 patients (88.5%), including 21/23 MAC patients (91.3%) and 2/3 MABC patients (66.7%), were administered inhaled AMK therapy for >3 months. The proportion of patients who had clinical symptoms, including, cough and sputum, declined after inhalation AMK therapy. Ten of the 23 patients (43.5%) who received AMK inhalation, including 8/21 MAC (38.1%) and 2/2 MABC patients (100%), showed sputum conversion, defined as at least three consecutive negative sputum cultures. Seven of the 23 patients, including, 5/21 MAC and 2/2 MABC patients, showed improvements in high-resolution computed tomography imaging of the chest. In addition, the serum AMK trough levels before the second inhalation were <1.2 μg/mL in all 26 patients, with no occurrence of severe adverse events, such as renal toxicity. One patient (3.8%) experienced auditory toxicity, in the form of tinnitus. However, this symptom was reversible, after temporary interruption of AMK, the patient was able to safely resume the therapy. CONCLUSIONS: Inhaled AMK therapy is an effective and feasible therapy for difficult-to-treat NTM lung disease.

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16S rRNA解析により起因菌を確認し得た肺放線菌症の1例

江田はるか, 南宮湖, 大畠孝則, 上蓑義典, 阪口真之, 大塚喜人, 長谷川直樹, 結城秀樹

日本内科学会関東地方会 (日本内科学会-関東地方会) 634回 26 - 26 2017.07

Rapid Detection and Typing of Carbapenemase Genes from Carbapenem-Resistant Enterobacteriaceae Isolates Collected in a Japanese Hospital Using the Xpert Carba-R Assay.

Yoshifumi Uwamino, Kayoko Sugita, Naoki Hasegawa, Tomoyasu Nishimura, Hiroshi Fujiwara, Satoshi Iwata

Japanese journal of infectious diseases (NATL INST INFECTIOUS DISEASES) 70 ( 1 ) 124 - 125 2017.01

ISSN 1344-6304

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The First Case Report of Acute Cholangitis and Bacteremia Due to Neisseria subflava.

Yoshifumi Uwamino, Kayoko Sugita, Eisuke Iwasaki, Hiroshi Fujiwara, Tomoyasu Nishimura, Naoki Hasegawa, Satoshi Iwata

Internal medicine (Tokyo, Japan) (JAPAN SOC INTERNAL MEDICINE) 56 ( 2 ) 221 - 223 2017

ISSN 0918-2918

We herein report a case of acute cholangitis and bacteremia caused by a commensal Neisseria species, Neisseria subflava, in an 82-year-old man with cholangiocarcinoma. Emergency endoscopic nasobiliary drainage and cefoperazone/sulbactam therapy were effective. Gram negative coccobacilli were isolated from both blood and bile cultures on 5% sheep blood agar. The isolate was identified as N.subflava biovar perflava by mass spectrometry, a sequence analysis of the 16S rRNA, and biochemical testing. Although biliary infections due to commensal Neisseria are extremely rare, this case demonstrates the possibility of its occurrence in patients undergoing bile duct treatment.

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