宇野 俊介 (ウノ シュンスケ)

Uno, Shunsuke

写真a

所属(所属キャンパス)

医学部 感染症学教室 (信濃町)

職名

専任講師(有期)

外部リンク

学歴 【 表示 / 非表示

  • 2002年04月
    -
    2008年03月

    慶應義塾大学, 医学部

    大学, 卒業, その他

  • 2021年04月
    -
    2022年03月

    慶應義塾大学, 健康マネジメント研究科, 公衆衛生・スポーツ健康科学先行(公衆衛生学)

    大学院, 修了, 修士

学位 【 表示 / 非表示

  • 博士(医学), 慶應義塾大学, 論文, 2021年09月

  • 修士(公衆衛生学), 慶應義塾大学, 課程, 2022年03月

 

研究分野 【 表示 / 非表示

  • ライフサイエンス / 感染症内科学

研究キーワード 【 表示 / 非表示

  • 外来静注抗菌薬療法

  • 抗酸菌感染症

  • 臨床感染症

 

著書 【 表示 / 非表示

  • シュロスバーグ 結核と非結核性抗酸菌症

    宇野 俊介, メディカルサイエンスインターナショナル, 2016年05月

  • 臨床検査ガイド2015年改訂版

    宇野 俊介, 文光堂, 2015年03月

  • 結核診療パーフェクトガイド

    宇野 俊介, 中外医学社, 2015年02月

論文 【 表示 / 非表示

  • Adverse effects of long-term drain placement and the importance of direct aspiration: a retrospective cohort study.

    Okui J, Obara H, Uno S, Sato Y, Shimane G, Takeuchi M, Kawakubo H, Kitago M, Okabayashi K, Kitagawa Y

    The Journal of hospital infection 131   156 - 163 2022年11月

    ISSN  0195-6701

     概要を見る

    BACKGROUND: Long-term placement of prophylactic drains can result in retrograde infections. AIM: We aimed to investigate the association between the timing of drain removal and clinical outcomes. METHODS: This retrospective, single-center cohort study evaluated 110 patients who underwent elective gastrointestinal or hepatopancreatobiliary surgery and developed subsequent organ/space surgical site infection (SSI) between 2016 and 2020. We evaluated the difference between the culture-positive species of prophylactic drains and direct aspiration, whether the prophylactic drains functioned effectively at the time of SSI diagnosis, and whether the empirical antibiotics administered before drainage were able to treat all the detected bacteria. Finally, clinical outcomes were compared between early (i.e. cases wherein the prophylactic drain had already been removed or replaced at the time of SSI diagnosis) and late (removal after diagnosis) drain removal. FINDINGS: The prophylactic drains functioned effectively in only 27 (25%) patients at the time of SSI diagnosis. Due to the results of direct aspiration cultures, 43% of patients required antibiotic escalation. The median time to drain removal or first replacement was seven postoperative days. The early removal group included 43 patients (39%). Compared with early removal, late removal resulted in a higher frequency of vancomycin use (7.0% versus 22.4%; P = 0.037). CONCLUSIONS: Prolonged prophylactic drain placement is associated with complicated infections requiring vancomycin, therefore, the drains should be removed as soon as possible. Additionally, obtaining the cultures of direct aspiration should be actively considered, as escalation of antimicrobial therapy is often performed based on culture results.

  • In vitro effects of diazabicyclooctane β-lactamase inhibitors relebactam and nacubactam against three subspecies of Mycobacterium abscessus complex

    Misawa K., Nishimura T., Kashimura S., Enoki Y., Taguchi K., Uno S., Uwamino Y., Matsumoto K., Hasegawa N.

    International Journal of Antimicrobial Agents (International Journal of Antimicrobial Agents)  60 ( 5-6 ) 106669 - 106669 2022年11月

    ISSN  09248579

     概要を見る

    Background: Mycobacterium abscessus complex (MABC) pulmonary disease is notoriously difficult to treat due to intrinsic resistance to many common antibiotics. MABC is β-lactam-resistant as it produces class A β-lactamases, such as blaMab, which are inhibited by diazabicyclooctane (DBO) β-lactamase inhibitors. Objectives: To investigate the microbiological effects of the combination of β-lactam and DBO β-lactamase inhibitors (relebactam and nacubactam) against MABC and determine if the effects are associated with the MABC subspecies and colony morphotype. Methods: The antimicrobial susceptibility of three type strains and 20 clinical isolates of MABC to the combination of seven β-lactams with relebactam or nacubactam was evaluated using broth microdilution checkerboard assays. For these strains, expression levels of blaMab were assessed using quantitative real-time polymerase chain reaction and genotypic diversity was evaluated using 18-locus variable number tandem repeat assay. Results: Relebactam and nacubactam lowered the minimum inhibitory concentrations of β-lactams, particularly imipenem, meropenem, and tebipenem, against MABC. There was no difference in efficacy of combination treatment between three subspecies, but rough morphotypes tended to be less susceptible than smooth morphotypes. There were no differences in blaMab expression levels and genotypic diversity between the morphotypes. Conclusions: The combination of β-lactam with relebactam or nacubactam improved the efficacy of β-lactams against all MABC subspecies, but higher concentrations of β-lactams were needed for rough morphotypes.

  • Impact of rifampicin on the pharmacokinetics of clarithromycin and 14-hydroxy clarithromycin in patients with multidrug combination therapy for pulmonary Mycobacterium avium complex infection

    Iketani O., Komeya A., Enoki Y., Taguchi K., Uno S., Uwamino Y., Matsumoto K., Kizu J., Hasegawa N.

    Journal of Infection and Chemotherapy (Journal of Infection and Chemotherapy)  28 ( 1 ) 61 - 66 2022年01月

    ISSN  1341321X

     概要を見る

    Introduction: Clarithromycin (CAM), ethambutol (EB), and rifampicin (RFP) combination therapy is used to treat pulmonary Mycobacterium avium complex (MAC) infection; however, serum CAM concentration decreases due to RFP-mediated induction of CYP3A activity. Therefore, we investigated the pharmacokinetics of CAM, 14-hydroxy clarithromycin (14-OH CAM), EB, and RFP in patients receiving this three-drug combination therapy. Methods: CAM monotherapy was started, EB was added 2 weeks later, and RFP was added 2 weeks after that. Serum CAM, 14-OH CAM, EB, and RFP concentrations were measured before and at 2, 4, 6, and 12 or 24 h after administration on days 14, 28, and 42, and pharmacokinetic parameters were calculated. Results: Median area under the curve (AUC) of CAM decreased by 92.1% from 0 to 12 h after concomitant administration of RFP compared with CAM monotherapy [1.7 (interquartile range [IQR], 1.4–1.8) μg·h/mL vs. 21.5 (IQR, 17.7–32.3) μg·h/mL, respectively]. In contrast, median AUC of 14-OH CAM was not significantly different between concomitant administration of RFP [9.1 (IQR, 7.9–10.9) μg·h/mL] and CAM monotherapy [8.2 (IQR, 6.3–9.3) μg·h/mL]. AUCs of CAM and 14-OH CAM did not change in CAM+EB combination therapy. Conclusions: When RFP is combined with CAM in the treatment of pulmonary MAC infection, the blood concentration of CAM significantly decreased and that of the active metabolite 14-OH CAM increased, but not significantly. Our results suggest that combination therapy with CAM and RFP needs to be reconsidered and may require dose modification in the treatment of pulmonary MAC infection.

  • Digestive Decolonization of Colorectal Carriage of Vancomycin-resistant Enterococcus faecium in a Japanese Adult

    Uno S., Takano Y., Iketani O., Abiko T., Miwa T., Nanki K., Kurihara T., Tamura Y., Ara M., Uwamino Y., Shinjoh M., Mori T., Hasegawa N.

    Internal Medicine (Internal Medicine)  61 ( 2 ) 249 - 252 2022年

    筆頭著者, 査読有り,  ISSN  09182918

     概要を見る

    Patients with vancomycin-resistant Enterococcus (VRE) colonization should be managed in an isolation room with contact precautions. We herein report a patient whose colorectal carriage of VRE was successfully decolonized using concomitant bowel irrigation with polyethylene glycol, probiotics, and oral antimicrobials, linezolid and orally-administered daptomycin, for release from isolation and contact precautions. We therefore would like to suggest a potential strategy for managing patients with VRE colonization.

  • CT screening for COVID-19 in asymptomatic patients before hospital admission

    Uchida S., Uno S., Uwamino Y., Hashimoto M., Matsumoto S., Obara H., Jinzaki M., Kitagawa Y., Hasegawa N.

    Journal of Infection and Chemotherapy (Journal of Infection and Chemotherapy)  27 ( 2 ) 232 - 236 2021年02月

    査読有り,  ISSN  1341321X

     概要を見る

    Introduction: In the novel coronavirus disease (COVID-19) pandemic era, it is essential to rule out COVID-19 effectively to prevent transmission in both communities and medical facilities. According to previous reports in high prevalence areas, CT screening may be useful in the diagnosis of COVID-19. However, the value of CT screening in low prevalence areas has scarcely been reported. Methods: This report examines the diagnostic efficacy of CT screening before admission to a hospital in Tokyo. We conducted a retrospective analysis at Keio University Hospital from April 6, 2020, through May 29, 2020. We set up an outpatient screening clinic on April 6 for COVID-19, administering both PCR with nasopharyngeal swabs and chest CT for all patients scheduled for surgery under general anesthesia. Results: A total of 292 asymptomatic patients were included in this study. There were three PCR-positive patients, and they all had negative CT findings, which revealed that both the sensitivity and positive predictive value of CT (PPV) were 0%. There were nine CT-positive patients; the specificity and the negative predictive value (NPV) were 96.9% and 98.9%, respectively. Conclusion: CT screening was not useful in low prevalence areas at this time in Tokyo, even with the inclusion of the most prevalent phase. Given that the utility of CT screening depends on disease prevalence, the criteria for performing CT screening based on the prevalence of COVID-19 should be established.

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KOARA(リポジトリ)収録論文等 【 表示 / 非表示

総説・解説等 【 表示 / 非表示

  • Enterococcus faecalis菌血症において質量分析器における血液培養陽性ボトルからの直接同定法が抗菌薬選択に及ぼす影響

    木村 陽菜, 上蓑 義典, 猪狩 嘉孝, 鮫島 朱里, 加藤 藍, 青木 渉, 石原 治, 永田 美香, 猪瀬 里夏, 宇野 俊介, 南宮 湖, 長谷川 直樹, 松下 弘道

    日本臨床微生物学会雑誌 ((一社)日本臨床微生物学会)  33 ( Suppl.1 ) 266 - 266 2022年12月

    ISSN  2434-866X

  • COVID-19術前PCR検査は必要か COVID-19術前PCR検査は必要か Prosの立場から

    宇野 俊介

    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)  36回   164 - 164 2021年09月

  • Accuracy and stability of saliva as a sample for reverse transcription PCR detection of SARS-CoV-2

    Uwamino Y., Nagata M., Aoki W., Fujimori Y., Nakagawa T., Yokota H., Sakai-Tagawa Y., Iwatsuki-Horimoto K., Shiraki T., Uchida S., Uno S., Kabata H., Ikemura S., Kamata H., Ishii M., Fukunaga K., Kawaoka Y., Hasegawa N., Murata M.

    Journal of Clinical Pathology (Journal of Clinical Pathology)  74 ( 1 ) 67 - 68 2021年01月

    ISSN  00219746

  • Gene Xpertを用いた空気予防策解除の妥当性評価

    上蓑 義典, 宇野 俊介, 鎌田 浩史, 西村 知泰, 石井 誠, 長谷川 直樹

    結核 ((一社)日本結核・非結核性抗酸菌症学会)  95 ( 5 ) 122 - 122 2020年09月

    ISSN  0022-9776

  • Antimicrobial Stewardship を意識した抗菌薬選択-発熱・頭痛を主訴に受診した65歳男性-

    宇野 俊介、笠原敬、細川直登、三鴨廣繁、矢野晴美、青木洋介

    日本化学療法学会雑誌 2015 ( 63 ) 494 - 498 2015年

    速報,短報,研究ノート等(学術雑誌), 共著

研究発表 【 表示 / 非表示

  • 2021年の国内新規診断未治療HIV感染者・AIDS患者における薬剤耐性HIV-1の動向

    菊地 正, 西澤 雅子, 小島 潮子, 大谷 眞智子, 椎野 禎一郎, 俣野 哲朗, 佐藤 かおり, 豊嶋 崇徳, 伊藤 俊広, 林田 庸総, 潟永 博之, 岡 慎一, 古賀 道子, 長島 真美, 貞升 健志, 近藤 真規子, 宇野 俊介, 谷口 俊文, 猪狩 英俊, 寒川 整, 中島 秀明, 吉野 友祐, 堀場 昌英, 茂呂 寛, 渡邉 珠代, 蜂谷 敦子, 今橋 真弓, 松田 昌和, 重見 麗, 岡崎 玲子, 岩谷 靖雅, 横幕 能行, 渡邊 大, 阪野 文哉, 森 治代, 藤井 輝久, 高田 清式, 中村 麻子, 南 留美, 山本 政弘, 松下 修三, 饒平名 聖, 仲村 秀太, 健山 正男, 藤田 次郎, 吉村 和久, 杉浦 亙

    日本エイズ学会誌, 

    2022年11月

    (一社)日本エイズ学会

競争的研究費の研究課題 【 表示 / 非表示

  • 複数回MAC感染マウスモデルによる、肺MAC症の病態解析および新規治療戦略開発

    2019年04月
    -
    2022年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 宇野 俊介, 若手研究, 補助金,  研究代表者

 

担当授業科目 【 表示 / 非表示

  • 症候学

    2023年度

  • 慢性期病態学各論

    2023年度

  • 臨床実習入門

    2023年度

  • 感染症学

    2023年度

  • 症候学

    2022年度

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教育活動及び特記事項 【 表示 / 非表示

  • シュロスバーグ 結核と非結核性抗酸菌症

    2016年05月

    , 教科書・教材の開発

  • 結核診療パーフェクトガイド

    2015年02月

    , 教科書・教材の開発

 

所属学協会 【 表示 / 非表示

  • 日本内科学会

     
  • 日本感染症学会

     
  • 日本化学療法学会

     
  • 日本臨床微生物学会