西村　知泰 (ニシムラ　トモヤス)

Nishimura, Tomoyasu

写真a

所属（所属キャンパス）

研究所・センター等 保健管理センター （日吉）

職名

専任講師

外部リンク
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経歴 【 表示 ／ 非表示 】

  • 2000年
    -
    2002年

    慶應義塾大学病院, 内科, 研修医

  • 2002年
    -
    2003年

    川崎市立川崎病院, 内科, 医員

  • 2003年
    -
    2004年

    水戸赤十字病院, 内科, 医員

  • 2004年
    -
    2010年

    慶應義塾大学医学部, 内科学(呼吸器), 助手

  • 2007年
    -
    2010年

    慶應義塾大学医学部, 微生物学・免疫学, 研究員

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学歴 【 表示 ／ 非表示 】

  • 2000年03月

    慶應義塾, 医学部, 医学科

    大学, 卒業

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学位 【 表示 ／ 非表示 】

  • 博士, 慶應義塾, 論文, 2008年06月

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免許・資格 【 表示 ／ 非表示 】

  • 医師免許, 2000年04月

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研究分野 【 表示 ／ 非表示 】

  • 呼吸器内科学

  • 感染症内科学

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研究キーワード 【 表示 ／ 非表示 】

  • 抗酸菌症

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著書 【 表示 ／ 非表示 】

  • EBM呼吸器疾患の治療2016-2017

    西村 知泰, 中外医学社, 2016年01月

    担当範囲: Interferon Gamma Release Assayの有用性は？

  • 新 呼吸器専門医テキスト

    西村 知泰, 南江堂, 2015年04月

    担当範囲: 肺結核症

  • 内科研修マニュアル　改訂第2版

    西村 知泰, 南江堂, 2006年07月

    担当範囲: 市中肺炎/院内肺炎

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論文 【 表示 ／ 非表示 】

  • Sitafloxacin-containing regimen for the treatment of refractory mycobacterium avium complex lung disease

    Asakura T., Suzuki S., Fukano H., Okamori S., Kusumoto T., Uwamino Y., Ogawa T., So M., Uno S., Namkoong H., Yoshida M., Kamata H., Ishii M., Nishimura T., Hoshino Y., Hasegawa N.

    Open Forum Infectious Diseases （Open Forum Infectious Diseases)  6 （ 4 ）  2019年04月

    　概要を見る

    © The Author(s) 2019. Background. Sitafloxacin (STFX) exhibits potent activity against Mycobacterium avium complex (MAC) in both in vitro and in vivo experiments. However, limited data are available for the clinical efficacy and adverse effects of STFX and the susceptibility of refractory MAC lung disease (MAC-LD) to the drug. Therefore, this study was aimed at evaluating the clinical efficacy and safety of an STFX-containing regimen for the treatment of refractory MAC-LD. Methods. We retrospectively evaluated treatment outcomes of 31 patients with refractory MAC-LD, who received an STFXcontaining regimen for ≥4 weeks between January 2010 and July 2017. Refractory MAC-LD was defined as persistent positive sputum cultures for >6 months of macrolide-based standard therapy. Results. Clarithromycin resistance (minimum inhibitory concentration [MIC] ≥32 μg/mL) was identified in 15 patients (48%). Twelve months after receiving the STFX-containing regimen, 26% and 19% of patients showed symptomatic and radiological responses, respectively. Although STFX-associated adverse effects were noted in 9 patients, their severity was grade 1 (National Cancer Institute Common Terminology Criteria); only 1 patient discontinued STFX because of suspected gastrointestinal disturbance. Negative sputum culture conversion was achieved in 7 patients (23%). Both univariate and multivariate logistic regression analyses revealed that surgery, low STFX MIC (≤1 μg/mL), and macrolide resistance were significant predictors of negative sputum culture conversion. Conclusions. Our results demonstrate that STFX may be effective in one-fourth of patients with refractory MAC-LD. Prospective larger studies that include the analyses of MAC are needed to determine the clinical efficacy of STFX against refractory MAC-LD.

  • Retrospective evaluation of natural course in mild cases of Mycobacterium avium complex pulmonary disease

    Kimizuka Y., Hoshino Y., Nishimura T., Asami T., Sakakibara Y., Morimoto K., Maeda S., Nakata N., Abe T., Uno S., Namkoong H., Fujiwara H., Funatsu Y., Yagi K., Fujie T., Ishii M., Inase N., Iwata S., Kurashima A., Betsuyaku T., Hasegawa N.

    PLoS ONE （PLoS ONE)  14 （ 4 ）  2019年04月

    　概要を見る

    © 2019 Kimizuka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background There is no proven management for mild cases of Mycobacterium avium complex (MAC) pulmonary disease, who do not immediately receive treatment and are managed with observation alone, because its long term-natural course, factors predictive of deterioration, and the effect of treating the disease remain unclear. Thus, we sought to investigate the natural course of mild cases of MAC pulmonary disease. Methods We conducted a multicenter retrospective study. Sixty-five patients with mild MAC pulmonary disease in whom treatment was withheld for at least 6 months after diagnosis were retrospectively recruited after a review of 747 medical records. Longitudinal changes in clinical features were evaluated by using a mixed effects model. Results Mean follow-up was 6.9 ± 5.7 years. During the follow-up period, 15 patients (23%) required treatment and 50 (77%) were managed with observation alone. At diagnosis, 65 patients had nodular bronchiectatic disease without fibrocavitary lesions. Among clinical features, mean body mass index (BMI), forced expiratory volume in 1 second as percent of forced vital capacity (%FEV 1 ), nodular lung lesions, and bronchiectasis worsened significantly in the observation group during follow-up. In the treatment group, BMI, and % FEV 1 were stable, but bronchiectasis significantly worsened. At diagnosis, the polyclonal MAC infection rate in the treatment group was higher than that in the observation group. Other microbiological factors, such as insertion sequences, did not differ significantly between the groups. Conclusions Mild MAC pulmonary disease progresses slowly but substantially without treatment. Treatment prevents the deterioration of the disease but not the progression of bronchiectasis. Polyclonal MAC infection is a predictor of disease progression.

  • Clinico-microbiological analysis of 121 patients with pulmonary Mycobacteroides abscessus complex disease in Japan – An NTM-JRC study with RIT

    Morimoto Kozo, Nakagawa Taku, Asami Takahiro, Morino Eriko, Fujiwara Hiroshi, Hase Isano, Tsujimoto Yoshie, Izumi Kiyohiko, Hayashi Yuta, Matsuda Shuichi, Murase Yoshiro, Yano Ryozo, Takasaki Jin, Betsuyaku Tomoko, Aono Akio, Goto Hajime, Nishimura Tomoyasu, Sasaki Yuka, Hoshino Yoshihiko, Kurashima Atsuyuki, Ato Manabu, Ogawa Kenji, Hasegawa Naoki, Mitarai Satoshi

    Respiratory Medicine 145   14 - 20 2018年12月

    ISSN  0954-6111

    　概要を見る

    <p>Rationale: No comprehensive analysis has previously been performed to evaluate the clinical aspects of and microbiological evidence associated with Mycobacteroides abscessus complex (MABC) infection in a region, such as Japan, with a low MABC incidence. Objectives: This study aimed to clarify the clinicopathological characteristics of MABC, which included clinical relatedness to erm(41) sequevar, phenotype (as colony morphology and minimum inhibitory concentration), and genotype. Methods: A total of 121 MABC patients (68 with M. abscessus subsp. abscessus and 53 with M. abscessus subsp. massiliense) were recruited into this retrospective clinical-biological study from tertiary hospitals in Japan between 2004 and 2014. Results: Approximately 30% of MABC patients had a history of previous nontuberculous mycobacterium (NTM) disease. Furthermore, 24.8% of the patients had another concomitant NTM infection after they were diagnosed with MABC. Fewer than 10% of the patients in the M. abscessus group had T28C in erm(41). While we observed a higher conversion rate for M. massiliense than for M. abscessus (72.4% and 34.8%, respectively, p = 0.002), recurrence remained relatively common for M. massiliense (31.0%). In the M. abscessus patients, the MIC of clarithromycin (CLR) was significantly lower on day 3 in patients with a better treatment response than in refractory patients (The median MIC; 0.75 μg/ml v.s 2.0 μg/ml, p = 0.03). There was no significant relation between clinical manifestations and variable number of tandem repeat genotypes. Conclusions: Because the history and simultaneous isolation of other NTM in MABC infection are relatively common, these information should be carefully translated into clinical actions. The evaluation of early CLR resistance in M. abscessus and the erm(41) functions should be important to improve the treatment strategy.</p>

  • Estimating latent tuberculosis infection using interferon-γ release assay, Japan

    Nishimura Tomoyasu, Ota Masaki, Mori Masaaki, Hasegawa Naoki, Kawabe Hiroshi, Kato Seiya

    Emerging Infectious Diseases 24 （ 11 ） 2111 - 2113 2018年11月

    ISSN  1080-6040

  • Association between six-minute walk test parameters and the health-related quality of life in patients with pulmonary Mycobacterium avium complex disease

    Yagi Kazuma, Asakura Takanori, Namkoong Ho, Suzuki Shoji, Asami Takahiro, Okamori Satoshi, Kusumoto Tatsuya, Funatsu Yohei, Kamata Hirofumi, Nishimura Tomoyasu, Ishii Makoto, Betsuyaku Tomoko, Hasegawa Naoki

    BMC Pulmonary Medicine 18 （ 1 ）  2018年07月

    ISSN  1471-2466

    　概要を見る

    <p>Background: Pulmonary Mycobacterium avium complex (pMAC) disease is a chronic, slowly progressive disease. The aim of the present study was to determine the association of six-minute walk test (6MWT) parameters with pulmonary function and the health-related quality of life (HRQL) in patients with pMAC disease. Methods: This cross-sectional study included adult patients with pMAC and was conducted at Keio University Hospital. We investigated the relationship of 6MWT parameters with clinical parameters, including pulmonary function, and HRQL, which was assessed using the 36-Item Short Form Health Survey (SF-36) and St. George's Respiratory Questionnaire (SGRQ). Results: In total, 103 consecutive patients with pMAC participated in 6MWT (median age, 64 years; 80 women) and completed SF-36 and SGRQ. The six-minute walk distance (6MWD) showed significant negative and positive correlations with all SGRQ domain scores [ρ = (- 0.54)-(- 0.32)] and the physical component summary (PCS) score (ρ = 0.39) in SF-36, respectively; the opposite was observed for the final Borg scale (FBS) score (all SGRQ scores, ρ = 0.34-0.58; PCS score, ρ = - 0.50). The distance-saturation product showed significant negative and positive correlations with all SGRQ scores [ρ = (- 0.29)-(- 0.55)] and the PCS score (ρ = 0.40), respectively. Multivariate analysis revealed that 6MWD and the FBS score were significant predictors of HRQL. Conclusions: Our findings suggest that 6MWD and the FBS score are useful parameters for evaluating HRQL in patients with pMAC. Further studies should investigate the impact of 6WMT parameters on disease progression, treatment responses, and prognosis.</p>

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研究発表 【 表示 ／ 非表示 】

  • 外国人留学生を対象とした結核感染調査

    西村知泰，森正明，牧野伸司，広瀬寛，和井内由充子，横山裕一，武田彩乃，畔上達彦，後藤伸子，河邊博史

    第116回日本内科学会総会・講演会 (名古屋) , 2019年04月, ポスター（一般）

  • 肺MAC症の新規検査法

    西村 知泰

    第101回日本細菌学会関東支部総会 (東京) , 2018年11月, シンポジウム・ワークショップ パネル（指名）

  • アスペルギルス沈降抗体陽性である肺Mycobacterium avium complex症患者の臨床的特徴

    鈴木翔二, 朝倉崇徳, 南宮湖, 岡森慧, 八木一馬, 鎌田浩史, 舩津洋平, 中野泰, 西村知泰, 石井誠, 海老原全, 別役智子, 長谷川直樹．

    第58回日本呼吸器学会学術講演会 (大阪) , 2018年04月, ポスター（一般）

  • 大学生における先天性心疾患の管理状況

    牧野伸司, 和井内由充子, 武田彩乃, 畔上達彦, 広瀬寛, 西村知泰, 横山裕一, 河邊博史, 森正明．

    第115回日本内科学会年次学術講演会 (京都) , 2018年04月, ポスター（一般）

  • 当大学医学部留学生に対するImmunization Recordの運用と考察

    武藤志保, 横山裕一, 弦巻美保, 齋藤圭美, 西村知泰, 森正明, 河邊博史．

    第55回全国大学保健管理研究集会 (宜野湾) , 2017年11月, ポスター（一般）

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競争的資金等の研究課題 【 表示 ／ 非表示 】

  • 肺MAC症の病態における菌細胞壁脂質の役割

    2019年06月
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    2022年05月

    武田科学振興財団, 医学系研究助成, 補助金,  代表

  • 肺非結核性抗酸菌症患者のゲノム情報に基づいた病態解明

    2019年04月
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    2022年03月

    文部科学省・日本学術振興会, 科学研究費補助金, 補助金,  分担

  • がん微小環境形成・腫瘍進展に関わるHYBID-ヒアルロン酸代謝機構の病理学的解析

    2019年04月
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    2022年03月

    文部科学省・日本学術振興会, 科学研究費補助金, 補助金,  分担

  • 菌細胞壁脂質に着目した肺MAC症の病態解明

    2019年04月
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    2022年03月

    文部科学省・日本学術振興会, 科学研究費補助金, 補助金,  代表

  • 肺MAC症の病態におけるホルモンの役割

    2019年04月
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    2020年03月

    大山健康財団, 西村知泰, 補助金,  代表

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担当授業科目 【 表示 ／ 非表示 】

  • 現代社会と医学Ⅱ

    2019年度

  • 感染症学

    2019年度

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  • 感染症学

    慶應義塾, 2018年度, 通年, その他, 講義, 兼担

  • 現代社会と医学Ⅱ

    慶應義塾, 2018年度, 通年, その他, 講義, 専任

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社会活動 【 表示 ／ 非表示 】

  • 平成27年度外務省巡回医師団

    2016年02月
    -
    2016年03月

  • 平成26年度外務省巡回医師団

    2015年01月
    -
    2015年02月
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所属学協会 【 表示 ／ 非表示 】

  • 日本免疫学会

    　

  • 日本内科学会

    　

  • 日本呼吸器学会

    　

  • 日本呼吸器内視鏡学会

    　

  • 日本感染症学会

    　

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委員歴 【 表示 ／ 非表示 】

  • 2016年04月
    -
    継続中

    評議員, 日本感染症学会

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