Publications by authors named "Kurai H"

Article Synopsis
  • Prolonged nephrostomy tube use can lead to nephrostomy tube-associated pyelonephritis (NTAP) in patients with malignancies, but data on NTAP characteristics in this group are limited.
  • A study analyzed 43 NTAP cases, identifying causative microorganisms primarily as E. coli and Klebsiella pneumoniae, with specific non-causative organisms like certain enterococci and Candida species.
  • Treatment with antimicrobials for 7 days resulted in recovery for most patients, indicating that not all detected microorganisms require immediate treatment, particularly those resistant to cephalosporins.
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Background: The target population for active surveillance culture (ASC) of vancomycin-resistant Enterococcus species (VRE) by stool or rectal swabs has not been fully determined during VRE outbreaks in healthcare settings in non-VRE endemic situation.

Aim: To evaluate cumulative incidences of VRE detection during a vancomycin-resistant Enterococcus faecium outbreak to determine reasonable target populations for ASC.

Methods: Cases included inpatients whose first VRE-positive sample was obtained at Shizuoka General Hospital between February 2022 and January 2023, during which we conducted admission screening for possible high-risk patients, bi-weekly screening of all inpatients, admission and discharge screening in the high-care unit, and screening of contacts in each ward using stool or rectal samples.

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Introduction Postoperative cholangitis (POC) after pancreaticoduodenectomy is a serious complication. However, the prognostic factors are unclear. We aimed to investigate the relationships between biliary lesions and prognosis in patients with cholangitis after pancreaticoduodenectomy.

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Article Synopsis
  • - The case describes a patient who potentially developed Graves' disease after being infected with COVID-19.
  • - It suggests that the COVID-19 vaccination may have worsened the patient's condition, leading to a thyroid storm.
  • - While it's difficult to prove a direct link between the vaccine and the thyroid disease onset, the combination of prior COVID-19 infection and vaccination could have played a role in triggering the Graves' disease.
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The clinical significance of enterococci in intra-abdominal infections, particularly those caused by multiple organisms, remains unclear. There are no definitive guidelines regarding the use of empiric therapy with antimicrobial agents targeting enterococci. In this study, we evaluated the impact of the initial antimicrobial therapy administration of anti-enterococcal agents on the treatment of intra-abdominal infections in patients with cancer in whom enterococci were isolated from ascitic fluid cultures.

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In vitro excystation of cysts of microscopically identified Chilomastix mesnili and Retortamonas sp. isolated from Japanese macaques and Retortamonas sp. isolated from small Indian mongooses could be induced using an established protocol for Giardia intestinalis and subsequently by culturing with H2S-rich Robinson's medium supplemented with Desulfovibrio desulfuricans.

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Background: The optimal perioperative antimicrobial agent for preventing surgical site infection (SSI) in pancreatoduodenectomy (PD) with preoperative biliary drainage (PBD) remains unclear.

Methods: We retrospectively reviewed 288 patients who underwent PD after PBD between 2010 and 2020 at our institution. Patients were classified into two groups according to the perioperative antimicrobial agent used (cefazoline [CEZ] group [n = 108] and ceftriaxone [CTRX] group [n = 180]).

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There is no clear consensus regarding the optimal isolation duration for immunocompromised patients with coronavirus disease 2019 (COVID-19). Therefore, we conducted a questionnaire survey at eight Japanese cancer centers to investigate the practices of infectious disease specialists regarding the duration of isolation for COVID-19 inpatients with cancer. For asymptomatic to severely ill COVID-19 inpatients without severe immunodeficiency, four centers reported at least 10 days of isolation without testing, and two reported at least 20 days.

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Background: Clostridium perfringens sepsis has been reported to have a rapid onset and severe clinical outcome. We herein report a case of C. perfringens sepsis associated with massive intravascular hemolysis after left hepatic trisectionectomy for perihilar cholangiocarcinoma.

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Aims: To investigate synergistic effects of liver fibrosis evaluated by FibroScan and sarcopenia on endothelial function and arterial stiffness in patients with type 2 diabetes.

Methods: This cross-sectional study evaluated liver fibrosis (LF) and sarcopenia in 115 patients with type 2 diabetes. LF was assessed as the liver stiffness measurement (LSM) in transient elastography (FibroScan) and was defined as an LSM greater than or equal to 8.

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Objective: We investigated longitudinal changes in circulating CD4 and CD8 T cells positive for programed cell death protein-1 (PD-1) and in other subsets of CD4 T cells in untreated hyperthyroid patients with Graves' disease after treatment with methimazole (MMI).

Design And Patients: The study included 18 untreated hyperthyroid patients with Graves' disease and 18 age-matched controls. Before and after 12-week treatment with MMI, we used flow cytometry to measure circulating PD-1  D4 and PD-1 CD8+ T cells and subsets of CD4 T cells in peripheral blood, as well as serum levels of chemokines related to T-helper type 1 (Th-1) and Th-2 cells.

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Antimicrobial resistance (AMR) is a threat to patient health. However, data to optimize antimicrobial use are limited. Furthermore, reducing antibiotic use raises concerns regarding patient safety.

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This is a case of pseudoaneurysm associated with lung abscess caused by . This infection can be fatal, as these bacteria can invade the vascular wall and induce lethal hemorrhage.

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Aim: To investigate acute effects of add-on therapy with the sodium glucose co-transporter 2 inhibitor tofogliflozin to dipeptidyl peptidase (DPP)-4 inhibitors on 24-hours glucose profile and glycaemic variability evaluated by continuous glucose monitoring (CGM) in patients with type 2 diabetes.

Patients And Methods: We studied 17 patients with type 2 diabetes who were hospitalised for glycaemic control. CGM was performed for 7 consecutive days in the last week of hospitalization.

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Background: Neisseria macacae was discovered in the oral cavity of monkeys in 1983. In humans, it has been isolated from the upper respiratory tract of neutropenic patients. However, only two cases of N.

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Background: Recently, the spread of multidrug-resistant bacteria has become a global problem. Extended-spectrum beta-lactamase (ESBL)-producing (enterobacteria) is one example. The incidence of urinary tract infections caused by ESBL-producing enterobacteria has been increasing in some Japanese community settings.

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Background: Little is known about the impact of infectious disease (ID) consultations on the management of patients with cancer. This study aimed to describe the consultation services provided by ID specialists to all departments in a comprehensive cancer center in Japan.

Methods: We conducted a retrospective review of ID consultations with adult patients at a comprehensive cancer center in Japan from April 2017 to March 2018.

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[Fungal Infections].

Gan To Kagaku Ryoho

May 2020

In cancer patients, fungal diseases are rare but remains an important complication. Chemotherapy or surgery procedures are often delayed or postponed in patients with fungal disease which might lead to impaired overall survival. Candida, Aspergillus, Cryptococcus and Pneumocystis jirovecii have accounted for most of yeast and mold infections reported in cancer patients.

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An 81-year-old man with lung cancer with bone metastases, interstitial pneumonia, and emphysema, was hospitalized for pain control. He developed fever and chills during hospitalization. Physical examination revealed a fever of 39.

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Background: Carbapenem-resistant Enterobacteriaceae (CRE) are classified as carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE; the majority of CPE in Japan produce IMP carbapenemase.

Objectives: We evaluated the clinico-epidemiological and microbiological information and effects of IMP-type carbapenemase production in CRE.

Methods: Patients with isolations of CRE (MICs of meropenem ≥2 mg/L, imipenem ≥2 mg/L or cefmetazole ≥64 mg/L) from August 2016 to March 2018 were included.

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In Japan, hospitals' pharmaceutical affairs committees freely select the drugs to be purchased depending on the regulations of each hospital. This system poses a risk of the absence of essential drugs or an excess of similar drugs, and may promote inappropriate use of third-generation cephalosporins (3GCs) and quinolones. Against this backdrop, we researched availability of antibacterial agents in Japanese hospitals.

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Article Synopsis
  • The study explores hypervirulent Klebsiella pneumoniae (hvKp) infections, which are severe infections occurring mostly in healthy individuals, focusing on cases in healthcare settings across Japan.
  • A total of 140 bloodstream infection cases were analyzed, revealing that 26 (18.6%) were caused by different clones of hvKp, identified through whole-genome sequencing.
  • Patients with hvKp infections showed higher rates of conditions like diabetes and experienced more severe complications such as pneumonia, liver abscess, and disseminated infections, with many cases being healthcare-associated or hospital-acquired.
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Clostridium bacteremia is a well-known cause of infection in patients with gastrointestinal lesions. However, the clinical characteristics of this infection in cancer patients are unclear. We retrospectively reviewed cases of blood cultures positive for Clostridium species between March 1, 2004 and May 30, 2018 at the Shizuoka Cancer Center Hospital.

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Background: The aim of the present study was to investigate whether the incidence of surgical site infection after pancreatoduodenectomy decreased after changing the prophylactic antibiotic to a third-generation cephalosporin in patients with unknown preoperative bile culture results after biliary drainage.

Methods: In a retrospective study of 138 pancreatoduodenectomy patients who underwent endoscopic biliary stenting and for whom recent preoperative bile culture results were unavailable, cefazolin sodium hydrate was administered as perioperative prophylactic antibiotic therapy from 2010 to 2014 (n = 69); whereas ceftriaxone was administered from 2014 to 2017 (n = 69) based on the results of institutional culture surveillance. The incidence of surgical site infection was compared between the two groups and the risk factor of surgical site infection was also evaluated.

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The most common complication in cancer patients is catheter-related bloodstream infection (CRBSI), of which Staphylococcus aureus is a common pathogen. Although S. aureus CRBSI patients are recommended for prolonged intravenous therapy, this is often not feasible.

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