Publications by authors named "Yoshikazu Mutoh"
Article Synopsis
- * The research involved a multicenter point-prevalence survey of 10,199 patients across 27 hospitals in Aichi Prefecture, revealing a 6.6% rate of HAIs, with pneumonia, urinary tract infections, and surgical site infections being the most common.
- * The study concludes that the findings are crucial for understanding HAIs in Japan and stresses the importance of national-level surveys to monitor healthcare challenges, especially in the context of post-COVID-19 conditions.
Although nirmatrelvir/ritonavir (NMV/r) reportedly increases blood levels of tacrolimus (TAC) due to CYP3A4 inhibition and other factors, reports on the use of NMV/r in combination with tacrolimus hydrate extended-release capsules (TAC-ER) in lung transplant patients are limited. Herein, we present a case with post-lung transplantation of elevated blood trough levels of TAC after concomitant use of NMV/r. A woman in her 60s had undergone lung transplantation.
View Article and Find Full Text PDFBackground: We investigated whether the initial voriconazole (VRCZ) dosing design, as determined using simulation software with a population pharmacokinetic model of Japanese patients, impacts the effectiveness and safety when compared with VRCZ initiation according to the package insert.
Methods: In this single-center retrospective observational study, we employed records from Tosei General Hospital (a 633-bed hospital), dated April 2017 to September 2023. Eligible patients were divided into the software-based simulation group, comprising patients administered initial VRCZ dosage adjustment by pharmacists using software-based simulation, and the standard therapy group, whose dosage was administered by a physician following the package insert recommendations without simulation.
Article Synopsis
- Recent cases showing resistance to antifungals complicate treatment strategies, highlighted by a novel case of Coniochaeta hoffmannii fungemia in a woman with acute myeloid leukemia following stem cell transplantation.
- The patient struggled with infection despite broad-spectrum antibiotics and micafungin, but her condition improved after switching to voriconazole, suggesting that disruption of skin/mucosal barriers combined with antimicrobial use may increase the risk of invasive fungal infections.
Tuberculous otitis media (TOM) is a rare manifestation caused by with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of several clinical manifestations and the high prevalence of secondary bacterial infections. Few reports have attributed secondary bacterial infections in patients with TOM to commensal .
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- - The study investigated surgical antimicrobial prophylaxis (SAP) practices in Japanese hospitals, revealing a lack of data on guidelines adherence and prescription standards.
- - Conducted across 27 hospitals, the survey found that only 33.9% of surgeries met appropriateness criteria, with a notable variability among surgical fields and hospitals regarding proper antimicrobial selection.
- - Results indicated that while cefazolin was commonly used, there is a pressing need for ongoing monitoring and interventions to enhance SAP compliance nationwide.
Article Synopsis
- * A study of 1656 Japanese patients identified rapid worsening of CXR findings—as indicated by increased lung infiltrates within 48 hours of hospital admission—as a significant risk factor for severe complications.
- * Factors contributing to this rapid deterioration include existing health conditions, elevated body temperature, and specific genetic variants, highlighting the importance of early detection and monitoring.
Article Synopsis
- - A 46-year-old man with a history of skin rash, potentially related to syphilis, experienced ataxia and weakness in his right limbs, leading to further medical evaluation.
- - MRI scans showed multiple areas of acute brain infarctions primarily affecting the right superior cerebellar artery and left anterior cerebral artery, resulting in a diagnosis of meningovascular neurosyphilis confirmed by positive syphilis tests in both serum and cerebrospinal fluid.
- - After intravenous penicillin treatment, there was improvement in the right superior cerebellar artery's signal intensity on MRI, indicating a reduction in vascular inflammation associated with the meningovascular neurosyphilis.
Article Synopsis
- The study investigates the relationship between COVID-19 and ABO blood group/genotype in a large Japanese population, including 1,790 patients and 611 healthy controls.
- Blood group A was found to be more common and blood group O less common among COVID-19 patients, while genotype OO was also less frequent in this group.
- Blood group AB was identified as a significant risk factor for severe disease, while blood group O appeared to provide some protective effect against infection.
Article Synopsis
- The study aimed to evaluate the effectiveness of baricitinib in COVID-19 patients, specifically its role in reducing the need for invasive mechanical ventilation and identifying which patient groups benefit most.
- Conducted by the Japan COVID-19 Task Force, it included 3309 patients across 70 hospitals, comparing those on baricitinib to matched controls.
- Results showed that baricitinib significantly lowered the need for invasive ventilation (9% vs. 18.8%) and was especially beneficial for patients requiring oxygen support or those with severe symptoms, despite similar ICU admission and mortality rates between groups.
, a Gram-positive anaerobic coccus, is a common constituent of the human gut microbiota but rarely causes any disease in humans. Herein, we report a case of bacteraemia in an immunocompromised 73-year-old man with sigmoid colon perforation. is usually reported as Gram-positive diplococci or short chains on Gram staining; however, in our patient, a blood isolate showed Gram-positive cocci in long chains, and organisms from an anaerobic subculture showed morphological diversity.
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- The study examined the link between complete blood count metrics, especially the neutrophil-to-lymphocyte ratio (NLR), and the outcomes of COVID-19 patients in Japan from February 2020 to November 2021.* -
- Out of 2425 patients analyzed, 19.5% faced severe complications, and NLR emerged as the best predictor for these outcomes, with a good area under the curve (AUC) of 0.81.* -
- Combining NLR with patients' oxygen requirements at admission provided an even better prediction (AUC of 0.88) for identifying those at risk of severe disease progression.*
Article Synopsis
- A study analyzed the rates and impact of respiratory bacterial infections in Japanese patients hospitalized with COVID-19, finding that 7.5% of patients experienced such infections.
- The most common causes of these infections included Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus pneumoniae, with more severe outcomes linked to hospital-acquired infections and pre-existing health conditions.
- The research highlights the importance of monitoring and assessing bacterial complications in COVID-19 patients, as these infections can significantly increase mortality rates.
The aging of patients with tuberculosis and better therapeutic management for them are recent concerns. This study aimed to identify risk factors for adverse drug reactions (ADRs) or death in very elderly patients with pulmonary tuberculosis and to assess the association between the dosage of antituberculosis drugs and outcomes. We conducted a multicenter retrospective study at two hospitals.
View Article and Find Full Text PDFMolnupiravir (MOV) and nirmatrelvir/ritonavir (NMV/r) are efficacious oral antiviral agents for patients with the 2019 coronavirus (COVID-19). However, little is known about their effectiveness in older adults and those at high risk of disease progression. This retrospective single-center observational study assessed and compared the outcomes of COVID-19 treated with MOV and NMV/r in a real-world community setting.
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- The study examined the impact of non-respiratory bacterial and fungal infections on hospitalized COVID-19 patients, focusing on the types of infections, their causative organisms, and their effects on mortality rates.
- Out of 1914 patients, 4.2% developed non-respiratory bacterial infections, predominantly bacteremia, which was linked to a higher risk of death, particularly in patients with certain predisposing factors.
- The findings highlight the need for effective medical strategies to manage secondary infections in COVID-19 patients, especially those at a greater risk, such as older individuals and those admitted to intensive care.
Objectives: Smoking and chronic obstructive pulmonary disease (COPD) are risk factors for severe COVID-19. However, limited literature exists on the effect of COPD and smoking on COVID-19 outcomes. This study examined the impact of smoking exposure in pack-years (PY) and COPD on COVID-19 outcomes among smokers in Japan.
View Article and Find Full Text PDFBackground: We aimed to elucidate differences in the characteristics of patients with coronavirus disease 2019 (COVID-19) requiring hospitalization in Japan, by COVID-19 waves, from conventional strains to the Delta variant.
Methods: We used secondary data from a database and performed a retrospective cohort study that included 3261 patients aged ≥ 18 years enrolled from 78 hospitals that participated in the Japan COVID-19 Task Force between February 2020 and September 2021.
Results: Patients hospitalized during the second (mean age, 53.
There are limited reports on the safety of remdesivir for patients with severe kidney disease. We investigated the safety of remdesivir administration for COVID-19 patients with estimated glomerular filtration rate (eGFR) <30 mL/min. This single-center retrospective study was conducted between March 2020 and April 2022 at Tosei General Hospital, Japan.
View Article and Find Full Text PDFBackground: Respiratory symptoms are associated with coronavirus disease 2019 (COVID-19) outcomes. However, the impacts of upper and lower respiratory symptoms on COVID-19 outcomes in the same population have not been compared. The objective of this study was to characterize upper and lower respiratory symptoms and compare their impacts on outcomes of hospitalized COVID-19 patients.
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- The study explored different clinical profiles (or phenotypes) of COVID-19 patients in Japan, focusing on how these profiles could predict disease severity and outcomes.
- Researchers analyzed data from 1,322 hospitalized patients, categorizing them into four clusters based on factors like age and health conditions.
- Results showed distinct characteristics in each cluster, with younger and healthier patients having better outcomes, while older and obese patients faced more severe symptoms, highlighting the importance of phenotyping in understanding COVID-19.
Article Synopsis
- * Researchers analyzed RNA-seq data from 465 blood samples, uncovering 1169 expression quantitative trait loci (eQTLs) and 1549 splice QTLs (sQTLs) linked to COVID-19 severity, including immune-related expressions.
- * The study highlights the impact of disease severity on gene expression, identifying specific eQTLs that interact with COVID-19 phenotypes, and provides an extensive resource for understanding gene regulation in response to the virus.
Background: Obesity is reported to be a risk factor for severe disease in patients with coronavirus disease 2019 (COVID-19). However, there are no specific reports on the risk of severe disease according to body mass index (BMI) in Japan. Thus, this study aimed to investigate the effect of obesity stratified by BMI on the severity of COVID-19 in the general Japanese population.
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- Researchers conducted a genome-wide association study (GWAS) with 2,393 COVID-19 patients and 3,289 controls in Japan, identifying a specific genetic variant (rs60200309-A) on chromosome 5 linked to severe cases in individuals under 65.
- The variant is more common in East Asians and associated with reduced expression of the DOCK2 gene, which was found to be lower in severe COVID-19 cases, particularly in non-classical monocytes.
- Additionally, inhibiting DOCK2 in hamsters worsened pneumonia symptoms, indicating its potential as a biomarker and therapeutic target for severe COVID-19.