Updated on 2024/12/04

Information

 

写真a

 
NISHIDA RURIKO
 
Organization
Kyushu University Hospital Clinical Laboratories Assistant Professor
Title
Assistant Professor

Papers

  • A Case of Pulmonary Nocardiosis Caused by Trimethoprim-Sulfamethoxazole-Resistant <i>Nocardia wallacei</i> treated with Clavulanic acid/Amoxicillin

    NAKAZAWA Megumi, YOKOYAMA Takashi, SATO Yoriko, NISHIDA Ruriko, UCHIDA Yujiro

    Kansenshogaku Zasshi   97 ( 4 )   136 - 140   2023.7   ISSN:03875911 eISSN:1884569X

     More details

    Language:Japanese   Publisher:The Japanese Association for Infectious Diseases  

    <p>An 86-year-old woman with a 6-year history of bronchiectasis and recurrent pneumonia in the right lung presented to our hospital with a several weeks' history of bloody sputum. Imaging studies showed ground-glass and infiltrative opacities in the right lung, and <i>Nocardia</i> species were repeatedly isolated on sputum culture testing. Genetic testing identified <i>Nocardia wallacei</i>, which was resistant to sulfamethoxazole/trimethoprim. Therefore, the patient was treated with clavulanic acid/amoxicillin (CVA/AMPC) for a total of 6 months, and the symptoms, including the bloody sputum and cough, as well as the imaging findings, improved. Pulmonary nocardiosis can occur in patients with chronic lung disorders such as bronchiectasis, even in the absence of immunodeficiencies. Trimethoprim-sulfamethoxazole is the drug of first choice for nocardiosis, but identification of the <i>Nocardia</i> species and susceptibility testing are recommended for treatment, because the susceptibility varies with the species.</p>

    DOI: 10.11150/kansenshogakuzasshi.e23001

    CiNii Research

  • ST合剤耐性のNocardia wallaceiによる肺ノカルジア症をclavulanic acid/amoxicillinで治療しえた1例

    中澤 愛美, 横山 貴士, 佐藤 依子, 西田 留梨子, 内田 勇二郎

    感染症学雑誌   97 ( 4 )   136 - 140   2023.7   ISSN:0387-5911

     More details

    Language:Japanese   Publisher:(一社)日本感染症学会  

    86歳女性。肺炎を繰り返し、他院で精査を行うも起炎菌は同定できず、環境誘発による肺炎とし、環境整備を行っていたが、今回、血痰が出現し、改善がみられないため、精査加療目的で当科へ紹介となった。喀痰培養をはじめ遺伝子解析、画像所見を踏まえて、Nocardia wallaceiによる肺ノカルジア症と診断された。治療を行うにあたり、感受性検査でST合剤が耐性であったことから、levofloxacin(LVFX)の内服を開始した。だが、クレアチニンおよびカルシウム値の上昇を認めたため、LVFX中止し、検査値の改善後、Clavulanic acid/amoxicillinの内服に変更した。その結果、症状や画像所見は改善し、治療終了11ヵ月現在、再燃なく経過している。

  • Breakthrough candidemia with hematological disease: Results from a single-center retrospective study in Japan, 2009-2020

    Nishida, R; Eriguchi, Y; Miyake, N; Nagasaki, Y; Yonekawa, A; Mori, Y; Kato, K; Akashi, K; Shimono, N

    MEDICAL MYCOLOGY   61 ( 6 )   2023.6   ISSN:1369-3786 eISSN:1460-2709

     More details

    Language:English   Publisher:Medical Mycology  

    Breakthrough candidemia (BrC) is a significant problem in immunocompromised patients, particularly those with hematological disorders. To assess the characteristics of BrC in patients with hematologic disease treated with novel antifungal agents, we collected clinical and microbiological information on said patients from 2009 to 2020 in our institution. Forty cases were identified, of which 29 (72.5%) received hematopoietic stem cell transplant (HSCT)-related therapy. At BrC onset, the most administered class of antifungal agents were echinocandins, administered to 70% of patients. Candida guilliermondii complex was the most frequently isolated species (32.5%), followed by C. parapsilosis (30%). These two isolates were echinocandin-susceptible in vitro but had naturally occurring FKS gene polymorphisms that reduced echinocandin susceptibility. Frequent isolation of these echinocandin-reduced-susceptible strains in BrC may be associated with the widespread use of echinocandins. In this study, the 30-day crude mortality rate in the group receiving HSCT-related therapy was significantly higher than in the group not receiving it (55.2% versus 18.2%, P =. 0297). Most patients affected by C. guilliermondii complex BrC (92.3%) received HSCT-related therapy and had a 30-day mortality rate of 53.8%; despite treatment administration, 3 of 13 patients had persistent candidemia. Based on our results, C. guilliermondii complex BrC is a potentially fatal condition in patients receiving HSCT-related therapy with echinocandin administration.

    DOI: 10.1093/mmy/myad056

    Web of Science

    Scopus

    PubMed

  • 肺Mycobacterium abscessus subsp. massiliense症の播種に起因する縦隔膿瘍と感染性動脈瘤の1症例(A case of mediastinal abscess and infected aortic aneurysm caused by dissemination of Mycobacterium abscessus subsp. massiliense pulmonary disease)

    Matsumoto Yuji, Murata Masayuki, Takayama Koji, Yamasaki Sho, Hiramine Satoshi, Toyoda Kazuhiro, Kibe Yasushi, Nishida Ruriko, Kimura Satoshi, Sonoda Hiromichi, Shiose Akira, Shimono Nobuyuki

    Journal of Infection and Chemotherapy   29 ( 1 )   82 - 86   2023.1   ISSN:1341-321X

     More details

    Language:English   Publisher:エルゼビア・ジャパン(株)  

    症例は81歳男性で、発熱と倦怠感を主訴に当院紹介となった。患者は10年前に大動脈弁逆流症による大動脈弁置換術、5年前に感染性心内膜炎による2回目の大動脈弁置換術を受け、同時に胃癌と診断され幽門側胃切除術を受けていた。2年前に肺NTM症と診断されていた。入院時の全身の外観はわずかに不良で肩と膝の関節痛を訴えていた。表在リンパ節は触診できなかった。血清アルブミン値の減少とCRP値の軽度上昇がみられた。9ヵ月前の胃癌フォローアップ造影CT検査で大動脈弁近傍の液体貯留が示されたが、無症状のため精密検査は実施されなかった。入院5日後に実施された造影CTで前縦隔内のリング状増強低密度領域、低密度領域近くの上行大動脈の偽動脈瘤、両側胸膜液が示された。右側胸膜液の穿刺により漏出性胸水が認められたが培養でNTMは検出されなかった。感染性大動脈瘤と縦隔膿瘍が示唆されたためバンコマイシンとメロペネムを投与した。血液培養で分離された抗酸菌は迅速発育菌であったためメロペネム/アミカシン/クラリスロマイシンに切り替えた。感染性動脈瘤破裂が認められ、緊急の大動脈置換術と縦隔膿瘍ドレナージを実施した。縦隔膿瘍と心膜パッチからMycobacterium abscessus subsp. massilienseが分離された。3剤治療により術後CRP値は低下し血液培養は陰性となり、2ヵ月後リハビリ病院へ転院した。

  • A case of mediastinal abscess and infected aortic aneurysm caused by dissemination of Mycobacterium abscessus subsp. massiliense pulmonary disease

    Matsumoto, Y; Murata, M; Takayama, K; Yamasaki, S; Hiramine, S; Toyoda, K; Kibe, Y; Nishida, R; Kimura, S; Sonoda, H; Shiose, A; Shimono, N

    JOURNAL OF INFECTION AND CHEMOTHERAPY   29 ( 1 )   82 - 86   2023.1   ISSN:1341-321X eISSN:1437-7780

     More details

    Language:English   Publisher:Journal of Infection and Chemotherapy  

    An 81-year-old man was admitted to our hospital because of fever and malaise that had persisted for 3 months. The patient had undergone two aortic valve replacements, 10 and 5 years previously, because of aortic valve regurgitation and infectious endocarditis. He also had had asymptomatic Mycobacterium abscessus complex (MABC) pulmonary disease for the two previous years. Contrast-enhanced computed tomography showed a mediastinal abscess and an ascending aortic aneurysm. Mycobacterium abscessus subsp. massiliense was cultured from his blood, suggesting the aortic aneurysm was secondary to infection of an implanted device. After enlargement over only a few days, a leakage of contrast medium to the mediastinal abscess was found on computed tomography. The patient was diagnosed with rupture of an infectious aortic aneurysm, and emergency aortic replacement and drainage of the mediastinal abscess were successful. The patient was treated with several antibiotics, including meropenem, amikacin, and clarithromycin, and his general condition improved. Cultures from both the mediastinal abscess and a pericardial patch that was placed at the time of surgery 5 years previously revealed MABC. In our case, the infected aortic aneurysm most likely resulted from MABC pulmonary disease rather than from previous intraoperative contamination. This route of infection is rare. Physicians should be aware of the possibility of dissemination and subsequent infection of implants related to MABC pulmonary disease.

    DOI: 10.1016/j.jiac.2022.09.017

    Web of Science

    Scopus

    PubMed

  • 母集団薬物動態解析に基づくメチシリン耐性黄色ブドウ球菌感染成人患者のための簡素なダプトマイシン投与レジメン(Simplified daptomycin dosing regimen for adult patients with methicillin-resistant Staphylococcus aureus infections based on population pharmacokinetic analysis)

    Yamada Takaaki, Soda Midori, Nishida Ruriko, Miyake Noriko, Maeshiro Yasutaka, Oida Yasuhisa, Yamashita Yuji, Egashira Nobuaki, Shimono Nobuyuki, Kitaichi Kiyoyuki, Ieiri Ichiro

    Drug Metabolism and Pharmacokinetics   44   1 - 8   2022.6   ISSN:1347-4367

     More details

    Language:English   Publisher:(一社)日本薬物動態学会  

    ダプトマイシンが投与された成人患者47名に由来する110個の血漿中濃度データを用いて母集団薬物動態(PK)モデルを構築した。目標とする血漿中濃度時間曲線下面積(AUC)/最小発育阻止濃度(MIC)比、ピーク濃度/MIC比および安全性を考慮したトラフ濃度の閾値をそれぞれ>600、>60および24.3mg/Lとした。腎機能をクリアランスの有意な共変量とした。全患者に標準用量(6mg/kg)のダプトマイシンが投与されMIC値が0.25および0.5mg/Lの場合のシミュレーションによる有効域達成の確率は、90%以上であった。種々の用量でPKシミュレーションを行った結果、MIC値が1mg/Lでクレアチニンクリアランス>60mL/minの場合、時間ごとに10mg/kgの投与が最適であった。

  • Simplified daptomycin dosing regimen for adult patients with methicillin-resistant<i> Staphylococcus</i><i> aureus</i> infections based on population pharmacokinetic analysis

    Yamada, T; Soda, M; Nishida, R; Miyake, N; Maeshiro, Y; Oida, Y; Yamashita, Y; Egashira, N; Shimono, N; Kitaichi, K; Ieiri, I

    DRUG METABOLISM AND PHARMACOKINETICS   44   100444   2022.6   ISSN:1347-4367 eISSN:1880-0920

     More details

    Language:English   Publisher:Drug Metabolism and Pharmacokinetics  

    Daptomycin is used to treat methicillin-resistant Staphylococcus aureus (MRSA) infections. Current guidelines recommend higher daptomycin doses (8–10 mg/kg) for severe infections; however, pharmacokinetic (PK) and pharmacodynamic-based dosing strategies are still limited. Therefore, we designed a new optimal daptomycin dosing regimen for patients with MRSA infections using a population PK modeling approach. A total of 110 plasma concentrations from 47 adult patients who received daptomycin in general wards were enrolled for population PK modeling. The target area under the concentration-time curve/minimum inhibitory concentration (MIC) ratio, target peak/MIC ratio, and threshold of the trough concentration for safety were set to >666, >60, and 24.3 mg/L, respectively. Renal function was indicated as a significant covariate for daptomycin clearance. The simulated probability of target attainment was more than 90% at MIC values of 0.25 and 0.5 mg/L in all patients at the standard dose (6 mg/kg). In contrast, comprehensive simulation assessments recommended 10 mg/kg every 24 h in patients with creatinine clearance >60 mL/min for MIC values of 1.0 mg/L. We propose a new simplified daptomycin dosing regimen stratified by renal function and MIC values based on PK model-based simulation analyses. The proposed regimen is expected to maximize clinical efficacy and minimize adverse events.

    DOI: 10.1016/j.dmpk.2022.100444

    Web of Science

    Scopus

    PubMed

  • <i>Helicobacter</i> <i>cinaedi</i> is a human-adapted lineage in the <i>Helicobacter cinaedi</i>/<i>canicola</i>/'<i>magdeburgensis</i>' complex

    Gotoh, Y; Atsuta, Y; Taniguchi, T; Nishida, R; Nakamura, K; Ogura, Y; Misawa, N; Hayashi, T

    MICROBIAL GENOMICS   8 ( 5 )   2022.5   ISSN:2057-5858

     More details

    Language:English   Publisher:Microbial Genomics  

    Helicobacter cinaedi is an enterohepatic Helicobacter that causes bacteremia and other diseases in humans. While H. cinaedi-like strains are isolated from animals, including dog isolates belonging to a recently proposed H. canicola, little is known about the genetic differences between H. cinaedi and these animal isolates. Here, we sequenced 43 H. cinaedi-or H. canicola-like strains isolated from humans, hamsters, rats and dogs and collected 81 genome sequences of H. cinaedi, H. canicola and other enterohepatic Helicobacter strains from public databases. Genomic comparison of these strains identified four distinct clades (clades I–IV) in H. cinaedi/canicola/‘magderbugensis’ (HCCM) complex. Among these, clade I corresponds to H. cinaedi sensu stricto and represents a human-adapted lineage in the complex. We identified several genomic features unique to clade I. They include the accumulation of antimicrobial resistance-related mutations that reflects the human association of clade I and the larger genome size and the presence of a CRISPR-Cas system and multiple toxin-antitoxin and restriction-modification systems, both of which indicate the contribution of horizontal gene transfer to the evolution of clade I. In addition, nearly all clade I strains but only a few strains belonging to one minor clade contained a highly variable genomic region encoding a type VI secretion system (T6SS), which could play important roles in gut colonization by killing competitors or inhibiting their growth. We also developed a method to systematically search for H. cinaedi sequences in large metagenome data sets based on the results of genome comparison. Using this method, we successfully identified multiple HCCM complex-containing human faecal metagenome samples and obtained the sequence information covering almost the entire genome of each strain. Importantly, all were clade I strains, supporting our conclusion that H. cinaedi sensu stricto is a human-adapted lineage in the HCCM complex.

    DOI: 10.1099/mgen.0.000830

    Web of Science

    Scopus

    PubMed

  • Global population structure of the <i>Serratia marcescens</i> complex and identification of hospital- adapted lineages in the complex

    Ono, T; Taniguchi, I; Nakamura, K; Nagano, DS; Nishida, R; Gotoh, Y; Ogura, Y; Sato, MP; Iguchi, A; Murase, K; Yoshimura, D; Itoh, T; Shima, A; Dubois, D; Oswald, E; Shiose, A; Gotoh, N; Hayashi, T

    MICROBIAL GENOMICS   8 ( 3 )   2022.3   ISSN:2057-5858

     More details

    Language:English   Publisher:Microbial Genomics  

    Serratia marcescens is an important nosocomial pathogen causing various opportunistic infections, such as urinary tract infec-tions, bacteremia and sometimes even hospital outbreaks. The recent emergence and spread of multidrug-resistant (MDR) strains further pose serious threats to global public health. This bacterium is also ubiquitously found in natural environments, but the genomic differences between clinical and environmental isolates are not clear, including those between S. marcescens and its close relatives. In this study, we performed a large-scale genome analysis of S. marcescens and closely related species (referred to as the ‘S. marcescens complex’), including more than 200 clinical and environmental strains newly sequenced here. Our analysis revealed their phylogenetic relationships and complex global population structure, comprising 14 clades, which were defined based on whole-genome average nucleotide identity. Clades 10, 11, 12 and 13 corresponded to S. nematodiphila, S. marcescens sensu stricto, S. ureilytica and S. surfactantfaciens, respectively. Several clades exhibited distinct genome sizes and GC contents and a negative correlation of these genomic parameters was observed in each clade, which was associated with the acquisition of mobile genetic elements (MGEs), but different types of MGEs, plasmids or prophages (and other inte-grative elements), were found to contribute to the generation of these genomic variations. Importantly, clades 1 and 2 mostly comprised clinical or hospital environment isolates and accumulated a wide range of antimicrobial resistance genes, including various extended-spectrum β-lactamase and carbapenemase genes, and fluoroquinolone target site mutations, leading to a high proportion of MDR strains. This finding suggests that clades 1 and 2 represent hospital-adapted lineages in the S. marc-escens complex although their potential virulence is currently unknown. These data provide an important genomic basis for reconsidering the classification of this group of bacteria and reveal novel insights into their evolution, biology and differential importance in clinical settings.

    DOI: 10.1099/mgen.0.000793

    Web of Science

    Scopus

    PubMed

  • 当科での膵移植後真菌症の検討

    野口 浩司, 加来 啓三, 岡部 安博, 西田 留梨子, 下野 信行, 中村 雅史

    移植   57 ( Supplement )   s298_1 - s298_1   2022   ISSN:05787947 eISSN:21880034

     More details

    Language:Japanese   Publisher:一般社団法人 日本移植学会  

    <p>【背景】膵移植後の真菌感染症は臓器生着率、患者死亡率に相関するとされる一方で、抗真菌剤の予防投与を支持するエビデンスは限られており、全例予防投与を行うことに対してのコンセンサスは得られていない。</p><p>【方法】当科ではこれまで膵移植患者に対する抗真菌薬予防投与を行っておらず、移植後の真菌症発症率を検討した。対象は2015年から2022年4月までに当科で行った膵移植患者47例とし、真菌症の定義は術後半年以内に「β-D-グルカン陽性」または「培養で真菌陽性」で、かつ臨床症状があり真菌症として加療したものとした。</p><p>【結果】47例中10例(20%)が真菌症と診断された。移植後から発症まで期間は中央値13日(4-113日)であった。真菌症の発症と術後半年以内の移植膵機能廃絶とは有意に相関していた(P<.001)。臓器保存液の培養では31例中1例(2%)が、ドナー十二指腸液培養では17例中12例(71%)がカンジダ陽性であった。いずれかがカンジダ陽性であった13例中4例(31%)が、術後真菌症をきたしたのに対して、どちらも培養陰性であった5例は真菌症を認めなかった(P=.082)。</p><p>【結語】膵移植後真菌症は術後早期に発症し、その後の移植膵機能廃絶と有意に相関していた。また真菌症発症のリスク評価に臓器保存液と十二指腸液培養が有用である可能性が示唆された。</p>

    DOI: 10.11386/jst.57.supplement_s298_1

    CiNii Research

▼display all

Presentations

▼display all