Biomedical subjects

K Tomono

Publications and source records attributed to K Tomono.

At least 109 records · Page 6Linked to original sources

PubMed1997

Rapid prediction of rifampin susceptibility of Mycobacterium tuberculosis.

We evaluated the relationship between rifampin (RIF) susceptiblility and amino acid substitution in rpoB gene of Mycobacterium tuberculosis and the usefulness of rpoB gene sequencing in the rapid prediction of RIF susceptibility of M. tuberculosis in clinical specimens. A total of 76 genetic alterations in the 69 bp core region of rpoB gene were detected in 74 of 130 M. tuberculosis strains. Examination of the correlation between the minimum inhibitory concentrations (MICs) of RIF and amino acid substitutions in the 69 bp core region of rpoB gene revealed that all 43 strains containing amino acid substitution with Leu or Trp in codon 531 showed RIF-resistant phenotypes, with MICs > or = 64 microg/ml. In contrast, a variable level of RIF susceptibility was observed among strains containing amino acid substitutions in either codon 516 or codon 526. In the clinical study, we tested 26 sputum samples, two gastric lavages, and one synovial fluid sample obtained from patients with tuberculosis. The RIF susceptibility predicted by direct rpoB sequencing was satisfactorily compatible with the results of the RIF-susceptibility test and the MICs of RIF against isolated organisms. Our results suggest that rpoB gene sequencing is useful for the detection of M. tuberculosis in clinical samples as well as the rapid prediction of RIF susceptibility of these strains.

Amino Acid Sequence↗

PubMed1997

[Relationship between streptomycin susceptibility and rpsL mutations of Mycobacterium tuberculosis strains].

The relationship between streptomycin (SM) susceptibility and rpsL mutations of Mycobacterium tuberculosis strains was studied. Of 18 clinically isolated SM-resistant M.tuberculosis strains, mutation was suspected in 9 strains (50%) with SM MICs of > or = 256 micrograms/ml by PCR-single strand conformation polymorphism targeting rpsL gene. On the other hand, using PCR-direct sequence method, amino acid substitution caused by single nucleotide point mutation in rpsL gene was demonstrated in 11 out of 18 strains (61%). The same amino acid substitution at codon 43 (Lys-->Arg) was observed in all 11 strains with SM MICs of > or = 256 micrograms/ml. In addition, PCR products obtained from these 11 strains could not be cut by a restriction enzyme, Mbo II, while H37Rv strain and the other 32 strains with SM MICs of < 256 micrograms/ml were cut into 2 fragments. In conclusion, our results suggest that highly SM-resistant M.tuberculosis strains with MICs of > or = 256 micrograms/ml could be rapidly and easily detected by the restriction enzymatic method.

Antibiotics, Antitubercular↗

PubMed1996

Antimicrobial activity of superoxidized water.

We tested the antimicrobial activity of superoxidized water against methicillin-sensitive Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, Serratia marcescens, Escherichia coli, Pseudomonas aeruginosa and Burkholderia cepacia. The number of bacteria was reduced below detection limit following incubation in superoxidized water for 10 s. The bactericidal activity of superoxidized water was similar to that of 80% ethanol, but superior to that of 0.1% chlorhexidine and 0.02% povidone iodine. We conclude that superoxidized water is a low cost but powerful disinfectant.

Burkholderia cepacia↗

PubMed1996

[Invasive pulmonary aspergillosis caused by aspiration of polluted water after nearly drowning].

A 21-year-old male nearly drowned in a reservoir by a traffic accident and he aspirated a large mount of polluted water containing Aspergillus fumigatus. On admission to our hospital, he was alert but cyanotic. Chest rentogenograms showed scatter infiltrative shadows in bilateral lung fields. We administered methylpredonizolon and antimicrobial agents immediately because of respiratory failure which was rapidly progressing. During the following six days, infiltrative shadows diminished but multiple nodular shadows in both lung fields appeared. The diagnosis of pulmonary aspergillosis was confirmed by serological and microbiological studies. Intravenous amphotericin B and oral itraconazol were administrated, and clinical improvement was observed.

Adult↗

PubMed1996

Evaluation of susceptibility of gram-positive and -negative bacteria to human defensins by using radial diffusion assay.

Defensins are small cationic bactericidal peptides present abundantly in the granules of polymorphonuclear neutrophils (PMNs). Human PMNs contain four defensins termed HNP-1 to HNP-4. We used a new assay system in agar plates, the radial diffusion assay, to evaluate the effects of human defensins against gram-positive and -negative bacteria. A crude mixture of HNP-1, -2, and -3 (crude HNPs) was purified from human PMN extracts by reversed-phase high-pressure liquid chromatography (RP-HPLC). The different components were later separated by RP-HPLC and gel permeation chromatography. We compared the antibacterial activities of purified HNP-1, -2, and -3 against Escherichia coli, Pseudomonas aeruginosa, methicillin-susceptible Staphylococcus aureus, and methicillin-resistant S. aureus strains using the radial diffusion assay. The antibacterial activities of HNP-1 and HNP-2 against all strains tested were similar to those of the crude HNPs, but the activity of HNP-3 was less than those of the other defensins. To quantitate the activities of HNPs against different bacteria, we defined the minimal dose of crude HNPs forming a detectable clear zone around the bacteria as the minimal inhibitory dose (MID) and determined the MIDs for 10 strains of E. coli, 12 strains of P. aeruginosa, 10 strains of methicillin-susceptible S. aureus, and 12 strains of methicillin-resistant S. aureus isolates, including clinical isolates. In general, the MIDs of the HNPs were similar against similar bacterial species. However, the MIDs for P. aeruginosa were higher than those for the other organisms tested. The radial diffusion assay is suitable as a screening test for measuring the susceptibilities of isolates to defensins, because it is sensitive and simple and has good reproducibility.

Anti-Bacterial Agents↗

PubMed1996

[Differential diagnosis of tuberculous pleurisy by the measurement of cytokine concentration in pleural effusion].

Pleural fluids obtained from 26 patients with tuberculous pleurisy (T-group), 11 with parapneumonic pleurisy (B-group) and 21 with malignant pleurisy (M-group) were tested for their biologic parameters and cytokine concentrations. 1) The average age of T-group was over 10 years lower than that of M-group with a statistically significant difference. 2) The average CRP value of B-group and the positivity on PPD skin test of T-group were higher than those of the other groups, respectively. 3) Yellowish pleural fluids were mainly observed in T- and B-group, while bloody pleural fluids were mostly seen in M-group with a statistically significant difference. The average total protein amount and adenosine deaminase value in pleural fluid significantly increased in T-group. The percentage of polymorphonuclear leukocytes showed a significant increase in B-group, while lymphocytes significantly increased in T-group with a statistically significant difference. 4) Although no significant difference in concentrations of IL-1 beta, IL-2, IFN-gamma and TNF-alpha in serum was noticed among the three groups, the average concentrations of IFN-gamma and TNF-alpha in pleural fluid in T-group were significantly higher than those in the other groups. 5) TNF-alpha-mRNA of mononuclear cells in pleural fluid was strongly expressed in 3 out of 11 patients of T-group, while no expression was observed in 6 patients of M-group. In conclusion, the measurement of concentrations of two kinds of cytokines in pleural fluid, IFN-gamma and TNF-alpha, may be clinically useful for the differential diagnosis of tuberculous pleurisy from parapneumonic pleurisy and malignant pleurisy.

Adult↗

PubMed1996

[Clinical evaluation of sulbactam/cefoperazone for lower respiratory tract infections. Correlation between the efficacy of sulbactam/cefoperazone and beta-lactamase].

The efficacy and safety of sulbactam/cefoperazone (SBT/CPZ) were evaluated in 42 patients with respiratory tract infections, including pneumonia (29 patients) and lower respiratory tract infections (5 patients). Overall clinical efficacy rates (excellent + good) were 79% in pneumonia and 80% in respiratory tract infections in 34 patients evaluated for clinical efficacy. It was excellent that the clinical efficacy rate was 92% in mild and moderate pneumonia. Pathogens isolated from sputa were 31 strains, including 8 strains of Pseudomonas aeruginosa, 7 of Streptococcus pneumoniae, 3 of Staphylococcus aureus and 3 of Haemophilus influenzae. Since the isolates were eradicated in 18 strains, replaced in 3, unchanged in 2 and unknown in 8, the overall eradication rate was 91%. The eradication rates were 89% in beta-lactamase producing strains and 100% in beta-lactamase positive sputum, and excellent or good in 19 (83%) of 23 patients with beta-lactamase negative sputum. The eradication rate was 88% in 5 patients with beta-lactamase positive sputum. One patient experienced a moderate rash. Abnormal laboratory test values were observed in 10 patients (26.3%), but these abnormalities were mild and transient. These results suggested that SBT/CPZ was effective and safe for the treatment of respiratory tract infections caused by beta-lactamase producing as well as beta-lactamase non-producing bacteria.

Aged↗

PubMed1995

[Isolation of Cryptococcus neoformans from environments (pigeon excreta) in Nagasaki].

Cryptococcosis is one of the serious deep-seated mycoses in immunocompromised patients, especially those with AIDS. Cryptococcus neoformans ordinarily lives in natural environments such as soil and reproduces in pigeon excreta. It spreads in the air and infects human by inhalation. We isolated C. neoformans from pigeon excreta in hospitals, private houses, parks in Nagasaki from October to December in 1994. C. neoformans was isolated from 4 of 8 samples (50%) of pigeon excreta and the isolation rate increased to 80% (4/5) if they were weathered excreta. Two patients with pulmonary cryptococcosis occurred in the last two years in the area where C. neoformans was isolated during that period. Epidemiological studies of clinical isolates and environmental isolates are important to determine its origin of infection and the route of transmission.

Animals↗

PubMed1995

Trends in antimicrobial resistance of Streptococcus pneumoniae in Japan.

A total of 184 isolates of Streptococcus pneumoniae were recovered from the sputa of patients over a 5-year period in the Nagasaki area and were examined. A total of 30 strains were resistant to penicillin (MIC, > or = 0.10 micrograms/ml), 13 of which belonged to serotype 19B. These strains showed decreased susceptibility to other antimicrobial agents. Vancomycin, cefpirome, and imipenem were the most active agents tested.

Anti-Bacterial Agents↗

PubMed1995

Random amplified polymorphic DNA analysis of clinically and environmentally isolated Cryptococcus neoformans in Nagasaki.

We examined clinical (pulmonary cryptococcosis and cryptococcal meningitis) and environmental (pigeon excreta) isolates of Cryptococcus neoformans var. neoformans (serotype A) in the southern Japanese prefecture of Nagasaki. The random amplified polymorphic DNA profiles obtained by using three primers revealed six patterns among 21 clinical isolates and three patterns among 8 environmental isolates. Pattern I was the most common (18 of 29 isolates) and was found among isolates obtained throughout the entire Nagasaki Prefecture. Patterns I, III, and IV were found among both clinical and environmental isolates. Patterns I and IV had a characteristic distribution, and in particular, pattern IV was isolated exclusively (five of six isolates) from isolates from Nagasaki City. Two environmental isolates from two locations associated strongly with two patients revealed identical random amplified polymorphic DNA patterns (patterns I and IV) for isolates from each patient. Our results suggest that clinical and environmental isolates belong to the same pool of C. neoformans isolates and that these isolates have certain geographic locations, although the number of isolated strains was limited.

Adolescent↗

PubMed1995

Infections in patients with liver cirrhosis and hepatocellular carcinoma.

Infections in immunocompromised hosts have been an important clinical problem. Patients with liver cirrhosis and/or hepatocellular carcinoma are at a high risk of infection due to multiple factors. Five hundred and two patients admitted with liver cirrhosis and/or hepatocellular carcinoma were evaluated for infection. The infection rate was not influenced by the etiology of hepatic diseases or the presence of hepatocellular carcinoma, however, it increased with the advance of clinical stages of liver cirrhosis and hepatoma. The respiratory tract and urinary tract were the most common sites of infection, being involved in 50% and 28% of cases, respectively. The major pathogens of respiratory tract infection were S. aureus, H. influenzae, and P. aeruginosa. Gram-negative bacteria was the common isolate from sputum and urine, and S. aureus was also common in gram-positive bacteria. The infection rate was high in patients who died although infections could rarely be implicated as the direct cause of death. These findings should be a guide for the clinicians in treating patients with liver cirrhosis and/or hepatocellular carcinoma who exhibit signs of infection.

Carcinoma, Hepatocellular↗

PubMed1995

[A rapid susceptibility test of Mycobacterium tuberculosis using hybridization protection assay].

The conventional drug susceptibility tests of Mycobacterium tuberculosis are time-consuming and usually require 2 to 4 weeks to obtain final results. In this study, we attempted to develop a novel method for rapid detection of drug-resistant M. tuberculosis using hybridization protection assay (HPA). Clinically isolated strains of M. tuberculosis including seven isoniazid (INH) susceptible strains and six resistant strains were used. The organisms grown on Ogawa egg medium were inoculated into Middlebrook 7H9 broth and cultured at 37 degrees C for one week. Then, the inoculum of each strain was prepared as a tenfold dilution of bacterial suspension at McFarland No. 0.5. The inocula were mixed with INH solutions to yield final concentrations of 0.1 and 1.0 micrograms/ml, and the resulting bacterial suspensions with or without test drug were cultured on the swaying plate at 37 degrees C for up to 5 days. At intervals, 50 microliters of each sample was withdrawn and subjected to the protocol of the HPA using acridinium-ester (AE) labeled DNA probe, and then the relative light unit (RLU) was read in a luminometer. In the case of the susceptible strains, a significant difference in the mode of increase in RLU ratio (% of RLU on day x/RLU on day 0) was observed between the INH-treated and drug-free control sets within three days of cultivation, while no such differences were seen in the case of the resistant strains.(ABSTRACT TRUNCATED AT 250 WORDS)

Acridines↗

PubMed1994

In-vitro and in-vivo activity of a new quinolone AM-1155 against Mycoplasma pneumoniae.

We investigated the in-vitro and in-vivo activity of a new quinolone AM-1155 against Mycoplasma pneumoniae, and compared it with ofloxacin, ciprofloxacin, lomefloxacin, tosufloxacin, erythromycin and minocycline. AM-1155 was the most potent agent in vitro of the quinolones tested. Its pre-treatment minimal inhibitory concentrations for 90% of the 41 strains (MIC90) was 0.06 mg/L. In contrast, pre-treatment MIC90 values for ofloxacin, ciprofloxacin, lomefloxacin, tosufloxacin, erythromycin, and minocycline were 1, 1, 2, 0.5, 0.0156, and 0.5 mg/L, respectively. Post-treatments MIC90s, which may reflect mycoplasmacidal potency, of AM-1155, ofloxacin, ciprofloxacin, lomefloxacin, tosufloxacin, erythromycin and minocycline were 0.125, 1, 2, 4, 0.5, 0.125 and 4 mg/L, respectively. In-vitro activities of antimicrobial agents were assessed in an experimental pulmonary infection model in Syrian golden hamsters. AM-1155 was the most effective agent among five antimicrobial agents (AM-1155, ofloxacin, tosufloxacin, erythromycin, minocycline) tested in terms of reduction in viable M. pneumoniae cells and in reducing macroscopic lung lesions. These results suggest that AM-1155 will be a useful antimicrobial agent for the treatment of M. pneumoniae infections.

Animals↗

PubMed1994

[Three cases of Pasteurella multocida infection in the respiratory tract].

Pasteurella multocida (P. multocida) is well recognized as "normal flora" in the upper respiratory tract of cats, dogs and other animals. Recently, various infections due to P. multocida in human have been noted as pulmonary infections in the patients with chronic pulmonary diseases as well as skin abscesses or septicemia after an animal bite or scratch. We report here three cases of respiratory tract infections caused by P. multocida. The first two patients had acute exacerbation of bronchiectasis caused by P. multocida and the other patients with pulmonary emphysema developed pneumonia. These three patients improved by antibiotic therapy. In Japan, P. multocida respiratory tract infection is rare, but it may become more common in the future. Therefore, it seems to be important to take this pathogen into consideration in the management of chronic lung disease.

Adult↗

PubMed1994

[Anaerobic respiratory infection--evaluation of methods of obtaining specimens].

Anaerobic cultures were performed on various kinds of specimens obtained from 67 patients with respiratory infections. The infections consisted of 33 cases of pneumonia, 14 cases of lung abscess, 6 cases of pyothorax, 9 cases of chronic lower respiratory tract infection, and 5 cases of infection of pulmonary cyst. Specimens included bronchoscopic specimens obtained using a single tube or protected catheter brush (PCB), transtracheal aspirate, percutaneous lung aspirate, aspirate using a suction tube through the tracheostomy or intubation tube, and pleural fluid. Anaerobes were isolated in 80% of pyothorax, 43% of lung abscess, and 15% of pneumonia (42% of aspiration pneumonia), respectively. Anaerobes isolated frequently in respiratory infections included Prevotella spp., Fusobacterium spp., and Peptostreptococcus spp. In regard to the type of specimen, bronchial aspirate obtained by bronchoscopy was useful in examination of pneumonia, and was useful as percutaneous lung aspirate in examination of lung abscess. But there was discrepancy of culture results between specimens obtained by different methods in the same patient. To confirm anaerobes as pathogens in respiratory infections, it is necessary to select an appropriate method to obtain specimens and to interpret the culture results comprehensively.

Adult↗

PubMed1994

[Clinical investigation of obstructive pneumonia with lung cancer].

Nineteen episodes (18 patients) of obstructive pneumonia occurring in 247 patients with lung cancer were clinically examined, and the following findings were obtained. 1) All 18 patients were male smokers, with an average of 64 years. 2) Body temperatures stood above 37 degrees C in 95% of the 19 episodes. Leukocytosis was detected in 41%, and neutrophilia was observed in 69%. CRP values were positive in all episodes. 3) The frequency of obstructive pneumonia according to the site of lung cancer was 13.2% in proximal tumors and 1.7% in peripheral tumors. Pathologically, the frequency was 5.2% in adenocarcinomas 7.6% in squamous cell carcinomas, 15.6% in small cell carcinomas and 9.1% in large cell carcinomas. Squamous cell carcinomas even in Stage I led to obstructive pneumonia at the rate of 13.0%. In contrast, higher frequency was observed in adenocarcinomas in Stage II or later and small cell carcinomas in Stage IIIB or later. 4) Obstructive pneumonia was detected at the time of discovery of lung cancer in 48% of the 18 patients, and during treatment and in the terminal stage in 26% respectively. 5) Chest X-ray examinations showed that 42% of the pneumonia cases were lobar pneumonia and 11% had pleural effusion. 6) In expectorated sputum, 50% of bacteria isolated were gram-negative, 10% were gram-positive and 40% were unknown. 7) Most of the bacteria isolated from expectorated sputum showed a good susceptibility to antimicrobial agents, but those proved clinically ineffective. 8) The prognosis of obstructive pneumonia was significantly affected by performance status and levels of total protein and choline-esterase.

Aged↗

PubMed1994

In vitro and in vivo activities of sparfloxacin against Mycoplasma pneumoniae.

The in vitro and in vivo activities of sparfloxacin against Mycoplasma pneumoniae were compared with those of erythromycin, levofloxacin, ofloxacin, and minocycline. The MICs of sparfloxacin, erythromycin, levofloxacin, ofloxacin, and minocycline for 90% of the 43 M. pneumoniae strains tested were 0.063, 0.016, 0.5, 1, and 0.5 microgram/ml, respectively. In the experimental pulmonary M. pneumoniae infection model in Syrian golden hamsters, sparfloxacin was as effective as erythromycin when orally administered at 15 mg/kg twice daily for 5 days and more effective than erythromycin when orally administered at 10 mg/kg once daily for 5 days. Sparfloxacin was more effective than levofloxacin and ofloxacin in both dosing regimens. The peak concentrations of sparfloxacin in hamster sera after administration of single oral doses of 15 mg/kg were almost the same as those in human sera after administration of single oral doses of 200 mg (the usual clinical dose), and the half-life of sparfloxacin in hamster serum was shorter than that in human serum after administration of a single oral dose of 200 mg. These results suggest that sparfloxacin may be clinically useful for the treatment of M. pneumoniae infections.

Animals↗

PubMed1994

In vitro and in vivo activities of macrolides against Mycoplasma pneumoniae.

We investigated the in vitro and in vivo activities of macrolides against Mycoplasma pneumoniae. In vitro MICs of azithromycin, erythromycin, clarithromycin, and roxithromycin were determined. Azithromycin was the most potent antimicrobial agent tested in vitro. Its MIC for 90% of the strains was 0.00024 micrograms/ml. MICs for 90% of the strains of erythromycin, clarithromycin, and roxithromycin were 0.0156, 0.0078, and 0.03125 micrograms/ml, respectively. In vivo activities were assessed in a pulmonary infection model with Syrian golden hamsters. We evaluated the in vivo effects on reduction of viable M. pneumoniae cell counts and on reduction of microscopic and macroscopic histopathologies for azithromycin, erythromycin, and clarithromycin given at 10 mg/kg once daily for 1 and 3 days and given at 15 mg/kg twice daily for 2.5 and 5 days. Azithromycin was significantly more effective than erythromycin or clarithromycin in the same regimens. Especially at 10 mg/kg once daily for 1 day, only azithromycin was significantly effective in the reduction of viable M. pneumoniae cells and histopathologies. These results show that azithromycin is more efficacious than the other drugs tested against M. pneumoniae pneumonia in hamsters. These data suggest that clinical studies of macrolides in human patients are warranted.

Animals↗