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Biomedical subjects

T Nagatake

Publications and source records attributed to T Nagatake.

At least 73 records · Page 4Linked to original sources
PubMed1998

Combination therapy with fluconazole and flucytosine for cryptococcal meningitis in Ugandan patients with AIDS.

We performed a randomized trial in which combination therapy with fluconazole and short-term flucytosine was compared with fluconazole monotherapy in 58 patients with AIDS-associated cryptococcal meningitis (CM). Thirty of these patients were randomized to receive combination therapy with fluconazole, 200 mg once a day for 2 months, and flucytosine, 150 mg/(kg.d) for the first 2 weeks, and 28 were randomized to receive monotherapy with fluconazole at the same dose for 2 months. Patients in both groups who survived for 2 months received fluconazole as maintenance therapy at a dose of 200 mg three times per week for 4 months. The combination therapy prevented death within 2 weeks and significantly increased the survival rate among these patients (32%) at 6 months over that among patients receiving monotherapy (12%) (P = .022). The combination therapy also resulted in a significant decrease in the severity of headache after 1 month of treatment, compared with monotherapy (P = .005). No serious adverse reactions were observed in patients receiving either regimen. These data indicate that treatment with fluconazole and short-term flucytosine is a cost-effective and safe regimen that improves the quality of life for patients with AIDS-associated CM in developing countries where human immunodeficiency virus is endemic.

AIDS-Related Opportunistic Infections↗
PubMed1998

Isolation of pathogenic bacteria from induced sputum from hospitalized children with pneumonia in Bangladesh.

A prospective study was carried out on 157 patients admitted to a paediatric hospital in Dhaka, Bangladesh to determine the bacteria present in the induced sputum of paediatric patients with X-ray proven pneumonia. Their ages ranged from 21 days to 11 years; 65 per cent of them were male and 35 per cent were female. The most affected age group was between 6 months and 2 years old. Respiratory secretions produced by induced cough were taken by swab from the oropharynx for culture and smear. The predominant bacteria were Haemophilus influenzae, Streptococcus pneumoniae, Branhamella catarrhalis and Gram-negative bacilli. Serotyping of H. influenzae revealed that 76 per cent were non-typable and 18 per cent were of type b; 23.5 per cent of isolates of H. influenzae were beta-lactamase producing. MIC90 of penicillin against S. pneumoniae and H. influenzae were 0.025 and 3.13 micrograms/ml respectively. Ampicillin, penicillin G (benzylpenicillin), amoxycillin, and gentamicin were administered for the treatment of these patients. All cases were apparently improved, on the basis of clinical evaluation, and discharged from the hospital.

Age Distribution↗
PubMed1998

Attachment of nontypable Haemophilus influenzae to human pharyngeal epithelial cells mediated by a ganglioside receptor.

Nontypable Haemophilus influenzae (NTHI) is one of the major pathogens of human respiratory infections and has the ability to attach to pharyngeal epithelial cells. We characterized the epithelial cell receptor to which NTHI bind. Neuraminidase pretreatment of pharyngeal epithelial cells resulted in a significant decrease in NTHI attachment, suggesting sialic acid as an important component of the receptor. The attachment was not decreased in NTHI pretreated with 1,000 microg/ml of fucose, N-acetyl-neuraminic acid, N-acetyl-glucosamine, N-acetyl-galactosamine, acetyl-salicylic acid and colominic acid. Only treatment with gangliosides D1a, D1b and D2 at a concentration of 12.5 microg/ml significantly decreased the attachment. On the other hand, treatment with gangliosides M1, M2, M3, D3, T1b and asialoganglioside M1 did not decrease the attachment of NTHI. Only ganglioside D2 inhibited the attachment significantly at a concentration of 12.5 ng/ml. Other isolates of NTHI showed a decrease in attachment after treatment with ganglioside D2. Treatment of cells with anti-human GD2 monoclonal antibody also decreased the attachment of NTHI in a dose-dependent manner. This study indicates that sialic acid glycoconjugate, GD2, is one of the receptors of NTHI on human pharyngeal epithelial cells.

Antibodies, Monoclonal↗
PubMed1998

[Clinical study of MRSA carrier in sputum].

We studied the clinical aspects of 25 patients (17 male, 8 female, median age 79.4 y.o.) whom MRSA was colonized in sputum from 1989 January to 1994 December. Main underlying diseases were 16 chronic bronchitis and 15 Cerebrovascular damage. Nineteen cases (76%) had catheters, for example 15 urinary tract catheters and 8 nasogastric tube. Twenty-two cases (88%) used previous antimicrobial agent. Fifteen cases (60%) were dead during previous period, and that 14 cases were dead because of respiratory failure within a year after MRSA was colonized in sputum. Nine cases (36%) were able to remove MRSA in sputum, but mortality rate was not different whether MRSA disappear or continue, MIC50 against MRSA (19 strains) were minocycline 12.5 micrograms/ml, arbekacin 6.25 micrograms/ml, vancomycin 0.78 microgram/ml and 16 cases (84.2%) were coagulase type II.

Aged↗
PubMed1998

[A fatal case of streptococcal toxic shock-like syndrome probably caused by acupuncture].

A 41-year-old male received acupuncture in the right shoulder for the sake of arthralgia. Three days after acupuncture he was admitted due to severe epigastralgia. Erythematous change and swelling were observed around the right shoulder. A study by magnetic resonance showed an increased signal intensity in a portion of the right subscapular muscle. Four hours after admission he became hypotensive. The erythematous and necrotic change in the right shoulder skin rapidly spread. Excisional debridement in the right lateral chest wall was immediately done. However, the patient died one day after admission despite administration of a high-dose ampicillin and other supportive therapies. Bacteriological and histological examinations confirmed severe streptococcal myositis. This is a case report of toxic shock-like syndrome probably caused by acupuncture.

Acupuncture Therapy↗
PubMed1997

The increasing burden of disease in Bangladeshi children due to Haemophilus influenzae type b meningitis.

A laboratory-based study of diagnosed bacterial meningitis in the national paediatric hospital identified 852 cases of meningitis in the 8-year period 1987-1994. There were 587 culture-positive cases, of which Haemophilus influenzae (47%) and Streptococcus pneumoniae (32%) accounted for 80%. H. influenzae showed a remarkable increase of 700% during the study period. Most of the H. influenzae cases (90%) occurred in the 1st 2 years of life. Analysis of culture-negative specimens by antigen detection in the last 2 years also revealed the predominance of H. influenzae (71.4%) and S. pneumoniae (22.4%). Typing of H. influenzae isolates during this time showed that 98% of the strains were type b. This retrospective hospital-based study indicated a pronounced increase in the incidence of H. influenzae meningitis and strongly supports the need for large-scale Hib vaccination for young children. However, such nationwide intervention will probably need to be based on a prospective on a prospective and population-based surveillance of H. influenzae infections.

Age Distribution↗
PubMed1997

Moraxella (Branhamella) catarrhalis adherence to human bronchial and oropharyngeal cells: the role of adherence in lower respiratory tract infections.

To study the role of Moraxella (subgenus Branhamella) catarrhalis (B. catarrhalis) adherence to airway cells in lower respiratory tract infections, the in vitro attachments of B. catarrhalis to upper airway (oropharyngeal) and lower airway (bronchial) epithelial cells were compared. The adherence of 4 strains (1 nonfimbriated and 3 fimbriated) of B. catarrhalis to respiratory tract epithelial cells collected from 11 patients with chronic pulmonary disease (CPD) and 11 healthy individuals was evaluated. Both the fimbriated and nonfimbriated strains showed increased attachment to oropharyngeal cells in the CPD patients (mean +/- SEM; 25.0 +/- 3.2/cell; P < 0.01) when compared to the control subjects (12.1 +/- 1.1/cell). On the average, the attachment to bronchial cells was 6.1 to 13.6 times greater per surface area (bacteria/micron2) than the attachment to oropharyngeal cells. The fimbriated strains tended to adhere in higher numbers to bronchial cells (19.0 +/- 1.8/cell) than the nonfimbriated strain (8.7 +/- 1.2/cell), although there was no difference between the CPD and control groups. In conclusion, the attachment of B. catarrhalis to oropharyngeal cells may be an enhancing factor for colonization in the upper respiratory tract in patients with CPD, and elevated adherence of the bacteria to bronchial cells may suggest pathogenic importance when mucociliary function is impaired.

Adult↗
PubMed1997

[Coagulase typing of Staphylococcus aureus in the geriatric wards after introduction of preventive measures of hospital infection].

In the early 1980's methicillin-resistant Staphylococcus aureus (MRSA) was reported as a major pathogenic organism of geriatric hospital infection in Japan. At the same time in our geriatric wards, including 190 beds, MRSA infection was prevalent. In the early 1980's in our geriatric wards minocycline was one of the most sensitive antibiotics to MRSA isolated in our wards and used frequently against MRSA pneumonias and bacteremia. In the late 1980's resistant strains of MRSA to minocycline rapidly increased because vancomycin was not allowed to introduced for treatment of MRSA before 1991 in Japan. At the same period the predominant coagulase type changed from type II to type VII. To decrease minocycline-resistant strains to MRSA after 1987, use of minocycline was limited. Moreover since Oct. 1991 to decrease nosocomial infections some active preventive measures against hospital infection, including limited use of 2nd and 3rd cephems, were taken. In this study changing patterns of coagulase type of Staphylococcus aureus were discussed. At least 4 years was needed to find out that the predominant coagulase type changed from type VII to type II again in 1991. In this study about 22 antimicrobial agents MICs of 313 strains of Staphylococcus aureus isolated between March 1992 and June 1993 were determined and compared with the data of MICs before introduction of preventive measures. The pattern of susceptibility to MINO was in part improved. Thus the some sensitive strains of S. aureus were observed again in our geriatric wards. Interestingly indeed it took approximately 5 years to find out the emergence of sensitive strains to MINO since limitation of use of MINO in 1987.

Bacterial Typing Techniques↗
PubMed1997

[A case of pseudomembranous enterocolitis which diagnosis was delayed in the outpatient clinic].

A 71-year-old male visited our hospital because of diarrhea. At first we suspected infectious colitis and levofloxacin (300 mg/day) was administered for four days. But the diarrhea continued, so performed a barium enema after about 3 weeks from onset. Round polyposis from the rectum to the sigmoid colon were found. Colonoscopy was suggested to the patient, but was rejected. However diarrhea continued and fever appeared. Ceftriaxone (1 g/day) and sparfloxacin (200 mg/day) were administered, but the symptoms increased. He was admitted about 6 weeks from onset, and the colonoscopy showed multiple round yellow-white pseudomembranes. Pseudomembranous enterocolitis diagnosed because Clostridium difficile and its toxin were positive in the feces. After oral administration of vancomycin (1.5 g/day) was started, the symptoms alleviated rapidly and disappearance of pseudomembrane was confirmed by colonoscopy.

Aged↗
PubMed1997

[A clinical study of skin flora in patients with MRSA colonization after introduction of preventive measures of hospital infection in a geriatric ward].

In early 1980's methicillin-resistant Staphylococcus aureus (MRSA) was reported as a major pathogenic organism of geriatric hospital infection in Japan. At the same time in the geriatric hospital MRSA infection was prevalent. To decrease nosocomial infections some active preventive measures against hospital infection were taken since Oct. 1991. After introduction of preventive measures of hospital infection in the geriatric ward (190 beds) nosocomial bacteremia and pneumonia were markedly decreased in comparison of episode number before introduction of prevention. However several patients with MRSA colonization were observed every month. The aim of this clinical study was to clear how frequent MRSA was isolated from skin. Consequently 3 strains (3.4%) of MRSA were observed in 86 cultured skin. In conclusion we considered frequency of MRSA colonization frequency of MRSA colonization on skin was not so high but rather very low under the preventive measures.

Aged↗
PubMed1997

Nitrite reductase from Pseudomonas aeruginosa induces inflammatory cytokines in cultured respiratory cells.

Persistent infection with Pseudomonas aeruginosa increases interleukin-8 (IL-8) levels and causes dense neutrophil infiltrations in the airway of patients with chronic airway diseases. To investigate the role of P. aeruginosa infection in IL-8 production in the airway of these patients, we examined whether cell lysates of P. aeruginosa could cause IL-8 production from human bronchial epithelial cells. Diluted sonicated supernatants of P. aeruginosa (SSPA) with a mucoid or nonmucoid phenotype stimulated human bronchial epithelial (BET-1A) cells to produce IL-8. In this study, we have purified a 59-kDa heat-stable protein with IL-8-inducing activity from the SSPA by sequential ion-exchange chromatography. The N-terminal sequence of this purified protein completely matched a sequence at the N-terminal part of the mature protein of nitrite reductase from P. aeruginosa. In addition, immunoblotting with a polyclonal immunoglobulin G (IgG) against recombinant Pseudomonas nitrite reductase demonstrated a specific binding to the purified protein. Furthermore, the immunoprecipitates of the SSPA with a polyclonal IgG against recombinant nitrite reductase induced a twofold-higher IL-8 production in the BET-1A cell culture than did the immunoprecipitates of the SSPA with a control IgG. These lines of evidence confirmed that Pseudomonas nitrite reductase was responsible for IL-8 production in the BET-1A cells. The purified nitrite reductase induced maximal expression of IL-8 mRNA in the BET-1A cells at 1 to 3 h after stimulation, and the IL-8 mRNA expression declined by 8 h after stimulation. New protein translation was not required for nitrite reductase-mediated IL-8 mRNA expression in the BET-1A cells. Nitrite reductase stimulated the BET-1A cells, as well as human alveolar macrophages, pulmonary fibroblasts, and neutrophils, to produce IL-8. In contrast, nitrite reductase induced significant levels of tumor necrosis factor alpha and IL-1beta protein only in human alveolar macrophages. These data support the notion that nitrite reductase from P. aeruginosa induces the production of inflammatory cytokines by respiratory cells and may contribute to the pathogenesis of chronic airway diseases and persistent P. aeruginosa infection.

Bronchi↗
PubMed1997

Serotypes of Streptococcus pneumoniae causing invasive childhood infections in Bangladesh, 1992 to 1995.

One hundred sixty-five invasive Streptococcus pneumoniae strains were isolated from children under five at Dhaka Shishu (Children's) Hospital during the period 1992 to 1995. Ninety-four strains were from cerebrospinal fluid, and 71 were from blood. More than 91% of the strains were isolated from patients aged 24 months or less. Predominant serotypes were, in descending order 7F, 12F, 14, 15B, 18, 5, and 22A. These comprised 70% of all isolates. The marked differences in serotype distribution in different countries indicate the need for a sentinel surveillance study for the countries of South Asia, particularly Bangladesh, China, India, and Pakistan.

Bacterial Vaccines↗
PubMed1997

[Comparative features of pneumonia associated with influenza].

Three manifestations of pneumonia that are associated with influenza are well recognized: primary influenza viral pneumonia, secondary bacterial pneumonia and mixed viral and bacterial pneumonias. In an outbreak of influenza, primary influenza viral pneumonia has occurred predominantly. After a typical onset of influenza, there is a rapid progression of fever, cough and dyspnea. Physical examination and chest roentgenography reveal bilateral findings but no consolidation. A Gram stain of the sputum fails to reveal significant bacteria, and bacterial culture yield sparse growth of normal flora, where as viral cultures yield high titers of influenza virus. Such patients do not respond to antibiotics. Secondary bacterial pneumonia often produces a syndrome that is clinically distinguishable from that of primary viral pneumonia. Recrudescence of fever is associated with symptoms and signs of bacterial pneumonia such as cough, sputum production, and an area of consolidation detected on physical examination and chest roentgenography. Gram staining and the culture of sputum reveals a predominance of a bacterial pathogen, most often H. influenzae, S. pneumoniae, B. catarrhalis, or S. aureus. Such patients usually respond to specific antibiotic therapy. During an outbreak of influenza many cases an observed that do not clearly fit into either of the aforementioned categories. The disease is not relentlessly progressive, and yet the fever pattern may not be biphasic. These patients may have primary viral, secondary bacterial, or mixed viral and bacterial infection of the lung.

Humans↗
PubMed1996

Attachment of Moraxella catarrhalis to pharyngeal epithelial cells is mediated by a glycosphingolipid receptor.

Moraxella catarrhalis is one of the major pathogens of respiratory infections and has the ability to attach to the pharyngeal cells iva fimbriae. We characterized the epithelial cell receptor to which fimbriate M. catarrhalis binds. Neuraminidase pretreatment of pharyngeal epithelial cells resulted in a significant decrease of M. catarrhalis attachment, suggesting interaction with the sialic acid component. The attachment was not decreased in M. catarrhalis pretreated with 2 and 1 mg/ml of fucose, N-acetyl-neuraminic acid, N-acetyl-glucosamine, N-acetyl-galactosamine, acetyl-salicylic acid and colominic acid. However, M. catarrhalis treated with gangliosides M1, M2, D1a, D1b and T1a at a concentration of 2.5 micrograms/ml had significantly decreased the attachment compared to the control. In contrast treatment with gangliosides M3 and asialoganglioside M1 did not decrease the attachment of M. catarrhalis and thereby provided evidence for specificity of the inhibition. Concentration dependent effects of ganglioside M2 on the attachment were also observed. Other fimbriate isolates of M. catarrhalis showed decrease in attachment after treatment with ganglioside M2. However there was no effect on attachment when a nonfimbriate isolate was treated with ganglioside M2. This study indicates that the receptor of fimbriate M. catarrhalis on pharyngeal epithelial cells resides in the sequences of ganglioside M2.

Bacterial Adhesion↗
PubMed1996

Rapid increase of pneumococcal resistance to beta-lactam and other antibiotics in isolates from the respiratory tract (Nagasaki, Japan: 1975-1994).

The susceptibility of 101 pneumococcal isolates from the respiratory tract during 1991-1994 was examined and compared with the susceptibility of isolates over the period of 1975-1990. A rapid increase of resistance was seen not only to penicillin but also other antimicrobial agents. During 1991-1994, 38% of all the isolates were resistant to penicillin. The rates of resistance during this period were 16-23% for three newer cephalosporins, 18% for imipenem, 69% for tetracycline, 31% for erythromycin, 20% for chloramphenicol and 9% for clindamycin. The use of antibiotics within one month prior to pneumococcal isolation was correlated with penicillin resistance (P < 0.05). Serotyping of the isolates by antiserum revealed differences in predominant types between penicillin-resistant (19F, 23F,4) and -susceptible isolates (15, 4, 11A). Our data suggests that anti-pneumococcal antibiotics should be carefully chosen on the basis of susceptibility tests.

Adult↗
PubMed1996

Airway interleukin-8 in elderly patients with bacterial lower respiratory tract infections.

We investigated the interleukin-8 (IL-8) levels and neutrophil numbers in the sputum of 9 elderly patients with lower respiratory tract infections, including Pseudomonas aeruginosa infection, before and after treatment with various antimicrobial agents. The IL-8 levels in sputum supernatants and the neutrophil numbers in sputum smears from 9 patients decreased significantly after the elimination of the causative respiratory pathogens. We also demonstrated that human recombinant IL-8 at a range of 6.25-25 ng/ml significantly enhanced opsonophagocytic killing of P. aeruginosa immunotype-1 strain by human neutrophils in the presence of a serotype-specific anti-lipopolysaccharide monoclonal antibody and fresh normal human serum. These data suggest that the level of IL-8 production in the airways of patients with lower respiratory tract infections is dependent on bacterial densities, and indicate the important role of IL-8 not only in neutrophil migration but also in opsonophagocytic killing of bacteria in the lower respiratory tract.

Aged↗