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11 pages, 955 KiB

Open AccessArticle

High Incidence of Metastatic Infections in Panton-Valentine Leucocidin-Negative, Community-Acquired Methicillin-Resistant Staphylococcus aureus Bacteremia: An 11-Year Retrospective Study in Japan

by Hitoshi Kawasuji, Yoshihiro Ikezawa, Mika Morita, Kazushige Sugie, Mayu Somekawa, Masayoshi Ezaki, Yuki Koshiyama, Yusuke Takegoshi, Yushi Murai, Makito Kaneda, Kou Kimoto, Kentaro Nagaoka, Hideki Niimi, Yoshitomo Morinaga and Yoshihiro Yamamoto

Antibiotics 2023, 12(10), 1516; https://doi.org/10.3390/antibiotics12101516 - 6 Oct 2023

Cited by 1 | Viewed by 1968

Abstract

Panton-Valentine leucocidin (PVL)-negative community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was originally disseminated in Japan and has since replaced healthcare-associated MRSA (HA-MRSA). However, the clinical characteristics of CA-MRSA bacteremia (CA-MRSAB) compared with those of HA-MRSA bacteremia (HA-MRSAB) are unknown. We aim to clarify differences and investigate associations between the clinical manifestations and virulence genes associated with plasma-biofilm formation in PVL-negative CA-MRSA. From 2011 to 2021, when CA-MRSA dramatically replaced HA-MRSA, 79 MRSA strains were collected from blood cultures and analyzed via SCCmec typing and targeted virulence gene (lukSF-PV, cna, and fnbB) detection. The incidence of metastatic infection was significantly higher in CA-MRSAB than in HA-MRSAB. PVL genes were all negative, although cna and fnbB were positive in 55.6% (20/36) and 50% (18/36) of CA-MRSA strains and 3.7% (1/27) and 7.4% (2/27) of HA-MRSA strains, respectively. cna and fnbB carriage were not associated with the development of metastatic infections in MRSAB; however, the bacteremia duration was significantly longer in CA-MRSAB harboring cna. CA-MRSAB may be more likely to cause metastatic infections than HA-MRSAB. Since CA-MRSA is dominant in Japan, suspected metastatic infection foci should be identified by computed tomography, magnetic resonance imaging, and echocardiography when treating MRSAB. Full article

(This article belongs to the Special Issue Rational Use of Antibiotics in Bloodstream Infection)

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12 pages, 2215 KiB

Open AccessArticle

Dominant CT Patterns and Immune Responses during the Early Infection Phases of Different SARS-CoV-2 Variants

by Kentaro Nagaoka, Hitoshi Kawasuji, Yusuke Takegoshi, Yushi Murai, Makito Kaneda, Kou Kimoto, Hideki Tani, Hideki Niimi, Yoshitomo Morinaga, Kyo Noguchi and Yoshihiro Yamamoto

Viruses 2023, 15(6), 1304; https://doi.org/10.3390/v15061304 - 31 May 2023

Cited by 2 | Viewed by 2288

Abstract

Ground-glass opacity (GGO) and organizing pneumonia (OP) are dominant pulmonary CT lesions associated with COVID-19. However, the role of different immune responses in these CT patterns remains unclear, particularly following the emergence of the Omicron variant. In this prospective observational study, we recruited patients hospitalized with COVID-19, before and after the emergence of Omicron variants. Semi-quantitative CT scores and dominant CT patterns were retrospectively determined for all patients within five days of symptom onset. Serum levels of IFN-α, IL-6, CXCL10, and VEGF were assessed using ELISA. Serum-neutralizing activity was measured using a pseudovirus assay. We enrolled 48 patients with Omicron variants and 137 with precedent variants. While the frequency of GGO patterns was similar between the two groups, the OP pattern was significantly more frequent in patients with precedent variants. In patients with precedent variants, IFN-α and CXCL10 levels were strongly correlated with GGO, whereas neutralizing activity and VEGF were correlated with OP. The correlation between IFN-α levels and CT scores was lower in patients with Omicron than in those with precedent variants. Compared to preceding variants, infection with the Omicron variant is characterized by a less frequent OP pattern and a weaker correlation between serum IFN-α and CT scores. Full article

(This article belongs to the Section SARS-CoV-2 and COVID-19)

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14 pages, 2993 KiB

Open AccessSystematic Review

Effectiveness and Safety of Linezolid Versus Vancomycin, Teicoplanin, or Daptomycin against Methicillin-Resistant Staphylococcus aureus Bacteremia: A Systematic Review and Meta-Analysis

by Hitoshi Kawasuji, Kentaro Nagaoka, Yasuhiro Tsuji, Kou Kimoto, Yusuke Takegoshi, Makito Kaneda, Yushi Murai, Haruka Karaushi, Kotaro Mitsutake and Yoshihiro Yamamoto

Antibiotics 2023, 12(4), 697; https://doi.org/10.3390/antibiotics12040697 - 2 Apr 2023

Cited by 23 | Viewed by 18863

Abstract

Vancomycin (VCM) and daptomycin (DAP) are standard therapies for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, despite concerns regarding clinical utility and growing resistance. Linezolid (LZD) affords superior tissue penetration to VCM or DAP and has been successfully used as salvage therapy for persistent MRSA bacteremia, indicating its utility as a first-choice drug against MRSA bacteremia. In a systematic review and meta-analysis, we compared the effectiveness and safety of LZD with VCM, teicoplanin (TEIC), or DAP in patients with MRSA bacteremia. We evaluated all-cause mortality as the primary effectiveness outcome, clinical and microbiological cure, hospital length of stay, recurrence, and 90-day readmission rates as secondary effectiveness outcomes, and drug-related adverse effects as primary safety outcomes. We identified 5328 patients across 2 randomized controlled trials (RCTs), 1 pooled analysis of 5 RCTs, 1 subgroup analysis (1 RCT), and 5 case-control and cohort studies (CSs). Primary and secondary effectiveness outcomes were comparable between patients treated with LZD versus VCM, TEIC, or DAP in RCT-based studies and CSs. There was no difference in adverse event incidence between LZD and comparators. These findings suggest that LZD could be a potential first-line drug against MRSA bacteremia as well as VCM or DAP. Full article

(This article belongs to the Special Issue Rational Use of Antibiotics in Clinical Infections)

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11 pages, 1612 KiB

Open AccessArticle

Effect of Casirivimab/Imdevimab Treatment on Serum Type I Interferon Levels in SARS-CoV-2 Infection

by Kentaro Nagaoka, Hitoshi Kawasuji, Yusuke Takegoshi, Yushi Murai, Makito Kaneda, Akitoshi Ueno, Yuki Miyajima, Hideki Niimi, Yoshitomo Morinaga and Yoshihiro Yamamoto

Viruses 2022, 14(7), 1399; https://doi.org/10.3390/v14071399 - 27 Jun 2022

Cited by 4 | Viewed by 2731

Abstract

The effects of casirivimab and imdevimab (C/I) on the innate immune response against SARS-CoV-2 infection remain unclear. We evaluated the effect of C/I on type I interferon (IFN-I) and cytokines in patients with SARS-CoV-2 infection. This prospective observational study recruited consecutive patients hospitalized with SARS-CoV-2 infection. Blood levels of IFN-I and cytokines before and after C/I administration were assessed using enzyme-linked immunoassay. The study enrolled 29 patients in the C/I group. In addition, 11 patients who received remdesivir and dexamethasone (R/D group) during the early phase (≤5 days after the onset of symptoms) were included as a comparator group. After treatment, IFN-α and IFN-β levels decreased significantly in both the C/I group and R/D group, whilst the post-treatment neutrophil-to-lymphoid ratio increased in the early C/I group but not the R/D group. In the C/I group, temporal temperature elevation and hypoxemia were observed after treatment in 58.6% and 41.4% of the cohort, respectively. However, most patients recovered by 5 days after treatment. This study could demonstrate the high therapeutic effect of C/I with an antibody-dependent enhancement-like response and decreased IFN-I production, which was likely due to the immediate induction of an antibody-dependent immune response against SARS-CoV-2. Full article

(This article belongs to the Special Issue Coronavirus Disease (COVID-19): Pathophysiology, Epidemiology and Clinical Management)

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10 pages, 892 KiB

Open AccessArticle

Initially Reduced Linezolid Dosing Regimen to Prevent Thrombocytopenia in Hemodialysis Patients

by Hitoshi Kawasuji, Yasuhiro Tsuji, Chika Ogami, Makito Kaneda, Yushi Murai, Kou Kimoto, Akitoshi Ueno, Yuki Miyajima, Yasutaka Fukui, Ippei Sakamaki and Yoshihiro Yamamoto

Antibiotics 2021, 10(5), 496; https://doi.org/10.3390/antibiotics10050496 - 26 Apr 2021

Cited by 11 | Viewed by 3581

Abstract

This retrospective cohort study investigated the effects of an initially reduced linezolid dosing regimen in hemodialysis patients through therapeutic drug monitoring (TDM). Patients were divided into two groups depending on their initial dose of linezolid (standard dose of 600 mg every 12 h or initially reduced dose of 300 mg every 12 h/600 mg every 24 h). The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia were compared between both groups using the Kaplan–Meier method and log-rank test. Eleven episodes of 8 chronic hemodialysis patients were included; 5 were in the initially reduced-dose group. Thrombocytopenia developed in 81.8% of patients. The cumulative incidence rates of thrombocytopenia and severe thrombocytopenia in the initially reduced-dose group were significantly lower than in the standard-dose group (p < 0.05). At the standard dose, the median linezolid trough concentration (C_min) just before hemodialysis was 49.5 mg/L, and C_min at the reduced doses of 300 mg every 12 h and 600 mg every 24 h were 20.6 mg/L and 6.0 mg/L, respectively. All five episodes underwent TDM in the standard-dose group required dose reduction to 600 mg per day. Our findings indicate that initial dose reduction should be implemented to reduce the risk of linezolid-induced thrombocytopenia among hemodialysis patients. Full article

(This article belongs to the Special Issue Novel Targets of Drug Monitoring for Antibiotics)

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