医学部 感染症科
Profile Information
- Affiliation
- Department of Infectious disease, Fujita Health University
- Degree
- 学士(藤田保健衛生大学)
- J-GLOBAL ID
- 201701018556614196
- researchmap Member ID
- 7000019922
Research Areas
4Research History
6-
Apr, 2023 - Present
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Apr, 2021 - Mar, 2023
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Apr, 2019 - Mar, 2021
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Oct, 2018 - Mar, 2019
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Apr, 2017 - Oct, 2018
Education
1-
Apr, 2009 - Mar, 2015
Awards
1-
Mar, 2018
Papers
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Sexually transmitted diseases, Feb 25, 2025BACKGROUND: The incidence of syphilis has been rising globally but effective screening strategies are lacking. Preoperative syphilis screening is commonly performed at Japanese hospitals for infection prevention purposes. However, its effectiveness in improving subsequent management is unclear. METHODS: A retrospective cohort study was conducted to assess the effectiveness of universal preoperative syphilis screening testing implemented at a Japanese tertiary care hospital from April 2017 to March 2023. The annual prevalence of positive preoperative treponemal tests was tracked, and subsequent clinical management for patients with a positive test result was investigated. Attributes of patients with a positive result who were more likely to receive further evaluation were also elucidated. RESULTS: In total, 82,439 patients underwent surgery during the study period. Preoperative treponemal testing was performed in 94.8% (78,170/82,439) of the patients. A positive test result was recorded in 544 (0.70%) with an annual positivity rate ranging from 0.61 to 0.83%, whereas the proportion of presumed active syphilis ranged from 0.02 to 0.08%. A total of 85 patients with a positive syphilis screening test, a nontreponemal test with a positive titer, and without history of syphilis were identified. Of those, only 45 patients (52.9%) received further evaluation. CONCLUSION: The positivity of preoperative treponemal testing was low despite the rising incidence of syphilis in Japan, and the prevalence of presumed active syphilis identified during the preoperative period was even smaller. Routine treponemal testing in the preoperative setting had limited utility in effectively identifying patients with active syphilis.
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Fujita medical journal, 10(4) 106-110, Nov, 2024OBJECTIVES: Consultation with infectious disease specialists is associated with reduced patient mortality in the care of patients with Staphylococcus aureus bacteremia (SAB) through appropriate management of complications including infective endocarditis. This study aimed to determine the rates of confirmation of a negative blood culture, implementation of echocardiography, and administration of appropriate antibiotics in patients with SAB at a university hospital in Japan that provides general internal medicine and not an infectious disease consultation service. METHODS: We conducted a retrospective cohort study at Dokkyo Medical University Hospital in Japan. Patients eligible for inclusion in the study were ≥20 years of age with ≥1 positive blood culture for S. aureus identified in a clinical microbiology laboratory. The primary outcome was the proportion of patients with confirmation of a negative blood culture, implementation of echocardiography, and administration of appropriate antimicrobial agents. RESULTS: A total of 109 patients with SAB were included in the analysis. Follow-up blood cultures were collected in 91 patients and negative results were documented in 88 patients. Follow-up blood culture collection was performed within 4 days of the initial blood culture collection in 49 patients. Echocardiography was performed appropriately in 40 patients. Appropriate antibiotic therapy was administered in 36 patients. CONCLUSIONS: Quality-of-care indicators were more commonly implemented in patients with SAB who received general internal medicine consultation than in those who did not.
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Dokkyo Medical Journal (Web), 3(1), 2024
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International journal of general medicine, 16 2709-2717, 2023PURPOSE: The effect of antibiotics administered before blood cultures performed in general internal medicine outpatient settings is not well known. PATIENTS AND METHODS: We conducted a retrospective case-control study including adult patients who underwent blood cultures in the general internal medicine outpatient department of a Japanese university hospital between 2016 and 2022. Patients with positive blood cultures were included as cases and matched patients with negative blood cultures were included as controls. Univariable and multivariable logistic regression analyses were performed. RESULTS: A total of 200 patients and 200 controls were included. Antibiotics were administered prior to blood culture in 20% of patients (79/400). Oral antibiotics were prescribed to 69.6% of the prior antibiotics (55/79). Prior antibiotic use was significantly lower among patients with positive than negative blood cultures (13.5% vs 26.0%, p = 0.002) and was an independent predictive factor in univariable (odds ratio, 0.44; 95% confidence interval, 0.26-0.73; p = 0.002) and multivariable (adjusted odds ratio, 0.31; 95% confidence interval, 0.15-0.63; p = 0.002) logistic regression models for positive blood culture. The area under the receiver operating characteristic (AUROC) curve of the multivariable model for predicting positive blood cultures was 0.86. CONCLUSION: There was a negative correlation between prior antibiotic use and positive blood cultures in the general internal medicine outpatient department. Therefore, physicians should interpret the negative results of blood cultures performed after the administration of antibiotics with care.
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International journal of general medicine, 16 1295-1302, 2023PURPOSE: The general internal medicine (GIM) department can be an effective diagnostic coordinator for undiagnosed outpatients. We investigated the contribution of GIM consultations to the diagnosis of patients admitted to specialty departments in hospitals in Japan that have not yet adopted a hospitalist system. PATIENTS AND METHODS: This single-center, retrospective observational study was conducted at a university hospital in Japan. GIM consultations from other departments on inpatients aged ≥20 years, from April 2016 to March 2021, were included. Data were extracted from electronic medical records, and consultation purposes were categorized into diagnosis, treatment, and diagnosis and treatment. The primary outcome was new diagnosis during hospitalization for patients with consultation purpose of diagnosis or diagnosis and treatment. The secondary outcomes were the purposes of consultation with the Diagnostic and Generalist Medicine department. RESULTS: In total, 342 patients were included in the analysis. The purpose of the consultations was diagnosis for 253 patients (74%), treatment for 60 (17.5%), and diagnosis and treatment for 29 patients (8.5%). In 282 consultations for diagnosis and diagnosis and treatment, 179 new diagnoses were established for 162 patients (57.5%, 95% confidence interval [CI], 51.5-63.3). CONCLUSION: The GIM department can function as a diagnostic consultant for inpatients with diagnostic problems admitted to other specialty departments in hospitals where hospitalist or other similar systems are not adopted.
Misc.
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ジェネラリスト教育コンソーシアム, 19 99-102, Aug, 2023<Highlight>医療現場のリーダーが,経済的に余裕を持って仕事をするために何をすべきかについて,筆者が勧める下記の3点を述べる.1)投資家から資金を集め,その集めた資金を専門家が株式や債券などに投資・運用する商品である投資信託2)価格が変動する商品を「常に一定金額を定期的に購入する」方法であるドルコスト平均法3)確定拠出年金と呼ばれる,自分で掛金を拠出し,自分で運用を行う節税も含めた投資 やりたい仕事があったときに「お金がないから」とあきらめないために,リーダーシップのスキルアップの参考にしてほしい.(著者抄録)
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レジデントノート, 25(5) 752-757, Jun, 2023<Point>・まず本当に感染症か考える・「患者背景」「感染臓器」「感染微生物」から可能性の重みづけを行う・フォローアップと再評価を続け,治療を見直すことを忘れない(著者抄録)
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臨床検査, 67(6) 640-646, Jun, 2023<文献概要>Point ●診断エラーは"患者の健康上の問題について正確かつタイミングよく解釈できなかったり,その解釈が患者に説明されなかったりすること"という概念であり,医療者間だけでなく,医師患者間でのコミュニケーションでも起因する.●診断エラーは"医療者の知識不足"のみで生じることは少なく,多くのエラーが積み重なって生じる.そのなかでも一番多いのが検査の解釈を含めた検査エラーである.●医師とのコミュニケーションを円滑に行うことで診断エラーが少なくなる可能性がある.
Books and Other Publications
5-
羊土社, Oct, 2019 (ISBN: 9784758116336)
Presentations
3Teaching Experience
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Apr, 2024 - PresentInfectious Disease (Fujita Health University)
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Apr, 2021 - Mar, 2023General Internal Medicine (Dokkyo Medical University)