Journal of Infection and Chemotherapy最新文献

{"title":"Antimicrobial use in pediatric patients: a subgroup analysis of the 2020 point prevalence survey in Aichi, Japan","authors":"Hiroshi Morioka ,&nbsp;Kenta Ito ,&nbsp;Yusuke Koizumi ,&nbsp;Masami Okudaira ,&nbsp;Yuka Tomita ,&nbsp;Takeshi Tsuji ,&nbsp;Kenji Akita ,&nbsp;Toshitaka Watariguchi ,&nbsp;Keisuke Oka ,&nbsp;Koichi Watamoto ,&nbsp;Hiroki Kato ,&nbsp;Masamitsu Ishihara ,&nbsp;Manabu Yokota ,&nbsp;Yuji Ito ,&nbsp;Yoshikazu Mutoh ,&nbsp;Masatoshi Nagaoka ,&nbsp;Susumu Iwata ,&nbsp;Yasuhiro Nozaki ,&nbsp;Hiroshi Hamada ,&nbsp;Yumi Kojima ,&nbsp;Tetsuya Yagi","doi":"10.1016/j.jiac.2025.102804","DOIUrl":"10.1016/j.jiac.2025.102804","url":null,"abstract":"<div><h3>Background</h3><div>Establishing the precise epidemiology of antimicrobial use (AMU) is essential to promote antimicrobial stewardship. However, data on AMU for pediatric inpatients in Japanese hospitals are lacking. In this study, we performed a subgroup analysis focusing on pediatric patients from a point prevalence survey.</div></div><div><h3>Methods</h3><div>A multicenter point prevalence survey was conducted in Aichi Prefecture in 2020. This subgroup analysis included pediatric patients (≦18 years old) and assessed AMU and their indications: community-acquired infections (CAIs), healthcare-associated infections (HAIs), medical prophylaxis (MP), and surgical prophylaxis (SP). Details of infections and interventions by the antimicrobial stewardship teams (AST) were also surveyed.</div></div><div><h3>Results</h3><div>Of the 736 patients from 23 hospitals included in this study, 241 patients (32.7 %, 95 % confidence interval [95 % CI]: 29.4–36.3) received a total of 399 antimicrobials. The prevalence of HAI was 6.0 % (95 % CI: 4.4–7.9). The number of antimicrobials administered per 100 patients ranged from 24.1 in small hospitals to 109.6 in university hospitals. CAI treatment was the most common indication in community hospitals, SP in specific centers, and MP in university hospitals. The most commonly prescribed antimicrobials were cefotaxime for CAI, meropenem for HAI, trimethoprim-sulfamethoxazole for MP, and cefazolin for SP. A total of 78 CAIs and 46 HAIs were identified, with AST intervention rates of 2.5 % and 34.8 %, respectively.</div></div><div><h3>Conclusion</h3><div>This subgroup analysis provides the first demographic data on AMU among pediatric inpatients at Japanese hospitals. The distinct distribution of AMU suggests that different approaches are necessary to promote antimicrobial stewardship in hospital settings.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102804"},"PeriodicalIF":1.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fourth nationwide surveillance of the antimicrobial susceptibility patterns of pathogens isolated from surgical site infections in Japan.","authors":"Norifumi Shigemoto, Hiroshige Mikamo, Hiroaki Hata, Junko Sato, Tetsuya Matsumoto, Satoshi Takahashi, Naoki Hasegawa, Hideji Yanagisawa, Minako Kobayashi, Shigeru Takeda, Mitsuo Nishiyama, Toru Mizuguchi, Junzo Shimizu, Hiroshi Maruyama, Hideki Kawamura, Shiko Seki, Kohji Okamoto, Katsunori Yanagihara, Kosuke Kosai, Keita Morikane, Yuji Toiyama, Hiroji Shinkawa, Shinji Akagi, Motoi Uchino, Yoji Fukumoto, Hiroki Ohge","doi":"10.1016/j.jiac.2025.102776","DOIUrl":"10.1016/j.jiac.2025.102776","url":null,"abstract":"<p><p>Inappropriate antimicrobial therapy for surgical site infections (SSIs) can lead to poor outcomes and an increased risk of antibiotic resistance. A nationwide survey was conducted in Japan from 2021 to 2023 to investigate the antimicrobial susceptibility of pathogens isolated from SSIs. The data were compared with those obtained in the 2010, 2014-2015, and 2018-2019 surveillance studies. The rate of detection of extended-spectrum β-lactamase-producing strains of Enterobacterales was 4.4 % in 2010, 13.5 % in 2014-2015, and 6.6 % in 2018-2019; the incidence increased to 11.2 % in 2021-2023. A high rate of susceptibility to tazobactam/piperacillin was detected in the 2018-2019 survey, and this decreased to 71.8 % in the 2021-2023 survey. The geometric mean MICs for tazobactam/ceftolozane showed an increasing trend (0.397 in 2018-2019 and 0.778 in 2021-2023). The MRSA incidence rate decreased from 72 % in the first surveillance to 53 % in the second and third surveillance and to 39 % in the fourth surveillance. The susceptibility of E. coli and K. pneumoniae to sulbactam/ampicillin and cefazolin decreased. For Bacteroides species, low levels of susceptibility were observed for moxifloxacin (57 %), cefmetazole (54 %), and clindamycin (44 %). In conclusion, antimicrobial susceptibility changed mainly for Enterobacterales isolated from SSIs. Bacterial sensitivity to carbapenems was generally good, suggesting that the use of antimicrobial agents may have contributed to the observed reduction in MRSA incidence.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102776"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical characteristics of hospitalized pediatric patients with respiratory syncytial virus infections before and during/after the coronavirus disease 2019 pandemic in Japan -importance of universal prevention using maternal vaccination and nirsevimab.","authors":"Yusuke Karahashi, Takayuki Yamanaka, Yuta Aizawa, Rie Habuka, Shinya Tsukano, Akihiko Saitoh","doi":"10.1016/j.jiac.2025.102779","DOIUrl":"10.1016/j.jiac.2025.102779","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has impacted the epidemiology of respiratory syncytial virus (RSV) infections. In this study, we aimed to elucidate the impact of COVID-19 on the clinical characteristics of hospitalized RSV-infected pediatric patients in Japan and to discuss the potential future roles of the maternal RSV prefusion F protein-based vaccine (RSVpreF) vaccine and universal nirsevimab in Japan.</p><p><strong>Methods: </strong>This retrospective study investigated RSV-infected pediatric patients hospitalized at Niigata City General Hospital, Niigata, Japan, from 2017 to 2023. We extracted the clinical characteristics of patients from their electronic medical records.</p><p><strong>Results: </strong>A total of 407 RSV-infected patients were hospitalized: 210 (51.6 %) were hospitalized before the pandemic, and 197 (48.4 %) were hospitalized during/after the pandemic. Age distribution and patients' backgrounds between the two periods did not differ significantly (p > 0.16). However, the proportion of patients who required intensive care unit (ICU) admission increased from 6.7 % (14/210) to 18.8 % (37/197), with increased ICU admission rates observed especially in those aged 1-2 months (5.4 % vs. 23.7 %, p = 0.006). Moreover, 188 (46.2 %) hospitalized patients were neonates and infants less than 6 months old without a risk of severe RSV disease, of which 33 were admitted to the ICU throughout the study period.</p><p><strong>Conclusions: </strong>More patients with severe RSV infection were hospitalized during/after the COVID-19 pandemic in Japan than before the COVID-19 pandemic. To prevent RSV infection in such populations, wider distribution of the maternal RSVpreF vaccine or universal use of nirsevimab is warranted.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102779"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of illness onset influences leukocyte destruction in critically ill patients with suspected sepsis.","authors":"Yoshitomo Morinaga, Motohiro Sekino, Kazuto Tsuruda, Hiroo Hasegawa, Tetsuya Hara, Katsunori Yanagihara","doi":"10.1016/j.jiac.2025.102787","DOIUrl":"10.1016/j.jiac.2025.102787","url":null,"abstract":"<p><strong>Background: </strong>The clinical significance of leukocyte destruction morphology in routine peripheral blood smears remains underexplored. This study aimed to systematically quantify leukocyte destruction and correlate these findings with clinical course, etiology, and outcome in patients with suspected sepsis.</p><p><strong>Methods: </strong>This was a retrospective observational study involving 30 intensive care unit (ICU) patients with suspected sepsis. Peripheral blood smear findings were evaluated chronologically, with the day of blood culture collection designated as Day 0, followed by four distinct phases. Leukocyte destruction was defined as clear evidence of cytoplasmic or nuclear dissolution. Correlations were assessed with 28-day prognosis and symptom onset (acute [no preceding symptoms before admission] vs. non-acute [preceding symptoms present]).</p><p><strong>Results: </strong>Leukocyte destruction showed no significant difference concerning 28-day mortality. However, it was significantly more frequent in acute onset cases within the first 48 h (7.0 % vs. 3.7 %, p < 0.05). Conversely, cases with toxic granulation were significantly more common in non-acute onset cases within the first 48 h (70 % vs. 14 %, p < 0.01).</p><p><strong>Discussion: </strong>The patterns of leukocyte destruction and toxic granulation may provide insights into the underlying pathophysiology of critically ill patients and warrant further investigation.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102787"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV-associated multicentric Castleman disease with Kaposi sarcoma: A case report with 120-week follow-up of HHV-8 after remission","authors":"Seitaro Abe ,&nbsp;Takato Nakamoto ,&nbsp;Takahiro Aoki ,&nbsp;Katsuji Teruya ,&nbsp;Hiroyuki Gatanaga","doi":"10.1016/j.jiac.2025.102806","DOIUrl":"10.1016/j.jiac.2025.102806","url":null,"abstract":"<div><div>HIV-associated multicentric Castleman disease (HIV-MCD) is a rare, life-threatening lymphoproliferative disorder featuring systemic inflammation and marked lymphadenopathy. HIV-MCD is characterized by a human herpesvirus-8 (HHV-8) infection, with an increasing incidence despite advances in antiretroviral therapy (ART). Although HHV-8 viremia is a recognized indicator of disease recurrence, the necessity of intervention for low-level viremia reactivation remains unclear. We present a case of a man with HHV-8-associated HIV-MCD and Kaposi sarcoma (KS) who achieved a prolonged remission despite occasional episodes of low-level viremia. A 58-year-old man with untreated HIV infection presented with fever, night sweats, and fatigue. Histopathological analysis confirmed the diagnosis of HIV-MCD with KS. He received rituximab, liposomal doxorubicin, and ART which induced remission. The patient was followed for 120 weeks with serial monitoring of HHV-8 DNA levels. Although occasional viremia was observed, no relapse occurred. When mild HHV-8 reactivation occurred post-therapy without clinical relapse, we avoided unnecessary treatments with potential drug-related toxicities. No established prevention for MCD flares exists, and prolonged rituximab or valganciclovir use risks pulmonary and hematologic toxicity. Thus, HHV-8 DNA monitoring and selective interventions seem practical. Timely diagnosis and immunochemotherapy, including rituximab and liposomal doxorubicin, are critical for the management of HIV-MCD with concurrent KS. This combination mitigated KS progression. Successful management of HIV-MCD requires early recognition and administration of ART and targeted therapies, which can result in sustained remission. Close HHV-8 DNA monitoring and clinical assessment minimize the need for additional treatment, underscoring the importance of balancing efficacy and safety in individualized HIV-MCD management.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102806"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors for bloodstream infection in totally implantable venous-access ports.","authors":"Kaori Ishikawa, Kozo Kataoka, Takashi Ueda, Kazuma Ito, Kaoru Ichiki, Yumiko Nishimura, Chisa Mizukuchi, Yuko Fukumoto, Toshinori Yanagawa, Madoka Einari, Emi Ohashi, Kei Kimura, Motoi Uchino, Yuki Horio, Kazuhiko Nakajima, Masataka Ikeda","doi":"10.1016/j.jiac.2025.102783","DOIUrl":"10.1016/j.jiac.2025.102783","url":null,"abstract":"<p><strong>Introduction: </strong>Central line-associated bloodstream infection (CLABSI) associated with implanted central venous (CV)-access ports (CV ports) remains one of the most serious complications that can worsen patient outcomes. Despite the importance of this problem, comprehensive reports are limited. Here we report an analysis of CLABSI risk factors in patients with CV ports at our institution.</p><p><strong>Methods: </strong>Data from patients who had CV ports placed between January 2018 and March 2023 were retrospectively collected and analyzed. The primary outcome was the incidence of CLABSI, which was determined based on the Japanese Healthcare Associated Infections Surveillance criteria. To identify independent risk factors for CLABSI, univariate and multivariate analyses were performed to investigate 19 factors, including sex, age, cancer carriage status, inflammatory bowel disease (IBD), and drugs administered through CV ports.</p><p><strong>Results: </strong>Out of 867 patients with a CV port, CLABSI was observed in 117 patients (13.5 %), with an incidence of CLABSI of 0.45 per 1000 device-days (laboratory-confirmed bloodstream infection: 0.31, clinical sepsis: 0.14). Multivariate analysis identified IBD [Odds ratio (OR): 4.47, 95 % Confidence Interval (CI): 2.34-8.52] and the administration of lipid emulsions [OR: 4.28, 95 % CI: 2.01-9.13] as independent risk factors for CLABSI. Multivariate analysis for cancer patients identified the use of lipid emulsions (OR: 5.39, 95 % CI: 2.38-12.24) as an independent risk factor for CLABSI.</p><p><strong>Conclusion: </strong>Close monitoring is essential when patients with a CV port receive lipid emulsions. Placement of a CV port may be avoided in patients with a history of IBD if possible.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102783"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of sputum specimen quality evaluation in improving diagnostic accuracy for Nontuberculous mycobacterium pulmonary disease.","authors":"Naohisa Urabe, Makiko Takeichi, Susumu Sakamoto, Nozomi Tokita, Keiya Watanabe, Kohshi Fukuda, Kensei Hata, Shotaro Inokuchi, Rio Tsunehara, Kazuma Kishi","doi":"10.1016/j.jiac.2025.102784","DOIUrl":"10.1016/j.jiac.2025.102784","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis of Nontuberculous mycobacterial pulmonary disease (NTM-PD) depends on the quality of sputum specimens. While assessing sputum purulence may enhance diagnostic accuracy in NTM-PD, its utility has yet to be fully established.</p><p><strong>Methods: </strong>This single-center retrospective study included 183 patients with NTM-PD. Sputum specimen quality was assessed using the Miller and Jones classification, and the association between the grade of sputum purulence and NTM culture positivity was evaluated. Additionally, we investigated whether specimens with lower purulence grades retained diagnostic value.</p><p><strong>Results: </strong>Of 469 sputum specimens evaluated, 252 (53.7 %) were NTM culture positive. Purulent specimens graded as P1, P2, and P3 showed significantly higher culture positivity rates compared to non-purulent specimens and were strongly associated with positive NTM culture (OR 4.58; 95 % CI, 2.961-7.086; p < 0.001). Culture positivity rates were 65.3 % for P1, 65.7 % for P2, and 65.9 % for P3 specimens, versus 36.4 % for M1 and 36.8 % for M2 specimens. Notably, approximately one-third of the lower-purulence (M1, M2) specimens still yielded positive cultures, indicating that they retain diagnostic value.</p><p><strong>Conclusions: </strong>Sputum purulence as assessed using the Miller and Jones classification provides valuable diagnostic information for NTM-PD. While purulent sputum (P1-P3) is strongly associated with positive culture and smear results, specimens with lower purulence grades (M1 and M2) also retain diagnostic value. These findings support the practicable use of sputum purulence assessment to enhance diagnostic yield in clinical settings.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102784"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First case of Pseudomonas guariconensis post-traumatic infection with bacteremia following agricultural machinery trauma.","authors":"Toma Iwase, Mikito Yamada, Masato Inaba","doi":"10.1016/j.jiac.2025.102788","DOIUrl":"10.1016/j.jiac.2025.102788","url":null,"abstract":"<p><p>Agricultural machinery-related injuries pose unique challenges due to contamination with diverse environmental pathogens. We report the first documented case of Pseudomonas guariconensis bacteremia following an agricultural machinery-related trauma. An 81-year-old man sustained bilateral lower extremity injuries from a portable cultivator, including a Gustilo type IIIA open fracture of the left tibial plateau. Prompt and thorough debridement with copious irrigation was performed, followed by prophylactic cephalosporin monotherapy. On day 4 of hospitalization, the patient developed fever and signs of wound infection in both lower extremities. Blood and wound cultures yielded P. guariconensis, identified by MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing revealed minimum inhibitory concentrations (MICs) of 16/4 mg/L for piperacillin-tazobactam (PIPC/TAZ) and 8 mg/L for meropenem (MEPM). The modified carbapenem inactivation method (mCIM) and the Xpert® Carba-R assay were performed; however, all results were negative. Treatment was initiated with PIPC/TAZ. Although additional debridement and skin grafting were required, the patient showed gradual clinical improvement. PIPC/TAZ therapy was continued for 21 days and resulted in complete resolution of the infection. Post-traumatic infections following agricultural machinery-related injuries typically involve diverse organisms, including anaerobes and gram-negative bacteria. This case highlights the potential for rare environmental pathogens such as P. guariconensis to emerge as causative agents in post-traumatic infections as identification technologies like mass spectrometry continue to advance. Recognizing such organisms may become increasingly important in managing heavily contaminated wounds.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102788"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment patterns and outcomes of patients hospitalized for leptospirosis in endemic and non-endemic regions in Japan, 2010-2023: A nationwide inpatient database study.","authors":"Satoshi Miike, Yuichiro Matsuo, Yusuke Sasabuchi, Shotaro Aso, Kiyohide Fushimi, Hiroki Matsui, Hideo Yasunaga","doi":"10.1016/j.jiac.2025.102786","DOIUrl":"10.1016/j.jiac.2025.102786","url":null,"abstract":"<p><strong>Introduction: </strong>Leptospirosis is endemic to Okinawa but non-endemic to other regions (non-Okinawa) of Japan. We evaluated the characteristics, treatment, and outcomes of patients with leptospirosis in and outside Okinawa.</p><p><strong>Methods: </strong>Using a Japanese national inpatient database, we identified patients hospitalized with leptospirosis between 2010 and 2023. Data on patient characteristics, antibiotic treatment, need for intensive care, and outcomes were collated and compared between patients in and outside Okinawa.</p><p><strong>Results: </strong>Among 342 patients, 162 were hospitalized in Okinawa, whereas 180 outside Okinawa. Okinawan patients were younger than non-Okinawan patients (median age: 35.5 vs. 54 years). Over 80 % received beta-lactams. Broad-spectrum beta-lactams or combination therapy with tetracyclines were administered more commonly outside Okinawa. Patients outside Okinawa required intensive care more frequently. The overall mortality rate was 1.2 %.</p><p><strong>Conclusion: </strong>Antimicrobial prescription patterns and intensive care requirements varied between the two regions. These disparities may be attributed to variations in physicians' diagnostic thresholds or diagnostic delays outside Okinawa.</p>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":" ","pages":"102786"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic oral antibiotic bowel preparation for colorectal surgery in Japan: results of a nationwide questionnaire survey","authors":"Akihisa Matsuda ,&nbsp;Hiroshi Maruyama ,&nbsp;Yusuke Mizuuchi ,&nbsp;Hitoshi Kanno ,&nbsp;Jun Hirai ,&nbsp;Manabu Watanabe ,&nbsp;Kenichiro Uemura ,&nbsp;Minako Kobayashi ,&nbsp;Shinji Akagi ,&nbsp;Hisanori Shiomi ,&nbsp;Toru Inoue ,&nbsp;Mitsugi Shimoda ,&nbsp;Takeshi Yamada ,&nbsp;Hiroshi Yoshida ,&nbsp;Yuko Kitagawa","doi":"10.1016/j.jiac.2025.102803","DOIUrl":"10.1016/j.jiac.2025.102803","url":null,"abstract":"<div><h3>Purpose</h3><div>Surgical site infections (SSIs) incur a large burden in colorectal surgery. The importance of oral antibiotic bowel preparation (OABP) in SSI prevention has been affirmed; however, the current trends in Japan are unknown. This investigated bowel preparation practices among Japanese surgeons, focusing on OABP.</div></div><div><h3>Methods</h3><div>A nationwide online questionnaire was distributed to 456 surgeons from 412 institutions through the Japan Society for Surgical Infection.</div></div><div><h3>Results</h3><div>The rates of each bowel preparation protocol, mechanical bowel preparation (MBP) alone, MBP plus OABP, OABP alone, and no preparation, were as follows: 52.3 %, 43.1 %, 0.7 %, and 4.0 % for right-sided colon; 54.7 %, 44.2 %, 0.2 %, and 0.9 % for left-sided colon; 53.0 %, 46.2 %, 0.2 %, and 0.7 % for rectum; and 32.5 %, 66.0 %, 0.4 %, and 1.1 % for intracorporeal anastomosis, respectively. Combination of metronidazole and kanamycin was selected as oral antibiotic regimen in 88.1 % of respondents, and oral antibiotics were administered only on the day before surgery in 91.4 % of respondents, and this method was introduced within the last 10 years. Factors associated with OABP usage were performing over 100 colorectal cancer surgeries per year, colorectal specialization, intracorporeal anastomosis, and lower self-reported SSI rates. Although there was no significant difference, only 25 % of respondents of younger surgeons (within 10 years of the career of surgery) used OABP.</div></div><div><h3>Conclusions</h3><div>Nearly half of surgeons routinely use OABP, and its adoption has grown over the past decade, although it remains less prevalent in Japan than in the United States. These finding may help optimize perioperative strategies and improve colorectal surgery outcomes in Japan.</div></div>","PeriodicalId":16103,"journal":{"name":"Journal of Infection and Chemotherapy","volume":"31 10","pages":"Article 102803"},"PeriodicalIF":1.5,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}