Iwata Kentaro

Iwata Kentaro
Kobe University | Shindai · Division of Infectious Diseases Therapeutics

MD, MSc, PhD

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143
Publications
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Publications

Publications (143)
Article
Full-text available
Morishita, Iwata. Int J Gen Med. 2022;15:3943—3950. On page 3947, fourth paragraph, first sentence, the text “Among those who had confirmed code status after admission, the mortality was higher among those who were given DNACPR orders than those on full code (52.7% vs 23.8%, P < 0.0001)” should read “Among those who had confirmed code status after...
Article
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Background Cutibacterium modestum was named in 2020. C. modestum was previously called Propionibacterium humerusii . Several implant-associated infections caused by Cutibacterium species have been previously reported, but native vertebral osteomyelitis due to these bacteria has rarely been reported. Case presentation A 72-year-old man, who had pre...
Article
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Introduction: Japan went through five surges of coronavirus disease 2019 (COVID-19) or "waves". However, their impacts on the do not attempt cardiopulmonary resuscitation (DNACPR) of the patients are not known. Methods: A retrospective single-center cohort study was conducted for all hospitalized patients with COVID-19 from March 1, 2020, to Sep...
Article
Introduction Because mycotic aneurysm is a rare infection, the effectiveness of endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) for mycotic aneurysm is difficult to evaluate. Methods We conducted a retrospective cohort study comparing EVAR/TEVAR and surgical repair (SR), using both Cox proportional regression ana...
Article
Nocardiosis usually occurs in immunocompromised patients and causes infections in various organs, including the lungs, skin, and organs of the central nervous system. Herein, we report the case of a patient with minimal change nephrotic syndrome who had been on immunosuppressive drugs and developed pulmonary nocardiosis due to Nocardia nova complex...
Article
Introduction: With the ongoing pandemic of coronavirus disease 2019 (COVID-19), there is an argument on whether we should increase the number of testing for the coronavirus (SARS-CoV-2) to mitigate the epidemic in a given country. Therefore, we investigated the correlation between testing number and mortality to evaluate the hypothesis. Methods: Da...
Article
Background: Neutralizing antibody cocktail therapy, REGN-COV2, is promising in preventing a severe form of coronavirus disease 2019 (COVID-19), but its effectiveness in Japan has not been fully investigated. Materials and methods: To evaluate the effectiveness of REGN-COV2, clinical data of 20 patients with COVID-19 who received REGN-COV2 was co...
Article
Background and objective Exercise capacity in idiopathic pulmonary fibrosis (IPF) is limited by exercise-induced hypoxaemia. This study aimed to examine the effect of high-flow nasal cannula oxygen therapy (HFNC) on exercise tolerance in patients with IPF. Methods We conducted a single-centre, open-label, randomized crossover trial to compare HFNC...
Article
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We conducted a study to estimate the seroprevalence of coronavirus disease 2019 (COVID-19) in Kobe, Japan with positive immunoglobulin G (IgG) rate of 3.3% (95% confidence interval [CI] 2.3%–4.6%) in April 2020. Because there were large concerns about the spread of COVID-19 among citizens thereafter, we conduct a follow-up cross-sectional study to...
Article
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COVID-19 patients reveal various clinical manifestations; however, the specific mechanisms and factors contributing to rapid recovery remain unclear. We performed serum cytokine profiling using a bead-based immunoassay in six COVID-19 patients with mild symptoms who experienced rapid recovery. All patients had fever that resolved within 4 days. Dur...
Article
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It is known that some with human immunodeficiency virus (HIV)–positive patients can remain immunocompetent for long period, maintaining their CD4‐positive T lymphocytes (CD4 cells) while suppressing HIV. However, this population became rarely seen recently since potent antiretroviral therapy (ART) became available worldwide, and the latest guidelin...
Article
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Listeria monocytogenes can cause gastrointestinal infections in healthy children and adults, but they tend to be mild and self-limiting. It can, however, cause serious potentially lethal infections, such as meningitis and bacteremia, to those with underlying conditions. A woman in her 60s with liver cirrhosis developed abdominal pain and a fever, a...
Article
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Background Antibody production is one of the primary mechanisms for recovery from coronavirus disease 2019 (COVID-19). It is speculated that massive clonal expansion of B cells, which can produce clinically meaningful neutralizing antibodies, occurs in patients who recover on the timing of acquiring adaptive immunity. Methods To evaluate fluctuati...
Article
Background: Secondary bacterial infection during the care of coronavirus disease 2019 (COVID-19) patients poses risks to the patients, but there are concerns of an increase in blood culture contamination. Methods: A retrospective comparative study was conducted from April 1 to December 31, 2020, when the patients with COVID-19 were taken care of (p...
Article
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A 45‐year‐old woman presented with persistent bilateral breast and axillary pain lasting for more than 3 months. Lengthy work‐up failed to identify the etiology. Physical examination was entirely normal, including breast examination. A traditional Kampo medicine, Goshaku‐san, was tried, and the symptoms began to improve gradually. This case is char...
Article
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Objectives Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been affecting many people on earth and our society. Japan is known to have relatively smaller number of its infections as well as deaths among developed nations. However, accurate prevalence of COVID-19 in Japan remains unknown. Therefore, we conducted a cross-section...
Article
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Background: The number of newly diagnosed human immunodeficiency virus (HIV) infections and acquired immune deficiency syndrome (AIDS) patients in Japan appears to be decreasing. However, whether these new infections cease to occur in the future in Japan, similar to abroad, is unclear. To evaluate the feasibility of this achievement, we conducted...
Article
Both the inactivated hepatitis A vaccine (Aimmugen) and purified chick embryo cell rabies vaccine (PCECV, Rabipur) are well tolerated. Anaphylaxis has rarely been reported as an adverse reaction of these vaccines. There have been no reports or published case reports of anaphylaxis due to Aimmugen. According to the Japanese Ministry of Health, Labou...
Article
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Background Infective endocarditis (IE) is associated with significant morbidity and mortality, and successful management requires expertise in both cardiac surgery and infectious disease (ID). However, the impact of ID consultation on clinical outcomes of IE is not clear. Methods The present study was a quasi-experimental, interrupted time series...
Article
Background Infective endocarditis (IE) is associated with significant morbidity and mortality, and successful management requires expertise in both cardiac surgery and infectious disease (ID). However, the impact of ID consultation on the clinical outcomes of IE is not clear. Methods The present study was a quasi-experimental, interrupted time ser...
Article
In Japan, patients with coronavirus disease 2019 (COVID-19) need to be hospitalized. We admitted patients with mild-to-severe disease as well as asymptomatic carriers at a designated hospital; however, we were also aware of the potential issues of shortage of personal protective equipment (PPE) and nosocomial infections among healthcare workers. Th...
Article
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Objectives Treating latent tuberculosis infection (LTBI) is essential for eliminating the serious endemicity of tuberculosis. A shorter regimen is preferred to longer regimens because the former has better adherence with a better safety profile. However, lengthy treatment with isoniazid is still recommended in Japan. Based on the latest evidence, w...
Article
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Objectives The Coronavirus disease 2019 (COVID-19) pandemic is causing significant damage to many nations. For mitigating its risk, Japan called on all elementary, junior high and high schools nationwide to close beginning March 1, 2020. However, its effectiveness in decreasing the disease burden has not been investigated. Methods We used daily da...
Preprint
Background Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been affecting many people on earth and our society. Japan is known to have relatively less number of infections as well as deaths among developed nations. However, accurate prevalence of COVID-19 in Japan remains unknown. Therefore, we conducted a cross-sectional stud...
Article
Full-text available
Acute inguinal lymphadenitis is usually caused by lower extremity infection and sexually transmitted diseases, such as chancroid, lymphogranuloma venereum, genital herpes, or syphilis. Yersinia pseudotuberculosis is a non-spore forming, pleomorphic, non-lactose fermenting Gram negative bacillus and a member of the family Enterobacteriaceae, which i...
Preprint
Background: Coronavirus disease 2019 (COVID-19) pandemic are causing significant damages to many nations. For mitigating its risk, Japan’s Prime Minister called on all elementary, junior high and high schools nationwide to close beginning March 1, 2020. However, its effectiveness in decreasing disease burden has not been investigated. Methods: We u...
Article
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Ongoing outbreak of pneumonia caused by novel coronavirus (2019-nCoV) began in December 2019 in Wuhan, China, and the number of new patients continues to increase. Even though it began to spread to many other parts of the world, such as other Asian countries, the Americas, Europe, and the Middle East, the impact of secondary outbreaks caused by exp...
Preprint
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Ongoing outbreak of pneumonia caused by novel coronavirus (2019-nCoV) began in December 2019 in Wuhan, China, and the number of new patients continues to increase. On the contrary to ongoing outbreak in China, however, there are limited secondary outbreaks caused by exported case outside the country. We here conducted simulations to estimate the im...
Article
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Background: Antimicrobial therapy with appropriate biliary drainage is considered the standard of care for acute cholangitis, but the optimal duration of antimicrobial therapy remains unknown. Seven to 10 days of antimicrobial therapy are common for the treatment of acute cholangitis, but a recent retrospective cohort study suggested a shorter dur...
Article
A 38-year-old Japanese man without any significant past medical history was referred to our clinic to undergo further examination for a "refractory infection in his joints". He suffered recurrent migratory polyarthritis starting from bilateral knees to his right elbow. Certain antibiotic therapies appeared to improve his symptoms, but the symptoms...
Article
Cough-variant asthma is the most common cause of chronic cough. It may progress to classic asthma and therefore requires adequate treatment intervention. We experienced two cases of cough-variant asthma that was refractory to standard drug therapy but improved after additional administration of kumibinroto. In Case 1, the patient was a 46-year-old...
Article
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Purpose This study aimed to evaluate the efficacy of an educational intervention on reducing the inappropriate use of oral third-generation cephalosporins, the prevalence of resistant bacteria, and clinical outcomes. Methods A before-after study was conducted to compare the data for 1 year before and after intervention at a Japanese university hos...
Article
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Background: Enterohemorrhagic Escherichia coli (EHEC) is an important pathogen that causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). After an EHEC outbreak involving uncooked beef, serving raw beef liver dishes at restaurants was completely banned starting on July 1, 2012 in Japan. However, its long-term associations with...
Article
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Gingyogedokusan (GGGS) is a herbal medicine approved for upper respiratory infections in Japan, and could be utilized for the treatment of influenza. We conducted a multi‐center, prospective trial, comparing GGGS against oseltamivir in patients with influenza, but failed to include enough participants for conventional analysis. We further conducted...
Preprint
Background: Antimicrobial therapy with appropriate biliary drainage is considered the standard of care of acute cholangitis, but the optimal duration of antimicrobial therapy remains unknown. Seven to 10 days of antimicrobial therapy is common for the treatment of acute cholangitis, but recent retrospective cohort study suggested shorter duration m...
Preprint
Full-text available
Background: Antimicrobial therapy with appropriate biliary drainage is considered the standard of care for acute cholangitis, but the optimal duration of antimicrobial therapy remains unknown. Seven to 10 days of antimicrobial therapy is common for the treatment of acute cholangitis, but a recent retrospective cohort study suggested a shorter durat...
Article
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Tokyo Guideline 2018 states Murphy's sign is not sensitive, citing a single center study with the sensitivity of only 20.5% [1,2]. However, a systematic review and an evidence based review of physical diagnosis stated the contrary, with sensitivity ranging 58‐71% and 48‐97% respectively [3,4]. We believe that clinical guidelines should cite referen...
Article
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A 48‐year‐old woman presented with various symptoms, including widespread body pains, insomnia, palpitations, and shortness of breath, after receiving tetanus toxoid. After going through multiple visits to clinicians of various subspecialties, she was referred to our infectious diseases clinic. She was diagnosed with bodily distress syndrome (BDS),...
Article
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Repetitive manipulation of thumbs and fingers too much can cause de Quervain tenosynovitis. Some smartphones are becoming larger than their predecessors, with larger display, which might lead to more occurrence of tenosynovitis. A Japanese man in his 40s developed de Quervain tenosynovitis after buying a smartphone while using his thumb to handle i...
Article
BACKGROUND: There are many side effects of antituberculous drugs, however, renal failure is relatively rare. Therefore, this side effect is thought to be unrecognized by most physicians. We experienced one case of acute renal failure caused by antituberculous therapy (rifampicin). CASE REPORT: A 64-year-old Japanese male developed tuberculous pleur...
Article
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Background: Mycotic aneurysm is an uncommon disease which could be fatal without appropriate treatment. Although standard therapy for mycotic aneurysms consists of resection of the infected aorta and in situ graft replacement, some treat with endovascular stent-grafting because patients may not tolerate graft replacement due to underlying diseases...
Article
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Objective To evaluate the long-term effects of comprehensive antibiotic stewardship programs (ASPs) on antibiotic use, antimicrobial-resistant bacteria, and clinical outcomes. DesignBefore–after study. SettingNational university hospital with 934 beds. InterventionImplementation in March 2010 of a comprehensive ASPs including, among other strategie...
Article
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Objectives: To assess the effectiveness of short duration antimicrobial therapy for acute cholangitis with bacteraemia. Methods: We conducted a retrospective cohort study of patients with acute bacteraemic cholangitis with successful biliary duct drainage at a single centre in Japan. We compared short-course antimicrobial therapy (SCT, ≤7 days)...
Article
Background: The purpose of this study is to investigate the medical students'perceptions of the Hybrid Educational Activities between team based learning (TBL) and problem based learning (PBL) Program (HEATAPP), a novel educational program that combines characteristics of PBL and TBL. Methods: A five-day HEATAPP on infectious diseases was provid...
Article
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Background With the advent of effective antiretroviral therapy, the care of patients with human immunodeficiency virus infection became more like that of other chronic diseases. Diabetes mellitus can also occur as one of the chronic illnesses affecting patients with human immunodeficiency virus infection. We report a case of newly developed diabete...
Article
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• Khoo HE. Implementation of problem-based learning in Asian medical schools and students' perceptions of their experience. Med Educ. 2003; 37: 401-409. Full Text PubMed • Okubo Y, Ishiguro N, Suganuma T, Nishikawa T, Takubo T, Kojimahara N, Yago R, Nunoda S, Sugihara S and Yoshioka T. Team-based learning, a learning strategy for clinical reasoning...
Article
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The board certification system in Japan is undergoing reform, but it is likely to be watered down without significant improvement. Traditionally, Japanese doctors had not given weight to board certification. Instead, they used to attach a high value in obtaining academic credentials such as a doctor's degree (PhD) by entering graduate schools. Unt...
Article
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Few studies have investigated the appropriateness of antibiotic use in postdisaster settings. We retrospectively evaluated clinical databases on health care delivered at clinics near shelters set up after the Great East Japan Earthquake, 2011. We defined appropriate, acceptable, and inappropriate antibiotic use for each diagnostic category, by appl...
Article
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Background: Tuberculosis meningitis (TBM) is the most devastating clinical presentation of infection with M. tuberculosis; delayed initiation of effective anti-tuberculosis (TB) therapy is associated with poor treatment outcomes. Our objective was to determine the relationship between drug resistance and 10-year mortality among TBM patients. Meth...
Article
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Background Tenofovir, one of antiretroviral medication to treat human immunodeficiency virus (HIV) infection, is known to cause proximal renal tubular acidosis such as Fanconi syndrome, but cases of distal renal tubular acidosis had never been reported. Case presentation A 20-year-old man with HIV infection developed nausea and vomiting without di...
Article
Interstitial nephritis is a common cause of renal dysfunction. It is primarily caused by drugs, infections, or autoimmune disorders. Patients with human immunodeficiency virus (HIV) infection can develop interstitial nephritis, although it typically occurs because of the aforementioned etiologies and not as a direct consequence of HIV infection. In...
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BackgroundESBL (Extended spectrum beta-lactamase) producing enterobacteriaceae are challenging organisms with little treatment options. Carbapenems are frequently used, but the emergence of carbapenem resistant enterobacteriaceae is a concerning issue, which may hinder the use of carbapenems. Although cephamycins such as cefoxitin, cefmetazole or c...
Article
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Somatic symptom disorder (SSD) often leads to frequent doctor visit not only to psychiatrists but also to various kinds of physicians. We encountered four cases of SSD, particularly associated with sexual intercourse and fear of sexually transmitted diseases (STDs). To best of our knowledge, there is no independent clinical entity assigned to this...
Article
Purpose of review: Personal protective equipment (PPE) protects healthcare workers (HCWs) from infection by highly virulent pathogens via exposure to body fluids and respiratory droplets. Given the recent outbreaks of contagious infectious diseases worldwide, including Ebola virus and Middle Eastern respiratory syndrome, there is urgent need for f...
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Background: De-escalation therapy is a strategy used widely to treat infections while avoiding the use of broad-spectrum antimicrobials. However, there is a paucity of clinical evidence to demonstrate the effectiveness and safety of de-escalation therapy compared to conventional therapy. Methods: A systematic review and meta-analysis was conducted...
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Objective: The purpose of this research is to elucidate the actual status of Infectious Diseases (ID) Fellowship programs in Japan to improve them further. Methods: We conducted qualitative interviews with infectious diseases fellows and his/her faculty consultants from 10 institutions providing ID Fellowships in Japan. We qualitatively analysed...
Data
Questionnaire used for the semi-structured interviews
Article
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Polymyalgia rheumatica (PMR) is relatively common among the elderly, and is characterized by multiple body aches with an elevated erythrocyte sedimentation rate. Even though the etiology of PMR remains unknown, a number of infectious agents have been suggested to cause PMR. Also, there are reports of PMR after influenza vaccination. The exact role...
Conference Paper
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This study proposes an epidemic model for Ebola virus disease (EVD) based on a combination between a delayed stochastic SIR model and a metapopulation network model. Our proposed model consists of a set of stochastic differential equations of state variables, such as the number of susceptible persons, the number of infected patients both inside and...
Article
There was a debate on the applicability of "Bushido" to professionalism among Japanese physicians. Regardless of the historical aspects upon the writing of "Bushido" by Inazo Nitobe, "Bushido" can be applicable to professionalism. This conclusion leads to the fact that one cannot avoid the fundamental discussion on the influence of the "Eyes of Oth...
Article
We conducted a retrospective comparative study of acid-fast bacilli (AFB) smear sensitivity according to time of specimen collection to assess whether three consecutive AFB smears collected in 1 day are useful when deciding to discontinue respiratory isolation of patients with pulmonary tuberculosis (TB). A total of 236 sputum specimens from 119 pa...
Article
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Background: Sushi is a traditional Japanese cuisine enjoyed worldwide. However, using raw fish to make sushi may pose risk of certain parasitic infections, such as anisakidosis, which is most reported in Japan. This risk of infection can be eliminated by freezing fish; however, Japanese people are hesitant to freeze fish because it is believed tha...
Article
We report herein on a case of community-acquired necrotizing soft tissue infection caused by Serratia marcescens. The patient had been treated with prednisolone, tocilizumab and tacrolimus for rheumatoid arthritis. Since Gram staining of the tissue revealed Gram negative rod bacteria, ceftriaxone and clindamycin were administered as empiric therapy...
Article
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Infective endocarditis (IE) is a severe disease with high morbidity and mortality, and these can be exacerbated by delay in diagnosis. We investigated IE diagnosis in Japan with the emphasis on the delay in diagnosis and its cause and implications. We conducted a retrospective study on 82 definite IE patients at Kobe University Hospital from April...
Article
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A 73-year-old man with no significant past medical history or any history of health care visits was hospitalized for pneumonia. Sputum culture revealed multidrug-resistant Streptococcus pneumoniae, even to carbapenems. The patient was later treated successfully with levofloxacin. Throat cultures from his two grandchildren revealed S. pneumoniae wit...
Article
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Background Although it has received a degree of notoriety as a cause for antibiotic-associated enterocolitis (AAE), the role of methicillin resistant Staphylococcus aureus (MRSA) in the pathogenesis of this disease remains enigmatic despite a multitude of efforts, and previous studies have failed to conclude whether MRSA can cause AAE. Numerous cas...
Article
An 85-year-old man underwent endoscopic submucosal dissection (ESD) for a large superficial esophageal epithelial neoplasm, which required removal of 95% of the circumference of the esophageal mucosa. Steroids were administered orally to prevent esophageal stricture starting on day 3 postoperatively. In the 6th week of steroid treatment, he develop...
Article
Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. An observational study was conducted from J...