神戸大学大学院医学研究科腎泌尿器科学分野

Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine

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研究グループ

化療（感染症）グループ

基礎的研究

化療グループは泌尿器科領域感染症（尿路感染、性器感染症、術後感染症、性感染症）の研究、治療をおこなっている。

Urosepsis, 尿路感染性SIRSに関する基礎的研究

現在、rat UTI modelを作成し、全身、局所のcytokine等のchemical mediatorの解析、抗炎症薬剤の治療効果の検討を行う計画をしている。

emphsematous pyelonephritisに関する基礎的研究

emphsematous pyelonephritisの発症機序は不明な点が多い。Rat modelでの作成および、局所でのガス産生機序、治療法、効果につき検討する計画をしている。

neobladderと尿路感染の基礎的研究

rat neobladder modelを作成し、hostとbacteriaの病原因子、防御反応につき基礎的研究をおこなう予定である。

臨床的研究

泌尿器科領域での周術期感染予防
  1. 体腔鏡下手術での感染予防の適正抗菌薬と使用期間、管理方法について検討
  2. 泌尿器科領域開放手術での感染予防の適正抗菌薬と使用期間、管理方法について検討
  3. 経尿道的手術における感染予防の適正抗菌薬と使用期間、管理方法について検討
  4. 前立腺生検時の感染予防抗菌薬における至適薬剤、投与期間の検討

以上を現在行っている。

淋菌性尿道炎に対する検討
  1. 男子淋菌性尿道炎にたいしCDZM one shot療法の治療効果の検討
  2. キノロン耐性淋菌の分布、菌の特徴について遺伝子levelでの解析を行う

以上を現在行っている。

泌尿器科領域抗癌化学療法時の感染予防

精巣腫瘍に対する超大量化学療法をはじめ、泌尿器科領域抗癌化学療法時のfebrile neutropeniaに対する、予防、治療、管理法の検討を計画している。

腎移植時の感染予防

腎移植患者の周術期、移植後早期、中期、後期での感染の発症頻度、管理、予防につき臨床的検討を行う予定である。

  • Matsumoto M, Shigemura K, Yamamichi F, Tanaka K, Nakano Y, Arakawa S, Fujisawa M.　Prevention of infectious complication and its risk factors after urological procedures of the upper urinary tract.　Urol Int. 2012;88(1):43-7.
  • Yasufuku T, Shigemura K, Shirakawa T, Matsumoto M, Nakano Y, Tanaka K, Arakawa S, Kawabata M, Fujisawa M.　Mechanisms of and risk factors for fluoroquinolone resistance in clinical Enterococcus faecalis isolates from patients with urinary tract infections.　J Clin Microbiol. 2011 Nov;49(11):3912-6.
  • Shigemura K, Matsumoto M, Tanaka K, Yamashita M, Arakawa S, Fujisawa M.　 Efficacy of combination use of Beta-lactamase inhibitor with penicillin and fluoroquinolones for antibiotic prophylaxis in transrectal prostate biopsy.　Korean J Urol. 2011 Apr;52(4):289-92. Epub 2011 Apr 22.
  • Shigemura K, Tanaka K, Adachi M, Yamashita M, Arakawa S, Fujisawa M. Chronological change of antibiotic use and antibiotic resistance in Escherichia coli causing urinary tract infections. J Infect Chemother. 2011 Oct;17(5):646-51
  • Yasufuku T, Shigemura K, Shirakawa T, Matsumoto M, Nakano Y, Tanaka K, Arakawa S, Kinoshita S, Kawabata M, Fujisawa M. Correlation of overexpression of efflux pump genes with antibiotic resistance in Escherichia coli Strains clinically isolated from urinary tract infection patients. J Clin Microbiol. 2011 Jan;49(1):189-94.
  • Miura T, Tanaka K, Nakano Y, Arakawa S, Takenaka A, Fujisawa M. The impact of decreasing urinary IgA levels on decreased bacteriuria in a rat model of ileal augmented bladder.J Urol. 2009Jan;181(1):372-8.
  • Shigemura K, Arakawa S, Miura T, Yasufuku T, Nakano Y, Tanaka K, Fujisawa M. Retroperitoneal abscess perforating into the thoracic cavity in an immunocompromised host. J Infect Chemother. 2008 Aug;14(4):305-
  • Arakawa S, Tanaka K, Kajio K, Yoshimoto T, Ogawa T, Yoshida T, Toshihiko M, Takenaka A, Yamamoto S, Shima H, Fujisawa M.A questionnaire survey on the theory of postoperative infection prophylaxis in urologic surgery. Nakano Y, Hinyokika Kiyo. 2008 Jun;54(6):395-9
  • Shigemura K, Arakawa S, Miura T, Nakano Y, Tanaka K, Fujisawa M. Significance of fluoroquinolone-resistant Escherichia coli in urinary tract infections. Jpn J Infect Dis. 2008 May;61(3):226-8
  • Miura T, Tanaka K, Shigemura K, Nakano Y, Takenaka A, Fujisawa M. Levofloxacin resistant Escherichia coli sepsis following an ultrasound-guided transrectal prostate biopsy: report of four cases and review of the literature. Int J Urol. 2008 May;15(5):457-9
  • Arakawa S, Tanaka K, Miura T, Shigemura K, Takenaka A, Matsui T, Kamidono S, Nakano Y, Fujisawa M. Usefulness and problems of the urinary tract infection criteria for evaluating drug efficacy for complicated urinary tract infections. J Infect Chemother. 2007 Oct;13(5):279-84. Epub 2007 Oct 30. Review.
  • Kurahashi T, Miyake H, Nakano Y, Shinozaki M, Oka N, Tanaka K, Takenaka A, Hara I, Arakawa S, Fujisawa M. A comparison of clinical features between chlamydial and non-chlamydial urethritis in men negative for gonococcal infection who attended a urological outpatient clinic in Japan. Int Urol Nephrol. 2007 Jan 9; Epub ahead of print.
  • Arakawa S, Nakano Y, Miura T, Shigemura K, Tanaka K, Fujisawa M. Clinical study of complicated urinary tract infection using 'The UTI Criteria (Draft Fourth Edition)': measurement methods for pyuria. Int J Urol. 2006 Dec;13(12):1484-7.
  • Shigemura K, Tanaka K, Hara I, Muramaki M, Arakawa S, Fujisawa M. Clinical study for management of supportive treatment for high-dose chemotherapy with peripheral blood stem cell transplantation (PBSCT) for intractable testicular tumor. Hinyokika Kiyo. 2006 Jul;52(7):531-6.
  • Shigemura K, Arakawa S, Sakai Y, Kinoshita S, Tanaka K, Fujisawa M. Complicated urinary tract infection caused by Pseudomonas aeruginosa in a single institution (1999-2003). Int J Urol. 2006 May;13(5):538-42.
  • Hara I, Miura T, Yamanaka K, Tanaka K, Yamada Y, Fujisawa M. A case of Sweet's syndrome following septic pulmonary emboli after high-dose chemotherapy for advanced testicular cancer. Int J Urol. 2006 Apr;13(4):481-4.
  • Shigemura K, Arakawa S, Nakano Y, Hara I, Tanaka K, Fujisawa M. Larger prostate causes higher frequency of infectious complications in prostate biopsy. Urol Int. 2006;76(4):321-6.
  • Shigemura K, Shirakawa T, Tanaka K, Arakawa S, Gotoh A, Fujisawa M. Rapid detection of the fluoroquinolone resistance-associated ParC mutation in Neisseria gonorrhoeae using TaqMan probes. Int J Urol. 2006 Mar;13(3):277-81.
  • Shigemura K, Shirakawa T, Massi N, Tanaka K, Arakawa S, Gotoh A, Fujisawa M. Presence of a mutation in ponA1 of Neisseria gonorrhoeae in numerous clinical samples resistant to various beta-lactams and other, structurally unrelated, antimicrobials. J Infect Chemother. 2005 Oct;11(5):226-30.
  • Shigemura K, Tanaka K, Yasuda M, Ishihara S, Muratani T, Deguchi T, Matsumoto T, Kamidono S, Nakano Y, Arakawa S, Fujisawa M. Efficacy of 1-day prophylaxis medication with fluoroquinolone for prostate biopsy. World J Urol. 2005 Nov;23(5):356-60. Epub 2005 Oct 28.
  • Shigemura K, Tanaka K, Okada H, Nakano Y, Kinoshita S, Gotoh A, Arakawa S, Fujisawa M. Pathogen occurrence and antimicrobial susceptibility of urinary tract infection cases during a 20-year period (1983-2002) at a single institution in Japan . Jpn J Infect Dis. 2005 Oct;58(5):303-8.
  • Fujisawa M, Sakai Y, Nakano Y, Arakawa S, Kamidono S. Changes in sodium transport in epithelial cells in a rat ileal-augmented bladder model. BJU Int. 2002 Dec;90(9):953-6.
  • Sakai Y, Fujisawa M, Nakano Y, Miyazaki S, Arakawa S, Kamidono S. Bacterial adherence in a rat bladder augmentation model: ileocystoplasty versus colocystoplasty. J Urol. 2000 Dec;164(6):2104-7.