Diagnostic approach for patients with unidentified fever according to the classical criteria of fever of unknown origin in the field of autoimmune disorders

ArticleImmunological medicine. 42(4): 176-184 (2019)journal articl

Long-term maintenance of the mucosal healing induced by azacitidine therapy in a patient with intestinal Behçet's-like disease accompanied with myelodysplastic syndrome involving trisomy 8

ArticleImmunological medicine. 42(3): 135-141 (2019)journal articl

Clinical outcomes of intervention for carbapenems and anti-methicillin-resistant Staphylococcus aureus antibiotics by an antimicrobial stewardship team

Background: There are no reports on the effects of interventions, such as discontinuation and change and/or deescalation of carbapenems and anti-methicillin-resistant Staphylococcus aureus (MRSA) antibiotics by an antimicrobial stewardship team focusing on detailed patient outcomes. This study aimed to evaluate these effects. Methods: This retrospective cohort study was conducted at a tertiary care hospital from December 2018 to November 2019. Results: Favorable clinical responses were obtained in 165 of 184 cases (89.7%) in the intervention-accepted group, higher than those in the not accepted group (14/19 cases, 73.7%; P = .056). All-cause 30 day mortality was lower in the accepted group than in the not accepted group (1.1% and 10.5%, respectively; P = .045). The microbiological outcomes were similar between the two groups. Duration of carbapenem and anti-MRSA antibiotic use in the accepted group was significantly lower than that in the not accepted group (median [interquartile range]: 8 days [5-13] versus 14 days [8-15], respectively, P = .026 for carbapenem; 10 days [5.3-15] vs 15.5 days [13.8-45.3], respectively, P = .014 for anti-MRSA antibiotic). Conclusions: This is the first study to investigate the effects of interventions such as discontinuation and change and/ or de-escalation of antibiotics on detailed outcomes. Our intervention could reduce the duration of carbapenem and anti-MRSA antibiotic use without worsening clinical and microbiological outcomes. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

All-trans-retinoic acid (atRA) increases host resistance to Listeria monocytogenes infection

Dietary vitamin A is an essential precursor of tissue retinol, which participates in a variety of biological processes including innate immunity. Functions of vitamin A mainly depend on retinoic acid（ RA）, principally all-trans- RA （atRA） and 9-cis-RA. We assessed whether atRA is benefi cial in host resistance against bacterial infections or not. Vitamin A-defi cient（ VAD） mice were highly susceptible to infection with Listeria monocytogenes. Pre-treatment with atRA enhanced host resistance against L. monocytogenes infection in both VAD and VAS mice. Interferon（ IFN） -γ production in atRA pre-treated VAS mice was not higher compared with the control VAD mice. The eff ect of atRA was independent of T cells and B cells. The bactericidal activity in macrophages obtained from atRA pre-treated VAS mice was almost the same level compared with the control VAS mice. Our results demonstrated that the treatment with atRA is benefi cial for host resistance against L. monocytogenes infection in the early phase and suggested a new therapeutic possibility of atRA in bacterial infections