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 - Clinical Medicine (Core Departments) - Clinical Bioregulation
Clinical Laboratory Medicine
Emerging and re-emerging infectious diseases and increasing drug resistance in various pathogenic microorganisms have created a worldwide interest in infectious diseases. A complex failure in the balance between pathogen, host, and environment causes infectious diseases. While it is thus very important to establish a correct diagnosis and to administer appropriate treatment for infectious diseases, it is also very difficult. Our aims are to develop novel diagnostic methodologies and to identify clinical evidence that will lead to more efficient management of infectious diseases. Our mission is to develop young, promising clinicians and investigators who will take an active part internationally in the fields of clinical infectious diseases, infection epidemiology, and clinical microbiology.

  Satoshi Ichiyama, M.D., Ph.D.
Research and Education
Infection is caused by a variety of pathogens from a virion to a multicellular parasite, while infected hosts show a range of immunological status from completely healthy to severely immunocompromised.
Many modalities such as microscopical examination, culturing, direct detection of antigens or genomes, are now available for the identification of causative pathogens leading to the initiation of optimal treatment. However, the correct cause cannot always be accurately identified, so that there is a growing need for the development and practical application of new technologies. To meet this need, we are cooperating with the clinical laboratory of Kyoto University Hospital and with many industries for the development and practical use of novel diagnostic methods for infectious diseases.
Infections in patients who are immunocompromised or have undergone aggressive surgery are likely to be highly complicating and life threatening. Effective prevention and control of nosocomial infections can be expected to result not only in improved outcomes but also in reduced medical costs. We are therefore conducting research into a thorough surveillance of postoperative or post-transplantation infections as well as into the prevention and control of these infections.
Unfortunately, the resources for adequate education in and management of infectious diseases in Japan have been insufficient compared with those available in other developed countries. To improve this situation, scientific rationality, rather than unsubstantiated “authoritative” comments, must take priority for better practice with regard to infectious diseases. At Kyoto University Hospital, we have been providing a sophisticated consultation service regarding efficient diagnostic procedures and appropriate management of patients with severe infection, which has resulted in a steady improvement of the prognosis for patients with nosocomial sepsis. In addition, we are educating both medical students and residents in the management of patients with infectious diseases on the basis of up-to-date clinical evidence.
We are continuing to pursue the development and application of novel methods for the diagnosis of infectious diseases, the control as well as prevention of nosocomial infection with the aim of putting everyday medical practice regarding infectious diseases on a foundation of scientific rationality.

Clinical Laboratory Medicine
Professor Satoshi Ichiyama

Shunji Takakura

Junko Ito, Miki Nagao

Takahiro Doi,
Aki Matsushima, Yasufumi Matsumura
TEL +81-75-751-3502
FAX +81-75-751-3233
Recent Publications
1. Close cooperation between infectious disease physicians and attending physicians results in better outcomes for patients with Staphylococcus aureus bacteraemia. Nagao M, Iinuma Y, Saito T, Matsumura Y, Shirano M, Matsushima A, Takakura S, Ito Y, Ichiyama S. Clin Microbiol Infect. 2010;16:1783-8.
2. Quantitative real-time PCR and the (1→3)-β-D-glucan assay for differentiation between Pneumocystis jirovecii pneumonia and colonization. Matsumura Y, Ito Y, Iinuma Y, Yasuma K, Yamamoto M, Matsushima A, Nagao M, Takakura S, Ichiyama S. Clin Microbiol Infect. 2011 [Epub ahead of print]
3. Interspecies dissemination of a novel class 1 integron carrying blaIMP-19 among Acinetobacter species in Japan. Yamamoto M, Nagao M, Matsumura Y, Matsushima A, Ito Y, Takakura S, Ichiyama S. J Antimicrob Chemother. 2011;66:2480-3.
4. Molecular and clinical characterization of plasmid-mediated AmpC β-lactamase-producing Escherichia coli bacteraemia: a comparison with extended-spectrum β-lactamase-producing and non-resistant E. coli bacteraemia. Matsumura Y, Nagao M, Iguchi M, Yagi T, Komori T, Fujita N, Yamamoto M, Matsushima A, Takakura S, Ichiyama S. Clin Microbiol Infect. 2012 [Epub ahead of print]
To assess the impact of intervention by infectious diseases physicians in cases with Staphylococcus aureus bacteremia, a retrospective cohort study of patients with SAB, comparing the management and outcome of patients during the initial (dashed line) and the later (solid line) half of the intervention period. The 30-day mortality significantly decreased in the later period (solid line).
The diagnosis of Pneumocystis pneumonia in non-HIV-infected patients is a challenge because of low sensitivity of microscopic Pneumocystis jirovecii visualization and low specificity of conventional PCR assay. We showed that both quantitative real-time PCR and blood (1→3)-β-D-glucan assays had high accuracy for discriminating colonization from microscopy-positive and -negative Pneumocystis pneumonia.
Interspecies dissemination of metallo-beta-lactamase (MBL)-encoding gene (blaIMP-19) among Acinetobacter spp. IMP-type MBL (blaIMP-19) was detected among various Acinetobacter spp., including A. pittii, A. baumannii, A. johnsonii, and A. junii at Kyoto University Hospital. This MBL was located in a novel class 1 integron as a gene cassette.