Exploratory research for new methodology of diagnosis and treatments of gynecological pelvic abscess using MR Spectroscopy and Identification of bacteria species by NGS.

• Project/Area Number: 18K16779
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Keio University
• Principal Investigator: Nogami Yuya 慶應義塾大学, 医学部(信濃町), 共同研究員 (90574294)
• Project Period (FY): 2018-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000); Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2018: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 骨盤内膿瘍 / MRS / リンパ嚢胞感染 / NGS / MR Spectoroscopy / 起因菌同定 / 感染症 / 婦人科腫瘍 / 16ｓ rRNA

Outline of Final Research Achievements

Pelvic abscesses are challenging to puncture because of its location in deep pelvis and the treatments are started without culture examination in most cases. Some cases are improved conservatively. Otherwise, invasive procedure such as drainage will be needed after expectant management, and it results in prolongation of duration of therapy. The examination which can predict the necessity of drainage in start will give merits.Even when the culture test was performed, causative bacteria are still unknown in some cases, because of proceeding antibiotics and culture difficulty of anaerobic bacteria.
We investigated that the necessity of drainage and bacteria species are predictable or not using MRS. In lymphocele infection cases, necessity of drainage was indicated to be predictable. It was difficult to predict bacteria species. Identification bacteria species using NGS could revealed the causative bacteria in all cases, even in case which culture test was false negative.

Academic Significance and Societal Importance of the Research Achievements

リンパ嚢胞感染においてMRSの有用性の可能性が示唆された。婦人科癌術後の合併症で致命的ではないが、癌が治癒した患者でもQOL低下の原因になる。その治療戦略改善は意義深い。婦人科癌治療数が多い施設以外では症例集積は難しく、当施設にて本研究を行ったことで有用なデータとなった。
膿瘍の起因菌はその特性から培養検査では同定が難しく、NGSの有用性が示唆された。他領域も含め、今後の研究にも活かされる。

Research Products

• [Journal Article] Profiling of the Causative Bacteria in Infected Lymphocysts after Lymphadenectomy for Gynecologic Cancer by Pyrosequencing the 16S Ribosomal RNA Gene Using Next-Generation Sequencing Technology (2019)
  • Author(s): Nogami Yuya, Banno Kouji, Adachi Masataka, Kunitomi Haruko, Kobayashi Yusuke, Tominaga Eiichiro, Aoki Daisuke.
  • Journal Title: Infectious Diseases in Obstetrics and Gynecology Volume: 2019 Pages: 1-5
  • DOI: 10.1155/2019/9326285
  • Peer Reviewed / Open Access
• [Presentation] 16s ribosomal RNAの次世代シークエンスによる菌叢解析を用いた婦人科癌術後のリンパ嚢胞感染の起因菌の同定 (2019)
  • Author(s): 野上侑哉,、阪埜浩司、青木大輔
  • Organizer: 第93回日本感染症学会
• [Presentation] 次世代シークエンスによる菌叢解析での起因菌同定を用いた婦人科骨盤内膿瘍に対するMR spectroscopyの臨床的有用性の検討 (2019)
  • Author(s): 野上侑哉、阪埜浩司、辻浩介、小林佑介、冨永英一郎、奥田茂男、田中守、青木大輔
  • Organizer: 第71回日本産科婦人科学会