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

Research Project

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 *help	¥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。