[in Japanese]

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[in Japanese]

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In order to evaluate the present status. of bacterial meningitis in children, inquiries were made to 127 institutions in Japan: Through the cooperation of the participants, following results were obtained in regard to age and sex of the patients and the causative organisms.
1. Incidence of bacterial meningitis
(a) Yearly distribution
Total number of the patients admitted to the hospitals during this 13-year period was 553,953, among which 3,273 patients were those with bacterial meningitis, its relative frequency being 0.59%. Yearly distribution varied between 0.40% and 0.74%, and there was noted no decline in its occurrence. No geographical difference was also noted.
(b) Age and sex distribution
The age distribution for all patients was as follows: Younger than 1 month, 27.3%; 1 to 3 months, 18.2%; 3 to 12 months, 21.1%; 1 to 3 years, 20.1%; 4 to 5 years, 5.0%; older than 6 years, 8.2%. Children under 4 years of age occupied 86.8% of all patients, most of whom were younger infants. There were more males affected than females for each age group, its overall ratio being 1.38: 1. 2. Causative organism
(a) Distribution according to age
E. coli and Streptococcus were by far the most common organisms in the newborn and early infancy, and S. pneumoniae and Haemophilus in infants older 3 months of age, respectively. Both of them for each age group occupied almost half of the cases, in which causative organisms were identified.
Distribution or the major organisms according to age indicated that liram-negative rods except for Haemophilus were the most frequently encountered in the first two weeks of life and its incidence declined after 3 months of age and that frequency of E. coli and Proteus became less than 1% after 1 year of age and 6 months, respectively. Haemophilus meningitis was rare under 3 months of age, increased thereafter, reached its peak between 6 months and 6 years, particularly 1 to 3 years, and became less after 6 years. Incidence of Streptococcus was frequent under 6 months, with its peak between 15 days and 3 months, although relatively less in the first 7 days, and gradually declined thereafter. S. pneumoniae was infrequent in the newborn period, increased after 3 months, and was most commonly seen in 6-12 months, although its incidence was also relatively high in older children. N. meningitidis was frequently noted after the late infancy, and there was no particular age predilection in ragard to Staphylococcus.
(b) Yearly change Yearly change of the causative organisms was determined with the patients divided into two age groups, i.e., younger or older than 3 months of age, respectively. In the first group, E. coli tended to decrease and Streptococcus to increase, which was presumed to be due to an increase in group B Streptococcus. The following organisms remained substantially unchanged, i.e., Proteus, Pseudomonas, Staphylococcus and S. pneumoniae. In the latter age group a prominent increase in Haemophilus was noted since 1972, and neither increase nor decline was found in the frequency of S. pneumoniae, Staphylococcus, Streptococcus and N. meninRitidis.
(c) cases causea by unicnown organisms
Number of cases, in which causative organisms were unknown, was 36.04% in total, but tended to decrease during the last several years.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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With the investigations of the effect of combination of hetacillin, cephapirin and amikacin, following experimental results were obtained;
1. Effect of combination of amikacin, cephapirin and hetacillin was differed depending upon the genus and species of bacteria. However, in general, in the cases showing effective results there was a relation in the concentration of these antibiotics. With strains of Escherichia coli amikacin and cephapirin was cooperative, but not with other combinations and strains of Proteus showed similar tendencies to those strains. In the strains of Pseudomonas, no effect was observed with these antibiotics. However, significant cooperative effect was shown in strains of Klebsiella pneumoniae. In penicillin-resistant strains of Staphylococci cooperative effect was represented only a combination of amikacin and hetacillin.
2. Amikacin was resistant against penicillinase isolated from penicillin-resistant strain of Staphylococcus and cephalosporinase extracted from cephalosporin-resistant strain of Escherichia coli.
3. When a strain of K. pneumoniae, showing cooperative effect with amikacin and cephapirin, was examined by electronmicroscopy, enlargement of cells and destruction of the cell walls were observed.

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A clinical investigation was carried out on a new penicillin derivative, bacampicillin with the following results.
(1) Clinical effect
Bacampicillin was administered orally to 18 patients with acute simple cystitis, acute simplepyelonephritis, chronic prostatitis and acute gonorrhoic urethritis.
Daily dosis ranged from 750mg to 1,000 mg. The administration continued for 4 to 14 days.
Clinical effect was excellent in 10 patients and good in 5 patients.
(2) Side effect
Side effects were noticed in 4 patients, one was allergic eruption and other 3 were gastralgia. In a patient the drug was discontinued to administer.

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