The majority of black molds found in the environment belong to Cladosporium species and do not typically cause invasive fungal infections. However, Aspergillus species in hospital environments are a cause for concern as they can lead to invasive pulmonary aspergillosis with a high mortality rate. Aspergillus species produce asexual spores called conidia that are airborne, and immunocompromised patients may develop invasive pulmonary aspergillosis by inhalation. Units where patients with a high risk of developing invasive pulmonary aspergillosis are hospitalized include hematology/oncology, intensive care, and lung transplant units, and these locations require special attention regarding fungal contamination in hospitals. A significant decrease in the number of airborne fungi was observed through the use of high-efficiency particulate air (HEPA) filters in an environmental survey conducted at Nagasaki University Hospital. In addition, the distribution of Aspergillus species in hospital environments showed a similar pattern between air and dust samples, suggesting that the distribution of Aspergillus species in the air could be indirectly examined by sampling dust. Aspergillus species commonly inhabit plants, soil, and dust, and to decrease the number of Aspergillus species in hospital environments, it is important to avoid placing potted plants in hospital units and maintain proper environmental cleaning to prevent the accumulation of dust. Furthermore, as the dispersal of dust can lead to the spread of Aspergillus species, preventive measures to minimize dust dispersal, such as dust control during construction or air filter replacement in units with a high risk of invasive pulmonary aspergillosis, are necessary.

The recombinant adjuvanted herpes zoster vaccine (Shingrix^®) has long-term immunogenicity and a high efficacy rate. Nonetheless, the cost and two-dose regimen may deter some individuals. This study examined the reasons for patients' decision to get vaccinated and the difference in adverse reactions between the first and second inoculations of the vaccine.

We retrospectively analyzed the medical records of 128 patients (average age: 73.9±7.9 years; male-to-female ratio: 39/89) who began vaccination in August 2021. Patients primarily learned about the vaccine through physicians (64.1%) and clinic bulletin boards (35.2%). Reasons for vaccination included the absence of prior herpes zoster infection history (50.0%), desire to avoid recurrence (33.6%), and concern regarding infections among family and acquaintances (32.8%). The incidence of local adverse reactions, such as swelling (74.2% vs. 70.1%), redness (68.0% vs. 66.1%), and pain (85.2% vs. 81.1%), and systemic adverse reactions, such as fever (26.6% vs. 28.3%), fatigue (29.7% vs. 34.6%), and myalgia (22.7% vs. 26.8%), was similar after the first and second inoculations. The duration of redness after the second inoculation was significantly shorter (p = 0.015). Those who experienced adverse reactions after the first inoculation were more prone to recurrence after the second inoculation, with redness (73.3%), swelling (69.1%), pain (82.4%), fever (70.6%), fatigue (47.4%), and muscle pain (41.4%). Notably, the adverse reactions following the first inoculation did not necessarily recur after the second. However, those encountering reactions, such as redness, fatigue, fever, and muscle pain, after the first inoculation were significantly more likely to experience them again. Systemic adverse reactions, such as fever, chills, headaches, and fatigue, were less frequent in individuals aged 75 years and older. Remarkably, 35.4% of patients reported milder adverse reactions after the second inoculation compared with those after the first inoculation. This study clarified the reasons for the decision to vaccinate and suggested that adverse reactions after vaccine inoculation were tolerated by Japanese people.

The University of Miyazaki Hospital established UV-C ultraviolet irradiation robots to strengthen measures against nosocomial infections. In this study, we collected cultures and environmental samples from outpatient examinations and patient rooms before and after UV irradiation and compared the effects of UV-C irradiation time, irradiation distance, and object structure on the disinfection effect of the UV-C irradiation robot, as well as the disinfection effect of the UV-C irradiation robot on patient rooms following their use. As a result, a certain disinfection effect was confirmed by the UV-C irradiation. However, the disinfection effect may be insufficient because of factors such as inadequate irradiation distance, object structure, and the presence of dust. To achieve a higher level of disinfection, it is necessary to complement UV irradiation using a UV-C ultraviolet irradiation robot with regular cleaning practices. Special attention should be paid to areas where objects have complex structures, shadows are easily formed, and dust tends to accumulate. By combining UV irradiation with thorough cleaning of these specific areas, an enhanced disinfection effect can be anticipated.

It is common for the prothrombin time-internationally normalized ratio (PT-INR) to increase during antimicrobial therapy in patients taking warfarin. Antimicrobial agents that are likely to increase PT-INR include broad-spectrum agents and those that contain N-methylthiotetrazole side chains. In this study, we retrospectively examined the effects of the type of antimicrobial agent and the background of patients receiving antimicrobial agents on changes in the PT-INR. The subjects were patients who received antimicrobial agents while taking warfarin from 2013 to 2017. There were 33 patients in the group with elevated PT-INR and 35 patients in the group with nonelevated PT-INR. In the univariate analysis for the search for factors contributing to PT-INR elevation, there were significant differences in missed meals, pneumonia, and the total number of antibacterial agents used (p<0.05), but not in the type of antimicrobial agent. The results for PT-INR elevation factors were similar to those of the univariate analysis in the multivariate analysis. The odds ratios (95% confidence interval) were 5.33 (1.47-19.30) for missed meals, 4.17 (1.28-13.60) for pneumonia, and 3.53 (1.32-9.43) for the total number of antibacterial agents used, respectively. These results suggest that no specific type of antimicrobial agent is responsible for the increase in PT-INR; however, multiple factors may be involved in the increase in PT-INR during antimicrobial therapy.