It is well documented that Mycoplasmal pneumonia breaks out periodically. Recently, we have studied on the complications of this disease in 72 cases (37 male and 35 female) who were hospitalized in the past three years.
Of the 72 cases, 40 cases (about 57%) had complications in one form or another.
Eruption accounted high incidence with 21 cases (29.2%). Of them, rubella-like eruption showed high incidence, followed by pleurisy 13 cases (18.1%) and epistaxis 10 cases (13.9%). In 6 cases, elevating serum titers against M. pneumonia and high values for ASO (of them, one case shifted to glomerulonephritis) were observed concomitantly, while the M. pneumonia titer was detected in two patients with MCLS and one case with asthmatic attack after M. pneumonia infection.
Besides, there were otitis media in four cases, two cases of encephalopathy and one case of meningitis, thrombocytopenia and Stevens_ Johnson's syndrome each.
As for the age composition for the cases of complications, those aged 4 to 10 years accounted for the highest incidence with 29 cases (72.5% of total cases). Apparently, this is the age breaked to which at most attention must be paid for further examination and treatment.

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The relationship between the serotype and the invasiveness of the strains of E coli for theuri uary tract tissue was studied by inoculation of Escherichia coli, which was isolated from the urine and feces of patients with lower urinary tract infection at the same time, into the rat bladder.
The organisms studied were 84 strains from 44 female patients with acute cystitis. Of these, 46 strains were obtained from the urine, and 38 strains from the feces. The serotypes of the strains from the urine were 0-1, 4, 6, 7, 14, 21, 28 & 75, and from the feces 0-1, 2, 4, 6, 7, 11, 14, 15, 19, 21, 28, 40, 75 & 80.
0.1 ml of pysiological saline containing about 10³ organisms per ml was transurethraly injected into the bladder of 8 week-aged female Sprague-Dawley rat, and the degree of invasion in the bladder removed 6 hours after injection was observed, using the indirect fluorescent antibody method.
Results:
1. In 32.6%(15/46) of the strains from the urine and 18.4%(7/38) of those from the feces, the invasiveness was found. However, there was no statistically significant difference between these two results.
2. The results of invasiveness in the serotypes were 0-2: 18.1%(2/11), 0-4: 54.6%(6/11), 0-6: 52.6%(10/19), 0-14: 16.6%(1/6) & 0-75: 50.0%(3/6), and the other serotypes were negative in the invasiveness test.
3. When the serotypes were classified in the specific group (0-2, 4, 6 & 75) and the general group (the other serotypes), the degree of invasiveness in the former group was 44.6%(21/47), whereas the degree of that in the latter was only 2.7%(1/37). Thus the highly significant difference between the degree of invasiveness of these two groups was found.
4. Even in the above specific serotype group, the strong, weak or zero invasiveness was observed, and this finding suggests that this difference may be caused by the difference in quantity of virulence factor.

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The anaerobic bacteria of the uterus and vagina in puerperas, both afebrile and febrile, were investigated during the period from January 1973 to December 1976.
The anaerobic bacteria were isolated at a rate of 35.4%(from the uterus) and 20.8%(from the vagina) in 48 afebrile puerperas, at a rate of 76.5%(from the uterus) and 44.1%(from the vagina) in 34 febrile puerperas (puerperal infection). Two significant characteristics were found from this study. The one is that the anaerobic bacteria were found more frequently in the uterus than in the vagina, in both afebrile and febrile puerperas. This was a striking contrast to widely known theory that the aerobes in puerperas were greater in number in the vagina than in the uterus. The other was that the rate of occurrence of the anaerobic bacteria in the uterus of the afebrile puerperas was high but still less than that in febrile puerperas.
Among 34 febrile puerperas 26 showed uterine anaerobes and in 13 cases the same types of bacteria were found also in the vagina. These findings contrasted well with those in afebrile puerperas, in which the uterine anaerobes were rarely found in vagina at the same time. Since both the vaginal and uterine bacteria in puerperal infections are almost always the same, it is sufficient to investigate only the vaginal bacteria in order to make the diagnosis.
Of the 26 patients found to have uterine anaerobes, 9 had also aerobes. When these 9 patients' symptoms were gradually relieved by therapy, the anaerobic bacteria gradually disappeared and were replaced by aerobes after a short time. It is said that many anaerobic infections are mixed infection involving aerobic bacteria. But the result of this study on postpartum was in sharp contrast to this concept.
Uterine anaerobes were found very frequently after intrauterine manipulations (e.g. vacuum extraction, forceps delivery, breech delivery, metreurysis, manual removal of placenta). In addition to these manipulations, some patients suffered premature or early rupture of membranes, prolonged labor, lacelations of the perineum or cervix. In these cases the detection rate of anaerobes in uterus was even higher.
In puerperas who were anemic during pregnancy and/or who have suffered serious hemorrhage during labor (more than 500 ml), puerperal infections often occurred especially when the anaerobic bacteria already existed in the uterus or invaded externally into the uterus. Therefore, anemia prepartum and postpartum may be an important factor to decrease the host defences and to make favorable conditions for infections.
In many textbooks, a temperature of 38.0°C or higher is regarded as one of the important criteria for diagnosing the puerperal infection, however, it has been proposed recently that 37.5°C or higher be accepted as a clinical criterion because of the increase of anaerobic infections. I am of the same opinion according to the results of this study.

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A 66-year-old man of diffuse panbronchiolitis with lower airway infection due to Achromobacter xylosoxidans is reported with particular reference to marked hypoxemia observed. He have had cough, much sputum and dyspnea.
In vitro antibacterial activity aganst A. xylosoxidans which was isolated from the patient, ST (SMXTMP) showed strong antibacterial activity. An MIC for ST (SMX-TMP) and SMX of the strain of A. xylosoxidans was 12.5 μg/ml and 6.25 μg/ml, while it was greater than 100 μg/ml with TC, CBPC, GM. and CER. Though there was no effective with CBPC, CL, GM, CP or MINO, excellent clinical response was obtained in the patient with ST (SMX-TMP).

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