Strains of Pseudomonas aeruginosa were detected from clinical materials obtained from patients atthe (DCCM), Nippon Medical School, over a period of about 5 years from April, 1977, to December, 1981. They were tested for serotype and sensitivity to six antibiotics. Their serotypes were comparedwith those of strains of the same species as this detected from the patients' feces and the environmentaround the patients' beds.
The results obtained are summarized as follows.
1) P. aeruginosa was isolated from 438 (14.7%) of 2, 987 samples collected. The total number ofclinical materials submitted for a year tended to increase with the lapse of time. On the contrary, the rateof detection of P. aeruginosa tended to decrease with the lapse of time.
2) An attempt was made to classify 328 strains isolated into serotypes. As a result, 325 strains (99.1%) could be divided into known serotypes. Type E was predominant, to which 165 strains (50.3%) belonged. To types G and I belonged 42 strains (12.8%) and 34 strains (10.4%), respectively. Type E wasmore frequently found than any other type among the strains detected in any year. It decreased, however, gradually in frequency with the lapse of time. Then, many other serotypes became detectablegradually.
3) The rate of resistant organisms showing an MIC of 100μg/ml or more was 53.0% to SBPC, 39.5% to DKB, and 35.5% to TOB, while it was only 1-2% to AMK, CL, or PL-B. Strains resistant toSBPC and DKB tended to decrease in frequency of detection, and those resistant to TOB to increaseyear by year. Those resistant to CL and PL-B began to appear in 1981.
4) Strains of P. aeruginosa of the same serotype as those originated from clinical materials wereisolated from the feces and the environment around the bed three of four patients tested. Almost thesame tendency was noticed in the strains of this species detected from the other patient. These resultsseemed to suggest the phase of opportunistic infection with this species.

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Antibacterial activity of 5 antimicrobial agents (penicillin G, ampicillin, tetracycline, kanamycin and spectinomycin) and β-lactamase activity were studied against 116 strains of N. gonorrhoeae clinicallyisolated at metropolitan Taito hospital and Jikei university hospital in 1981.
About 55% of the isolates were resistant (MIC≥0.8μg/ml) to penicillin G and ampicillin, andresistant strains (MIC≥3.13μg/ml) against tetracycline were observed in 30% of all. Otherwise, theresistant strains having over 25μg/ml MIC of kanamycin were in low freequency (7%), and no resistantstrain against spectinomycin was observed.
There was a remarkable correlation between penicillin G and ampicillin in susceptibility. On theother hand, no correlation was noted between penicillin G and other 3 antimicrobial agents (tetracyclin, kanamycin and spectinomycin).
The strains of β-lactamase producing N gonorrhoeae isolated, were about 10%(12 to 116) and themajority of these cases were infected in Japan.

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Autopsy cases of SLE (systemic lupus erythematosus) with infection were studied by analysis ofannual of the pathological autopsy cases in Japan. For 19 years from 1958 until 1976, 1097 autopsy casesof SLE were reported in annual of the pathological autopsy cases in Japan. Five hundred twenty-sixcases (48%) combined with infection. Annual cases of SLE with infection tended to increase in numberyear by year, according to increase in numbers of total cases of SLE. But the ratio was almost constant. The result of classifying by age was as same trend as the above result. Major infectious manifestations incases whose direct causes of death were infection were pneumonia (3.5%), mycosis (3.3%), milialytuberculosis (2.5%) and sepsis (2.0%).
There was no significant difference in annual numbers of these major infectious manifestations. Allcases were classified five groups by the causes of death (1. Related to SLE 2. Related to therapy 3. Unrelated to SLE 4. Multiple factors 5. Infection). Cases with infection were high frequent in Group 5 (100%) and Group 4 (83%). Contrary in Group 1 (22%) were low frequent. This result shows that infectionwhich combines with SLE is not directly related to the activities of SLE.

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This study was done to assess the changing pattern of microorganisms isolated from various sites ofpatients. Bacteriological examination was carried out in 11 patients continuously during a period afterthe surgical operation.
The results were as follows:
1) It was a total of 761 strains from 493 clinical materials. Gram negative rods were 12.7% of thestrains from nose, 13.5% from pharynx and 17.2% from sputum. Staphylococcus aureus was 18.2% of thestrains from nose, 4.6% from pharynx and 7.6% from sputum. From operation wounds and drainages Staph. aureus was 28.2% and 35.3%, respectively, and Gram negative rods were 17.9% and 35.3%, respectively.
2) Concidering the change of bacterial flora at the nose and pharynx of the patients from the statusof preoperation to that of postoperation, the samples containing normal flora were only decreased andthose having the strains of Staph. aureus or those of Gram negative rods were increased at the first day ofpostoperation.
3) Staph. aureus and Pseudomonas aeruginosa were isolated from the samples taken from the nose ofthe patients being inserted a naso-gastric tube. Therefore, it was expected that the change of the nasalflora was affected by inserting a nasogastric tube.
4) There were 4 patients from whom P. aeruginosa iaolated from two different sites and more aswell as from their feces. The strains isolated after the surgical operation, which were isolated fromdifferent sites of these patients, showed same sero-type and same antibiotic susceptibility pattern.
5) There were 6 patients from whom Staph. aureus was isolated from two different sites or more.The strain was isolated from the nose of all of 6 patients. The strains from 2 of 4 patients, isolated fromtheir fingers, showed same coagulase-type and same antibotic susceptibility pattern as those isolatedfrom nose, pharynx, sputum, and feces.

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One hundred clinical strains of beta-hemolytic streptococci isolated in Kyushu University Hospital were studied in terms of laboratory and clinical data. They were classified as 30 strains of group A, 47 of group B, 0 of group C, 11 of group G, and 12 of other groups. The Group A strains were mainly isolated from suppurative inflammatory lesions of the upper respiratory tract tissues, and some were also the cause of acute glomerulonephritis and chorea minor.
The group B strains were isolated from the urine and other specimens, and some of them were the cause of vaginitis and UTI, and rarely of endocarditis. About half of them, however, were nonpathogenic normal flora bacteria. The group G strains were isolated concomitantly with strains of S. aureus, E. coli, K. pneumoniae, Enterobacter, etc. The other groups were mostly isolated from gingival abscesses and the oral cavity.
T-12 and T-6 were the most frequent strains of group A. The API STREP 20 system was the most useful method for the identification of these beta-hemolytic streptococci. The test for susceptibility to Bacitracin was also useful for the identification of group A, but there was the passibility that group G and other strains were mixed in. Pigment-production of Colombia agar was useful for the identification of group B.
Clinical isolates of beta-hemolytic streptococci were sensitive to PCs and CEPs, but more resistant to AGs. About 50% of groups A and B were resistant to TC, and 40% of group A were resistant to EM and CLDM.

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The pathogenicity of Ubol type El Tor vibrio which has been said to be non or less pathogenic was examined by using experimental cholera in mice and rabbits. Five strains were examined in their toxigenicity, infectivity (adhesive property to the intestinal epithelium) and pathogenicity (property to bring about symptom). At the same time, 5 strains of Celebes type El Tor vibrios were examined in the same way as the control study.
Toxigenicity was determined with Syncase media and yeast extract enriched peptone water in vitro, and with the assay of cholera toxin in the intestinal fluid of infected rabbits. The adhesive property was determined with counting live vibrio adhered to the intestinal wall after washing in the physiological saline solution, and with electronmicroscopy. The pathogenicity was judged with the mortality of infected suckling mice and fluid accumulation in the intestine of rabbits. As the results, all Celebes type strains revealed positive findings; toxigenic, adhesive and pathogenic. Although 2 strains of Ubol type organism gave totally negative findings, 3 strains revealed positive as Celebes type organisms. Some of the pathogenic strains did not produce cholera toxin (less than 8 ng/ml) in vitro, but they produced much amount of cholera toxin in the rabbits intestine. Pathogenic strain, regardless the type, was toxigenic and adhesive. Non pathogenic strain lacked both properties. No strain had only one of them. In conclusion, the hypothesis “Ubol type El Tor vibrio is non or less pathogenic” should properly be corrected.

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A total of 123 patients under treatment by hemodialysis were divided into a vaccinated group of 59 and a nonvaccinated group of 64. They were examined on the production of HI antibody before and after inoculation with commercial HA vaccine (in 1980) and on the rise and fall of the antibody before and after the epidemic. The following results were obtained.
1) After inoculation with vaccine there was a significant increase (p<0.01) in average HI antibody titer against the vaccine strain used.
2) In 73%, 83%, and 66% of the strains of Russian A, Hong Kong A and B types, respectively, individual HI antibody titer increased significantly after the inoculation: It finally became more than four times as high as before the inoculation.
3) The rates of infection with the strains of Russian A, Hong Kong A and B types were 0%, 3.3%, and 0% respectively, in the inoculated group; 11%, 36%, and 11%, respectivly, in the noninoculated. They were distinctly lower in the inoculated than in the noninoculated group.

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A multi-clinic double-blind study in comparison with ibuprofen was conducted to evaluate the effectiveness, safety and usefulness of sulindac, a new non-steroidal analgesic/anti-inflammatory agent, in acute upper respiratory tract infection. Patients were treated with sulindac 150mg twice a day or ibuprofen 300 mg three times a day for 4 days.
The effectiveness and usefulness were statistically analyzed and compared in 141 sulindac-treated and 150 ibuprofen-treated patients; safety was similarly assessed in 144 and 152 patients, respectively.
The sulindac group was superior to the ibuprofen group in improvement of headache, low back pain and tonsil redness on the 3rd day, and in low back pain on the 5th day.
Not statistically significant difference was observed in the final global evaluations of the effectiveness, safety or usefulness. Therefore, sulindac is considered to be a highly useful drug equivalent or superior to ibuprofen in the treatment of acute respiratory tract infection.

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We have reported a case of sepsis caused by Edwardsiella tarda (E. tarda) which is known as enteric bacterium commonly present among reptiles such as snakes. A 68-year-old male was diagnosed as double cancer (hepatocellular carcinoma and gastric carcinoma) with diabetes mellitus and choledochitis. We suspected of sepsis because of chill, spike fever, neutrophilia and increased erythrocyte sedimentation rate, which were observed since he had admitted to hospital. We performed cultural study for blood and stool, and from which E. tarda was isolated respectively. From these clinical microbiological results, we considered that E. tarda was the cause of his sepsis and antibiotics were administered. Improvement in the clinical condition were observed since the 5th day after administration of antibiotics and cultural study for clinical specimens turned out to be negative. In addition, E. tarda isolated from blood was sensitive to colistin.
As for the reasion why E. tarda sepsis was allured to him, it can be considered several factors that he had the weakened resistance to infection due to treatment of the anticancer drugs, diabetes mellitus prone to ketoacidosis and choledochitis.

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Many cases of encephalitis associated with rubella virus infection were reported (44 cases between 1935 to 1976, 222 cases between 1976 to 1981) in Japan, and 11 adult cases were involved in these cases. In view of the rarity of this association, a case of 22 years old man, who was affected by encephalitis associated with rubella virus infection, was reported, and we discussed clinical and laboratory findings of 11 adult cases. In addition, comparative analysis of clinical and laboratory findings between adult cases and infant cases was done.
Case report: 22 years old man, his family history and past history was not remarkable.
Chief Complaint: Vomiting and loss of consciousness.
Present Illness: There was an onset of exanthema on his trunk, headache and fever. These symptoms diminished 3 days later. Chief complaint manifested 7 days later from the onset and he was admitted. Level of his consciousness was 100, and he did not exhibit pathological reflex nor meningeal irritation syndrome. Examination of the blood disclosed leukocytosis with a shift to the left in the hemogram. HI titer of rubella was positive in dilution of 1: 516 in sera, CRP was false positive and IgA showed an increase. Urinalysis showed a 1+ test for albumin and 2+ for glucose.
The sediment contained 18 to 20 white cells and many red cells per high-power field. A lumbar puncture revealed an inital pressure equivalent to 75mm of water, and the fluid gave 189/3 cells (granulocyte 59/3, lymphocyte 130/3). The EEG showed slowing θ wave. HI titer of rubella on 7 days later from onset was positive in dilution of 1: 8162 in sera.
Comparative analysis of clinical and labolatory findings between adult cases and infant ones was as follows: Infant cases were liable to exhibit nausea, vomiting and convulsion on onset, and had poor prognosis with higher mortality, but adult cases did not exhibit such syndromes on onset and had better prognosis.

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