We quantified anti-streptococcal esterase (ASE) using a commercially available new kit, based on the enzyme antigen-antibody reaction. The results were as follow: 1) Upper limit of ASE titer in 621 children without infertion, aged 0 to 14 years was 300 ASE units. 2) There was no significant difference in positive rate of ASE among Henoch-Schönlein purpura, purpura nephritis, acute glomerular nephritis, rheumatic fever and rheumatic heart disease, and the accordance rates with ASO titer were 66.7 to 91.6% among the above diseases. 3) In 19 cases with scarlet fever, one in acute phase and four in recovery phase had a positive ASE but ASO titer remained low in any phase. 4) According to serial quantification in scarlet fever, ASE titer was elevated significantly 1 to 2 weeks after infection. 5) ASE determination was useful as a serological diagnosis in earlier phase of streptococcal infection because the test is highly sensitive to trace amount of antibody. 6) Relationship between ASE titer and age-group, and elevation ratio of ASE in paired serum samples were discussed.
One hundred and seventy four isolates of group A beta-hemolytic Streptococcus, which were obtained in 1978-80 from 174 children with various streptococcal infections at Asahikawa district, Japan, were typed serologically, and their antibiotic susceptibilities were determined, and compared with those isolated in 1974-75. One hundred and six (61%) of 174 patients has streptococcal pharyngitis, 60 (35%) carlet fever, three glomerulonephritis, two anaphylactoid purpura, and one each had septicemia, pneumonia and impetigo, respectively. The peak number of patients occurred at the age of 5 years. One hundred and seventy one strains (98.3%) were typable by means of T-typing, with an occurrence of type 12 in 64 (36.8%), type 4 in 30 (17.2%), type 1 in 29 (16.7%), type 6 in 22 (12.6%); and small numbers of strains were distributed in other serotypes. Type 1 strains were prevalent in patients with nephritis and purpura. Out of the 174 strains tested, 94 (54.0%) were resistant to tetracycline (TC), 44 (25.3%) to chloramphenicol (CP), and 28 (16.1%) to erythromycin (EM) and lincomycin (LCM), atan antibiotic concentration of 32μg/ml. None of the 174 strains was resistant against each three of penicillin and cephalosporin antibiotics tested. Rates of antibiotic-resistant strains among isolates in 1978-80 were appreciably lower than those in 1974-75 were appreciably lower than those in 1974-75, in which rate of resistant strains was 72.8% to TC, 69.1% to CP, 61.8% to EM and 64.7% to LCM. 61.8% of strains in 1974-75 were multiply resistant to TC, CP, EM and LCM, in contrast to 13.2% in those in 1978-80. The serotype of multiply resistant strains was almost exclusively type 12 in either studies. The decline in antibiotic resistance among group A streptococci, accompanied by decrease in occurrence of type 12 strains, was presumably related with decreased use of TC, CP and macrolide antibiotics in Japan since 1975.
The fecal specimens of patients suffered from acute diarrhea, were examined during the period from December 1979 to January 1982. Enterotoxigenic Escherichia coli strains were isolated from 24 (2.2%) cases. Two out of the 24 patients were cases which have been infected in abroad and one was thought to be a contagious case with the family that was a traveller listed above. Other 21 cases had no contact with oversea travellers. Serotype of 21 enterotoxigenic Escherichia colistrains were distributed to 13 0 serogroups. The commonly isolated were 0 148 and 0 6. The cases with ST only producing strain were most frequently found (16 cases 76.2%). The cases with both LT and ST producing strain and case with LT only producing strain were 5 (23.8%) and 1 (4.8%), respectively. From one patient, ST only and both LT-ST producing strains were isolated simultaneously. Indole negative strains which produce ST and serotyped 0 148: H ut were found from 4 individual cases.
Domestic and wild pigeons have been recognized as an important source of psittacosis in human, because human cases associated with pigeons have been frequently occured in Japan and the United States. So, the levels of CF and HI antibodies against Chlamydia psittaci (C. psittaci) were carried out on a total 53 wild pigeons caught at Nagoya city (A point) and the suburbs of Nagoya (B point) in Aichi Prefecture. In addition, pathological examinations and C. psittaci isolations were performed on 10 cases of 14 sero positive pigeons obtained from A point and the results were as followed. Both of CF and HI antibodies were found in 14 of 15 pigeons (93.3%) obtained from A point in September 1980. While in B point, CF antibodies were found 3 of 19 pigeons (15.8%) caught in October 1980 and 3 of 19 (15.8%) caught in May 1982. Positive rates of HI antibodies were 15.8% and 21.1% respectively. CF titers of sero positive cases ranged from 1: 4 to 1: 128, and HI titers ranged from 1: 8 to 1: 256. Macroscopic changes showing swellings of the liver and spleen were observed in one case of 10 pigeons. Histologically six of 10 pigeons had some lesions caused by C. psittaciin the liver and the spleen. Inclusion bodies were observed in 3 cases of above 6 pigeons. Mouse L-cell was used for C. psittaci isolations, but C. psittaci could not be isolated from supernatants of their liver and spleen. From above results, it was suggested that pigeons in our prefecture (especially, in A point) were very important as a source of human infection.
Out of 1, 219 pediatric patients who were brought to our hospital with chief complaint of diarrhea and abdominal pain and in whom stool cultures were obtained for bacteriological studies in the 17 month period from May 1 in 1981 to September 30 in 1982, strains of Campylobacter jejuni were isolated from 203 patients (16.7%). In these patients clinical studies and statistical analysis were made. It was found that clinical symptoms of Campylobacter jejuni enteritis did not give any important clue for its differentiation from bacterial diarrhea. Antibiotic susceptibility tests revealed extremely high susceptibility of Campylobacter jejuni to fosfomycin (FOM) as well as erythromycin. Moreover, the effect of FOM on improvement of diarrheal symptoms and the period required for erradication of organisms were assessed with favourable results. However, since among strains of Campylobacter jejuni there were those resistant even to these drugs, although their incidence was very low, it was considered that isolation and susceptibility testing of Campylobacter jejuni were essential for treating enteritis caused by this species of organism.
Epidemiological studies were made on the male patients with gonorrhoea in the departments of urology, Tokyo metropolitan Taito hospital and Jikei university hospital since 1965 through 1982, during 18 years. The male patients with gonorrhoea tended to increase since 1979 in both hospitals, and the number of the cases at metropolitan Taito hospital was about eight times as many as that in 1978 and four times at Jikei university hospital, in 1982. The striking increases of infected patients from employees in Japanese Torukoburo were very remarkable since 1979, and the patients infected from non-prostitute women gradually increased too. In past four years, the majorities (about 75%) of the patients were ages of twenties and thirties, and the patients in twenties tended to increase year by year.
Bacteriological studies were made on 120 strains of N. gonorrhoeae clinically isolated in Tokyo metropolitan Taito hospital in 1982. Futhermore, clinical studies were made on 349 cases of gonorrheal urethritis treated with various antimicorbial agents in the departments of urology, both Tokyo metropolitan Taito hospital and Jikei univerrsity hospital at intervals of January 1981 to December 1982. About 58%(70 to 120) of the isolates were resistant (MIC≥0.8g/ml) to penicillin G, and the strains of β-lactamase producing N. gonorrhoeae were about 17%(20 to 120). BRL 25000, kanamycin, spectinomycin, cefoxitin, latamoxef, cefoperazone, cefotaxime and ceftizoxime showed excellent antimicorbial activity to the clinical isolates, especially to the β-lactamase producing strains. Low effective rate of 67% after the treatment with ampicillin peroral administration was observed. However, the clinical effectiveness of the treatments with bacampicillin or BRL 25000 peroral administration were over 90%. High effectiveness of 97-100% after the treatments with one shot injection of cefoxitin 2g with probenecid 1g, cefoperazone 1g without probenecid and ceftizoxime 0.5g with probenecid 1g were observed. On the other hand, the clinical effectiveness of the treatment with one shot peroral administration of bacampicillin 1.5g with probenecid 1g was low efficacy of 75% in comparison with above new β-lactam compounds.
In the recent years, cases of Campylobacter enteritis were reported and animal-derived Campylobacter as an important infectious source was focused. Eighty-seven strains of Campylobacter were isolated from 132 feces among chickens carried to the Saga city Butchery in 1980-1981. From the biological characteristics, these 87 strains isolated were identified to Campylobacter jejuni biological type I, calssified by Skirrow and Benjamin. Also they were biologically perfectly the same as those of 19 among the 20 strains of Campylobacter isolated from feces of enteritis patients in Saga city in 1981. Drug-sensitivities also revealed similarities between strains isolated from chicken and human feces; high sensitivity to CP, KM, GM, MNC, JM and EM, and fair sensitivity to TC and NA. Many strains, however, were showed to be resistant to Pc-G and CER, and resistance for all strains to CET was observed. The 37 of the 87 strains isolated from chicken feces and the 13 of the 20 strains isolated from human feces were examined serologically by the Tokyo Metropolitan Research Laboratory of Public Health. Among the 37 strains isolated from chicken feces 33 were serologically classified into 8 serotypes, i. e., TCK 3, 5, 7, 8, 13, 20, 22 and 24, and the remaining 4 were unable to be classified. Among the 13 strains isolated from human feces 7 were classified into 4 serotypes, i. e., TCK 7, 19, 24 and 26, and the remaining 6 were unable to be classified. Thereby, the common serotypes found in strains isolated from chicken and human feces were TCK 7 and 24. The survival period of these strains in chicken mince were examined at temperatures of 42, 25, 5 and-25°C. At 42°C and 25°C complete extinction was observed within 1-2 days. However, the longest survival at 5°C was 19 days and a survival of longer than 3-4 month was observed at-25°C.
A 24-year-old man with chronic granulomatous disease was suffered from pneumonia. Mycoplasma pneumoniae was considered to be the etiologic agent because of a rise of the specific antibody titer. The patient was treated with MINO, SMX-TMP and GM. He had good clinical course as well as a patient of Mycoplasma pneumoniae peumonia without underlying disease did.
Three cases of Acinetobacter anitratus sepsis were experienced. 1) Case 1 is a so-called community acquired A. anitratus sepsis, which is considered the first report on this kind of disease in Japanese literature. 2) Test for sensitivity of the isolated strains of A. anitratus to antibiotics revealed both sensitive and resistant to synthetic penicillin preparations, cephalosporin preparations and CP. 3) MINO and DOXY have excellent MICS of 0.2 to 0.78μg/ml, which possibly make them drugs of first choice for A. anitratus sepsis. 4) There 3 cases had a fever stage of average 22 days, and bacteremia long persisted in spite of an administration of antibiotics strongly antibacterial to A. anitratus. 5) Hypertonic media are suggested to be useful for detecting of bacteremia during antibiotic administration for the patients.