The frequency of isolation of S. aureus from vaginal fluor obtained from 836 outpatients at the Department of obstetrics & Gynecology, Mishuku National Public Service Personnal Mutual Aid Association Hospital, was studied during in one year from Sep. 1983. The isolated strains were classified as three types: enterotoxin type, coagulase type and phage type. The susceptibility of the strains to antibiotics was also investigated. The results were as follows: 1. S. aureus was isolated from 99 of 836 specimens (11.8%). 2. The isolation rates of S. aureus tended to be less frequently in mid and later stages of pregnancy than in early pregnancy or at one month after birth. S. aureus was also isolated significantly more frequently in patients of vaginitis and other inflammatory diseases, myoma uteri, uterine cancer and prolapsus uteri than in those of other disease. 3. Only 2 out of 99 strains (2.4%) were demonstrated to produce Toxic Shock Syndrome Toxin-1 (TSST-1), one of which was classified as coagulase IV and phage type I, and the other as coagulase III and phage type III. 4. Approximately 70% of the strains obtained were resistant to penicillin G, but not to nine other antibiotics in their susceptibility. 5. From the fact that the tampon is rare by used during menstruation in Japan, Toxic Shock Syndrome was unlikely to become popular unless the frequency of TSST-1 producing S.aureus is increased.
The serum level of the third component of complement (C3) of mice was decreased by intraperitoneal injections 4 times a day with 1.25 U/mouse of cobra venom factor (CVF);the C3 levels being 20% below the normal level (71.8±4.0D2).This lower levels retained 4 days. This C3-depletion was recovered effectively within 24 hours by subcutaneous treatment with a single dose (10μg/mouse) of Nα-(N-acetylmuramyl-L-alanyl-D-isoglutamine)-Nε-stearoyl-L-lysine [MDP-Lys (L18)].Then the C3-restored mice were challenged with 8.6×108and 7.4×108 cfu/mouse (LD50) of Serratia marcescens and Pseudomonas aeruginosa, respectively, one day after treatment with MDP-Lys (L18) or PBS. All of the mice with MDP-Lys (L18) survived from the infections during a period of 7 days, whereas 60% of mice without MDP-Lys (L18) (control) died of the infections.These results indicated that treatment of C3-depletion mice with a single dose of MDP-Lys (L18) could restore the resistance to bacterial infections as the result of restorative effect on C3 levels.
This paper reviews the clinical and bacteriological features of patients with Enterobacter bacteremia at Juntendo University Hospital in Tokyo during a 5 year period from 1979 to 1983. E. cloacae was most frequently isolated among Enterobacter species.Most of the patients were in the early or later stages of life: 9 infants were under one year of age and 12 patients were 50 years of age or older. One or more underlying diseases were found in all of 27 patients: malignancy in 14 patients, congeniatal anomary in 8 infants and liver cirrhosis and diabetes mellitus in 3 patients either.During the hospital course, acute complications;septic shock and/or disseminated intravascular coaguration occured in 4 and 5 patients, respectively and were fatal in all.Of 63%(17/27) of the patients who died, bacteremia was responsible in 11 and underlying disease was responsible in 6. Ampicillin, cefazoline, cefmetazole and cefotiam were not effective for most isolates of E. cloacae from blood of the patients, whereas gentamicin, nalidixic acid, chloramphenicol and minocycline were effecive. Enterobacter bacteremia is an opportunistic infection and noscocomial infection in hospitalized patients.
A serological and virological study was carried out about six ATL (Adult T-cell Leukemia) patients and their family members in Osaka where the incidence of ATL is relatively low, less than 2%. Sera of all ATL patients were anti-ATLA (Adult T-cell Leukemia associated antigen) positive, and 10 of total 25 familiy members were seropositive (40%), including one of four spouses and four of 11 children.Four of six children were seropositive when their mothers or both of parents were seropositive (67%).But all were seronegative when their fathers only were seropositive. This study showed the familial accumulation of anti-ATLA antibody in non-endemic area, Osaka, and it is suggested that ATLV (HTLV-I) may be transmitted vertically.
Microbial circumstances of 33 surveillance points surrounding burned patients in the burn center were investigated periodically, in order to determine the epidemiological background of infectious diseases in burned patients.The isolation frequencies of Gram-positive cocci (especially Staphylococcus aureus), glucose non-fermenter (especially Pseudomonas aeruginosa) and Bacillus species were greatly changeable, depending on the existence of burned patients and also the humidity of the surveillance points. Serotype and antibiotic susceptibility of S. aureus and P. aeuginosa from burned patients (patient strain) and also from the surveillance in the burn center (center strain) were investigated and compared with those from non-burned patients (reference strain).Coagulase type of the patient strains of S. aureus (20 strains) was uniformly type II (100%) and those of the center strains (22 strains) were type II (77.3%) and type VII (22.7%), whereas those of the reference strains (53 strains) varied widely, including type II (56.6%), type III (18.9%) and type IV (11.3%) as the predominant types.Serotype of the all patient strains of P. aeruginosa (20 strains) was uniformly type F (100%) and those of the center strains (29 strains) were also type F (96.6%) with an exceptinal strain of type A, whereas those of the reference strains (107 strains) varied widely, including type E (39.2%), type A (17.9%) and type B (12.3%) as the predominant types.The patient strains and the center strains of S. aureus and P. aeruginosa were highly more resistant than the reference strains of each species to 18 antibiotics, respectively. The strains of S. aureus (coagulase type II) and P. aeruginosa (serotype F) with high resistance to antibiotics were isolated repeatedly from various points in the burn center. Moreover, the strains with the same characters were isolated repeatedly from the burned patients, suggesting the close relationship between infections in burned patients and the microbial flora in the burn center.
The fecal flora and blood culture were comparatively studied in 15 immunocompromised children, who were suspected of having sepsis from clinical symptoms.Their age ranged from 2 days to 7 years, and the underlying disorders were leukemia in 5 patients, other malignant diseases in 2, aplastic anemia in one, low-birth-weight of less than 1, 500 g in 4, and premature infant with congenital malformations in 3. Blood cultures were positive in 6 patients.From 4 cases Gram-negative organisms were isolated. They were Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Clostridum, and E. coli. These organisms were identical with those which were predominant in fecal flora of the individual patients.The numbers of the pathogens were more than 109 per g of feces, which indicated an overgrowth.Another common finding in these cases was a strong suppression of anaerobic organisms, such as bifidobacteria. In the remaining 2 cases Gram-positive cocci, Staphylococcus aureus and Streptococcus pneumoniae, were isolated from the blood.The fecal flora did not show overgrowth of these organisms (less than 102 per g feces), but revealed a strong suppression of the anaerobic organisms, as did in cases with Gram-negative sepsis. These results suggested that the overgrowth of Gram-negative bacilli cause septicemia by the same organisms in immunocompromised patients. For the prevention of Gram-negative bacillary sepsis, therefore, it seems necessary to preserve the normal intestinal flora in these patients.
The multi-drug-resistant preparations of lactic acid bacteria commersially available in Japan were studied on their viable cell numbers, drug-resistancy and stability of organisms. Preparations tested were A (Enterococcus faecalis, powder), A'(E. faecalis, tablet), B (E. faecalis, powder), B'(E. faecalis, tablet), C (mixture of E. faecalis, Lactobacillus acidophilus and Bifidobacteria, powder) and D (mixture of L. acidophilus, L. lactis and Streptococcus lactis, capsule). Among these, B and B'contained the highest viable cell numbers (108.1-8.4 CFU/g) and viable cell numbers of preparation D were the lowest (107.0 CFU/g). On testing antibiotics-resistancy using aminobenzyl-penicillin (ABPC), tetracycline (TC), chloramphenichol (CP), erythromycin (EM) and cephalexin (CEX), preparations A and A'showed 50-100% resistancy against all antibiotics tested, whereas B, B'and C showed rather little resistancy aganist TC, CP and EM and preparation D showed few resistancy against ABPC and CP. Preparations B and B' exhibited firm stability in keeping at 40°C for 30 days, preparations A, A' and C lost 50%viability during storage at 30°C for 30 days, whereas preparation D showed marked decrease of its viable cells either at 30°Cor40°C storage.
The rapid detection of bacteremia in blood cultures is of great diagnostic and therapeutic importance. In this study, we evaluated a new visual detection method of microorganisms in blood culture, acridine orange (A. O.) staining technique, to use 5 commercial blood culture bottles and samples with 5%rabbit blood and 4 reference strains of aerobes. And the following results are obtained. 1. All culture bottles are macroscopically positive within 24 hrs of incubation.By A. O. staining technique, E. faecalis and E. coli can be detected at only 8 hrs in some culture bottles, but smears of S. aureus and P. aeruginosa are negative at that time. 2.The number of 104 or more CFU per milliliter required for detection of microorganisms in samples.And also, it was suggested that detection time were changed by kind of strains and mediums (culture bottles). Our results suggest that A. O. staining technique is supposed to be sensitive, effective screening method for the early detection of bacteremia but that in some cases, blind subculture and other supplementary methods are necessary when A. O. staining technique is used.
This study deal with the proliferation and antigenicity of Nakayama NIH, JaGAr 01, Mie 44-1 and Beijing-1 strains of Japanese encephalitis virus grown in chick embryo cell cultures. 1.High titered virus yields were obtained when the Nakayama-NIH, JaGAr 01 and Beijing-1 strains were passage through over serially 8 times in CE cell culture. 2.The hemagglutinating (HA) activity of Nakayama NIH and Mie 44-1 strains grown in CE cell culture decreased markedly by treatment with 1.0%Tween 80, while that of 2 remaining strains were unaffected. 3.Antigenic relationship among the 4 strains were checked by HI and NT tests, using mouse antiserum against inactivated vaccine.Antiserum of Nakayama NIH showed low NT and HI titers against JaGAr 01 and Beijing-1 strains, but was found no significant discrepancy against Mie 44-1 strain. 4.Both Beijing-1 strain and JaGAr 01 strain showed high closs reaction by HI and NT tests and seemed to fall under the same immunotype. 5.Inactivated vaccine of Nakayama NIH and Beijing-1 grown in CE cell culture were found to have the same level of potency against each homologous strains, compare to commercial mouse brain vaccine.
The present study confirmed the observation of Makino et al.which almost all sera from Japanese people reacted specificially with hens'egg antigen (CAF antigen) contaminated in purified mumps virus antigen in enzyme-linked immunosorbent assay (ELISA).The author studied further on CAF antigen and anti-CAF antibodies.The ELISA anti-CAF antibodies appeared from 7 months age.The positive ratio of antibody increased with ageing and reached about 100%12 months age.The high ratio was observed until-at least 18 years old.The antibodies were not detected in most of adults. The CAF-antibodies were detected in all of three rabbits after immunization with influenza vaccine and also in one of three rabbits with Japanese encephalitis vaccine.On the other hand, Forssman antibody developed in these six rabbits following immunization.The two antibodies could be differed by adsorption-test with guinea pig kidney tissues.The CAF antigen did not react with anti-Forssman rabbit serum in ELISA.The antigencity of the CAF was observed in fractions of the highest molecular weight, which were separated by Sephacryl S-300 chromatography, and also the CAF antigen showed the same antigenecity to ovomacroglobulin by ELISA.Titers of anti-CAF antibody in IgE ELISA were significantly higher in egg-allergic children than healthy children.
Total 489 cases of human listeriosis have been reported since the first case in Japan in 1958. The serological types of 470 strains out of these cases were confirmed as follows: type 4b counted predominantly 285 cases, followed by type lb (145 strains), while the other serotypes such as la, 2, 3, 4a, 4c 4d were quite few. The authers isolated a strain of Listeria monocytogenes from cerebrospinal fluid and blood specimens of a patient with purulent meningitis who was a 67 years-old female inpatient of Shinkoh Hospital of Kobe city on August of 1984, and it was identified asListeria monocytogenes type 4c. This is the first report of Listeria monocytogenes type 4c strain isolated from human origin in Japan. The outline of clinical process of this patient, bacteriological and serological tests of this isolated strain, named as “Fukushima strain”, i. e. by quantitative agglutination test and absorption test using the immune serum of standard strain were presented. The patient had severe diseases such as liver cirrhosis and diabetes mellitus, and die after complicated with Listeria monocytogenes infection at her final stage. The autopsy had not been done. The infection route of Listeria monocytogenes to this patient was uncertain.
Two cases of Campylobacter fetus Meningitis without underlying diseases were reported. Case 1. A-42-year-old man had high fever and headache in December, 1977. He was treated by personal physician, but he complained nausea, vomiting and tinnis. He was admitted to the Kansai Medical University on January 17, 1978.The CSF findings showed that initial pressure was 190mm H2O, cell count was 960/3mm3 (all lymphocyte), protein level was 130mg/dl, glucose level was 37mg/dl, and tryptophan test was positive. He was treated with Isoniazide, Streptomycin and Rifampicin for suspected tuberclous meningitis. But Campylobacter fetus subsp. fetus (C. fetus) was isolated from CSF. It was sensitive to AB PC, MINO, TC, CP, and aminoglycosides.We used MINO 200 mg/day for 6 weeks. The patient was discharged as recovered in March, 1978. Stool and blood culture were negative for C. fetus. The patient did not have a history contact with animals. The infection route was not detected.Case 2. A-30-year-old man admitted on November, 15, 1983 because high fever and headache. Two weeks earlier he ate raw beef liver with his friend. His conciousness was clear but neck stiffness was present.The CSF findings showed that turbirity was positive, initial pressure was 170mm H2O, cell count was 129mg/dl, and glucose level was 65mg/dl. We found gram-negative spinal rods in gram stain, and C. fetus was isolated from CSF. Rokitamycin 1200 mg/day was orally administered, but fever and headahe continued. CSF and serum levels of Rokitamycin (300 mg orally administered) were measured. Serum peak level was 0.625μg/ml at 2 hours, but CSF levels were lower than measurable level.It was sensitive to AB PC, MINO, EM, TC, and aminoglycosides. We used AB PC 12g/day intravenously and TOB 5mg/day intrathecally twice a week for 4 weeks. He was discharged as recovered on January, 1984. He ate raw beef liver, but his blood and stool culture for C. fetus were negative. And stool culture for C. fetus of his friend was negative.