Basic and clinical evaluation of anti-pseudomonas, anti-klebsiella and anti-E.coli antibody in respiratory infection by ELISA has been performed. Outer menbrane protein (10 μg/ml), 30, 000-80, 000 in molecular weight, purified from 10 strains of clinical isolates of peudomonas aeruginosa, klebsiella pneumoniae and E.coli was used as an antigen for ELISA.
Anti-pseudomonas antibody of immunized rabbit sera does not crossreact with other two sera but anti-klebsiella and anti-E.coli antibody crossreact each other.
Among pulmonary diseases, the titer of anti-pseudomonas antibody in chronic respiratory infection is high, especially in pseudomonas infection and correlate with anti-OEP antibody titer. However, the titer of anti-klebsiella and anti-E.coli antibody is high in normal people.
Acording to those results, the ELISA method for anti: pseudomonas antibody is helpful for the diagnosis of pseudomonas infection.

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A catalase-negative variant of Citrobacter freundii was isolated from the urinary tract of a patient who had gastric cancer and congestive heart failure. In Gram-stained smears the variant showed a clear difference in shape and size with changes in culture conditions on various culture media. The variant formed smooth and tiny colonies like streptococci on various culture media under aerobic conditions. No large-colony revertants were formed by the variant repeatedly subcultured under aerobic conditions. With the variant, active stimulation of growth around a paper disk containing a high concentration of hemin was observed. This patient had been treated with 4 antibiotics containing Gentamicin before the variant was isolated, and the MICs were GM 100, AMK 200, CFX 12.5, SBPC>1600 (μg/ml). It was assumed that the various characteristics of the variant had been induced by treatment with various antibiotics containing Gentamicin.

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The records of 51 fungemia in aged patients at Tokyo Metropolitan Geriatric Hospital from 1972 through 1985 were reviewed. All cases were monomicrobial fungemia. Major funji isolated from the blood were Candida albicans (33.3%), Candida tropicalis (27.5%), and Candida glabrata (23.5%). Ninety eight per cent of them were Candida species. The predominant risk factors associated with fungemia were prior antibiotic therapy (88.2%), Foley catheter (64.7%), intravenous catheter (47.1%), anti cancer therapy (11.8%), adrenal corticosteroid administration (7.8%), and irradiation (5.9%). Major underlying diseases were longstanding bedridden state associated with cerebrovascular diseases (13 cases, 25.5%), solid tumor (14 cases, 27.5%), and haematological malignancies (4 cases, 7.8%). Tissue invasion by Candida albicans was found in two of 28 patients who died within a month after the isolation. The overall mortality rate was 61%.

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Coxsackie virus of group B type 3 (CB3) was inoculated into monkeys to determine whether or not atrial myocarditis occur in the heart. The histopathological changes in the atria were moderate to mild degeneration, necrosis, vacuolation of the muscle fibres and inflammatory mononuclear cell infiltration on the degenerating or nerocitizing muscle fibres and in the interstitial tissues. Pericardial lesions in the atria were observed moderate to mild degeneration, oedema, thickness and inflammatory mononuclear cell infiltration. Mild degeneration, inflammatory mononuclear cell infiltration, oedema and thickness were also found in the endocardium. A virus titre was found in the atrial myocardium and virus antigen was detected in degenerating or necrotizing muscle fibres in the auricle by immunofluorescent technique. Serum neutralizing antibody titre had risen in monkeys inoculated with CB3. From the present results, it is clear that CB3 could produce atrial myocarditis as well as ventricular myocarditis. We suggests, therefore, that damage of the atrial myocardium is due to direct action of the virus.

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To simplify the procedure of virus isolation, a new microplate method has been attempted. Four kinds of cell, i.e. human embryonic fibroblast (HEF), Hep-2, Vero, MDCK were prepared together in a tissue culture microplate. 657 viruses recovered from throat swabs obtained from 2, 310 infants and children with acute respiratory infections (ARI) tested between December, 1984 and December, 1985. The isolates were influenza viruses, RS virus, parainfluenza viruses, mumps virus, adenoviruses, enteroviruses, herpes simplex virus and cytomegalovirus. Influenza and parainfluenza viruses were isolated by adding trypsin to a medium. The new microplate method is more sensitive to virus isolation, simpler to handle, cheaper economically and more convenient than ordinary tube method for the isolation of viruses from syndrome due to multiple agents such as ARI.

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The phagocytic cells such as leukocytes and macrophages emit light or chemiluminescence during phagocytosis. The chemiluminescence response of mouse whole blood was studied for Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. We compared the chemiluminescence response and the superoxide dismutase (SOD) of organism, the phagocytosis of organism by using mouse neutrophils, and the virulence of organisms by mouse systemic infection. The results may be summarized as follow: The slope of the initial chemiluminescence and maximum chemiluminescence was independent of the test organism. The organisms which showed the high chemiluminescence response were low SOD activity, sensitive for killing by neutrophils, and high minimum lethal dosis. The whole blood chemiluminescence assay is a simple, sensitive method of evaluating the function of relatively small numbers of phagocytic cells. The chemiluminescence response of whole blood may be a reliable assay for virulence of organism.

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The prevalence of serum antibodies to Chlamydia trachomatis and Chlamydia psittaci were determined using the microplate immunofluorescence antibody technique (MFA), an indirect immunofluorescence antibody test, from 100 serum samples from healthy adults, 158 samples from patients with upper respiratory tract infection and 90 samples from patients with pneumonia.
In the 100 serum samples collected from healthy adults, titer levels against C. psittaci were higher than 1: 8 in 4 (4.0%) and against C. trachomatis in 5 (5.0%).
In the 158 serum samples collected from patients with upper respiratory tract infection, titer levels against C. psittaci were higher than 1: 8 in 14 (8.9%) and against C. trachomatis in 31 (19.6%).
A significant difference was observed in the prevalence of antibodies to C. trachomatis between the patients with upper respiratory tract infection (19.6%) and healthy adults (5.0%) (p<0.001).
In the 90 serum samples collected from patients with pneumonia, titer levels against C.psittaci were higher than 1: 8 in 5 (5.6%) and against C. trachomatis in 12 (13.3%).
A significant difference was observed in the prevalence of antibodies to C.trachomatis between the patients with pneumonia (13.3%) and healthy adults (5.0%) (p<0.05).
These results suggest that some pulmonary infectious diseases in adults may be caused by C. trachomatis.

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A double blind comparative study was conducted to objectively evaluate the clinical efficacy and safety of Cefuzonam (CZON) in the treatment of chronic respiratory infections. Cefmenoxime (CMX) was used as a control drug. Each drug was administered by intravenous drip infusion 1g at a time, twice daily, for 14 days as a rule.
The results were as follows:
1. Treated in this study were 167 cases in total, 88 of CZON group and 79 of CMX group, but subjected for clinical evaluation by the evaluation committee were 147 cases, 77 of CZON group and 70 of CMX group, with 20 cases (11 of CZON group and 9 of CMX group) excluded from the committee's evaluation.
2. Clinical effectiveness assessed by the committee showed the efficacy rates of 81.8%(63 cases our of 77) for CZON group and 80.0%(56 cases out of 70) for CMX group, with no significant difference observed between the two drug groups. Also, there was no significant difference between the two groups in clinical efficacy evaluation by physicians in charge.
3. Classified by causal bacteria, clinical efficacy rates were 85.2% for CZON group and 78.6% for CMX group, and in single infection cases of gram-positive bacteria the effectiveness rates were 100% for CZON group and 75.0% for CMX group. In these two evaluations, CZON group showed higher efficacy percentages but no statistically significant difference was observed between the two drug groups. As for bacterial eradication rate, CZON group showed higher percentage but no significant difference was noted.
4. The incidence rate of abnormality in laboratory tests was lower for CZON than for CMX, but no significant difference was observed. Side effects incidence rates showed no significant difference between the two groups.
5. Usefulness rates by the evaluation of the committee were 77.9%(60 cases out of 77) for CZON group and 77.1%(54 cases out of 70) for CMX group, whereas evaluation by physicians in charge were 71.1%(54 cases out of 76) for CZON group and 82.6%(57 cases out of 69) for CMX group. In either evaluation, there was no significant difference observed between the two drug groups.
These results show that CZON is a useful drug in the treatment of chronic respiratory infections.

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A comparative study was conducted to objectively evaluate the efficacy and safety of Cefuzonam (CZON) with Cefotiam (CTM) used as a control drug. Subjected diseases were bacterial pneumonia and pulmonary suppuration. Each drug was administered by intravenous drip infusion 1g at a time, twice a day, for 14 days as a rule. The following are the results:
1. A total of 235 patients, 117 of CZON group and 118 of CTM group, were treated, but subjected for clinical efficacy assessment by the efficacy evaluation committee were 187 cases, 99 of CZON group and 88 of CTM group, 48 cases were excluded from the evaluation.
2. Overall clinical efficacy rates were 63.3% for CZON group and 69.0% for CTM group, with no significant difference shown between the two drug groups.
3. Clinical efficacy classified by causal bacteria showed no significant difference between the two drug groups. Bacterial eradication rates were as high as 95.2% for CZON and 80.0% for CTM, but there was no significant difference between the two.
4. Against causal bacteria, MICs of CZON were significantly superior to those of CTM.
5. As for side effects incidence and abnormality in laboratory test values, no significant difference was observed between the two groups.
6. Usefulness rate for CZON was 62.2%, whereas that for CTM was 67.8%, showing no significant difference.
From these results, CZON was proved to be a useful drug for bacterial pneumonia and pulmonary suppuration.

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A 65-year-old woman had been treated with acupuncture therapy for lumbago. She developed lumbar pain and high fever. CT scan revealed the low density area as abscess inthe left pelvic lesion. Staphylococcus aureus was isolated from blood and pus of the abscess. She was recovered completely after the administration of cefazoline, cloxacillin and minocycline.

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Neisseria mucosa, a species of non-pathogenic genus Neisseria which has generally been considered a resident of the nasopharyngeal region was isolated from an abscess of Bartholin's gland in an adult female in pure culture. The viable count was 1.8 × 10⁷/ml. In a Gram-stained smear of the abscess puncture, many Gram-negative diplococci were observed within polymorphonuclear leukocytes. Therefore, Neisseria gonorrhoeae infection was suspected. The patient had been treated with Dibekacin and Cefaclor, and the MICs were DKB 1.56 and CCL 3.13 (μg/ml), respectively. This case was eventually diagnosed as an N. mucosa infection of an adult female with no basal disease, and is the first report of an abscess of Bartholin's gland caused by this organism.

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