We newly developed a transfusion plug that has an air passage of polymer porous material (I Cap). This porous polymer material theoretical does not pass the infectious microorganisms. We experimented contaminations during the transfusions by I Cap and that using air needles. Trypticated soy broth was used for the experiments. Experiments of transfusion in a dusty environment revealed that the transfusions by air needles got 100% contamination and that by I Cap was 0%. The experments in a clinic room transfusions also reveald that air needle resulted in 30.3% contamination but on the contrary 0% with the I Cap. Dusty air was flown under high pressure (1.5 atmospheric pressure) through the same filter of I Cap for 30 minutes into the trypticated soy broth. These experiments revealed that the filter did not permeate bacteria and that transfusions with air needle was contaminanted with dust.
Although 18 cases of Legionnaires' disease have been reported in Japan, these have included none from the northern areas of Japan. The first confirmed case of Legionnaires' disease in Hokkaido district, a northern island of Japan, is reported. A 48 year-old male was admitted for fulminant pneumonia, and died the next day. Legionella pneumophila, serogropu 1, was cultured and determined from the sputum and lung tissue obtained at autopsy. Postmorten examination by means of the indirect immunofluorescent method, using group specific antisera against Legionella pneumophila as a primary antibody, revealed phagocytized bacilli in the alveoli of the lung.
When fecal specimens obtained from infants with acute gastroenteritis during the acute phase between January 1986 and March 1987 were examined by enzyme immunoassay (ETA), 72 cases were found to have the rotavirus antigen. Such 3 clinical signs as diarrhea (D), fever (F) and vomiting (V) were all observed in 38 cases. These cases showing DFV syndrome demonstrated the highest geometric mean titer of rotavirus antigen among the rotavirus antigen-positive cases. Geomtric mean titers (GMTs) were calculated to be as high as more than 103.1 in 26 of the 38 DFV cases (68%) and in 11 of 34 cases with DV, DF, FV or D syndromes (32%), showing a significant difference between the 2 group (p<0.005). GTMs were slightly higher in cases having fever of 38°C or more, than in those having fever of less than 38°C.
Levels of antibody against GBS type III in pregnant women have been determined using ELISA assay method that we originally deviced. Toyo Jozo Co. have also introduced an assay system (the Toyo kit) that resembles ours. The present study was performed to compare our system with the Toyo kit. Correctivity between the two systems was good, giving a regression curve of Y=1.18X-0.60 and a correlation coefficient of r=0.794. Antibody levels in pregnant women were determined by the Toyo kit, and were found to be less than 10 μg/ml in almost all samples. Among 19 serum samples from vaginal carriers of GBS type III, the antibody levels ranged from 1.5 to 93.8μg/ml. Among seven maternal serum samples in cases of GBS type III infection, the maximum level was 6.0 μg/ml. Thus, the Toyo kit showed satisfactory sensitivity for determining the level of antibody against GBS type III. Hereafter, we intend to use the Toyo kit for determining antibody levels in pregnant women.
A neonatal pneumonia caused by Chlamydia trachomatis (C. trachomatis) is well-known. But it is uncertain whether C. trachomatis causes penumonia in a patient over 1 year of age. Therefore, a search for serologic and cultural evidence of C. trachomatis infection in patients sufferring from acute pneumia over 1 year of age was made. We studied 183 children ages 1 to 5 year-old suffering from acute pneumonia admitted to Kousei General Hospital to assess the relation between acute pneumonia and C. trachomatis. We investigated the serologic evidence of acute C. trachomatis infections in 73 children with a persistant cough and wheezing, detecting specific IgG antibodies and IgM antibodies by microimmunofluorescence test. Selorogic results signifying acute infection were observed in 4 cases (2.2%). Then we tried to isolate C. trachomatis from the cultures of nazopharyngeal swabs, specific inclusion bodies of C. trachomatis in 2 cases (1.1%) were found. A neonatal pneumonia caused by Chlamydia trachomatis (C. trachomatis) is well-known. But it is uncertain whether C. trachomatis causes penumonia in a patient over 1 year of age. Therefore, a searchfor serologic and cultural evidence of C. trachomatis infection in patients sufferring from acute pneumia over 1 year of age was made. We studied 183 children ages 1 to 5 year-old suffering from acute pneumonia admitted to Kousei General Hospital to assess the relation between acute pneumonia and C. trachomatis. We investigated the serologic evidence of acute C. trachomatis infections in 73 children with a persistant cough and wheezing, detecting specific IgG antibodies and IgM antibodies by microimmunofluorescence test. Selorogic results signifying acute infection were observed in 4 cases (2.2%). Then we tried to isolate C. trachomatis from the cultures of nazopharyngeal swabs, specific inclusion bodies of C. trachomatis in 2 cases (1.1%) were found.
The effects of anti-inflammatory drugs (acetylsalicylic acid, ASA; salicylic acid, SA; indomethacin, IM; hydrocortisone, HC) on the respiratory burst oxidase (NADPH oxidase) from human neutrophils in both whole cell and fully soluble (cell-free) systems were investigated. These drugs were found to inhibit the superoxide generation by human neutrophils exposed to phorbol myristate acetate in a whole cell system and the activation of superoxide-generating NADPH oxidase by sodium dodecyl sulfate in cell-free systems. Concentrations of these drugs required for 50% inhibition of the oxidase (ID50) were; ASA (more than 3.0 mM in the whole cell system and 1.35 mM in the cell-free system), SA (more than 3.0 mM in the whole cell system and 1.30 mM in the cell-free system), IM (180 μM in both systems) and HC (50 μM in the whole cell system and 40 μM in the cell-free system). In addition, these drugs time-dependently inhibited the activation of NADPH oxidase in cell-free systems. In the cell-free system, all of the drugs did not change the Km values for NADPH of the oxidase. These results suggest that these anti-inflammatory drugs, especially HC and IM, inhibit the reconstitution (activation) of neurtophil NADPH oxidase enzyme in the cell-free (whole cell) system.
Deep-seated mycosis is prominently increasing as a terminal infection in compromised hosts with malignant blood disorders or malignant tumors. Moreover, localized candidal abscess of visual organs has recently been reported in several laboratories. We investigated the occurrence of deep-seated mycosis in 105 autopsied cases with blood disorders in our clinic from 1980 to 1987. Forty-four of those cases had died of various infections, and 80% of them were fungal infections. More than half of the fungal infections were aspergillosis. Deep-seated candidiasis was recognized in 10 cases, 6 of which were systemic candidiasis, theaverage duration of neutropenia below 500/mm3 was 19.7 days that of lymphopenia was 36.5 days. Two cases were complicated with GI-tract ulcer, and involved with hepatic candidiasis. On the other hand, in the 4 cases of localized candidial abscess, the duration of neutropenia was 58.5 days and that of lymphopenia was 28.8 days. These four cases were complicated with GI-tract ulcer. Histologically, Candida spp. were recognized at the bottom of the ulcer and invasion by inflammatory cells or tumor cells was found in the portal vein. We surmised that GI-tract ulceration is a very important complication of hepatic candidiasis or liver abscess, and the occurrence of localized candidiasis seems to depend on the duration and severity of neutropenia.
Pasteurella multocida is a Gram-negative short rod-shaped bacteria that has been reocgnized as a pathogen of hemorrhagic septicemia and fowl cholera in the veterinary medicine. Infections by this microorganism as seen in the foreign literature vary widely from local infections due to bites and scratches by animals to general infections such as infections of the respiratory tract, sepsis, and meningitis. In Japan, reported cases of P. multocida infections are predominantly local infections, followed by respiratory infection. Recently, death of diabetic patients due to septicemia by this pathogen has also been reported. In this study, we experienced a case of respiratory tract infection in which the pathogen P. multocida subsp. multocida was suggested to have been transmitted from a pet cat by the agreement of the serotype of the bacterial isolates between the patient and the cat. This case was evaluated from the zoonotic viewpoint. The patient was a 68-year-old male who had been followed up since 1982 with a diagnosis of bronchiectasis. After his referral to our hospital, P. multocida subsp. multocida was isolated from his bloody sputum and, then, from the cat kept by the patient. The tow isolates were identical in terms of the biochemical properties, drug susceptibility profile, andserotype (-: 1), and the derivation of P. multocida subsp. multocida infection from cat was established for the first time in this report. The incidence of P. multocida infections is increasing in Japan, and particular attention is considered to be needed about these conditions as zoonoses as indicated in “Preventive Measures against Zoonoses Derived from Pet Animals (Dog, Cat)”, an official communication from the Ministry of Health and Welfare to related instititions in 1989. Also, to check whether the patient keeps any pet at the clinical inquiry is a practice of bacteriological importance in all fields of medicine.
Serum samples were collected from 55 pairs of calves that had not passed the first summer and their dams reared in Kagoshima from 1983 through 1985. They were investigated for the HI antibody to Japanese encephalitis virus (JEV) in calves and for the correlation of antibody levels between calves and their dams. The maternally derived antibody was detected in 35 of 55 calves (63.6%), showing the mean antibody titer of 12.4. A significant negative correlation (p<0.01) was noted between the age of calve and titer of passively acquired antibodies. The regression equation suggested that the maternal antibody disappeared from the calf serum at about 3 months of age. On the other hand, 37 of 55 dams (67.3%) were positive for HI antibody to JEV, and the mean titer of the antibody was 12.7. There was a significant correlation (p<0.01) in serum antibody titers between dams and their calves.
The bacteriology of the isolates from the throat swab and the sputum respectively of 2, 539 patients with respiratory infections visiting 21 private clinics in Tohoku district of Japan during the period from January to April in 1989 was documented. Of the 2, 539 patients, 1, 694 had an acute upper respiratory infection, 609 had acute bronchitis, 46 had acute pneumonia, 84 had acute exacerbation of chronic respiratory infections and 106 had respiratory infections without diagnosis registered. 1887 (74.3%) strains of potential pathogens were recovered from 1507 (59.4%) of the 2539 cases. The rate of recovery of potential pathogens was very high in patients of the younger age. These patients had elevated body-temperature. There were statistically significant differences in recovery rate when classified by diagnosis, prefecture and the period of investigation. Of the 1, 887 strains, 996 (52.8%) were gram-positive and 891 (47.2%) were gram-negative bacteria. The rate of recovery of gram-negative bacteria was high in patients who were less than 10 years old and more than 51 years old, in patients with pneumonia and chronic respiratory infections, and in patients with fever. Of the 1, 887 strains, those which exceeded 100 were Staphylococcus aureus (481 strains), Haemophilus influenzae (340 strains), Streptococcus pneumoniae (329 strains), Streptococcus pyogenes (117 strains) and Acinetobacter spp. (100 strains). Species other than those mentioned above had less than 100 strains. In this group there were 39 strains of Branhamella catarrhalis, 32 strains of Esherichia coli, 97 strains of Klebsiella spp., 40 strains of Enterobacter spp., 25 strains of Serratia spp., 12 strains of Pseudomonas aeruginosa and 43 strains of Pseudomonas putida. There was a remarkable difference in recovery rate of each species when classified by diagnosis, age class, prefecture and the period of investigation, respectively. The above results indicated that gram-positive bacteria are more frequent than gram-negative bacteria, that enterobacteriaceae and glucose-non-fermentative gram-negative bacteria are only rarely found in primary care clinics, and that the bacteriology in primary care clinic is different from that of medical school-affiliated hospitals.
We determined the MICs of ampicillin, methicillin, cefaclor, cefixime, cefteram, ofloxacin and ciprofloxacin against a total of 1, 448 strains from 11 species: 464 strains of Staphylococcus aureus, 306 strains of Streptococcus pneumoniae, 114 strains of Streptococcus pyogenes, 37 strains of Branhamella catarrhalis, 329 strains of Haemophilus influenzae, 32 strains of Escherichia coli, 66 strains of Klebsiella pneumoniae, 26 strains of Enterobacter cloacae, 20 strains of Serratia marcescens, 12 strains of Pseudomonas aeruginosa and 42 strains of Acinetobacter calcoaceticus, isolated from the throat swab and the sputum of 2, 539 patients with respiratory infections who visited 21 private clinics in Tohoku ditrict of Japan during the period from January to April in 1989. Ciprofloxacin and ofloxacin were more active against S. aurues, B. catarrhalis, P. aeruginosa and A. calcoaceticus than other antibiotics. Ampicillin and cefteram were more active against S. pneumoniae and S. pyogenes than other antibiotics. New-quinolones and cephems of new-generation were active against H. influenzae, E. coli, K pneumoniae, E. cloacae and S. marcescens. Of 30 strains of S. aureus which were resistant (MIC≥12.5μg/ml) to ampicillin, only one strain was resistant (MIC≥12.5μg/ml) to methicllin. Twenty strains (6.5%) of S. pneumoniae and 49 strains (14.9%) of H. influenzae were resistant (MIC≥1.56 μg/ml) to ampicillin. Of 101 strains of H. influenzae of which their β-lactamase activity was determined by Nitrocephin-method, 27 (26.7%) were β-lactamase-positive strains. The above results indicated that MRSA is only rarely found in primary care clinics but the incidence of amplicillinresistant H. influenzae in primary care clinics is almost the same as that of the intensive care clinic, i. e. medical school-affiliated hospitals. Therefore caution should be exercised as regards antibiotic resistance of the causative organism even in primary care clinics.
In order to determine the type-specific antibody to gruop B streptococcus (GBA) type Ia, Ib, II and III, the ELISA system was established in Research laboratories, Toyo Jozo Co., Ltd. We assayed type-specific antibody by this ELISA system in both maternal and neonatal (or cord) sera. The cut off levels were determined by the antibody levels of maternal and neonatal sera of 26 infected cases and 90 GBS carriers, that type Ia, Ib, II were 0.20 and type III was 0.15. Prevalence of type-specific antibody levels were studied in 356 maternal sera (14 affected cases, 100 GBS carriers and 242 non carriers). Antibody levels were positive in 47.2% of maternal sera to type Ia, 34.0% to type Ib, 46.9% to type II and 45.5% to type III. Antibody levels to type Ia, Ib, II and III were positive, respectively, in 100%, 88.2%, 25.0% and 42.9% of the sera of carrier mothers whose infants were not affected. Antibody levels in 50 pair sera of maternal and cord blood were well correlated.
We experienced two cases of atypical pneumonia accompanied with rhabdomyolysis and diagnosed them as psittacosis based on the results of investigation of paired serum samples. Rhabdomyolysis may be associated with some kinds of viral or bacterial infections, but no report was found in the case of psittacosis as far as we searched and such a description was not found in textbooks. Heretofore, the elevation of GOT and LDH as the laboratory findings in psittacosis was considered as the reflection of liver injury, but that might be brought about by rhabdomyolysis. Although the mechanism (s) of the occurrence of rhabdomyolysis in psittacosis is unknown, when the elevation of muscular origin-enzymes including CPK is recognized in cases of atypical pneumonia, it may be the clue of diagnosis of psittacosis.
An outbreak of epidemic diarrhea (nonbacterial acute gastroenteritis) in Fukuoka was studied electron microscopically and electrophoretically. From the result of electron microscopy, rotavirus particles about 70 nm in diameter were observed in fecal samples. However, the serological study did not reveal any antigenic relatedness to the ordinary rotaviruses by RPHA. The outbreak appeared to be caused by gorup C rotaviruses, based on the pattern of the RNA genome segments in polyacrylamide gels.