Group B Streptococcus (GBS) is an important pathogen in newborn infants and has shown a remarkble increase in Japan since 1970. It has been reported that the early-onset type of GBS infection may be caused by vertical transmission whereas the late-onset type may be caused by horizontal or nosocomial transmission. However we think that the late-onset type may be caused by continuous carriage of GBS after vertical transmission. Therefore, we studied the continuous carriage of GBS using mice. Mice were separated into two groups, and one was given 10³ colony-forming units of type Ia and the other type III GBS (isolated from the affected human neonates) by intraperitoneal injection on the first day of life. Then, on the 2nd, the 5th, the 8th and the 10th day after injection, viable counts were obtained per 10mg of liver, spleen, lung and brain tissues. Each organ was homogenized and dissolved in 1ml physiological saline per 10mg of tissue, and 0.1ml of each was infused into brain-heart infusion agar and incubated for 36 hours at 37°C. The type III GBS isolated from many organs on these days, but type Ia was isolated in only two among 72 mice. These results suggested the possibility that type III GBS acquired by vertical transmission at birth may be carried over in a non-inflammaory state for a long time, and that the symptoms will become manifest only when the host-parasite relationship is disturbed later.

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Two strains of Clostridium absonum isolated from clinical specimens and a type strain were tested for heat resistance of spores, biochemical properties and neutralization of their lecithinase by and-C. perfringens a toxin antiserum. In addition, the usefulness of RapID ANA (AMUCO) and ANIDENT (API) kits for the identification of C. absonum was examined.
The results were summarized as follows:
1. C. absonum isolates from clinical specimens were resistant against heating at 70°C for 10 min and a type strain against heating at 85°C for 10 min, less resistant than those of C. perfringens BP6K.
2. C. absonum differentiated from C. perfringens in fermentation of trehalose, melibiose and raffinose, and hydrosis of esculin and starch.
3. Lecithinase of C. absonum was not completely neutralized by anti-C. perfringens α toxin antiserum.
4. Both RapID ANA and ANIDENT kits were useful for differentiation of C. absonum from C. perfringens but not for the identification of C. absonum.

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From November to December in 1990, 7 cases of tsutsugamushi disease were found first in the southern foot of Mt. Haruna of Gunma Pref., Japan. The present study was conducted to clarify the clinical features and the outbreak pattern of rickettsial infection in this area.
All the patients consisting of 6 males and 1 female farmers were admitted to our hospital, complaining of high fever, chills and skin rash on 5-12 days after working in the field. Based on laboratory examinations and one (or two) typical eschar, a tentative diagnosis of tsutsugamushi disease was made and all patients became better soon after the therapy with intravenous administration of minocyclin (200 mg/day). The high titer of serum antibody to Karp type Rickettsia (Orientia?) tsustugamushi was detected by an immunoperoxidase test (IP) in most of the patients, and also a Karp-like strain was isolated from only one patient, probably due to low virulence to mice.
The agricultural areas along the Agatuma and Nakuta rivers in the northern foot of Mt. Haruna have been well known as the most endemic foci of the disease in Gunma Pref. Nevertheless, it was suggested that outbreaks of the disease might be potentially wide-spread throughout this Pref., when the prevalences of the disease were evaluated as incidences to a hundred thousand inhabitants or adjusted by the density of agricultural populations of each administrative divisions. As most of the patients in Gunma Pref. have been officially reported in autumn, a statistical trial indicates that there is a significant correlation between the levels of temperature and outbreaks of the disease in autumn. In fact, the patients in Haruna District were densely found in autumn, 1990, when the average temperature was up to the highest level.

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Immune status of apparently healthy Nepalese against hemolytic streptococci was studied by measuring antibodies to various streptococcal antigens such as streptolysin-O (SO), streptokinase (SK), deoxyribonuclease-B (DN-B) and streptococcal polysaccharide (SP). The normal range of anti-streptolysin-0 (ASO), anti-streptokinase (ASK), anti-deoxyribonuclease-B (ADN-B) and anti-Streptococcus polysaccharide (ASP) was 60-480 (T. U.), 40-1024 (titer), 60-1280 (titer) and<2-128 (Unit), respectively. No difference was observed between the two sexes. ASO and ADN-B were measured by the neutralization method. Passive hemagglutination (PHA) was used to measure ASK and ASP. These values were 2-3 fold higher than those obtained on the Japanese subjects.

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In the virological surveillance of children with acute respiratory tract illnesses, five human respiratory coronaviruses (HRCV) were recovered. Three of these strains were isolated from nasopharyngeal swabs of patients with influenza-like illness collected in Kuji City on March 29, 1979. This may suggest the association of HRCVs and influenza-like illness. The other 2 strains were yielded from nasopharyngeal swabs of patients with afebrile acute upper respiratory tract illness collected in Morioka City on March 16 and April 27, 1979.
These 5 isolates exhibited typical properties of HRCV; distinctive morphology, resistant to BUDR, chloroform sensitivity, and electron microscopic features of growth in L132 cells. These isolates were identified as 229E-like HRCV by indirect immunofluorescence test, but these were considerably different to HRCV (strain 229E) in antigenicity.
Reciprocal neutralization titers of antisera against HRCV (strain 229E) and each isolate were determined by 50% plaque reduction tests in monolayers of L132 cells. The neutralizing activities of anti-HRCV (strain 229E) serum against each isolate were 40-to 100-fold lower than that of homologous reaction. The remakable differences of antigenicity among the isolates did not be observed.

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A total of 6, 816 strains of nontyphoidal Salmonella isolated from oversea travellers (imported cases) and domestic healthy individuals and sporadic cases (domestic cases) in Tokyo from 1980 to 1989 were studied for their serovar distribution and antimicrobial sensitivity.
The serological typing results showed that the Salmonella strains were classified into 22 O groups and 156 serovars. Among serovars identified, S. ser. Anatum, S. ser. Derby, S. ser. Blockley, S. ser. Agona and S. ser. Typhimurium were predominant in imported cases, while S. ser. Litchfield, S. ser. Typhimurium, S. ser. Hadar, S. ser. Infantis and S. ser. Thompson were predominant in domestic cases. It was also noticed that isolation rates of S. ser. Hadar and S. ser. Blockley have tended to increase noticeably in recent years in both cases.
From antimicrobial sensitivity testing, 739 (28.1%) of 2, 628 strains isolated from imported cases and 1, 047 (25.0%) of 4, 188 strains isolated from domestic cases were found to be resistant to any one of the drugs tested (CP, TC, SM, KM, ABPC, ST, NA, FOM and NFLX). From 1980 to 1983 the resistance rate was<20% for both cases and then the rate was increased year by year, and it became>40% in 1989.
Serovars of a high resistant rate during this period were S. ser. Hadar (96.3%), S. ser. Blockley (92, 0%), S. ser. Typhimurium (75.7%), S. ser. Kentuckey (64.1%), S. ser. Krefeld (59.3%), and S. ser. Panama (58.3%) for the imported cases and S. ser. Hadar (97.5%), S. ser. Blockley (57.4%), S. ser. Litchfield (44.6%), S. ser. Enteritidis (44.4%), S. ser. Muenchen (42.2%) and S. ser. Typhimurium (40.9%) for the domestic cases. Drug resistance patterns of the resistant isolates varied up to as much as 50 patterns. Prevalent patterns recognized were TC·SM, CP·TC·SM·KM, TC, CP·TC·SM·KM·ABPC and SM for imported cases and TC·SM, TC, TC·SM·KM, SM, and CP·TC for the domestic cases. 21 (12.4%) of 170 drug resistant strains were isolated from imported cases from 1988 to 1989 were found to have conjugative transmissible R plasmids.

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In order to establish a national reference system for Campylobacter serotyping in Japan, 7 local institutes of public health collaborated to prepare 30 serogrouping antisera including 26 antisera of Lior's serogrouping system and 4 antisera of TCK serogrouping system which was developed by the Tokyo Metropolitan Research Laboratory of Public Health.
A total of 603 strains (92.2%) out of 654 isolates from 23 outbreaks of C. jejuni throughout Japan were serogrouped by the 30 antisera.
Out of 1, 198 strain isolated from sporadic cases of Camplyobacter gastroenteritis, 883 (73.7%) were typed and 298 strains (24.9%) were untypable. The remaining 17 strains belong to rough form were not used for serogrouping. A hundred thirteen out of 883 strains have reacted with more than one typing serum. Among C. jejuni isolated from 7 prefecture, Lior's serogroup 4 was mos common followed byLior's serogroup 4, 2, 11, 1 and TCK serogroup 1 and 12.
We conclude from the experiment described above that this Lior's serogrouping system by combining with TCK serogroup for Campylobacter jejuni/coli is useful in epidemiological investiga tions in Japan

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Contamination of endoscopes and endoscope washers by atypical mycobacteria was studied. Large amounts of atypical mycobacteria were detected with high frequency inside endoscopes and endoscope washers. The species of atypical mycobacteria was Mycobacterium chelonae subsp. abscessus.
Antibacterial-effects of glutaraldehyde against isolated atypical mycobacteria were checked. Sufficient antibacterial-effect was not obtained by 2% glutaraldehyde solution for endoscope sterilization. However, after frequent manual washing and brushing of endoscopes, by using 3% glutaraldehyde solution and 70% alcohol, all endoscopic instruments were completely decontaminated. We must pay attention to contamination of endoscopes and endoscope washer at least once a month.r

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We treated 245 strongyloidiasis patients with 7 schedules of mebendazole (MBZ) and obtained the eradication rates at 8 months to 2 years after the final treatment as described follows;
MBZ (100 mg) was given twice a day orally.
[Square bracket shows incidence of liver disfunction]
1) The eradication rates at 2 years after single course of MBZ therapy for 28 days and a combination therapy (thiabendazole 500mg powder form three times daily for 5 days followed by MBZ in powder form for 9 days, repeated once) were 93.8%(15 of 16 patients), [71.4%] and 100.0%(16/16), [50.0%].
2) The eradication rates at 8-15 months after using MBZ alone in varying dosages were as follows:
a) MBZ powder was administered for 5 days and was then repeated 1, 3 and 4 weeks later: 87.1 (27/31), [51.1%].
b) MBZ powder was given for 5 days and repeated 1 and 3 weeks later: 100.0%(7/7), [30.8%].
c) MBZ powder was administered for 4 days and repeated 1, 3 and 4 weeks later: 96.3%(26/27), [57.8%].
d) MBZ in tablet form was given for 4 days and repeated 1, 3 and 4 weeks later: 89.6%(43/48).[66.2%]
e) MBZ in tablet form was administered for 4 days and repeated 1 week later: 69.2%(9/13), [25.0%].
As described above, although the incidence of liver disfunction in the 4-day with 2-course therapy was lower than the other schedules, the eradication rate was lower.
From these results, MBZ should be given to strongylodiasis patient for 4 days and repeated once, or for 3 days and repeated two or three times with 1 to 2 weeks intervals.

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An outbreak of Pseudomonas aeruginosa folliculitis in 6 children occurred within 5 days after playing in a tiny vinyl pool. The follicular macular or pustular eruptions were mainly distributed on the trunk. No associated symptoms were seen. The causative Pseudomonas aeruginosa strain isolated from pustules of one case belonged to serogroup E, corresponding to 0-11 (Difco). The rash subsided promptly and spontaneously. Furthermore, we have encountered another case of Psedomonas folliculitis caused by P. aeruginosa serogroup G, corresponding to O-6 (Difco). The maculopustular rash was distributed on the trunk and disappeared spontaneously as the cases mentioned above. The folliculitis of this baby were probably associated with the repeated use of family bath without changing water.
In U.S. and Europe Pseudomonas folliculitis have been reported very frequently, but our cases were reported for the first time in Japan.

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In order to compare 4 serological and biochemical diagnostic tests, HA-test (Candida-HA-test), Cand-Tec, D-arabinitol detective test and Fungal Index (F. I.) were carried out in a total of 8 patients with candidemia, 6 were diagnosed to have systemic candidosis and 2 transient fungemia due to colonized catheters.
Rabbits were given venous injections of 1.0 × 10⁶ CFU (1 ml) of living Candida albicans type A to study the 4 diagnostic methods by sequential blood culture. Prior to clinical administration of antimycotics the diagnostic methods produced almost the same positive ratios. After administration of antimycotics, the HA-test became positive later than Cand-Tec or D-arabinitol because it detected antibodies in the serum, but its conversion to negative also tended to be slightly slower. Accordingly, the HA-test is considered to be useful for retrospective diagnosis of systemic candidosis. In Cand-Tec, D-arabinitol and F. I., the cases where reversion to normal was not achieved soon after therapy were intractable. In one case, the antigen values after therapy were four times as high as prior to treatment. To differentiate the two cases with transient fungemia from those with systemic candidosis HA-and D-arabinitol tests were considered to be superior to Cand-Tec and F. I. In the experiments with rabbits Cand-Tec was, in spite of its being positive in blood culture, always negative.

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Since the end of 1987, we have noticed an increasing incidence of Methicillin resistant Staphylococcus aureus (MRSA) among the inpatients of Yamanashi Medical College Hospital. MRSA strains were identified in 70-80 percent of the specimens obtained from patients with Staphylococcus aureus.
From 1988 we performed yearly bacteriological examinations of the nares of medical personnel at Yamanashi Medical College Hospital. We treated nasal carriers with OFLX drop lotion or Povidoneiodine applied to the nares.
In 1991 we treated eight nasal carriers, who had been unsuccessfully treated with Povidoneiodine, with 0.01% Methylrosanilinium Chloride ointment which was applied to the nares once a day for two weeks.
A post-bacteriological examination again revealed that MRSA vanished from the nares of six nasal carriers.
The minimum inhibitory concentration (MIC) of Methylrosanilinium Chloride was determined by the agar plate dilution method. The 100% MICs of MSSA were 1.0 μg/ml and of MRSA were 1.0 μ/ml by Methylrosanilinium Chloride. Moreover we examined the MICs of Methylrosanilinium Chloride against MRSA under the existing 5% Albumin, and consequently the 100% MICs were 4.0 μg/ml. Therefore a 0.01% Methylrosanilinium Chloride has sufficient efficacy against MRSA.
The reaction of the skin and nasal mucosa to Methylrosanilinium Chloride was examined by using three groups of guinea pigs. 0.1% and 0.01% Methylrosanilinium Chloride ointment and hydrophylic poloid were applied to the nares and skin once a day for two weeks. Post-observation with an opticmicroscope revealed no significant findings.
Methylrosanilinium Chloride shows good anti-Staphylococcus aureus ability. Further investigation is needed to determine if Methylrosanilinium Chloride has additional clinical application.

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To clarify the colonization rate of Mobiluncus spp., 889 specimens were collected from the vagina and 688 specimens from the cervical canal in three groups of women, namely, non-pregnant women, pregnant women, and patients fulfilling the criteria of bacterial vaginosis. On screening, this organism was detected from the vagina in 18/576 cases (3.2%) in non-pregnant women and in 2/280 cases (0.7%) in pregnant women, and it was detected from the cervical canal in 12/410 cases (2.9%) in non-pregnant women, and 3/278 (1.1%) in pregnant women. Although the positive rates were slightly higher in non-pregnant women from both the vagina and cervical canal, they were not significant.
However, in cases of bacterial vaginosis, the positive rate of Mobiluncus spp. was 9/33 cases (27.3%), so that it was significantly higher than in the other two groups. Although the role of Mobiluncus spp. in bacterial vaginosis has not been clarified, our results indicate that the presence of Mobiluncus spp. is abnormal, since its colonization rate in healthy women is too small to be regarded as a member of normal flora.
G. vaginalis and anaerobes (other than Mobiluncus spp.) are also closely connected to bacterial vaginosis. G. vaginalis alone was seen in 7/33 cases (21.3%), anaerobes alone in 7/33 (21.3%), and Mobiluncus spp. alone in 3/33 cases (9.1%). Multiple infections including 2 or 3 of the above organisms were seen in 13/33 cases (39.3%), and all cases had anaerobes. On the other band, only three cases were infected by none of the above organisms. It is interesting that all the multiple infections had anaerobes suggesting that odor, the chief symptom of bacterial vaginosis, may be due to the metabolic products of anaerobes. Mobiluncus spp. is known to be susceptible to PCG, EM, CLDM, but it is resistant to TC and OFLX. Since TC and OFLX are the most popular antimicrobial agents for treating STD, the possibity of bacterial vaginosis should be kept in mind when treating STD.

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A fully automated microparticle enzyme immunoassay (IMx AUSAB, Abbott) has been recently introduced for the detection of the presence of antibody to hepatitis B surface antigen (anti-HBs).
The present trial was carried out to determine the feasibility of using the IMx AUSAB with sera and plasma, and for comparison with RIA (AUSAB, Abbott) and EIA (AUSAB EIA, Abbott). According to the kinds of vaccines used and locations of residents, the subjects were divided into six groups.
Results obtained were as follows;
In the test of 642 sera from 446 vaccines and 196 other inhabitants of Okinawa and Miyazaki prefectures, 388 (87.0%) were found positive for anti-HBs using IMx, 392 (87.9%) with RIA and 359 (80.5%) with EIA.
Among those vaccinated with recombinant vaccines, 96.6% were found positive with IMx, 96.2% with RIA and 89.4% with EIA. Among subject vaccinated with plasma derived vaccines, 72.9% were found positive with IMx, 75.7% with RIA, and 68.5% EIA.
Quantitative agreement between IMx and RIA among the six groups gave linear correlation coefficients ranging from 0.459 to 0.821. In the group vaccinated with the recombinant vaccine by K company (r=0.459), anti-HBs was confirmed in many sera by IMx compared to that confirmed by RIA and EIA.
In addition, anti-HBs was assayed within one hour by IMx and the procedure was simplified by autoanalyser equipped for this method.
The results indicate that the sensitivity of IMx is equal to that of RIA and more than that of EIA, and that quantitative linear correlations were obtained between IMx and RIA, andIMx and EIA.

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A clinical study of 24 patients with respiratory tract infection due to S. aureus detected by transtracheal aspiration (TTA) was conducted, and the following results were obtained. 1) The detection frequency of S. aureus was relatively low (4.6%). 2) Pneumonia was the principal clinical manifestation. 3) Approximately one half of the patients had previously received antimicrobials. 4) Multiple organisms were frequently detected, particularly in cases of hospital-acquired infection. H. influenzae was the most frequently simultaneously detected organism. 5) On sputum examination, approximately 20ml of purulent sputum was found in most cases, and S. aureus was detected in sputum specimens from 20 of the patients. 6) The largest number of cases was found in 1987. Onset was most common from autumn to spring. 7) Undernutriton was the most frequently associated host factor. As indicated by the above findings, the clinical expression of S. aureus infection is variable, and it is important that it be diagnosed accurately.

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Chronic Pseudomonas aeruginosa lung infection with mucoid strains is the predominant cause of death in cystic fibrosis (CF) or diffuse panbronchiolitis (DPB). This infection is characterized by a chronic course without spread of the bacteria to the blood when compared with other infections due to the non-mucoid strains. However, the mechanism of P. aeruginosa lung infection with the mucoid strains remains obscure.
Intra-tracheal and systemic infection in mice, susceptibility to the bactericidal activity of fresh human and mouse serum, and adherent activity to mouse fetal lung cell were examined for mucoid and non-mucoid strains of P. aeruginosa.
After intra-tracheal infection, the mucoid strains were distributed to other organs anormously but not the non-mucoid stains, and the bacterial number of the mucoid strains in the blood were significantly lower than that of the non-mucoid strains. On the other hand, when these strains were inoculated into the tail vein of mouse, the mucoid strain was eliminated more rapidly from blood as compared with the non-mucoid strain. The mucoid strains showed reduced bacteremic virulence when compared with non-mucoid strains with a 50% lethal dose (LD₅₀) of 1.5 × 10⁷ CFU/mouse as the mean value in a systemic infection.
In contrast to the non-mucoid strains, the mucoid strains were sensitive to human fresh serum but were resistant to mouse fresh serum. The mucoid strains adhered to the monolayer of the mouse fetal lung cell 7-fold better than did non-mucoid strains.
These results suggest that the chronic lung infection with the mucoid strains of P. aeruginosa isattributed to eradication from blood by trapping of reticuloendothelial system, and high adherent ability to lung cell.

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Moraxella subgenus Moraxella sp. was isolated in pure culture from the sputum of a 43-year-old male with pneumonia and congestive heart failure due to idiopathic dilated cardiomyopathy. In this case, we concluded that the patient's bacterial pneumonia was caused by M. (M.) sp. based on a Gram stain of the sputum smear and bacterial findings, increased WBC count, and elevated CRP. A chest X-ray revealed right middle, and left upper and middle lobe infiltrates.
This Moraxella strain produced a BRO-type β-lactamase, a carbenicillinase-type enzyme.

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