Infection of Hellcobacter pylori (H. pylori) in the gastric mucosa is said to participate in the pathogenesis of gastric and duodenal ulcers as well as gastritis. The detection rate of H. pylori in tissue specimens endoscopically taken from adult patients with these diseases was 75.2%(408/542). In affected children (2-15 yrs), on the other hand, 27 biopsies were performed in 22 cases but the initial positive rats was as low as 45.5%. According to the diagnosis, it was 75% for acute gastric mucosal lesion (AGML), 50% for duodenal ulcer, 33% for duodenitis, and 38% in seemingly normal children.
When changes in the detection rate of H. pylori was examined after administration of H₂ blocking antiulcer agents, it was found to very case by case, e.g. changed in individual disease stages or completely or reoccurence disappeared.

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To evaluate the immunogenicity of the Chinese hamster ovary cell derived HB vaccine (CHB), CHB and yeast derived HB vaccine (YHB) were given to 110 medical students divided into four groups. CHB was given to group A subcutaneously (0.5 ml, 3 times) and to group B intradermally (0.125 ml, 3times). YHB was given to group C (Y company) and to group D (Z company) subcutaneously (0.5 ml, 3 times).
The and-HBs positive rate at 7 months was 85.7% in group A, 95.8% in group B, and 100% in groups C and D. The percentage responding with high anti-HBs concentration (≥100mIU/ml by RIA) at 7 months was 67.9% in group A, 79.2% in group B, 58.3% in group C and 63.3% in group D. Thus, although the and-HBs positive rate was rather low when CHB was given subcutaneously, it was almost the same as YHB when given intradermally. The percentage of high responders to CHB given both subcutaneously and intradermally was high compared to YHB.
These data suggest that CHB has almost the same immunogenicity to the conventional YHB.

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Recently, the case reports of Pasteurella multocida infection has been increasing in Japan. In 1989, the Japanese Government, Veterinary Sanitation Division, Ministry of Health and Welfare officially communicated this infection as a zoonosis to related institutions. The current status of Pasteurella multocida infection is not well known in Japan. Because of this, a nation wide questionnaire survey on Pasteurella multocida was conducted to clarify the status.
A questionnaire was sent to 380 laboratories of the hospitals, and 258 (67.9%) replied. An infectious disease caused by Pasteurella multocida was found in Japan in 369 cases in 115 (44.6%) of 258 hospitals, or an average of 3.2 cases per hospital. The 369 cases were broken down into 123 males (from 1 month old to 87 years old), 118 females (from 7 months old to 88 years old), and 128 patients whose sex was unknown. The incidence of the infections tends to increase year by year. This incidence is higher than our expectation. It is considered that the contact with pets will in increase the infection with this agents. The organism was isolated in as many as nineteen different body specimens, including the appendix and urine, which in Japan has not been reported as organs harboring this organism. Some of the nineteen cases were severely infected. This organism was isolated most often from the sputum (48.5%). Pus was the next most common site (27.1%). This order was reversed in the U. K. and the U. S. Possible explanations for the reversal are given below. Japanese people can easily receive diagnosis and treatment at low fees under the Japanese national health insurance system, which unlike that in the U. S. or the U. K. covers all citizens. In Japan, when someone is bitten or scratched by an animal, antibiotics are generally administered to prevent suppuration. In Japan, the number of pets being kept nationwide has grown as a result of changing social values and a concomitant increase in ferroconcrete building, (which have steadily been replacing Japanesestyle wooden houses), together with an increase in the number of elderly citizens. Under these circumstances, Pasteurella multocida infectious disease should be openly recognised so that it can be addressed in the field of zoonosis.
This study was aided by Grant-in-Aid for Encouragement of Young Scientists of the Ministry of Education, Science and Culture (No.03857348).

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We report the prevalence of bacterial pathogens isolated from various clinical specimens in 17 medical centers in Akita during the period of December 1990 to February 1991, and their antimicrobial susceptibility. The results were as follows:
1. The total number of isolates was 8, 929 and common bacteria were Staphylococcus aureus (18.7%), Pseudomonas aeruginosa (11.8%), Esherichia coli (10.1%), coagulase negative staphylococcus (6.7%) and Enterococcus faecalis (5.0%). This is similar to our previous result which was reported in the same season in 1987.
2. S. aureus was a common isolate from sputum, throat swab, pus, and blood. 53% of isolated S. aureus were methicillin-resistant. Arbekacin (ABK) had a high degree of activity (99%) against methicillin-resistant S. aureus (MRSA). Minocycline (MINO) retained activity against 70% of MRSA strains, and quinolones only 20%.
3. P. aeruginosa and E. coli were frequently found in urine from the patients in the small hospitals. More than 80% of the P. aeruginosa strains were sensitive to imipenem (IPM), cefsulodin (CFS) and amikacin (AMK). The susceptibility of P. aeruginosa to ceftazidime (CAZ) and piperacillin (PIPC) had been decreasing for the last 3 years.
4. CNS were frequently found in blood, pus, and pleural effusion usion f rom the patients in the large hospitals. The isolates were resistant to most antibiotics.
5. Enterococcus was common isolates from urine and ascites, the susceptibility to cephem was low.
6. We conclude that attention should be specially paid to S. aureus, P.aeruginosa CNS and E. Faecalis.

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Since Helicobacter pylori is isolated very frequently from gastric ulcer specimens, the combination therapy of antimicrobial agent and proton pump inhibitor has recently been used. A study was made on whether cefdinir (CFDN), amoxicillin (AMPC), metronidazole (MNZ), omeprazole (OPZ), and omeprazole-M (OPZ-M) have antimicrobial activity against H. pylori and whether they can inhibit H. pylori-producing urease.
1) CFDN, AMPC and MNZ showed a potent antimicrobial activity against H. pylori, and especially, AMPC showed a marked bactericidal activity in a short time.
2) OPZ is reported to be converted to OPZ-M, and active form, in the body. OPZ and OPZ-M showed a moderate antimicrobial activity against H. pylori, and scarcely any bactericidal activity.
3) CFDN and OPZ or AMPC and OPZ in combination did not show any synergistic effect on the antimicrobial activity, but MNZ and OPZ in combination showed additive effect on the antimicrobial activity against H. pylori.
4) OPZ and OPZ-M inhibited H. pylori-producing urease and the inhibitory effect of OPZ-M was more stronger than that of OPZ. CFDN, AMPC and MNZ did not show any inhibitory effect on H. pylori-producing urease at 10 μg/ml.
From these data, antimicrobial agents and proton pump inhibitors in combination are expected to exert the in vivo synergistic effect since these drugs eradicate H. pylori and inhibit H. pylori-producing urease.

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An experimental Pseudomonas cepacia lung infection was induced in ddY mice pretreated with cyclophosphamide. A single dose of 250 mg of cyclophosphamide per kg resulted in leukopenia which lasted for four days. At the lowest PMN levels, the mice were exposed to various doses of bacteria by either intratracheal inoculation or aerosol inhalation. Experimental pneumonia was established by intratracheal inoculation of 1×10⁷-2×10⁸ colony-forming units of P. cepacia. The duration of survival time of the mice and the number of viable bacteria in their lungs were determined. A dramatic rise in the viable counts of P. cepacia was found within 24 hours after intratracheal inoculation of 1×10⁸ colony-forming units of P. cepacia. It was impossible to establish P. cepacia pneumonia by aerosol inhalation, since the bacteria were immediately cleared from the lung. Mice which had not been treated with cyclophosphamide remained healthy and did not show any lung lesions. Thus, neutrophils appear to play an important role in the early defense mechanisms of the lung against P. cepacia. This animal model could be of use in evaluating additional therapies for the infection, and the pathologic determinants of infection caused by P. cepacia.

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We have experienced 2 cases of MRSA infection.
Case 1: A 16 month-old girl, whose underlying disease was VAHS, had chronic sinusitis. MRSA was isolated from the blood and rhinorrhea. Her sinusitis was very intractable and it was difficult icult to eradicate MRSA from the nare.
Case 2: A 6-months-old girl was admitted to our hospital with urinary tract infection. She had an ectopic uretelocele. Partial nephrectomy and uretectomy was performed.
Retroperitoneal and intraperitoneal abscess had recurred three times during 17 months after the first operation. This abscess was slowly progressive and MRSA was very difficult to eradicate.
These 2 cases showed characteristics of MRSA infection.

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