Amebiasis caused by Entamoeba histolytica at an institution for mentally retarded in Shizuoka Prefecture is reported. Five of the 50 patients showed E. histolytica cysts in their stools and 4 were positive serologically. The polymerase chain reaction and restriction fragment length polymorphism revealed that the isolates were pathogenic-type E. histolytica. Epidemiological analysis revealed that the amebic infection was caused by the abnormal behavior of mentally retarded patients. Administration of diloxanide furoate and metronidazole for cyst-carriers eliminated cysts from the stool and lowered the antibody titer.

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Nine verotoxin-producing Escherichia coil 0157: H7 strains were isolated from 9 pediatric patients with sporadic enteritis between July and September 1994 at four clinics in the Fukuoka area. The patients included two families with two cases each. These strains were analyzed by pulsed-field gel electrophoresis for Xba I-digested DNA fragments. The restriction patterns were identical between each two strains within the two family outbreaks, but different among the seven strains of the distinct seven sporadic cases. It is strongly suggested that the seven sporadic cases were infected through distinct sources, and that the two family cases were due to a common source of infection or person to person infection.

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The activity of induce tumor necrosis factor alpha (TNFα) production of several mycoplasmas, including AIDS associated mycoplasmas was investigated. M. penetrans which was detected and isolated from urine and tissue of Kaposi's sarcoma of patients with AIDS markedly exhibited the induction of TNFa production of both THP-1 cells and murine peritoneal macrophages to compare to other mycoplasmas. Each amount of M. penetrans, M. fermentans, M. incognitus, Acholeplasma ladilawii, M. orale, M. salivarium, M. hominis required for induction of 50% cytotoxicity to L cells in the supernatants of mouse peritoneal macrophages cultured with those microorganisms was 0.65μg/ml, 11.3μg/ml, 19.6μg/ml, 6.6μg/ml, 7.7μ g/ml, 6.3μ g/ml, 5.7μ g/ml respectively.
Next, the components of M. penetrans were extracted by Bligh-Dyer method, in order to investigate chemical component to induce TNFa-production. The activity of TNFa induction was mainly found in the methanol-phase, but not in the chloroform-phase, where lipid and glycolipid of the microorganisms were generally thought to be accumulated. The binding of the active component to concanavalin A-Sepharose was blocked in the presence of Methyl a-Dmannopyranoside and Methyl α-D-glucopyranoside. These results suggest that the component possess mannoside and glucoside active site.

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The number of pertussis patients has decreased steadily in the late 1960s and was extremely small in early 1970s. During 1973-74 the first national survey on pertussis cases confirmed by culture was conducted, when whole cell pertussis vaccine was used. The study revealed that 33.3% of culture positive cases had 2-4 doses of DT combined with whole cell pertussis vaccine
Acellular pertussis vaccine was introduced in 1981 and for the last several years the number of pertussis patients became low for the second time. During 1988-92 exactly the same study was conducted as the previous one. Among 2501 pertussis cases diagnosed clinically 403 were culture positive. Most of the patients were below 1 year of age. Most of the patients were below 1 year of age. Clinical symptoms of those infants were more serious than those of older children. Only 7 out of 403 (1.8%) had a history of 2-4 doses of DT combined with acellular pertusis vaccine. This proved that the acellular pertussis vaccine is by far more effective than the whole cell pertussis vaccine.
Serotypes of 377 Bordetella pertussis were identified and 370/377 (98.1%) were serotype 1-3 group.

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During the last 2 years and 8 months before the closure of Osaka Airport Quarantine Station (from Jan. 1992 to Sep. 3, 1994), a total of 7, 421, 909 overseas travellers were quarantined. 15, 919 reported themseleves of suffering from diarrhoea. Bacteriological examination of a total of 6, 031 individuals' stools were performed.<BR1) Various enteropathogenic bacteria were isolated from 31.2% of the stools examined. Isolated species were as follows: Plesiomonas shigelloides, 1, 127 cases (59.9 %); Vibrio parahaemolyticus, 293 cases (15.6%); Salmonella spp., 262 cases (13.9%); Shigella spp., 235 cases (12.5%); Aeromonas sobria, 93 cases (4.9%); V. cholerae non-01, 69 cases (3.7%).
2) The enteropathogenic bacteria were isolated through out the year without any seasonal variation.
3) The major regions where the travellers were infected with the pathogens are as follows: V. cholerae non-01 (NAG Vibrio) and enteropathogenic Escherichia coli, South-East and South-West Asia; Vibrio other than NAG, South-East and East Asia; Shigella, widely distributed but especially in India; P. shigelloides and Salmonella, widely distributed.
4) 2 strains of toxigenic (cholera toxin-producing) V. cholerae 0139 were isolated frompatients who had visited Indonesia and Thailand, respectively.
5) In 320 cases (17%), plural enteropathogenic bacteria were isolated from single patients, suggesting a high frequency of the mixed infections.
6) Among Shigella strains, S. sonnei were isolated the most, followed by S. flexneri (24.7%), S. boydii (8.8%) and S. dysenteriae (2.9%).
7) Among Salmonella serovers, Salmonella Enteritidis was isolated the most frequently (39 cases, 14.1%).
8) 218 (91.6%) of 238 Shigella strains and 103 (37.6%) of 276 Salmonella strains were resistant to one or more drugs tested (SM·CP·TC·KM·ABPC·NA·OFLX).
9) All of the 22 V. cholerae 01 strains were Ogawa, El Tor. Among them, 19 were toxigenic strains and 3 were non-toxigenic. 10) O4: K8 was the most frequently isolated serover of V. paraemolyticus. 87.4% of all V. parahaemolyticus strains were positive with thermostable direct hemolysin (TDH) gene, and 12.6% of them were positive with TDH-related hemolysin (TRH) gene by DNA-probe methods.

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A total of 3, 647 non-typhoidal Salmonella strains consisting of 2, 655 domestic strains and 992 imported strains isolated in Tokyo from 1990 to 1994, were examined for their serovardistribution and their drug-resistance.
The serological typing results showed that the domestic strains were classified into 15 0-groups and 96 serovars, and the imported strains were classified into 13 0-groups and 73 serovars. Among the serovars identified, Salmonella serovar Enteritidis (S. Enteritidis), S. Thompson, S. Hadar, S. Litchfield, and S. Tennessee were predominant in the domestic strains, whereas S. Hadar, S. Enteritidis, S. Anatum, S. Derby, and S. Blockley were predominant in the imported strains.
The drug-resistance test using 9 drugs (CP, TC, SM, KM, ABPC, ST, NA, FOM, and NFLX) showed that 30.5% of the domestic strains and 40.5% of the imported strains were resistant to any of the drugs examined. The serovars of a high resistant rate during this period were S. Hadar (96.2%), S. Blockley (88.7%), S. Enteritidis (63.4%), S. Virchow (54.3%), and S. Typhimurium (51.3%) in the domestic strains and S. Krefeld (100%), S. Hadar (98.9%), S. Blockley (98.2%), S. Emek (83.3%), S. Kentucky (76.5%), S. Panama (69.2%), S. Derby (63.8%), S. Typhimurium (57.1%), S. Rissen (55.6%), and S. Agona (53.7%) in the imported strains. Drug-resistance patterns of the resistant isolates varied to 62 types. Prevalent patterns recognized were SM, TC & SM, TC & SM & KM, TC, TC & SM & KM & ABPC and CP & TC & SM & KM in the domestic strains and TC & SM, TC, CP & TC? SM & ST, TC & SM & KM, and CP & TC & SM & KM in the imported strains.

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Antibacterial activity of pazufloxacin (PZFX) against 65 strains of Shigella spp., 13 strains of Salmonella spp., 7 strains of Escherichia coli, 4 strains of Vibrio parahaemolyticus, 4 strains of V. cholerae 01, 2 strains of Aeromonas spp., 4 strains of Plesionomas shigelloides and 3 strains of V. cholerae non-01 isolated from patients of infectious enteritis and carriers was compared with that of ofloxacin (OFLX), ciprofloxacin (CPFX), tosufloxacin (TFLX) and nalidixic acid (NA). The MIC₉₀ of PZFX against Shigella spp., Salmonella spp. and E. coli were 0.025, 0.025 and 0.025μ g/ml, respectively. The MIC₉₀ of PZFX against Shigella spp. was comparable to that of CPFX, 2-fold higher than that of TFLX and 4-fold lower than that of OFLX. Against Salmonella spp., MIC₉₀ of PZFX was comparable to TFLX and 2-to 8-fold lower than those of CPFX and OFLX. PZFX showed the highest antibacterial activity between the drugs tested. Against other species, the MIC90 values of PZFX were ≤-0.006-0.1 μg/ml. No NA-resistant isolates were observed.
The antibacterial activity of PZFX against stocked strains (clinical isolates from Aug 1989 to Feb 1991), containing 51 strains of Shigella spp., 50 strains of Salmonella spp., 19 strains of E. coli, 12 strains of V. cholerae 01 and 13 strains of V. parahaemolyticus, was also investigated. The MIC₉₀ of PZFX of each strains were 0.05μg/ml for Shigella spp., 0.05μg/ml for Salmonella spp., 0.1μg/ml for E. coli, 0.0125 μg/ml for V. cholerae 01, 0.2 μg/ml for V. parahaemolyticus, respectively.
As shown above, PZFX has strong antibacterial activity against isolates from infectious enteritis and this suggests the usefulness of PZFX for the treatment of these patients and carriers.

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A clinical study was carried out on pazufloxacin (PZFX) in 137 patients including shigellosis, Salmonella enteritis, enteropathogenic Esherichia coli enteritis and cholera, and carriers of these pathogens. Antibacterial activity of PZFX against clinical isolates, fecal concentration of PZFX and effects of PZFX on fecal microflora were also investigated.
The overall clinical efficacy rate was 97.2%.
The bacteriological efficacy rates were 98.2% against Shigella spp., 81.8% against Salmonella spp., 50% against Vibrio cholerae 01, and 100% against E. coli, V. parahaemolyticus, Aeronomas spp., Plesionomas shigelloides and V. cholerae non-01, respectively.
Side effect (epigastralgia) was observed in 1 of 130 cases (0.8%).The rate of abnormal laboratory findings was 11.2%(11/98). These were mainly elevation of GOT and/or GPT and increased eosinophils.
The clinical usefulness rate was 95.2%.
The MIC₉₀ values of PZFX against Shigella spp., Salmonella spp. and E. coli were 0.025, 0.025 and 0.025, μg/ml, respectively.
The results of fecal drug concentration and the effects on fecal microflora in one patient were compatible with those obtained in healthy volunteers.

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A food-poisoning outbreak occurred in G Town in Minami-Akita District, Akita Prefecture on 16 January 1995. As the causative agent of the outbreak, Enteropathogenic Escherichia coli (EPEC) O126: NM were isolated. The isolates showed the same plasmid profile and antibiotic susceptibility patterns suggesting that the EPEC strains originated from same infectious source.
The isolates lacked eae and EAF genes which were considered to play a significant role in the diarrheagenic mechanism of EPEC. On the otherhand, the isolates possessed Enteroaggregative E. coli (EAggEC) heat-stable enterotoxin-1 (EAST-1) gene, though they did not possess the agg A gene in which the coded structural subunit of Aggregative adherence fimbriae 1 (AAF/ 1) has been demonstrated to be involved in the expression of ability for EAggEC to adhere to cultured cells in aggregative pattern, indicating that the EPEC strains apparently differed from EAggEC.
These data suggested that EAST-1 showed its enterotoxic activity to human, and that EPEC represented multiple category of E. coli strains with different diarrheagenic mechanism, in which both eae and EAST-1 might be involved.

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A total of 239 serum samples from 136 persons were used for bacterial agglutination assay (BA) against predominant three 0-antigens of VTEC. All VTEC isolates from stools of 30 patients were only 0157: H7 serotype (these patients are called group I). The levels of positive BA antibody titers (over 1: 160) to 0157-antigen were recognized in each patients as follows;
The VTEC isolated patients with HUS or without HUS in group I were all of 13 (100%) and 14 (82.4%) in 17 patients, respectively. And 21 (65.6%) patients of group II (HUS patients with stool negative clutures, or stool cultures were not performed in 32 patients), and 6 (15.0%) patients of group III (family members of group I and II; 40 persons), were also recognized. In group IV (patients with diarrhea due to other pathogen than VTEC; 11 patients), and V (clinically healthy persons; 23 persons), none were recognized as positive BA antibody titers. All patients in the group II except one who had a positive BA antibody titer to 0111, were not recognized to 0111 and 026. A few VTEC-positive patients without gastrointestinal syndrome did not have significant agglutinating titers to 0157-antigen on the days after VTEC isolation. However, almost all patients with diarrhea due to VTEC and HUS, and with VTEC but no HUS, had a level of positive BA antibody titer on the 5 day after onset of diarrhea.
These results suggest that this serological assay is a very simple and useful tool for diagnosis of VTEC infection when VTEC are not detected by culture method due to antimicrobial treatment, or due to the lapse of many days after onset of diarrhea.

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A 18-year-old male was admitted to another hospital complaining of his chest X-ray. After transfer to our hospital, increased serum antibody titers to simultaneous M. pneumoniae and C. psittaci were noted. These antibody titers decreased after about four months. Positive results for M. pneumoniae was obtained by Polymerase chain reaction in the right pleural effusion. Based on these findings, this case was diagnosed as M. pneumoniae and C. psittaci pneumonia. A transbronchial lung biopsy and a bronchial biopsy revealed rare histological findings, including histiocytic intra-alveolar pneumonia with palisaded granuloma and small foci of necrosis in the left upper lobe and eosinophilic bronchitis in the right middle bronchus. His chest X-ray and chest CT showed a nodular shadow, obstructive pneumonia and pleural effusion which are rare in M. pneumoniae and C., psittaci pneumonia.

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