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Volume 78, Issue 10
Displaying 1-8 of 8 articles from this issue
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Yuji WATANUKI, Shigeki ODAGIRI, Hiroshi TAKAHASHI, Takashi OGURA, Tosh ...2004 Volume 78 Issue 10 Pages 873-878
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSHamophlus influenzae persists in the respiratory tract and sometimes causes respiratory tract infections.To evaluate the pathogenesis of β-lactam-resistant Haemophilus influenzae, we classified 193Haemophilus influenzae strains isolated from sputum of patients with respiratory tract disease in 24 β-lactamase positive (BLP) strains, 65 β-lactamase negative ampicillin resistant (BLNAR) strains and104 β-lactamase negative ampicillin sensitive (BLNAS) strains and reviewed the pathogenesis of the strains. The pathogenesis of the strains was evaluated as definite pathogen, presumptive pathogen, colonization and contamination. It was judged to be the definite pathogen that many bacteria isolated from high quality sputum of the patients with respiratory tract infections. Presumptive pathogen was considered to be the bacteria provided from the patient with respiratory infections when the quality of the sputum or quantity of bacteria did not satisfy superscription basis. We considered the bacteria to be colonization or contamination isolated from patients without infections. The breakdown of definite pathogen/presumptive pathogen/colonization/contamination in each by groups was BLP (8/4/8/4), BLNAR (26/14/15/10), BLNAS (36/20/31/17). The ratio of definite or presumptive pathogen was 50% in BLP, 62% in BLNAR and 54% in BLNAS and the significant difference was not recognized in these. Pathogenesis of β-lactam-resistant Haemophilus influenzae is estimated to be equal with β-lactam-sensitive Haemophilus influenzae.View full abstractDownload PDF (825K) -
Keisuke SUNAKAWA, Masato NONOYAMA, Tomohiro OOISHI, Satoshi IWATA, Hir ...2004 Volume 78 Issue 10 Pages 879-890
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe surveyed the epidemiology of bacterial meningitis in pediatrics between July 2000 and December 2002 in Japan and obtained the following results.: The number of cases of bacterial meningitis was 316 (182 boys and 134 girls), which was equivalent to 1.1-1.7 children out of 1, 000 hospitalized those in pediatrics per year. The age-distribution for the infections was the highest under 1 year of age and it decreased as the age increased. Haemophilus influenzae was the most common pathogen causing the infections, followed by Streptococcus pneumoniae, group B streptococcus, and Escherichia coli. Relationship between causing pathogens and age-distribution was as follows: group B streptococcus and E. coli were major pathogens under 4 months of age and H. influenzae and S. pneumoniae were major pathogens over 4 months of age. Susceptibility tests performed at each facility demonstrated that 53.7% of H. influenzae isolates and 67.7% of S. pneumoniae isolates in 2003 were drugresistant.
As ampicillin and cephem antibiotics are effective against GBS, E. coli and Listeria at present, then the combination of ampicillin and cephem antibiotics was used as first line antibiotics in many facilities under 4 month of age and a combination of carbapenem which showed effective against PRSP and cephem which showed effective against H. influenzae is first choice against childhood bacterial meningitis over 4 month of age.View full abstractDownload PDF (1675K) -
The Prevalence of β-lactamase Negative Ampicillin Resistant Haemophilus influenzae in Mie PrefectureTokuyoshi MARUYAMA, Hitoshi YOSHIMURA, Akiko NAKAMURA, Kumiko ABE, Yok ...2004 Volume 78 Issue 10 Pages 891-897
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSEquivalent MIC breakpoints to detect β-lactamase negative ampicillin resistant Haemophilus influenzae (BLNAR) were controversial. We studied the relationship of drug resistance with gene alterations in 74 clinical isolates of H. influenzae. Out of 74 isolates, 26 showed MIC of ampicillin (ABPC) 1μg/ml. All isolates, except one, with MIC of ABPC≥4μg/ml were found to produce β-lactamase, while all 19 isolates with MIC of ABPC at 1 or 2μg/ml were non-producing. Twenty-six ABPC resistant isolates were subjected to the analysis of genes involved in the drug resistance such as pbp3-1 pbp3-2, and TEM by the Haemophilus influenzae gene detection kit (Wakunaga Pharmaceutical Co., Ltd.) according to the supplier's instructions. Three (21.4%) of 14 β-lactamase non-producing isolates ABPC-MIC of 1μg/ml had mutations of pbp3-1 gene, while all 5 non-producing isolates with ABPC-MIC of 2μg/ml showed mutations of both pbp3-1 and pbp3-2 genes. Accordingly, it seems appropriate to set ABPC-MIC≥2μg/ml for detection of BLNAR. In this study, six (8.1%) of 74 isolates found to be BLNAR, and all of these six isolates were derived from patients of 5 year-old or younger.View full abstractDownload PDF (895K) -
Akira ISHIKAWA, Jun OKADA, Hirobumi KONDO, Youko TAKAYAMA, Keisuke SUN ...2004 Volume 78 Issue 10 Pages 898-904
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 88 year old female with active rheumatoid arthritis treated by low dose of prednisolone and methotrexate was admitted to our hospital because of severe bilateral pulmonary infiltration and acute respiratory distress syndrome. On admission, she had consciousness disturbance and was intubated because of severe respiratory failure. We heard from her family of her habit she had taking a private whirlpool bath 2 or 3 times everyday. So, we suspected a Legionella pneumophila infection. We started intravenous erythromycin (EM) (1, 500mg/day) and methylprednisolone pulse therapy (1, 000mg×3days) and full controlled mechanical ventilation supported with PEEP. Her respiratory failure was gradually improved and she was discharged on the 44 the hospital day. Legionella pneumophila (serogroup 6) was isolated in her sputum by B-CYE α culture. Legionella pneumophila (serogroup6) was isolated in her private whirlpool bath too. Both samples revealed the same by genetic analysis with pulse field gel electrophoresis (PFGE). This is the first adult case of Legionella pneumophila pneumonia infected from a private whirlpool bath confirmed by genetic analysis. We should always suspect Legionella pneumonia as one of the severe community-acquired pneumonia, because Legionella pneumophila were frequently detected among various water sources including the private whirlpool bath.View full abstractDownload PDF (3905K) -
Kazue FUJITA, Yoshihiro HONDA, Takeyuki KURIHARA, Hideo OHBA, Niro OKI ...2004 Volume 78 Issue 10 Pages 905-909
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 47-year-old woman was hospitalized because of urinary-tract infection. She was treated with antibiotics for 6 days. However, severe watery diarrhea and pyrexia developed 6 days after stopping administration of antibiotics. Stool, throat and blood cultures were positive for methicillin-resistant Staphylococcus aureus (MRSA) and negative for Clostridium difficile DI toxin. In spite of administration of VCM, she died of septic shock. At autopsy, macroscopic observation revealed a pseudomembrane in the ileum. MRSA enterocolitis can occur in patients with antibiotic-related diarrhea, and physicians should be aware of its rapid clinical course and possible lethal outcome.View full abstractDownload PDF (4160K) -
Tetsuji KAWAMURA, Shin SASAKI, Akira TANAKA, Yasuharu NAKAHARA, Yoshir ...2004 Volume 78 Issue 10 Pages 910-915
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 36-year-old male who had been in good health visited our hospital because of fever, productive cough and lobar pneumonia of the right lower lobe. Bronchoscopic examination revealed pulmonary cryptococcosis. After the initiation of fluconazole the pneumonia started to improve, however, it was aggravated after the discontinuation of fluconazole because of liver dysfunction induced by it. The pulmonary cryptococcosis improved by lobectomy of the right lower lobe. There have been few reports of lobar pneumonia caused by primary pulmonary cryptococcosis. We report this case with fourteen other cases of primary pulmonary cryptococcosis which have been experienced in our hospital.View full abstractDownload PDF (5434K) -
Kammei RAI, Etuko KURIMOTO, Nobuchika KUSANO, Norio KOIDE, Kenji NISHI ...2004 Volume 78 Issue 10 Pages 916-922
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 26-year-old woman visited the first hospital due to ascites in August 2003, She had continual abdominal pain diagnosed as Irritable bowel disease after a gastrointestinal and colon fiberscopy was performed. Chest-abdominal CT scan revealed normal chest, massive ascites and swollen ovary. To rule out malignancy, surgical biopsy was performed, which brought no significant findings. We focused on the high value of Adenosin deaminase (ADA) in ascites and strongly suspected tuberculotic peritonitis. Consequently, pathologist confirmed the existence of bacterial bodies stained by acid-fast stain after our consultation. Compared with the poor diagnostic accuracy of surgical biopsy, the value of ADA in ascites has a very high sensitivity and specificity. Considering the high risk of being infertile, to begin diagnostic medication of tuberculotic peritonitis is an acceptable choicefor young women with a high value of ADA in the ascites.View full abstractDownload PDF (2683K) -
Hiroshi MIYAMOTO, Kayo URYU, Hiroko YOSHIMURA, Hatsumi TANIGUCHI2004 Volume 78 Issue 10 Pages 923-924
Published: October 20, 2004
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSDownload PDF (251K)
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