Kansenshogaku Zasshi
Online ISSN : 1884-569X
Print ISSN : 0387-5911
ISSN-L : 0387-5911
Volume 79, Issue 4
Displaying 1-8 of 8 articles from this issue
  • Ayumi MATSUMOTO, Mitsuaki HOSOYA, Masahiko KATAYOSE, Kiyohiko WATANABE ...
    2005 Volume 79 Issue 4 Pages 249-253
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    The present study investigated the host risk factors for carriage of Haemophilus influenzae (H. influenzae) with resistant gene (s) against antibiotics. From September 2001 to January 2004, 174 strains of H. influenzae were isolated from the nasopharynx of children with respiratory tract infections. We classified these strains on the basis of the MIC to Ampicillin and the presence of resistant gene (s) for antibiotics resistance (gene for β-lactams and altered pbp gene (s)).The patients'background such as previous antibiotic usage, age, daycare attendance, siblings and underlying diseases was investigated. The risk factor for carriage of strains with altered pbp gene (s) was the usage ofβ-lactams within the last 3months. Controlled usage of oral β-lactams might be an important issue for preventing the spread of resistant H. influenzae strains such as β-lactamase non-producing ampicillin resistant H. influenzae. We have to reconsider a therapeutic approach for the treatment of young children with respiratory tract infection.
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  • Naohide TAKAYAMA
    2005 Volume 79 Issue 4 Pages 254-259
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    In recent years, the number of Japanese traveling to foreign countries is increasing. Most of them travel to Asian regions where many infectious diseases that are rare or don't occur in Japan still remain endemic or epidemic.
    Of these infectious diseases typhoid fever and meningococcal infection are now preventable becausesafe and effective vaccines have been developed and now marketed. However, these vaccines are hardly available in Japan because the Japanese Government has not admitted them.
    To investigate the demand for the two vaccines, the author personally imported inactivated polysaccharide typhoid vaccine and groups A, C, Y and W 135 combined polysaccharide meningococcalvaccine, both manufactured by Aventis-Pasteur. After obtaining approval of the ethical committee of our hospital, vaccination was started. From May 6, 2003 to September 30, 2004, 124 applicants received typhoid vaccine and 35 were injected with meningococcal vaccine. Of 124 vaccinees of typhoid vaccine, 46 went to Afghanistan, 15 to India, 8 to Thailand. Of 35 vaccinees of meningococcal vaccine 6 went to the USA, 5 to Guinea and 3 to England. In addition a total of 12 physicians and nurses having no international scheduled trip were also immunized with meningococcal vaccine.None of these vaccines are widely known in Japan now. Based on our results, however, the expansion of recognition and demand for these two vaccines is expected.
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  • Rumi OKUNO, Miyoko ENDOH, Yukako SHIMOJIMA, Yoshitoki YANAGAWA, Satosh ...
    2005 Volume 79 Issue 4 Pages 260-269
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    Previously, we have performed T typing of Streptococcus pyogenes strains isolated from patients with streptococcal toxic shock syndrome (STSS) in Japan, and streptococcal pyrogenic exotoxin (SPE) typing for epidemiological examination. In this study, we conducted a drug sensitivity test using these strains, and investigated the results of gene analysis by pulse-field gel electrophoresis (PFGE) of S. pyogenes strains derived from patients with STSS, the patient's family, and patients other than those with STSS. To clarify the relationship between the host and bacterial factors, we investigated the association between clinical symptoms and T typing of the isolated strains/production of streptococcal pyrogenic exotoxin. There were no strains resistant to β-lactams, and only 1 strain was resistant to multiple agents other than β-lactams. The PFGE pattern of T1 type strains was classified into 2; the pattern was consistent between the strains derived from patients with STSS and those derived from the patient's family. The PFGE pattern of T3 type strains was classified into 5 (IV); Pattern I, which was most frequently observed, was detected in both the strains derived from patients with STSS/non-STSS. However, Patterns II and III were detected only in the strains derived from patients with non-STSS.Patterns IV and V were detected only in the strains derived from patients with STSS. When examining the association between clinical symptoms and bacterial factors, disseminated intravascular coagulation (DIC) was associated with Tl-SPE B-producing strains, and pharyngitis was associated with T3-SPE A-producing strains.
    In the future, the relationship between the host and bacterial factors should be further investigated.
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  • Fubito ISHIGURO, Yoshito KYOTA, Michio MOCHIZUKI, Tetsuya FUSEDA, Shig ...
    2005 Volume 79 Issue 4 Pages 270-275
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    From May 2003 to March 2004, nine strains of multidrug-resistant (MDR) Salmonella enterica serovar Newport were isolated from 5 sewages of 3 sewage treatment plants located in 2 different regionsof Fukui Prefecture. Antimicrobial susceptibility testing identified 2 different MDR patterns (type I and II). Type I strains were resistant to ampicillin, tetracycline, streptomycin, chloramphenicol.amoxicillin/clavulanic acid, sulfisoxazole, cefotaxime, cephalothin, ceftriaxone, and ceftrazidimeand type II strains were additionally resistant to sulfamethoxazole-trimethoprim and spectionomycin.Neither of kanamycin, fosfomycin, nalidixic acid, gentamycin, or ciprofloxacin resistance was observed.Type I and II strains were different in pulsed-field gel electrophoresis patterns and plasmidprofiles, while they showed the same profiles with in each type.
    All the MDR strains in this study were proved to carry the bla CMY-2 gene by PCR and sequenceanalyses. Numbers of reports on MDR S. Newport with blaCMY-2 have been increasing in foreign countries such as the United States. The MDR patterns of the isolates in this study were similarto those of the United States.
    These properties of the type I strains were identical with that a strain isolated rom a 7-year-old patient in Fukui Prefecture, in September 2003 which we previously reported. However, the patient lived in a region where no epidemiological associations with the sewage treatment plants were found.This suggests that the MDR strains might prevail in Fukui Prefecture. Domestic surveillance for MDR S. Newport would be need.
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  • Kuniki HAYASHI, Takahisa UCHIYAMA, Michiko IWATA, Kazumitsu SANO, Mits ...
    2005 Volume 79 Issue 4 Pages 276-283
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    ImmunoCard STAT!TM RSV (Meridian Bioscience, Inc, USA) is a rapid immunoassay method newly developed for detection of respiratory syncytial virus (RSV) by immunochromatography. We carried out an evaluation of the ImmunoCard STAT!TM RSV.
    One hundred fifty-nine nasal wash samples and nasopharyngeal aspirates from patients were used to evaluate three different kits, which are ImmunoCard STAT!TM RSV, RSV testpack (Abbott JAPAN) and DirectigenTM EZ RSV (Nippon Becton, Dickinson and Company). One hundred twentyeight samples showed equivalent results.
    When nested reversed transcription-PCR (nested RT-PCR) results for 31 samples showing discrepancies among three kits, 10 samples were positive, and 21 samples were negative by nested RTPCR. Compared to Nested RT-PCR results, ImmunoCard STAT!TM RSV showed a sensitivity of 90.5% (19/21) and a specificity of 80.0% (8/10), as well as RSV testpack showed a sensitivity of 10.0% (2/21) and a specificity of 100% (10/10), DirectigenTM EZ RSV showed 95.2% (20/21) and 0.0% (0/10), respectively.
    Furthermore, the detection limits were also evaluated by using ACTT No. VR1540 for RSV A-2 strain, and ACTT No. VR1401 for Wash strain.
    The detection limit of ImmunoCard STAT!TM RSV was 5.15×106 TCID50/mL in subgroup A strain and was 7.58×105 TCID50/mL in subgroup B strain. This result was similar to RSV testpack, and was better than the detection limit of Directigen EZ RSV.
    It is concluded that ImmunoCard STAT!TM RSV is useful in detecting RSV in a clinical setting with equivalent performance to conventional other detecting kits.
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  • Mikiko HANADA, Haruki IMAOKA, Yuichi OSHITA, Toru RIKIMARU, Hisamichi ...
    2005 Volume 79 Issue 4 Pages 284-289
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    A 63-year-old woman was admitted to our hospital with fever and cough. Candidemia was diagnosed by blood culture and culture of IVH catheter. Although, the patient was treated with fluconazole, clinical symptoms and chest radiographic findings worsened. After micafungin was replaced with fluconazole, her symptoms, chest radiographic findings improved and stabilized. It is suggested that micafungin is useful for the treatment of candidemia associated with Candida parapsilosis.
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  • Yoshikazu ISHII, Masashi BANDO, Shoji OHNO, Yukihiko SUGIYAMA
    2005 Volume 79 Issue 4 Pages 290-293
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    A 75 year-old male was admitted to our hospital with high fever and dyspnea. He had traveled in Turkey 10 days before. His chest X-ray showed infiltrations in bilateral lower lung fields. His urinary antigen detection test for Legionella pneumophilia was positive. He was treated with pazufloxacin added to clarithromycin and his symptons were promptly resolved.
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  • Mitsuo SAKAMOTO, Tetsuro KATO, Fumiya SATO, Koji YOSHIKAWA, Masaki YOS ...
    2005 Volume 79 Issue 4 Pages 294-298
    Published: April 20, 2005
    Released on J-STAGE: February 07, 2011
    JOURNAL FREE ACCESS
    We report a patient with leptospirosis caused by Leptospira borgpetersenii serovar Sejroe infection on Bali Island, Indonesia. This 33-year-old Japanese man had stayed at a resort hotel on the island from July 8 to July 13 2004. At the hotel, he swam in the pool, walked barefoot, and lied down in the grass. He developed a high fever and headache 7 days after completing his trip, and was admitted to our hospital on July 23. On admission he showed conjunctival suffusion and complained of myalgias. Laboratory findings included granulocytosis and elevated CRP.Plasmodiumspp. were not found in blood smears, and no pathogenic bacteria were isolated from blood or fecal cultures. We diagnosed the patient as leptospirosis upon detection of slender coiled organisms with characteristic morphology by darkfield examination of blood sample. Minocycline 100 mg i. v. b. i. d. showed excellent efficacy. A microscopic agglutination test (MAT) during the convalescent stage demonstrated a significant increase in antibodies against L. borgpeterseniiserovar Sejroe, confirming the diagnosis of leptospirosis. Despite occurrence of a pandemic of leptospirosis in certain Southeast Asian countries including Indonesia, information concerning pandemic disease is limited. In addition serovars of “imported” cases representing infection in pandemic areas differ widely from those in domestic cases. Adequate laboratory support therefore is crucial for accurate diagnosis of leptospirosis.
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