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Volume 80 (2006)
- Issue 6 Pages 651-
- Issue 5 Pages 463-
- Issue 4 Pages 345-
- Issue 3 Pages 185-
- Issue 2 Pages 59-
- Issue 1 Pages 1-
Volume 80, Issue 6
Displaying 1-12 of 12 articles from this issue
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Shigemi KONDO, Toshihiko YAMADA, Naotake SATOH, Katsu SAIONJI, Toyoko ...2006 Volume 80 Issue 6 Pages 651-655
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSObjective: Methylrosaniline Chloride (MRC) is recognized as a disinfectant, but recently is rarely used in the clinic, because of its cytotoxicity when used continuously with conventional concentrations (1% MRC). We have reported the antibacterial activity of MRC with lower concentration against Methicillin-resistantStaphylococcus aureus(MRSA). In this study, we evaluated the antifungal activity of MRC with lower concentrations.
Material and Methods: Antifungal activities of MRC againstCandidaspp. andTrichosporonspp. were tested. All strains tested were isolated from 106 blood or intravenous catheter samples at Juntendo University Hospital from 1995 to 2004. Minimum inhibitory concentrations against fungi were assayed by agar dilution, under both aerobic and anaerobic conditions.
Results: A 0.01% or less concentration of MRC solutions showed marked antifungal activity againstCandidaspp. andTrichosporonspp. under aerobic or anaerobic conditions.
Conclusion: A 0.01% or less concentration of MRC should be reevaluated for the control of fungal infection and MRSA infection control.View full abstractDownload PDF (674K) -
Toyoko OGURI, Shigeki MISAWA, Ayako NAKAMURA, Shigemi KONDO, Jun IGARI ...2006 Volume 80 Issue 6 Pages 656-664
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSIncreased resistance of strains to antifungal drugs has gained increasing attention.
We studied the status of fungal isolation from blood and vascular catheters at Juntendo University Hospital from 1994 to 2002. The major fungi isolated wereCandida albicans, Candida parapsilosis, Candida glabrataandCandida trophicalis, or 86% yeast-like fungi. Isolation of these fungi from vascular catheters is increasing.
The effectiveness of 6 anti-fungal agents against 116 yeast-like fungi was measured by microdilution. In antifungal activity of micafungin (MCFG), MIC90 was≤0.03g/mL forC.albicans, C.glabrataandC.tropicalis.MCFG showed the strongest antifungal activity among the drugs tested for aboveCandidaspp. Five of 37 strains ofC. albicanswere resistant to fluconazole (FLCZ) showing MIC≥64g/mL.These strains were also resistant to itraconazole (ITCZ) but MICs of MGFG, flurocytosine (5-FC) and amphotericin B (AMPH-B). Two of 38 strains ofC. parapsilosisare resistant to flurocytosine (5-FC) showing MIC≥64g/mL There is no resistant strain of fungi (yeast-like organisms) tested against AMPH-B. Six patients from whom resistant fungi were isolated from blood and vascular catheters have severe diseases and/or are have just undergone a major surgical operation.
These results indicate that it is vital for deep mycosis to start early treatment with appropriate drugs selected based on rapid detection and identification of organisms and the drug susceptibility of organisms.View full abstractDownload PDF (1226K) -
Noriko MITSUNO, Tomohiro HARI, Nobuyoshi TAMAGAWA, Juichi ITOI, Eiji I ...2006 Volume 80 Issue 6 Pages 665-673
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe studied the basic performance of eight rapid diagnostic kits for the detection of Group A streptococcus by immunochromatography under the same conditions. Kits were the QuickVue Dipstick Strep A (Sumitomo Seiyaku Biomedical Co., Ltd.), TESTPACK Plus STREP A (ABBOTT JAPAN Co., Ltd), CLEAVIEW STREP A (Nihon Schering K. K.), QuickVue STREP A (Wako Pure Chemical Industries, Ltd), ImmunoCard STAT! STREP A (TFB, INC.), DIPSTICK ‘Eiken’STREP A (Eiken Chemical Co., Ltd.), Rapid Testa Strep A (Daiichi Pure Chemical Co., Ltd.), and StatCheck Strep A (KAINOS Laboratories, Inc.).
Four of these kits, i.e. QuickVue Dipstick Strep A, TESTPACK Plus STREP A, Rapid Testa Strep A, and StatCheck Strep A showed sensitivity at 1.0×105CFU/mL (1.0×104CFU/test) with all ofS.pyogenestested, while the Anginosus group andS. dysgalactiaesubsp.equisimiliswith Lancefield' s group A antigen showed sensitivity very similar toS. pyogenes.
Of these strains, S. dysgalactiaesubsp.equisimilisformed a β-hemolytic colony resembling that ofS. pyogeneson sheep blood agar, and was sensitive to bacitracin. It is thus indispensable to identify the colony using biochemical tests such as the PYR (pyrrolidonylarylamidase production) test.
In using rapid diagnostic kits for the detection of Group A streptococcus, it is important to rule out the possibility of Group A streptococcus other thanS. pyogenesin throats.
Severe invasive group-G streptococcal infections are increasing recently. ConcerningS. dysgalactiaesubsp.equisimilis, it is especially important to conduct these identification tests.View full abstractDownload PDF (1209K) -
Yuko MATSUMOTO, Mikiko YAMADA, Masaki SUZUKI, Harue KITAZUME, Tetsunor ...2006 Volume 80 Issue 6 Pages 674-679
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe reported two familial clusters of paratyphoid fever after travel to China occurring in the same Yokohama ward from September to October 2002. SixSalmonella entericaserovar Paratyphi A (S. Paratyphi A) strains, 3 each from 2 clusters, were isolated and their characteristics analyzed using phage typing, susceptibility to antibiotics, and patterns of restriction endonuclease-digested DNA fragments in agarose gel following pulsed-field gel electrophoresis (PFGE). Mutations in genes forgyrAandparC, which determine sensitivity to fluoroquinolones, were also investigated.
All isolates showed the same characteristics, i.e. “untypable”, employing bacteriophages, resistant to antibiotics nalidixic acid and fosfomysin, and decreased susceptibility to fluoroquinolones. No difference was observed in PFGE patterns after digesting with 4 restriction enzymes, XbaI, BlnI, SpeI, andXhoI. We also found that thegyrAgene, which is one of the quinolone-resistance-determining regions (QRDR), was mutated at position 83 from serine to phenylalanine (from TTC to TCC) in all 6 strains. Other QRDR's, parCwere not mutated commonly in them.
Hearing from patients and family members, it was apparent that these 2 families had been contacted neither in Japan nor in China during ill or incubation period of paratyphoid fever, although a member of one cluster had a familial relationship with one of another family. It was also reported by them that typhoid fever is endemic in both of the areas of their visits. From these results, it was suggested that these 2 cluster cases were infected separately in China with the progeny of the same clone which is endemic in these regions.View full abstractDownload PDF (1037K) -
Hirotaka OISHI, Yukiko URA, Shinji MITSUMIZO, Mikio NAKASHIMA2006 Volume 80 Issue 6 Pages 680-689
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSVibrio vulnificus is found globally in marine coastal waters. Infection with this organism, via ingestion of raw shellfish or exposure to marine water, can cause necrotizing fasciitis and sepsis, which have high mortality and short latency. In Japan, many cases have been reported since 1980, mainly from hospitals in western prefectures. However, because of the sporadic nature of infection outbreaks, a thorough epidemiologic survey has not been done. We studied the epidemiological and clinical characteristics of Vibrio vulnificus infections reported in Japan from 1975 to 2005. We identified 185 cases using the medical article search engines Ichushi (Japan Medical Abstracts Society), CiNii (Citation Information by National Institute of Informatics), and PubMed over 30 years. The median age of patients was 59. The number of male patients was eight times the number of female patients; however, no significant difference in mortality was found between genders. In yearly distributions of patients, 20 cases were reported in 2001, a year in which we experienced more rainfall and a longer rainy season in Northern Kyushu. In monthly distribution, about 80% of cases were reported from July to September when sea water temperatures rise. About 40% of cases were reported in four prefectures around the Ariake Sea. The underlying disease indicated liver dysfunction in 90% of patients, but mortality was the same regardless of the infection pathway (oral ingestion or wound). Because of its rapid aggravation and high mortality rate, public education is important to prevent new cases. It is also highly recommended that patients with preexisting liver dysfunction avoid raw fish and limit exposure to marine water during the summer.View full abstractDownload PDF (1531K) -
Jun HANEDA, Yasumasa SHIOBARA, Masami INUI, Tomoko SEKIGUCHI, Yoshinor ...2006 Volume 80 Issue 6 Pages 690-693
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSDespite reports of Clostridium tetani being isolated from soil in Kanazawa, Okinawa, and Tokyo, Japan, little has been studied about C. tetani distribution in other regions. We studied C. tetani in topsoil samples collected from private gardens, public road shoulders, a university campus, mountains, and fields in Sagamihara. C. tetani occurred in 8 of 35 soil samples (22.9%) and tetanus toxin in 7 of the 8 C. tetani-positive samples (87.5%). Contamination was clearly higher in soils from mountains near Tsukui-gun (Kanagawa Prefecture), Minamitsuru-gun, and Uenohara and Koshu cities (Yamanashi Prefecture) than in other regions. These findings suggest that tetanus toxin-producing strains of C. tetani tend to inhabit the topsoil of western Sagaminaha region, as a geographical feature.View full abstractDownload PDF (664K) -
Kiyoe YODA, Eiji YOKOYAMA, Masako UCHIMURA2006 Volume 80 Issue 6 Pages 694-700
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSIn an outbreak of gastroenteritis in elementary school students and their families in Chiba Prefecture, Japan, Campylobacter jejuni was isolated from the stools of 14 patients who developed diarrheal illness after a one-day bus trip. C. jejuni was also isolated from the stools of 3 patients not going on the bus trip. Pulsedfield gel electrophoresis (PFGE) analysis was done on 17 isolates of C. jejuni to study genetic relationships among them. PFGE profiles of isolates treated with restriction enzymes Sma I, Ksp I and Kpn I were separated into 9, 10, and 10 types, but the relationship between PFGE profiles and epidemiological profiles was unclear. Dendrograms of PFGE of isolates double-digested with both Sma I and Ksp I were typed into D1, D2, D3 and D4, and profiles compared to profiles of serotyping and flagellin typing of isolates and epidemiological profiles to evaluate genetical and epidemiological relationships. Thirteen isolates of PFGE type D1 possessed serotype G and flagellin type Al and were isolated from patients going on the bus trip. Type D2 isolated from a student going on the bus trip and type D3 isolates from two students not going on the bus trip had serotype B and flagellin type A2. C. jejuni of PFGE type D4, serotype UT, and flagellin type A3 was also isolated from a student not going on the trip. Our results show that at least two outbreaks of C. jejuni occurred simultaneously in people related to the school. Restriction enzyme double-digestion PFGE was thus useful in the molecular epidemiological analysis of the C. jejuni outbreak.View full abstractDownload PDF (1942K) -
Comparison with Conventional MethodKoichiro YOSHIDA, Naoyuki MIYASHITA, Yasushi OBASE, Minoru FUKUDA, His ...2006 Volume 80 Issue 6 Pages 701-705
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe had reported that the rate of non-specific reaction in measurement of (1→3)-β-D-glucan was decreased by improvement of the alkaline pretreatment reagent of Fungitec G-test MK (MK assay). To compare the clinical usefulness between conventional MK assay and new MK assay using improved alkaline pretreatment reagent, 121 plasma samples were tested. The sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV) in conventional MK assay were 91.7%, 85.3%, 44.0% and 98.8%, respectively. Those in new MK assay were 75.0%, 91.6%, 52.9% and 96.7%, respectively. On the other hand, area under the curve (AUC) of receiver operating characteristic (ROC) analysis in conventional and new MK assay was 0.9175 and 0.9123 without a significant difference. It has been recognized that the sensitivity in conventional MK assay is higher than those in other β-glucan assays. Then, the specificity of new MK assay was improved by using improved alkaline pretreatment reagent, without decreasing the sensitivity. Thus, the present findings indicate that the new MK assay is clinically quite useful.View full abstractDownload PDF (805K) -
Yasutaka MIZUNO, Hitomi FUJIMOTO, Kyoko YOKOTA, Yasuyuki KATO, Ikumi G ...2006 Volume 80 Issue 6 Pages 706-710
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe report a 54-year-old Japanese man who contracted severe falciparum malaria after visiting West African countries. The patient presented with Plasmodium falciparum parasitemia of 10% on admission and was successfully treated with intravenous artesunate combined with continuous hemodiafiltration. We found that intravenous artesunate had excellent antimalarial activity with rapid parasite clearance and that few adverse effects were observed compared to those reported for intravenous quinine treatment. Supportive therapy was indispensable for saving the life of the patient. Few cases of intravenous artesunate treatment are reported in Japan because the drug has not been legally registered. We wish to emphasize the efficacy of intravenous artesunate with general supportive therapy in the treatment of possible imported severe malaria patients in Japanese medical settings.View full abstractDownload PDF (1411K) -
Hirokazu NAKAJIMA, Hirochiyo SAWAGUCHI, Shigenori NAKAJIMA2006 Volume 80 Issue 6 Pages 711-715
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 30-year-old woman with malnutrition due to alcoholism and eating disorders was found to have acute respiratory distress syndrome (ARDS) and sepsis due to severe Streptococcus pneumoniae pneumonia. S. pneumoniae was detected by an in vitro rapid immunochromatographic assay for S. pneumoniae antigen in urine on the day of admission and by blood culture 2 days after admission. Symptoms and laboratory findings improved after treatment with sivelestat sodium hydrate, antibiotics, and mechanical ventilation. Treatment with sivelestat sodium hydrate also decreased serum neutrophil elastase activity. This case demonstrates the usefulness of early treatment with sivelestat sodium hydrate in ARDS due to severe pneumonia.View full abstractDownload PDF (1114K) -
Masafumi SEKI, Kenji HIROMATSU, Kosuke KOSAI, Yuichi FUKUDA, Tomoyuki ...2006 Volume 80 Issue 6 Pages 716-720
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSA 76 year-old man admitted for general malaise with fever was found in clinical examination on admission to have eosinophilic pleural effusion, peripheral eosinophilia, and a slightly elevated inflammatory reaction. Immunological examination, including microplate ELISA, showed a high titer of specific antibody againstToxocara canisin both the serum and pleural effusion. We started treatment using albendazole, and found inflammatory findings and serum IgE were ameliorated. Parasitic disease is an important consideration in the differential diagnosis of eosinophilic pleural effusion, and serology is useful in screening for this.View full abstractDownload PDF (924K) -
Shigeki NAKAMURA, Tomo MIHARA, Tsutomu HITOTSUMATSU, Yoshifumi SOEJIMA ...2006 Volume 80 Issue 6 Pages 721-725
Published: November 20, 2006
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSNocardia is typically regarded as an opportunistic infection, with pulmonary nocardiosis frequently disseminated to organs hematogenous by, and nearly half of these cases resulting in complicated nocardia brain abscess. Disseminated nocardia has a dismal prognosis with high mortality, and should be checked for multiple organs including the brain when nocardiosis is diagnosed.
We describe the successful treatment of nocardia brain abscesses in an immunocompetent older people with pneumoconiosis by combining trimethoprim-sulfamethoxazole and ciprofloxacin. Patients had no history of fever, headache, or respiratory symptoms such as cough, or sputum until the acute hemiplegia episode. Nocardia infection is not as rare as generally assumed and should be considered as a possibility in the elderly due to its high mortality.View full abstractDownload PDF (1798K)
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