All issues
Volume 81, Issue 1
Displaying 1-13 of 13 articles from this issue
- |<
- <
- 1
- >
- >|
-
Koji SUDO, Takako SHIMA, Makiko KONDO, Shingo KATO, Mitsunobu IMAI2007 Volume 81 Issue 1 Pages 1-5
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe evaluated the use of COBAS TaqMan HIV-1 for highly pure system (COBAS TaqMan) recently developed as a second-generation quantification of human immunodeficiency virus type 1 (HIV-1) RNA. The linearity, sensitivity, reproducibility, and effects of possibly interfering materials were examined and results compared to those of AMPLICOR HIV-1 MONITOR Test version 1.5 (AMPLICOR) using 6 virus isolates that were all different subtypes. Excellent linearity was obtained at 1.67×102-1.73×106 copies/mL (r2=0.991). Sensitivity was 40 copies/mL at a 100% hit rate. Intraexperimental CVs were 27.4-50.8%, and interexperimental CVs were 29.3-81.5%. Although COBAS TaqMan showed an excellent titer correlation with AMPLICOR (r2=0.960), mean titer obtained with COBAS TaqMan was 3.1 times higher than that with AMPLICOR (p=0.002), and 7.1 times higher in a sample of subtype C, suggesting discrepancies in HIV-1 RNA quantification between the two kits. This point should be noted when AMPLICOR is replaced by COBAS TaqMan.View full abstractDownload PDF (725K) -
Tadashi HOSHINO, Naruhiko ISHIWADA, Katsuaki ABE, Kyoko SAWADA, Yoichi ...2007 Volume 81 Issue 1 Pages 6-11
Published: January 20, 2007
Released on J-STAGE: May 20, 2011
JOURNAL FREE ACCESSWe analyzed the clinical and bacterial backgrounds of 120 patients with pediatric urinary tract infection (UTI). Escherichia coli was the main pathogen recovered from 98 patients (81.7%). All causative agents isolated from 50 uncomplicated UTI cases were E. coli. Of 98 cases of E. coli UTI, 71 were treated with secondgeneration cephems, whose therapeutic effect was equal to that of third and fourth-generation cephems. MIC50 and MIC90 (μg/mL) for E.coli were as follows: cefazolin: 2, 4; cefmetazole: ≤0.52; and ceftazidime: ≤0.25, ≤0.25. Yearly decline in susceptibility was not observed, but MIC elevation for thirdgeneration cephems (≥2μg/mL) including ceftazidime was seen in six isolates. Careful monitoring of susceptibility trends is therefore necessary for appropriate antimicrobial therapy.View full abstractDownload PDF (754K) -
Hajime SAITO, Kiyoshi ZAYASU, Eriko SHIGETO, Tomotada IWAMOTO, Kazue N ...2007 Volume 81 Issue 1 Pages 12-19
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSMycobacterium shimoidei (Tsukamura 1982) is an uncommon but widely distributed pathogen usually isolated from respiratory specimens. We report two cases of lung disease due to M. shimoidei and the associated bacteriological results.
A 45-year-old man (Case 1) admitted to National Hospital Organization (NHO) Miyagi Hospital, a 75-year-old man (Case 2) admitted to NHO Higashi-Hiroshima Medical Center were found in initial chest X-ray and thoracic computed tomography (CT) to have a tuberculosis-like cavity in the left apex (Case 1) and the right apex (Case 2). In Case 1, the patient was treated with isoniazid and rifampicin for one month and lesions showed a partial response. In Case 2, the patient responded favorably with rifampicin, ethambutol, streptomycin, and clarithromycin therapy.
Mycobacteria were repeatedly detected in smear and culture from sputum specimens in both patients. Isolates were nonphotochromogenic and rough. Isolated colonies developed after two to three weeks on 2% Ogawa egg medium. Organisms grew on 2% Ogawa egg medium at 30, 37, 42, and 45°C, but not 25°C. Both organisms were susceptible t0 500μg of p-nitrobenzoate per mL and 5mg of sodium chloride per mL. Isolates were negative for niacin accumulation, nitrate reduction, semiquantitative catalase, 68°C catalase, 3-day arylsulfatase, iron uptake, and MPB64 antigen production, but positive for Tween 80 hydrolysis (5 and 10 days), acid phosphatase, and pyrazinamidase. Isolates had typical uv-HPLC chromatograms similar to M. shimoidei demonstrating triple-peak clusters with peaks in the early cluster. 16S rRNA gene sequencing showed isolates to be consistent with Mycobacterium shimoidei. Based on composite characterization, isolates were identified as M. shimoidei. This is, to our knowledge, the third case of M. shimoidei infection reported in Japan.View full abstractDownload PDF (1233K) -
Mikako TSUNODA, Tomonobu KOIZUMI, Masanori YASUO, Kenji TSUSHIMA, Masa ...2007 Volume 81 Issue 1 Pages 20-25
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe studied the clinical utility of in situ hybridization (Hybrisep) in diagnosing respiratory infection and/or sepsis. Peripheral blood was taken from patients with respiratory infections and suspected sepsis for both routine blood culture and in situ hybridization, and focal samples including sputum, bronchoalveolar lavage, and central and thoracic catheter, were simultaneously examined for bacterial culture. Specimens numbered 46. The clinical diagnosis was 20 cases of septicemia, with 26 specimens diagnosed as respiratory infectious diseases including hospital-acquired pneumonia and pleurisy. Positive cases of in situ hybridization were seen in 19 specimens (41.3%) in all specimens, significantly higher than that in blood culture (17.4%). Respiratory infection showed a high positive rate in in situ hybridization. Interestingly, the bacterial pathogen detected by in situ hybridization was not always consistent with that taken from focal samples. Whether the pathogen isolated by in situ hybridization is accurate etiologically or diagnostically remains unknown, but our findings suggest a polymicrobial infection in patients with hospital-acquired respiratory infections. In situ hybridization thus provides important information on the etiological pathogen in different infectious diseases.View full abstractDownload PDF (906K) -
Development of O-serogroup Serodiagnosis for Patients with Hemolytic Uremic Syndrome by Ec-LPS ArrayKen-ichi AMANO, Jun YATSUYANAGI, Shioko SAITO2007 Volume 81 Issue 1 Pages 26-32
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe extracted lipopolysaccharides from 58 O-serogroup strains of Escherichia coli with phenol-water for use as antigens for an Ec-LPS array. The Ec-LPS array was made by dot-blotting of E.coli LPS on PVDF membrane. Commercial anti-E.. coli O-serogroup antisera reacted with homologous O-serogroup LPS in Ec-LPS arrays. Convalescent sera of 6 patients with hemolytic uremic syndrome reacted strongly with O157 LPS when IgM and IgA antibodies in patient sera analyzed by Ec-LPS arrays. When IgG antibody was analyzed in this array, it was difficult to diagnose the O-serogroup because of the reactivity of patient sera against many O-serogroup LPS. These results match those by ELISA and western blotting. Compared to these serological techniques, Ec-LPS array appears superior to ELISA and western blotting in cost performance, time performance, and technical complexity.View full abstractDownload PDF (2990K) -
Masahiro TOYOKAWA, Akiko UEDA, Isao NISHI, Seishi ASARI, Keiko ADACHI, ...2007 Volume 81 Issue 1 Pages 33-38
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSToxin detection from stool specimens is critical for the diagnosis of Clostridium difficile-associated diarrhea (CDAD). In Japan, only two toxin detection kits targeting toxin A alone are commercially available. We evaluated ImmunoCard Toxin A & B (ImmunoCard), based on enzyme immunoassay for the rapid detection of both C. difficile toxins A and B in stool specimens, compared to a toxin A detection kit (Uniquick) and cytotoxin assay. C. difficile was also cultured from stool specimens and the toxin production type of C. difficile isolates was identified by PCR analysis. Compared to cytotoxin assay, ImmunoCard sensitivity was 86.2%, specificity 93.8%, positive predictive value 91.8%, and negative predictive value 89.4% (n=146). Sensitivity was significantly higher than that of Uniquick (60.0%, p=0.0016). ImmunoCard detected 90.6% of cytotoxin positive specimens with isolated toxin A-positive, toxin B-positive C. difficile strains (Uniquick; 67.9%, p=0.008) and 70.0% of these with isolated toxin A-negative, toxin B-positive C. difficile strains. Although ImmunoCard was slightly less sensitive than cytotoxin assay, it requires no special equipment and completes the entire test in up to 20min. ImmunoCard thus appears very useful in the rapid diagnosis of CDAD in the clinical laboratory. Kits for the detection of both C. difficile toxins A and B should be immediately introduced into Japan to ensure the correct diagnosis of CDAD and infection control.View full abstractDownload PDF (1059K) -
Report of Questionnaires' Data Obtained from Clinical Laboratory Personnel in JapanMieko GOTO, Tomonari YAMASHITA, Shigeki MISAWA, Toshiaki KOMORI, Katsu ...2007 Volume 81 Issue 1 Pages 39-44
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSTo determine the status of biosafety in clinical laboratories in Japan, we conducted a survey using questionnaires on the biosafety of laboratory personnel in 2004. We obtained data from 431 hospitals (response: 59.5%).
Respondents were 301 institutions (70%) having biological safety cabinets (BSCs). BSCs were held in 78% of microbiological laboratories, 7.9% of genetic laboratories, 2.7% of histopathological laboratories, and 1% or less at other laboratories.
A clean bench in examination rooms for acid-fast bacilli was applied at 20 hospitals. We found 28 cases of possible laboratory-associated tuberculosis infection, 25 of which were associated with lack of BSC. Other risk factors were immature skills and insufficiently skilled eguipment operation.
The frequency of rupture accidents during specimen centrifugation was 67% in dealing with blood and 9.7% in collecting acid-fast bacilli. Half or more accidents were related to inadequate sample tube materials.
Technologists were shown to be working on blood collection in many hospitals (75%), and 1, 534 events of self-inflicted needle puncture developed in the last 5 years.
These results suggest that biosafety systems are woefully lacking or inadequate in clinical laboratories in Japan and must be established at the earliest possible opportunity.View full abstractDownload PDF (877K) -
Molecular Epidemiology of Environment-derived Strains and Clinical IsolatesKenji OONAKA, Katsunori FURUHATA, Motonobu HARA, Masafumi FUKUYAMA2007 Volume 81 Issue 1 Pages 45-50
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSTo clarify the route and source of Vibrio vulnificus infection, we conducted molecular epidemiological investigation by DNA analysis of 355 environmental isolates (seawater-derived strain: 86, sea mud-derived strain: 36, and oyster-derived strain: 233) and 65 human clinical isolates, for a total of 420 isolates, using pulse field gel electrophoresis (PFGE), with the following results.
1. When DNA was cleaved with 2 enzymes, Not I and Sfi I, and subjected to PFGE, Not I DNA interpretation was 76.9%, and Sfi I cleavage was 97.9%, showing that Sfi I was superior in cleaving DNA of this bacteria.
2. Sfi I-interpreted strains were subjected to PFGE and migration patterns were analyzed by UPGMA, but close classification was not possible because similarity was low, this infectious disease clearly originated from multiple rather than a single-clone. In this cluster, we concluded that this infectious disease was acquired through contact between the environment and human beings and viceversa. We identified an assortment of clinical isolates and environment-derived strains among more than 89% of strain groups tested, none of which could be expected to have the same origin.
We conclued DNA analysis on these two types of restriction enzymes using PFGE, but were unable to classify test results in detail due to the proliferation of migration patterns and low degree of similarity.View full abstractDownload PDF (1084K) -
Tadashi HOSHINO, Naruhiko ISHIWADA, Katsuaki ABE, Junko OGITA, Chie FU ...2007 Volume 81 Issue 1 Pages 51-58
Published: January 20, 2007
Released on J-STAGE: May 20, 2011
JOURNAL FREE ACCESSWe summarize 41 cases of bacterial meningitis in the last 11 years caused by Haemophilus influenzae. All isolates were serotype b strain (Hib). Initial chemotherapy was started with ceftriaxone (CTRX) in 22 cases, ampicillin plus cefotaxime (CTX) in 9, CTRX plus panipenem/betamipron in 5, and CTX in 2. Some 31 cases were treated mainly with CTRX. Although therapeutic antibiotics showed good susceptibility for isolates, 8 complicated cases (19.5%) occurred. Sequalae were observed in 7 (17.1%) but none were fatal. Five strains with elevated MIC of CTX (0.12 to 1 μg /mL) recovered after 2001, and 3 of 5 strains also showed elevated MIC of CTRX (0.12 to 0.5 μg /mL), but all were cured completely with CTRX At present, no treatment failures due to antibiotic resistance have been observed, and CTRX remains suitable as initial therapy for Hib meningitis. A decline in susceptibility for third-generation cephalosporin against β -lactamase-nonproducing ampicillin-resistant H. influenzae is emerging, however, so it will be necessary to consider combination therapy with CTRX given the foreseeable trend in MICs.View full abstractDownload PDF (1096K) -
Hitoshi KAMIYA, Tatsuo KATO, Takehiro TOGASHI, Satoshi IWATA, Tomomich ...2007 Volume 81 Issue 1 Pages 59-66
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSTo determine the distribution ofStreptococcus pneumoniae serotypes isolated from patients under 6 years of age with acute suppurative otitis media, to calculate the serotype coverage of 7-valent pneumococcal conjugate vaccine, and to clarify trends in PCG-resistant Streptococcus pneumoniae, we conducted a one-year prospective study from April 2005 to March 2006 at 10 medical institutions in Hokkaido, Miyagi, Chiba, Tokyo, Kanagawa, and Mie, Japan.
Specimens collected by tympanotomy or myringotomy numbered 856, and 691 strains were isolated from 599 specimens. Of these, 219 isolates (31.7%) were identified asStreptococcus pneumoniaeand 201 met study requirements. The most common serotype was 19F (52 isolates, 25.9%), followed by 6B (30 isolates, 14.9%) and 23F (24 isolates, 11.9%). Seven-valent vaccine serotype coverage was 62.7%.
The percentage of PSSP was 40.3%, PISP 42.8%, and PRSP 16.9%, resistant strains (PISP and PRSP) combined accounted for 59.7%. Seven-valent vaccine serotype coverage for PISP was 80.2% and PRSP 82.4%. PBP gene mutation was observed in 175 isolates (87.1%), including 70 of gPISP (34.8%) and 105 of gPRSP (52.2%). Gene mutation induced by macrolides was found in 176 isolates (87.6%).View full abstractDownload PDF (1380K) -
Hirochiyo SAWAGUCHI, Hirokazu NAKAJIMA, Sigenori NAKAJIMA, Mitsuru KON ...2007 Volume 81 Issue 1 Pages 67-71
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSCase 1: A 35-year-old man admitted for fever and respiratory failure during several weeks was found in chest computed tomography (CT) to have interstitial pneumonia, and the plasma β-D-glucan level indicated Pneumocystis jiverociipneumonia. Psoriasis from second-stage syphilis raised the suspicion of HIV infection. Serum anti-HIV-1 antibody proved positive and CD4-positive lymphocytes in peripheral blood were 18/μL. The man died despite treatment. Autopsy confirmedP. jiverociipneumonia.
Case 2: A 28-year-old man seen for a fever and respiratory failure was found in chest CT to have mild interstitial pneumonia. We checked for hypersensitivity pneumonitis, Mycoplasma pneumoniae pneumonia, etc. The plasma β-D-glucan level indicated possible P. jirovecii pneumonia and immunodeficiency. Serum anti-HIV-1 antibody proved positive and CD4-positive lymphocytes in peripheral blood were 34/μL. The man was treated successfully, using trimethoprim with sulfamethoxazole for his interstitial pneumonia. His clinical symptoms were compatible with P. jirovecii pneumonia.
P. jirovecii pneumonia with AIDS may present with more subacute or subtle symptoms than other immunosuppressive diseases, making it difficult to diagnose. Medical professionals should thus make it a point to familiarize themselves with AIDS prevention.View full abstractDownload PDF (1025K) -
Katsuaki ABE, Naruhiko ISHIWADA, Tadashi HOSHINO, Yoichi KOHNO2007 Volume 81 Issue 1 Pages 72-75
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe present 2 cases of meningitis caused by the sameHaemophilus influenzaetype b (Hib) strain in a nursery at a 3-month interval. Causative agents isolated showed good susceptibility to β-lactams and both patients recovered without any sequelae. Survey culture at each occurrence of meningitis showed 10 asymptomatic nasopharyngeal carriers. Oral rifampin was administrated to all staff and infants, but 2 carriers were found a month later from chemoprophylaxis. Pulsed-field gel electrophoresis analysis showed that the two strains isolated from meningitis patients and 12 from asymptomatic carriers were apparently identical. When systemic Hib infection occurs in a nursery, other infants may be at high risk for secondary disease. It is difficult, however, to eliminate Hib carriage by chemoprophylaxis, indicating that Hib vaccination to prevent systemic Hib infection is necessary in Japan.View full abstractDownload PDF (751K) -
Takuya KAWAHATA, Yoko KOJIMA, Haruyo MORI, Toru OTAKE, Tsuyoshi OKUNI2007 Volume 81 Issue 1 Pages 76-77
Published: January 20, 2007
Released on J-STAGE: February 07, 2011
JOURNAL FREE ACCESSWe found two cases of HIV-1 acute infection, confirmed by nucleic amplification test (NAT) and/or RTPCR, with HIV-1 antibody negative by immunochromatography (IC) method but weakly positive by particle agglutination (PA) test. These cases suggested that IC method was less sensitive than PA test in the detection of acute infections. It is necessary to execute the post counseling that considers the possibility of the acute infection in public health centers and testing places where IC method is used for the screening test. It is also important to recommend taking the following re-examination after a certain period to a person who seems to have had a chance of infection in a short time before testing.View full abstractDownload PDF (265K)
- |<
- <
- 1
- >
- >|