All issues
Volume 87 (2013)
- Issue 6 Pages 721-
- Issue 5 Pages 581-
- Issue 4 Pages 409-
- Issue 3 Pages 357-
- Issue 2 Pages 189-
- Issue 1 Pages 1-
Volume 87, Issue 6
Displaying 1-8 of 8 articles from this issue
- |<
- <
- 1
- >
- >|
ORIGINAL ARTICLES
-
Yumi AKIYAMA, Etsuko SAITO, Miki ENOMOTO, Hidetaka TSUJI, Masatsugu C ...2013 Volume 87 Issue 6 Pages 721-725
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSA simultaneous screening method using conventional PCR was developed for the detection and discrimination of Bordetella pertussis, Bordetella parapertussis, and Bordetella holmesii. A formulated multiprex method employing 4 kinds of paired primers on amplification of 4 corresponding different insertion sequences (IS481,IS1001,IS1002 and hIS1001) enabled rapid screening and identification. The detection limits of each DNA extracted from 3 kinds of Bordetella species were 5fg/μL for each. Obscure existences of B. pertussis and B. holmesii at low levels were confirmed with the LAMP method. This multiplex assay was applied to the clinical specimens obtained from patients with pertussis-like symptoms at sentinel clinics under the epidemiological surveillance of infectious diseases of Hyogo prefecture in FY2012. Among 42 nasopharyngeal swabs, B. pertussis was detected from 12 samples including 8 samples collected at outbreak in nursery school. The use of this method for the surveillance of infectious agents enabled us to search for 3 kinds of Bordetella species at once with low costs.View full abstractDownload PDF (306K) -
NAGANO Hiroaki , Ryoichi AMITANI, Natsumi OKAMOTO, Masanori YOSHIDA, M ...2013 Volume 87 Issue 6 Pages 726-731
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSPulmonary Mycobacterium abscessus infection is resistant to many antibiotics and is difficult to treat. We retrospectively analyzed the clinical characteristics of pulmonary infection due to M. abscessus. Eleven cases diagnosed as having pulmonary M. abscessus infection at Osaka Red Cross Hospital from January, 2008, to June, 2012 were enrolled in this study. The average age of the 11 cases was 63 years (all were females). Nine cases showed underlying diseases, comprising 5 cases with Mycobacterium avium complex lung infection, 3 with old pulmonary tuberculosis, and 3 with bronchiectasis. The radiological examination revealed that 10 cases showed the small nodular type, 7 showed the bronchiectatic type, 4 showed a cavity lesion and 4 showed infiltrative shadows. A microbiological definite diagnosis was made from sputum in 10 cases and bronchial lavage fluid in one. As treatment for M. abscessus pulmonary infection, combined multi-drug chemotherapy was carried out in 7 of the 11 cases. No patients were successfully treated with antibiotics alone, whereas 4 patients had no exacerbation of radiological findings without any treatment. One patient received antibiotics including clarithromycin, amikacin and levofloxacin for 2 to 12 months following surgical excision and her sputum cultures have been maintained as negative over the long term. During the study, none of the 11 patients were known to have died. In this study, we found that M. abscessus pulmonary infection is more common among females, and is found frequently in patients with M. avium complex lung infection. We also found that the clinical course of M. abscessus pulmonary infection was different among patients. We think this is because M. abscessus was shown to comprise three closely related species. M. abscessus is extremely difficult to eradicate, and surgical resection of localized disease or the main lesion or cavity may be significantly effective in preventing the progression of disease.View full abstractDownload PDF (627K) -
Takayuki MASAKI, Masanori OHKUMA, Kuniaki NAGATA, Mari KINOSHITA, Mik ...2013 Volume 87 Issue 6 Pages 732-738
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSTo investigate the current status of drug-resistant bacteria (except MRSA) in Kumamoto prefecture, a study was conducted to determine the isolation numbers and ratios of extended-spectrum β-lactamase (ESBL)-Escherichia coli,ESBL-Klebsiella species, ESBL-Proteus mirabilis,two-drug resistant Pseudomonas aeruginosa, (resistant to two drugs either carbapenems, quinolones and aminoglycosides) multi-drug-resistant Pseudomonas aeruginosa, multi-drug-resistant Acinetobacter baumannii, and vancomyacin-resistant Enterococcii in eight general hospitals from May in 2009 to April in 2010. ESBL-E. coli was mostly isolated,and two-drugresistant P. aeruginosa came second. The isolation ratio of overall drug-resistant bacteria did not increase, while the isolation ratio of twodrugs resistant P. aeruginosa declined, suggesting that infection control was successfully conducted in these hospitals. However, the isolation numbers of ESBL-Klebsiella spp. and two-drug resistant P. aeruginosa were variable in each hospital. Furthermore, drug-resistant bacteria were occasionally spread into another medical facilities by patients transferred from these hospitals, indicating that sharing information on drug-resistant bacteria between medical facilities is required.View full abstractDownload PDF (467K) -
Yoshinari NAKATSUKA, Chie MORIMOTO, Ikkoh YASUDA, Takahiro TSUJI, Yusu ...2013 Volume 87 Issue 6 Pages 739-745
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSBackground : The nursing and healthcare-associated pneumonia (NHCAP) guidelines recommend broad-spectrum antibiotics usage when the presence of multidrug resistant pathogens is anticipated. However, it has not been proved that guidelines-concordant treatment improves the outcome. Purpose : To clarify the impact of guidelines-concordant treatment on the outcome of NHCAP patients. Method : This was a single-center, medical record based retrospective study. The outcomes of NHCAP patients who were treated with guidelines-concordant antibiotics were compared with those of the patients who were not so treated. Then, along with other parameters such as pneumonia severity or patient backgrounds, we analyzed what parameters affected the outcome of NHCAP. Result : Two hundred and twenty-six admissions were analyzed. Guidelines-concordant treatment did not show significant correlation with 30 days mortality, in-hospital mortality or treatment failure. A multivariate analysis showed a significant correlation between the treatment outcome and no parameters other than “Classified into severe-group of community-acquired pneumonia”. Even in the analysis limited to the patients who were actually proved to possess drug-resistant pathogens, the antibiotic coverage of the pathogens did not show any correlation with the outcomes. Conclusion : NHCAP guidelines-concordant treatment might not improve the patient outcome.View full abstractDownload PDF (254K)
CASE REPORTS
-
Hiroyuki YAMASHITA, Yo UEDA, Yuko TAKAHASHI, Akio MIMORI2013 Volume 87 Issue 6 Pages 746-751
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSA 51-year-old male patient with no underlying illness developed a fever of 38-39℃ in June 2009. The fever persisted for 4 days and, because elevated hepatobiliary enzymes, leukocytopenia and thrombocytopenia were observed, along with chest CT findings of inflammation of the soft tissues surrounding the left pulmonary artery, the patient was admitted for further examination. Three days after admission, the patientʼs blood pressure rapidly decreased, resulting in respiratory failure. Rapid proliferation of the soft tissue surrounding the pulmonary artery and mediastinum was observed on an emergency chest CT. Malignant lymphoma was initially considered as a possible differential diagnosis ; however, neither pleural effusion nor infiltration of malignant cells could be observed on bone marrow examination. In addition, because the patient responded well to antibiotics, a diagnosis of acute mediastinitis was reached. Mediastinal drainage was not performed because the quantity of accumulated fluid was small and because the patient, both in terms of his clinical symptoms and imaging results, showed improvement with the continuation of antibiotics alone. The patient was ambulatory and was discharged after 24 days of hospitalization. Acute mediastinitis often follows a rapidly progressive and fatal course without specific symptoms. In the event of unknown infection following an aggressive course, as in the present case, acute mediastinitis must be considered with the goal of early diagnosis and treatment.View full abstractDownload PDF (557K) -
Toshihiro TONO, Yoko TAKAYAMA, Eisuke OGAWA, Takayuki HOSHIYAMA, No ...2013 Volume 87 Issue 6 Pages 752-755
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSWe report herein on a 52-year-old Japanese woman with acute pericarditis and glomerulonephritis associated with human parvovirus B19 infection, who had no significant medical history. The patient was admitted for progressive edema and upper abdominal pain. On physical examination, she had hypertension, generalized edema and upper abdominal tenderness. Urinalysis revealed protein (1＋), and occult blood (±), with cellular casts. Echocardiography revealed pericardial effusion measuring 3-9mm in diameter. A serological test showed elevation of serum IgM antibodies for parvovirus B19. At the end of two weeks, generalized edema and glomerulonephritis improved spontaneously, and pericardial effusion was resolved three weeks after admission. This case would appear to be a very rare case indicating a direct relationship between human parvovirus B19 infection and acute pericarditis in a healthy adult patient.View full abstractDownload PDF (355K) -
Shohei MINEZAKI, Takashi HIRAMA, Ayako SHIONO, Ai MASUMOTO, Tomohiko ...2013 Volume 87 Issue 6 Pages 756-760
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSA 40-year-old woman, who was born in Thailand and moved to Japan 20 years previously, was admitted to our university hospital because of eosinophilia and abnormal chest radiography findings over a 6-month period. The chest CT showed multiple cavitary nodules in the subpleural area and a tubular structure that extended from each cavity to the pleura. Immunological examination revealed an elevation of antibody titers against Ancylostoma duodenale, Paragonimiasis miyazakii and Paragonimiasis westermanii based on an ELISA assay. In addition, hookworm eggs were found in the stool. We firstly administered pyrantel pamoates, followong which the eggs become undetectable. Nevertheless, eosinophilia and abnormal chest CT findings persisted. We diagnosed the patient as having a superinfection with paragonimiasis and hookworm, then administered praziquantel. Subsequently, the number of eosinophils returned to a normal level and the abnormal shadow in the chest CT images diminished without scarring. The final diagnosis was a superinfection of paragonimiasis and hookworm.View full abstractDownload PDF (687K) -
Satoshi UBUKATA, Daisuke JINGU, Takehiro YAJIMA, Makoto SHOJI, Hiroshi ...2013 Volume 87 Issue 6 Pages 761-766
Published: November 20, 2013
Released on J-STAGE: February 18, 2015
JOURNAL FREE ACCESSA 46-year-old man with no underlying diseases visited our hospital with otorrhea, ocular motility disorder of the left eye, dizziness and loss of appetite which had lasted for two months. Chest radiography and computed tomography (CT) showed bilateral multiple pulmonary nodules and cavities. Furthermore, CT of the head and neck revealed bilateral mastoiditis, a left orbital abscess and a deep neck abscess. Peptostreptococcus micros was cultured from blood and otorrhea specimens. In addition, P. micros DNA was detected with the polymerase chain reaction (PCR) method in the specimens from the site of culture-negative lesions (i.e. sputum, bronchoalveolar lavage, neck abscess). Thus, we diagnosed the lung lesions as septic pulmonary embolisms (SPEs). The clinical findings of the head and neck had improved following antibiotics treatment for five weeks, and follow-up chest radiography and CT showed that all lesions almost disappeared. Since some SPE patients demonstrate a slow progression, SPE should be included in the differential diagnosis of multiple pulmonary nodules such as Wegenerʼs glanulomatosis or neoplasm.View full abstractDownload PDF (652K)
- |<
- <
- 1
- >
- >|