In order to investigate the spread of intestinal carriage of β-lactam antibiotics-resistant Enterobacterales (BLARE) in Kumamoto prefecture, we attempted to isolate them from 1,434 fecal samples received at our laboratory between April 2015 and March 2020, and 354 drug-resistant strains were isolated from 340 (23.7%) samples.

Of these, 343 (96.9%) strains were Escherichia coli, and ESBL-producing E. coli accounted for 305 (86.2%) of the 343 strains.

Furthermore, 133 (43.6%) of the strains were identified as belonging to the E. coli O25b-ST131 pandemic clonal group which has spread worldwide; thus, expansion of this clonal group was suggested as being one of the causes of the increase in the intestinal carriage rate of drug-resistant bacteria in kumamoto prefecture.

All of the ESBL producers isolated in this study were found to carry the bla_CTX-M gene: 210 (67.7%) strains carried the bla_CTX-M-9 gene, 80 (25.8%) carried the bla_CTX-M-1 gene, and 13 (4.2%) carried both the bla_CTX-M-1 and bla_CTX-M-9 genes, etc.

In addition, when the BLARE isolates were sorted by the types of facility from which the specimens were received, the isolation rate from infant facilities was particularly high, exceeding 35%, and horizontal transmission of several serotypes of ESBL-producing E. coli were detected at multiple facilities. Based on our findings, we suggest that infant facilities may be one of the most important reservoirs of ESBL producers.

Pasteurellosis is a common zoonosis caused by bacteria in the genus Pasteurella, which form part of the oral flora of dogs and cats. Pasteurella multocida is the most common pathogen for pasteurellosis. Skin and soft tissue infections resulting from animal injuries, such as bites and scratches, are prevalent. Still, severe infections, such as sepsis, can present in elderly patients with comorbidities and immunocompromised individuals. The recent rise in pet ownership has been reported to increase the prevalence of pasteurellosis. In our hospital, a higher incidence of pasteurellosis was reported after 2020 than in the years preceding 2020. Therefore, we conducted a 10-year retrospective study and found that 29 cases of pasteurellosis (with duplicates) were reported. Seventeen cases, forming more than half of the total number of cases, were reported after 2020. Diabetes mellitus, which was detected in 10 cases, was the most common comorbidity. Additionally, autoimmune diseases, such as rheumatoid arthritis and vasculitis syndrome, were reported in eight cases. Only two patients had no comorbidities. Notably, the number of patients with dog bite injuries and respiratory tract infections has increased since 2020. The year 2020 coincides with the start of the novel coronavirus disease 2019 (COVID-19) pandemic, which possibly may have contributed to the increasing incidence of pasteurellosis.

A special survey on drug use outcomes was conducted to assess the clinical safety of Comirnaty intramuscular injection (Monovalent: Original) during the period between the time of administration of the first dose and 28 days after administration of the second dose among recipients with comorbidities considered to increase the risk of developing severe COVID-19.

A total of 1,075 participants were recruited from 17 sites between May and August 2021. The safety analysis cohort included 1,038 participants, which included 58.29% males and 41.71% females. The median age of the participants was 63.0 years.

The overall incidence of adverse reactions (ARs) was 5.68%. Among males and females, the incidences were 3.80% and 8.31%, respectively. The incidences were 7.57% and 3.21% among participants in the 15-64 years and ≥65 years age groups, respectively. After administration of the first and second doses, 2.89% and 3.78% of participants, respectively, reported ARs. Therefore, the incidences of ARs among participants who were females, young, and second dose recipients were higher than those among males, elderly, and first dose recipients, respectively. The incidences of Grade 1 or higher local reactions and systemic reactions according to the medical records of participants were 80.77% and 62.61% for the first dose and 84.41% and 69.79% for the second dose, respectively.

A risk ratio adjusted for sex and age was confirmed from further subgroup analyses, and no baseline characteristics were found to affect the incidence of ARs.

These findings were similar to those obtained from clinical trials conducted in and outside Japan and those obtained from the Japanese-focused survey in the early stages of administration of the new COVID-19 vaccine. No new concerns regarding the safety of Comirnaty were found. (ClinicalTrials.gov ID: NCT04880447)

Lymphedema is an underlying cause of recurrent cellulitis; therefore, febrile patients with lymphedema tend to be diagnosed as having cellulitis even if the clinical findings are not consistent. We managed a case that was initially treated as cellulitis, but was subsequently diagnosed as a case of retroperitoneal abscess with concurrent soft tissue infection and vertebral osteomyelitis. The patient was completely cured after 6 weeks of intravenous antibiotic therapy and oral antibiotic therapy for the remaining lesions, with no recurrence during follow-up.

A 76-year-old man was admitted to our hospital with a history of fever and difficulty in moving. Blood culture at admission grew β-hemolytic streptococci, identified by biochemical testing (BD CRYSTAL GP) as Streptococcus porcinus. S. porcinus is a swine-derived streptococcal species, and has been reported as a causative bacterium of female genitourinary infection. The clinical background of our patient did not match with the detected bacterium, so further testing by MALDI-TOF MS and 16S rRNA gene sequencing was performed, which identified the bacterium as Streptococcus iniae. There are many case reports of cellulitis caused by this bacterium in persons cooking infected fish, and some reports of arthritis, endocarditis, and empyema. Reports of S. iniae from Japan are rare, and since this bacterium may not be included in some biochemical identification databases, it might not have been identified correctly. In cases with inconsistency between the culture-identified organisms and the clinical course, performing additional identification tests may be useful to obtain an accurate diagnosis.