Japanese Journal of Infectious Diseases
Online ISSN : 1884-2836
Print ISSN : 1344-6304
ISSN-L : 1344-6304
Volume 65, Issue 3
Displaying 1-20 of 20 articles from this issue
Original Article
  • Se-Min Hwang, Hack-Lyoung Kim, Kyueng-Whan Min, Min Kim, Jae-Sung Lim, ...
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 193-197
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    The first large-scale outbreaks of respiratory disease in the 21st century were caused by the influenza A (H1N1) virus in 2009, which affected mostly young adults. The M59 vaccine was developed to control pandemic influenza A (H1N1). However, the complications arising from the use of the non-adjuvanted and adjuvanted vaccines in young male Korean soldiers have not previously been evaluated and compared. We conducted a prospective multicenter study of 2,864 healthy male soldiers aged 19 to 25 years to evaluate the adverse events associated with both the MF59-adjuvanted and non-adjuvanted forms of the influenza A/California/2009 (H1N1) surface-antigen vaccine. In most cases, the adverse-event symptoms were mild, and the most frequent adverse events were swelling at the injection site and myalgia, which were noted in 4.8% and 10.7% of participants, respectively. Administration of the MF59-adjuvanted vaccine was associated with an increased incidence of local (crude odds ratio [cOR], 1.56; 95% confidence interval [CI], 1.11–2.29) and systemic adverse events (cOR, 1.64; 95% CI, 1.29–2.07) after vaccination. Atopic dermatitis (adjusted OR [aOR], 2.32; 95% CI, 0.99–5.46) might be the choice risk factor for local adverse events, and adjuvant use (aOR, 1.35; 95% CI, 1.03–1.78) was a significant predictor of systemic adverse events in healthy young male Korean soldiers.
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  • Midori Hiroi, Naomi Takahashi, Tetsuya Harada, Fumihiko Kawamori, Nats ...
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 198-202
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    The serotype, Shiga toxin (Stx) type, and antimicrobial resistance patterns of 138 Stx-producing Escherichia coli (STEC) strains isolated from humans between 2003 and 2007 in Shizuoka Prefecture, Japan were characterized. The predominant O serogroups of the STEC isolates were O157, O26, and O111. Antimicrobial susceptibility testing of the STEC isolates showed that 31 of the 138 isolates (22.5%) were resistant to antibiotics. Compared to the results reported in the previous studies, a higher rate of STEC O157 isolates were susceptible to all the antimicrobial agents used in this study. However, antimicrobial susceptibility data from this study showed that antimicrobial resistance patterns have increased by 6 compared to the survey performed by Masuda et al. between 1987 and 2002 (Jpn. J. Food Microbiol., 21, 44–51, 2004). This indicates that STEC isolates have evolved to show a variety of antimicrobial resistance patterns. It is important to consider the population of isolates showing decreased susceptibility to clinically relevant drugs such as ciprofloxacin (CPFX) and fosfomycin (FOM). All the 3 STEC isolates resistant to nalidixic acid showed low susceptibility to CPFX (MIC, 0.25–0.5 μg/ml). In addition, a decreased susceptibility to FOM was clearly observed in the E. coli O26 isolates. Our findings also showed that 1 STEC O26 strain could possibly be a chromosomal AmpC β-lactamase hyperproducer. These results suggest that antimicrobial therapy may be less effective in patients with non-O157 STEC infections than in those with STEC O157 infections.
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  • Takayuki Konno, Jun Yatsuyanagi, Shiho Takahashi, Yuko Kumagai, Eriko ...
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 203-207
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    A microbial strain harboring the eae gene, which is known as the virulence gene of enteropathogenic Escherichia coli (EPEC) and most enterohemorrhagic E. coli, was isolated from a patient in a gastroenteritis outbreak that occurred in 22 patients in Akita Prefecture, Japan, in November 2011. The biochemical characteristics of the isolate were more similar to those of a novel Escherichia sp., E. albertii than E. coli. Partial 16S rRNA gene sequences of the isolate were identical to those of a certain E. albertii strain, but also showed a high degree of similarity to those of E. coli strains. Finally, we identified this isolate as E. albertii by performing PCR analysis that targeted the uidA, lysP, mdh, and cdtB genes in addition to stx and eae genes to differentiate between the EPEC and E. albertii strains.
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  • Zi-feng Yang, Yang-qing Zhan, Rong-chang Chen, Rong Zhou, Yu-tao Wang, ...
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 208-214
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    Comparisons of the clinical characteristics of contemporaneous pandemic (H1N1) 2009 influenza A virus (A(H1N1)pdm09)- and seasonal influenza viruses-infected patients are important for both clinical management and epidemiological studies. A prospective multicenter observational study was conducted using a preestablished sentinel surveillance system in Guangzhou, China during 2009. In this study, the clinical presentations of patients with either acute respiratory infection or community-acquired pneumonia were recorded, and nasopharyngeal swab samples were collected for detection of respiratory virus strains using cell cultures or real-time reverse transcription/real-time polymerase chain reaction. Comparisons of the clinical features between A(H1N1)pdm09- and seasonal influenza viruses-infected patients were conducted accordingly. Of the 1,498 patients examined, 265 tested positive for A(H1N1)pdm09, 286 were positive for seasonal influenza A viruses, and 137 for influenza B viruses. The predominant virus was influenza B before the emergence of A(H1N1)pdm09 (epidemiological week [EW] 1–EW 21); then, predominantly non-A(H1N1)pdm09 influenza A and, later, A(H1N1)pdm09, which peaked in EW 46. Compared with the common seasonal influenza-infected patients, A(H1N1)pdm09-infected patients were younger, and had a higher proportion of these patients reported prior contact with infected individuals (P < 0.001, by χ2 test). However, few significant differences were observed in clinical symptoms and severity among any of the infections caused by the different influenza A strains. Our hospital-based network served as a useful source of information during A(H1N1)pdm09 monitoring. Viral distribution in Guangzhou was characterized by a sharp rise in A(H1N1)pdm09-infected patients in September 2009. Similar to seasonal influenza A-infected cases, A(H1N1)pdm09 cases had a very small proportion of severe cases.
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  • Yun Feng, Shihong Fu, Hailin Zhang, Minghua Li, Tao Zhou, Jinglin Wang ...
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 215-221
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    A total of 54,673 mosquitoes were collected at 11 sites located near the China-Myanmar border in the western part of Yunnan Province during July and August 2007. There were 29 species in 4 genera identified from the collections, including 12 species of Culex, 12 species of Anopheles, 3 species of Aedes, and 2 species of Armigeres. Culex tritaeniorhynchus Giles (67.9%, 37,119/54,673) and Anopheles sinensis Wiedemann (25.9%, 14,170/54,673) were the most abundant species in this investigation. Virus was isolated using BHK-21 and C6/36 cells from 22 of 510 mosquito pools. Isolates included Japanese encephalitis virus (JEV) and Getah virus (GETV), which were identified by serological and molecular methods. Twenty JEV strains were isolated from Cx. tritaeniorhynchus (15 isolates), An. sinensis (3 isolates), and Armigeres subalbatus Coquillett (2 isolates), and 2 GETV strains were isolated from Culex pseudovishnui Colless and Cx. tritaeniorhynchus. This study suggests that Ar. subalbatus is a potentially important local vector because of the high JEV infection ratio found in this species. Enzootic JEV transmission persists in this area and therefore, surveillance for human disease caused by JEV and GETV should be conducted in the region.
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  • Jinhyun Kim, Eunhee Lee, Hae-Chun Rhee
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 222-227
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    The purpose of this research was to evaluate the economic value of the tsutsugamushi disease prevention program and to suggest whether to abolish or expand this program. A cost-benefit analysis was conducted to evaluate the economic feasibility of this prevention program. We collected cost data from 25 public health centers (PHCs) and the medical insurance data for all tsutsugamushi patients. We estimated the costs and benefits of the program using a macro-costing method. The estimated total cost was $1.22 million with a governmental cost of $697,000 and a cost of $521,000 to the PHCs. After the prevention program was implemented, $581 were salvaged from medical costs, $46 from non-medical costs, and $847 from productivity loss due to the reduced number of patients, with an estimated $6.66 million per year in total benefits of the program. The ratio of benefit to cost was found to be 5.5, making the economic value of the program significant. The net benefit should increase if the tsutsugamushi disease prevention program is continued and the implementation period is expanded to 10 years.
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  • Takashi Toya, Yasuhito Nannya, Kensuke Narukawa, Motoshi Ichikawa, Min ...
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 228-232
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    Many patients with hematologic malignancies show immunosuppression and/or neutropenia, and are at a high risk of developing a serious infection that would require empiric therapy with broad-spectrum antibiotics. However, a thorough comparison of the efficacies of different carbapenems has not been carried out. To compare the efficacies of meropenem (MEPM) and doripenem (DRPM) in febrile patients with hematologic neoplasms, we retrospectively reviewed data of 149 consecutive febrile patients with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome (MDS) who were treated empirically with MEPM or DRPM. The duration from the start of carbapenem administration to decline of fever was not significantly different between the MEPM and DRPM groups (median, 3 versus 4 days; P = 0.79). Multivariate analysis showed that a diagnosis of MDS and the use of liposomal amphotericin-B or voriconazole are statistically significant risk factors for sustained fever. In conclusion, MEPM and DRPM showed similar efficacies in febrile patients with acute leukemia and MDS.
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  • Kiminobu Takeda, Akiko Nishibu, Kazushi Anzawa, Takashi Mochizuki
    Article type: Original Article
    2012 Volume 65 Issue 3 Pages 233-239
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    Arthroderma benhamiae vectored by small animals, such as household pets, causes tinea lesions on human skin. The number of tinea cases caused by this species is increasing in Japan. We attempted to develop a simple molecular method for strain discrimination, which is expected to be useful in molecular epidemiology. Out of the 61 strains of A. benhamiae registered at our institute, 46 A. benhamiae strains showed very high degrees of sequence similarity on cluster analysis of the internal transcribed spacer regions of ribosomal RNA (rRNA) genes. These 46 strains, including 22 strains isolated from Japan, were further used for strain typing by analyzing the non-transcribed spacer (NTS) region of the rRNA gene. Polymerase chain reaction was performed using a primer pair designed for amplification of a part of the NTS region, and the amplicons were successfully discriminated by restriction fragment length polymorphism (RFLP) analysis performed using MvaI. RFLP analysis showed 11 NTS types (NTS1–NTS11) among the 46 strains. Out of the 22 Japanese strains, 10 were of the NTS8 type; 6, of the NTS1 type; 3, of the NTS2 type; and 3, of the NTS5 type. Molecular typing showed consistency of NTS types among the strains isolated from different lesions on the same patient, among the strains derived from the same family, and among the strains from pets and their owners. We observed that 3 out of the 4 NTS types among the Japanese strains were detected outside Japan as well.
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Short Communication
  • Caie Yang, Hong Lei, Di Wang, Xianghong Meng, Jufang He, Aihua Tong, L ...
    Article type: Short Communication
    2012 Volume 65 Issue 3 Pages 240-242
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    The in vitro activity of linezolid was evaluated against 84 clinical isolates of Mycobacterium tuberculosis, including multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains, isolated from the center for tuberculosis research and treatment of the Chinese army. Linezolid showed excellent activity, with minimum inhibitory concentrations (MICs) of 0.125–0.5 μg/mL against all tested isolates. There were no differences in the MIC50 and MIC90 of linezolid between susceptible, isoniazid-resistant, MDR, and XDR. Indeed, all of the groups displayed identical MIC90 values of 0.25 μg/mL, which is lower than previously reported in similar studies. We conclude that linezolid may be a more effective drug against M. tuberculosis and may play an important role in treating drug-resistant tuberculosis in China.
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  • Hitoshi Kawada, Gabriel O. Dida, Kazunori Ohashi, George Sonye, Sammy ...
    Article type: Short Communication
    2012 Volume 65 Issue 3 Pages 243-246
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    We evaluated the effectiveness of installing the Olyset® Net on the ceiling in preventing the invasion of malaria vectors. This study was conducted in houses in western Kenya. The number of resting mosquitoes inside the houses reduced when the ceiling and eaves of the houses were covered with the net. The mosquito densities remained low for 9 months, until the nets were removed.
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  • Aixiao Bi, Chie Nakajima, Yukari Fukushima, Aki Tamaru, Isamu Sugawara ...
    Article type: Short Communication
    2012 Volume 65 Issue 3 Pages 247-251
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    A rapid, simple, and low-cost diagnostic tool for tuberculosis (TB) detection is urgently needed in countries with a high TB burden. Here, we report a novel loop-mediated isothermal amplification (LAMP) assay targeting the hspX gene for the rapid detection of Mycobacterium tuberculosis, M. bovis, M. africanum, and M. microti. The specificity of this assay was evaluated using 4 reference strains of Mycobacterium tuberculosis complex (MTC), 22 species of non-tuberculous mycobacteria (NTM), 7 non-mycobacterial species, and 50 clinical M. tuberculosis isolates. All the reference MTC strains and M. tuberculosis clinical isolates were successfully detected by this method, and there were no false-positive results with NTM or non-mycobacterial species, which demonstrates the high specificity of this assay for MTC. The detection limit was 10 copies of MTC genome within 27 min, and the detection speed of this assay was higher than that of any other isothermal methods reported so far. Because of its speed, simplicity, sensitivity, specificity, and inexpensiveness, the TB hspX LAMP assay is a potential gene diagnostic method for TB detection in developing countries with a high TB burden.
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  • Masaru Usui, Mototaka Hiki, Koichi Murakami, Manao Ozawa, Hidetaka Nag ...
    Article type: Short Communication
    2012 Volume 65 Issue 3 Pages 252-255
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    Bacteriocin-producing Escherichia coli (donors) rapidly kill conventional recipient E. coli DH5α in conjugation experiments. To evaluate plasmid transferability of bacteriocin-producing donors, we established 2 different bacteriocin-resistant mutants derived from E. coli DH5α and used them as recipients. When the bacteriocin-resistant mutants were used in conjugation experiments, the transconjugant recovery from 20 bacteriocin-producing donors increased from 5% (1/20) to 65% (13/20), and the transfer frequencies increased. These results showed that bacteriocins inhibited the transfer of the R-plasmid from bacteriocin-producing donors. Thus, application of bacteriocin-resistant recipients might aid the evaluation of the potential transferability of plasmids from bacteriocin-producing donors.
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  • Mohammad Ahangarzadeh Rezaee, Nastaran Langarizadeh, Mohammad Aghazade ...
    Article type: Short Communication
    2012 Volume 65 Issue 3 Pages 256-259
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    We investigated the prevalence of multidrug resistance, production of extended-spectrum β-lactamases (ESBLs), and presence of class 1 and 2 integrons in 150 clinical isolates of Klebsiella pneumoniae from northwest Iran by performing phenotypic confirmatory tests and polymerase chain reaction (PCR) analysis. Of the 150 isolates, 149 (99.3%) were multidrug resistant (MDR). Of the MDR isolates, 124 (83.2%) were ESBL positive. The results of the PCR analysis showed that 117 (78.5%) and 20 (13.4%) MDR K. pneumoniae isolates carried intI1 and intI2, respectively, and 16 (10.7%) MDR K. pneumoniae isolates contained the integrase genes of both class 1 and 2. Resistance of the isolates to gentamicin, tetracycline, ceftazidime, cephalothin, chloramphenicol, and nalidixic acid was observed to be significantly associated with the presence of class 1 integrons; however, the resistance to tetracycline was observed to be associated with the presence of class 2 integrons alone. This study showed that integrons are widely prevalent in the clinical isolates of K. pneumoniae from northwest Iran, and that they may be playing an important role in attributing multidrug resistance to the clinical K. pneumoniae isolates. To the best of our knowledge, this is the first report showing the presence of class 1 and class 2 integrons in MDR K. pneumoniae isolates from clinical settings in northwest Iran.
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  • Tsuguto Fujimoto, Yuki Matsushima, Hideaki Shimizu, Yoko Ishimaru, Ats ...
    Article type: Short Communication
    2012 Volume 65 Issue 3 Pages 260-263
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    A local outbreak of epidemic keratoconjunctivitis (EKC) caused by human adenovirus type 8 (HAdV-D8) occurred in Kawasaki city, Japan in July–August 2011. Since the cases were sporadic in nature, the source of the infection could not be identified. The results of PCR analysis and the appearance of cytopathic effects in the samples indicated that 22 patients were positive for HAdV. The mean age of the patients (10 men and 12 women) was 64.3 ± 17.3 years (median, 68 years; range, 11–86 years). The sequences of hexon, which included hypervariable loop 1; the penton, which included RGD loops; and the fiber, which included the knob-coding regions, were identical in all the HAdV-positive cases. Phylogenetic analysis of the major capsid protein-encoding regions of HAdV confirmed that the isolates were HAdV-D8. Although the incidence of HAdV-D8 outbreaks has decreased in Japan since 1997, the results of our study imply that HAdV-D8 is still a causative agent for EKC outbreaks in Japan.
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  • Dhruba Acharya, Suwanna Trakulsomboon, Surendra Kumar Madhup, Sunee Ko ...
    Article type: Short Communication
    2012 Volume 65 Issue 3 Pages 264-267
    Published: 2012
    Released on J-STAGE: September 03, 2012
    JOURNAL FREE ACCESS
    Monitoring the antibiotic susceptibility pattern of Salmonella enterica serovar Typhi (S. Typhi) is important for efficiently managing cases of typhoid fever. In this study, the antimicrobial susceptibility patterns of 114 S. Typhi isolates, which were collected from a university hospital in Nepal during July 2009–December 2010, were investigated by disc diffusion assays. All of the S. Typhi isolates were sensitive to amoxycillin-clavulanic acid. More than 95% of the isolates were sensitive to chloramphenicol, ceftazidime, ceftriaxone, and cotrimoxazole. In addition, 1.7% of the studied isolates showed multiple drug resistance patterns. Of the 40 S. Typhi isolates, 32 strains (80%) showed nalidixic acid (NA) resistance with decreased susceptibility to ciprofloxacin (CIP). Importantly, we found the simultaneous presence of NA resistance and decreased susceptibility to CIP, suggesting that the resistance to NA is a reliable indicator of decreased CIP susceptibility (sensitivity, 97.5%; specificity, 100.0%). Furthermore, the sequencing of NA-resistant S. Typhi isolates showed a predominant amino acid alteration in the quinolone resistance-determining region (QRDR) of gyrA gene at position 83 from Ser→Phe. Two isolates with resistance to both CIP and NA had a double-mutation (Ser83→Phe and Asp87→Asn) in the QRDR of the gyrA gene, of which one had an additional amino acid mutation (Ser80→Ilu) in the QRDR of the parC gene.
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Laboratory and Epidemiology Communications
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