Japanese Journal of Infectious Diseases
Online ISSN : 1884-2836
Print ISSN : 1344-6304
ISSN-L : 1344-6304
Advance online publication
Displaying 1-17 of 17 articles from this issue
  • Gnatoulma Katawa, Adodo Sadji, Gérard Akouétévi Toudji, Kossi Touglo, ...
    Article ID: JJID.2022.082
    Published: October 31, 2022
    Advance online publication: October 31, 2022
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    The monitoring of antimicrobial resistance is becoming a priority mainly in developing countries in order to control the emergence of multi-resistant bacteria strains. This study evaluated the antibiotic resistance profile of bacteria isolated at the National Institute of Hygiene in Togo. Lab records from January 2013 to December 2015 were examined. A total of 33,147 samples were analyzed. Among them, vaginal swabs and urines were more represented with 38.17% and 33.24% respectively. 3,497 Gram-positive and 1,970 Gram-negative bacterial strains were cultured. Enterobacteriaceae (57.6%), Staphylococcus spp. (21.1%) and Streptococcus spp (10.5%) were more isolated. Escherichia coli was resistant over the three years to piperacillin (79.66%, 75.1%, 83%), trimethoprim/sulfamethoxazole (79.3%, 82%, 82.8%), ticarcillin (89%, 89.7%, 93%) and amoxicillin (94.1%, 94%, 96.09%); whereas Staphylococcus aureus was resistant to penicillin G. Streptococcaceae isolates was resistant to trimethoprim/sulfamethoxazole (78.11-87.1%), tetracycline (82.2-91.16%) and norfloxacin (86.16-94.3%). Escherichia coli and Staphylococcus aureus isolated from urines were more resistant to antibiotics than those isolated from vaginal swabs. There is a need to develop new strategies in order to fight against the emergence of multi-resistant bacteria in Togo.

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  • Milenna Chaves Machado, Lorena Andrade de Moraes, Thais Ribeiro Maia, ...
    Article ID: JJID.2022.028
    Published: September 30, 2022
    Advance online publication: September 30, 2022
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    To evaluate the profile of ophthalmological manifestations of patients affected by chikungunya accompanied in the ophthalmology service of a reference center in the Northeast region of Brazil. A retrospective study, whose data collection was carried out between August 2018 and March 2019, covering the medical records of patients attended in the Leiria de Andrade Foundation (FLA) who presented ocular manifestations and who had a history of prior Chikungunya Virus (CHIKV) involvement. 230 patients participated in this study, with a prevalence of females (71.7%) and ages ranging from 61 to 80 (46,1%) years. Regarding the previous pathological history, 71 patients (30%) had comorbidities and 86 participants (37%) reported previous ophthalmologic pathology. The most reported eye complaint was Low Visual Acuity (LVA). From the study sample, 137 people (59.6%) presented ophthalmologic manifestations after CHIKV infection, cataract being the most evidenced. When analyzing the use of corticosteroids, it was observed that 85 participants who used this medication. It was found that the patients seen were predominantly female, aged between 61 and 80 years and with previous comorbidities. It was found that LVA was the most reported complaint by patients and cataracts were the main ophthalmological pathology presented.

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  • Fumi Kasuya, Kohji Mori, Sachiko Harada, Ryota Kumagai, Ai Suzuki, Ari ...
    Article ID: JJID.2022.035
    Published: September 30, 2022
    Advance online publication: September 30, 2022
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    During the COVID-19 pandemic in 2021, Japan experienced an outbreak of respiratory syncytial virus (RSV) infection. A total of 51 RSV cases were detected from the infant specimens, including 38 rhinorrhea and 13 nasopharyngeal swabs, collected at the Tokyo Metropolitan Institute of Public Health. Of these 51 cases, 12 belonged to RSV-A and 39 to RSV-B. G protein gene sequences of RSV-A belonged to the ON1 genotype, whereas RSV-B belonged to the BA9 genotype; thus, different types of RSV were detected during the same period, suggesting that the unusual 2021 RSV season was not due to a single strain or genotype. Of all RSV-positive cases, the proportion of cases aged ≥2 years was 56.8% in 2021, which was higher than 31.2% in the past 5 years. This indicates that infants aged <1 year who were originally susceptible to RSV infection were less likely to be infected with RSV because of the COVID-19 control measures. The 2021 epidemic peaked in the 28th week, which was 9 weeks earlier than the average from 2016 to 2020. It seems necessary to accumulate and analyze further data, such as factors that became an outbreak and the characteristics of the detected viruses in 2021.

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  • Shiori Tanaka, Jun Umezawa, Taiki Yamaji, Sarah K. Abe, Akinobu Hamada ...
    Article ID: JJID.2022.093
    Published: September 30, 2022
    Advance online publication: September 30, 2022
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    This study aimed to investigate the difference in antibody titers indicative of the presence of SARS-CoV-2 between those who had experienced symptoms of Coronavirus Disease of 2019 (COVID-19) infection and those who had never shown symptoms. The study used data from a cross-sectional survey conducted at the National Cancer Center Japan in 434 individuals who reported no previous infection with COVID-19. Participants provided self-reported symptoms beginning from the start of 2020. A generalized linear model was used to compare the mean SARS-CoV-2-specific IgG nucleocapsid protein (N-IgG) titer with estimated confidence intervals (CI) according to the onset of symptoms indicative of COVID-19. We observed a tendency toward an association between higher mean N-IgG titers and having had a high fever within the past eight months (p = 0.053). The mean N-IgG titer was higher for those with a history of symptoms (p = 0.03) and for those with more than three symptoms (p < 0.01) than for those with no symptoms. We demonstrated that the mean N-IgG titer was higher in those who had any symptom and a greater number of symptoms that might indicate COVID-19, relative to those without symptoms, suggesting that transient but contained SARS-CoV-2 infection had occurred.

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  • Masamune Higashigawa, Mitsue Ito, Yuji Nashida
    Article ID: JJID.2022.108
    Published: September 30, 2022
    Advance online publication: September 30, 2022
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    We present a case study of a 6-day-old male infant who was referred to our hospital for fever, jaundice, and poor suckling, and was diagnosed with meningitis due to Edwardsiella tarda. We were able to detect E. tarda DNA after performing broad-range polymerase chain reaction targeting the bacterial 16S rRNA gene followed by a basic local alignment search tool analysis of the DNA extracted from the cerebrospinal fluid. Further, a Japanese literature review showed that E. tarda caused perinatal invasive infections to mothers and infants and the risk of fetal meningitis might be related to the food preference of Japanese people for raw fish. It is crucial to spread the knowledge that pregnant women should refrain from eating high risk raw fish, including freshwater fish.

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  • Leo Uchida, Yoshimi Sakurai, Makoto Shimooka, Ronald Enrique Morales-V ...
    Article ID: JJID.2022.179
    Published: September 30, 2022
    Advance online publication: September 30, 2022
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    Mosquitoes are an important arthropod vector of arboviruses. Family Phenuiviridae includes several medically important arboviruses, such as Rift Valley fever phlebovirus and Toscana phlebovirus. Recent comprehensive genetic analyses identified many novel mosquito-specific viruses that are phylogenetically related to Phenuiviridae. We collected mosquitoes in Hokkaido, northern Japan, and conducted reverse transcription polymerase chain reactions (RT-PCRs) targeting the RNA-dependent RNA polymerase (RdRp) gene of Phenuiviridae. A total of 285 pools comprising 3,082 mosquitoes from two genera and eight species were collected. Partial RdRp sequences were detected from 97 pools, which allowed us to classify the viruses into three clusters provisionally designated Etutanne virus (ETTV) 1, 2, and 3. The closest related virus was Narangue virus (family Phenuiviridae, genus Mobuvirus), which was detected from Mansonia mosquitoes, and the similarities of its nucleotide and amino acid sequences with those of the ETTVs were 58.4%–66.2% and 64.7%–86.7%, respectively. PCRs and RT-PCRs using DNA and RNase digestion methods showed that the ETTVs were RNA viruses, but they do not form non-retroviral integrated RNA virus sequences in the mosquito genome.

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  • Hisato Yoshida, Akira Makino, Ayaka Yamaguchi, Shinpei Matsuda, Ippei ...
    Article ID: JJID.2022.184
    Published: September 30, 2022
    Advance online publication: September 30, 2022
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    The most common routes of transmission of coronavirus disease 2019 are droplet and contact infections. During dental treatment, many instruments are used that generate droplets of saliva and blood. Several droplets are generated during extraction of an impacted third molar (M3). Surgical masks are often used during tooth extraction; however, the surface structure of surgical masks against droplets is not fully understood. Therefore, we analyzed the droplets adhered to surgical masks during impacted M3 extraction using electron microscopy. A surgical mask used during impacted M3 extraction was studied. The collected surgical mask was divided into three layers and observed using electron microscopy. The outer and inner layers had a similar mesh-like structure, while the middle layer had a denser three-dimensional structure. Droplets ranging from 20-100 μm in size generated during the extraction adhered to the fibers of the outer layer of the mask. Fewer droplets adhered in the middle layer than those in the outer layer. No droplets reached the inner layer. In conclusion, it is suggested that a surgical mask can prevent droplet infection when performing impacted M3 extraction. This study is expected to contribute to the study of infection control strategies during dental treatment in the future.

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  • Akihisa Horigome, Junko Yamanaka, Satoshi Takasago, Noriko Iwamoto, To ...
    Article ID: JJID.2021.896
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    We report the first pediatric patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in Japan. The patient was a one-year-old boy who resided in Japan. He went abroad from 12 November 2021 to 28 November 2021 with his parents and had no known contact with COVID-19 patients there. His father tested positive for SARS-CoV-2 via quantitative antigen test on arrival at Narita International Airport on 28 November 2021. Because the boy and his mother both tested negative for SARS-CoV-2, they quarantined together at a hotel separately from his father. On 4 December 2021, the boy tested positive by reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 without symptoms and was hospitalized with his mother. He and his father were both found to be infected with SARS-CoV-2 Omicron variant. The boy had not been vaccinated for COVID-19. The RT-PCR results were negative starting 20 December 2021. The incubation period and required period for negative conversion of SARS-CoV-2 RNA of this Omicron variant case were similar to the periods of conventional cases. We have to carefully consider the potential of the SARS-CoV-2 Omicron variant to spread widely among unvaccinated children.

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  • Masahiro Kitabatake, Noriko Ouji-Sageshima, Shota Sonobe, Ryutaro Furu ...
    Article ID: JJID.2022.041
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    Since February 2021, healthcare workers in Japan have been preferentially vaccinated with a messenger RNA vaccine (BNT162b2/Pfizer) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While many studies have confirmed that this vaccine is highly effective in reducing hospitalizations and deaths from coronavirus disease 2019 (COVID-19), antibody titers tend to decline at 3 months, leading to a risk of breakthrough infections. Thus, information is needed to support decision making regarding the third vaccination. In this study, we investigated transition of the anti-SARS-CoV-2 spike protein receptor-binding domain (RBD) IgG and neutralizing antibody titers of 37 vaccinated Japanese healthcare workers. Samples were collected six times starting prevaccination until 6 months after the second vaccination. Anti-SARS-CoV-2 RBD IgG levels peaked at 1 week after the second vaccination, then declined over time and decreased to <10% at 6 months after the second vaccination. Additionally, approximately one third of subjects at 6 months after the second vaccination were seronegative for the Omicron variant. Workers with low anti-SARS-CoV-2 RBD IgG levels also had low neutralizing antibody titers. These data support the active use of boosters for healthcare workers, especially for those with low anti-SARS-CoV-2 RBD IgG levels.

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  • Hidetoshi Nomoto, Masahiro Ishikane, Yoshiaki Gu, Ryosuke Yamamuro, Ry ...
    Article ID: JJID.2022.049
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    We investigated epidemiological findings regarding the route of coronavirus disease 2019 (COVID-19) and infection prevention and control (IPC) measures among returnees in the emergent evacuation from Wuhan, China to Japan under the COVID-19 outbreak in 2020. A total of 12 of 14 returnees (median age [range]: 49.5 years [29–65 years]; 9 men [75%]) were confirmed COVID-19. The proportions of returnees with COVID-19 were 12/566 (2.1%) in the 1-3 flights and 2/263 (0.8%) in the 4-5 flights. Six patients were asymptomatic on admission, while three patients developed symptoms thereafter. None reported a specific history of contact with animals, going to seafood markets, or visiting medical facilities. Two patients contacted with an individual confirmed or suspected to have COVID-19, respectively. Most patients resided in hotels in the center of Wuhan city, taking taxis and trains to work and supermarkets. Patients relatively adhered to IPC measures such as wearing a mask and hand hygiene. However, emphasis on IPC measures such as universal masking and more rigorous avoidance of exposure risk may have been necessary to prevent infection. In addition, forced social distancing due to lockdown might contribute to the lower infection rates in Flights 4 and 5, compared to Flights 1-3.

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  • Janisara Rudeeaneksin, Benjawan Phetsuksiri, Chie Nakajima, Yukari Fuk ...
    Article ID: JJID.2022.055
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    Drug-resistant tuberculosis (TB) is a great challenge in TB control. The frequency and mutation characteristics can imply the efficiency of molecular tests for the rapid detection of TB drug resistance. This study examined the existence of mutations in katG and inhA for isoniazid (INH) resistance, and rpoB for rifampicin (RIF) resistance. A total of 178 drug-resistant Mycobacterium tuberculosis (MTB) isolates were analyzed. Mutations in katG encoding and inhA regulatory regions were detected in 136/168 (81.0%) and 29/168 (17.3%), respectively, with the most prominent mutation of Ser315Thr substitution in katG in 126/168 (75.0%), and -15 C > T substitution in the regulatory region of the inhA (26/168; 15.5%). Two distinct katG mutations (Tyr337Cys, 1003InsG) were identified. Of 125 RIF-resistant isolates, 118 (94.4%) carried mutations affecting the 81-bp RIF resistance-determining region (RRDR) with the most commonly affected codons 450, 445, and 435 identified in 74 (59.2%), 26 (20.8%) and 12 (9.6%) isolates, respectively. The genetic mutations were highly associated with phenotypic INH and RIF resistance, and the majority shared similarities with those in previous studies in Thailand and other Asian countries. The data is useful for guiding the use and the improvement of molecular tests for TB-drug resistance.

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  • Daiqin Zhang, Wenting Li, Xin Hu, Hongyu Huang, Xiaobing Zhang
    Article ID: JJID.2022.101
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    Aeromonas was re-identified in the work, and the clinical aspects of Aeromonas bacteremia were clarified, additionally drug resistance and virulence genes connected to Aeromonas. By using the housekeeping genes, 188 Aeromonas strains were identified into 7 species, which was a standard to assess the accuracy of the VITEK MALDI-TOF system and the VITEK2 compact system. VITEK MS system and housekeeping genes had a 39.89% clear coincidence rate, while Vitek2 Compact system and the standard had a 2.13%. Aeromonas bacteremia was associated with septic shock, hematologic malignancy, and posthepatitic cirrhosis. Hematologic malignancy, hypoproteinemia, systemic steroid use, central venous catheterization and act and ast gene were all linked to poor outcomes. Aeromonas bacteremia had a 37.5% mortality, but there were differences in mortality among Aeromonas species. According to the broth microdilution method, except for ceftriaxone (83.33%) and imipenem (83.33%), over 90% of isolates were sensitive to the most antimicrobials. Touch-down polymerase chain reaction (PCR) assays and DNA sequencing verified the presence of drug resistance genes, and blaCphA was found in three isolates, and blaNDM-1 in one. In short, common methods for identifying Aeromonas species were ineffective. Immunocompromised patients had a higher risk of infections and mortality. Carbapenem resistance was a serious issue.

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  • Noriko Konishi, Hiromi Obata, Keiko Yokoyama, Kenji Sadamasu, Akemi Ka ...
    Article ID: JJID.2022.174
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    Salmonella foodborne outbreaks have markedly decreased in recent years, and different serovars of Salmonella have been isolated. In order to clarify the characteristics of Salmonella strains causing annual epidemics and to estimate the source, we conducted a serotyping test both on 1,132 human-derived Salmonella isolated in the 1990s and the 2010s, and 1,061 food-derived Salmonella isolated in the 2010s in Tokyo. The serovars commonly isolated from human feces in the 1990s and after 2012 were S. Enteritidis, S. Typhimurium, S. Infantis, S. Thompson and S. Agona. The new main serovars isolated after 2012 were S. Schwarzengrund, S.enterica serovar 4:i:- and S. Chester. On the other hand, the main serovars detected from foods after 2012 were S. Infantis, S. Schwarzengrund, S. Agona, S. Manhattan, S. Typhimurium and S.enterica serovar UT: r: 1,5. S. Schwarzengrund has recently been particularly frequently isolated. Those strains were mainly isolated from chicken meat and chicken offal. It was suggested that same serovars of human-derived isolates were also isolated from foods, especially chicken meat and offal, and those were recently an important causative food of Salmonellosis.

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  • Jiro Takeuchi, Takashi Kawamura
    Article ID: JJID.2022.187
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    A catch-up campaign of measles and rubella (MR) vaccinations was conducted for third-year high school (MR-4) students between 2008 and 2012 as part of governmental policy. We examined three analytical methodologies for the assessment of vaccination policy. We measured the antibody titers of the first-year students involved and not-involved in the catch-up campaign, and analyzed the increase in antibody titers after two-or-more-dose vaccination using conventional regression analysis, proxy exposure analysis with the individual’s birth year, and two-stage least square (2SLS) regression with the birth fiscal year as an instrumental variable. Among 379 students invited to participate in the study, 220 (58.0%) and 213 (56.2%) were included in the analysis. Conventional regression analysis revealed that two-or-more-dose vaccination produced 0.27 (95% confidence interval [CI], 0.04 to 0.49) greater log-scale antibody titers against measles. Proxy exposure analysis with the birth year revealed that two-or-more-dose vaccination produced 0.40 (95% CI, 0.18 to 0.63) greater log-scale antibody titers against measles. According to 2SLS regression, two-or-more-dose vaccination produced 0.72 (95% CI, 0.31 to 1.13) greater log-scale antibody titers against measles. All three analyses showed similar trends but no findings for rubella. These results were consistent throughout three different analytical methodologies used to assess the vaccination policy.

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  • Meliha Cagla Sonmezer, Taha Koray Sahin, Enes Erul, Gulcin Telli Dizma ...
    Article ID: JJID.2022.255
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    Common Human Coronaviruses (HCoVs) (NL63, HKU1, 229E, and OC43) circulate worldwide and cause respiratory tract infections. Epidemiologic study of HCoVs paramount importance since the disease burden and its trajectory in years has not been well addressed in adults. Here, we aimed to describe the burden of HCoVs in a hospital setting over five years before the COVID-19 pandemic. This is a retrospective study among patients (>18 years) between Jan 1, 2015, and Jan 1, 2020, whose respiratory specimens were tested by multiplex RT-PCR. In total, 7861 respiratory samples (4540 patients) were included; 38% tested positive for any respiratory viruses. Of these, 212 (12.2%) samples were positive for HCoVs, and their co-infection with other respiratory viruses was 30.6%. Rhinovirus (RV) (27.6%) was the most common co-infection for all three HCoVs. The overall prevalence of HCoVs tended to be the highest in the winter (40.9%). Patients aged ≥60 years had the highest prevalence of overall HCoVs (39.7%). Given the duration and the large sample size, this study from Turkey is one of the largest to date among adults in the literature. These epidemiological data and molecular surveillance HCoVs have important implications for the control and prevention of respiratory infection.

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  • Shoko Komatsu, Shinobu Tanaka, Noriko Nakanishi
    Article ID: JJID.2022.397
    Published: August 31, 2022
    Advance online publication: August 31, 2022
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    Legionella pneumophila, the primary causative agent of Legionnaires’ disease, is classified into at least 15 serogroups (SGs). Before genotyping, serotyping is first performed to limit the sources of L. pneumophila infections that cause outbreaks. Serotyping using multiplex polymerase chain reaction (M-PCR) was recently developed for L. pneumophila, in addition to conventional assays using monoclonal or polyclonal antisera. In this study, we applied the M-PCR system to 41 strains that remained to be SGUT (untypable) by the slide agglutination tests among 220 L. pneumophila strains isolated from bath water in Kobe City during 2016–2020 to determine SG-genotypes (SGg) by the PCR amplification of the specific target gene of SGs. Among the 41 SGUT strains, SGg4/10/14 was the most predominant strain (24/41, 58.5%), followed by SGg1 (7/41, 17.1%). Seven strains, except for the strains determined as SGg1, were identified as belonging to a single SGg using M-PCR serotyping [SGg5 (3/41, 7.3%), SGg8 (3/41, 7.3%), and SGg7 (1/41, 2.4%)]. Furthermore, we found that the seven strains identified as SGg1 harbored particular genotypes. In conclusion, the M-PCR serotyping assay will be helpful in investigating the distribution of L. pneumophila in environmental and clinical settings.

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  • Yixin Kang, Junchang Cui
    Article ID: JJID.2022.289
    Published: July 29, 2022
    Advance online publication: July 29, 2022
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    The objective of this pharmacokinetic (PK)/pharmacodynamic (PD) analysis was to evaluate the efficacy of different dosing regimens of ceftazidime-avibactam (CZA) for the treatment of extensively drug-resistance (XDR) Pseudomonas aeruginosa pulmonary infections by using optimized two-step-administration therapy (OTAT) and traditional infusion (TI). We used Monte Carlo simulations (MCS) to integrate PK parameters with PD parameters to assess the adequacy of ceftazidime-avibactam dosing for critically ill patients with XDR P. aeruginosa pulmonary infections. Dosing models were as follows: 2.5 g q8h, 2.5 g q6h, 4 g q8h, 4g q6h, 1.25 g q8h, 1.25 g q6h, and 0.94 g q12h. MCS showed that the cumulative fraction of response (CFR) of all dosing regimens of OTAT was higher than 90%. The probability of target attainments (PTAs) of all dosing regimens of OTAT at MICs of 16-32 mg/L was higher than those of TI. Based on the models, PK/PD goals were met with OTAT regimens even with high MICs (>16 mg/L) compared with traditional infusion intervals. Our work indicated that OTAT with sufficient pharmacokinetic exposures could improve the efficacy of CZA for critically ill patients with XDR P. aeruginosa pulmonary infections.

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