Japanese Journal of Infectious Diseases
Online ISSN : 1884-2836
Print ISSN : 1344-6304
ISSN-L : 1344-6304
Advance online publication
Showing 1-31 articles out of 31 articles from Advance online publication
  • Kouji Kida, Yasuhiro Matsuoka, Tetsuya Shimoda, Hiroaki Matsuoka, Haru ...
    Article ID: JJID.2018.526
    Published: 2019
    [Advance publication] Released: July 31, 2019
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  • Hisatoshi Kaneko, Nozomu Hanaoka, Masami Konagaya, Tomoko Tsukahara-Ka ...
    Article ID: JJID.2019.064
    Published: 2019
    [Advance publication] Released: July 31, 2019
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  • Hirofumi Ishikawa, Rieko Shimogawara
    Article ID: JJID.2019.094
    Published: 2019
    [Advance publication] Released: July 31, 2019
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    In Tokyo, Japan, an outbreak of autochthonous dengue fever occurred in summer of 2014. In summer of 2020, when the Olympic Games will be held, a lot of participants and spectators from abroad will visit Tokyo. This study is aiming at analyzing a risk of autochthonous dengue infections in Tokyo in summer and also an additional risk in the Olympiad by using a mathematical model. We developed a stochastic transmission model with the cooperation of seasonal factors which influence much on the transmission cycle of dengue virus, and carried out stochastic simulations for each of the scenarios provided adequately. We found that (1) the incidence of dengue autochthonous infections is predicted to be small number cases; (2) the local climate makes a great influence on a scale of dengue autochthonous infections; (3) the incidence reaches a peak in August and early September; and (4) there is a bare possibility of development into dengue outbreak. In the Olympiad held in summer of 2020, an additional risk of dengue autochthonous infections will amount to about the double of risk in normal years.

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  • Hideo Kato, Mao Hagihara, Yuki Yokoyama, Hiroyuki Suematsu, Nobuhiro A ...
    Article ID: JJID.2019.109
    Published: 2019
    [Advance publication] Released: July 31, 2019
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    Community-acquired pneumonia (CAP) can involve mixed-infection. However, there are few studies investigating its antimicrobial activity in mixed-infection. The aim of this study was to compare the in vivo antimicrobial activity of GRNX and levofloxacin (LVFX) against Streptococcus pneumoniae and Parvimonas micra in a murine pneumonia mixed-infection model. S. pneumoniae D-6888 and P. micra No. 242 were used in this study. Antimicrobial activity was calculated for each isolate as the change in bacterial count of lungs (Δlog10 CFU/mL) obtained in the treated mice after 24 h compared with the count in the starting control animals (0 h). The MICs of GRNX and LVFX against S. pneumoniae D-6888 were 0.06 and 0.5 mg/L. The MICs of these quinolones against P. micra No. 242 were 0.03 and 0.12 mg/L. In a murine pneumonia mixed-infection model, GRNX showed significantly higher in vivo antimicrobial activity against S. pneumoniae than LVFX (GRNX; -2.02 ± 0.99 log10 CFU/mL vs. LVFX; -0.97 ± 0.61 log10 CFU/mL, p = 0.0188). Numerically better activity against P. micra was noted for GRNX therapy in this model (GRNX; -1.12 ± 0.56 log10 CFU/mL vs. LVFX; -0.61 ± 0.43 log10 CFU/mL, p = 0.1029). These results suggested that GRNX has potential to be a preferable treatment for CAP.

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  • Wenjing Zhang, Sayaka Yoshizaki, Yasushi Ami, Yuriko Suzaki, Naokazu T ...
    Article ID: JJID.2019.129
    Published: 2019
    [Advance publication] Released: July 31, 2019
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    Cynomolgus monkey is an important experimental animal for hepatitis E virus (HEV) infection. In Japan, cynomolgus monkeys are imported mainly from Asian countries for use at animal facilities and institutions. However, the status of HEV infection in cynomolgus monkeys remains unclear. A total of 187 pairs of serum and fecal samples were collected from cynomolgus monkeys (Macaca fascicularis) imported from China and Cambodia to detect anti-HEV IgG and IgM antibodies as well as HEV RNA. Based on an enzyme-linked immunosorbent assay using HEV-like particles derived from genotype 3 HEV as the antigen, 184 of 187 (98.4%) and 102 of 187 (54.5%) samples were found to be positive for anti-HEV IgG and IgM antibodies, respectively. In contrast, all 45 serum samples collected from cynomolgus monkeys bred and grown at the Tsukuba Primate Research Center, Japan, were negative for both antibodies. However, real-time quantitative reverse transcription polymerase chain reaction detected no HEV RNA in any of the 187 serum and fecal samples. These results strongly indicated that HEV infection is common in imported cynomolgus monkeys. A source of HEV-free monkeys for HEV studies is urgently needed.

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  • Shuxu Shen, Wen Tian, Yangtao Ji, Yang Gao, Min Zhang, Xiaoxu Han, Hon ...
    Article ID: JJID.2018.336
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    Dozens of broadly neutralizing antibodies (bnAbs) have been identified from chronically infected HIV-1 patients, but it is still unclear what determines the acquisition of broad neutralizing activities. Two chronic HIV-1 infected cases with similar autologous neutralizing activities were followed up for two years to study viral evolution of the envelope gene and the neutralizing activity against autologous and heterologous viruses. The neutralization activities against homologous viruses gradually increased in both patients. HA172 eventually developed a cross-clade neutralizing antibodies response, with a neutralization breadth of 88.9% (8/9) against tier 2 heterologous HIV-1. However, HA084 could only neutralize 44.4% (4/9) of the same virus panel. Higher genetic diversity of the env gene at baseline (0.027 vs. 0.002, p<0.001), stronger immune pressure on V3 (3.08 vs. 0.99, p<0.001) or V4 loops (2.63 vs. 0.62, p=0.002), increasing length of V1V2 and V4 loops, and evolution on V1V2 and CD4-binding sites (CD4bs) were identified in HA172. This study demonstrated that higher viral genetic diversity, viral evolution on V1V2 and CD4bs might contribute to the development of bnAbs. Above findings support the potential of inducing better neutralizing antibodies in immunodeficient patients and may help to develop the bnAbs-based immune therapy strategy.

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  • Yoshinobu Abe, Kiwamu Nakamura, Daiki Kaji, Hiroshi Takahashi, Kotaro ...
    Article ID: JJID.2018.466
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    In this study, we evaluated extended-spectrum β-lactamase (ESBL)-producing bacteria with the newly developed primer and probe sets to detect blaCTX-M, blaTEM, and blaSHV using BD MAXTM, a fully automated multiplex polymerase chain reaction assay system. In 36 isolates confirmed to have any one of blaCTX-M, blaTEM, or blaSHV by whole-genome sequencing, the product accurately detected each gene without influenced by the presence of other β-lactamase genes. In nine control strains which do not harbor either blaCTX-M, blaTEM, or blaSHV did not cross react with the product. In 191 strains phenotypically determined ESBL-producers by conventional antimicrobial susceptibility tests, 189 strains were blaCTX-M, blaTEM, or blaSHV positive by the product, and two strains were negative for these genes. Whole-genome sequencing revealed that these two strains were phenotypically false positive ESBL-producers. The accuracy of the primer and probe sets seems to be satisfactory and they may be applicable to detect CTX-M type ESBL-producing bacteria.

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  • Harun Agca, Beyza Ener
    Article ID: JJID.2018.510
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    Respiratory viral and atypical bacterial agents lead to infections in a large spectrum, from mild symptoms to respiratory failure. In this study, we aimed to detect mutiple viral and bacterial agents in the respiratory samples of inpatients by real-time PCR (RT-PCR). Nasopharyngeal swab and broncho alveolar lavage samples’ results from the inpatients with respiratory infection symptoms at the Uludag University Hospital between 01.12.2015 and 31.03.2018 were investigated. DNA/RNA was extracted with EZ1 Virus Mini Kit v2.0 (Qiagen, Belgium) in EZ1 (Qiagen, Belgium). R-GENE® Real-Time PCR (Biomerioux, France) kit was used to detect Influenza A, Influenza B, RSV, human Meta-pneumo virus (hMPV), Rhino/Enterovirus, Adenovirus (AdV), human Bocavirus (hBoV), Corona virus (CoV), Parainfluenza virus (PIV), Chlamydia pneumoniae/Mycoplasma pneumoniae, Legionella pneumophila in Rotor-Gene Q (Qiagen, Belgium). Patients’ ages were between 0-90 years. Patients’ 177 (56.9%) were male and 134 (43.1%) were female. There was a total 311 samples and 214 (68.8%) were positive. We detected a total of 360 agents including 338 viruses and 22 bacteria. Most common agents were; Influenza A+B (n=65, 18,1%), hBoV (n=64, 17.8%), Rhino/Enterovirus (n=56, 15.6%) and RSV (n=47, 13.1%). Rapid diagnosis of viral infections by Real Time PCR is important for the specific treatment.

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  • Yu Sun, Jie Deng, Yuan Qian, Runan Zhu, Fang Wang, Run Tian, Ri De, Li ...
    Article ID: JJID.2018.528
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    We evaluated two currently available rapid antigen detection tests (RADTs) for Respiratory syncytial virus (RSV), Sofia® RSV FIA and BinaxNOW RSV Card (BinaxNOW). Between November 2017 and February 2018, 395 nasopharyngeal swabs were collected from children diagnosed with acute respiratory infections, and were evaluated with these RADTs, reverse transcription–quantitative real-time PCR (RT–qPCR), and a direct immunofluorescence assay (DFA). The sensitivity of Sofia® RSV FIA (80.82%) was significantly higher than that of BinaxNOW (53.42%) when RT–qPCR was used as the standard. This was confirmed with DFA. The sensitivities of Sofia® RSV FIA (85.4% [41/48]) and BinaxNOW (58.3% [28/48]) were higher for RSV A than for RSV B (69.6% [16/23] and 43.5% [10/23], respectively). The optimal critical cycle threshold (Ct) values on RT–qPCR that correlated with Sofia® RSV FIA and BinaxNOW were 24 and 22, respectively. The kappa value for Sofia® RSV FIA and RT–qPCR in the patients aged ≤ 2 years was 0.962, but 0.648 in those aged > 2 years. Thus, Sofia® RSV FIA is more sensitive than BinaxNOW; its results were affected by the RSV viral strain and load. It is more effective in children aged ≤ 2 years than in those aged > 2 years.

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  • Seiji P. Yamamoto, Yu Kasamatsu, Daiki Kanbayashi, Atsushi Kaida, Mich ...
    Article ID: JJID.2018.554
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    Dengue fever (DF) is a mosquito-borne disease and significant global public health problem. Although limited serologic surveys in the literature suggest endemic DF in many parts of Africa, DF cases in Africa are generally underreported due to the lack of diagnostic testing and systematic surveillance, and thus, little is known about the phylogenetic profile of circulating strains. In April 2015, DF was diagnosed in a Japanese national returned from the Democratic Republic of the Congo (DRC). Dengue virus 1 (DENV-1) RNA was detected from the patient’s serum sample by real-time reverse transcription PCR. Phylogenetic analysis of the E gene found that the detected DENV-1 strain was classified in genotype V and closely related to that of the 2013 DF epidemic in Angola, which is located directly south of DRC, with 100% nucleotide identity. This is the first report to characterize the circulating DENV strain in DRC, and indicates that the epidemic DENV-1 strain in Angola in 2013 was also circulating in DRC in 2015.

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  • Hiroaki Moroi, Kouji Kimura, Ayaka Ido, Hirotsugu Banno, Wanchun Jin, ...
    Article ID: JJID.2019.015
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    Streptococcus agalactiae (Group B Streptococcus, GBS) is a pathogen causing neonatal sepsis, meningitis, and invasive infections in the elderly and people with medical conditions. Macrolide and lincosamide resistance rates of GBS are increasing worldwide. A macrolide resistance gene, erythromycin ribosomal methylase (erm), typically confers MLSB phenotype. However, in this study, we recovered and characterized three clinical ermB-PCR-positive isolates of GBS with L phenotype. PCR of ermB and lnuB (lincosamide nucleotidyltransferase) genes were positive in all three clinical isolates. The ermB gene of the clinical isolates harbored C222T (N74N), T224C (I75T), and A299G (N100S) nucleotide (amino acid) substitutions and insertion of an IS1216E element at nucleotide position 643, resulting in the deletion between 643th-738th nucleotide positions of ermB gene, and suggesting loss-of-function of ErmB protein in the three clinical isolates. Since these clinical isolates are pitfalls of PCR method for detecting antimicrobial drug resistance genes, partial deletion of antimicrobial drug resistance genes, which confer contradiction between PCR detection of antimicrobial drug resistance genes and antimicrobial drug resistance phenotypes, must be considered.

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  • Toshihiko Sunahara
    Article ID: JJID.2019.047
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    Aedes albopictus (Skuse) transmits several arboviral diseases. This mosquito was the vector responsible for the past and the recent dengue outbreaks in Japan. Sites with high density of A. albopictus are at potential risks of outbreaks of arboviral diseases. This study describes extremely high biting densities of A. albopictus at a campus of Nagasaki University, southwestern Japan. In August of 2015 and 2016, human-bait-sweep collection for 8 min obtained on average 33.4 and 38.9 females, respectively. In both 2015 and 2016, the highest and the second highest biting densities were observed in sites densely shaded by trees and covered with a lot of understory plants. In addition, major breeding sites were identified near these sites in 2016. A predaceous larval mosquito, Lutzia vorax Edwards, appeared to strongly suppress the breeding of A. albopictus in catch basins near the site with highest adult density, although its effect was insufficient to keep A. albopictus density at a low level. After cleaning the catch basins, A. albopictus immatures become more abundant especially in shallow catch basins in shaded sites.

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  • Yuichi Fukui, Hisashi Inokuma
    Article ID: JJID.2019.076
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    DNA from 1084 ticks collected by flagging in vegetation in Tsukuba and Moriya (Ibaraki, Japan), where several cases of canine granulocytic anaplasmosis were found, was molecularly examined for infection with the family Anaplasmataceae. Twenty-six positive samples of Anaplasmataceae-specific PCR of partial 16S rRNA gene were subjected to semi-nested PCR covering the divergent regions the gene and sequence analysis. Anaplasma phagocytophilum was detected in three pools of Haemophysalis longicornis larvae, and Anaplasma bovis from a Haemophysalis flava male. Sequences of both amplicons had highest homologies to those from dogs in our previous studies in Ibaraki, respectively. These results suggest that genus Haemophysalis ticks are the candidate vectors of Anaplasma phagocytophilum and Anaplasma bovis in Ibaraki, Japan.

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  • Huifeng Fan, Bingtai Lu, Diyuan Yang, Dongwei Zhang, Tingting Shi, Gen ...
    Article ID: JJID.2019.113
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    The pathogenesis of Mycoplasma pneumoniae pneumonia (MPP), especially the local immune responses of the lungs, is poorly understood. In this study, we used FCM (Flow Cytometry) to analyze IL-17 and related cytokines in plasma and bronchoalveolar lavage fluid (BALF) samples from 18 patients with general MPP (GMPP) and 30 patients with refractory MPP (RMPP). The levels of IL-1Ra, IL-6, IL-8, IL-17 and TNF-α were significantly elevated in the BALF of MPP children compared with the plasma (P<0.01). The plasma IL-6 levels in the children with RMPP were higher than those in the children with GMPP (P<0.05), but the IL-17 levels showed the opposite trend (P<0.05). The children with RMPP had significantly higher BALF levels of IL-8, IL-17 and TNF-α than the children with GMPP (P<0.05), and the elevated levels of IL-17 correlated with the focal size of the lung lesions (P<0.05). The elevated levels of IL-17 and related cytokines in the BALF could suggest that the local inflammatory response should be distinguished from the systemic inflammatory response in children with MPP. RMPP might involve aggravated inflammatory progression at the site of infection. The level of IL-17 might correlate with the extent and severity of the lung lesions in MPP.

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  • Mildred A. Adusei-Poku, Saori Matsuoka, Evelyn Y. Bonney, Christopher ...
    Article ID: JJID.2019.201
    Published: 2019
    [Advance publication] Released: June 28, 2019
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    In human immunodeficiency virus type-1 (HIV-1) infections, cytotoxic T-lymphocyte (CTL) responses targeting human leukocyte antigen (HLA)-restricted viral epitopes exert strong suppressive pressure on viral replication and frequently select for mutations resulting in viral escape from CTL recognition. Numerous data on these HLA-associated mutations in HIV-1 subtypes B and C have been amassed with few reports described in other subtypes. In the present study, we investigated HLA-associated mutations in HIV-1 subtype CRF02_AG prevailing in Ghana, Western Africa. We determined viral gag sequences in 246 out of 324 HIV-1-infected Ghanaians. Phylogeny analysis revealed that 200 (81.3%) were infected with HIV-1 CRF02_AG. Full gag and vif sequences were obtained from 199 and 138, respectively, out of the 200 individuals infected with CRF02_AG and subjected to determination of HLA-associated mutations. The analysis found HLA-associated HIV-1 CRF02_AG nonsynonymous polymorphisms at nineteen sites, thirteen in gag and six in vif, including those newly determined. Generation of this data is an important contribution to our understanding of HIV-1 CRF02_AG and host T cell interaction.

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  • Mehdi Goudarzi, Maryam Fazeli, Ramin Pouriran, Gita Eslami
    Article ID: JJID.2018.406
    Published: 2019
    [Advance publication] Released: May 31, 2019
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    The spread of PVL-carrying S. aureus strains in patients with wound infections in both the community and hospitals are increasing in some areas of Iran. In the present study, we determined the molecular characteristics and distribution of PVL-producing S. aureus strains isolated in wound infections. Genes encoding resistance, toxin, and staphylococcal enterotoxins were analyzed by polymerase chain reaction assays. Genotyping was performed by using multi-locus sequence typing. Aminoglycoside resistance genes including ant (4΄)-Ia gene (57.4%) and aac (6΄)-Ie/aph (2˝) (45.7%) were the most prevalent genes in isolates. Staphylococcal enterotoxin type A, as the most frequent type, was present in 20.2% of isolates. Strains belonged to seven clonal complexes. The most frequent clonal complex was CC30 (ST30) (29.8%); followed by CC22 (ST22) (21.3%), CC8 (ST8 and ST931) (17%), CC88 (ST88) (10.6%), CC59 (ST59 and ST338) (8.5%), CC1 (ST772 and ST1) (7.5%), and CC15 (ST15) (5.3%). Our findings indicated an increasing trend of CC30, carrying a wide range of resistance and toxin genes that could be a dilemma for treating the patients with wound infections indeed. Further studies are required to investigate the carriage of resistance, the antibiotic susceptibility pattern, and toxins encoding genes in different molecular types.

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  • Shinya Murata, Yuzuru Takeuchi, Kou Yamanaka, Jun Hayakawa, Masashige ...
    Article ID: JJID.2018.448
    Published: 2019
    [Advance publication] Released: May 31, 2019
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    Human papillomavirus (HPV)-associated disease is common among men with HPV infection. A quadrivalent HPV (qHPV) vaccine has demonstrated 85.9% efficacy against HPV6/11/16/18-related persistent (≥6 month) infection in a study of Japanese men aged 16–26 yr. Here, we report results of an open-label study of the immunogenicity and tolerability of the qHPV vaccine (NCT02576054), conducted to bridge findings in Japanese men to Japanese boys aged 9–15 yr. A total of 100 boys completed a three-vaccination regimen (Day 1, Months 2, and 6), and 99 boys were included in the primary analysis population. The rate of seroconversion at 1 month after vaccine Dose 3 (Month 7) was high for each vaccine HPV type (anti-HPV6/11/16/18 seroconversion rates [95% CI]: 94.9% [85.5%, 98.3%], 99.0% [94.4%, 100.0%], 99.0% [94.5%, 100.0%], and 99.0% [94.4%, 100.0%], respectively) and anti-HPV6/11/16/18 geometric mean titers were 482.9 mMU/mL, 1052.8 mMU/mL, 3878.3 mMU/mL, and 1114.5 mMU/mL, respectively. Immune responses to qHPV vaccine were non-inferior among Japanese boys included in the current study compared with young Japanese men in a separate study. Injection-site reactions were the most common adverse events, and administration of the vaccine was well tolerated in Japanese boys.

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  • Keisuke Nonaka, Yoko Matsuda, Mototsune Kakizaki, Shoichiro Takakuma, ...
    Article ID: JJID.2018.494
    Published: 2019
    [Advance publication] Released: May 31, 2019
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    An 84-year-old man with chronic renal failure, anemia, and diabetes was admitted for hemodialysis initiation. His vital signs were stable until the eighteenth hospital day, before having an influenza A virus infection. Three days later, he died of septic shock with severe liver impairment. His leukocyte count, prothrombin time (PT-INR), and liver enzymes, such as AST and ALT, were significantly increased. Hypercytokinemia was also observed. Autopsy revealed bilateral diffuse pneumonia with neutrophil infiltration. The liver showed extensive centrilobular hepatocyte necrosis. Immunohistochemistry for influenza A nucleoprotein was positive in the ciliated columnar epithelium of the bronchi and negative in the trachea, lungs, and liver. Hypoxic hepatitis is characterized by an abrupt and massive increase in aminotransferase levels (more than 20 times of the upper normal limit) due to the anoxic centrilobular hepatocyte necrosis. The occurrence of hypoxic hepatitis requires a pre-existing, chronic condition, such as anemia, causing less oxygen supply to the liver, followed by an acute drop in hepatic oxygen supply, such as septic shock. Therefore, this report suggests that hypoxic hepatitis can be an important causative factor for acute liver failure associated with influenza virus infection.

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  • Metawee Thongdee, Somjit Chaiwattanarungruengpaisan, Paisin Lekcharoen ...
    Article ID: JJID.2019.061
    Published: 2019
    [Advance publication] Released: May 31, 2019
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      We performed Leptospira culture of 76 clinical samples collected from animals and 6 soil samples for the investigation of a leptospirosis outbreak in southern Thailand, 2017. Recovery of leptospires was found in a kidney sample of a fatal canine leptospirosis case and all of the soil samples. 16S rRNA sequence analysis demonstrated that the clinical isolate was closely related to the pathogenic L. interrogans while the soil isolates were related to different species including the pathogenic L. ellisii, the intermediate L. wolffii and the non-pathogenic L. yanagawae. Multilocus sequence typing (MLST) identified a novel sequence type (ST) of the isolate of L. interrogans in ST263, suggesting the causative agent of canine leptospirosis in the southern Thailand outbreak has a unique genetic profile.

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  • Miwako Saikusa, Naganori Nao, Chiharu Kawakami, Shuzo Usuku, Nobuko Ta ...
    Article ID: JJID.2019.124
    Published: 2019
    [Advance publication] Released: May 31, 2019
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      Human metapneumovirus (HMPV) has been a major causative agent of acute respiratory infections in humans. Recently two types of variant A2b subtype HMPV strains possessing 111- or 180-nucleotide duplication (nt-dup) in the G gene (HMPV A2b180nt-dup and HMPVA2b111nt-dup, respectively) were detected in Japan, Spain, Vietnam, and China. Surveillance for infectious agents in Yokohama City, Japan revealed that the HMPV111nt-dup strain became predominant in Yokohama City in 2018. In contrast, no classical HMPV A2b strain was detected after 2017. These data suggest a beneficial role of the 111nt-dup in the G gene for the transmission of HMPV.

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  • Shuji Hatakeyama, Koh Okamoto, Kenichi Ogura, Chise Sugita, Minoru Nag ...
    Article ID: JJID.2018.354
    Published: 2019
    [Advance publication] Released: April 26, 2019
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    Histoplasmosis is occasionally encountered in non-endemic countries owing to more frequent international travel and migration, as well as to an increase in the number of vulnerable hosts (e.g., patients with cellular immunodeficiencies). However, diagnosis of endemic mycoses may be challenging owing to its rarity and the limited availability of diagnostic tests. We report a case of disseminated histoplasmosis in a human immunodeficiency virus (HIV)-infected Japanese man who had often travelled to histoplasmosis-endemic countries. We also reviewed the reported cases of HIV-associated histoplasmosis in Japan. To the best of our knowledge, this is the ninth case report of co-infection with Histoplasma and HIV in Japan, and the second involving a Japanese patient. This case emphasizes the importance of noting the details of not only the present residence of patients but also their previous residence and travels. If histoplasmosis is suspected, physicians should inform laboratory personnel that fungal cultures should be incubated for 6 weeks, and compliance with biosafety guidelines for handling the specimens should be practiced. Since death occurred in nearly 50% of HIV-associated histoplasmosis in Japan, early recognition, timely diagnosis, and appropriate treatment are mandatory.

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  • Yoshiki Kusama, Masahiro Ishikane, Chika Tanaka, Yuki Kimura, Erina Yu ...
    Article ID: JJID.2018.417
    Published: 2019
    [Advance publication] Released: April 26, 2019
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    The National Action Plan on Antimicrobial Resistance in Japan aims to achieve a 50% reduction in the use of broad-spectrum oral-antimicrobials (cephalosporins, macrolides, and quinolones) from 2013 to 2020. We estimated regional antimicrobial use (AMU) during 2013–2016 using national antimicrobial sales data, and evaluated differences in broad-spectrum oral-antimicrobials AMU among three regions with previous differences in total AMU. AMU was standardized by defined daily dose (DDD) and described as DDDs/1,000 inhabitants/day (DID). Annual combined total-oral and total-parenteral AMU during 2013–2016 was 14.9, 14.5, 14.7, and 14.6 DID. The mean ± standard deviation of prefectural change in total AMU was –0.2 ± 0.8 DID. Among 47 prefectures, 34 showed decreasing trends, and 13 increasing ones. In 2016, there was no significant difference in mean oral-cephalosporins use among the three regions. Mean oral-macrolides in the East (4.1 DID) was significantly smaller than in Central (4.7 DID) (p=0.009) and West (4.8 DID) (p=0.002). Mean oral-quinolones in the West (3.2 DID) was significantly higher than in East (2.3 DID) (p<0.001) and Central (2.7 DID) (p=0.001). To specify appropriate targets for antimicrobial stewardship intervention to reduce broad-spectrum oral-antimicrobials use, studies to identify the reasons for these differences are needed.

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  • Hiroshi Yoshikura
    Article ID: JJID.2018.421
    Published: 2019
    [Advance publication] Released: April 26, 2019
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    The number of eaters and that of patients per outbreak followed lognormal distribution in food poisonings caused by microbes while it followed scale-free distribution in food poisoning caused by plant or animal toxins. Attack rates of the individual outbreaks were distributed continuously and almost linearly from >0 to 1 for all the food poisonings, i.e., they could not be represented by median and standard deviation. For monitoring of the number of patients and the attack rate in individual outbreaks simultaneously, the number of patients was plotted in the x-axis in the logarithmic scale against the attack rate in the y-axis in the normal scale. There emerged plots characterized by repeating arcs assuming shape of a butterfly with extended wings viewed from above, which was called “backbone configuration”. The butterfly-shaped plot patterns were generally stable over time, but variable depending on pathogens, implicated facilities and their combinations. The backbone configuration was reproduced by assuming that the number of patients per outbreak was distributed continuously from 1 to the number of eaters per outbreak.

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  • Daiki Kanbayashi, Atsushi Kaida, Yuki Hirai, Seiji P Yamamoto, Ryoko F ...
    Article ID: JJID.2018.532
    Published: 2019
    [Advance publication] Released: April 26, 2019
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    The second largest epidemic of hand, foot, and mouth disease since 1982 occurred in 2017, which involved 6,173 cases in Osaka City, Japan. The main causative agent was coxsackievirus A6 (CV-A6). Phylogenetic analysis revealed that the detected CV-A6 strains belonged to genetic group A3 and A4 in clade A.

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  • Toshihiro Matsui, Noriko Kinoshita, Takahiro Maeki, Satoshi Kutsuna, K ...
    Article ID: JJID.2018.537
    Published: 2019
    [Advance publication] Released: April 26, 2019
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    In July 2018, a Japanese traveler returning from Saudi Arabia was diagnosed with dengue. Dengue virus type 2 gene was detected from the whole blood sample. Phylogenetic analysis revealed that the strain clustered with isolates from Singapore and India. Travelers to Saudi Arabia should be cautious about mosquito bites.

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  • Rabee Alhossiny Ombarak, Mahmoud Gamaleldin Zayda, Atsushi Hinenoya, S ...
    Article ID: JJID.2018.538
    Published: 2019
    [Advance publication] Released: April 26, 2019
    JOURNALS FREE ACCESS ADVANCE PUBLICATION

    Subclinical mastitis (SCM) is regarded as not only a problem to dairy producers worldwide but also a threat to human health due to the potential bacterial contamination of milk and dairy products, particularly those made from raw milk. In this study, E. coli were isolated from fourteen (9.3%) SCM milk samples. The isolated E. coli (n=14) were serotyped, their potential pathogenicity and antimicrobial resistances (AMRs) were investigated. Serotyping results showed that the E. coli isolates belonged to the O55:H7 (n=2), O111:H4 (n=2), O127:H6 (n=2), O128:HUN (n=2), O26:HUN (n=1), O44:H18 (n=1), O114:H21 (n=1), O86:HUN (n=1), O124:HUN (n=1) and O127:H7 (n=1) serogroups. Potential pathogenicity was detected in 93% (13/14) of the isolates. In particular, thirteen isolates possessed at least one of the examined virulence genes. Ten isolates (71%) exhibited AMR to at least one of the tested antimicrobials, 4 (40%) of them were- multidrug-resistant and one isolates showed ESBL production. The obtained results indicate that SCM acts as a source for the spread of potentially pathogenic E. coli strains that are resistant to many groups of antibiotics which may constitute a hazard for both public and animal health.

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  • Hiroshi Yoshikura
    Article ID: JJID.2019.005
    Published: 2019
    [Advance publication] Released: April 26, 2019
    JOURNALS FREE ACCESS ADVANCE PUBLICATION

    Death of HIV/AIDS patients <54 years old declined from 1995 to 2000; from 2000 on, however, the deaths of the HIV/AIDS patients >55 years old started increasing. Though deaths directly linked to infections declined since 2005, those related to malignancy, encephalopathy, interstitial pneumonia, wasting syndrome, etc. persisted. For all of HIV/AIDS (mainly males), ATL, CJD and general population, age of death shifted to older ages by 5 years in 10 years from 1999-2004 to 2010-2017. Among them, only HIV/AIDS patients and general population exhibited unequivocal gender difference. As of 2011-2016, the median of the deaths of the HIV/AIDS patients was 52.5 years for males and 70 years for females, while the median of the deaths of the general population was 75 years for males and 85 years for females. Male HIV/AIDS patients died 22.5 years earlier and female HIV/AIDS patients 15 years earlier than the general population. A common denominator of HIV/AIDS deaths and the deaths among the general population could be CD4+T cells: CD4+T cells were primary targets of HIV infection and decline of naïve CD4+T cells was a hallmark of aging.

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  • Chiaki Okai, Yoshiro Itani, Akira Furuta, Yoshimitsu Mizunoe, Tadayuki ...
    Article ID: JJID.2019.102
    Published: 2019
    [Advance publication] Released: April 26, 2019
    JOURNALS FREE ACCESS ADVANCE PUBLICATION

    Lactobacillus rhamnosus is a gram-positive, rod-shaped bacterium and is commonly used as a probiotic to maintain intestinal health. Recently, surveillance of Lactobacillus bacteremia was conducted using biochemical or conventional PCR assay; however, these assays are unable to quantify the target, and might detect a small number of DNA fragments or yield a false-positive result. In this study, we developed an L. rhamnosus-targeting quantitative PCR assay, which produces accurate and reproducible results based on the specificity of a TaqMan probe targeting the unique 16S rDNA sequence of L. rhamnosus. The assay specifically detected the targeted bacterium, L. rhamnosus, and no non-specific signals were generated under the study conditions. Using genomic DNA from the bacterial cells of L. rhamnosus (101 to 106 cells), the cycle threshold value showed a linear trend (R2 = 0.9993). This L. rhamnosus-targeting quantitative PCR assay can contribute to advance research into the effects of the organism on microflora, microbial infections, and the host.

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  • Takako Inoue, Tomoyuki Ohike, Kumiko Ohne, Shigeru Sato, Takaaki Goto, ...
    Article ID: JJID.2018.472
    Published: 2019
    [Advance publication] Released: March 26, 2019
    JOURNALS FREE ACCESS ADVANCE PUBLICATION

    An advanced and fully automated chemiluminescent enzyme immunoassay for hepatitis C virus core antigen (HCVcAg) was recently developed in Japan. We aimed to evaluate its clinical utility.

     The new Fujirebio assay (Lumipulse Presto HCVcAg [LP-Presto]) was compared with 2 conventional assays (Lumipulse Ortho HCVcAg [LP-Ortho] and Abbott’s Architect HCVcAg). Basic assessments of LP-Presto (reproducibility, stability, range of quantitation, and specificity) were performed on 220 frozen sera (83 positive and 137 negative by LP-Ortho) and 206 fresh sera negative by LP-Ortho. Correlation analysis was performed. Concordance rates between each assay were determined. Additionally, 42 frozen sera of patients with hyperimmunoglobulinemia, including 3 unmeasurable by LP-Ortho, were tested by LP-Presto.

     The basic assessments of LP-Presto were all consistent with LP-Ortho and Architect. Concordance rates between LP-Presto and LP-Ortho for the 220 frozen sera were 98.8% (219/220), and between LP-Presto and Architect were 97.6% (218/220). LP-Presto (HCVcAg cut-off value; 20 fmol/L) was 100% consistent with LP-Ortho, which found a total of 343 sera negative for HCVcAg. All 42 hyperimmunoglobulinemic sera were measurable by LP-Presto.

     In conclusion, LP-Presto shows rapid, reliable performance. Nonspecific testing results due to hyperimmunoglobulinemia were reduced by LP-Presto. LP-Presto is a high-quality HCVcAg assay that shows promise for various applications.

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  • Dimosthenis Chochlakis, Elpis Mantadakis, Stavros Thomaidis, Yannis Ts ...
    Article ID: JJID.2016.302
    Published: 2016
    [Advance publication] Released: October 31, 2016
    JOURNALS FREE ACCESS ADVANCE PUBLICATION
    This article has been retracted by the authors under the agreement between the Editor-in-Chief, Masayuki Saijo and authors.
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  • Phan Le Thanh Huong, Pham Thu Hien, Nguyen Thi Phong Lan, Tran Quang B ...
    Article ID: JJID.2015.157
    Published: 2015
    [Advance publication] Released: November 13, 2015
    JOURNALS FREE ACCESS ADVANCE PUBLICATION
    This article has been retracted by the authors under the agreement between the Editor-in-Chief, Masayuki Saijo and authors.
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