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Shin Nihonyanagi,
Yuzuru Adachi,
Tomoyo Onuki,
Nobuhiko Nakazaki,
Yasuyosi Hirata,
Kuniko Fujiki, Yoko Takayama,
Yuhsaku Kanoh,
Yuki Bandoh,
Yurika Dantsuji,
Hideaki Hanaki,
Keisuke Sunakawa
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ABSTRACT: We report herein on the isolation of three linezolid-resistant Enterococcus faecalis strains in 2011 from two pediatric inpatients at Kitasato University Hospital, Japan. Three linezolid resistant strains were isolated from two patients who shared the same room of a pediatric inpatient ward. Two linezolid resistant strains were isolated from patient A who had been treated with a total of 17,600mg of linezolid during 60 days of hospitalization (strains 1 and 2). The linezolid resistant E. faecalis persisted through the time that the patient had been discharged from the hospital. Another linezolid resistant strain was isolated from patient B who had no history of linezolid administration. The resistant strain in patient B phased out spontaneously. The minimum inhibitory concentration of linezolid in these strains ranged from 8.0 to 16.0 microg/mL. PCR amplification of the chromosomal gene encoding domain V of the 23S rRNA and subsequent nucleotide sequencing revealed that all the strains had at least one G2576T mutation. The pulse-field-gel electrophoretograms of the DNA treated with the SmaI restriction enzyme showed an identical profile suggesting that they were derived from a single resistant strain. These results suggested that the resistant strain occurred in patient A and was transmitted to patient B within the inpatient ward.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 09/2012; 86(5):555-62.
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ABSTRACT: To evaluate the epidemiology, clinical features, and microbiological features (including antibiotic susceptibility) of infective endocarditis (IE) at Kitasato University Hospital, Japan.
We retrospectively analyzed 153 patients (155 episodes) with definite IE according to the Duke criteria, who presented over a 17-year period. The minimum inhibitory concentrations of antibiotics for cultured causative microorganisms were also examined.
Viridans group streptococci were the most common pathogens (36.8%, 57 episodes), followed by Staphylococcus aureus [21.3%, 33 episodes, including 10 episodes due to methicillin-resistant S. aureus (MRSA)]. Thirty-nine of the 40 strains of viridans streptococci were fully susceptible to penicillin. Comparison of IE due to methicillin-sensitive S. aureus (MSSA) and MRSA showed that the latter had a higher mortality rate (34.8%, 8/23 vs. 70.0%, 7/10). Compared with MSSA, IE caused by MRSA was significantly more likely to be related to nosocomial infection (10/10, p < 0.001), hemodialysis (4/10, 40.0%, p = 0.005), and surgery or intravascular catheter insertion (8/10, 80.0%, p = 0.007). There was a significantly higher mortality rate in non-operated (15/43, 34.9%) than in operated (2/21, 9.5%) (p < 0.001) elderly patients. In 92/155 episodes (59.4%), antibiotics were given before blood cultures were obtained. Culture-negative IE occurred in 20.7% (19/92) of patients on antibiotics versus 6.3% (4/63) of those not on antibiotics (p = 0.02). Of 155 episodes of IE, 34 (21.9%) were fatal and staphylococcal had significantly higher mortality than streptococcal IE [(19/40, 47.5%) vs. (7/72, 9.7%); p < 0.001].
The most frequently isolated pathogens were viridans group streptococci, which differed from other recent studies. In the present study, no penicillin-resistant strains were detected and there was a higher mortality rate for IE caused by MRSA than MSSA. IE should be considered in MRSA patients with the following risk factors: nosocomial infection, hemodialysis, and surgery or intravascular catheter insertion.
Journal of the Formosan Medical Association 11/2010; 109(11):788-99. · 1.13 Impact Factor
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ABSTRACT: Two hundred thirty-one Campylobacter were isolated from acute diarrheic patients between January 2001 and December 2005. We evaluated annual changes in identified species of Campylobacter and their susceptibilities against antibiotics. Campylobacter jejuni (219 strains; 94.8%) and Campylobacter coli (12 strains; 5.2%) were identified to the species. Susceptibilities to four antimicrobial agents, minocycline (MINO), levofloxacin (LVFX), erythromycin (EM) and clindamycin (CLDM) were examined. The resistant rates of four antimicrobial agents in C. coli were significantly higher than that in C. jejuni. The susceptibility of C. jejuni to LVFX was variable, and MICs gave a bimodal distribution. The resistant rate against EM was estimated to be 9.2% in C. jejuni, 66.7% in C. coli. Moreover, young people ranging from 19 to 24 years old were predominant (47.7%) among the Campylobacter enteritis patients.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 12/2008; 82(6):638-43.
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Shin Nihonyanagi,
Susumu Obata,
Nobuhiko Nakazaki,
Makoto Hirai,
Yasuyosi Hirata, Yoko Takayama,
Shinichi Ohtani,
Yuhsaku Kanoh,
Tohru Akahoshi,
Keisuke Sunakawa,
Matsuhisa Inoue
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ABSTRACT: We report a Food-borne group A streptococcus epidemic at Kitasato University campus on July 30 and 31, 2005, believed caused by lunch. A current mass group A streptococcus infection differing from the food-borne epidemic above occurred at Kitasato University East Hospital, also believed caused by lunch. Group A streptococcus was detected using a prompt diagnostic kit and bacterial culture from 116 clinical specimens taken from 116 patients with group A streptococcus pharyngitis at Kitasato University East Hospital on August 5, 2005. To investigate the utility of immunochromatographic detection of group A streptococcus antigen, 116 clinical specimens obtained from pharyngeal membranes by swab were examined using a prompt diagnostic kit for group A streptococcus (ImmunoCard STAT! STREP A TEST) and conventional bacterial culture. Group A streptococcus positivity differed between the two methods. Fourteen patients were found to be positive by the prompt diagnostic kit and 23 by bacterial culture. Four patients showing 1.0 x 10(6) cfu/mL estimated by the culture were difficult to diagnose with the prompt diagnostic kit,even though the detection sensitivity of this kit was 1.0 x 10(6) cfu/mL or more. Conventional bacterial culture should therefore be used in addition to the prompt diagnostic kit to detect group A streptococcus, especially in pharyngeal samples obtained from patients with pharyngitis.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 08/2007; 81(4):441-8.
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ABSTRACT: A 29-year-old woman chiropractor with repeated episodes of bacteremia and positive for cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) and antiproteinase-3 (PR3) antibody had an 11-year history of asthma and repeated hospitalization. While hospitalized she developed a spiking nocturnal fever with chills and erythema of the lower leg. Her fever resolved spontaneously, but corticosteroid therapy and antibiotics did not effectively reduce her symptoms. Plain X-ray film and CT showed pulmonary changes, and lung biopsy granulomas without vasculitis. Immunological studies showed a positive PR3-ANCA (c-ANCA) test, and skin biopsy of the crural erythema showed foreign body granuloma. Multiple blood cultures were positive for several strains of bacteria, including Fusobacterium necrophurum, Mycobacterium fortuitum, and Clostridium species. When placed in a single room and monitored, she did not develop new fever or erythema. Because self-injury was assumed, she was diagnosed as having Münchausen syndrome. This is, to our knowledge, the first report of Münchausen syndrome with PR3-ANCA positivity. In patients with repeated infections, the possibility of self-injury, the development of PR3-ANCA positivity, and pulmonary granuloma with a disease profile similar to vasculitis syndrome should be considered in the definitive diagnosis.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 04/2007; 81(2):189-93.
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ABSTRACT: Despite reports of Clostridium tetani being isolated from soil in Kanazawa, Okinawa, and Tokyo, Japan, little has been studied about C. tetani distribution in other regions. We studied C. tetani in topsoil samples collected from private gardens, public road shoulders, a university campus, mountains, and fields in Sagamihara. C. tetani occurred in 8 of 35 soil samples (22.9%) and tetanus toxin in 7 of the 8 C. tetani-positive samples (87.5%). Contamination was clearly higher in soils from mountains near Tsukui-gun (Kanagawa Prefecture), Minamitsuru-gun, and Uenohara and Koshu cities (Yamanashi Prefecture) than in other regions. These findings suggest that tetanus toxin-producing strains of C. tetani tend to inhabit the topsoil of western Sagaminaha region, as a geographical feature.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 12/2006; 80(6):690-3.
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ABSTRACT: We studied whether the infectivity of Cryptosporidium parvum oocysts for suckling mice could be inactivated by copper tubing or by other types of tubing used to construct water distribution systems, including stainless steel, rigid polyvinyl chloride (PVC), PVC-lined steel, polyethylene (PE), cross-linked PE, and polybutene (PB), using glass tubing as the control. Oocysts were incubated in each tubings for 24 hours. The extent of inactivation of infectious oocysts by copper tubing was -1.303 log, which significantly inactivated of infectivity. In contrast, other types of tubing had no significant effect on some oocyst infectivity, although PB did show a maximum inactivation of -0.313 log. 25% of oocysts showed degeneration morphologically after passing through copper tubing, while 0.3% to 1.8% showed degeneration after passing through other tubing. Significant inactivation of infectious oocysts was not caused by water in which copper tubing had been let stand for 24 hours, although it had a cupric ion (Cu2+) concentration of 2.4 mg/L. The direct contact of oocysts with copper surface resulted in a decrease in the recovery percentage of oocysts and generation of hydrogen peroxide (0.5 mg/L) after 24 h of incubation. The percentage of degenerating oocysts was 29%. Such cryptosporidicidal effects of the copper surface on oocysts were completely inhibited by overlaying the surface with a Millipore filter before adding oocysts and incubating oocysts in the presence of catalase, an antioxidant enzyme. These findings suggest that copper tubing inactivates infectious C. parvum oocysts cytotoxically which may be due to oxygen radicals generated by the interaction between Cu2+ and hydrogen peroxide on the tubing surface.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 08/2006; 80(4):377-82.
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ABSTRACT: A 31-year-old Japanese man who had been in Africa for two years presented with gross hematuria. He had been swimming in Lake Malawi during this period. Urinary specimen consisted of hematuria and pyuria. Cystoscopy showed tumors resembling Bilharzial tubercles located in the trigone, left lateral and posterior wall and dome. Further urine examination demonstrated eggs of schistosome haematobium. The patient was highly suspected of having Bilharzial schistosomiasis in the urinary bladder. Transurethral resection of bladder tumors was performed for diagnosis. Pathological examination revealed granuloma with many eggs of schistosome haematobium. He was diagnosed with Bilharzial schistosomiasis and was treated with 3,600 mg of praziquantel daily for two days. There have been no signs of recurrence during the one-year follow up except for excretion of degenerated eggs of schistosome haematobium in the urine specimens.
Hinyokika kiyo. Acta urologica Japonica 05/2006; 52(4):281-3.
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ABSTRACT: Killing of Legionella pneumophila by an antimicrobial ceramic was evaluated during culture in nine kinds of hot spring water at 40 degrees C. After 24 hours, the efficacy against L. pneumophila varied, depended on water quality. The strongest antibacterial effect was seen in chloride hot spring water from Wakayama and in deionized water. In four hot spring water samples (sulfur and hydrogen carbonate springs from Fukushima, simple thermals from Mie, and radioactive spring from Tottori), the decrease was < -2 log cfu after 48 hours. These results suggest that the antimicrobial ceramic is able to eradicate Legionella from hot spring waters.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 03/2005; 79(3):157-60.
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ABSTRACT: We examined the relationship between the distribution of Legionella bacteria and various physicochemical characteristics of hot springs in Japan. Legionella bacteria were isolated from 52 (49.5%) out of 105 water samples, particularly from outdoor hot springs (67.3%). The bacterial count in the water samples positive for Legionella (86.5%) ranged from 10(1) to < 10(3) cfu/100 mL. L. pneumophila serogroup (SG) 4 (27.8%) was predominant in the water samples, followed by SG 5 (12.2%). The pulsefield gel electrophoresis (PFGE) patterns of chromosomal DNA for L. pneumophila SG 4 isolated from different parts of a hot spring resort were identical. Isolation of Legionella species from hot spring waters did not occur at pH 1.8-3.3, SO4(2-): > 780 mg/L, and H2SiO3: > 146 mg/L. The hot water-recirculating systems were applied to 18 out of 20 (90%) hot spring facilities which were found positive for Legionella. These results indicate that Legionella species are widespread in hot springs throughout Japan, except for waters with a low pH and non-recirculating waters, and that a single strain of L. pneumophila SG 4 is predominant in a particular hot spring resort.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 08/2004; 78(7):545-53.
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Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 03/2004; 78(2):138-40.
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ABSTRACT: To evaluate the efficacy of an antimicrobial ceramic for killing Legionella strains in vitro, bacteria were exposed to the ceramic soaked in PBS at 25 degrees C or 42 degrees C. The number of L. pneumophila began to decrease significantly after 4 h of exposure at 25 degrees C and reached < 10 log cfu/ml after 12 h. A similar significant decrease was also observed after exposure at 42 degrees C. Furthermore, it was found that the antimicrobial ceramic showed bactericidal activity against six strains of Legionella isolated from various water sources, including L. pneumophila (serotype 1-4), L. micdadei, and L. dumoffii, after 24 h of exposure. The antimicrobial activity against L. pneumophila of the supernatant obtained by soaking the ceramic in PBS for 24 h was also assessed. Bactericidal activity of this supernatant was also noted. Analysis of the supernatant by ICP-MS resulted in the detection of eight metals (Mg, Al, Ca, Mn, Zn, Sr, Ag, and Ba) at a maximum concentration of 2.5 mg/l. When reconstituted PBS was made with all eight metals at the same concentrations as in the supernatant, the reconstituted PBS containing Ag alone and all metals showed significantly bactericidal activity against L. pneumophila, but PBS with only one metal component except Ag or a combination of Ag with Zn and/or Ca did not. These findings suggest that the antimicrobial ceramic possesses strong bactericidal activity against Legionella species and that eight metals released from the ceramic have a synergistic bactericidal effect against Legionella. When the antimicrobial ceramic was placed in hot spring water or cooling tower water instead of PBS, the number of L. pneumophila in the water decreased to < 10 log cfu/ml after 24 h of exposure and the bactericidal activity persisted for 5 weeks. These results indicate that the antimicrobial ceramic can be used to eradicate Legionella species contaminating various water sources.
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 02/2004; 78(1):22-31.
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ABSTRACT: Vancomycin-resistant enterococci have recently emerged as significant nosocomial pathogens. Here we describe two Japanese patients, a 57-year-old man and a 12-year-old boy, with ventriculoperitoneal shunts for hydrocephalus who developed meningitis caused by vancomycin-resistant Enterococcus gallinarum. The infection of the central nervous system in these two patients may have been associated with E. gallinarum derived from the gut. Removal of the shunts and antimicrobial treatment promoted apparent improvement in these patients. The risk factors and management of vancomycin-resistant enterococcal infections in the central nervous system are discussed.
Journal of Infection and Chemotherapy 01/2004; 9(4):348-50. · 1.80 Impact Factor
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ABSTRACT: The influence of the pretreatment of Pseudomonas aeruginosa strain O1 (PAO-1) with a sub-minimum inhibitory concentration (MIC) of imipenem on bactericidal activity, phagocytosis, the production of oxygen radical intermediates, and the induction of apoptosis in murine peritoneal neutrophils, as well as the catalase activity in the bacteria in comparison with that of ceftazidime-treated bacteria were studied. Bacteria treated with imipenem at (1/4) MIC were killed at significantly higher rates by neutrophils than ceftazidime-treated and nontreated bacteria. However, antibiotic-treated bacteria showed similar numbers of bacteria-phagocytized neutrophils to those in untreated bacteria. Imipenem pretreatment of bacteria led to an increase in the production of oxygen radical intermediates by neutrophils and the inhibition of neutrophilic apoptosis following incubation, whereas these features did not occur in neutrophils incubated with nontreated and ceftazidime-treated bacteria. The catalase activity of bacteria was not suppressed by pretreatment with either antibiotic at (1/4) MIC. These findings suggest that the exposure of P. aeruginosa to a sub-MIC of imipenem enhances the susceptibility of the bacteria to neutrophilic killing and effectively modifies the physiological activities of neutrophils, but does not decrease bacterial catalase activity. These actions may account for the postantibiotic leukocyte enhancement (PALE) effect of a sub-MIC of imipenem in the host.
Journal of Infection and Chemotherapy 01/2004; 9(4):297-303. · 1.80 Impact Factor
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ABSTRACT: A patient with infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) was treated with vancomycin (VAN). VAN was ineffective, although therapeutic drug monitoring (TDM) indicated that the recommended trough level was maintained. Five MRSA isolates obtained at various times were analyzed to determine the minimum inhibitory concentration (MIC) and were subjected to population analysis, simulation analysis pulsed-field gel electrophoresis (PFGE). MRSA susceptible to VAN was isolated before and during the early stage of treatment, while an MRSA strain showing reduced VAN MIC was isolated during treatment. Simulation analysis indicated that the viable bacterial count only decreased to 10(-3) to 10(-4) cells after 72 h of incubation. The five MRSA strains isolated at various times were identical by PFGE.
International Journal of Antimicrobial Agents 01/2004; 22(6):567-73. · 4.13 Impact Factor
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ABSTRACT: Using a neonatal mouse model of Cryptosporidium parvum infection, we investigated whether apoptosis of epithelial cells was induced in the small intestine. At the time when the number of C. parvum oocysts in the ileum was maximal, columnar goblet cells and absorptive cells showed a decrease in the ileal epithelium that was accompanied by a significant reduction in the height of the villi. A few apoptotic epithelial cells were also observed in the vicinity of the basal crypts where C. parvum was proliferating. Morphological changes of the villous structure and apoptotic epithelial cells associated with proliferation of the parasite were scarcely detected in the duodenum, cecum, and colon of the infected mice. These findings suggest that the loss of absorptive cells and goblet cells, and the apoptosis of intestinal epithelial cells, are common events in the ileum after C. parvum infection, and that epithelial apoptosis may have a significant role in the pathogenesis of cryptosporidiosis.
Journal of Infection and Chemotherapy 10/2003; 9(3):278-81. · 1.80 Impact Factor
