Publications (33)108.09 Total impact
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Article: [Helicobacter pylori eradication therapy in children].
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ABSTRACT: Proton pump inhibitor-based triple therapies are performed worldwide for Helicobacter pylori-associated diseases in childhood. As the first-line therapy, the Japanese Pediatric Guideline in H. pylori Infection has recommended a triple regimen with amoxicillin and clarithromycin, because the Japanese national health care insurance system has permitted only this regimen. However, the primary resistance to clarithromycin in Japan is demonstrated in around 30% of the strains, leaving an urgent issue for the physicians. A triple regimen with amoxicillin and metronidazole is acceptable as the second-line therapy. In children with chronic H. pylori gastritis, eradication should be considered if they have gastric atrophy or a family history of gastric cancer. In children, however, a 'test and treat' strategy to prevent gastric cancer is not recommended.Nippon rinsho. Japanese journal of clinical medicine 12/2009; 67(12):2311-6. -
Article: Primary antimicrobial resistance of Helicobacter pylori in children during the past 9 years.
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ABSTRACT: Antimicrobial resistance of Helicobacter pylori is a growing problem in clinical practice, particularly clarithromycin resistance. The aim of the present study was therefore to investigate the prevalence of H. pylori resistance to antimicrobial agents in Japanese children. A total of 61 H. pylori strains isolated from children (mean age, 12.6 years; range, 4-18 years) between 1999 and 2007 were studied for primary antimicrobial resistance, using a microdilution method. In addition, the eradication rate with lansoprazole-based triple regimens was determined. The overall resistance rate of clarithromycin, amoxicillin and metronidazole was 36.1%, 0% and 14.8%, respectively. Resistance to both clarithromycin and metronidazole was detected in 6.6% of the strains. The rate of clarithromycin-resistant strains was 32.4% from 1999 to 2002 and 40.7% from 2003 to 2007, and clarithromycin minimum inhibitory concentration at which 90% of the isolates were inhibited (MIC(90)) increased fourfold from 1999-2002 to 2003-2007, with all clarithromycin-resistant strains showing low-level resistance. Metronidazole resistance rates were not different between these two study periods. Regimens involving amoxicillin and clarithromycin (n= 49) had a higher eradication rate in clarithromycin-susceptible strains (97.1%) than in the resistant strains (57.1%; P < 0.001). There was no difference in the eradication rate between 7 day and 10 or 14 day courses of the regimens (P= 0.53). The regimen with amoxicillin and metronidazole produced successful eradication in all nine patients with clarithromycin-resistant strains. Clarithromycin resistance of H. pylori is high, and triple regimen treatment containing clarithromycin should be decided based on susceptibility to the agent.Pediatrics International 07/2009; 52(2):187-90. · 0.63 Impact Factor -
Article: A global, evidence-based consensus on the definition of gastroesophageal reflux disease in the pediatric population.
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ABSTRACT: To develop an international consensus on the definition of gastroesophageal reflux disease (GERD) in the pediatric population. Using the Delphi process, a set of statements was developed and voted on by an international panel of eight pediatric gastroenterologists. Statements were based on systematic literature searches using Medline, EMBASE, and CINAHL. Voting was conducted using a six-point scale, with consensus defined, a priori, as agreed by 75% of the group. The strength of each statement was assessed using the GRADE system. There were four rounds of voting. In the final vote, consensus was reached on 98% of the 59 statements. In this vote, 95% of the statements were accepted by seven of eight voters. Consensus items of particular note were: (i) GERD is present when reflux of gastric contents causes troublesome symptoms and/or complications, but this definition is complicated by unreliable reporting of symptoms in children under the age of approximately 8 years; (ii) histology has limited use in establishing or excluding a diagnosis of GERD; its primary role is to exclude other conditions; (iii) Barrett's esophagus should be defined as esophageal metaplasia that is intestinal metaplasia positive or negative; and (iv) extraesophageal conditions may be associated with GERD, but for most of these conditions causality remains to be established. The consensus statements that comprise the Definition of GERD in the Pediatric Population were developed through a rigorous process. These statements are intended to be used for the development of future clinical practice guidelines and as a basis for clinical trials.The American Journal of Gastroenterology 05/2009; 104(5):1278-95; quiz 1296. · 7.28 Impact Factor -
Article: When does gastric atrophy develop in Japanese children?
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ABSTRACT: Long-term Helicobacter pylori infection causes inflammatory sequelae such as atrophy and intestinal metaplasia in the stomach, which is thought to increase the risk of developing gastric malignancy. We previously reported that gastric atrophy can develop in Japanese children with H. pylori infection, predominantly in the antrum. However, detailed data about the age of children with atrophy are largely lacking. In the present study, 131 children (79 boys) with H. pylori infection were re-analyzed for an association between age and the grade of gastric atrophy. The gastric antrum was histologically evaluated in all 131 patients and the corpus in 46 patients. Grade 2 and 3 antral atrophy was observed in 13 and one patients, respectively: the mean age was 12.1 years. Two patients (11 and 14 years old) had grade 2 corpus atrophy but no patients had grade 3. No significant difference was found in age among patients with grade 0, 1 and 2 or 3 atrophy in the antrum (p = .97) and in the corpus (p = .59). None of the patients with grade 2 or 3 atrophy had intestinal metaplasia either in the antrum or in the corpus. The results of the present study require a careful interpretation because of the retrospective analysis. In high-risk countries of gastric cancer, however, eradicating H. pylori in childhood could prove more effective in preventing gastric atrophy, ultimately, the development of cancer.Helicobacter 09/2008; 13(4):278-81. · 3.15 Impact Factor -
Article: Water source as a Helicobacter pylori transmission route: a 3-year follow-up study of Japanese children living in a unique district.
Journal of Medical Microbiology 08/2008; 57(Pt 7):909-10. · 2.50 Impact Factor -
Article: Non-Helicobacter bacterial flora rarely develops in the gastric mucosal layer of children.
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ABSTRACT: Non-Helicobacter bacteria can be cultured from the gastric mucosa in adults but in children, there are no studies about such microflora. The purpose of this study, therefore, was to clarify whether gastric biota develops in children. In 10 children and 10 adults or elderly (5 H. pylori-infected and 5 uninfected in each group), biopsy specimens of the gastric antrum and corpus and gastric juice were studied for bacterial examinations and the data were compared between both age groups in relation to H. pylori status and luminal pH. Bacterial genera and species were analyzed using both culture and real-time polymerase chain reaction (PCR) with the 52 genus- and species-specific primer sets. Non-Helicobacter bacteria in the mucosa were cultured from all adult patients, whereas microorganisms were cultured in only one child (p < .001). Gastric pH was lower in children (median, 1.4) than in adults (median, 2.6) (p < .005). The grade of endoscopic gastric atrophy was moderate or severe in 8 adults, but absent or mild in all 10 children. Among adults, there was a significant positive correlation between gastric pH and total bacterial counts of both the mucosa and juice. These data indicate that impaired gastric acid secretion associated with long-term H. pylori infection enables non-Helicobacter bacteria to colonize in the human stomach. Such microorganisms rarely colonize in the gastric mucosa in children regardless of H. pylori status.Digestive Diseases and Sciences 05/2006; 51(4):641-6. · 2.12 Impact Factor -
Article: Conditioned medium from enterohemorrhagic Escherichia coli-infected T84 cells inhibits signal transducer and activator of transcription 1 activation by gamma interferon.
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ABSTRACT: Gamma interferon (IFN-gamma) is a cytokine important to host defense which can signal through signal transducer and activator of transcription 1 (Stat1). Enterohemorrhagic Escherichia coli (EHEC) modulates host cell signal transduction to establish infection, and EHEC serotypes O113:H21 and O157:H7 both inhibit IFN-gamma-induced Stat1 tyrosine phosphorylation in vitro. The aim of this study was to delineate both bacterial and host cell factors involved in the inhibition of Stat1 tyrosine phosphorylation. Human T84 colonic epithelial cells were challenged with direct infection, viable EHEC separated from T84 cells by a filter, sodium orthovanadate, isolated flagellin, bacterial culture supernatants, and conditioned medium treated with proteinase K, trypsin, or heat inactivation. Epithelial cells were then stimulated with IFN-gamma and protein extracts were analyzed by immunoblotting. The data showed that IFN-gamma-inducible Stat1 tyrosine phosphorylation was inhibited when EHEC adhered to T84 cells, but not by bacterial culture supernatants or bacteria separated from the epithelial monolayer. Conditioned medium from T84 cells infected with EHEC O157:H7 suppressed Stat1 activation, and this was not reversed by treatment with proteinases or heat inactivation. Use of pharmacological inhibitors showed that time-dependent bacterial, but not epithelial, protein synthesis was involved. Stat1 inhibition was also independent of bacterial flagellin, host proteasome activity, and protein tyrosine phosphatases. Infection led to altered IFN-gamma receptor domain 1 subcellular distribution and decreased expression in cholesterol-enriched membrane microdomains. Thus, suppression of host cell IFN-gamma signaling by production of a contact-dependent, soluble EHEC factor may represent a novel mechanism for this pathogen to evade the host immune system.Infection and Immunity 04/2006; 74(3):1809-18. · 4.16 Impact Factor -
Article: Association between gastric atrophy and Helicobacter pylori infection in Japanese children: a retrospective multicenter study.
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ABSTRACT: The purpose of this study was to determine whether Helicobacter pylori infection and mucosal inflammation result in gastric atrophy in Japanese children. A total of 196 patients ages 1-16 years were retrospectively studied: 131 patients were infected with H. pylori and 65 patients were uninfected. Antral (n = 196) and corpus biopsy specimens (n = 70) were investigated based on the Updated Sydney system. In both the antrum and corpus, H. pylori-infected patients showed significantly higher degrees of inflammation and activity of gastritis, compared with noninfected patients. The prevalence of grade 2 or 3 atrophy in the antrum was 10.7% in H. pylori-infected patients and 0% in the noninfected patients (P < .01) and in corpus 4.3% and 0%, respectively (P = .20). The frequency of intestinal metaplasia in the 2 study groups was 4.6% and 4.6% in the antrum and 0% and 4.2% in the corpus, respectively. Among H. pylori-infected patients, the antrum showed significantly higher degrees of H. pylori density, inflammation and activity of gastritis, and atrophy than the corpus. In the antrum, atrophy was significantly correlated with activity, whereas in the corpus, atrophy correlated with H. pylori density, inflammation, and activity. H. pylori-induced gastric inflammation can cause atrophy in Japanese children, predominantly in the antrum. It remains to be determined whether H. pylori-infected children with gastric atrophy are at increased risk for gastric cancer.Digestive Diseases and Sciences 02/2006; 51(1):99-104. · 2.12 Impact Factor -
Article: In vitro activity of tetracyclines against Helicobacter pylori isolates from Japanese children.
The Pediatric Infectious Disease Journal 08/2005; 24(7):660. · 3.58 Impact Factor -
Article: What is new related to Helicobacter pylori infection in children and teenagers?
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ABSTRACT: Helicobacter pylori infection is a common bacterial infection for humans, and the organism is the most prevalent gastric microbial pathogen. However, the major route of transmission remains poorly understood. The outcome of chronic H pylori infection varies from asymptomatic gastritis to peptic ulceration and gastric malignancies. Recently, H pylori has been associated with the development of extradigestive disorders, including refractory iron-deficiency (sideropenic) anemia and chronic autoimmune thrombocytopenic purpura. Virulence factors of H pylori and host genetic factors are both considered important determinants of disease outcome. Multiple tests, including novel noninvasive approaches, are available for establishing the presence of H pylori infection, but there is still little consensus about which study should be performed and in what clinical setting. Eradicating H pylori uses combination therapy, including a proton pump inhibitor and 2 antibiotics taken twice daily for 7 to 14 days. Antibiotic resistance is a growing and serious problem that interferes with the success of eradication therapy. Testing and eradication therapy for H pylori are currently recommended only for the subset of infected persons in whom the disease sequelae are proven or highly suspected.Archives of Pediatrics and Adolescent Medicine 06/2005; 159(5):415-21. · 4.14 Impact Factor -
Article: Gastric epithelial cell turnover and mucosal protection in Japanese children with Helicobacter pylori infection.
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ABSTRACT: In adults, epithelial cell proliferation and apoptosis of the gastric mucosa are induced by Helicobacter pylori infection and are associated with gastric atrophy or gastric carcinoma. In children, there are few studies about such epithelial changes. To elucidate the role of H. pylori infection in gastric mucosal inflammation, we immunohistochemically examined gastric mucosa of Japanese children. Biopsy specimens obtained from the gastric antrum and corpus of H. pylori-infected (n = 13) and noninfected children (n = 15) were studied for immunolocalization of Ki-67, single-strand DNA, manganese superoxide dismutase (Mn-SOD), and CD68, and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling. In 10 patients with successful eradication, pre- and posttreatment results were compared. In both gastric antrum and corpus, neutrophil and mononuclear cell infiltration, epithelial cell proliferation, and apoptosis significantly increased in H. pylori-infected patients, predominantly in the antrum. In the antrum of H. pylori-infected patients, there was positive correlation between the degrees of neutrophil infiltration and cell proliferation (P < 0.05) or apoptosis (P < 0.05). H. pylori eradication improved mucosal inflammation, cell proliferation (P < 0.001), and apoptosis (P < 0.01) in the antrum. Mn-SOD immunoreactivity and CD68-positive macrophages in the antrum, which significantly increased in H. pylori-infected patients, decreased after the eradication. H. pylori infection induced gastric mucosal inflammation and epithelial cell turnover in children. Moreover, gastric mucosal defense mechanism against H. pylori infection was activated. H. pylori eradication in childhood might prevent the accumulation of gastric epithelial cell damage.Journal of Gastroenterology 03/2005; 40(3):236-46. · 4.16 Impact Factor -
Article: Helicobacter heilmannii infection in a child after successful eradication of Helicobacter pylori: case report and review of literature.
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ABSTRACT: An 11-year-old boy with Helicobacter pylori-associated duodenal ulcer was successfully treated with a combination of lansoprazole, amoxicillin, and clarithromycin. Endoscopy and gastric biopsies were repeated 2 and 12 months later, showing ulcer healing and eradication of H. pylori. However, a 3-year follow-up study demonstrated H. heilmannii in the antral mucosa based on its characteristic morphology and positive urease test and negative culture. The patient had no contact with domestic animals such as cats and dogs. A 7-day course with lansoprazole, amoxicillin, and clarithromycin was performed again, resulting in successful eradication of the organism. Pediatric cases with H. heilmannii infection reported are reviewed.Journal of Gastroenterology 02/2005; 40(1):94-7. · 4.16 Impact Factor -
Article: Multicenter comparison of rapid lateral flow stool antigen immunoassay and stool antigen enzyme immunoassay for the diagnosis of Helicobacter pylori infection in children.
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ABSTRACT: The stool antigen enzyme immunoassay (EIA) methods are widely used for diagnosing Helicobacter pylori infection. Recently, a novel, rapid stool antigen test, the lateral flow immunoassay (LFI) method, has been developed. The primary purpose of this study was to compare the EIA method with the LFI method for the diagnosis of H. pylori infection in children. Stool specimens from children being evaluated for H. pylori infection were also examined using the LFI (ImmunoCard STAT! HpSA) and EIA methods (Premier Platinum HpSA). The sensitivity, specificity and accuracy of the test were based on the 13C-labeled urea breath test. One hundred and eighty-two children and adolescents, 3-17 years of age (mean 9.2 years), were studied. In addition, 29 patients who received eradication therapy were re-evaluated 2 or 3 months post-treatment. The 13C-labeled urea breath test was positive in 64 patients (35.2%). The sensitivity, specificity and accuracy of the LFI method were 90.6% (95% CI = 80.7-96.5%), 95.8% (92.1-99.4%), and 94.0% (90.5-97.4%), respectively and for the EIA method, sensitivity, specificity and accuracy were 96.8% (95% CI, 89.0-99.6%) and 99.2% (97.5-100%), and 98.3% (96.5-100%), respectively. There were no significant differences in results among the age groups 3-5, 6-10 and 11-17 years. As for the assessment of H. pylori eradication, the results of the LFI and EIA methods agreed with those of 13C-urea breath test in 27/29 and 29/29 patients, respectively. The LFI stool antigen method showed a good sensitivity, specificity and accuracy for diagnosing H. pylori infection in children. This novel method may be useful in clinical practice as an office-based test because it is rapid, reliable and easy to perform.Helicobacter 01/2005; 9(6):669-73. · 3.15 Impact Factor -
Article: Comparison between the 13C-urea breath test and stool antigen test for the diagnosis of childhood Helicobacter pylori infection.
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ABSTRACT: As noninvasive tests for Helicobacter pylori infection, the 13C-urea breath test (UBT) and stool antigen test have been widely used. In children, however, there are few studies reporting which test shows superior performance. The purpose of this study was to compare the 13C-UBT and stool antigen test for their accuracy in diagnosing H. pylori infection in children. A total of 123 Japanese children, ages 2 to 17 years (mean, 12 years) who underwent gastric biopsies for H. pylori infection were studied. The diagnoses included gastritis (n = 55), gastric ulcer (n = 5), duodenal ulcer (n = 20), iron-deficiency anemia (n = 7), and other conditions (n = 36). The cutoff value of the 13C-UBT was defined to be 3.5 per thousand. The stool antigen test was performed using the HpSA enzyme-linked immunosorbent assay (ELISA) (Premier Platinum HpSA). In 16 patients who received eradication therapy, the 13C-UBT and HpSA were repeated 2 months after treatment. Based on biopsy tests, 60 children were infected with H. pylori and 63 children were not. For the 13C-UBT, the sensitivity, specificity, and accuracy were 95.0% (95% confidence interval [CI], 86.1%-99.0%), 98.4% (95% CI, 91.5%-100%), and 96.4% (95% CI, 93.6%-99.9%), respectively. For the HpSA, the sensitivity, specificity, and accuracy were 98.3% (95% CI, 90.8%-100%), 98.4% (95% CI, 91.2%-100%), and 98.3% (95% CI, 96.0%-100%), respectively. There were no significant differences between the performance of these two tests. In the assessment of H. pylori eradication, the results of 13C-UBT and HpSA agreed with those of biopsy tests. The 13C-UBT and the HpSA are equally accurate for the diagnosis of active H. pylori infection in Japanese children.Journal of Gastroenterology 12/2004; 39(11):1045-50. · 4.16 Impact Factor -
Article: Detection of Helicobacter pylori in the stools of newborn infants.
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ABSTRACT: To investigate the transmission route of Helicobacter pylori, stool specimens of 50 infants 3 days old were studied by a stool antigen immunoassay and polymerase chain reaction (PCR). By PCR, H. pylori DNA was detected in 15 neonates (30%). The stool antigen test was positive in only 1 neonate with a positive PCR. The detection rate of H. pylori DNA in neonates was significantly higher for those with mothers having urines positive for anti-H. pylori IgG antibody (60%) than for those mothers with negative urines (17%) (P < 0.01). A follow-up study was done 24 months later on 8 of the 15 infants with positive PCR results, including the infant with a positive stool antigen test. All infants were negative by both PCR and stool antigen test.The Pediatric Infectious Disease Journal 11/2004; 23(11):1055-6. · 3.58 Impact Factor -
Article: In vitro activity of fluoroquinolone and the gyrA gene mutation in Helicobacter pylori strains isolated from children.
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ABSTRACT: Resistance to antibiotics, especially clarithromycin, is the major cause of the failure to eradicate Helicobacter pylori. There are few studies in children concerning fluoroquinolone activity against H. pylori. Primary resistance to antibiotics including fluoroquinolones was studied in 55 H. pylori strains isolated from Japanese children. DNA sequences of the gyrA gene in fluoroquinolone-resistant strains were determined. Twelve strains (21.8%) were resistant to clarithromycin and three (5.5%) were resistant to both levofloxacin and ciprofloxacin. Out of 12 clarithromycin-resistant strains, 11 (91.7%) were susceptible to levofloxacin and ciprofloxacin. Sequence analysis in three fluoroquinolone-resistant strains showed point mutations of the gyrA gene at G271A, G271T and A272G, indicating mutations of the codon Asp91 in the fluoroquinolone-resistance-determining region of the DNA gyrase. The results suggest that fluoroquinolones should be considered as an option for second- or third-line H. pylori eradication therapy in children.Journal of Medical Microbiology 11/2004; 53(Pt 10):1019-22. · 2.50 Impact Factor -
Article: The prevalence of Helicobacter pylori in Japanese children with gastritis or peptic ulcer disease.
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ABSTRACT: Although Helicobacter pylori infection is typically acquired in childhood, the role of H. pylori infection in gastroduodenal diseases in childhood remains to be defined. The purpose of this study was to evaluate the prevalence of H. pylori infection in children with gastritis, duodenal ulcer, and gastric ulcer. This was a retrospective analysis of 283 Japanese children (mean age, 11.5 years) with non-nodular gastritis ( n = 73), nodular gastritis ( n = 67), duodenal ulcer ( n = 100), and gastric ulcer ( n = 43). H. pylori status was based on biopsy tests. Clinical symptoms at the time of endoscopy were analyzed with regard to a possible association with the infection. The prevalence of H. pylori in non-nodular gastritis, nodular gastritis, duodenal ulcer, and gastric ulcer was 28.8%, 98.5%, 83.0%, and 44.2%, respectively. H. pylori was significantly linked to duodenal ulcer and gastric ulcers in the age group of 10-16 years, but not in the age group of 9 years and under. In children with H. pylori infection, nodular gastritis was observed in 26.3% of gastric ulcer patients and in 74.7% of duodenal ulcer patients ( P < 0.001). H. pylori infection was significantly associated with the prevalence of anemia ( P < 0.05). H. pylori is the most important causal factor for the development of duodenal ulcer in childhood. While H. pylori infection appears to be a risk factor in gastric ulcer, other causes are responsible for most cases. Nodular gastritis is the most common type of H. pylori gastritis in childhood. Chronic infection with H. pylori is associated with anemia.Journal of Gastroenterology 09/2004; 39(8):734-8. · 4.16 Impact Factor -
Article: Results of triple eradication therapy in Japanese children: a retrospective multicenter study.
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ABSTRACT: Large-scale clinical trials in children are lacking concerning Helicobacter pylori eradication therapies. The purpose of this study was to assess the efficacy of proton pump inhibitor (PPI)-based triple therapies in Japanese children. This was a retrospective analysis of the first- and second-line PPI-based triple therapies from pediatric gastrointestinal units between 1996 and 2003. Data collected included doses and duration of regimens, drug compliance, success or failure of eradication, ulcer healing, and symptom response of those with dyspepsia and no ulcers. The results of antibiotic susceptibility tests were also reported in cases where these were performed. A total of 149 pediatric patients (mean age, 12.6 years) were studied, including 123 patients who received first-line therapy: 115 received a PPI plus amoxicillin and clarithromycin (PAC) and 8 received a PPI plus amoxicillin and metronidazole (PAM). Overall eradication rates of the first-line PAC and PAM therapies were 77.4% and 87.5%, respectively ( P = 0.68). All 14 patients with failed PAC therapy received the second-line PAM regimen, resulting in an eradication rate of 100%. Mild side effects were reported only in PAC regimens (13.8%). Primary resistance to amoxicillin, clarithromycin, and metronidazole was detected in 0%, 34.7%, and 12.5% of the strains, respectively. The PAC regimen showed a high eradication rate for clarithromycin-susceptible strains (91.7%), but was relatively ineffective for resistant strains (40.0%) ( P < 0.01). Eradication of H. pylori was associated with ulcer healing and symptomatic improvement among those with gastritis only (both; P < 0.001). Among 17 patients with iron-deficiency anemia, post-treatment hemoglobin levels were higher than the pretreatment levels ( P < 0.001). The PAC regimen is effective in children. Clarithromycin resistance is associated with eradication failure. Metronidazole is a good substitute for clarithromycin as the second-line option for children.Journal of Gastroenterology 09/2004; 39(9):838-43. · 4.16 Impact Factor -
Article: In vitro exposure to macrolide antibiotics in Helicobacter pylori strains isolated from children.
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ABSTRACT: Clarithromycin resistance of Helicobacter pylori is a serious problem in eradication therapy. We investigated whether the use of maclorides (clarithromycin, erythromycin, and azithromycin) induces clarithromycin resistance in the organism. Twenty H. pylori strains were isolated from pediatric patients with gastrointestinal symptoms. The minimum inhibitory concentrations (MICs) of each macrolide antibiotic were determined by the Etest. Among these, 17 strains susceptible to macrolide antibiotics were used for the in vitro induction of drug resistance. In each of these 17 strains of H. pylori, 30-day exposure to clarithromycin in experiments for in vitro induction did not change the MIC of any antibiotic, nor did it induce either the A2143G or the A2144G mutation in the 23S rRNA gene. These results suggest that the use of macrolide antibiotics does not induce clarithromycin resistance in H. pylori by 23S rRNA gene mutation.Journal of Infection and Chemotherapy 05/2004; 10(2):128-30. · 1.80 Impact Factor -
Article: Survey of methicillin-resistant Staphylococcus aureus from neonates and the environment in the NICU.
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ABSTRACT: Methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor of nosocomial infection with compromised hosts including neonates. Currently, the prevalence of MRSA carriers among children is increasing in Japan. There are some reports of nosocomial infection caused by MRSA in a pediatric ward or neonatal intensive care unit (NICU). During 6 months (from January 2001 to June 2001), 37 MRSA strains were isolated from 37 neonates who were admitted in the NICU and 52 MRSA were strains isolated from NICU environments. We performed DNA typing of MRSA using an arbitrary primed-PCR method on these isolates. Thirty-seven clinical isolates were classified into four types (A type, 14; B type, 4; C type, 4; D type, 3; and others, 12). The A-type strains of MRSA continued to be isolated for more than 6 months. In the NICU environment, the detection rate of the A-type MRSA was 23.1% (12/52). The A-type strains were frequently isolated from environments around patients. The A-type strains of MRSA were prevalent in the NICU, probably due to nosocomial infection. Although none of the neonatal patients developed severe MRSA infection, the same genotype strains were persistently isolated during a period of more than 6 months from patients and the NICU environment around patients. Environmental control around neonatal patients is important to prevent nosocomial infection in the NICU.Journal of Infection and Chemotherapy 05/2004; 10(2):131-2. · 1.80 Impact Factor
Top co-authors
Top Journals
Institutions
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2008
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Hoshigaoka Koseinenkin Hospital
Hirakata, Osaka-fu, Japan
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2002–2008
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Tohoku University
- • Institute of Development, Aging and Cancer
- • Department of Pediatrics
Sendai-shi, Miyagi-ken, Japan
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2005
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SickKids
- Department of Paediatrics
Toronto, Ontario, Canada
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2002–2004
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Miyagi University
Masaki-chō, Ehime, Japan
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1996
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Sendai City Hospital
Sendai, Kagoshima-ken, Japan
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