Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for clinical microbiology in 2014: General view of the pathogens' antibacterial susceptibility

The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from the patients in Japan was conducted by Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2014. The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period between January 2014 and April 2015 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical Laboratory Standards Institute. Susceptibility testing was evaluated in 1534 strains (335 Staphylococcus aureus, 264 Streptococcus pneumoniae, 29 Streptococcus pyogenes, 281 Haemophilus influenzae, 164 Moraxella catarrhalis, 207 Klebsiella pneumoniae, and 254 Pseudomonas aeruginosa). Ratio of methicillin-resistant S. aureus was 43.6%, and those of penicillin-susceptible S. pneumoniae was 100%. Among H. influenzae, 8.2% of them were found to be β-lactamase-producing ampicillin-resistant strains, and 49.1% to be β-lactamase-non-producing ampicillin-resistant strains. Extended spectrum β-lactamase-producing K. pneumoniae and multi-drug resistant P. aeruginosa with metallo β-lactamase were 9.2% and 0.4%, respectively.

[A survey of perioperative asthmatic attack among patients with bronchial asthma underwent general anesthesia]

BACKGROUND

We investigated the risk factor of perioperative asthmatic attack and effectiveness of preventing treatment for asthmatic attack before operation.

METHODS

We performed retrospective chart review of one hundred eleven patients with asthma underwent general anesthesia and surgical intervention from January 2006 to October 2007 in our hospital.

RESULTS

The rate of perioperative asthmatic attack were as follows; 10.2% (5 in 49 cases) in no pretreatment group, 7.5% (3 in 40 cases) in any pretreatments except for systemic steroid, and 4.5% (1 in 22 cases) in systemic steroid pretreatment group. Neither preoperative asthma severity nor duration from the last attack had significant relevancy to perioperative attack rate. The otolaryngological surgery, especially those have nasal polyp and oral surgery had high perioperative asthma attack rate, although there was no significant difference.

CONCLUSION

We recommend the systemic steroid pretreatment for asthmatic patients, especially when they have known risk factor such as administration of the systemic steroid within 6 months, or possibly new risk factor such as nasal polyp, otolaryngological and oral surgery.

Experience with injections of botulinum toxin type A into the detrusor muscle

INTRODUCTION

We evaluated the effects of intra-vesical injection of botulinum toxin type A in the detrusor muscle in patients with neurogenic overactive bladder (OAB), patients with non-neurogenic overactive bladder and patients with interstitial cystitis.

MATERIALS AND METHODS

Between January 2003 and December 2006 we treated 30 patients with 100 I. U. to 300 I. U. of botulinum toxin A in the detrusor muscle. Patients were clinically and urodynamically followed up for 4, 12 and 36 weeks thereafter.

RESULTS

Neurogenic overactive bladder: of the 19 injected doses, 18 (94.7%) in 7 patients were judged as effective, and 1 (5.2%) of 200 U of BTX-A was judged as ineffective. Mean bladder volume increased from 137 to 396 ml. Non-neurogenic overactive bladder: of 7 injections, 6 (85.7%) were judged effective in 5 patients. Mean bladder volume increased from 149 to 322 ml. Interstitial cystitis: in all 4 patients the treatments were deemed ineffective.

CONCLUSIONS

Injecting 300 units of BTX-A into 30 sites in the muscle located in the body of the bladder region is effective for neurogenic bladder patients with intermittent catheterization who have urge and reflective types of incontinence. Injections of 100 and 200 units of BTX-A to treat non-neurogenic overactive bladder with urinary incontinence provided together without retention. The optimal dose of BTX-A requires further investigation. Injection with 200 units of BTX-A was not useful against interstitial cystitis. None of the patients developed any adverse effects after injecting the bladder wall with BTX-A.

[Molecular epidemiological analysis of Pseudomonas aeruginosa by pulsed-field gel electrophoresis]

In order to see the nosocomial infection by Pseudomonas aeruginosa (P. aeruginosa) in the Akita University Hospital, we analyzed the serotype and genotype for 150 strains isolated from various clinical specimens from 1994 to 1996. One hundred strains chosen at random were divided into 11 serotypes by serotyping and into 50 genotypes by pulsed-field gel electrophoresis of Spe I-digested P. aeruginosa genomic DNAs. Serotype E strains, most common, gave 17 genome patterns. Fifty strains separated periodically in certain wards had further 7 genome patterns. The strains isolated from one patient with different times or with different serotypes showed the same stable genotype. Genome patterns were inconsistent with susceptibility to antimicrobial agents. Both drug-susceptible and -resistant strains were found in strains with the same genome pattern. The genome pattern was identical, even though the susceptibility was different due to isolation time or storage. This suggested that the multidrug-resistant strains of P. aeruginosa expanded in the hospital were not derived from one original strain.

Cross reactivity of Mycoplasma pulmonis and Mycoplasma arthritidis antigen strains to anti-Mycoplasma pulmonis antibody in the sera of Mycoplasma pulmonis infected rats

Reactivity of Mycoplasma pulmonis (Mp) antigen strains to anti-Mp antibody in the sera of Mp infected rats was examined by enzyme linked immunosorbent assay (ELISA). Antibody titers to 7 kinds of Mp antigens were measured in the sera of 20 Mp isolated rats and 20 Mp free rats by ELISA and complement fixation test (CF test). ELISA showed that there was no difference in the antibody titer of the same serum among 7 Mp antigen strains employed, and the main cross reaction to anti-Mp antibody took place on the common recognition site (common antigen) in all the Mp antigens. The CF test suggested that the antibody titers largely differed due to the kind of Mp antigen strains, and the detection rate was between 0 and 60%, presumably due to the difference in the reactivity or binding ability of complements but not due to the difference in the cross reactivity of Mp antigen to anti-Mp antibody. When the cross reactivity of anti-Mp antibody to Mycoplasma arthritidis (Ma) antigen was examined in the sera of 33 Mp isolated rats, the CF test exhibited the negative results, but ELISA showed 4 positive cases to support the cross reactivity of anti-Mp antibody to Ma antigen.