Molecular and Clinical Epidemiology of Paratyphi A Isolated from Patients with Bacteremia in Nepal.

Little is known about the epidemiology of typhoid and paratyphoid fever in Nepal. We aimed to elucidate the molecular and clinical epidemiology of Paratyphi A in Nepal. Isolates were collected from 23 cases of bacteremia due to Paratyphi A between December 2014 and October 2015.

Impact of rapid identification of positive blood cultures using the Verigene system on antibiotic prescriptions: A prospective study of community-onset bacteremia in a tertiary hospital in Japan.

Background: Rapid identification of positive blood cultures is important for initiation of optimal treatment in septic patients. Effects of automated, microarray-based rapid identification systems on antibiotic prescription against community-onset bacteremia (COB) remain unclear.

Methods: We prospectively enrolled 177 patients with 185 COB episodes (occurring within 72 h of admission) over 17 months.

Correction for Miyoshi-Akiyama et al., "Comparative Genome Analysis of Extended-Spectrum-β-Lactamase-Producing Sequence Type 131 Strains from Nepal and Japan".

[This corrects the article DOI: 10.1128/mSphere.00289-16.

Successful treatment of recurrent bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy.

Introduction: is an enterohepatic species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for infection.

Case Presentation: bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer.

Comparative Genome Analysis of Extended-Spectrum-β-Lactamase-Producing Sequence Type 131 Strains from Nepal and Japan.

The global spread of extended-spectrum-β-lactamase (ESBL)-producing (ESBL-) has largely been driven by the pandemic sequence type 131 (ST131). This study aimed to determine the molecular epidemiology of their spread in two Asian countries with contrasting prevalence. We conducted whole-genome sequencing (WGS) of ESBL- ST131 strains collected prospectively from Nepal and Japan, two countries in Asia with a high and low prevalence of ESBL-, respectively.

High rate of multidrug-resistant organism colonization among patients hospitalized overseas highlights the need for preemptive infection control.

We performed 4 years of active screening for multidrug resistant organism (MDRO) colonization among patients with a history of overseas hospitalization. Thirteen (56.5%) of 23 cases were positive for MDROs, which highlights the importance of preemptive infection control to prevent the spread of MDROs in this population.

Epidemiology of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli in Japan: Characteristics of community-associated versus healthcare-associated ESBL E. coli.

Data on community-associated extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (CA-ESBLEC) infections in Japan are scarce. We compared the clinical and microbiological epidemiology of CA-ESBLEC infections with that of healthcare-associated-ESBLEC infections among 76 patients with ESBLEC infections. We identified a high prevalence (26%) of CA-ESBLEC infections in Japan; only a small proportion (15%) of patients with CA-ESBLEC infections had recent exposure to antibiotics.

Bacteremia Due to Arthrobacter creatinolyticus in an Elderly Diabetic Man with Acute Cholangitis.

An 87-year-old man with poorly controlled diabetic mellitus presented with fever, bedsores, and elevated hepatobiliary enzyme levels. He was diagnosed with bacteremia with acute cholangitis due to Arthrobacter species, which are Gram-positive, aerobic, catalase-positive, coryneform bacteria belonging to the family Microbacteriaceae. Doripenem and subsequencial sulbactam/ampicillin treatment were used for the acute cholangitis, and the bacteremia was treated with a 2-week course of vancomycin.

Escherichia coli Vertebral Osteomyelitis Diagnosed According to Broad-range 16S rRNA Gene Polymerase Chain Reaction (PCR).

Identifying the causative agent of pyogenic osteomyelitis is often challenging, especially when antibiotics are administered before a biopsy. We herein present a case of osteomyelitis in the cervical vertebrae presenting with progressive paralytic symptoms, in which we successfully identified Escherichia coli from a biopsy specimen using broad-range 16S rRNA gene polymerase chain reaction (PCR) even though sensitive antibiotics had been used for more than 50 days before the biopsy. Broad-range 16S rRNA gene PCR is a useful diagnostic method, especially when prebiopsy antibiotics are unavoidably used for a clinically unstable state.

Use of polymerase chain reaction in the diagnosis of Whipple's disease.

Whipple's disease, a systemic, chronic infectious disease caused by Tropheryma whipplei, is extremely rare in Asian populations. A correct diagnosis is necessary due to its high mortality rate. Unfortunately, patients are apt to be misdiagnosed with connective tissue diseases since they typically present with arthritis or arthralgia.

Osteomyelitis due to Clostridium innocuum in a patient with acute lymphoblastic leukemia: case report and literature review.

Introduction: Clostridium innocuum is an anaerobic Gram-positive bacterium, unable to produce toxins and rarely causes infections. We report the first case of C. innocuum osteomyelitis and bacteremia in a patient with acute lymphoblastic leukemia (ALL).

Two Cases of Granulomatous Mastitis Caused by Corynebacterium kroppenstedtii Infection in Nulliparous Young Women with Hyperprolactinemia.

Recently, an association between granulomatous mastitis and local infection with Corynebacterium (C.) kroppenstedtii has been suggested. We herein report two cases of granulomatous mastitis resulting from C.

Clinical epidemiology and molecular analysis of extended-spectrum-β-lactamase-producing Escherichia coli in Nepal: characteristics of sequence types 131 and 648.

Recently, CTX-M-type extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli strains have emerged worldwide. In particular, E. coli with O antigen type 25 (O25) and sequence type 131 (ST131), which is often associated with the CTX-M-15 ESBL, has been increasingly reported globally; however, epidemiology reports on ESBL-producing E.

Multidrug-resistant Acinetobactor baumannii isolated from a traveler returned from Brunei.

We report a case of multidrug-resistant (MDR) Acinetobactor baumannii isolates obtained from a traveler returned from Brunei. Whole-genome sequencing analysis revealed that the isolates harbored blaOxA-23 and armA. The minimum inhibitory concentrations of antibiotics against the strain were as follows: imipenem, 32 μg/ml; meropenem, 32 μg/ml; ciprofloxacin, 16 μg/ml; amikacin, ≧ 1024 μg/ml; arbekacin, ≧ 1024 μg/ml; aztreonam, 64 μg/ml; colistin, 4 μg/ml.

Evaluation of an automated rapid diagnostic test for detection of Clostridium difficile.

The Verigene Clostridium difficile Nucleic Acid Test (Verigene CDF Test) (Nanosphere, Northbrook, IL, USA) is a new multiplex qualitative polymerase chain reaction (PCR) test used to detect C. difficile toxin genes in fecal specimens. To evaluate the performance of the new method, we tested 69 fecal samples from patients with suspected C.

Molecular and epidemiological characterization of IMP-type metallo-β-lactamase-producing Enterobacter cloacae in a Large tertiary care hospital in Japan.

IMP-type metallo-β-lactamase enzymes have been reported in different geographical areas and in various Gram-negative bacteria. However, the risk factors and epidemiology pertaining to IMP-type metallo-β-lactamase-producing Enterobacter cloacae (IMP-producing E. cloacae) have not been systematically evaluated.

Evaluation of an automated rapid diagnostic assay for detection of Gram-negative bacteria and their drug-resistance genes in positive blood cultures.

We evaluated the performance of the Verigene Gram-Negative Blood Culture Nucleic Acid Test (BC-GN; Nanosphere, Northbrook, IL, USA), an automated multiplex assay for rapid identification of positive blood cultures caused by 9 Gram-negative bacteria (GNB) and for detection of 9 genes associated with β-lactam resistance. The BC-GN assay can be performed directly from positive blood cultures with 5 minutes of hands-on and 2 hours of run time per sample. A total of 397 GNB positive blood cultures were analyzed using the BC-GN assay.

Parvimonas micra as a causative organism of spondylodiscitis: a report of two cases and a literature review.

Spondylodiscitis caused by Parvimonas micra, a rarely reported infection, might be under-detected using conventional methods. This report of the detection and treatment of two cases of spondylodiscitis due to P. micra and review of the literature indicates that the use of gene sequencing methods might improve the accuracy of diagnosing this infection.

Isolation of OXA-48 carbapenemase-producing Klebsiella pneumoniae ST101 from an overseas traveler returning to Japan.

OXA-48 carbapenemase-producing organisms have emerged rapidly worldwide and may be transmitted through patients who receive medical care abroad. To our knowledge, this is the second case of OXA-48-producing Klebsiella pneumoniae isolated from a patient who had returned to Japan after receiving treatment abroad.

Neonatal meningitis caused by Streptococcus gallolyticus subsp. pasteurianus.

We encountered a case of neonatal meningitis caused by Streptococcus gallolyticus subsp. pasteurianus. The patient was an 8-day-old boy.

Whitening efficacy of plant extracts including orchid extracts on Japanese female skin with melasma and lentigo senilis.

The purpose of this study was to assess the in vivo efficacy of a cosmetic formulation containing plant extracts including orchid extracts, compared to 3% vitamin C derivative formulated with the same excipient, in Japanese female adult volunteers with melasma and/or lentigo senilis. The ethics committee of Osaka National Hospital approved the protocol of the study. Before recruitment, selection and inclusion of a volunteer in this study, signed informed consent was obtained from each volunteer after she was given clear and precise information on the study, enabling her to appreciate the aim of the study and the consequences of her consent.