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Risako Kakuta,Ryuichi Nakano,Hisakazu Yano,Daiki Ozawa,Nobuo Ohta,Takayuki Matsuoka,Naotaka Motoyoshi,Shunsuke Kawamoto,Yoshikatsu Saiki,Yukio Katori,Mitsuo Kaku 대한진단검사의학회 2020 Annals of Laboratory Medicine Vol.40 No.3
Dear Editor, Infected aortic aneurysm (IAA) is an uncommon, but life-threatening condition. Identification of the causative pathogen is essential for accurate diagnosis and effective treatment. However, 14–40% of IAA cases are culture-negative [1]. IAA due to Streptococcus pneumoniae is rare, and reports of the involvement of S. pneumoniae capsular serotypes and sequence types (STs) in IAA are even rarer [2-5]. We identified S. pneumoniae from culture-negative IAA by genetic analysis. To the best of our knowledge, as of 2019, only 59 cases of pneumococcal IAA have been reported in France, the United Kingdom (UK), the Netherlands, Germany, Switzerland, Belgium, Denmark, the United States (USA), Canada, Chile, Japan, Hong Kong, Korea, and Austria since 1977 [2-5]. In the previous cases of IAA due to S. pneumoniae, capsular serotype analysis was reported only for seven: 10A and 23F in the UK, 4 and 8 in Denmark, 19F in Hong Kong, 4 in Belgium, and 23 in USA [2-5]. We report the first two cases of culture-negative IAA due to non-vaccine S. pneumoniae serotype 23A, ST338. The study protocol was approved by the Institutional Ethics Committees of Tohoku University, Sendai, Japan (No. 2018-1-456).
Yoshihiko Ogawa,Masatoshi Sato,Takaya Yamashita,Ryuichi Nakano,Satoshi Mochizuki,Kei Kasahara,Hisakazu Yano,Keiichi Mikasa 대한진단검사의학회 2018 Annals of Laboratory Medicine Vol.38 No.1
Dear Editor, Intraabdominal infections are well-known sources of polymicrobial bacteremia [1, 2]. Anaerobes such as Bacteroides spp. and Clostridium spp. account for 30–50% of these cases [2-4]. However, a significant proportion of anaerobes remain unidentified. Lee et al [5] reported that the conventional identification method correctly identifies anaerobic bacteria only 79.4% to the genus level and 60.1% to the species level. Here, we report a case of polymicrobial bacteremia with three anaerobes in a patient with peritonitis following intestinal perforation. The anaerobes included Butyricimonas virosa and Brachyspira pilosicoli, both of which are difficult to identify by the conventional identification method
Takashi Takahashi,Kazuaki Arai,이동현,고은하,Haruno Yoshida,Hisakazu Yano,Mitsuo Kaku,김선주 대한진단검사의학회 2016 Annals of Laboratory Medicine Vol.36 No.1
Background: We determined the epidemiological characteristics of erythromycin (EM)-resistant Streptococcus pyogenes (group A streptococci, GAS) strains isolated from Korea and Japan, using emm genotyping and multilocus sequence typing (MLST). Methods: Clinical isolates of GAS had been collected from 1992 to 2012 in Korea and from 2004 to 2009 in Japan. EM resistance was determined by the microdilution method, and resistance genotypes were assessed by PCR. The emm genotyping and MLST were performed by DNA sequencing. Results: The emm genotypes and sequence types (STs) were concordant in 143 (85.1%) of 168 EM-resistant GAS strains from Korea. ST36/emm12 (35.1%), ST52/emm28 (22.6%), and ST49/emm75 (16.1%) were the most common types. Most of the ST36 (93.9%) and ST52 (95.8%) strains harbored erm(B), whereas strains ST49, ST42, and ST15 contained mef(A). The concordance between emm genotypes and STs was 41 (93.2%) among 44 EM-resistant GAS strains from Japan. ST36/emm12 (34.1%), ST49/emm75 (18.2%), and ST28/emm1 (15.9%) were the major types. ST36 isolates harbored either erm(B) (56.3%) or mef(A) (37.5%), whereas isolates ST28, ST49, and ST38 carried only mef(A). The proportion of erm(B) and mef(A) was 66.1% and 33.3% in Korea and 22.7% and 68.2% in Japan, respectively. Conclusions: The common STs in Korea and Japan were ST36 and ST49, whereas ST52 was present only in Korea and ST28 only in Japan. Genotype erm(B) was predominant in Korea, whereas mef(A) was frequent in Japan. There were differences between Korea and Japan regarding the frequencies of emm genotypes, STs, and EM resistance genes among the EM-resistant GAS.
Akiyo Nakano,Ryuichi Nakano,Yuki Suzuki,Kyoichi Saito,Kei Kasahara,Shiro Endo,Hisakazu Yano 대한진단검사의학회 2018 Annals of Laboratory Medicine Vol.38 No.4
Dear Editor, Carbapenem-resistant Enterobacteriaceae have acquired carbapenemase genes [1], which differ substantially across countries [2]. Transferable carbapenemase IMP-type metallo-β-lactamases, particularly IMP-1 and IMP-6, are commonly identified in the clinical setting in Japan [3, 4] and exhibit different substrate specificity despite having a difference of only one amino acid (IMP-6: Ser214Gly). IMP-1 producers are more resistant to imipenem than to meropenem, whereas IMP-6 producers are more resistant to meropenem [5]. We previously found that the susceptibility rate of IMP-6-positive Escherichia coli was higher for imipenem than for meropenem [3]. Thus, IMP-6-producing isolates may be erroneously categorized as imipenem-susceptible, which could lead to treatment failure in patients.
Naoki Kakuta,Ryuichi Nakano,Akiyo Nakano,Yuki Suzuki,Ayako Tanouchi,Takashi Masui,Saori Horiuchi,Shiro Endo,Risako Kakuta,Yasuo Ono,Hisakazu Yano 대한진단검사의학회 2020 Annals of Laboratory Medicine Vol.40 No.1
Background: Mutations in the quinolone resistance-determining regions (QRDRs) of Acinetobacter baumannii DNA gyrase (gyrA) and topoisomerase IV (parC) are linked to fluoroquinolone (FQ) resistance. We developed a mismatched PCR-restriction fragment length polymorphism (RFLP) assay to detect mutations in the gyrA and parC QRDRs associated with FQ resistance in A. baumannii. Methods: Based on the conserved sequences of A. baumannii gyrA and parC, two primer sets were designed for mismatched PCR-RFLP to detect mutations in gyrA (codons 83 and 87) and parC (codons 80 and 84) by introducing an artificial restriction enzyme cleavage site into the PCR products. This assay was evaluated using 58 A. baumannii strains and 37 other Acinetobacter strains that have been identified by RNA polymerase β-subunit gene sequence analysis. Results: PCR amplification of gyrA and parC was successful for all A. baumannii strains. In 11 FQ -susceptible strains, the gyrA and parC PCR products were digested by the selected restriction enzymes at the site containing gyrA (codons 83 and 87) and parC (codons 80 and 84). PCR products from 47 FQ-resistant strains containing mutations in gyrA and parC were not digested by the restriction enzymes at the site containing the mutation. As for the non-baumannii Acinetobacter strains, although amplification products for gyrA were obtained for 28 strains, no parC amplification product was obtained for any strain. Conclusions: This assay specifically amplified gyrA and parC from A. baumannii and detected A. baumannii gyrA and parC mutations with FQ resistance.