Multiple recombinant noroviruses in Japan.

A total of 417 fecal specimens collected from sporadic pediatric cases of acute gastroenteritis in Japan from 2005 to 2006 were tested for noroviruses by RT-PCR. Noroviruses were detected in 44 of 417 (10.1%) fecal specimens tested. Of these, the GII/3 was the most predominant genotype with a prevalence rate of 56.8%, followed by 34% of the GII/4 and others. Phylogenetic analysis reveals that multiple recombinant noroviruses, which were both dependently and independently introduced from four different continents (Asia, America, Europe, and Oceania), emerged to cause acute gastroenteritis among Japanese children. Of these, "new variant" noroviruses suddenly emerged to become the leading strain in Japan for the first time. This report is also the first indication of the existence of multiple recombinant noroviruses co-circulating in Japan.

[Survey of susceptibility of methicillin-resistant Staphylococcus aureus to antimicrobial agents in Hokusetsu General Hospital].

We examined the annual isolation rate, susceptibility to antimicrobial agents and coagulase types of methicillin-resistant Staphylococcus aureus (MRSA) isolated from inpatients in Hokusetsu General Hospital to ascertain the situation of MRSA isolates between 1992 and 2001. The isolation rate of MRSA in S. aureus increased annually from 1992, reaching 65.3% in 2001. The isolation rates of MRSA in the inpatients were 3.2 times greater than those in the outpatients. In the clinical specimens the isolation rate of MRSA from sputum was the highest, i.e., 32.9%. In respect of the coagulase types, type II accounted for 85.7% of the all types. MIC90 values of arbekacin, sulfmethoxazole-trimethoprin, vancomycin, teicopranin and minocycline were 4.0, 2.0, 2.0, 2.0, and 8.0 micrograms/ml, respectively.

[Clinical efficacy and bacteriological studies of clarithromycin and cefdinir against group A beta-hemolytic streptococcal tonsillopharyngitis].

The clinical efficacy and safety of clarithromycin (CAM) and cefdinir (CFDN) were evaluated in 65 pediatric outpatients with group A beta-hemolytic streptococcal tonsillopharyngitis. Treatment was "effective" or better in 26 (78.8%) children receiving CAM and in 27 (87.1%) receiving CFDN based on antigen clearance and the "Criteria for Evaluation in Clinical Trials of Antibacterial Agents in Children" proposed by Japan Society of Chemotherapy (p = NS). The causative organisms were eradicated in 94.7% and 93.8% of subjects in the CAM and CFDN groups, respectively (p = NS). Adverse drug reactions were limited to moderate diarrhea in one patient in each group, and subsided during treatment. Causative organisms exhibited good susceptibility to CAM and CFDN. These results suggest excellent efficacy, safety and usefulness of CAM and CFDN in the treatment of group A beta-hemolytic streptococcal tonsillopharyngitsis in children.

[Pharmacokinetic and clinical studies on teicoplanin for sepsis by methicillin-cephem resistant Staphylococcus aureus in the pediatric and neonate field].

Pharmacokinetics, clinical efficacy and safety of teicoplanin (TEIC) were evaluated in pediatric and neonate patients with MRSA sepsis in the dosages approved in overseas. The administrated dose for pediatrics patients was 10 mg/kg once at hour 0, 12 and 24, followed by every 24 hours intervals. In neonates patients, first dose was 16 mg/kg, then 8 mg/kg every 24 hours intervals. 1. Pharmacokinetic results. All 17 patients (9 neonates and 8 pediatrics) who received TEIC were evaluated for pharmacokinetics. Trough concentrations were analyzed in 16 patients (9 neonates and 7 pediatrics) excluding one patient for lack of measurement of drug concentration at day 7. No patient with a concentration exceeding 60 micrograms/mL in peak or trough concentrations were reported. Mean concentrations in trough at day 3, 4 and 7 in neonates were 15.2, 14.7 and 17.8 micrograms/mL, and in pediatrics were 12.5, 12.2 and 13.1 micrograms/mL, respectively. These results were similar to those reported in foreign pediatrics and neonates patients. 2. Efficacy and safety results. Since no patient was excluded, all patients were evaluated for efficacy and safety. Microbiological efficacy as well as clinical cure were secondarily evaluated in 2 patients for whom MRSA was isolated from blood. Clinical efficacy rate was 76.5% (13/17) and number of cases in judgments of excellent, good, fairly improved and no change were 12, 1, 3 and 1 cases respectively. The patients for whom MRSA was isolated from blood were judged as MRSA eradicated case and cured without any additional anti-MRSA drugs. Adverse events were reported in 2 neonates and 3 pediatric patients. Possibly related adverse events to study drug (adverse drug reactions) were: 1 case of respiratory disorder, thrombocythemia, gamma-GTP increased, GOT increased and GPT increased in 3 pediatrics. These results suggest that an application of overseas dose regimen of TEIC for neonate and pediatrics is appropriate in Japan.