Propionimicrobium lymphophilum and Actinotignum schaalii bacteraemia: a case report.

Propionimicrobium lymphophilum is an anaerobic Gram-positive bacillus that exists in human skin and urinary tract. The pathogenicity is, however, not well known. Only two cases of urinary tract infection have been described recently. In the case presented here, the bacterium was isolated, concomitant with Actinotignum schaalii, from blood culture of a patient with fever and difficulty of urination. The bacteria were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA sequencing. The case was successfully treated with ampicillin/sulbactam.

First reported case of Staphylococcus condimenti infection associated with catheter-related bacteraemia.

We report a case of a patient who experienced a catheter-related bloodstream infection caused by Staphylococcus condimenti, which was first isolated from soy sauce mash. This is the first reported case of human infection. Although blood culture isolates and the catheter tip tube did not reveal coagulase or clumping factor, false-positive results were obtained from latex agglutination tests for clumping factor and protein A due to self-agglutination. Care is needed when performing only latex agglutination test without a coagulase test. Further studies are needed to determine the pathogenic potential of S. condimenti based on appropriate identification.

The SOCS and STAT from JAK/STAT signaling pathway of kuruma shrimp Marsupenaeus japonicus: molecular cloning, characterization and expression analysis.

Signal transducer and activators of transcription (STAT) gene, suppressors of cytokine signaling (SOCS) has been isolated from kuruma shrimp, Marsupenaeus japonicus and characterized. The kuruma shrimp STAT (MjSTAT) cDNA was composed of 2901 bp consisting of 801 amino acid residues which includes a protein interaction domain, all alpha domain, DNA binding domain and SH2 domain. Homology analysis of MjSTAT showed 94.1% and 34.0% identities with Penaeus monodon STAT (PmSTAT) and Drosophila melanogaster STAT92E (DmSTAT), respectively. The kuruma shrimp SOCS (MjSOCS) cDNA was composed of 1675 bp consisting of 342 amino acid residues including a SH2 domain and C-terminal SOCS domain. Homology analysis of MjSOCS showed 52.6% and 21.3% identities with Chinese mitten crab (Eriocheir sinensis) SOCS2 and fruit fly (D. melanogaster) SOCS44A, respectively. The MjSTAT and MjSOCS genes are constitutively expressed in the muscle, stomach, brain and gill of kuruma shrimp. In lymphoid organ cells, an enhanced expression of both MjSTAT and MjSOCS genes are observed following stimulation with peptidoglycan and polycytidylic acid. These observations suggest that MjSTAT and MjSOCS might play a major role in the innate immune defense of kuruma shrimp. The discovery of JAK/STAT signaling pathway in shrimp will allow a complete and concrete understanding of shrimp cytokine signaling.

Clinical features of Bacteroides bacteremia and their association with colorectal carcinoma.

PURPOSE: We investigated the clinical features of Bacteroides bacteremia for 5 years to determine the risk factors for mortality and to ascertain whether bacteremia due to Bacteroides spp. is associated with colorectal carcinoma. METHODS: This study comprised a review of all patients with Bacteroides bacteremia at a teaching hospital in Tokyo from April 2003 to March 2008. We also conducted a case-control study between Bacteroides bacteremia and bacteremia due to other pathogens. RESULTS: During the study period, 25 cases of bacteremia were due to Bacteroides spp. Bacteroides bacteremia was associated with a high mortality rate (24%). Malignancy (76%) was the major comorbidity, followed by a history of surgery (40%). Colorectal carcinoma was the most frequent (n = 8, 32%) of the comorbid malignancies and was recognized as the primary infection site in six cases. Prevalence of colorectal carcinoma as comorbidity was significantly higher in Bacteroides bacteremia than in other bacteremia. CONCLUSIONS: In the Bacteroides bacteremia cases of this study, colorectal carcinoma was the major comorbidity and primary infection site. Colorectal carcinoma screening in Bacteroides bacteremia patients is potentially an important diagnostic marker for the early detection of this infection in the future.

Deciphering the DNA repair protein, Rad23 from kuruma shrimp Marsupenaeus japonicus: full-length cDNA cloning and characterization.

AIMS: Lesions of DNA are removed by nucleotide excision repair (NER) process in the living systems. NER process-related host factors are believed to aid recovery steps during viral integration. Here, we report identification and characterization of a DNA repair molecule Rad23 from kuruma shrimp Marsupenaeus japonicus. METHODS AND RESULTS: The full-length cDNA of M. japonicus Rad23 gene (MjRad23) has 1149 bp coding for a putative protein of 382 amino acids with a 5' untranslated region (UTR) of 92 bp and 3' UTR region of 1116 bp. Quantitative expression analysis revealed MjRad23 is constitutively expressed in all the organs of healthy shrimp, whereas with high level in muscle tissue. Although MjRad23 expression is observed in every haemolymph samplings to post-white spot syndrome virus infection, high expression is recorded at 2 h post infection (h.p.i.). MjRad23 consists of putative functional domains including one ubiquitin domain (UBQ), two ubiquitin-associated domains (UBA) and one heat-shock chaperonin-binding motif (STI1). Multiple alignment of MjRad23 with Rad23 of other species showed highly significant identity ranging from 37 to 53%; however, high homology is observed with Rad23 of Bombyx mori (BmRad23). UBQ domain region alignment revealed maximum of 66% homology with Rad23 of Apis melifera (AmRad23). MjRad23 clustered with invertebrate sector along with insect species in evolution analysis. Three-dimensional structural analyses demonstrated the highest identity between MjRad23 and human Rad23A (hHR23A). CONCLUSIONS: The present work revealed the presence of MjRad23 gene, which is essential in DNA repair process. Further studies are required to clarify the involvement of MjRad23 in NER process. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first report on identification and characterization of DNA repair protein in crustaceans, which will lead to further investigation to explore the molecular mechanisms behind the NER process.

Molecular cloning and transcriptional analysis of a newly identified anti-lipopolysaccharide factor gene in kuruma shrimp, Marsupenaeus japonicus.

AIM: In the present study, we have cloned a new family of anti-lipopolysaccharide factor (ALF) from haemocytes of kuruma shrimp Marsupenaeus japonicus (MjALF2) using RACE method. METHODS AND RESULTS: Transcriptional analysis of MjALF2 gene in the organs of healthy shrimp revealed prominent expression in gills and muscle. In vitro LPS stimulation in the lymphoid organ cells resulted in significant increase in expression at 48, 8 and 12 h poststimulation, compared to the nonstimulated cells. In vivo injection of V. penaeicida does not show any high expression in time course assay. Phylogenetic analysis showed MjALF2 is placed in the group closer to P. monodon isoform 1 and 2 than to MjALF1. The full-length MjALF2 gene consists of 558 bp with a 363 -bp open reading frame, encoding 121 amino acids. The deduced peptide contains a putative signal peptide of 22 amino acids with molecular mass of about 13.8 kDa molecular mass. The deduced amino acid sequence of MjALF2 showed 83.3 and 56.7% identity with ALF sequences of P. monodon. CONCLUSIONS: The present work revealed the presence of MjALF2 gene, which is highly expressed in gills and muscle of healthy kuruma shrimp. Further studies are required to clarify the involvement of MjALF2 in immune responses for using as a therapeutic agent. SIGNIFICANCE AND IMPACT OF THE STUDY: Antimicrobial peptides are promising potential therapeutic agents for disease control in aquaculture. Understanding the relation of MjALF2 with innate immunity mechanism will lead to develop better health management strategies for long-term sustainability of the shrimp industry.

Clinical epidemiology of ciprofloxacin-resistant Proteus mirabilis isolated from urine samples of hospitalised patients.

This study investigated the clinical characteristics of ciprofloxacin-resistant Proteus mirabilis isolates from urine samples associated with nosocomial infection or colonisation, and identified the risk-factors for ciprofloxacin resistance. Data for patients with ciprofloxacin-resistant P. mirabilis isolates (n=13) were compared with those for randomly selected patients with ciprofloxacin-susceptible P. mirabilis isolates (n=40) who were matched by temporal occurrence as control patients. The majority of ciprofloxacin-resistant P. mirabilis isolates were multiresistant, and ciprofloxacin resistance was associated significantly with previous use of fluoroquinolones and production of extended-spectrum beta-lactamases.

Successful treatment of disseminated Nocardia farcinica infection in a living-donor liver transplantation recipient.

Nocardiosis is a serious infection with high mortality. We report a case of subcutaneous and neural lesions due to Nocardia farcinica infection after living-donor liver transplantation. The neural lesion was cured with antibiotics without drainage.

Cardiovascular response to combined static-dynamic exercise of patients with myocardial infarction.

BACKGROUND: Graded dynamic exercise-stress testing of patients with acute myocardial infarction prior to discharge from hospital has an important diagnostic and prognostic implication. Although many daily tasks involve combinations of static and dynamic exercise, little is known about cardiovascular responses during combined static-dynamic exercise. OBJECTIVE: To determine the difference between cardiovascular responses during two types of combined static-dynamic exercise (a 10 kg weight in one hand, and a 10 kg weight bearing on the shoulder). METHODS: We studied 27 male patients who had recently suffered myocardial infarction using ear densitography. The patients were divided into two groups: group 1 was comprised of 14 patients with resting left ventricular end-diastolic volumes > or = 140 ml, and group 2 was comprised of 13 patients with left ventricular end-diastolic volumes < 140 ml. RESULTS: For eight patients in group 1 we detected positive electrocardiographic changes during one-hand weight-carrying exercise, but for none of these patients was there an electrocardiographic change during weight-bearing exercise. All the patients in group 2 completed both types of exercise without significant ST-segment change. Although there were no significant differences between values of any of the indices measured for the two groups during weight-bearing exercise, patients in group 1 had significantly shorter diastolic times/min (21.8 +/- 2.1 versus 25.1 +/- 2.4 s/min, P < 0.01) during one-hand weight carrying. CONCLUSIONS: In addition to decrease in subendocardial coronary blood flow associated with increase in left ventricular end-diastolic volume, shortening of diastolic perfusion time during one-hand weight-carrying exercise for patients in group 1 can potentially contribute to subendocardial ischemia, which was favorably altered by bearing a weight on the shoulder.

[Long-term hospitalization of elderly patients in a regional hospital].

Clinical characteristics of elderly patients who had been admitted in Sawauchi Hospital for more than 100 days between 1988 and 1992, were analyzed. The average hospital stay of inpatients was 38.0 days, and the longest hospitalization was observed at ages between 76 and 85 year old. During 4 years, there were 74 patients who were admitted for more than 100 days. Thirty-seven cases had serious and complicated conditions, while the remaining 37 cases did not have clear-cut reasons for such a long hospitalization. The latter group was significantly older than the former, and included more females (p < 0.01, respectively; the care-forcussed group). Clinical characteristics of the care-forcussed group were degenerative bone/joint diseases with long-standing pain and uncertain complaints such as autonomic nerve dysfunction. These patients were often admitted to the hospital repeatedly, particularly in winter. Patients with multiple cerebral infarction or chronic respiratory disorders were mostly males (p < 0.01). It is important to examine the clinical course and severity of elderly patients who are in hospital for long periods, particularly from the viewpoint of differentiating quality of treatment and care.

[Satisfaction with medical care in hospitals for elderly people].

To examine satisfaction with medical care in hospital for elderly people, a questionnaire was sent to 900 patients who discharged two geriatric hospitals recently. 598 answers were obtained (66%) and analyzed in relation to activity of daily living (ADL) and types of disorder. Although patients who were not satisfied with medical care were only 7 cases (1.2%), patients with lowered ADL and with cerebrovascular disease or bone/joint disease showed significantly negative response. These patients admitted immediately and stayed longer periods than other patients, but they wanted to stay more days in hospital. In addition, these patients judged attitude of medical staffs negatively in comparison with other ADL groups and other disorders. On the contrary, total dependency in daily living did not relate to dissatisfaction with medical care and attitude of medical staffs. Withholding of judgment was characteristic answer in this group. Satisfaction with keeping privacy in hospital decreased in parallel to decrease of ADL. These results suggest that dissatisfaction with medical care is centered on patients with compromised independence. This must be considered when improving quality of life in elderly people.

[Correlation of health status, disability and hospital life and satisfaction with quality of life in elderly in-patients].

To examine satisfaction with quality of life among elderly people with active diseases, in-patients aged 65 and over in Tokyo Metropolitan Geriatric Hospital were interviewed. Multivariate analysis was performed using Hayashi's quantification theory (the 2nd family). The dependent variable was the question "are there any satisfactory aspects of your becoming old?" and 18 explanatory variable items including age, gender, activity of daily living (ADL) and physical and mental status. Among 68 patients examined, 49 cases fulfilled all the items. The correlation ratio was 0.353, and rate of correct discrimination was 77.6% (78.9% and 76.7% of positive and negative responses, respectively). The range and correlation coefficient of ADL and age were greater than those of other items. Affirmative answers increased with advancing age and loss of independency in ADL responded negatively. Poor prognosis also affected satisfaction with life. These results suggest that age and progression of disability are important factors which determine life satisfaction in elderly in-patients.