Vessel development in compound buds of interspecific hybrid grape induced by artificial deacclimation treatments.

Grape compound buds adapt to subfreezing temperatures in winter by supercooling, but the supercooling ability is thought to be lost upon formation of xylem connections between canes and buds. It was reported that compound buds of the Vitis vinifera variety 'Chardonnay' lack xylem cells in mid-winter, and that vessels differentiate during deacclimation. However, the pattern of vessel formation in compound buds may differ in cold-hardy Vitis species and interspecific hybrid varieties grown in colder regions. We investigated vessel formation in compound buds of the interspecific hybrid variety 'Yamasachi', which were harvested in mid-winter, during artificial deacclimation treatments. Before these treatments, 'Yamasachi' buds had a high supercooling ability (approx. -30°C) and contained cells with characteristics of vessel elements, that is, secondary wall thickening and lignification, at the basal parts. However, the cells still contained organelles and did not have a hydraulic conductivity function. Xylem continuity between the canes and buds was established from day 7 of deacclimation at 20°C. The different pattern of seasonal vessel formation in compound buds of 'Yamasachi' from that of V. vinifera may reflect the rapid development traits of Vitis species growing in cold regions with short growing seasons.

A case of acute focal bacterial nephritis caused by methicillin-resistant Staphylococcus saprophyticus in a 13-year-old adolescent girl treated with daptomycin.

Staphylococcus saprophyticus is a gram-positive, coagulase-negative member of the Staphylococcus genus and is second only to Escherichia coli as a cause of urinary tract infections in the young female population. S. saprophyticus usually has good susceptibility to drugs commonly used to treat urinary tract infections, but it is often methicillin-resistant. Here we report a case of acute focal bacterial nephritis in a 13-year-old female patient caused by methicillin-resistant S. saprophyticus and treated with daptomycin (DAP). The patient had a history of unilateral hearing loss and presented to her previous physician with a 3-day history of fever, right-sided abdominal pain, and diarrhea. Cefotaxime antimicrobial chemotherapy was initiated as an empiric therapy targeting E. coli, the most frequent cause of community-onset pyelonephritis. Vancomycin (VCM) was started for acute focal bacterial nephritis caused by methicillin-resistant S. saprophyticus but was stopped due to allergy and replaced with DAP. After 13 days of treatment with DAP, the patient received 17 days of treatment with sulfamethoxazole-trimethoprim combination therapy. The patient experienced no adverse events and did not relapse. DAP is a relatively new anti-methicillin-resistant Staphylococcus aureus drug used to treat gram-positive cocci infections. It is primarily excreted by the kidneys, which may be desirable in treating urinary tract infections. For children who cannot receive VCM for any reason, DAP may be a viable alternative.

Bordetella pertussis is a common pathogen in infants hospitalized for acute lower respiratory tract infection during the winter season.

INTRODUCTION: There is some evidence that Bordetella pertussis (B. pertussis) can co-infect with viral respiratory infections in young infants. METHODS: B. pertussis infection was studied by culture, polymerase chain reaction (PCR), and loop-mediated isothermal amplification (LAMP) from nasopharyngeal swabs (NPSs) in 49 infants < 12 months of age, who were admitted for lower respiratory tract infections during the winter season. Seven other possible viral pathogens were documented by antigen detection or PCR in NPSs. The clinical feature of infants with mixed infection of B. pertussis and respiratory viruses were examined. RESULTS: Overall, B. pertussis infection was found in 10 (20.4%) cases, nine were less than 6 months of age and seven were unvaccinated. Viral etiology was found in 41 (84%) cases and pertussis-viral co-infection was present in eight patients, five of whom had mixed infection with respiratory syncytial virus. Only the presence of staccato coughing, cyanosis, and lymphocytosis were significantly different in B. pertussis-positive cases compared with B. pertussis-negative cases. Of the 10 pertussis cases, only the culture-positive cases showed the typical symptoms and laboratory findings of pertussis in addition to virus-associated respiratory symptoms with severe hospital course, whereas cases identified as DNA-positive lacked the characteristics of pertussis and their clinical severities were the same as B. pertussis-negative cases. CONCLUSION: In the absence of typical paroxysmal cough and lymphocytosis, we should carefully consider diagnosis of pertussis in young children hospitalized for presumed viral respiratory illness according to local epidemiological surveillance.

Effectiveness of four doses of pertussis vaccine during infancy diminished in elementary school age: A test-negative case-control study in Japan.

OBJECTIVE: The Japanese national immunization program recommends that children receive 4 doses of acellular pertussis vaccine between 3 months and 2 years of age. Nevertheless, the number of pertussis cases is increasing in elementary school children aged 6-12 years. Therefore, a test-negative case-control study was conducted to assess the effectiveness of the pertussis vaccine program. METHODS: Subjects included children aged ≥3 months who visited a collaborating hospital due to pertussis-specific cough between October 2017 and November 2019. All subjects underwent diagnostic tests for pertussis, and those diagnosed as positive were regarded as cases. Subjects diagnosed as pertussis-negative were classified as controls. Vaccination history was collected using a questionnaire administered to parents with reference to immunization records. Logistic regression models were employed to calculate the odds ratio (OR) and 95% confidence interval for laboratory-confirmed pertussis. RESULTS: Of 187 recruited subjects (120 cases and 67 controls), questionnaire responses were obtained for 145 subjects (95 cases and 50 controls). Compared with unvaccinated subjects, the vaccine effectiveness (VE) of 4 doses was 70% among all subjects and reached to 90% with marginal significance among subjects under 6 years of age. However, among school-aged subjects, the VE was not suggestive of protection against pertussis (VE: 8%). For vaccinees given 4 doses, the OR for developing pertussis increased significantly with longer duration since the fourth dose (compared with <4.5 years, OR of 6.0-8.2 years = 5.74; OR of ≥8.3 years = 3.88; P for trend by duration < 0.01). CONCLUSION: Effectiveness of administering 4 doses of pertussis vaccine during infancy decreases with time passed since the fourth dose. This regimen does not protect school-aged children against pertussis.

Unexpected Ventriculitis Complication of Neonatal Meningitis Caused by Streptococcus gallolyticus Subsp. pasteurianus: a Case Report.

Streptococcus gallolyticus subsp. pasteurianus, previously recognized as S. bovis biotype II/2, is an uncommon yet important cause of invasive infection in young infants. Here, we report the first case of ventriculitis that was unexpectedly diagnosed in the course of neonatal meningitis due to S. gallolyticus subsp. pasteurianus, and we review the relevant literature. A 28-day-old male infant from Japan presented with fever, lethargy, and irritability. S. bovis was isolated from blood and the cerebrospinal fluid culture and was then identified as S. gallolyticus subsp. pasteurianus. Intravenous antibiotic therapy was initiated, which helped improve the clinical course of the disease; however, the patient presented ventriculitis-related complications diagnosed using follow-up magnetic resonance imaging (MRI) on day 12 of hospitalization. Ampicillin was administered for 21 days and discontinued after the patient showed improvement, according to MRI findings. The patient was discharged without sequelae. Ventriculitis is a rare complication of childhood meningitis due to S. gallolyticus subsp. pasteurianus. However, it may have been underdiagnosed, especially in cases with no specific manifestations similar to the present case. We suggest that MRI should be performed to screen for ventriculitis in the course of meningitis to avoid failure in treatment.

Umbilical hernia: Influence of adhesive strapping on outcome.

BACKGROUND: Adhesive strapping for umbilical hernia has been re-evaluated as a promising treatment. We evaluated the influence of adhesive strapping on the outcome of umbilical hernia. METHODS: We retrospectively evaluated patients with umbilical hernia referred to the present institution from April 2011 to December 2015. Patients who were treated with adhesive strapping were compared with an observation alone group. The adhesive strapping group was also subdivided into two groups: the cure group and the treatment failure group. RESULTS: A total of 212 patients with umbilical hernia were referred to the present institution. Eighty-nine patients were treated with adhesive strapping, while 27 had observation only. The cure rate in the adhesive strapping group was significantly higher than that in the observation group. The duration of treatment of the adhesive strapping group was significantly shorter than that of the observation group. In the adhesive strapping group, the patients in the cure group were treated significantly earlier than those in the treatment failure group (P < 0.001). Furthermore, even in cases of umbilical hernia non-closure, surgical repair was easier after adhesive strapping. CONCLUSION: Adhesive strapping represents a promising treatment for umbilical hernia. To achieve the best results, adhesive strapping should be initiated as early as possible.

Clinical and host genetic characteristics of Mendelian susceptibility to mycobacterial diseases in Japan.

PURPOSE: The aim of this study is to investigate clinical characteristics and genetic backgrounds of Mendelian susceptibility to mycobacterial diseases (MSMD) in Japan. METHODS: Forty-six patients diagnosed as having MSMD were enrolled in this study. All patients were analyzed for the IFNGR1, IFNGR2, IL12B, IL12RB1, STAT1, and NEMO gene mutations known to be associated with MSMD. RESULTS: Six patients and one patient were diagnosed as having partial interferon-γ receptor 1 deficiency and nuclear factor-κB-essential modulator deficiency, respectively. Six of the seven patients had recurrent disseminated mycobacterial infections, while 93% of the patients without these mutations had only one episode of infection. CONCLUSIONS: The patients with a genetic mutation were more susceptible to developing recurrent disseminated mycobacterial infections. Recurrent disseminated mycobacterial infections occurred in a small number of patients even without these mutations, suggesting the presence of as yet undetermined genetic factors underlying the development and progression of this disease.