[In-vitro susceptibilites to levofloxacin and various antibacterial agents of 18,639 clinical isolates obtained from 77 centers in 2004].

A total of 18,639 clinical isolates in 19 species collected from 77 centers during 2004 in Japan were tested for their susceptibility to fluoroquinolones (FQs) and other selected antibiotics. The common respiratory pathogens, Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae showed a high susceptible rate against FQs. The isolation rate of beta lactamase non-producing ampicillin-resistant H. influenzae was approximately three times as large as those of western countries. Most strains of Enterobacteriaceae were also susceptible to FQs. The resistance rate of Escherichia coli against FQs has however been rapidly increasing so far as we surveyed since 1994. The FQs-resistant rate in methicillin-resistant Staphylococcus aureus (MRSA) showed approximately 90% except for 36%. of sitafloxacin while FQs-resistant rate in methicillin-susceptible S. aureus (MSSA) was around 5%. The FQs-resistant rate of methicillin-resistant coagulase negative Staphylococci (MRCNS) was also higher than that of methicillin-susceptible coagulase negative Staphylococci (MSCNS), however, it was lower than that of MRSA. In Pseudomonas aeruginosa clinical isolates, 32-34% from UTI and 15-19% of from RTI was resistant to FQs. Acinetobacter spp. showed a high susceptibility to FQs. Although FQs-resistant Neisseria gonorrhoeae have not been increased in western countries, it is remarkably high in Japan. In this survey, isolates of approximately 85% was resistant to FQs.

[Analysis of small dense LDL in patients with type 2 diabetic mellitus by the modified Krauss method using an internal standard].

In patients with Type 2 diabetes mellitus (Type 2 DM), the relationship between the prevalence rate of small dense LDL (sdLDL) and parameters of lipid metabolism was analyzed using the method devised by modified Krauss method using apoferritin as an internal standard. The prevalence rate of sdLDL was 34% compared with it of normal subjects in this study. When the severity of Type 2 DM was classified into three groups of the HbA1c value, neither the sdLDL size nor its prevalence rate differed significantly depending upon the severity of the Type 2 DM. Also, when the prevalence rate of sdLDL was analyzed in relation to the severity of complications, i.e., of microangiopathy (retinopathy and nephropathy) or macroangiopathy (cerebral infarction), there was no significant difference in the prevalence rate of sdLDL depending on the severity of any of these complications. On the other hand, the prevalence rate of sdLDL was found to be correlated with the serum TG level. The serum level of TG-rich remnants (metabolites of TG) was also high in patients with sdLDL. It should take notice that the assessment of sdLDL should be used the authorized method for the evaluation. Thus it is concluded that the levels of sdLDL were important in evaluation of Type 2 DM. The prevalence rate of sdLDL did not correlate with the severity, nor the modalities for the complications of Type 2 DM.

[Pitfalls in laboratory testing for autoantibodies].

Quantitative autoantibody determination has recently can be widely used to confirm the diagnosis of autoimmune diseases, however, there are several problems with the assay methods. As pitfalls in terms of measurement methods, in this report we describe actual examples of a problem related to the analysis and of a large discrepancy between the data obtained by different methods of measurement. In the first example, the reaction solution in the microplate evaporated during the reaction process in automated analysis using an Eitest CA-RF ELISA kit, causing the values in the outermost wells to be significantly higher than in the inner wells. In the second example, there was a large discrepancy between the values obtained when the anti-dsDNA antibody of a systemic lupus erythematosus(SLE) patient was measured by radioimmunoassay(RIA) and by enzyme-linked immunosorbent assay(ELISA). The reason for the discrepancy in the second example may have been related to the method of the RIA, which used 50% ammonium sulfate in the B/F separation, and the possibility that certain patients have autoantibody that recognizes the ELISA solid-phase antigen more strongly. Accordingly, quantitative assay data for anti-dsDNA antibody, which possesses such diversity, should be evaluated with due consideration of the characteristics of the assay method and by checking them against the clinical data.