In the last few years, many attempts have been made to use conserved gene sequences for identification and for phylogenetic studies of Staphylococcus species. In an effort to identify a more reliable approach, a dnaJ gene sequence-based database was created. In this study, an approximately 883 bp portion of the dnaJ gene sequence from 45 staphylococcal type strains was compared with 16S rRNA and other conserved gene (hsp60, sodA and rpoB) sequences available in public databases. Nucleotide sequence comparisons revealed that the staphylococcal dnaJ gene showed higher discrimination (mean similarity 77.6 %) than the 16S rRNA (mean similarity 97.4 %), rpoB (mean similarity 86 %), hsp60 (mean similarity 82 %) and sodA (mean similarity 81.5 %) genes. Analysis of the dnaJ gene sequence from 20 Staphylococcus isolates representing two clinically important species showed <1 % sequence divergence. Phylogenetic data obtained from the dnaJ gene sequence were in general agreement with those of 16S rRNA gene sequence analysis and DNA-DNA reassociation studies. In conclusion, the dnaJ gene sequence-based assay is an effective alternative to currently used methods, including 16S rRNA gene sequencing, for identification and taxonomical analysis of Staphylococcus species.

Patients with cancer should appropriately receive antiemetic therapies against chemotherapy-induced nausea and vomiting (CINV). Antiemetic guidelines play an important role in managing CINV. Accordingly, the first Japanese antiemetic guideline published in 2010 by the Japan Society of Clinical Oncology (JSCO) has considerably aided Japanese medical staff in providing antiemetic therapies across chemotherapy clinics. With the yearly advancements in antiemetic therapies, the Japanese antiemetic guidelines require revisions according to published evidence regarding antiemetic management worldwide. A revised version of the first antiemetic guideline that considered several upcoming evidences had been published online in 2014 (version 1.2), in which several updated descriptions were included. The 2015 JSCO clinical practice guideline for antiemesis (version 2.0) (in Japanese) has addressed clinical antiemetic concerns and includes four major revisions regarding (1) changes in emetogenic risk categorization for anti-cancer agents, (2) olanzapine usage as an antiemetic drug, (3) the steroid-sparing method, and (4) adverse drug reactions of antiemetic agents. We herein present an English update summary for the 2015 JSCO clinical practice guideline for antiemesis (version 2.0).

Pharmacists contributed to the improved efficiency of medical practices.

Three mycobacterium strains isolated from clinical specimens in Japan were provisionally assigned to the genus Mycobacterium based on their phenotypical characteristics. These isolates were further investigated to determine their specific taxonomic statuses. Mycolic acid analysis and 16S rRNA gene, rpoB, and hsp65 sequence data for the isolates showed that they are most similar to M. terrae complex. DNA-DNA hybridization studies indicated that the three strains were of two species and were distinguishable from M. terrae, M. nonchromogenicum, and M. hiberniae. Therefore, these strains represent two novel species within the genus Mycobacterium. However, one potential new species should have been considered as M. arupense with the 16S rRNA gene and hsp65 sequences similarities of 99.8% and 100% respectively; it was isolated from human specimens in the United States and was proposed in June 2006 as a new species. This report describes the first isolation of M. arupense in Japan, suggesting that the organism is clinically relevant. In addition, we propose the novel species designation Mycobacterium kumamotonense sp. nov.

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Five strains of an unknown, multidrug-resistant coryneform, gram-positive rod were isolated from blood, bronchial aspirate, and abscess specimens. Four of the five strains isolated were highly resistant to antimicrobial agents, including ␤-lactams, aminoglycosides, macrolides, quinolones, and tetracyclines, except for glycopeptides. In immunocompromised patients, bacteremia associated with this organism was rapidly fatal. This coryneform bacterium was nonmotile, lipophilic, and nonsaccharolytic. Lack of pyrazinamidase activity differentiated this organism from other lipophilic corynebacteria. Chemotaxonomic studies indicated that this multidrug-resistant coryneform bacterium belongs to the genus Corynebacterium. Comparative 16S rRNA gene sequencing and DNA-DNA hybridization analyses revealed that the five isolates were genetically identical and that they represent a new subline within the genus Corynebacterium, for which we propose the designation Corynebacterium resistens sp. nov. The type strain of Corynebacterium resistens is GTC 2026 T (SICGH 158 T , JCM 12819 T , CCUG 50093 T ).With the exception of Corynebacterium diphtheriae, the pathogenicity of corynebacteria has been underestimated and often underappreciated, despite an increasing number of reports associating corynebacteria with human disease (2, 7). Not only is the increase in case reports of corynebacteria involved in infections consistent with improved recognition of these bacteria, it also reflects the growing number of immunocompromised patients who are at risk for opportunistic infections. With respect to opportunistic infections associated with corynebacteria, lipophilic Corynebacterium jeikeium and Corynebacterium urealyticum are multidrug-resistant species frequently associated with bacteremia in patients with underlying hematological dyscrasia (6,7,13,18). When lipophilic multidrug-resistant corynebacteria are isolated from blood cultures, those that oxidize only glucose and are negative for urease are tentatively identified as C. jeikeium.During the management of two patients, one with acute myelocytic leukemia and one with myelodysplastic syndrome, we recovered two multidrug-resistant, lipophilic, asaccharolytic, urease-negative isolates from blood cultures. In addition, three other clinically significant, lipophilic, multidrug-resistant corynebacteria were recovered, bringing the total to five isolates resistant to antimicrobial agents at a level not previously observed. Because the isolates could not be assigned to any of the established taxa of coryneform bacteria, we studied these five strains further using a polyphasic taxonomic approach that included both phenotypic and molecular genetic methods. On the basis of the results of this investigation, we propose that our isolates represent a new Corynebacterium species, Corynebacterium resistens sp. nov. MATERIALS AND METHODSStrains and culture conditions. Strains SICGH 158 (Social Insurance Central General Hospital 158 ϭ GTC 2026) and SICGH 279 (GTC 2027) included in this study were reco...

We report two cases of suture-related keratitis following penetrating keratoplasty. In both cases, Corynebacterium macginleyi was isolated from corneal specimens. Scanning electron microscopy revealed that corynebacteria could aggregate and form a biofilm. The MICs of sulbenicillin and fluoroquinolones were high for both isolates. Our findings show that C. macginleyi can cause keratitis with biofilm formation. CASE REPORT Case 1. A 74-year-old woman underwent penetrating keratoplasty for a corneal opacity. Postoperatively, she was treated with topical corticosteroids (0.1% dexamethasone) and 0.3% gatifloxacin four times daily, and her recovery was uneventful. Four months later, she visited us with a complaint of blurred vision in her right eye. Slit-lamp biomicroscopy revealed an epithelial defect and a moderate degree of stromal infiltration, along with a loose corneal suture thread. We scraped over the surface of the suppurative area of the cornea and removed the loose corneal suture thread. Direct microscopy and bacterial culture of the corneal scraping were performed. The direct microscopy of the corneal scraping demonstrated the presence of gram-positive rods, and confluent growth of corynebacteria occurred after 48 h of incubation at 37°C in a 5% CO 2 -enriched atmosphere on Columbia agar plates supplemented with 5% sheep blood (SBA). Colonies were grayish translucent and less than 0.5 mm in diameter. We considered corynebacteria to be the causative agent of the keratitis. We stopped the topical corticosteroids and 0.3% gatifloxacin and started treatment with topical 0.3% tobramycin and 0.5% cefmenoxime every hour. The corneal lesion responded to these agents promptly, and the corneal infiltration healed within 1 week.Case 2. A 49-year-old man underwent penetrating keratoplasty for bullous keratopathy caused by a birth injury. Postoperatively, he was treated with topical corticosteroids (0.1% dexamethasone) and 0.5% levofloxacin four times daily, and his recovery was uneventful. The antibiotic eye drops were stopped 1 year after surgery. When he visited us 3 years after the surgery, slit-lamp biomicroscopy revealed an epithelial defect and a corneal plaque with a loose corneal suture thread (Fig. 1A). We removed the loose corneal suture thread and performed direct microscopy and bacterial culture of the removed corneal plaque. Direct microscopy demonstrated the presence of numerous gram-positive rods (Fig. 1B), and a large number of small colonies (Ͻ0.5 mm in diameter after 48 h of incubation) were observed on SBA. We diagnosed keratitis caused by corynebacteria, stopped the topical corticosteroids, and initiated treatment with topical 0.3% tobramycin and 0.3% gatifloxacin every hour. The epithelial defect and corneal plaque disappeared within 1 week.Bacteriological findings. The isolates (EC009 in case 1 and EC010 in case 2) were suspected of being lipophilic corynebacteria because small colonies (Ͻ0.5 mm in diameter) were found after 48 h of incubation on SBA. In order to identify corynebacteria, biochem...

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