The capsular antigen detection (CAD) kit is widely used in clinics to detect Streptococcus pneumoniae infection from urine, because it is rapid, convenient, and effective. However, there are several disadvantages, including false-positive results in children colonized with S. pneumoniae and prolonged positive readings even after the bacteria have been cleared. RP-L7/L12 is a component of the 50S ribosome that is abundant in all bacteria and is specific for each bacterial species. We investigated whether RP-L7/L12 could be used to accurately diagnose pneumococcal pneumonia infection in mouse models of pneumonia and colonization generated by infecting CBA/JN or CBA/N mice, respectively, with S. pneumoniae strain 741. RP-L7/L12 detection by enzyme-linked immunosorbent assay accurately assessed active lung infection, as RP-L7/L12 levels decreased simultaneously with the bacterial lung burden after imipenem administration in the pneumonia mouse model. Based on the data, antibodies detecting RP-L7/L12 were applied to rapid immunochromatographic strips (ICS) for urine sample testing. When we compared the ICS test with the CAD kit in the pneumonia model, the results correlated well. Interestingly, however, when the lung bacterial burden became undetectable after antibiotic treatment, the ICS test was correspondingly negative, even though the same samples tested by the CAD kit remained positive. Similarly, while the ICS test exhibited negative results in the nasal colonization model, the CAD kit demonstrated positive results. Bacterial RP-L7/L12 may be a promising target for the development of new methods to diagnose infectious disease. Further studies are warranted to determine whether such a test could be useful in children.
We document the household spread of extended-spectrum -lactamase-producing Escherichia coli. One isolate belonged to sequence type 1193 and caused urinary tract infection in a 4-month-old female, and the other isolate belonged to sequence type 131 and colonized three family members, including the index patient. These isolates carried similar Inc-I1-I␥ plasmids, harboring bla CTX-M-15 . CASE REPORT
Background: Kawasaki disease (KD) and acute myeloid leukemia (AML) both occur predominantly in young children. However, considering that the incidence rate of cancer during 0-14 years of age in Japan is 10.1 per a hundred thousand and that of KD during 0-4 years of age is 260 per a hundred thousand, there is little possibility of the same individual developing 2 diseases. Both inside and outside Japan we found at least 19 case reports of KD some relevant to cancer. Herein, we report a case of KD in a four-year-old Japanese girl with history of AML. Case report: A four-year-old Japanese girl was diagnosed with KD at 3 days of illness. She had the medical history of AML-M7 at her age of 1. She had no chimeric genes and was classed as intermediate risk. She had been treated following JPLSG AML05 protocol including etoposide, cytarabine (Ara-C), mitoxantrone, idarubicin, methotrexate (MTX), hydrocortisone (HDC) and triple intrathecal therapy (Ara-C, MTX and HDC). More than 2 years had passed without recurrence since her last chemotherapy. When we diagnosed her as KD, laboratory findings showed WBC 15.5 х103/μl with 85% neutrophils, hematocrit 33.7%, platelet count 19.1x10 6 /μl, CRP 10.5mg/dl, serum albumin 3.8g/dl and BNP 12.2pg/ml. She responded well to IVIG (2g/kg) plus prednisolone (2mg/kg/day) and ASA (30mg/kg/day). Although BNP transiently had increased to 151.8pg/ml at 5 days after onset, neither coronary arterial abnormalities nor myocardial complications were detected at 1 year of illness. Conclusions: We experienced the rare case of KD in a four-year-old Japanese girl with history of AML. She responded well to IVIG and any cardiovascular complications were not detected at 1 year of illness. Referring to only this case, it is unclear whether the history of AML could influence developing and progress of KD or not. The possibility of the same individual developing KD during 0-4 years of age and cancer during 0-14 years of age would be 2.6 per 10 million in Japan. However, among three hundred thousand cumulative patients of KD in Japan, 14 cases have been reported that they had developed cancer during 0-14 years of age. To discuss the relation to character of cancer, chemotherapy and severity or compilations of KD, more case should be evaluated.
Background:The aim of the present study was to evaluate the relationship between white deposits observed in the duodenum and malabsorption of nutrients. Methods: 132 consecutive subjects presenting with diagnostic upper endoscopy were recruited in this study. 13 C-acetate was given intraduodenally in 65 patients and 13 C-glucose in 67 patients. At the end of endoscopy, the tip of the endoscope was placed in the second part of the duodenum and 20 mL water containing 100 mg 13 C-substrate was sprayed onto the duodenal mucosa. Breath samples were taken at baseline and at 10 min intervals. Results: There were no significant differences between 13 CO2 excretion and the grade of white deposits after giving intraduodenal 13 C-acetate. A delay in the 13 CO2 excretion curve in patients with a body mass index of more than 26 was noted after giving 13 C-glucose and there was a significant delay in 13 CO2 excretion in the 'diffuse' group as compared with the other two groups. The mean values of 13 CO2 were significantly lower in obese patients than in non-obese subjects. Conclusion: Results from the duodenal infusion study using stable isotopes demonstrate a close association between diffuse white deposits on the duodenal mucosa and delayed glucose absorption.
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