Deployment of Infectious Disease Experts an Prevalence of Antimicrobial Resistance in Okayama: A Call for Training of Specialists

Objective During the ongoing global pandemic of novel coronavirus disease 2019 (COVID-19), an emerging infectious disease, the implementation and execution of infection prevention and control (IPC) is of paramount importance. In this study, we aimed to assess the current deployment of infection control medical personnel in Okayama prefecture, who are supposed to play an essential role to prevent the outbreak of infectious diseases, and the current prevalence of antimicrobial-resistant (AMR) bacteria isolated in Okayama. Materials and methods This was a descriptive study using publicly available data. The numbers of infectious disease (ID)-doctors and the certified nurses in infection control (CNIC) per 100,000 population in 47 prefectures in Japan were calculated. We then compared the detected proportions of AMR pathogens among the prefectures in 2019 to be employed as a comparative parameter, which was obtained from Japan Nosocomial Infections Surveillance (JANIS) data. Results The number of ID-doctors was the 11th highest in Japan; however, they were unevenly distributed in southern Okayama, particularly at three tertiary hospitals. While the deployment of CNIC was geographically less uneven in the prefecture, their number was lower than the domestic average. According to the JANIS data, isolation rates of AMR pathogens were high in Okayama compared to other prefectures in Japan: vancomycin-resistant Enterococcus faecium (the third-worst); cefotaxime-resistant Escherichia coil and Klebsiella pneunioniae (the third-worst and the second-worst, respectively); and meropenem-resistant Pseudomonas aeruginosa (the worst). Conclusions Our assessment provides underlying data and reinforces the need for educating multi-professional experts in the field of infectious diseases to prevent future public health threats in Okayama

ハクソウクロマトグラフィーノコウブンシカガクエノオウヨウ

京都大学0048新制・論文博士工学博士乙第2509号論工博第689号新制||工||276(附属図書館)3815UT51-49-B75(主査)教授 稲垣 博, 教授 西島 安則, 教授 中島 章夫学位規則第5条第2項該当Kyoto UniversityDA

Glaciological and chemical characteristics of snow in the inland plateau, East Queen Maud Land, Antarctica

Glaciological observations on the high plateau in the East Queen Maud Land, Antarctica, were carried out along a route of the oversnow traverse, by the 25th and 26th Japanese Antarctic Research Expeditions in 1984 and 1985. The surface topography of the dome-like plateau (Valkyrjedomen, which is the second highest in Antarctica) and the positions of ice divides were determined clearly. The position and altitude of the highest place of the dome are 77°22′S, 39°37′E and 3807m a.s.l. Snow drift samples were collected along the route from Mizuho Station to Valkyrjedomen and were melted carefully in a snow vehicle. The value of electric conductivity of the melted snow samples at 0℃ was obtained before storing in the pre-cleaned bottles. In a home laboratory, pH measurements of the samples were carried out. It was revealed that the high electric conductivity and low pH values were found among the snow samples collected in the dome area, especially around the region higher than 3600m a.s.l. The region has the different glaciological characteristics from those in the katabatic wind region, that is, the lower degree of the surface inclinations, the lower net accumulation, the more smooth surface morphology, the lower ram hardness of surface snow layer and the higher lapse rate of snow temperature at 10m depth. Taking the comparatively higher concentration of artificial radio nuclides reported in the other Antarctic inland area into consideration too, the glacio-chemical environments in the Antarctic inland region are thought to be characterized by the transportation of the stratospheric aerosols or gases

Clinical and microbiological characteristics of polymicrobial bacteremia: a retrospective, multicenter study

Purpose To clarify the clinical and microbial characteristics of polymicrobial bacteremia (PMB) to contribute to improvements in clinical diagnosis and effective early treatment. Methods This retrospective multicenter study used data from three acute-care hospitals in Okayama Prefecture, Japan, collected between January 2014 and March 2019. We reviewed the demographics, comorbidities, organisms isolated, infectious focus, and 30-day mortality of patients with PMB. Results Of the 7233 positive blood cultures, 808 (11.2%) were positive for more than one organism. Of the patients with bacteremia, 507 (7.0%) had PMB, of whom 65.3% were male. Infectious foci were identified in 78.3% of the cases, of which intra-abdominal infections accounted for 47.1%. A combination of Gram-positive cocci (GPC) (chain form) and Gram-negative rods (GNR) accounted for 32.9% of the cases, and GPC/GNR and GNR/GNR patterns were significantly associated with intra-abdominal infections. The 30-day mortality rate of patients with PMB was 18.1%, with a median of 7.5 days from diagnosis to death. The mortality in patients with an infectious focus identified was significantly lower than that in patients with an unknown focus (16.3% vs. 24.5%; p = 0.031). Conclusions Intra-abdominal infections were the most common source of PMB, and were strongly associated with a Gram-staining combination pattern of GPC (chain form)/GNR. PMB cases with an unknown focus had a poorer prognosis, highlighting the importance of early diagnosis and appropriate treatment