Effect of Different Approaches to Antimicrobial Therapy with Cefmetazole and Meropenem on the Time to Defervescence in Non-Severe Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> Bacteremia

Carbapenems are antimicrobial agents commonly used to treat extended-spectrum β-lactamase (ESBL)-producing bacteria. Although cefmetazole (CMZ) is considered effective for ESBL-producing Escherichia coli (ESBL-EC) bacteremia, previous studies showed its limitations, including the influence of the initial antimicrobial agent. Here, we examined the effects of different approaches to antimicrobial therapy with CMZ and meropenem (MEPM) on the time to defervescence in ESBL-EC bacteremia. Notably, the influence of previous antimicrobial agents was excluded. Inpatients with ESBL-EC detected in blood cultures between April 2018 and March 2023 were included and assigned to CMZ (n = 14), MEPM (n = 8), de-escalation to CMZ (dCMZ; n = 9), or escalation to MEPM (eMEPM; n = 11) groups. The median time to defervescence was 3.5, 1.0, 2.0, and 4.0 days in the CMZ, MEPM, dCMZ, and eMEPM groups, respectively, with no significant differences. Cox proportional hazards analysis showed a significant difference in the hazard ratio (95% confidence interval) of 0.378 (0.145–0.984) for the time to defervescence with CMZ versus MEPM (p = 0.046). The extent of a delayed time to defervescence is greater with early CMZ administration than with MEPM administration in patients with non-severe ESBL-EC bacteremia

Application of Multiple Antigen Simultaneous Test to the Measurement of Allergen-specific IgA and IgG in Human Sera and Saliva

Multiple antigen simultaneous test (MAST) kit using for the measurement of allergen-specific human serum IgE was applied for the measurement of antigen-specific IgA and IgG in human serum and saliva. In measurement of IgA and IgG, an appropriate dilution by fish gelatin was necessary, 5^2 times for saliva IgA, 10^2 times for serum IgA and 10^3 times for serum IgG. When the expression of antigen-specific serum IgE, IgG and IgA, and saliva IgA in four volunteers were studied using the MAST method, a positive relationship was observed in the expression of serum IgE and serum IgA, and a negative relationship in the expression of serum IgE and saliva IgA. These results suggest possibilities that the expression of serum and saliva IgA are regulated differently and secretory IgA plays a putative role in the amelioration of food allergy