Early-onset and late-onset group B streptococcal disease in Japan: a nationwide surveillance study, 2004–2010

SummaryObjectivesTo clarify the incidence and prognosis of early-onset (EOD) and late-onset (LOD) GBS disease in Japan. To evaluate the influence of national guidelines issued in 2008 on the epidemiology of GBS disease.MethodsRetrospective nationwide questionnaire surveillance on culture-confirmed GBS infections between 2004 and 2010.ResultsEighty-eight EOD and 162 LOD cases were reported from 152 participating hospitals. The case fatality of EOD was 13.6% and of LOD was 8.0%. Premature birth <37 weeks (p<0.001) and low birth weight <2500g (p<0.001) were significantly associated with EOD mortality. A high rate of neurological sequelae was noted in meningitis in EOD (8/24) and LOD (29/85) cases. Based on a live-birth number of 438 359 and inborn case numbers of 36 EOD and 42 LOD, the incidence of EOD and LOD were estimated to be 0.08 (95% confidence interval (CI) 0.06–0.11)/1000 and 0.10 (95% CI 0.07–0.12)/1000 live-births, respectively. Before (2004–2008) and after (2009–2010) the issue of guidelines, the mortality of EOD (from 14.8% to 11.8%) and LOD (from 9.8% to 2.5%) improved, but the incidence was unchanged.ConclusionsThe incidence of EOD and LOD is apparently low in Japan, but the mortality and morbidity rates remain substantial. The issue of national guidelines did not affect the incidence

A gene expression profile of human corneal epithelium and the isolation of human keratin 12 cDNA. Invest Ophthalmol Vis Sci 37:1800–1809

Purpose. To describe the quantitative and qualitative aspects of gene expression in human corneal epithelium and to discover novel cornea-specific genes. Methods. A 3&apos;-directed cDNA library was constructed with messenger RNA prepared from normal human corneal epithelial cells, and inserts in 1069 randomly chosen clones were sequenced. These sequences were compared with each other to determine the frequency of appearance and were searched against GenBank for identification. The resultant expression profile, a list of gene species and their recurrences, reflected the composition of mRNA in the cornea. Recurrently appearing sequences, representing abundant transcripts, were compared with sequences in expression profiles obtained from seven other tissues and from those in dbEST to discover cornea-specific genes

Late onset group B streptococcus disease manifesting as acute suppurative parotitis

Few patients with acute suppurative parotitis (ASP) due to group B streptococcus (GBS) have been documented. Limited data on clinical and microbiological features and infectious route are available. We present a 21-day-old boy with invasive GBS disease manifesting as ASP. The patient was admitted because of irritability, fever, and erythematous swelling over the right parotid area. No purulent material exuded from the Stensen’s duct. Ultrasonography and computed tomography of the neck showed findings indicative of ASP. On the day after admission, blood culture yielded GBS. The isolate was determined as GBS serotype Ia and sequence type-23, and the patient was successfully treated with intravenous ampicillin for 10 days. A review of the literature revealed 11 GBS ASP infants including ours with age at onset between 13 days and 12 weeks. All infants had bacteremia while pus from the Stensen’s duct was detected in only one case. This finding remarkably contrasts with ASP caused by pathogens other than GBS, where the infection usually spreads via a retrograde route from Stensen’s duct. The present case and literature review indicate GBS ASP primarily arises from bloodstream infection, and that ASP should be included in an infectious focus as late onset GBS disease