Associations of HIV testing and late diagnosis at a Japanese university hospital

OBJECTIVES: This study was conducted to clarify the rate of late diagnosis of HIV infection and to identify relationships between the reasons for HIV testing and a late diagnosis. METHODS: This retrospective cohort study was conducted among HIV-positive patients at the Jikei University Hospital between 2001 and 2014. Patient characteristics from medical records, including age, sex, sexuality, the reason for HIV testing and the number of CD4-positive lymphocytes at HIV diagnosis, were assessed. RESULTS: A total of 459 patients (men, n=437; 95.2%) were included in this study and the median age at HIV diagnosis was 36 years (range, 18-71 years). Late (CD4 cell coun

Epidemiology of Extended-Spectrum β-Lactamase Producing <i>Escherichia coli</i> in the Stools of Returning Japanese Travelers, and the Risk Factors for Colonization

<div><p>Objective</p><p>Travel overseas has recently been considered a risk factor for colonization with drug-resistant bacteria. The purpose of this study was to establish the epidemiology and risk factors associated with the acquisition of drug-resistant bacteria by Japanese travelers.</p><p>Methods</p><p>Between October 2011 and September 2012, we screened the stools of 68 Japanese returning travelers for extended-spectrum β-lactamase (ESBL) producing <i>Escherichia coli</i>. All specimens were sampled for clinical reasons. Based on the results, the participants were divided into an ESBL-producing <i>E. coli</i> positive group (18 cases; 26%) and an ESBL-producing <i>E. coli</i> negative group (50 cases; 74%), and a case-control study was performed. Microbiological analyses of ESBL-producing strains, including susceptibility tests, screening tests for metallo-β-lactamase, polymerase chain reaction amplification and sequencing of <i>bla</i>_CTX-M genes, multilocus sequence typing, and whole genome sequencing, were also conducted.</p><p>Results</p><p>In a univariate comparison, travel to India was a risk factor (Odds Ratio 13.6, 95% Confidence Interval 3.0–75.0, p<0.0001). There were no statistical differences in the characteristics of the travel, such as backpacking, purpose of travel, interval between travel return and sampling stool, and duration of travel. Although 10 of 13 analyzed strains (77%) produced CTX-M-15, no ST131 clone was detected.</p><p>Conclusion</p><p>We must be aware of the possibilities of acquiring ESBL-producing <i>E. coli</i> during travel in order to prevent the spread of these bacteria not only in Japan but globally.</p></div

The characteristics of ESBL-producing <i>E. coli</i> positive/negative groups.

1)<p>Student’s t-test, ²⁾ Fisher’s exact test.</p><p>ESBL = extended-spectrum β-lactamase; SD = standard deviation; VFR = visiting friends and relatives;</p

The characteristics of ESBL-producing <i>E. coli</i> positive/negative groups in travelers to India.

1)<p>Student’s t-test, ²⁾ Fisher’s exact test.</p><p>ESBL = extended-spectrum β-lactamase; SD = standard deviation; VFR = visiting friends and relatives;</p