A Systematic Review of Pica and Geophagy in Japan and Korea

Pica, the craved and purposive consumption of non-food substances, is a globally widespread behavior that has critical connections to public health. Although there is a rich literature describing these behaviors from nearly every culture around the world, there is a dearth of English language literature reporting these behaviors in Japan and Korea. Here, we systematically reviewed the medical evidence of pica in Korean and Japanese language journals to confirm their presence in these cultures and to characterize culturally-specific factors associated with these behaviors. We used Ichusi-Web and KoreaMed with a broad variety of recombined search terms including “pica,” “geophagy,” “amylophagy,” and “trichobezoar” in Korean and Japanese characters. Our results confirm that pica is present in both of these cultures, with particularly frequent reports of trichobezoar (the consumption of human hair)

Latency of Klebsiella species and Escherichia coli strains that harbor a conjugative IncA/C type plasmid carrying both rmtB and bla_<CTX-M-14>

Six high-level aminoglycoside and third generated cephalosporin of cefotaxime resistance Klebsiella pneumoniae, Klebsiella oxytoca, and Escherichia coli isolated from clinical specimens in the same Japanese hospital since 2001. These 6 strains were resistant to all 4,6-disubstituted deoxystreptamine including albekacin. The results of multiplex PCR for 16S rRNA methylase and bla_, bla_, bla_ specific PCR reaction show that these strains harbor 16S rRNA methylase of rmtB and β-lactamase resistance gene of bla_ group in the same large plasmid. Sequence analysis of bla_ group PCR products shows this β-lactamase is bla_. rmtB-harbored plasmids are classified the IncA/C by PCR and restriction pattern by EcoRI show only one or two band differences. Moreover, southern hybridization of EcoRI digested rmtB harbored plasmid by rmtB probe show the same hybridization pattern of 4.8 kbp bands. PFGE fingerprinting analysis of four K. pneumoniae revealed two fingerprinting patterns. These facts suggested that rmtB-positive starains not only spread horizontal transfer of rmtB-harbored plasmid but also clonal spread of the same strain

Simple and rapid detection method for qepA1 by loop-mediated isothermal amplification

Although fluoroquinolone (FQ) has been used for the treatment of various bacterial infectious diseases, its continued use has been problematic given the appearance of FQ-resistant bacteria. However, the recent discovery of four plasmid-mediated quinolone resistance (PMQR) genes comprising qnr, aac(6\u27)Ib-cr, qepA and OqxAB since 1998 has provided insights in the area of FQ-resistance. For practical detection of qepA in microbiology laboratory, a specific, simple, rapid and cost-effective isothermal amplification method designated as LAMP is the good candidate to use. In this study, the development of a new detection method using LAMP to identify qepA1, one variant of the qepA gene, was tried. As the results, the LAMP method using a qepA1-specific LAMP primer set comprising five primerscould detect all four qepA1-positive strains in addition to 17 qepA1-negative strains. The LAMP method is clearly much more advantageous for use in clinical laboratories. Furthermore, the time and accuracy benefits allow for the selection of antibiotics in a clinical setting

Complete Genome Sequence of blaIMP–6-Positive Metakosakonia sp. MRY16-398 Isolate From the Ascites of a Diverticulitis Patient

A novel species of carbapenemase-producing Enterobacteriaceae (CPE) was isolated from a patient diagnosed with sigmoid colon diverticulitis. At first, laboratory testing suggested it was Klebsiella oxytoca or Pantoea sp.; however, a complete genome sequence of the isolate, MRY16-398, revealed that it could be novel species, most similar to [Kluyvera] intestini, of which taxonomic nomenclature is still under discussion. Orthologous conserved gene analysis among 42 related bacterial strains indicated that MRY16-398 was classified as the newly proposed genus Metakosakonia. Further, MRY16-398 was found to harbor the blaIMP-6 gene-positive class 1 integron (In722) in plasmid pMRY16-398_2 (IncN replicon, 47.4 kb in size). This finding implies that rare and opportunistic bacteria could be potential infectious agents. In conclusion, our results highlight the need for continuous monitoring for CPE even in nonpathogenic bacteria in the nosocomial environment

16S rRNA Methylase–producing, Gram-Negative Pathogens, Japan

To investigate the exact isolation frequency of 16S rRNA methylase–producing, gram-negative pathogenic bacteria, we tested 87,626 clinical isolates from 169 hospitals. Twenty-six strains from 16 hospitals harbored 16S rRNA methylase genes, which suggests sparse but diffuse spread of pan-aminoglycoside–resistant microbes in Japan

A View on 20 Years of Antimicrobial Resistance in Japan by Two National Surveillance Systems: The National Epidemiological Surveillance of Infectious Diseases and Japan Nosocomial Infections Surveillance

The Ministry of Health, Labour and Welfare (MHLW) of Japan has conducted two national surveillance systems for approximately 20 years to monitor antimicrobial resistance (AMR) in bacteria: the National Epidemiological Surveillance of Infectious Diseases (NESID) and the Japan Nosocomial Infections Surveillance (JANIS). Data accumulated for 20 years by these two surveillance systems have helped depict the epidemiology of the representative AMR bacteria in Japan chronologically. The epidemiology of methicillin-resistant Staphylococcus aureus teaches us that once AMR bacteria have established their high endemicity, controlling such AMR bacteria requires time and is challenging. On the other hand, the epidemiology that multidrug-resistant Acinetobacter sp. exhibits when a strict containment policy for AMR bacteria was introduced in the early phase of its emergence and spread reveals that it is possible to control it. Detailed epidemiology provided by these two different national surveillance systems in Japan enabled us to set up the goal for controlling each AMR bacteria at the hospital level to the prefecture/national level. It is the public health authorities’ responsibility to maintain a good surveillance system for AMR bacteria and share the data and findings with healthcare professionals and academicians

Japan nosocomial infections surveillance (JANIS): a model of sustainable national antimicrobial resistance surveillance based on hospital diagnostic microbiology laboratories

Abstract Background Antimicrobial resistance (AMR) is now recognized as a major threat to public health, and surveillance of AMR is essential for successful containment. In 2000, Japan Nosocomial Infections Surveillance (JANIS) Clinical Laboratory (CL) division has been launched as a voluntary AMR surveillance funded by the Ministry of Health, Labour and Welfare and managed by the National Institute of Infectious Diseases. In this study, we aimed to propose a model of sustainable national AMR surveillance which provides not only national AMR surveillance reports but also benchmarking reports to each hospital to facilitate infection control practices. Methods JANIS CL division collects comprehensive specimen-based data complies with JANIS data format from participating hospitals each month. It had targeted only blood and cerebrospinal fluid samples but was expanded to all types of specimens in 2007 at revision of JANIS. The JANIS system interprets the antimicrobial susceptibility according to the same criteria and conducts removal of duplicates to allow accurate comparison between hospitals. Monthly feedback reports are created automatically within 48 h, while quarterly and annual reports are generated after data validation. Results At the beginning, 468 hospitals were enrolled in the JANIS CL division, but the number of hospitals that submitted data decreased to 210 (45%) in 2006. After surveillance revision in 2007, annual recruitment of hospitals was initiated and as of 2015, 1475 hospitals participated, and 1461 (99%) of them submitted data throughout the year. Nationwide surveillance data collected over the past decade revealed that the prevalence of methicillin-resistant Staphylococcus aureus has decreased since 2008, and that its prevalence is higher in the western part of Japan, where the number of hospitals per capita is higher than in the eastern part. Conclusions JANIS CL division serves a model of sustainable national AMR surveillance system. Comprehensive data for all specimens promotes understanding of the sampling frequency and prevalence of AMR. As a well-established system for providing rich information to guide action both locally and nationally, JANIS may also be utilized for sharing AMR data globally

Plasmid-Mediated qepA Gene among Escherichia coli Clinical Isolates from Japan▿

Seven hundred fifty-one Escherichia coli clinical isolates collected from 140 Japanese hospitals between 2002 and 2006 were screened for the qepA and qnr genes. Two E. coli isolates (0.3%) harbored qepA, but no qnr was identified. The results suggested a low prevalence of E. coli harboring qepA or qnr in Japan

Emergence of the mcr-1 colistin resistance gene in extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Taiwan

Objectives: The resistance ofmcr-1-carrying Enterobacteriaceae to polymyxins, which are last-resort antibiotics, has raised great concern worldwide. In this study, four mcr-1-carrying plasmids isolated from Klebsiella pneumoniae clinical isolates were completely sequenced and the genome composition of the mcr-1-carrying plasmids was analysed. Methods: Antimicrobial resistance genes and antimicrobial susceptibility of fourmcr-1-carrying K. pneumoniae isolates were characterised. Comparison of mcr-1-carrying plasmids with closely related plasmids and analysis of the mcr-1 gene cassette were performed. Results: The genome composition of the fourmcr-1-carrying plasmids revealed the Tn6330 and Tn6390 cassettes embedded in two IncHI1-type plasmids, ΔTn6330 in an IncHI2-type plasmid, and mcr-1–pap2 in an IncX4-type plasmid. We also predicted the intermediate structures of the Tn6330 and Tn6390 cassettes. Conclusion: Dissemination of the colistin resistant genemcr-1 in Taiwan could have been driven by various plasmids and mobile gene cassettes. Evolution of the genetic environment has led to diversity in the mcr-1 gene among plasmids. This work sheds light on the urgent need for continued surveillance of the worldwide distribution of mcr-1 and evaluates the public-health risk of colistin resistance