Molecular epidemiological analysis of drug-resistant Acinetobacter sp. strains detected in a northern Osaka Prefecture medical facility

In recent years, the spread of drug-resistant bacteria has become a serious problem worldwide. Species of the genus Acinetobacter, a group of pathogens that commonly cause opportunistic infections, have also become increasingly drug resistant, and cases of healthcare-associated infections have been reported.In this study, we characterized 16 drug-resistant Acinetobacter sp. strains detected at a medical facility in northern Osaka Prefecture in 2019 and 2020 through molecular epidemiological analyses. Although a multidrug-resistant Acinetobacter which showed resistance to three classes of drugs, namely carbapenems, aminoglycosides, and new quinolones was not detected, seven strains were resistant to two drugs. Moreover, species and strain identification using the POT method revealed that 15 of the strains were A. baumannii and three of them were international clones which are known to cause outbreaks. In addition, one strain that could not be identified by the POT method was found to be A. dispersus through analysis of the 16S rRNA gene sequence. Our results indicate that the number of detected strains and POT types increased and diversified over the years. In addition, some clonal strains with the same POT value showed expansion of drug resistant, suggesting that the trends in drug resistance must continue to be closely monitored

TEACCH-based group social skills training for children with high-functioning autism: a pilot randomized controlled trial.

[Background]Although social skills training programs for people with high-functioning autism (HFA) are widely practiced, the standardization of curricula, the examination of clinical effectiveness, and the evaluation of the feasibility of future trials have yet to be done in Asian countries. To compensate for this problem, a Japanese pilot randomized controlled trial (RCT) of the Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH)-based group social skills training for children with HFA and their mothers was conducted. [Methods]Eleven children with HFA, aged 5–6 years, and their mothers were randomly assigned to the TEACCH program (n=5) or a waiting-list control group (n=6). The program involved comprehensive group intervention and featured weekly 2-hour sessions, totaling 20 sessions over six months. The adaptive behaviors and social reciprocity of the children, parenting stress, and parent–child interactions were assessed using the Strengths and Difficulties Questionnaire (SDQ), Parenting Stress Index (PSI), Beck depression inventory-II (BDI-II), and Interaction Rating Scale (IRS). [Results]Through this pilot trial, the intervention and evaluation of the program has been shaped. There were no dropouts from the program and the mothers’ satisfaction was high. The outcome measurements improved more in the program group than in the control group, with moderate effect sizes (SDQ, 0.71; PSI, 0.58; BDI-II, 0.40; and IRS, 0.69). This pilot trial also implied that this program is more beneficial for high IQ children and mothers with low stress than for those who are not. [Conclusion]We have standardized the TEACCH program, confirmed the feasibility of a future trial, and successfully estimated the positive effect size. These findings will contribute to a larger trial in the future and to forthcoming systematic reviews with meta-analyses

Association between floating toe and toe grip strength in school age children: a cross-sectional study

[Purpose] This study investigated the association between floating toe and toe grip strength. [Subjects and Methods] A total of 635 Japanese children aged 9-11 years participated in this study. Floating toe was evaluated using footprint images, while toe grip strength was measured using a toe grip dynamometer. All 1, 270 feet were classified into a floating toe group and a normal toe group according to visual evaluation of the footprint images. Intergroup differences in toe grip strength were analyzed using the unpaired t-test and logistic regression analysis adjusted for age, gender, and Rohrer Index. [Results] There were 512 feet (40.3%) in the floating toe group. Mean toe grip strength of the feet with floating toe was significantly lower than that of normal feet (floating toe group, 12.9 ± 3.7 kg; normal toe group, 13.6 ± 4.1 kg). In addition, lower toe grip strength was associated with floating toe on logistic regression analysis after adjustment for age, gender, and Rohrer Index (odds ratio, 0.954; 95% confidence interval, 0.925-0.984). [Conclusion] This study revealed that lower toe grip strength was significantly associated with floating toe. Therefore, increasing toe grip strength may play a role in preventing floating toe in school age children

Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults.

[Objectives]Frailty in older adults is a serious problem because of various adverse health outcomes in many countries with aging populations, such as Japan. The purpose of this study was to determine whether frailty and pre-frailty are associated with cognitive decline and sarcopenia in community-dwelling older adults. [Design]This is a cross-sectional study. [Setting]Japan. [Participants]The participants were 273 Japanese community-dwelling older women aged 65 years and older. [Measurements]We used the frailty criteria developed by the Cardiovascular Health Study to define physical frailty. We divided the cohort into nonfrail, prefrail, and frail according to frailty scores. Cognitive decline and memory decline were defined by using the Mini-Mental State Examination and Scenery Picture Memory Test, respectively. Sarcopenia was defined according to the diagnostic algorithm recommended by the Asian Working Group for Sarcopenia. [Results]In the multivariate logistic regression analysis by using non-frail participants as the reference, pre-frail elderly individuals were significantly more likely to have sarcopenia than non-frail elderly individuals [odds ratio (OR): 2.77, 95% confidence interval (CI): 1.05–9.26], but not cognitive decline or memory decline. Frail elderly individuals were significantly more likely to have cognitive decline (OR: 5.76, 95% CI: 1.20–27.6), memory decline (OR: 5.53, 95% CI: 1.64–18.7) and sarcopenia (OR: 19.1, 95% CI: 3.73–98.0) than non-frail elderly individuals. [Conclusions]Sarcopenia was associated with pre-frailty and frailty, whereas cognitive decline was associated only with frailty

Functional Movement Screen for Predicting Running Injuries in 18- to 24-Year-Old Competitive Male Runners.

The purpose of this study was to investigate whether the functional movement screen (FMS) could predict running injuries in competitive runners. Eighty-four competitive male runners (average age = 20.0 ± 1.1 years) participated. Each subject performed the FMS, which consisted of 7 movement tests (each score range: 0-3, total score range: 0-21), during the preseason. The incidence of running injuries (time lost because of injury ≤ 4 weeks) was investigated through a follow-up survey during the 6-month season. Mann-Whitney U-tests were used to investigate which movement tests were significantly associated with running injuries. The receiver-operator characteristic (ROC) analysis was used to determine the cutoff. The mean FMS composite score was 14.1 ± 2.3. The ROC analysis determined the cutoff at 14/15 (sensitivity = 0.73, specificity = 0.54), suggesting that the composite score had a low predictability for running injuries. However, the total scores (0-6) from the deep squat (DS) and active straight leg raise (ASLR) tests (DS and ASLR), which were significant with the U-test, had relatively high predictability at the cutoff of 3/4 (sensitivity = 0.73, specificity = 0.74). Furthermore, the multivariate logistic regression analysis revealed that the DS and ASLR scores of ≤3 significantly influenced the incidence of running injuries after adjusting for subjects' characteristics (odds ratio = 9.7, 95% confidence interval = 2.1-44.4). Thus, the current study identified the DS and ASLR score as a more effective method than the composite score to screen the risk of running injuries in competitive male runners

Children with flat feet have weaker toe grip strength than those having a normal arch.

[Purpose] This study investigated the relationship between toe grip strength and foot posture in children. [Subjects and Methods] A total of 619 children participated in this study. The foot posture of the participants was measured using a foot printer and toe grip strength was measured using a toe grip dynamometer. Children were classified into 3 groups; flatfoot, normal, and high arch, according to Staheli's arch index. The differences in demographic data and toe grip strength among each foot posture group were analyzed by analysis of variance. Additionally, toe grip strength differences were analyzed by analysis of covariance, adjusted to body mass index, age, and gender. [Results] The number of participants classified as flatfoot, normal, and high arch were 110 (17.8%), 468 (75.6%), and 41 (6.6%), respectively. The toe grip strength of flatfoot children was significantly lower than in normal children, as shown by both analysis of variance and analysis of covariance. [Conclusion] A significant difference was detected in toe grip strength between the low arch and normal foot groups. Therefore, it is suggested that training to increase toe grip strength during childhood may prevent the formation of flat feet or help in the development of arch

Pseudomonas otitidis bacteremia in an immunocompromised patient with cellulitis: case report and literature review

Abstract Background Pseudomonas otitidis belongs to the genus Pseudomonas and causes various infections, including ear, skin, and soft tissue infections. P. otitidis has a unique susceptibility profile, being susceptible to penicillins and cephalosporins but resistant to carbapenems, due to the production of the metallo-β-lactamase called POM-1. This revealed genetic similarities with Pseudomonas aeruginosa, which can sometimes lead to misidentification. Case presentation We report the case of a 70-year-old Japanese male who developed cellulitis and bacteremia during chemotherapy for multiple myeloma. He was initially treated with meropenem, but blood culture later revealed gram-negative bacilli identified as P. otitidis using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Carbapenem resistance was predicted from previous reports; therefore, we switched to dual therapy with levofloxacin and cefepime, and favorable treatment results were obtained. Conclusion This is the first reported case of P. otitidis cellulitis and bacteremia in an immunocompromised patient. Carbapenems are typically used in immunocompromised patients and P. otitidis is often resistant to it. However, its biochemical properties are similar to those of Pseudomonas aeruginosa; therefore, its accurate identification is critical. In the present study, we rapidly identified P. otitidis using MALDI-TOF MS and switched from carbapenems to an appropriate antimicrobial therapy, resulting in a successful outcome

Association between the Frequency of Protein-Rich Food Intakes and Kihon-Checklist Frailty Indices in Older Japanese Adults: The Kyoto-Kameoka Study

We aimed to investigate whether frequencies of protein-rich food intake were associated with frailty among older Japanese adults. A cross-sectional study was conducted in 2011 among 3843 men and 4331 women in a population-based cohort of Kameoka city, Kyoto Prefecture, Japan. Frailty was assessed by the weighted score based on the 25-item Kihon-Checklist. The frequency of protein-rich food intake was examined as “seafood”, “meat”, “dairy products”, “eggs”, and “soy products”. The outcome of frailty was analyzed with a multiple logistic regression model using the frequency of protein-rich food intake. When compared to the first quartile, it was observed that there was a significant association between the lower adjusted prevalence ratio (PR) for frailty and the frequency of seafood intake in the fourth quartile among men (PR 0.64, 95% confidence interval (CI), 0.42, 0.99) and from the second quartile to the third quartile among women (PR 0.61, 95% CI, 0.43, 0.85; PR 0.64, 95% CI, 0.46, 0.91). The frequency of dairy products intake in the third quartile among women was significantly associated with a lower PR for frailty (p-value = 0.013). Our findings suggest that the consumption of seafood and dairy products may help older adults in maintaining their independence

Multicenter Study To Evaluate Bloodstream Infection by Helicobacter cinaedi in Japan▿

Helicobacter cinaedi has being recognized as an important human pathogen which causes bloodstream infections. Although the first case of bacteremia with this pathogen in Japan was reported in 2003, the true prevalence of H. cinaedi as a pathogen of bloodstream infections in this country is not yet known. Therefore, the aim of our study was to assess the incidence of bacteremia with H. cinaedi in Japan. We conducted a prospective, multicenter analysis in 13 hospitals during 6 months in Tokyo, Japan. Among positive blood cultures from 1 October 2003 to 31 March 2004, isolates suspected of being Helicobacter species were studied for further microbial identification. Identification of the organisms was based on their biochemical traits and the results of molecular analysis of their 16S rRNA gene sequences. A total of 16,743 blood culture samples were obtained during the study period, and 2,718 samples (17.7%) yielded positive culture results for coagulase-negative staphylococci. Among nine isolates suspected to be Helicobacter species, six isolates were finally identified as H. cinaedi. The positivity rate for H. cinaedi in blood culture was 0.06% of total blood samples and 0.22% of blood samples with any positive culture results. All patients with bacteremia with H. cinaedi were found to have no human immunodeficiency virus (HIV) infection, but many of them had complications with either malignancy, renal failure, or a history of surgical operation. Therefore, our results suggest that bacteremia with H. cinaedi is rare but can occur in compromised hosts other than those with HIV infection in Japan

Validation of Energy and Nutrition Intake in Japanese Elderly Individuals Estimated Based on a Short Food Frequency Questionnaire Compared against a 7-day Dietary Record: The Kyoto-Kameoka Study

To determine the association between geriatric disorders and dietary intake, validation of a food frequency questionnaire (FFQ) for elderly individuals is needed. We compared energy and nutrient intakes derived from dietary records (DR) and FFQ in an elderly population and compared the data against results from middle-aged individuals (30–68 years) from a previous study. Current participants included 65 women and 78 men (65–88 years) who completed FFQ and 7-day DR in a subpopulation of the Kyoto-Kameoka study. Our FFQ was created for middle-aged individuals. To validate the FFQ, we investigated equivalent precision by comparing the correlation coefficients between the present and previous study. Median correlations for energy and nutrient intake between the DR and FFQ in the current and previous studies were 0.24 and 0.30 (p = 0.329) in women and 0.24 and 0.28 (p = 0.399) in men, respectively. The median ratio of FFQ to DR for these intakes were also similar. The accuracy and precision of the FFQ for energy and nutrient intake in elderly individuals did not differ compared with previous findings in a middle-aged population. A validation study evaluating energy and nutrient intake using recovery biomarkers is further needed