The BNT162b2 and mRNA-1273 COVID-19 vaccines are the main vaccines that have been used for mass vaccination in Japan. Information on adverse reactions to COVID-19 vaccines in the Japanese population ...is limited.
We conducted an online survey on self-reported adverse reactions in individuals who had received two doses of the BNT162b2 or mRNA-1273 vaccine. The incidence of adverse events after each dose of vaccine was investigated. Propensity score matching was used to compare the incidence of adverse reactions after the second dose of the BNT162b2 and mRNA-1273 vaccines.
After the first and second doses of the BNT162b2 vaccine, and the first and second doses of the mRNA-1273 vaccine, 890, 853, 6401, and 3965 individuals, respectively, provided complete responses. Systemic reactions, including fever, fatigue, headache, muscle/joint pain, and nausea were significantly more common in females, individuals aged <50 years, and after the second dose. The incidence of injection site pain did not differ significantly according to the dose. The incidence of delayed injection site reactions after the first dose of mRNA-1273 vaccine was 3.9% and 0.8% among females and males, respectively, and 10.6% among females aged 40–69 years. Local and systemic reactions after the second dose, including fever, fatigue, headache, muscle/joint pain, nausea, and skin rash were more common in individuals who had received the mRNA-1273 vaccine.
Adverse reactions were more frequently reported in females, younger individuals, and after the mRNA-1273 vaccine.
The detailed epidemiology of invasive mycoses and superficial mycoses has not been clarified in Japan. In addition, treatment options have increased because of novel antifungals and/or guidelines for ...fungal infection. In the present study, we aimed to clarify the trends of antifungal use in Japan from 2006 to 2015 based on sales data to serve as an alternative indicator of fungal infection trends. We found that the total antifungal use decreased over time (r = −0.057, Pfor trend < 0.0001). Oral and parenteral use significantly decreased by 44.1% (r = −0.056, Pfor trend < 0.0001) and 27.1% (r = −0.0012, Pfor trend = 0.00061), respectively. The trend of antifungal use for superficial mycoses significantly decreased by 49.8% (r = −0.061, Pfor trend < 0.0001). However, the trend of antifungal use for invasive mycoses was significantly increased by 19.9% (r = 0.0032, Pfor trend = 0.00045). In Japan, the increase in the number of immunocompromised patients might be associated with the increase in the frequency of antifungal use for invasive mycoses. This is the first study to clarify the trends of antifungal use in Japan. Further research is needed to establish a continuous surveillance system to compare fungal infections between Japan and the world.
Infection by Dialister micraerophilus, an obligate anaerobic gram-negative bacillus, has rarely been described, and its clinical characteristics remain unclear.
We report a case of bacteremia caused ...by D. micraerophilus, Enterocloster clostridioformis, and Eggerthella lenta in a 47-year-old woman, associated with pyometra. D. micraerophilus was identified using 16S rRNA gene sequencing and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. D. micraerophilus was detected by polymerase chain reaction using D. micraerophilus-specific primers and E. clostridioformis and E. lenta was isolated from the drainage pus sample obtained from the pyometra uterus. The patient achieved a cure after abscess drainage and 2-week antibiotic treatment.
To the best of our knowledge, this is the first report of D. micraerophilus bacteremia. D. micraerophilus may be associated with gynecological infections. Clinicians should consider both oral and gynecological sites when searching to identify the focus of D. micraerophilus infection.
Patients after lung transplantation are at risk for Nocardia infections. We herein report a case of lung and cerebral nocardiosis caused by Nocardia elegans, a rare species of Nocardia, in a lung ...transplant recipient. Antibiotic therapy, including sulfamethoxazole-trimethoprim (ST), and brain abscess drainage improved symptoms and imaging findings. A literature review of N. elegans infections showed that 12 of 14 cases (85.7%) were reported from East Asia, particularly Japan (9 cases, 64.2%). The lungs were the predominant site (12/14 cases, 85.7%), and most of the cases were susceptible to ST (9/10 cases, 90%).
Objectives: This study has investigated the efficacy and safety of daikenchuto (DKT) in elderly patients with fecal incontinence (FI).Methods: This was an open-label, single-arm study (UMIN Clinical ...Trials Registry as UMIN000030252). DKT at 15 g/day was orally administered to patients for 28 days. Patients over 70 years old with FI, who scored over 11 in the Mini-Mental State Examination, are capable of oral intake, and provided written informed consent, were enrolled in this study. Changes in abdominal pain and bloating, Cleveland Clinic Incontinence Score (CCIS), FI Quality of Life Scale (FIQLS), maximum resting pressure (MRP), FI frequency, and stool form were evaluated.Results: In total, 21 patients (1 requested to withdraw) were enrolled in this study. The compliance rate was 95.2%, and no serious adverse drug reactions were observed. Improvements in terms of abdominal pain and bloating were observed at 2 weeks (p < 0.01). In the CCIS, the total score, leakage of solid stool, and leakage of liquid stool improved after 2 weeks (p < 0.01), while pad use and lifestyle alteration improved after 4 weeks (p < 0.05). Improvement in FIQLS was also observed at 2 weeks (p < 0.01). MRP demonstrated significant improvement at 2 weeks (p < 0.01). Eleven (52.4%) patients had no FI during the study period.Conclusions: DKT improves MRP and quality of life in patients with abdominal symptoms; moreover, it is considered to be a safe and effective drug for elderly patients with FI.
•Shared devices may become contaminated with nosocomial pathogens in hospitals.•Five (10%) of the 50 mobile phones investigated here were contaminated with MRSA.•222-nm UV disinfection is safe and ...effectively reduced MRSA CFUs in vitro.•222-nm UV disinfection reduced aerobic bacterial contamination of mobile phones.
Mobile phones may be contaminated with nosocomial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA). The aim of this study was to investigate the MRSA contamination rate on doctors’ hospital-use-only mobile phones and the efficacy of 222-nm ultraviolet light (UV) disinfection.
We investigated the MRSA contamination rate of doctors’ hospital-use-only mobile phones, as well as the reduction in MRSA counts on plastic plates and aerobic bacteria (AB) on mobile phones before and after exposure to 222-nm UV irradiation.
Five (10%) of the 50 mobile phones investigated were contaminated with MRSA. Exposure to 0.1 mJ/cm2 222-nm UVC irradiation for 1.5 and 2.5 min (9 and 15 mJ/cm2) achieved mean log10 MRSA colony-forming units reductions of 2.91 and 3.95, respectively. Exposure to 9 mJ/cm2 222-nm UVC irradiation (0.1 mW/cm2 for 1.5 minutes) significantly reduced AB contamination on mobile phones (P < .001).
The use of 222-nm UV disinfection resulted in effective in vitro reduction of MRSA and significantly reduced AB contamination of mobile phone surfaces.
Flomoxef is generally used to treat abdominal infections and as antibiotic prophylaxis during lower gastrointestinal surgery. It is reportedly effective against extended-spectrum beta-lactamase ...(ESBL)-producing Enterobacteriaceae and an increasingly valuable alternative to carbapenems. However, its abdominal pharmacokinetics remain unclear. Herein, pharmacokinetic analysis of flomoxef in the abdominal tissue was conducted to simulate dosing regimens for pharmacodynamic target attainment in abdominal sites.
Flomoxef (1 g) was administered intravenously to a patient 30 min before commencing elective lower gastrointestinal surgery. Samples of plasma, peritoneal fluid, peritoneum, and subcutaneous adipose tissue were collected during surgery. The flomoxef tissue concentrations were measured. Accordingly, non-compartmental and compartmental pharmacokinetic parameters were calculated, and simulations were conducted to evaluate site-specific pharmacodynamic target values.
Overall, 41 plasma samples, 34 peritoneal fluid samples, 38 peritoneum samples, and 41 subcutaneous adipose samples from 10 patients were collected. The mean peritoneal fluid-to-plasma ratio in the areas under the drug concentration-time curve was 0.68, the mean peritoneum-to-plasma ratio was 0.40, and the mean subcutaneous adipose tissue-to-plasma was 0.16. The simulation based on these results showed the dosing regimens (q8h 3 g/day and q6h 4 g/day) achieved the bactericidal effect (% T > minimum inhibitory concentration MIC = 40%) in all tissues at an MIC of 1 mg/L.
We elucidated the pharmacokinetics of flomoxef and simulated pharmacodynamics target attainment in the abdominal tissue. This study provides evidence concerning the use of optimal dosing regimens for treating abdominal infection caused by strains like ESBL-producing bacteria.
Cefmetazole (CMZ) has gained interest as a carbapenem-sparing alternative to the epidemic of extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-E). In this study, we investigated ...the pharmacokinetics (PK) of CMZ in plasma, peritoneal fluid, peritoneum, and subcutaneous adipose tissue to assess the dosing regimen needed to achieve pharmacodynamic (PD) goals at the target site.
Patients scheduled for elective lower gastrointestinal surgery were intravenously administered CMZ. Plasma, peritoneal fluid, peritoneum, and subcutaneous adipose tissue samples were collected after CMZ infusion and during the surgery, and CMZ concentrations were measured. The non-compartmental and compartmental PK parameters were estimated and used to evaluate site-specific PD target attainment.
A total of 38 plasma, 27 peritoneal fluid, 36 peritoneum, and 38 subcutaneous adipose tissue samples were collected from 10 patients. The non-compartmental PK analysis revealed the ratios of the mean area under the drug concentration-time curve (AUC0–3.5 h) of peritoneal fluid-to-plasma, peritoneum-to-plasma, and subcutaneous adipose tissue-to-plasma were 0.60, 0.36, and 0.11, respectively. The site-specific PD target attainment analyses based on the breakpoints for ESBL-E per the Japanese surgical site infection (SSI) surveillance (MIC90 = 8 mg/L) revealed that 2 g CMZ every 3.5 h achieved desired bactericidal effect at all sites and 2 g CMZ every 6 h achieved PD goals at peritoneum and peritoneal fluid.
These findings clarify the PK of CMZ in abdominal tissues and could help decide optimal dosing regimens to treat intra-abdominal infection and prophylaxis of SSI.
•Intermittent 222 nm UVC irradiation inactivates SARS-CoV-2 on contaminated surface.•Three different irradiance levels had a similar effect on SARS-CoV-2 reduction.•Irradiation with 222 nm UVC ...inactivates SARS-CoV-2 in a fluence-dependent manner.
The effectiveness of 222 nm ultraviolet (UV) C light for disinfecting surfaces contaminated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported. The aim of this study was to evaluate the effect of the intermittent irradiation of 222 nm UVC on SARS-CoV-2 and the fluence-dependent effect of 222 nm UVC irradiation on SARS-CoV-2 inactivation.
We experimented with 5 min continuous and intermittent irradiation for 0.1, 0.05, 0.013, and 0.003 mW/cm2 of 222 nm UVC to evaluate the differences in the effect of the continuous and intermittent irradiation of 222 nm UVC on SARS-CoV-2 inactivation. For intermittent irradiation, we followed the on-off irradiation cycles with every 10-s irradiation followed by a 380-s interval. Thereafter, we evaluated the effects of 0.1, 0.013, and 0.003 mW/cm2 222 nm UVC irradiation on SARS-CoV-2 contamination at UV fluences of 1, 2, and 3 mJ/cm2 at each irradiance.
At each irradiance, no significant difference was observed in the log reduction of SARS-CoV-2 between continuous and intermittent irradiation. At each UV fluence, no significant difference was observed in the log reduction of SARS-CoV-2 among the three different irradiance levels.
There was no significant difference between continuous and intermittent irradiation with 222 nm UVC with regards to SARS-CoV-2 inactivation. Moreover, 222 nm UVC inactivates SARS-CoV-2 in a fluence-dependent manner. The efficacy of 222-nm UVC irradiation in reducing the contamination of SARS-CoV-2 needs to be further evaluated in a real-world setting.
The national action plan on antimicrobial resistance (AMR) in Japan emphasizes the importance of understanding antimicrobial use (AMU). Some studies have been conducted on oral and parenteral AMU in ...Japan. However, there are few studies on the use of topical antimicrobials, such as in dermatology and ophthalmology. Therefore, the purpose of this study was to investigate the use of topical AMU in Japan. Data on AMU in dermatology and ophthalmology were obtained from the 2017 National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data. The number of dermatological products used was 58,396,530 in 2017. The proportions of betamethasone/gentamicin and gentamicin used were 50.5% and 16.7%, respectively, whereas that of the ingredient quantity in gentamicin was 7.8%. It has been suggested that topical AMU should be evaluated based on the number of products being used. The number of ophthalmological products used was 24,655,653 in 2017, and the proportion of quinolones used was 95.9%. The high prescription rate of quinolones may cause an increase in quinolone resistance in the ophthalmologic field. Topical AMU, which is a potential “blind spot” in the measures against AMR, needs to be continuously monitored, together with systemic AMU.
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