Hajime Yoshioka

Microbiologic characteristics of exfoliative toxin-producing Staphylococcus aureus.

Exfoliative toxin (ET) production, phage types and antibiotic susceptibilities of 74 strains of Staphylococcus aureus isolated from patients with generalized staphylococcal scalded skin syndrome or bullous impetigo were studied. Of 74 staphylococcal isolates, 61 strains were found to produce ET by the newborn mouse assay method and the latex agglutination method. Fifteen strains were positive for ET-A, 32 for ET-B and 14 for both ET-A and ET-B. Among 61 ET-producing strains 27 (44%) were classified as Phage Group II, 16 (26%) as Group III, and 14 (23%) as Groups I and III. Of 27 Phage Group II strains 14 produced ET-A and 13 produced both ET-A and ET-B, but no strain was positive solely for ET-B. On the other hand 15 of 16 Phage Group III strains and all 14 Phage Group I and III strains produced only ET-B. It was demonstrated that the phage types of staphylococci were closely related to ET types. Characteristically the minimal inhibitory concentrations of penicillin G against ET-producing strains were less than 2 jug/ml, in contrast to other pathogenic staphylococci, 60 to 70% of which are highly penicillin G-resistant.

Placental transfer of gentamicin

A single intramuscular injection of 40 mg. of gentamicin was given to 37 pregnant women prior to delivery. Maternal and cord blood values of the drug were determined at the time of delivery. The mean peak level of 3.65 μg per milliliter in the maternal serum was reached within 30 minutes after injection, whereas that of 1.25 μg per milliliter in the cord serum was reached within 60 to 120 minutes. The mean peak level in the cord serum corresponded to 34.2 per cent of that in the maternal serum. At 60 minutes after injection, there was a significant correlation between the drug concentration in maternal and cord sera.

Selective inhibition of enterobacteriaceae in fecal flora of children by oral trimethoprim-sulfamethoxazole.

Fecal flora of nine pediatric inpatients who were receiving trimethoprim-sulfamethoxazole were studied by quantitative aerobic and anaerobic culture methods. During the course of trimethoprim-sulfamethoxazole, the number of Enterobacteriaceae decreased from 10(8-9) to 10(4-5) bacteria per g feces. The isolation rate and the number of Veillonella were also reduced. Other prominent aerobic and anaerobic flora, including Streptococcus, Bacteroidaceae and Bifidobacterium, were not affected. No overgrowth of Pseudomonas, Staphylococcus, Candida or Clostridium was noted. These results support the usefulness of oral trimethoprim-sulfamethoxazole for the prophylaxis of bacterial infection in the compromised host.

Steroid Therapy and Fatal Varicella in a Nephrotic Patient; A Necropsy case with Atypical Rash

In this paper we present an autopsy case of fatal varicella. The patient was a 14‐year‐old boy who had minimal change nephrotic syndrome. While undergoing treatment with 1.5 mg/kg/day of prednisolone, he developed atypical vesicular lesions and disseminated intravascular coagulation. He died within 3 days of showing signs of varicella. The microscopic tests revealed herpetic viral particles in many organs. When treating nephrotic syndrome with steroids, each individual patient must be taken into consideration and the smallest effective dose should be used for a shorter period.