Tominaga K

Catheter-related infections by Hansenula anomala in children.

During August and September, 1992, we experienced 4 cases of Hansenula anomala (H. anomala, synonym Pichia anomala) fungemia in immunocompromised patients. Two patients had been suffering from a malignant disease, 3 of them had received broad-spectrum antibiotics and a central venous catheter (CVC) had been inserted in all of them. H. anomala was isolated as the sole pathogen from all 4 patients. Three of them responded favorably to fluconazole after withdrawal of the catheter, but one failed. H. anomala should be considered as a possible cause of catheter-related infections.

Abdominal cerebrospinal fluid pseudocyst in a severely handicapped patient with hydrocephalus.

We present a case of an abdominal cerebrospinal fluid pseudocyst as a rare complication of a ventriculoperitoneal shunt. The patient is a severely handicapped bedridden spastic quadriplegic with hydrocephalus. He underwent surgical reconstruction of a shunt tube because of shunt disconnection at the age of 12 years. Fever and frequent vomiting developed 2 months after surgery, and abdominal fullness gradually became severe. He was diagnosed as having an abdominal cerebrospinal fluid pseudocyst on abdominal ultrasonography. If a shunt dysfunction is suspected, this type of cyst should also be considered, and abdominal ultrasonography should be performed as one of the screening tests for determining the cause of the shunt dysfunction. (J Child Neurol 1999; 14:320-322).

[Antibiotic susceptibility and T-serotypes of group A hemolytic streptococci, clinically isolated in 1986 and 1987].

Determination of T-serotype for a total 245 strains (157 strains in 1986, 88 strains in 1987) of Streptococcus pyogenes (Group A hemolytic streptococci) isolated from clinical specimens (throat swab) of pediatric patients in Fukuoka Prefecture from 1986 until 1987 were performed. The susceptibilities of 9 antibiotics against 241 strains were studied. The most dominant strain was T-12 (57 strains, 36.3%) and followed by T-4 (32 strains, 20.4%) and T-28 (30 strains, 19.1%) in 1986. The total of these three strains was 75.8% of all strains. In 1987, T-4 (41 strains, 46.6%) was the dominant strain instead of T-12 (14 strains, 15.9%). T-28 was isolated only 4 strains (4.5%) in 1987, although it was isolated in 30 stains (19.1%) in 1986. In susceptibility-tests, no strains of 1986 and 1987 was resistant to beta-lactams. Resistant strains (MIC greater than or equal to 25 micrograms/ml) to erythromycin (EM), tetracycline (TC) and chloramphenicol (CP) were 4 (2.6%), 51 (33.3%) and 1 (0.7%), respectively in 1986. In 1987, resistant strains to EM and CP were not detected, to TC were 52 strains (59.1%), so there was an increase of susceptibility to EM and CP. As for relationship between T-serotype and antibiotic resistance, only one strain (T-12) showed multiple resistance in 1986, however in 1987, multiple resistant strain was not detected. In 1986 and 1987, 31 of 49 only TC resistant strains (63.3%) and 41 of 52 only TC resistant strains (78.8%) were T-4, respectively.