1.Study of Outbreak of Infectious Gastroenteritis due to Norovirus
Shunji HORIKAWA ; Nobuko TADASA ; Keiko HIRAHARA ; Hisako ITO ; Shizue MORISUE ; Takaharu HARADA ; Yasuo EGI ; Ichiro OMORI
Journal of the Japanese Association of Rural Medicine 2008;57(1):16-21
In 2006 there was a multiple outbreak of infectious gastroenteritis due to norovirus in health care facilities, old age nursing homes and other facilities in Hiroshima Prefecture. Also at JA Yoshida General Hospital during the period from October 3 to 17, 2006, symptoms of vomiting and diarrhea were observed in a total of 47 people including 29 in-patients in three out of six wards and 18 hospital staff members.This was reported to the public health center and an emergency meeting of the Infection Control Committee was convened. Under the guidance of the Public Health Center, the Infection Control Team (ICT) immediately had a good control over the situation, took infection preventive measures, informed patients of what had happened, and restricted hospital admissions and hospital visits. The number of new patients dropped to zero on October 17.After re-examining the gastroenteritis outbreak, the ICT reviewed the existing manual and prepared a new operation manual to cope withe future outbreaks of infectious gastroenteritis, including emergency measures to be taken, staff assignments, and improvement of the hospital environment. The ICT considers that there is a need for disseminating knowledge regarding measures against the infection and for making preparations for the future as a vanguard.
Hospitals
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Gastroenteritis
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seconds
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Infectious gastroenteritis, NOS
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Infection as complication of medical care
2.5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis
Shinta MIZUNO ; Keiko ONO ; Yohei MIKAMI ; Makoto NAGANUMA ; Tomohiro FUKUDA ; Kazuhiro MINAMI ; Tatsuhiro MASAOKA ; Soichiro TERADA ; Takeshi YOSHIDA ; Keiichiro SAIGUSA ; Norimichi HIRAHARA ; Hiroaki MIYATA ; Wataru SUDA ; Masahira HATTORI ; Takanori KANAI
Intestinal Research 2020;18(1):69-78
Background/Aims:
5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota.
Methods:
We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC.
Results:
Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P< 0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P< 0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P< 0.05).
Conclusions
In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC.