1.Total Removal of a Contaminated Pacemaker under Cardiopulmonary Bypass in a Case of MRSA Septicemia.
Yutaka Hasegawa ; Susumu Ishikawa ; Akio Otaki ; Yasushi Sato ; Kazuhiro Sakata ; Toru Takahashi ; Motoi Kano ; Tetsuya Koyano ; Masao Suzuki ; Yasuo Morishita
Japanese Journal of Cardiovascular Surgery 1995;24(5):347-350
A 78-year-old man underwent successful removal of a contaminated pacemaker in a case of methicillin-resistant Staphylococcus aureus (MRSA) septicemia. Septicemia was due to a subcutaneous abscess at the site of old cut electrodes. Following debridement of the infected pacemaker pocket, residual leads and the pacemaker system were removed under cardiopulmonary bypass. Bacterial examination of arterial blood and vegetation attached to the leads showed septicemia caused by MRSA. After the operation, antibiotic therapy with vancomycin, arbekacin and minocycline was performed for several weeks. His postoperative course was uneventful without the recurrence of infection. In cases of pacemaker contamination, with septicemia, total removal of the pacemaker system and adequate antibiotic therapy are necessary.
2.Possible association between recent migration and hospitalisation for dengue in an urban population: A prospective case-control study in northern Vietnam
Ataru Tsuzuki ; Vu Trong Duoc ; Toshihiko Sunahara ; Motoi Suzuki ; Nguyen Hoang Le ; Yukiko Higa ; Lay-Myint Yoshida ; Futoshi Hasebe ; Tran Vu Phong ; Noboru Minakawa
Tropical Biomedicine 2014;31(4):698-708
A prospective case–control study was conducted in urban districts in Hanoi,
northern Vietnam to evaluate the effect of migration on the risk of hospitalisation for dengue
in a Vietnamese urban population. We enrolled laboratory-confirmed dengue patients aged
>18 years who were hospitalised in local hospitals in November and December 2010. Four
neighbourhood-matched controls for each case were recruited within a week of hospitalisation.
Sociodemographic data were collected by interviews, and the number of immature and adult
mosquitoes within household premises was counted by entomological survey. Matched-pair
analyses were conducted using conditional logistic regression models. Among 43 cases and
168 controls, 84% and 83% were migrants from rural areas, respectively. Although statistical
significance was marginal, recent migration (residing in study area for <5 years) independently
increased the risk of hospitalisation for dengue compared with inhabitants after controlling
for potential confounders (adjusted odds ratio [aOR] = 3.78; 95% confidence interval [CI] =
0.99–14.27), whereas longer-term migration (residing in study area for >6 years) did not
change the risk (aOR = 1.1; 95% CI = 0.30–4.05). Younger age (18–34 years) (aOR = 7.26; 95%
CI = 2.39–22.06) and higher adult Aedes aegypti infestation level within household premises
(aOR = 9.25; 95% CI = 1.68–51.09) were also independently associated with hospitalisation
for dengue. Recent migration from rural areas seems to increase the risk of hospitalisation for
dengue in urban populations in endemic areas. Further research including cohort study should
be done to confirm the impact of migration on the risk of dengue in urban areas.
3.The Khanh Hoa Health Project: Characterization of Study Population and Field Site Development for Clinical Epidemiological Research on Emerging and Re-Emerging Infectious Diseases
Hideki Yanai ; Vu Dinh Thiem ; Toru Matsubayashi ; Vu Thi Thu Huong ; Motoi Suzuki ; Le Phuong Mai ; Nguen Hien Anh ; Le Huu Tho ; Trung Tan Minh ; Lay Myint Yoshida ; Paul Kilgore ; Dang Duc Anh ; Koya Ariyoshi
Tropical Medicine and Health 2007;35(2):61-63
4.Population based cohort study for Pediatric Infectious Diseases research in Vietnam
Lay-Myint Yoshida ; Motoi Suzuki ; Vu Dinh Thiem ; Wolf Peter Smith ; Ataru Tsuzuki ; Vu Thi Thu Huong ; Kensuke Takahashi ; Masami Miyakawa ; Nguyen Thi Hien Anh ; Kiwao Watanabe ; Nguyen Thu Thuy Ai ; Le Huu Tho ; Paul Kilgore ; Hiroshi Yoshino ; Michiko Toizumi ; Michio Yasunami ; Hiroyuki Moriuchi ; Dang Duc Anh ; Koya Ariyoshi
Tropical Medicine and Health 2014;():-
A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges.
5.Population Based Cohort Study for Pediatric Infectious Diseases Research in Vietnam
Lay-Myint Yoshida ; Motoi Suzuki ; Vu Dinh Thiem ; Wolf Peter Smith ; Ataru Tsuzuki ; Vu Thi Thu Huong ; Kensuke Takahashi ; Masami Miyakawa ; Nguyen Thi Hien Anh ; Kiwao Watanabe ; Nguyen Thu Thuy Ai ; Le Huu Tho ; Paul Kilgore ; Hiroshi Yoshino ; Michiko Toizumi ; Michio Yasunami ; Hiroyuki Moriuchi ; Dang Duc Anh ; Koya Ariyoshi
Tropical Medicine and Health 2014;42(2SUPPLEMENT):S47-S58
A population-based cohort study on pediatric infectious diseases was established at Khanh Hoa Province, central Vietnam in 2006, to determine the etiology and risk factors for severe pediatric infectious diseases (SPID) such as acute respiratory infection (ARI), diarrhea and dengue which are the major causes of under 5 mortality. A population census survey was conducted in Nha-Trang and Ninh-Hoa to collect demographic, social-behavioral data and disease burden on SPID. The study site covered a population of 353,525 residing in 75,826 households with 24,781 children less than 5 years. Hospital databases from two hospitals covering the region were obtained. Linking the census and hospital databases, we were able to investigate on a variety of SPID such as environmental tobacco smoking exposure and increased risked of pediatric pneumonia hospitalization, population density, water supply and risk of dengue fever and animal livestock and risk of hospitalized diarrhea. To determine incidence, viral etiology and risk factors for pediatric ARI/pneumonia, we setup a population based prospective hospitalized Pediatric ARI surveillance at Khanh Hoa General Hospital, Nha-Trang in February 2007. The study has revealed RSV, rhinovirus and influenza A as major viral pathogens, role of multiple viral infection and its interaction with bacteria in the development of pneumonia. In addition, we are also conducting a birth cohort study to investigate the incidence of congenital infection and its impact on physical-neurological development, and role of host genetic polymorphism on SPID hospitalization in Vietnam. Population mobility, high cost of regular census update and low mortality are the challenges.
6.Nosocomial outbreak of coronavirus disease in two general wards during the initial wave of the pandemic in 2020, Tokyo, Japan
Naoya Sakamoto ; Masayuki Ota ; Tomoko Takeda ; Atsushi Kosaka ; Takuya Washino ; Sentaro Iwabuchi ; Minako Beppu ; Itaru Nishiduka ; Tamano Matsui ; Motoi Suzuki ; Fukumi Nakamura-Uchiyama
Western Pacific Surveillance and Response 2022;13(1):38-42
Objective:
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in China and subsequently spread worldwide. In Japan, many clusters occurred during the first wave in 2020. We describe the investigation of an early outbreak in a Tokyo hospital.
Methods:
A COVID-19 outbreak occurred in two wards of the hospital from April to early May 2020. Confirmed cases were individuals with laboratory-confirmed SARS-CoV-2 infection linked to Wards A and B, and contacts were patients or workers in Wards A or B 2 weeks before the index cases developed symptoms. All contacts were tested, and cases were interviewed to determine the likely route of infection and inform the development of countermeasures to curb transmission.
Results:
There were 518 contacts, comprising 472 health-care workers (HCWs) and 46 patients, of whom 517 were tested. SARS-CoV-2 infection was confirmed in 42 individuals (30 HCWs and 12 patients). The proportions of SARS-CoV-2 infections in HCWs were highest among surgeons, nurses, nursing assistants and medical assistants. Several HCWs in these groups reported being in close proximity to one another while not wearing medical masks. Among HCWs, infection was thought to be associated with the use of a small break room and conference room.
Discussion
Nosocomial SARS-CoV-2 infections occurred in two wards of a Tokyo hospital, affecting HCWs and patients. Not wearing masks was considered a key risk factor for infection during this outbreak; masks are now a mandated countermeasure to prevent the spread of SARS-CoV-2 infection in hospital settings.
7.Integration of publicly available case-based data for real-time coronavirus disease 2019 risk assessment, Japan
Kota Ninomiya ; Mariko Kanamori ; Naomi Ikeda ; Kazuaki Jindai ; Yura K Ko ; Kanako Otani ; Yuki Furuse ; Hiroki Akaba ; Reiko Miyahara ; Mayuko Saito ; Motoi Suzuki ; Hitoshi Oshitani
Western Pacific Surveillance and Response 2022;13(1):43-48
In response to the outbreak of coronavirus disease 2019 (COVID-19) in Japan, a national COVID-19 cluster taskforce (comprising governmental and nongovernmental experts) was established to support the country’s Ministry of Health, Labour and Welfare in conducting daily risk assessment. The assessment was carried out using established infectious disease surveillance systems; however, in the initial stages of the pandemic these were not sufficient for real-time risk assessment owing to limited accessibility, delay in data entry and inadequate case information. Also, local governments were publishing anonymized data on confirmed COVID-19 cases on their official websites as daily press releases. We developed a unique database for nationwide real-time risk assessment that included these case lists from local government websites and integrated all case data into a standardized format. The database was updated daily and checked systematically to ensure comprehensiveness and quality. Between 15 January 2020 and 15 June 2021, 776 459 cases were logged in the database, allowing for analysis of real-time risk from the pandemic. This semi-automated database was used in daily risk assessments, and to evaluate and update control measures to prevent community transmission of COVID-19 in Japan. The data were reported almost every week to the Japanese Government Advisory Panel on COVID-19 for public health responses.
8.Replacement of SARS-CoV-2 strains with variants carrying N501Y and L452R mutations in Japan: an epidemiological surveillance assessment
Yusuke Kobayashi ; Takeshi Arashiro ; Miyako Otsuka ; Yuuki Tsuchihashi ; Takuri Takahashi ; Yuzo Arima ; Yura K. Ko ; Kanako Otani ; Masato Yamauchi ; Taro Kamigaki ; Tomoko Morita-Ishihara ; Hiromizu Takahashi ; Sana Uchikoba ; Michitsugu Shimatani ; Nozomi Takeshita ; Motoi Suzuki ; Makoto Ohnishi
Western Pacific Surveillance and Response 2022;13(3):41-50
Objective:
Monitoring the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants is important due to concerns regarding infectivity, transmissibility, immune evasion and disease severity. We evaluated the temporal and regional replacement of previous SARS-CoV-2 variants by the emergent strains, Alpha and Delta.
Methods:
We obtained the results of polymerase chain reaction screening tests for variants conducted in multiple commercial laboratories. Assuming that all previous strains would be replaced by one variant, the new variant detection rate was estimated by fitting a logistic growth model. We estimated the transmission advantage of each new variant over the pre-existing virus strains.
Results:
The variant with the N501Y mutation was first identified in the Kinki region in early February 2021, and by early May, it had replaced more than 90% of the previous strains. The variant with the L452R mutation was first detected in the Kanto-Koshin region in mid-May, and by early August, it comprised more than 90% of the circulating strains. Compared with pre-existing strains, the variant with the N501Y mutation showed transmission advantages of 48.2% and 40.3% in the Kanto-Koshin and Kinki regions, respectively, while the variant with the L452R mutation showed transmission advantages of 60.1% and 71.9%, respectively.
Discussion
In Japan, Alpha and Delta variants displayed regional differences in the replacement timing and their relative transmission advantages. Our method is efficient in monitoring and estimating changes in the proportion of variant strains in a timely manner in each region.
9.Letter to the Editor: Pathogens detected from patients with acute respiratory infections negative for SARS-CoV-2, Saitama, Japan, 2020
Yuzo Arima ; Yuuki Tsuchihashi ; Osamu Takahara ; Reiko Shimbashi ; Takeshi Arashiro ; Ayu Kasamatsu ; Yusuke Kobayashi ; Katsuhiro Komase ; Takuri Takahashi ; Kanako Otani ; Fangyu Yan ; Taro Kamigaki ; Kiyosu Taniguchi ; Motoi Suzuki
Western Pacific Surveillance and Response 2024;15(1):78-79
Utilizing data presented in the article by Miyashita et al., we illustrate the importance of testing data when assessing surveillance data. Accounting for the number of tests (denominator) and positivity (proportion of tests positive for a specific pathogen(s)) improves data interpretation in ways not possible from numerator case data alone.