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 ; Gastroenteritis ; seconds ; Infectious gastroenteritis, NOS ; Infection as complication of medical care

Objective: In urological operations, many endourological procedures and pre-existing urinary tract infections may cause surgical complications. It is essential to identify the risk factors for surgical site infections (SSI) and determine additional influences. Patients and Methods: In the present retrospective investigation, a total of 324 patients who underwent open urological surgery between January 2003 and December 2007 at Anjo-Kosei Hospital were assessed for SSI along with possible associated factors. Results: Forty-four cases (13.6%) proved positive for SSIs during the surveillance period. Among these, 31 demonstrated incisional SSI and 13 demonstrated deep/organ space SSI. Greater age and body mass index, low preoperative haemoglobin levels, long preoperative hospital stay, prolonged operation time and increased blood loss during surgery were all positively associated with SSI in general. For the deep/organ space SSI cases, advanced age, low preoperative haemoglobin levels, long preoperative hospital stay and prolonged operation time were significant factors. Conclusion: This study identified several independent predictors of SSI in general, as well as deep/organ space infection, for urological open surgery at our hospital. The results provided a basis for urologists to decrease the incidence of urological SSI.
Surgical aspects ; Hospitals ; Organ ; Infection as complication of medical care ; Risk Factors

Non-tubercuous mycobacterial (NTM) infection in peritoneal dialysis (PD) patients has been rarely reported. We report a case of a 55-year-old female on continuous ambulatory peritoneal dialysis (CAPD). After a 2-year-history of recurrent exit-site infection of a PD catheter caused by Mycobacterium abscessus (M. abscessus), the patient was admitted to the hospital with signs of peritonitis. Since the same species, M. abscessus, was isolated from the CAPD effluent, multiple antibiotics were administered. However, the treatments could not relieve the symptoms of her infection. Consequently, the PD catheter was removed. Her condition gradually recovered over the course of subsequent, long-term, empirical antimicrobial therapies. NTMs, especially a rapidly growing NTM infection, have rarely been reported in PD patients and are commonly resistant to a variety of antimicrobial agents. Routine acid-fast staining is most likely helpful in promptly initiating treatment against NTM infection in PD patients. Moreover, an appropriate treatment regimen for a rapidly growing NTM infection should be established by accumulating data from cases as reported here.
Infection as complication of medical care ; PUPILLARY DISTANCE ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Patients

A 73-year-old man with diabetes mellitus fell and sustained distal tibia and fibula fracture on December 8, 2006. On December 14, both tibia and fibula were internally fixed with plates, but on the ninth post-operative day, pus discharge was observed from the surgical sites. MRSA was detected and antibiotic therapy was commenced. But finally all the plates had to be removed and an external fixator was placed instead. The wounds were refractory and maggot therapy was begun from January 26, 2007. Maggots were changed twice a week for three weeks followed by vacuum-assisted closure. On the other hand, pin-tract infection was found, so the external fixator was removed and the fracture was splinted. But from the calcaneal region, pus discharge did not stop. On March 20, extensive debridement was done. From April 6, maggot therapy and vacuum-assisted closure were also used in this area. Although the fracture was malunited, all the infected wounds were healed completely and leg amputation was avoided. Maggot therapy is said to be especially effective against intractable wound such as diabetic ulcer. At present this therapy is not approved in Japan, but its use is expected to spread in the future.
Therapeutic procedure ; Maggots ; Tibia ; Fibula ; Infection as complication of medical care

A survey on intestinal parasitic infections and some risk factors of infection (social, economic and behavioral) was conducted in suburban area at Simum subdistrict, Mueang district, Nakhon Ratchasima Province during the period of April 3rd to April 11th, 2007. A total of 214 stool samples, from 85 males and 129 females were examined using simple direct smear, Kato's thick smear and modified Harada-Mori Filter Paper Strip culture technique. The results showed that the prevalence rate of protozoa infections by simple direct smear method was 17.3% (37 infected samples) in 11 males and 26 females and were from all age groups. Mixed infections (56.8%), showed higher results than single infection. The highest number of intestinal protozoan infections was Entamoeba histolytica (11.7%), followed by Blastocystis hominis (5.6%). Fifty four percent of protozoan infection was at a moderate to high level. Ninety five percent of infected cases consumed unboiled water. The prevalence rate of helminthic infections was 7% total by Kato's thick smear and Modified Harada-Mori Filter Paper Strip culture technique. Kato's Thick smear Technique showed the highest rate of Strongyloides stercolaris (2.8%), followed by hookworm infection (1.4%) Taenia spp. (0.9%), and Enterobius vermicularis (0.5%), respectively. All infections showed a light intensity, (< 200 epg), using Kato-Katz thick smear. Although Modified Harada-Mori's culture Technique showed higher S. stercolaris (3.3%) and hookworm infection (2.3%) than Kato's thick smear in the area where there is low Soil transmitted helminthes, we recommend using Simple or Kato's thick smear to determine the prevalence of parasitic infection due to these techniques being able to detect various groups of parasites, and being inexpensive and less time consuming.
seconds ; Kato ; Infection as complication of medical care ; parasitic ; suburban area

We retrospectively investigated the prevalence of influenza virus type A infection and the efficacy of Kampo medicine as a prophylactic for handicapped residents at our social welfare institution, during the 2004/5 flu season. Upon studying a nationwide surveillance report for said season, we supposed that it had been difficult to prevent mass infection at our welfare institution with the usual preventive methods, because type B had prevailed for most of the season, and because of the differing type A (AH 3) antigenicity which prevailed late-season, for which there were no type A vaccines.43 of 90 (47.8%) residents given flu vaccinations twice, and 25 of 110 (22.7%) of staff members given flu vaccinations once contracted type A influenza between March and May of 2005. Interestingly, residents who had been administered Hozai for either short-term health problems or chronic disease, demonstrated a low influenza prevalence, there being a statistically significant difference (p<0.05) between our “Hozai” and “non-Hozai” groups. Furthermore Juzentaihoto, known to enhance immune function, seemed beneficial because of its low associated morbidity rate, and only 2 of 8 residents administered it contracted flu. No difference was observed, however, between generalized “Kampo treatment” and “non-Kampo treatment” groups.We consider that certain Kampo medicines may be useful for the prevention of influenza infection, in institutionalized handicapped residents with short-term health problems. Immunological enhancements, and the influence of Hozai are discussed here.
Medicine, Kampo ; Seasons ; Infection as complication of medical care ; Influenza ; Prophylactic

Nosocomial infection management is one of the most important subjects in terms of risk management in a hospital. To achieve the nosocomial infection management appropriately, both public relations and information gathering are important. When it comes to publicity, it is desirable that information is offered quickly and efficiently and the personnel are able to access the information easily anytime and wherever they are. As for information gathering, it is also important to collect the information concerning the nosocomial infection promptly, and to tell it quickly to infection management persons including infection control team members. The infection control committee of our hospital has engaged in both publicity and information gathering by using the committee web site established in the LAN of the hospital since January 2004. The web site carries notifications, organization chart, list of committee members, various manuals, guidance of educational activities, infection management, etc. It is also used for questions and answers, and gathering information concerning nosocomial infection. The number of times the web site was accessed was about 200 every month, and was considerable at night and on holidays. This method of using the web site seems to be useful to promote nosocomial infection management.
Nosocomial Infections ; Infection as complication of medical care ; Information gathering ; Local Area Networks ; Hospitals

Infection by hepatitis B virus (HBV) is a major global health-care problem. HBV is an accepted factor in the elevated risks for liver disease such as cirrhosis and development of hepatocellular carcinoma. This problem is particularly prevalent in the Asia-Pacific region which includes Malaysia. During infection, the hepatitis B e antigen (HBeAg) is produced in the hosts. This antigen is an important serological marker for diagnosing chronic hepatitis B. Seroconversion to anti-body (anti-HBe) corresponds to the improvement of disease prognosis. However, certain mutations such as the core promoter dual mutations (A1762G1764→T1762A1764), the codon 15 variants (C1858/ T1858) and the precore stop codon mutations (TGG→TAG) can affect the HBeAg expression. This has diagnostic and clinical implications. Besides that, the HBV can be grouped into eight genotypes (A to H). Moreover, genotypic subtypes and recombinants have been observed as well. Studies have observed that these can differ in their affiliations with the mutations above as well as with disease prognosis.
Hepatitis B virus measurement ; Hepatitis B e Antigens ; Infection as complication of medical care ; MALAYSIAN ; prognostic

We investigated the immunogenicity of recombinant rMSP1 (rPbMSP1) that was generated from Plasmodium berghei. The rPbMSP1 formulated in alum was found to be immunogenic which induced high levels of specific anti-rPbMSP1 antibody. The IgG2a response predominated over IgG1 during the challenge infection in the vaccinated mice. Mice vaccinated with rPbMSP1 in alum mounted significant protective immunity against challenge infection (P < 0.01). On day 121 after the booster, three out of ten mice immunized with rPbMSP1 in PBS survived parasite infection (P < 0.05) and eight out of ten mice vaccinated with r MSP1 in alum did (P < 0.01). Hence, immunization with MSP1 in alum obviously has conferred protective effects, which prevented death from P. berghei lethal infection in mice (P < 0.01). These observations provide an excellent model for clinical assessment of this formulation in human subjects.
aluminum sulfate ; Laboratory mice ; upper case pea ; Infection as complication of medical care ; protect

The objective was to estimate the prevalence of intestinal protozoa among the aborigines and to determine the problems regarding the infection. The study was carried out in January 2006 in Pos Senderut, Pahang, Malaysia. Samples of faeces were collected from children and adults and these were fixed in PVA and trichrome staining was carried out. From the 130 individuals studied, 94 (72.3%) were positive with at least one intestinal protozoa. Nine intestinal protozoa namely Blastocystis hominis, Giardia lamblia, Entamoeba histolytica, Entamoeba coli, Endolimax nana, Entamoeba hartmani, Entamoeba polecki, Iodamoeba butschlii and Chilomastix mesnili were detected. The prevalent species were B. hominis (52.3%), followed by G. lamblia (29.2%), E. coli (26.2%) and E. histolytica (18.5%). The other species ranged from 1.5 to 10.8%. Among the positive samples, mixed infection with E. histolytica and G. lamblia was 3.8%, E. histolytica and B. hominis was 15.4%, G. lamblia and B. hominis was 17.7%. Triple infection of E. histolytica, G. lamblia and B. hominis was 3.1%. The infection was more prevalent in children below 10 years age group (45.4%) and lowest in the age above 60 years (3.8%). The high prevalence was attributable to poor environmental management, poor personal hygiene and lack of health education.
Protozoal ; upper case gee ; Upper case ee ; Upper case Bee ; Infection as complication of medical care