Lower Limb Infection in an Infant with <i>Haemophilus influenzae</i> Serotype b / General Medicine

We describe a rare case of lower leg infection caused by <i>Haemophilus influenzae</i> serotype b (Hib) in a previously healthy 14-month-old boy. In primary care, <i>H. influenzae</i> is a common pathogen affecting children, and which causes respiratory and central nervous system infection alike. Conversely, skin and soft tissue infections caused by Hib are a somewhat rare occurrence. Beta-lactamase-negative ampicillin-resistant strains have been spreading throughout Japan, although the type of Hib in our case was cephalosporin-sensitive. As a result, we need to pay attention to Hib infection in various clinical settings.

Incidence of Community-associated Methicillin-resistant Staphylococcus aureus Infections in a Regional Hospital / Journal of Rural Medicine

<b>Background and Objective:</b> Since the early 2000s, the incidence of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections among the community of people lacking known healthcare risk factors has increased. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection and is distinct from hospital-associated MRSA (HA-MRSA) infection, which occurs among people with known healthcare risk factors. Understanding the epidemiology of CA-MRSA infections is critical; however, this has not been investigated in detail in Japan. Our objective was to investigate the incidence of CA-MRSA infections in a regional hospital. <BR><b>Patients and Methods:</b> We investigated CA-MRSA isolates and infections in a rural regional hospital by reviewing medical records of one year. Infections were classified as CA-MRSA if no established risk factors were identified. <BR><b>Results:</b> During 2008, 31 <i>Staphylococcus aureus</i> (<i>S. aureus</i>) isolates were detected in 29 unique patients, with 1 methicillin-sensitive <i>S. aureus</i> (MSSA) isolates obtained from 19 patients (66%) and MRSA obtained from 10 patients (34%). In the 10 patients with MRSA, the number of HA-MRSA and CA-MRSA cases were nine (32% of patients with <i>S. aureus</i> isolates) and one (3%), respectively. The patient with CA-MRSA was diagnosed with cellulitis due to CA-MRSA. All nine patients with HA-MRSA exhibited colonization. <BR><b>Conclusion:</b> We observed a CA-MRSA case in a regional hospital in Japan, suggesting that incidence trends of CA-MRSA should be considered in future research and treatment.