Third nationwide surveillance of bacterial pathogens in patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2020 and 2021: Antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.

The Japanese surveillance committee conducted a third nationwide surveillance of antimicrobial susceptibility of acute uncomplicated cystitis at 55 facilities throughout Japan between April 2020 and September 2021. In this surveillance, we investigated the susceptibility of Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Staphylococcus saprophyticus (S. saprophyticus) for various antimicrobial agents by isolating and culturing bacteria from urine samples. In total, 823 strains were isolated from 848 patients and 569 strains of target bacteria, including E. coli (n = 529, 92.9 %), K. pneumoniae (n = 28, 4.9 %), and S. saprophyticus (n = 12, 2.2 %) were isolated. The minimum inhibitory concentrations of 18 antibacterial agents were determined according to the Clinical and Laboratory Standards Institute manual. In premenopausal patients, there were 31 (10.5 %) and 20 (6.8 %) fluoroquinolone (FQ)-resistant E. coli and extended-spectrum ß-lactamase (ESBL)-producing E. coli, respectively. On the other hand, in postmenopausal patients, there were 75 (32.1 %) and 36 (15.4 %) FQ-resistant E. coli and ESBL-producing E. coli, respectively. The rate of FQ-resistant E. coli and ESBL-producing E. coli in post-menopausal women was higher than that for our previous nationwide surveillance (20.7 % and 32.1 %: p = 0.0004, 10.0 % and 15.4 %; p = 0.0259). For pre-menopausal women, there was no significant difference in the rate of FQ-resistant E. coli and ESBL-producing E. coli between this and previous reports, but the frequency of FQ-resistant E. coli and ESBL-producing E. coli exhibited a gradual increase. For appropriate antimicrobial agent selection and usage, it is essential for clinicians to be aware of the high rate of these antimicrobial-resistant bacteria in acute uncomplicated cystitis in Japan.

Second nationwide surveillance of bacterial pathogens in patients with acute uncomplicated cystitis conducted by Japanese Surveillance Committee from 2015 to 2016: antimicrobial susceptibility of Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.

The Japanese Surveillance Committee conducted a second nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for acute uncomplicated cystitis (AUC) in premenopausal patients aged 16-40 years old at 31 hospitals throughout Japan from March 2015 to February 2016. In this study, the susceptibility of causative bacteria (Escherichia coli, Klebsiella pneumoniae, Staphylococcus saprophyticus) for various antimicrobial agents was investigated by isolation and culturing of organisms obtained from urine samples. In total, 324 strains were isolated from 361 patients, including E. coli (n = 220, 67.9%), S. saprophyticus (n = 36, 11.1%), and K. pneumoniae (n = 7, 2.2%). The minimum inhibitory concentrations (MICs) of 20 antibacterial agents for these strains were determined according to the Clinical and Laboratory Standards Institute (CLSI) manual. At least 93% of the E. coli isolates showed susceptibility to fluoroquinolones and cephalosporins, whereas 100% of the S. saprophyticus isolates showed susceptibility to fluoroquinolones and aminoglycosides. The proportions of fluoroquinolone-resistant and extended-spectrum ß-lactamase (ESBL)-producing E. coli strains were 6.4% (13/220) and 4.1% (9/220), respectively. The antimicrobial susceptibility of K. pneumoniae was retained during the surveillance period, while no multidrug-resistant strains were identified. In summary, antimicrobial susceptibility results of our second nationwide surveillance did not differ significantly from those of the first surveillance. Especially the numbers of fluoroquinolone-resistant and ESBL-producing E. coli strains were not increased in premenopausal patients with AUC in Japan.

Study of Electrical Conduction Mechanism of Organic Double-Layer Diode Using Electric Field Induced Optical Second Harmonic Generation Measurement.

By using electric field induced optical second harmonic generation (EFISHG) and current voltage (I-V) measurements, we studied the electrical transport mechanism of organic double-layer diodes with a structure of Au/N, N'-di-[(1-naphthyl)-N, N'-diphenyl]-(1,1'-biphenyl)-4,4'-diamine (a-NPD)/poly(methyl methacrylate) (PMMA)/indium zinc oxide (IZO). Here the α-NPD is a carrier transport layer and the PMMA is an electrical insulating layer. The current level was very low, but the I-V characteristics showed a rectifying behavior. The EFISHG measurement selectively and directly probed the electric field across the α-NPD layer, and showed that the electric field across the a-NPD layer is completely relaxed owing to the charge accumulation at the a-NPD/PMMA interface in the region V > 0, whereas the carrier accumulation was not significant in the region V < 0. On the basis of these experimental results, we proposed a model of the rectification. Further, by coupling the I-V characteristics with the EFISHG measurement, the I-V characteristics of the diodes were well converted into the current-electric field (I-E) characteristics of the α-NPD layer and the PMMA layer. The I-E characteristics suggested the Schottky-type conduction governs the carrier transport. We conclude that the I-V measurement coupled with the EFISHG measurement is very useful to study carrier transport mechanism of the organic double-layer diodes.

Nationwide surveillance of the antimicrobial susceptibility of Chlamydia trachomatis from male urethritis in Japan.

Genital chlamydial infection is a principal sexually transmitted infection worldwide. Chlamydia trachomatis can cause male urethritis, acute epididymitis, cervicitis, and pelvic inflammatory disease as sexually transmitted infections. Fortunately, homotypic resistant C. trachomatis strains have not been isolated to date; however, several studies have reported the isolation of heterotypic resistant strains from patients. In this surveillance study, clinical urethral discharge specimens were collected from patients with urethritis in 51 hospitals and clinics in 2009 and 38 in 2012. Based on serial cultures, the minimum inhibitory concentration (MIC) could be determined for 19 isolates in 2009 and 39 in 2012. In 2009 and 2012, the MICs (MIC90) of ciprofloxacin, levofloxacin, tosufloxacin, sitafloxacin, doxycycline, minocycline, erythromycin, clarithromycin, and azithromycin were 2 µg/ml and 1 µg/ml, 0.5 µg/ml and 0.5 µg/ml, 0.125 µg/ml and 0.125 µg/ml, 0.063 µg/ml and 0.063 µg/ml, 0.125 µg/ml and 0.125 µg/ml, 0.125 µg/ml and 0.125 µg/ml, 0.016 µg/ml and 0.016 µg/ml, and 0.063 µg/ml and 0.063 µg/ml, respectively. In summary, this surveillance project did not identify any resistant strain against fluoroquinolone, tetracycline, or macrolide agents in Japan.

Fluid friction and wall viscosity of the 1D blood flow model.

We study the behavior of the pulse waves of water into a flexible tube for application to blood flow simulations. In pulse waves both fluid friction and wall viscosity are damping factors, and difficult to evaluate separately. In this paper, the coefficients of fluid friction and wall viscosity are estimated by fitting a nonlinear 1D flow model to experimental data. In the experimental setup, a distensible tube is connected to a piston pump at one end and closed at another end. The pressure and wall displacements are measured simultaneously. A good agreement between model predictions and experiments was achieved. For amplitude decrease, the effect of wall viscosity on the pulse wave has been shown as important as that of fluid viscosity.

The second nationwide surveillance of the antimicrobial susceptibility of Neisseria gonorrhoeae from male urethritis in Japan, 2012-2013.

Worldwide, the most important concern in the treatment of sexually transmitted infections is the increase in antimicrobial resistant Neisseria gonorrhoeae strains including resistance to cephalosporins, penicillins, fluoroquinolones or macrolides. To investigate the trends of antimicrobial susceptibility among N. gonorrhoeae strains isolated from male patients with urethritis, a Japanese surveillance committee conducted the second nationwide surveillance study. Urethral discharge was collected from male patients with urethritis at 26 medical facilities from March 2012 to January 2013. Of the 151 specimens, 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None of the strains was resistant to ceftriaxone, but the minimum inhibitory concentration (MIC) 90% of ceftriaxone increased to 0.125 µg/ml, and 11 (10.7%) strains were considered less susceptible with an MIC of 0.125 µg/ml. There were 11 strains resistant to cefixime, and the MICs of these strains were 0.5 µg/ml. The distributions of the MICs of fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin, were bimodal. Sitafloxacin, a fluoroquinolone, showed strong activity against all strains, including strains resistant to other three fluoroquinolones, such as ciprofloxacin, levofloxacin and tosufloxacin. The azithromycin MICs in 2 strains were 1 µg/ml.

Experimental study on the pressure and pulse wave propagation in viscoelastic vessel tubes-effects of liquid viscosity and tube stiffness.

A pulse wave is the displacement wave which arises because of ejection of blood from the heart and reflection at vascular bed and distal point. The investigation of pressure waves leads to understanding the propagation characteristics of a pulse wave. To investigate the pulse wave behavior, an experimental study was performed using an artificial polymer tube and viscous liquid. A polyurethane tube and glycerin solution were used to simulate a blood vessel and blood, respectively. In the case of the 40 wt% glycerin solution, which corresponds to the viscosity of ordinary blood, the attenuation coefficient of a pressure wave in the tube decreased from 4.3 to 1.6 dB/m because of the tube stiffness (Young's modulus: 60 to 200 kPa). When the viscosity of liquid increased from approximately 4 to 10 mPa·s (the range of human blood viscosity) in the stiff tube, the attenuation coefficient of the pressure wave changed from 1.6 to 3.2 dB/m. The hardening of the blood vessel caused by aging and the increase of blood viscosity caused by illness possibly have opposite effects on the intravascular pressure wave. The effect of the viscosity of a liquid on the amplitude of a pressure wave was then considered using a phantom simulating human blood vessels. As a result, in the typical range of blood viscosity, the amplitude ratio of the waves obtained by the experiments with water and glycerin solution became 1:0.83. In comparison with clinical data, this value is much smaller than that seen from blood vessel hardening. Thus, it can be concluded that the blood viscosity seldom affects the attenuation of a pulse wave.