Psychosocial Factors and the Need for Multidisciplinary Support in Nutrition Counselling for Cancer Chemotherapy Patients.

This study aims to identify the background factors and experiences of patients with cancer with eating-related problems who require nutrition counselling. Using a mixed-methods approach, this secondary analysis study was conducted on patients with head and neck, oesophageal, gastric, colorectal, or lung cancers who were receiving outpatient chemotherapy. They completed a questionnaire measuring nutrition impact symptoms, eating-related distress, and quality of life (QOL). Patients who required nutrition counselling were interviewed to identify the specific issues they experienced. We reported on nutritional status and nutrition impact symptoms in a previous study. Of the 151 participants, 42 required nutrition counselling. Background factors associated with nutrition counselling were related to the following psychosocial variables: small number of people in the household, undergoing treatment while working, low QOL, and eating-related distress. Four themes were extracted from the specific issues experienced by patients: motivation for self-management, distress from symptoms, seeking understanding and sympathy, and anxiety and confusion. The desire for nutrition counselling was attributable to 'anxiety caused by the symptoms' and 'confusion about the information on eating'. Healthcare professionals should promote multidisciplinary collaboration after considering the factors associated with the required nutrition counselling to provide nutritional support.

Need and demand for nutritional counselling and their association with quality of life, nutritional status and eating-related distress among patients with cancer receiving outpatient chemotherapy: a cross-sectional study.

PURPOSE: Patients with cancer often experience general nutritional problems as the disease progresses. We aimed to examine if there is a need and demand for nutritional counselling among cancer outpatients, and explore relevant psychological factors pertaining to eating and nutrition. METHODS: A survey was conducted among adult patients receiving outpatient chemotherapy at the Tokyo Medical and Dental University Hospital. The participants completed self-report questionnaires, which included questions on their nutritional state (Patient-Generated Subjective Global Assessment Short Form), experience of eating-related distress and quality of life (QOL) (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30). RESULTS: Of the 151 (median age, 66.5 years) participants, 42 had a demand for nutritional counselling. Patients' experience of eating-related distress and demand for nutritional counselling were significantly associated, particularly in regard to 'conflicts over food between patients and the people surrounding them' (p = 0.005), 'concerns about food' (p = 0.007) and 'self-motivated effect related to nutrition' (p = 0.018). A significant association was also observed between the demand for nutritional counselling and global health status (p = 0.028), emotional functioning (p = 0.022), cognitive functioning (p = 0.028) and social functioning (p = 0.040) in terms of QOL. Patients with a low QOL tended to demand nutritional counselling. CONCLUSIONS: The demand for nutritional counselling was associated with QOL and eating-related distress. Therefore, medical staff caring for patients with cancer, such as attending physicians, dietitians, nurses, clinical psycho-oncologists, social workers and psychiatric oncologists, should collaborate and share information to provide nutritional counselling.

Rapid detoxification of cereulide in Bacillus cereus food poisoning.

Bacillus cereus is recognized as a major pathogenic bacterium that causes food poisoning and produces gastrointestinal diseases of 2 types: emetic and diarrheal. The emetic type, which is often linked to pasta and rice, arises from a preformed toxin, cereulide, in food. Rapid and accurate diagnostic methods for this emetic toxin are important but are limited. Here we describe 3 patients with B cereus food poisoning in which cereulide was detected and measured sequentially. Three family members began to vomit frequently 30 minutes after consuming reheated fried rice. After 6 hours, a 1-year-old brother died of acute encephalopathy. A 2-year-old sister who presented with unconsciousness recovered rapidly after plasma exchange and subsequent hemodialysis. Their mother recovered soon by fluid therapy. From leftover fried rice and the children's stomach contents, B cereus was isolated. Serum cereulide was detected in both children; it decreased to an undetected level in the sister. These cases highlight the importance of measuring the value of cereulide, which would reflect the severity of B cereus emetic food poisoning. The cases also suggest the possible role of blood-purification therapy in severe cases.

Genotyping of Pseudomonas aeruginosa isolated from cockroaches and human urine.

Molecular-epidemiological analysis of Pseudomonas aeruginosa isolated from cockroaches captured in hospitals and from patient urine was performed, employing randomly amplified polymorphic DNA (RAPD) analysis to investigate the usefulness of RAPD analysis. Four specific bands at positions of 993, 875, 521, and 402 bp were commonly detected using primer 272 in 16 of 45 cockroach-derived strains (35.6%), but not in 21 urine-derived strains. On analysis using primer 208, 4 specific bands at positions of 1,235, 1,138, 1,068, and 303 bp were commonly detected in 15 of the 45 cockroach-derived (33.3%) and 10 of the 21 patient urine-derived (47.6%) strains, in a total of 25 of 66 strains (37.8%). On cluster analysis, 12 (48.5%) and 16 (66.7%) clusters were grouped based on a homology of 89% or greater, using primer 272 and primer 208, respectively, showing that primer 208 was suitable for the confirmation of diversity. Seven patterns were clustered based on 100% homology using either primer, and 6 of these consisted of only cockroach-derived strains. In the individual groups with 100% homology, all strains in the group were isolated at an identical site during the same period. P. aeruginosa isolated from cockroaches showed diverse genotypes suggesting several sources of contamination, indicating the necessity for investigating infection control targeting cockroaches inhabiting hospitals.

Biofilm formation abilities and disinfectant-resistance of Pseudomonas aeruginosa isolated from cockroaches captured in hospitals.

Forty-five strains of Pseudomonas aeruginosa isolated from cockroaches captured in hospitals were investigated with regard to their biofilm-forming ability and resistance to various disinfectants in various cellular states. The hydrophobicity value varied among the test strains from 0.001 to 0.241, and the mean +/- standard deviation (SD) was 0.101 +/- 0.074. The relative viscosity of the extracellular product was measured. All test strains produced a mucous substance, and the value was 1.05-1.30 (mean +/- SD: 1.11 +/- 0.06), showing that all test strains had a biofilm-forming ability. Bactericidal experiments were performed using 6 disinfectants: ethanol, Hibitane, Isojin, Osvan, Tego 51, and Welpas. When bacteria in suspension were exposed to the disinfectants for 1 min (suspension test), 5 of the 6 disinfectants excluding Tego 51 completely killed all test strains, showing high bactericidal effects. In contrast, when adherent bacteria were exposed to the disinfectants for 1 min (adhesion test), the killing rate by Welpas was 100%, but those by Isojin and ethanol were lower (88.9 and 60.0%, respectively), that by Osvan was only 4.4%, and no bacteria were killed by Hibitane or Tego 51. These findings showed that the bactericidal effects markedly decreased in the case of adherent P. aeruginosa.

Isolation of Pseudomonas aeruginosa from cockroaches Captured in hospitals in Japan, and their antibiotic susceptibility.

Pseudomonas aeruginosa strains were isolated from 45 of 370 (12.2%) cockroaches captured in hospitals. By cockroach species, the bacterial strains were isolated from 39 of 181 (21.5%) Periplaneta fuliginosa and 6 of 183 (3.3%) Blattella germanica, showing a significant difference (p<0.01). Many P. aeruginosa-carrying cockroaches inhabited locker rooms (66.7%) and kitchens (17.8%). In terms of serotyping, many isolates were typed into groups A, G, and B. In drug sensitivity tests, strains showed the highest sensitivity to ciprofloxacin with an MIC90 of 0.25 microg/ml, followed by 2 microg/ml meropenem, and 4 microg/ml ceftazidime, gentamicin, and ofloxacin. In contrast, many strains were resistant to cefotaxime and minocycline, accounting for 86.7% of all resistant strains. However, there was no multidrug-resistant P. aeruginosa strain, and all strains were negative for the metallo-beta-lactamase gene (IMP-1 and VIM-2). These findings suggested that cockroach-derived P. aeruginosa may contaminate hospital environments, for which the control of disease-carrying insects in hospitals is important.

Identification of pink-pigmented bacteria isolated from environmental water samples and their biofilm formation abilities.

Sixty-seven strains of pink-pigmented bacteria, which were isolated from environmental water samples collected nationwide, were identified by partial 16S rDNA sequence analysis. In addition, the biofilm formation ability of the isolates was experimentally investigated. We could identify only 2 strains at the species level: Pedobacter roseus HS-38 and Runella slithyformis HS-77. The results showed that of the strains tested, 22 strains (32.8%) were Pedobacter spp., which was most frequently identified, followed by 19 strains (28.4%) of Arcicella spp., 16 strains (23.9%) of Deinococcus spp., 5 strains (7.5%) of Roseomonas spp., 4 strains (6.0%) of Flectobacillus spp. and 1 strain (1.5%) of Runella sp. Most isolates showed low similarity values to previously known species, and they were found to be novel species. At a result, it was difficult to identify environmental water-derived pink-pigmented bacteria at the species level. On the other hand, when we measured the absorbance by the crystal violet staining to examine the quantities of biofilm formation of these strains, fifty-five (82.0%) of the 67 isolates formed biofilm. The absorbance of Deinococcus sp. HS-75 was the highest (3.56). When comparing the absorbance values among the genera, Roseomonas spp. showed the highest absorbance (mean:1.62), followed by Deinococcus spp. (mean: 1.03), and Arcicella spp. (mean: 1.01). Strains of Flectobacillus spp. (mean: 0.48) and Pedobacter spp. (mean: 0.42) showed lower absorbance values. As above, it was shown that, at the species level, the pink-pigmented bacteria in the water in the Japanese environment had various levels of ability to form biofilm.

Identification of yellow-pigmented bacteria isolated from hospital tap water in Japan and their chlorine resistance.

Twenty-five yellow chromogenic strains isolated from hospital tap water samples collected nationwide were identified by partial 16S rDNA sequencing. In addition, the chlorine resistance of the isolates was experimentally investigated. The results showed that of the strains tested, 12 strains (48.0%) were Sphingomonas ursincola/natatoria, which was most frequently identified, followed by 2 strains (8.0%) of Mycobacterium frederiksbergense and 1 strain (4.0%) each of Sphingomonas adhaesiva, Sphingopyxis witflariensis and Porphyrobacter donghaensis. The other strains were not identified clearly but they belonged to the order of Alphaproteobacteria. On the other hand, the identification results by sequencing and biochemical property testing were not consistent in any of the strains, showing that it was difficult to accurately identify the yellow chromogenic bacteria in tap water based on only their biochemical properties. When the 25 isolates were exposed to 0.1 mg/l residual free chlorine for 1 minute, 22 isolates (88.0%) survived. When the CT (Concentration Time) value killing 99.99% of the bacteria was investigated in 6 of these survivors, M. frederiksbergense (Y-1 strain) was most resistant to chlorine with the CT value of 32 mg x min/l, followed by S. ursincola/natatoria (Y-7 strain) with the CT value of 3.3 mg x min/l. The CT values of Y-5 (Sphingomonas sp.), Y-27 (S. ursincola/natatoria) and Y-21 (Asticacaulis sp.) were within the range of 0.9-0.1 mg x min /l. Of the 6 strains, S. adhaesiva (Y-10) showed the weakest resistance with the CT value of 0.03 mg x min/l. It was clarified that most yellow chromogenic bacteria isolated from hospital tap water were Sphingomonas spp., and these bacteria were experimentally resistant to chlorine.

Characteristics of a pink-pigmented bacterium isolated from biofilm in a cooling tower in Tokyo, Japan.

Strain K-20, a Gram-negative, non-motile, non-spore-forming and strictly aerobic rod, which produces a pale pink pigment, was isolated from biofilm in a cooling tower in Tokyo, Japan. The taxonomic feature of the strain was studied using phenotypic tests and phylogenetic analysis. Phylogenetic analysis of 16S rRNA gene sequences showed that the strain was related to Roseomonas gilardii subsp. rosea, Roseomonas gilardii subsp. gilardii, Roseomonas cervicalis and Roseomonas mucosa at 94.3-94.6 sequence similarities. Growth occurred at 25-40 C and pH 5.0-10.0, optimal at 35 C and pH 7.0. Growth did not occur in the presence of >or=2% NaCl. The API 20NE identification system gave a positive result for urease, L-arabinose, potassium gluconate, adipic acid, malic acid and trisodium citrate (API code number 0201465). The predominant fatty acids of strain K-20 were C18:1Delta11 (50.8%) and C16:1 (17.2%). Cells contained ubiquinone 10 (Q-10) as the major quinone and the G+C content was 72.0 mol%. Based on phenotypic, chemotaxonomic and phylogenetic data, it was assumed that strain K-20 (=JCM 14634) is a novel species of the genus Roseomonas.