Antibodies to penicillin in children receiving long-term secondary prophylaxis for rheumatic fever

The occurrence of IgE and IgG antibodies to penicillin G and V in children on long-term treatment with penicillin as secondary prophylaxis for rheumatic fever was studied using Phadebas® RAST (Pharmacia Diagnostics, Uppsala, Sweden) and ELISA respectively. The duration of the prophylaxis ranged between 1.5 months and 5 years (mean 1.8 years). Of 18 patients who had been given penicillin for more than 1.5 months, two had IgE antibodies and 12 had IgG antibodies to penicillin. Patients with acute rheumatic fever who had not yet received long-term treatment with penicillin had antibodies of the IgG class in two out of 12 cases. The patients gave no history of adverse reactions to the penicillin injections and there were no signs of immune complex-mediated disease. The two children who had IgE antibodies were switched to oral erythromycin instead of the penicillin injections. Penicillin is the drug of choice in the prophylaxis of rheumatic fever and can apparently be safely given as intramuscular injections of depot-penicillin to prevent recurrences of the disease and ensuing cardiac damage.     

基因工程菌株产生的青霉素酰化酶的纯化及其性质

以构建的青霉素酰化酶基因工程菌(E.Coli 108/PPAHD 1)为材料,经硫酸铵沉淀、离子交换和制备电泳等手段将青霉素酰化酶的纯度提高了155倍,比活达17 u/mg,其凝胶电泳呈现单带。该酶有两个亚基,分子量分别为62300 d 和14900 d。并测定了该酶对温度及 pH 稳定范围、米氏常数等电点。     

Antimicrobial activity of ozenoxacin and other antimicrobials against Staphylococcus aureus strains isolated from clinical skin specimens in Japan in 2019 and 2020

Skin infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and the spread of antimicrobial resistance are a major problem in Japan. Here, we investigated the susceptibility of S. aureus clinical isolates to ozenoxacin (OZNX), a topical antimicrobial approved for superficial skin infection treatment in Japan. Susceptibility to OZNX was measured in 110 skin-derived methicillin-susceptible S. aureus (MSSA) and 130 MRSA strains isolated in 2019 and 2020 in Japan. The broth microdilution method was performed, and results were analyzed according to the Clinical and Laboratory Standard Institute (M07 and M100) guidelines. The results were compared with those of other antimicrobials used against S. aureus. The minimum inhibitory concentrations (MIC)₉₀ of OZNX for MSSA and MRSA were 0.12 and 0.25 μg/mL, respectively, indicating that OZNX exhibited the same or stronger antibacterial activity than that of the other antimicrobials tested, such as nadifloxacin, fucidic acid, and gentamicin. No strains exhibited reduced OZNX susceptibility. Notably, a low MIC of OZNX was observed even for strains with reduced susceptibility to nadifloxacin, a similar quinolone-based topical antimicrobial. OZNX is a highly potent antimicrobial used in Japan for superficial skin infections caused by S. aureus, such as impetigo contagiosa and related diseases.     

A decrease of intracellular ATP is compensated by increased respiration and acidification at sub-lethal parathion concentrations in murine embryonic neuronal cells: measurements in metabolic cell-culture chips

We present a label-free in vitro method for testing the toxic potentials of chemical substances using primary neuronal cells. The cells were prepared from 16-day-old NMRI mouse embryos and cultured on silicon chips (www.bionas.de) under the influence of different parathion concentrations with sensors for respiration (Clark-type oxygen electrodes), acidification (pH-ISFETs) and cell adhesion (interdigitated electrode structures, IDES). After 12 days in vitro, the sensor readouts were simultaneously recorded for 350 min in the presence of parathion applying a serial 1:3 dilution. The parathion-dependent data was fitted by logistic functions. IC₅₀ values of approximately 105 μM, 65 μM, and 54 μM were found for respiration, acidification, and adhesion, respectively. An IC₅₀ value of approximately 36 μM was determined from the intracellular ATP-levels of cells, which were detected by an ATP-luminescence assay using micro-well plates. While the intracellular ATP level and cell adhesion showed no deviation from a simple logistic decay, increases of approximately 29% in the respiration and 15% in the acidification rates above the control values were found at low parathion concentrations, indicating hormesis. These increases could be fitted by a modified logistic function. We believe that the label-free, continuous, multi-parametric monitoring of cell-metabolic processes may have applications in systems-biology and biomedical research, as well as in environmental monitoring. The parallel characterization of IC₅₀ values and hormetic effects may provide new insights into the metabolic mechanisms of toxic challenges to the cell.     

草分支杆菌注射液联合苄星青霉素治疗早期梅毒的疗效分析

目的:探讨草分支杆菌注射液联合苄星青霉素在早期梅毒治疗中的作用。方法:将80例早期梅毒患者分为治疗组(草分支杆菌注射液联合苄星青霉素)和对照组(单用苄星青霉素),观察时间6个月。结果:治疗3、6个月时治疗组快速血浆反应素试验(RPR)几何平均滴度低于对照组(P<0.05),治疗6个月治疗组RPR阴转率为40%,对照组为21.2%,两者差异有统计学意义(P<0.05)。结论:草分支杆菌注射液辅助治疗早期梅毒可以增强苄星青霉素驱梅的疗效。     

苏州地区2010～2011年儿童临床分离肺炎链球菌耐药监测

目的监测苏州地区儿童肺炎链球菌的临床分布及耐药性,为临床合理应用抗菌药物提供依据。方法对2010年1月～2011年6月门诊与住院患儿各临床标本分离的1 521株肺炎链球菌,采用梅里埃链球菌和肺炎球菌药敏试剂盒ATB STREP5进行MIC测定。结果 1 521株肺炎链球菌对青霉素不敏感率为43.6%,其中耐青霉素肺炎链球菌（PRSP）4.6%;低耐青霉素肺炎链球菌（PISP）39.1%。对阿莫西林、头孢噻肟、红霉素、克林霉素、四环素、复方新诺明、喹奴普丁/达福普丁,氯霉素,左旋氧氟沙星的耐药率为20.6%,21.0%,99.3%,97.6%,76.2%,92.0%,75.3%,7.0%,0.13%,未检出耐万古霉素肺炎链球菌。结论苏州地区儿童肺炎链球菌对青霉素耐药以低耐为主,青霉素仍是一个有效药物。对耐青霉素肺炎链球菌需做细菌药敏试验后再根据药敏结果合理选择用药。     

BSACI guidelines for the management of drug allergy

These guidelines have been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI) and are intended for allergists and others with a special interest in allergy. As routine or validated tests are not available for the majority of drugs, considerable experience is required for the investigation of allergic drug reactions and to undertake specific drug challenge. A missed or incorrect diagnosis of drug allergy can have serious consequences. Therefore, investigation and management of drug allergy is best carried out in specialist centres with large patient numbers and adequate competence and resources to manage complex cases. The recommendations are evidence-based but where evidence was lacking consensus was reached by the panel of specialists on the committee. The document encompasses epidemiology, risk factors, clinical patterns of drug allergy, diagnosis and treatment procedures. In order to achieve a correct diagnosis we have placed particular emphasis on obtaining an accurate clinical history and on the physical examination, as these are critical to the choice of skin tests and subsequent drug provocation. After the diagnosis of drug allergy has been established, communication of results and patient education are vital components of overall patient management.     

固定化酶催化合成头孢克洛与产物的分离纯化

应用来源于粪产碱杆菌的青霉素G酰化酶催化合成头孢克洛,并对生物转化反应过程进行了研究。在反应条件：pH 7.0、25 ℃、磷酸钠缓冲体系、加酶量3 U/mL和底物浓度60 mmol/L时,转化率达到85%,表明粪产碱杆菌青霉素G酰化酶具有较高的催化活力。研究了新型分离纯化方法,经过树脂分离的产物纯度超过95%,主要杂质含量小于0.5%,可以达到药典要求,为生物法合成头孢抗生素走向产业化奠定了基础。     

Severe Sequelae of Group B Streptococcal (Streptococcus Agalactiae) Meningitis in an 82-year-old Man

Abstract : Group B Streptococcal (GBS) meningitis is rare in adults, and only 2 cases have been reported in Japan. Here we report GBS meningitis in an 82-year-old man. The patient with a history of colon cancer developed a high fever and severe headache, and was taken to our hospital several hours later. On admission he was semi-comatose, light and corneal reflexes were normal, his neck was only mildly stiff. He was then on a respirator due to status epilepticus. Cerebrospinal fluid examination demonstrated marked pleocytoisis (46,2507/μ1, mostly polymorphonuclear cells) and GBS. With intensive care and antibiotic therapy, he regained consciousness 10 days later. However, he suffered severe dementia, hearing loss, limb muscle atrophy, and urinary retention in the chronic stage of the disease. Although survivors of adult GBS meningitis are reported to be free of severe neurologic sequelae, factors such as being the oldest patient among the reported cases, the premorbid malignancy and the marked inflammation were considered to be related to the severe neurologic sequelae in the present case.     

Syphilis treatment: old and new

Syphilis has challenged scientists and clinicians since its first appearance in the late 1400s and debate continues to surround the best practice in management. Difficulties in defining the goals of successful treatment have contributed to problems in determining recommendations for the ideal management. Treatment regimens currently in use were developed before randomised controlled trials became standard. This, combined with national differences in disease definition, staging and varying interpretations of the studies, as well as the emergence of complicating comorbid conditions, such as HIV, has resulted in a lack of consensus for treatment. This paper will discuss the history and current treatment of syphilis focusing on dilemmas faced by clinicians today, including the emergence of a resistant strain. Despite the difference between current national guidelines, penicillin G largely remains the treatment of choice. Close follow up, monitoring and ensuring adequate compliance remain the most important aspects in the treatment of syphilis.