{"title":"Superior in vitro Activity of Cefepime-Enmetazobactam Over Ceftazidime-Avibactam and Piperacillin-Tazobactam Against 3<sup>rd</sup> Generation cephalosporin resistant Enterobacterales.","authors":"Prabhav Aggarwal, Sonal Saxena, Anugula Amritha, Manisha Kaim","doi":"10.7883/yoken.JJID.2025.245","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2025.245","url":null,"abstract":"<p><p>The rise of extended-spectrum β-lactamase (ESBL) and carbapenem-resistant Enterobacterales (CRE) has severely limited treatment options in India. Cefepime-enmetazobactam (FPE), a novel β-lactam/β-lactamase inhibitor combination approved by the US FDA in 2024, shows promise as a carbapenem-sparing agent. A total of 383 non-duplicate resistant isolates of Escherichia coli and Klebsiella pneumoniae subsp. pneumoniae. were studied (January 2023-December 2024) at a tertiary-care centre in New Delhi. Isolates were categorized as third generation cephalosporin resistant but carbapenem-susceptible (Group A, n=258) or carbapenem-resistant (Group B, n=125). Antimicrobial susceptibility was determined by CLSI disc diffusion, and synergy with aztreonam was evaluated. Among Group A isolates, FPE exhibited the highest activity-95.4% E. coli and 97.4% K. pneumoniae susceptibility-outperforming ceftazidime-avibactam (88.1% and 84.6%) and Piperacillin tazobactam (5.4% and 10.2%, respectively). In Group B (CRE), activity was significantly lower: FPE (13% E. coli, 14.3% K. pneumoniae), CZA (31.9% and 7.1%), and PT (0%). ESBL production was observed in 88% of Group A isolates, predominantly bla<sub>CTX-M</sub> (94%), while all CRE carried bla<sub>NDM</sub> and bla<sub>OXA-48</sub> genes. FPE-aztreonam synergy was infrequent (≤4%). Cefepime-enmetazobactam demonstrated superior in vitro activity to CZA and Piperacillin Tazobactam against ESBL-producing but carbapenem-susceptible Enterobacterales, making it a potent carbapenem-sparing option.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Administrative data-based assessment of oral antibiotic prescribing for acute upper respiratory tract infections using the WHO AWaRe classification: a single-center retrospective study at a tertiary care outpatient setting in Japan (2020-2024).","authors":"Shigeru Hasebe, Hideto Anzai, Ryo Nitta, Tomohisa Kawakami, Seiya Igo, Natsumi Nakagaki, Kayo Naramoto, Keitaro Kishida, Keiji Muratsu, Daisuke Yamashita, Minoru Kawai, Maho Kikuta","doi":"10.7883/yoken.JJID.2026.041","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2026.041","url":null,"abstract":"<p><p>Outpatient antibiotic use for acute upper respiratory tract infections contributes to antimicrobial resistance, yet data from Japanese tertiary outpatient settings are limited. We retrospectively reviewed outpatient encounters at National Hospital Organization Osaka National Hospital (Osaka, Japan) from April 2020 to March 2024 with ICD-10 diagnoses J00, J01, J02, or J06. Oral antibiotic prescriptions were mapped to the 2022 World Health Organization Access/Watch/Reserve classification and assessed using a conservative, guideline-derived operational framework across indication, agent, and intended duration; multivariable logistic regression evaluated factors associated with algorithm-defined guideline nonconcordance. Among 2,431 encounters, antibiotics were prescribed in 19.5% (475/2,431). Watch-group agents accounted for 64.0% (304/475). Under the operational criteria, 92.2% (438/475) of prescriptions were algorithm-defined guideline-nonconcordant, most often because antibiotics were not indicated for the recorded diagnosis. Nonconcordant prescribing was strongly associated with age ≤12 years (adjusted odds ratio [aOR] 7.56) and acute pharyngitis (aOR 2.56 vs acute rhinosinusitis). Because assessment relied on ICD-10 and prescription data, these estimates should be interpreted as algorithm-defined guideline nonconcordance rather than definitive clinical inappropriateness. Findings highlight priorities for outpatient antimicrobial stewardship and support prospective validation with chart-level clinical data and microbiological testing.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aysun Benli, Selva Ala Selek, Seniha Başaran, Serap Şimşek Yavuz, Sevim Meşe, Atahan Çağatay, Oral Öncül, Halit Özsüt, Mustafa Önel, Ali Ağaçfidan, Haluk Eraksoy
{"title":"Long COVID symptom trajectories according to post-COVID-19 vaccination status: a prospective longitudinal study.","authors":"Aysun Benli, Selva Ala Selek, Seniha Başaran, Serap Şimşek Yavuz, Sevim Meşe, Atahan Çağatay, Oral Öncül, Halit Özsüt, Mustafa Önel, Ali Ağaçfidan, Haluk Eraksoy","doi":"10.7883/yoken.JJID.2026.021","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2026.021","url":null,"abstract":"<p><p>Long COVID remains a substantial public health challenge, and the relationship between post-COVID-19 vaccination and symptom persistence remains uncertain. This prospective longitudinal study evaluated long COVID symptom trajectories according to post-COVID-19 vaccination status. Adult patients who were unvaccinated at the time of COVID-19 diagnosis were followed at 1, 3, 6, and 9 months and categorized according to vaccination status. Symptom Tool (ST) and Impact Tool (IT) scores and SARS-CoV-2 IgG antibody levels were assessed longitudinally. A total of 59 patients (mean age 43.1±14.1 years; 45.8% male) were included, of whom eight were vaccinated. The most frequently reported symptoms were memory problems, fatigue, brain fog, word-finding difficulties, and excessive sweating. Baseline characteristics were broadly comparable between groups. ST and IT scores decreased significantly over time in the overall cohort; however, no statistically significant association between vaccination status and symptom trajectories was identified. SARS-CoV-2 IgG antibody levels were higher among vaccinated participants but were not associated with symptom burden. Given the small sample size and substantial group imbalance, the study is underpowered and the findings should be interpreted cautiously. Larger prospective studies are needed to better clarify the relationship between post-COVID-19 vaccination and long COVID outcomes.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Foodborne outbreak of norovirus GII.17 due to water contamination caused by backflow from a malfunctioning sewage tank.","authors":"Ryogo Ishihara, Yusuke Oguchi, Hisashi Takahashi, Masayuki Kikuchi, Satoshi Yoshizu, Ayako Nagano, Yasuyuki Takata, Noriaki Tateshita, Masayuki Saijo","doi":"10.7883/yoken.JJID.2026.046","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2026.046","url":null,"abstract":"<p><p>Food poisoning caused by human norovirus genotype GII.17 affecting 73 individuals occurred in a single commercial building in Sapporo, Hokkaido, Japan, from late December 2024 to early January 2025. An epidemiological and environmental investigation was carried out and it was identified that the potable water contaminated with the virus was the sole factor for patients with gastrointestinal symptoms. Furthermore, it was revealed that the building's water distribution system was tainted with the virus because the potable water storage tank for supply in the building's underground system was contaminated by sewage which flowed from the wastewater tank. A malfunction of the tank drainage system caused an overflow of sewage containing norovirus into the potable water storage tank, contaminating the building's water supply. Although the mechanism causing this norovirus outbreak is infrequent, ageing building water infrastructure may increase such risks in future, unless appropriate maintenance is regularly performed.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Core-genome single-nucleotide polymorphism (SNP) analysis of two foodborne outbreaks caused by the Bacillus cereus group in Japan.","authors":"Tsuyoshi Kudeken, Tetsuya Kakita, Haruno Taira, Morimi Teruya, Makoto Ohnishi","doi":"10.7883/yoken.JJID.2026.045","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2026.045","url":null,"abstract":"<p><p>Foodborne outbreaks caused by the Bacillus cereus group remain a public health concern, yet genome-based outbreak investigations in Japan remain limited. Whole-genome sequencing (WGS) and core-genome single-nucleotide polymorphism (cgSNP) analyses were used to characterize two foodborne outbreaks that occurred in Okinawa Prefecture, Japan, in 2021 (OB1) and 2022 (OB2). From the two outbreaks, 30 cereulide synthetase gene-positive isolates from patients, implicated foods (OB1 only), and food preparation environments were analyzed. All isolates were classified as B. paranthracis and were assigned to sequence type 26 (ST26) and panC group III. Although the two outbreaks involved B. paranthracis ST26 isolates and appeared similar by conventional typing, cgSNP analysis revealed low within-outbreak diversity (0-2 SNPs in OB1; 0-3 SNPs in OB2), while clearly separating the two outbreaks (353-356 SNPs), indicating that genetically distinct strains caused two outbreaks occurring one year apart in the same prefecture. In OB1, cgSNP clustering supported source attribution by linking the isolates from patients, foods, and the environment to the implicated catering facility. Overall, WGS-based SNP analysis enabled high-resolution discrimination and strengthened the epidemiological interpretation of the B. cereus group outbreak investigations.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Antimicrobial Resistance and Molecular Epidemiology of Campylobacter Isolates from Foodborne Illness Cases in Saitama, Japan.","authors":"Yuki Koyama, Risa Yoshida, Asami Arashima, Rie Doi, Kazumi Narisawa","doi":"10.7883/yoken.JJID.2025.230","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2025.230","url":null,"abstract":"<p><p>Campylobacter jejuni and C. coli are major causes of foodborne illness worldwide. Increasing antimicrobial resistance (AMR) and the implication of C. jejuni in Guillain-Barré syndrome (GBS), a post-infectious complication, are serious public health concerns. In this study, we characterized Campylobacter isolates from foodborne illness cases in Saitama Prefecture, Japan, focusing on AMR profiles, CPS (Penner) genotypes, multilocus sequence types (STs), and GBS-associated LOS biosynthesis genes. High resistance rates to quinolones and tetracycline were observed in C. jejuni (46.6%, 26.4%) and C. coli (50.0%, 60.0%), and C. coli also showed erythromycin resistance (25.0%), whereas C. jejuni remained susceptible. CPS genotyping of 148 C. jejuni isolates showed a high typeability rate (97.3%), supporting its utility for molecular surveillance. In a 40-isolate C. jejuni subset, MLST revealed that clonal complex 21 (CC21) predominated and ST-4526 was the most common ST. All ST-4526 isolates were quinolone-resistant and carried the GBS-associated genes cst-II (Thr51 variant), cgtA, and cgtB. The ST distribution of C. jejuni overlapped with that of chicken-derived strains, suggesting poultry as a major source of infection. These findings highlight the utility of CPS genotyping and the public health importance of the quinolone-resistant ST-4526 lineage carrying GBS-associated LOS biosynthesis genes.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genome-Epidemiological and Seroepidemiological Study of the COVID-19 Cluster in a Nursing Home.","authors":"Kei Fukuyama, Kinuko Kamiyoshi, Masae Itamochi, Shunsuke Yazawa, Kosuke Tamura, Koji Shinbo, Rie Kawakami, Yumiko Saga, Takahisa Shimada, Naobumi Sasaki, Makoto Kuroda, Kazunori Oishi, Hideki Tani","doi":"10.7883/yoken.JJID.2025.071","DOIUrl":"10.7883/yoken.JJID.2025.071","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) clusters pose a serious risk for older adults in nursing homes. Several studies have analyzed patient epidemiology and trends in blood antibody titers after COVID-19 cluster outbreaks, but few comparative analyses of the periods both before and after cluster outbreaks have been reported. This study aimed to investigate epidemiological surveys and whole-genome sequences of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in clinical specimens following a COVID-19 cluster occurrence in a nursing home. Routes and modes of infection among the study participants were analyzed using \"Pomegraph,\" a newly developed integrated graphical tool, in combination with epidemiological and genome information. Our findings showed that, although all the viruses belonged to the Omicron XBB.1.5 or XBB.1.16 subvariants of SARS-CoV-2, they were imported from three different locations, based on the genome sequences. We evaluated the amount of antibodies and neutralizing antibody titers in the participants' sera before and after the cluster outbreak. Before the cluster outbreak, no significant differences were observed between infected and uninfected participants in the period after vaccination or in the levels of antibodies and neutralizing antibody titers, which are difficult to determine in investigations of general clusters. Our results facilitated the analysis of cluster factors, such as pathogens, susceptible individuals, and transmission.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"143-149"},"PeriodicalIF":1.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of Cyclospora cayetanensis in Diarrheal Patients in Eastern India.","authors":"Ajanta Ghosal, Sanjib Kumar Sardar, Koushik Das, Tapas Haldar, Akash Prasad, Seiki Kobayashi, Yumiko Saito-Nakano, Shanta Dutta, Tomoyoshi Nozaki, Sandipan Ganguly","doi":"10.7883/yoken.JJID.2024.104","DOIUrl":"10.7883/yoken.JJID.2024.104","url":null,"abstract":"<p><p>Cyclospora cayetanensis, a food and waterborne pathogen, is responsible for prolonged diarrheal illness. This study aimed to investigate the prevalence, risk factors, and seasonal patterns of C. cayetanensis infection among diarrheal patients in eastern India. A hospital-based cross-sectional study was conducted. The overall prevalence of C. cayetanensis in the study region was determined to be 2.11%. The highest incidence (7%) was observed during the monsoon months, particularly in July and August. Children aged >5-12 years were the most susceptible group (17.8%, odds ratio [OR] = 47.45, P-value [P] < 0.0001). Individuals from households lacking proper sanitation or from rural areas showed a higher burden of infection. A statistically significant association between infection and contact with animals was also found (3.45%; OR = 2.81; P < 0.0001). Symptomatic individuals predominantly experienced profuse diarrhea with abdominal cramps. Coinfection with soil-transmitted helminths (STHs) was found to be most common in Cyclospora positive cases. Limited genetic diversity of Cyclospora was found within the population, with 6 haplotypes circulating in the region. Overall, this study highlights the public health risk posed by C. cayetanensis in eastern India. We recommend including Cyclospora detection in routine laboratory diagnoses to prevent its spread. Raising awareness of hygiene and implementing rigorous control measures will prove effective in the eradication of Cyclospora from this endemic country.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"129-137"},"PeriodicalIF":1.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ongoing Shift Toward an Earlier RSV Season in Children: The Case of Saitama After the COVID-19 Pandemic.","authors":"Masayuki Fujii, Takuma Ohnishi, Koichi Moriwaki, Tetsuya Kunikata","doi":"10.7883/yoken.JJID.2025.119","DOIUrl":"10.7883/yoken.JJID.2025.119","url":null,"abstract":"<p><p>Epidemics of respiratory syncytial virus (RSV) infection previously followed a predictable and seasonal pattern. However, the emergence of COVID-19 and the accompanying public health measures disrupted RSV seasonality worldwide. To investigate the long-term epidemiological impact, we analyzed weekly RSV-related hospitalizations in children under 15 years of age from 2018 to 2024 in Saitama Prefecture, Japan. During the COVID-19 pandemic, RSV admissions notably declined in 2020, but the number of hospitalizations returned to pre-pandemic levels. The peaks of admission rates occurred in March, in both 2023 and 2024, which were earlier than the August peaks seen in 2018 and 2019. We also found that the proportion of hospitalized patients aged ≥2 years increased notably to 30% in 2021 and 2022, and declined to 21.2% in 2024. Although an upward trend in intubation rates was observed, no statistically significant differences were found. These findings suggest that the COVID-19 pandemic led to earlier RSV outbreaks and temporary shifts in age distribution. It remains unclear whether RSV seasonality and age patterns will return to their pre-pandemic status. Ongoing surveillance is essential to better predict future outbreaks and inform optimal timing for preventive interventions, such as vaccination or monoclonal antibody administration.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"168-171"},"PeriodicalIF":1.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Outbreak of Acute Respiratory Illness Caused by Human Rhinovirus Species C at a Residential Hospital for Individuals with Severe Motor and Intellectual Disabilities.","authors":"Rina Kubota, Hiroyuki Tsukagoshi, Ryo Shimada, Yuki Nakazawa, Yuri Shinohara, Akio Saito, Fumitaka Inoue, Tsuyoshi Nakano, Nobuhiro Saruki","doi":"10.7883/yoken.JJID.2024.308","DOIUrl":"10.7883/yoken.JJID.2024.308","url":null,"abstract":"<p><p>Human rhinovirus (HRV) commonly causes mild respiratory illness but may occasionally result in severe disease requiring hospitalization. Herein, we report a respiratory outbreak at a residential hospital for individuals with severe motor and intellectual disabilities where HRV was detected. The facility housed 47 residents, 31 of whom developed symptoms. Of those, 20 symptomatic patients were tested, and HRV-C was detected in 15 of them using RT-PCR. The nucleotide identity of the detected strains was 100%, and based on phylogenetic analysis, the strain was identified as HRV-C type 56. No other pathogens were detected. Although the specific mode of transmission remains unclear, the patients had been residing at the facility for an extended period of time with limited mobility. Therefore, healthcare workers or visitors may have been the source of infection. In this outbreak, HRV-C disseminated rapidly among the residents, resulting in the spread of infections to healthcare workers and affecting healthcare. It is imperative for medical institutions, particularly long-term care facilities, to establish systems for the early detection and management of respiratory infections.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"165-167"},"PeriodicalIF":1.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}