For the purpose of a nationwide surveillance of the antimicrobial susceptibility of bacterial respiratory pathogens in patients in Japan, the Japanese Society of Chemotherapy conducted their second year survey, during the period from January to August, 2007. A total of 1178 strains were collected from clinical specimens obtained from adult patients with well-diagnosed respiratory tract infections. Susceptibility testing was evaluable for 1108 strains (226 Staphylococcus aureus, 257 Streptococcus pneumoniae, 6 Streptococcus pyogenes, 206 Haemophilus influenzae, 120 Moraxella catarrhalis, 122 Klebsiella pneumoniae, and 171 Pseudomonas aeruginosa). A total of 44 antibacterial agents, including 26 beta-lactams (four penicillins, three penicillins in combination with beta-lactamase inhibitors, four oral cephems, eight parenteral cephems, one monobactam, five carbapenems, and one penem), three aminoglycosides, four macrolides (including ketolide), one lincosamide, one tetracycline, two glycopeptides, six fluoroquinolones, and one oxazolidinone were used for the study. Analysis was conducted at the central reference laboratory according to the method recommended by the Clinical and Laboratory Standards Institute (CLSI). The incidence of methicillinresistant Staphylococcus aureus (MRSA) was high, at 59.7%, and the incidences of penicillin-intermediateresistant and -resistant Streptococcus pneumoniae (PISP and PRSP) were 30.4% and 5.1%, respectively. Among Haemophilus influenzae strains, 19.9% of them were found to be beta-lactamase-non-producing ampicillin (ABPC)-intermediately-resistant (BLNAI), 29.1% to be beta-lactamasenon-producing ABPC-resistant (BLNAR), and 6.7% to be beta-lactamase-producing ABPC-resistant (BLPAR) strains. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae was not isolated. Two isolates (1.2%) of Pseudomonas aeruginosa were found to be metallo-beta-lactamase-producing strains, including one (0.6%) suspected multidrug-resistant strain showing resistance to imipenem, amikacin, and ciprofloxacin. These data will be a useful reference for future periodic surveillance studies and for investigations to control resistant infections as well. Continued surveillance is required to prevent the further spread of these antimicrobial resistances.

ObjectiveIn optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI), stent size is usually determined according to the pre-PCI lumen size of either the distal or proximal reference site. However, the effect of the OCT imaging catheter crossing the target lesion on the reference lumen measurements has not been studied. We evaluated changes in the reference lumen size before and after PCI using frequency domain OCT.MethodsFor 100 consecutive patients with PCI, mean lumen diameter (LD) and lumen area (LA) were measured at the proximal and distal reference sites before and after coronary stent implantation with OCT.ResultsMean LD and LA of the distal reference site were significantly increased after PCI with stent implantation (2.57 ± 0.6 to 2.62 ± 0.64 mm, p < 0.01 and 5.20 ± 2.66 to 5.41 ± 2.54 mm2, p < 0.01, respectively). By contrast, these indices at the proximal reference site were significantly decreased. ROC curve analysis selected MLA of 1.50 mm2 as the best cutoff value for changes in mean LD. Distal mean LD was markedly increased after PCI in lesions with MLA < 1.50 mm (2.28 ± 0.48 to 2.40 ± 0.17 mm, P < 0.001), but did not change in lesions with MLA > 1.50 mm2. Tissue characteristics were not correlated with changes in reference lumen size.ConclusionsWhen we select the stent size during OCT-guided PCI, we need to pay attention to the decrease in the luminal measurement of the reference sites, especially in lesions with tight stenosis.

Previous studies suggested possible discordant quantitative measurements between different IVUS catheters and/or systems. The purpose of this study was to assess compatibility of two different IVUS catheters and consoles for quantitative measurements of coronary arteries. (1). In vitro study: IVUS imaging was performed in a concentric cylindrical phantom with 6 sections of known, cross-sectional diameter ranging from 3.0 to 8.0 mm. The lumen diameter (LD) and lumen cross-sectional area (LA) were measured and compared. To compare between 2 different IVUS consoles, IVUS images were obtained using a single IVUS catheter (catheter 1) connected to 2 different IVUS consoles (console 1 and 2). To compare between 2 different IVUS catheters, IVUS imaging was obtained using 2 different IVUS catheters (catheter 1 and 2) connected to a single IVUS console (console 2). (2). In vivo study: IVUS imaging was performed in 40 stented coronary arterial segments from 40 patients. The maximal stent diameter (Max SD), minimal stent diameter (minSD), and stent area (SA) were measured at both distal and proximal stent edges and compared between the two IVUS consoles (console 1 and 2) connected to a single IVUS catheter (catheter 1) (n = 20). IVUS imaging was also performed to compare between catheter 1 and 2 connected to IVUS console 2 (n = 20). Both in vitro and in vivo studies showed good correlation between the two IVUS consoles as well as two IVUS catheters. In conclusion, two IVUS catheters and consoles provide comparable IVUS measures both in vitro and in vivo.

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