URL: http://www.clinicaltrials.gov. Unique identifier: NCT01994720.

We demonstrated that differences in the composition of n-3 and n-6 polyunsaturated fatty acids, excluding eicosapentaenoic or docosahexaenoic acid, were able to influence the Th1/Th2 balance of lymphocytes in humans as well as in mice, even with normal habitual dietary intake. Background: It has become increasingly clear that polyunsaturated fatty acids (PUFAs)

A nationwide study was undertaken to determine the susceptibility to penicillin and serotypes of Streptococcus pneumoniae in Japan. S. pneumoniae was isolated from 114 adult patients with community-acquired pneumonia over 22 months at 20 hospitals and medical centres in different regions in Japan. All but five isolates were from sputum. Forty-eight isolates (42·1%) were susceptible, 40 (35·1%) showed intermediate resistance (MIC, 0·12–1·0 μg/ml) and 26 (22·8%) were resistant (MIC, [ges ]2·0 μg/ml) to penicillin G. All isolates were susceptible to ceftriaxone (breakpoint 1 μg/ml), imipenem (4 μg/ml) and vancomycin (4 μg/ml). Most were resistant to erythromycin, clarithromycin and azithromycin; only two were resistant to levofloxacin. Differences were found in the distribution of serotypes among isolates showing susceptibility to penicillin (predominant types 3, 6B, and 19F), intermediate resistance (6B, 14, 19F, and 23F) and full resistance (19F and 23F). PFGE typing showed that 14 of the 25 strains of serotype 19F had a single DNA profile, pattern A, a pattern closely similar to that of the Taiwan multidrug-resistant 19F clone. Twelve pattern A strains were not susceptible to penicillin but carried the macrolide resistance gene mef(A). The DNA profiles of the 15 strains of 23F were also heterogeneous but six were highly similar (pattern b) yet distinct from the Spanish multidrug-resistant 23F clone although possibly related to the Taiwan multidrug-resistant 23F clone. The pattern b strains were not susceptible to penicillin and also harboured either mef(A) or erm(B). Our results indicate that multidrug-resistant pneumococci are spreading rapidly in Japan. Efforts to prevent the spread of the pandemic multidrug-resistant serotypes should be intensified.

SUMMARYThe minimum inhibitory concentration (MIC) of five antibiotics and the presence of resistance genes was determined in 163Haemophilus influenzaeisolates collected over 13 years (1987–2000) in four two-yearly sampling periods from patients with respiratory tract infections. The prevalence of β-lactamase-negative ampicillin-susceptible strains was approximately 80% over the sampling period although fewer strains (65·9%) were recovered in the period 1995–1997. TEM-1 type β-lactamase-producing strains were less frequent starting at 15·6% and declining to 2·2% in the final sampling period. Low-β-lactamase-negative ampicillin-resistant (BLNAR) strains were uncommon in 1987–1989 (2·2%), peaked to 19·5% in 1995–1997, but fell back to 11·1% by 2000. Fully BLNAR strains were not detected until the last sampling period (6·7%). The MICs of ampicillin, levofloxacin, cefditoren and ceftriaxone remained stable but there was an eight-fold increase in the MIC of cefdinir over the sampling period. Pulsed-field gel electrophoresis of DNA digests showed that three representative BLNAR strains were genetically distinct and 11 DNA profiles were identified among 17 low-BLNAR strains. These data suggest that the number of genetically altered BLNAR and low-BLNAR strains are increasing in Japan.