0001). Ct of smear-positive/smear-trace/smear-negative specimens were 21.7 ± 4.2/26.5 ± 3.9/27.4 ± 3.6, respectively. Rifampin resistance tested by Xpert and culture was 98.3% concordant. Region covered by probe E was the most frequently mutated (50.0%). Xpert showed reliable performance in detecting pulmonary tuberculosis in smear-positive/culture-positive specimens and further improvements are needed for smear negative/culture positive specimens.Genes conferring carbapenem resistance have spread worldwide among gram-negative bacteria. Subtyping of these genes has epidemiological value due to the global cross-border movement of people. Subtyping of blaIMP genes that frequently detected in Japan appears to be important in public health settings; however, there are few useful tools for this purpose. We developed a subtyping screening tool based on PCR direct sequencing, which targets the internal sequences of almost all blaIMP genes. The tool used bipartite multiplex primers with M13 universal sequences at the 5'-end. According to in silico analysis, among the 78 known IMP-type genes, except for blaIMP-81, 77 detected genes were estimated to be differentiated. In vitro evaluation indicated that sequences of amplicons of IMP-1, IMP-6, IMP-7, and IMP-20 templates were identical to their respective subtypes. Even if the amplicons were small or undetectable through the first PCR, sufficient amplicons for DNA sequencing were obtained through a second PCR using the M13 universal primers. In conclusion, our tool can be possibly used for subtype screening of blaIMP, which is useful for the surveillance of bacteria with blaIMP in clinical and public health settings or environmental fields.Sputum microscopy and Xpert MTB/RIF are the primary rapid diagnostic methods for tuberculosis (TB) in Nepal. Disagreements among Xpert, microscopy, and culture, for example, cases with Xpert positive and microscopy negative, were frequently observed in Nepal including in our reference laboratory. The objective of this study was to compare the effectiveness of Xpert with culture and microscopy for TB diagnosis in Nepal. A total of 125 TB suspected sputum samples were processed for Xpert, microscopy, and culture. The Xpert results when compared with culture showed 100% sensitivity and 97.4% specificity with an excellent agreement (kappa = 0.96), whereas microscopy showed the sensitivity and specificity of 43.2% and 98.7%, respectively, with a moderate agreement (kappa = 0.4). The sensitivity and specificity of microscopy, when compared with Xpert, were 43.5% and 100%, respectively. The majority of Xpert positive samples of a medium MTB detection and all samples of low and very low MTB detection were missed by microscopy. Our study showed that Xpert MTB/RIF is a reliable tool for the diagnosis and management of TB in Nepal. Because of its high cost and sustainability, alternative simple and rapid diagnostic methods with a similar efficiency would be helpful for TB control in Nepal.Neonatal pertussis has the potential for severe complications, even death. Mothers have been identified as the most frequent source of neonatal pertussis. Almost a dozen countries have implemented pertussis vaccination programs for pregnant women to protect neonates, but Japan has not yet done so. The aim of this questionnaire-based study was to ascertain the willingness of women to be vaccinated during pregnancy and the factors associated with willingness. Subjects were 977 pregnant women who visited either of two selected hospitals for maternity health checks. Most of the women were in their first pregnancy (96%) and about half considered a physician to be the most reliable source of information about vaccination (481/977, 49%). "Willingness to receive pertussis vaccination" was significantly associated with the factors "no fear of receiving vaccination" (odds ratio [OR]=3.10, 95% confidence interval [CI] 2.21-4.34), "necessary to prevent pertussis" (OR=8.70, 95% CI 6.17-12.28), "effective in pregnancy"(OR=5.46, 95% CI 3.94-7.56), and "no concern about side effects after vaccination"(OR=3.03, 95% CI 1.66-5.55). Pregnant women are likely to consider vaccination if they have a good understanding of the disease and its outcomes. Physicians are well positioned to improve knowledge and attitudes toward pertussis vaccination during pregnancy.Public health interventions have served an important role in controlling coronavirus disease 2019 (COVID-19), a rapidly spreading infectious disease. To contribute to future COVID-19 countermeasures, we aimed at verifying the results of countermeasures achieved by public health centers (PHCs) against the first wave of COVID-19 in Yamagata Prefecture, Japan. During January-May 2020, 1,253 patients suspected of SARS-CoV-2 infection were invited for testing. Simultaneously, based on retrospective contact tracings, PHCs investigated the infection sources and transmission routes of laboratory-confirmed COVID-19 cases and tested 928 contacts. Consequently, 69 cases were confirmed during March 31 - May 4, 58 (84.1%; 95% confidence interval 75.5-92.7) of whom were found from contacts. The spread of infection was triggered by cases harboring epidemiological links outside of Yamagata. Then, the number of cases increased rapidly. However, PHCs identified epidemiological links in 61 (88.4%; 95% confidence interval 80.8-96.0) of the 69 cases and transmission chains up to the fifth generation. Finally, the spread of infection ended after approximately one month. Our results indicate that the identification of infection sources and active case finding from contacts based on retrospective contact tracing was likely to be an effective strategy to end the first wave of COVID-19 in Yamagata.To understand the clinical course of human adenoviral (HAdV) conjunctivitis for establishing a better treatment regimen, thirty-eight eyes of 19 patients with HAdV-54 conjunctivitis for less than one week from onset were evaluated for clinical signs and symptoms and DNA copy numbers. It is observed that a viral load of 104-105 is required to develop symptoms of HAdV conjunctivitis, as symptoms were present in all the eyes whose viral load was ≥104 at least once during the course.  https://www.selleckchem.com/products/Eloxatin.html  Next, it is observed that asymptomatic infections in contralateral eyes are common as the virus was detected in most eyes that did not develop conjunctivitis. Furthermore, there was no rapid decrease of the viral load in healed eyes, on the contrary, the viral load in healed eyes on day 15 was significantly higher than in unhealed eyes. This was likely due to corticosteroid instillation that rapidly alleviated symptoms but prolonged the duration of viral shedding. Recently, combination treatment with iodine and corticosteroids has been recommended for HAdV conjunctivitis.