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Manabu Saito,1,&ast; Hiroshi Uchino,1,&ast; Yoko Iwata,1 Ayako Fuchigami,1 Genki Sato,1 Fukumi Yoshikawa,1 Masahiko Miyagi,1 Taito Miyazaki,2 Yoshihisa Urita,2 Kotaro Aoki,3 Yoshikazu Ishii,3 Kazuhiro Tateda,3 Takahisa Hirose1 1Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan; 2Department of General Medicine and Emergency Care, Toho University School of Medicine, Tokyo, Japan; 3Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan&ast;These authors contributed equally to this workCorrespondence: Hiroshi Uchino, Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Toho University Graduate School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan, Tel +81-3-3762-4151, Fax +81-3-3765-6488, Email h.uchino@med.toho-u.ac.jpPurpose: The severe pathogenic ancient-type COVID-19, SARS-CoV-2/WA-1/2020 was the predominant gene variant in early 2020 in Japan, however, its transmissibility was uncertain. The period before the public commenced using any personal protective equipment (PPE) was evaluating to describe the transmissibility of the SARS-CoV-2/WA-1/2020. We analyzed the secondary attack rate (SAR) among close contacts and the risk factor for SAR.Methods: This retrospective cohort study included a total of 539 patients who were anticipated for the SARS-CoV-2/WA-1/2020 infection at Toho University Medical Center Omori Hospital from February to May 2020. We selected 54 patients with 1) exclude other pathogens infection, 2) include “Three Cs” condition: crowded places between distance< 6 feet, closed spaces indoor and close contact settings involving contact > 15min with a person tested positive for SARS-CoV-2/WA-1/2020 without PPE. We evaluated alternative infection risks: the body mass index (BMI) and diabetes (DM) status (non-DM, pre-DM, and DM) as demographic determinants of transmissibility and infectivity of SARS-CoV2/WA-1/2020 cases during the incubation period.Results: The calculated SAR was 79.3%. BMI was significantly associated with the PCR positivity rate, which was significant in the univariate (CI 95%, 1.02– 1.51; P = 0.03) and multivariate (CI 95%, 1.02– 1.60; P = 0.03) analyses. Comparing the different BMI groups, the highest BMI group (25.5− 35.8 kg/m2) had an elevated risk of SAR compared to the lowest BMI group (14.0– 22.8 kg/m2), with an odds ratio of 1.41 (95% CI, 1.02– 1.59; P = 0.03). There were no significant differences in the risk of SAR among different DM statuses.Conclusion: The transmissibility of SARS-CoV2/WA-1/2020 was high (79.3%) among household members without PPE who had “Three Cs” exposure. Although pre-DM and established DM did not confer a risk for transmissibility, higher BMI was associated with an increased risk of SAR.Trial Registration: UMIN Clinical Trials Registry, UMIN0000 50905.Keywords: obesity, pre-diabetes, SARS-CoV-2 transmission

Michael Woodward,1,&ast; Venkatasubramanian Ramasubramanian,2 Adeeba Kamarulzaman,3 Terapong Tantawichien,4 Minggui Wang,5 Joon Young Song,6 Won Suk Choi,7 Samsuridjal Djauzi,8 Rontgene Solante,9 Wen-Sen Lee,10 Kazuhiko Tateda,11 HongXing Pan,12 Ning-Chi Wang,13 Tikki Pang14,&ast; 1Aged Care Research, Austin Health, Melbourne, VIC, Australia; 2Department of Infectious Diseases, HIV & Tropical Medicine, Apollo Hospitals, Chennai, TN, India; 3Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia; 4Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 5Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, SH, People’s Republic of China; 6Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea; 7Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korean University College of Medicine, Ansan, Korea; 8Allergy and Clinical Immunology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; 9Adult Infectious Diseases and Tropical Medicine, San Lazaro Hospital, Manila, NCR, Philippines; 10Division of Infectious Diseases, Department of Internal Medicine, New Taipei City Hospital, New Taipei, Taiwan; 11Department of Microbiology and Infectious Diseases, Faculty of Medicine, Toho University, Tokyo, Japan; 12Institution of Vaccine Clinical Trials, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, JS, People’s Republic of China; 13Department of Medicine, Tri-Service Hospital, Taipei, Taiwan; 14Centre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, Singapore&ast;These authors contributed equally to this workCorrespondence: Tikki Pang, Centre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, 117597, Singapore, Tel +65 6516 1048, Email mdctep@nus.edu.sgAbstract: The impact of vaccinating the older population against vaccine-preventable diseases in terms of health, social and economic benefits has been increasingly recognised. However, there is a gap in the utilisation of vaccines worldwide. The population is ageing at an unprecedented pace in the Asia-Pacific (APAC) region, with the number of persons older than 65 years set to double by 2050 to around 1.3 billion. More than 18% of the population in Japan, Hong Kong, and China is over the age of 65 years. This highlights the importance of prioritising resources to address societal obligations toward the needs of the ageing generation. This review provides an overview of the challenges to adult vaccination in APAC, drivers to increase vaccination coverage, vaccination insights gained through the COVID-19 pandemic, and potential measures to increase the uptake of adult vaccines in the region.Keywords: adult vaccination, vaccine-preventable diseases, VPD, adult vaccines, COVID-19 vaccination

Tetsuo Yamaguchi,1,2 Rina Ando,2 Tetsuya Matsumoto,2 Yoshikazu Ishii,1 Kazuhiro Tateda11Department of Microbiology and Infectious Diseases, Toho University School of Medicine, Tokyo, Japan; 2Department of Microbiology, Tokyo Medical University, Tokyo, JapanObjectives: We investigated the association between the rate of cell growth and vancomycin (VAN) resistance by comparing the genomic and phenotypic characteristics of different sized colonies isolated from a single origin.Methods: Vancomycin-intermediate Staphylococcus aureus (VISA) strain TMUS2136 was isolated from the pus of a patient with a brain abscess and a chronic subdural abscess. This strain grew slowly and formed colonies poorly on agar plates within 24 h of incubation. However, variously sized colonies were observed after 48 h of incubation. We isolated five strains from different sized colonies and compared their VAN susceptibility and genomic sequences using next-generation sequencing.Results: The five strains showed different rates of growth and susceptibilities to VAN (range of MIC after 48 h of incubation; 3–5 mg/L), and slower growing strains tended to be more VAN resistant. Deletion of the spdC gene and SNPs in the sarA gene was confirmed in all five strains and six SNPs in other genes (including mreC, hssS, prs, SA2339, sun, and SA1132) were confirmed when comparing the five strains.Conclusions: Deletion of the spdC gene, a novel virulence factor of S. aureus, and SNPs in the sarA gene may be associated with VAN resistance. It was hypothesized that any of the six genes in which SNPs were detected could affect cell growth rate and VAN resistance in slow-VISA strains.Keywords: next generation sequencing, MRSA, VISA, vancomycin

Aims: Otitis externa (OE), one of the most common ear diseases in dogs, is caused by bacterial pathogens such as Staphylococcus sp. To understand the network of microbial communities in the canine ear canal affected with OE, we performed a cross‐sectional study using next‐generation sequencing. Methods and Results: Ear swab samples were collected from 23 OE‐affected and 10 healthy control dogs, and the 16S rRNA gene sequenced using Illumina MiSeq. The otic microbiota in the OE‐affected dogs showed significantly decreased alpha diversity compared to controls. The community composition also differed in the affected group, with significantly higher relative abundance of the phylum Firmicutes and the genus Staphylococcus (P = 0·01 and 0·04 respectively). Contrary to our expectations, the severity of the disease did not impact the otic microbiota in OE‐affected dogs. Conclusions: The ear canal microbiota of OE‐affected dogs is distinct from that of healthy dogs, irrespective of disease status. Significance and Impact of the Study: This study, one of the few detailed analyses of the otic microbiota, can provide practical information for the appropriate treatment of canine OE. [ABSTRACT FROM AUTHOR]