切除肺結核病巣の細菌学的研究

抄録

The author report the results of bacteriological and pathological study on 220 cases of pulmonary tuberculosis undergone the lung resection after chemotherapy and included 446lesions, that is,136 cavities,12 inspissated cavities,10 open healed cavities,285 caseous lesions and 3 cicatrical lesions.
Materials obtained from these cases (sputum and lesion) were smeared by the ordinary acid-fast staining and malachitegreen-fuchsin staining, and cultured by the standard technique.
Secondly the connection with the bacteriological examination from the lesion was studied in the duration of chemotherapy and the existence of tubercle bacilli from the sputum before operation.
Finally the existence of drug resistant tubercle bacilli from the lesion or the sputum was considered in the some sorts of chemotherapy and lesion.
The conclusion was as follows.
1) In cavity group positive smear were 79.4%, positive cultures 46.3%, positive smears with nepative cultures 33.1% and both negative only 9.6%. In inspissated cavity group the result was approximately similar in the former. In caseous lesion group the positive percent to smear and culture was less than in cavity group. In open healed cavities only a case showed the positive culture.
There was the close relation between the positive percent to smear by the malachitgreenfuchsin staining and the positive percent to culture from the cavities, open heald cavities and cicatricial lesions, but no close relation in the inspissated cavities and caseous lesions.
2) The significant correlation could not be found between the the duration of chemotherapy and the increase of the negative percent to smear and culture from the cavities and the caseous lesions.
The negative percent to culture from lesion increased in proportional to the negative duration of tubercle bacilli during a year or less before operation, while those during more than a year decreased again.
In the cavity group that was negative to smear and culture from the sputum overall the period before operation the positive smears were 83.3%, but the positive cultures only 8.3% from the lession.
On the other hand, in some cavity cases that were positive to both test from the sputum. over all the period before operation, the positive percent to both from the lesion was higher than in the former.
3) The resistant population of tubercle bacilli from the lesion to SM-PAS was higher than to those in addition of INH.
In cavity group the resistant grade to the drugs and the resistant population from the lesion was higher than from the sputum, and in the inspissated cavity group these were much higher.
In caseous lesion group the resistant population was lower than in cavity group and inspissated cavity group, but the relation between the resistant grade and the resistant population obtained from the sputum and the lesion was similar in cavity group.