1985 Volume 60 Issue 4 Pages 241-245
Yearly changes in the number of patients excreting tubercle bacilli and the proportion of patients excreting drug-resistant tubercle bacilli from 1972 to 1982 were examined, and the clinical courses of drug-resistant tuberculosis cases in 1982 were examined.
The number of tuberculous patients excreting tubercle bacilli in these 11 years has decreased from 172 in 1972 to 121 in 1982, and the proportion of drug-resistant cases in 1982 (42.9%) was comparatively higher than that in 1972 (33.7%) or in 1977 (30.8%). The proportion of EB and RFP resistant cases in 1982 was significantly higher than in 1972 and 1977.
Out of 52 drug-resistant cases in 1982, 13 cases (25%) were newly diagnosed in the year, 8 cases (15.4%) were also diagnosed in the year with past history of tuberculosis and the remaining 31 (59.6%) were cases under treatment with antituberculous drugs. The proportion of RFP resistant cases was higher than that of cases resistant to other drugs. The drug-resistant cases newly diagnosed in 1982 including cases with past history of tuberculosis treatment were occupied mainly by single drug resistant cases (18/21; 85.7%) and the prognosis of these resistant cases was good in 19 cases. The drug-resistant cases under treatment with antituberculous drugs were occupied mainly by multiple drugs resistant cases (29/31; 93.5%), and the prognosis of these cases was not good in 28 cases. Four drug-resistant tuberculous patients under treatment died during the observation period. Most of patients showing good prognosis were treated with INH, EB, plus RFP or INH, EB, RFP plus aminoglycosides. The time required for negative conversion of drug-resistant tubercle bacilli was 3.8 months on the average, and it correlated with the amounts of pre-treatment bacilli discharge.
In the present study, therapeutical effects of newly diagnosed tuberculosis were very good, and no increase in the number of drug-resistant tuberculosis under treatment was observed. These facts suggest that increase of drug-resistant tuberculosis may most unlikely take place.
