All issues
Volume 74, Issue 5
Displaying 1-6 of 6 articles from this issue
- |<
- <
- 1
- >
- >|
-
Kayo MUI, Kazuhiko KAMEDA1999 Volume 74 Issue 5 Pages 425-432
Published: May 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThis survey was made at the end of 1996 in Osaka prefecture including three ordinance designated cities of Osaka, Sakai and Higashiosaka.
As of December 31 1996, 109 or 3.3% of active tuberculosis cases were found to be chronic tubercle bacilli excreters in Osaka city, and 128 or 3.6% in Osaka prefecture other than Osaka city, respectively. In the area called Airin at Nishinari-ward, Osaka, which has been an area with high prevalance of the disease, 33 or 5.8% were chronic tubercle bacilli excreters, and the rate was slightly higher than the other areas.
Compared to the survey conducted 10 years ago, while the number of the chronic tubercle bacilli excreters decreased by half to 109 from 200 in Osaka city, to 128 from 211 in Osaka prefecture excluding Osaka city, the rate of chronic excreters to total active tuberculosis showed almost no change.
Various factors such as difficult living conditions often attributed to defaulting of active tuberculosis patients from their treatment, thus resulting to development of chronic excretion. It is highly recommended to apply DOTS strategy for the completion of their treatment. Public health centers that have personal clinical records of each patient should be familiar with the results of their bacillus examinations. They should also be required to cooperate with medical institutions to cope with those who need retreatment.View full abstractDownload PDF (8575K) -
Akimasa SATO, Toshiaki SONOBE, Miki OKAZAKI, Bun-ichi UMEDA1999 Volume 74 Issue 5 Pages 433-439
Published: May 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSMTD (GEN-PROBE AMPLIFIED MYCOBACTERIUM TUBERCULOSIS DIRECT TESTTM) for Mycobacterium tuberculosis, and AmplicorTM Mycobacterium for Mycobacteria (AMP-M. tb for M.tuberculosis, AMP-M. av for M. avium and AMP-M. in for M. intracellulare) were used for the detection of relevant Mycobacterium. Their sensitivity and specificity were evaluated. Total 244 clinical specimens including 164 sputa were examined by the above two tests. The results were compared with those obtained by the conventional methods.
Of 244 samples, number of the M. tuberculosis positive samples by microscopy, cultural test, MTD and AMP-M. tb were 32, 33, 38 and 35, respectively. Among 33 culture positive samples, 25 were MTD positive and 26 were AMP-M. tb positive. Therefore, sensitivity of MTD and AMP-M. tb were 75.8% and 78.8%, and their specificity were 93.8% and 95.7%, respectively. When only sputa were used for the tests as the clinical specimens, both sensitivity of MTD and AMP-M. tb were increased to 94.4%.
For MAC, positive samples of M. avium complex by culture, M. avium by AMP-M. av and M.intracellulare by AMP-M. in were 13, 16, and 8, respectively. Sensitivity and specificity of AMP-M. av/M. in were 100% and 95.2%, respectively.
Clinical findings of the patients whose MTD tests were positive but negative by culture were reexamined. Three of 9 specimens were also positive in AMP-M. tb. From the records of the isolations of tubercle bacilli or other important pathogens from the other kind of clinical specimens, smear tests and patients' response to tuberculosis chemotherapy, four of 9 specimens were confirmed as true positive, three were suspected as positive, and two other specimens were false positive which might be caused by contamination.
From these observations, it could be concluded that MTD and AMP-M. tb are more sensitive than conventional culture method, and MTD is more sensitive than AMP-M. tb but needs more careful treatment to avoid the contamination.View full abstractDownload PDF (867K) -
Shigehisa HOASHI, Hisakazu TAI, Mayumim TAMARI1999 Volume 74 Issue 5 Pages 441-445
Published: May 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe screened clinical isolates of tubercle bacillus for mutations in the pncA gene, which encodes pyrazinamidase (PZase), by polymerase chain reaction (PCR)-direct sequencing method. Sixty-eight strains of tubercle bacillus were isolated from 32 patients with pulmonary tuberculosis. The patients were treated with antituberculous agents including pyrazinamide (PZA) for 2 months. Thirty-two of the 68 strains were isolated from sputum samples collected from the patients before treatment; 29 strains and 7 strains were collected after 1 month and 2 months of treatment, respectively. The pncA genes in these strains, were assessed for mutations by direct sequencing of PCR products using an automated sequencer. Similarly, we examined two clinical isolates (ka567 and minami22) of tubercle bacillus, determined to be deficient in PZase activity by the Wayne method. A PZA-sensitive strain (H37Rv, ATCC27294), and a PZA-resistant strain (H37Rv-PZA-R, ATCC35828) were used as negative and positive controls for mutations in the pncA gene, respectively. None of the 68 strains demonstrated any mutations in the pncA gene; however, the 2 PZase-deficient strains had missense mutations in the pncA gene resulting in an amino acid substitution from His82 to Arg in clone ka567, and from Ala171 to Val in clone minami22.View full abstractDownload PDF (655K) -
Yoshihisa NAKAGAWA, Kazuyoshi SHIMAZU, Momoko EBIHARA, Kumiko AMAN1999 Volume 74 Issue 5 Pages 447-452
Published: May 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSBeta-lactamase activity was determined using a nitrocefin disc method on 34 Mycobacterium tuberculosis (M. tuberculosis) strains and 13 nontuberculous mycobacteria strains. In the 34 M. tuberculosis strains, 23 strains showed beta-lactamase activity. In 10 Mycobacterium avium complex strains, no beta-lactamase activity was detected. In the Mycobacterium chelonae strains, all three strains examined showed strong beta- lactamase activity.
No correlation was found between beta- lactamase activity and resistance to antituberculous chemotherapeutic agents.
Four patients who were persistently positive for multi-drug-resistant M. tuberculosis (MDR-TB) on sputum and positive in beta-lactamase activity, were treated with penicillin/beta-lactamase inhibitor combinations. In two cases, the trials were discontinued because of diarrhea; the trials were continued in the remaining two for four months, but the MDR-TB was positive during the course of the therapy.
Effectiveness of the therapy with penicillin/beta-lactamase inhibitor combinations against M. tuberculosis was obscure, although many of M. tuberculosis examined showed beta-lactamase activity.View full abstractDownload PDF (618K) -
Tetsuro INOUE, Nobuaki IKEDA, Takuya KURASAWA, Atsuo SATO, Kohichi NAK ...1999 Volume 74 Issue 5 Pages 453-456
Published: May 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 26-year-old female was admitted to our hospital with complaints of fever, cough, otorrhea and otalgia and progressive hearing loss of her left ear. Smears of her sputum were positive for acid-fast bacilli. Smears of her otorrhea were negative for acid-fast bacilli but PCR of her otorrhea was positive. Chest X-ray showed infiltrative shadows with the cavity. She was diagnosed as middle ear tuberculosis associated with pulmonary tuberculosis. After anti-tuberculous chemotherapy, fever, cough, otorrhea and pain of her left ear were improved, but her hearing level was not improved.
In the case of middle ear tuberculosis, it is necessary to make an early diagnosis and treatment. This is the first reported case in Japan in which PCR of the otorrhea is positive.View full abstractDownload PDF (3351K) -
Yumiko TOMIYAMA, Shigefumi MAESAKI, Bin YONG, Yasuhito HIGASHIYAMA, Yo ...1999 Volume 74 Issue 5 Pages 457-461
Published: May 15, 1999
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSSeventy years old woman had fever and hemosputum at May 1997. She was diagnosed as mycobacteriosis because of the positive acid fast bacilli smear from sputum. Mycobacterium gordonae was isolated from sputum, gastric juice, and bronchial aspirate. The combination therapy of isoniazid, rifampicin, ethambutol, and clarithromycin was administrated; however, M. gordonae was not eradicated from sputum. Sparfloxacin was administered instead of isoniazid based on the result of drug susceptibility test. The smear became negative and M. gordonae was eradicated from sputum one month after the initiation of treatment with the combination of clarithromycin and sparfloxacin.View full abstractDownload PDF (2108K)
- |<
- <
- 1
- >
- >|