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Volume 82, Issue 12
Displaying 1-5 of 5 articles from this issue
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Yuko KAZUMI, Nobunori ITAGAKI, Masako OHMORI, Masako WADA, Hitoshi HOS ...2007 Volume 82 Issue 12 Pages 891-896
Published: December 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] To observe the frequency of MDR-TB/XDR-TB strains isolated from chronic pulmonary tuberculosis patients in Japan.
[Object] Ad hoc National Tuberculosis Survey 2000 on frequency of MDR-TB and XDR-TB strains.
[Materials and method] Four hundre d and thirty four clinical isolates were collected by the Ad hoc National Tuberculosis Survey 2000, the drug susceptibility testings (proportion method, MGIT Middlebrook, and BrothMlC NTM) were conducted on these strains. These clinical isolates were obtained from patients registered at Health Centers in Japan by the end of 1999 who were culture-positive in 1999 and were registered before January 1st, 1 998. The isolates used in this study were selected from patients who were culturepositive at shortest 2 years after the registration.
[Result] The clinical isolates resis tant to both I NH and RFP were 321 out of 434 (74.0%). The 180 MDR-resistant clinical isolates were also resistant to levofloxacin and amikacin and/or kanamycin. These phenotypes are XDR-TB. No previously registered cases were 165, and previously registered cases were 143 and unknown cases were 13 out of 321 MDR-TB. In 180 XDR-TB cases, no previously registered cases were 95, previously registered cases were 78 and unknown cases were 7. In no previously registered cases, more than 50%cases started treatment in 1990s. Approximately 50% of previously registered patients started treatment in 1960s and 1970s.
[Conclusion] We performed drug susceptibility testing for 434 clinical isolates which were culture-positive at shortest 2 years after registration. No. of MDR-TB patients was 321and that of XDR-TB patients was 180. The treatment outcome of these patients have to be followed up carefully at Health Centers. The frequency of amikacin resistance was relatively high. This may be due to either common use of amikacin or cross-resistance against streptomycin and kanamycin.View full abstractDownload PDF (1119K) -
Hitoshi HOSHINO, Masako OHMORI, Takashi YOSHIYAMA, Masako WADA, Yuko Y ...2007 Volume 82 Issue 12 Pages 897-901
Published: December 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] To know factors to influence treatment outcome of new cohort analysis method in revised TB surveillance system and important points for quality improvement of the system using hospital based real data of TB patients.
[Methods] To analyze treatment outcome of n ew sputum smear positive TB patients hospitalized to Fukujuji Hospital during 2004 year by new cohort analysis method.
[Results] One hundred and ninety-fou r TB patients were hospitalized. Out of them, 166 were new cases. Cohort analysis showed 104 treatment success cases (62.7%), 27 died cases (16.3%), 2 failure cases (1.2%), 9 defaulter cases (5.4%), 15 transfer-out cases (9.0%), 7 cases with treatm ent longer than 1 year (4.2%), and 2 other cases (1.2%). Among 27 died cases, 18 cases were due to TB death. Out of other 9cases, 4 were due to malignancy, 3 due to pneumonia, and 2other causes. Out of 9 defaulter cases, 6 were self-interruption, 2 were due to medical doctor's decision to resolve side effects. Out of 7 cases with treatment longer than 1 year, half were due to drug resistance and another half were due to side effects. Twenty-eight retreatment cases showed 15 treatment success, 4 failure cases, 5 transferred-out, 2 cases with longer treatment than I year, and 2 other cases.
[Discussion] To evaluate TB tre atment outcome, died cases should be categorized into TB death and non-TB death. Defaulter cases and cases with treatment longer than 1 year should be categorized by causes into drug resistant cases and cases with interruption by side effects. At national level, data collection of drug sensitivity test results and development of cohort analysis method for drug resistant cases, especially multi-drug resistant cases, are needed to make new cohort analysis method more relevant to TB treatment outcome.View full abstractDownload PDF (1030K) -
Kenji HIBIYA, Futoshi HIGA, Masao TATEYAMA, Jiro FUJITA2007 Volume 82 Issue 12 Pages 903-918
Published: December 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSMycobacterium avium complex (MAC) causes respiratory tract infections and develops granulomatous lesions in the alveolar areas and bronchioles in humans. In contrast with the above, the intestinal tract is the primary infection site of immunocompromised hosts, such as patients with acquired immune deficiency syndrome (AIDS), or animals, such as pigs. Recent studies have revealed that hosts with hereditary dysfunction of mediators in the Th-1 cascade as well as hosts with a high titer of auto-antibodies against interferon- γ are susceptible to MAC, and such hosts facilitate dissemination of MAC. However, their disseminated lesions are formed mainly in the lung or in soft tissues, and the mechanism of development of MAC in such host may be different from that of AIDS-related MAC infection. In this review, we specifically discuss the development mechanism of disseminated MAC disease in recently-identified several pathological conditions.View full abstractDownload PDF (12328K) -
Norihiko IDA, Keizo YAMAMOTO, Hideo GONDA, Takashi OISHI, Nobukazu SUG ...2007 Volume 82 Issue 12 Pages 919-923
Published: December 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 44-year-old man consulted medical clinic, complaining of cough and sputum. Then he was admitted to our hospital, because of positive acid-fast bacilli in his sputum and positive PCR (polymerase chain reaction) for Mycobacterium tuberculosis. Combined use of isoniazid (INH), rifampicin (RFP), ethambutol (EB) and pyrazinamide (PZA) was started. But 4 days after starting treatment, we had to suspend tuberculosis chemotherapy because of hepatopathy. Since then he started to complain epigastralgia and vomiting. Plain abdominal X-ray and abdominal computed tomography (CT) led to a diagnosis of ileus. Inspite of insertion of ileus tube symptoms of ileus did not improve. Small bowl series showed severe stenosis at ileum end, necessitating jejunectomy.
Macroscopic study revealed a ring ulcer and multiple epithelioid cell granuloma with Langhans' giant cells was detected histopathologically. PCR for M. tuberculosis of extracts from ileum was positive. Therefore the patient was diagnosed small intestinal tuberculosis. Treatment was continued by the combination of INH, RFP, EB, and the symptoms markedly improved. There have been no sign of recurrence since the end of the 6-month treatment for tuberculosis.View full abstractDownload PDF (5842K) -
2007 Volume 82 Issue 12 Pages 925-957
Published: December 15, 2007
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (12840K)
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