All issues
Volume 83, Issue 5
Displaying 1-5 of 5 articles from this issue
- |<
- <
- 1
- >
- >|
-
Takeo INOUE, Haruki KOYASU, Satoru HATTORI2008 Volume 83 Issue 5 Pages 403-409
Published: May 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objectives] To elucidate TB transmission with multiple secondary patients (MSP) in comparison with a single secondary patient (SSP).
[Subjects and Method s ] The subjects of this retrospective study were 10, 088 TB patients registered in Aichi Prefecture between 1989 and 2003. Pulmonary TB was found in 8, 629patients, and 1, 459 had extra-pulmonary TB. Bacteriological examination revealed sputum smear-positive (SPBP) in 3, 332, sputum smear-negative bacillus-positive (SNBP) in 2, 139, and smear-negative bacillus-negative (SNBN) in 3, 158.
All registration files were reviewed to iden tify epidemiological links of patients. When linked patients with an interval of the dates of registration of less than 10 years were found, the first case was considered as the index case, and the other patients were regarded as secondary cases.
An index case rate (ICR) for a category of patients was defined as following; ICR=NI/NA, where NA: Number of TB patients in a category A, and NI: Number of index cases in category A. An epidemic source rate (ESR) was used instead of ICR when the index case and the TB patients in a category were smear-positive.
[Re sults] A total of 337 patients were considered as index cases. Sixty-nine patients had MSP, while 268 had a SSP. The ICRs for MSP were 1.74% for the SPBP patients, 0.33%for the SNBP patients, 0.06% for the SNBN patients, and 0.14% for the exrtra-pulmonary TB patients. These ICRs for SSP were 5.43%, 1.73%, 1.14%, and 0.96%, respectively. The ESR differences with MSP were highly significant (p< 0.001)between patients aged 0-59 and those aged 60-99 (3.8% vs 0.5%), between patients with cavitary lesion and those wit h non-cavitary lesion (2.6% vs 0.4%), and between patients with large amount of bacilli and those with small amount of bacilli (2.9% vs 0.9%). These differences were also found in those with SSP.
[Conclusi on] These findings suggest that TB transmission with multiple secondary patients is closely correlated with aging, cavitary lesion, and bacillary amount, and that no characteristic changes were found between index cases with multiple secondary patients and those with a single secondary patient.View full abstractDownload PDF (1425K) -
Takashi YOSHIYAMA, Hideo OGATA2008 Volume 83 Issue 5 Pages 411-416
Published: May 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] To evaluate the value of CT scan for the detection of tuberculous diseases among persons who are suspected to be infected at the contact examination.
[Settings] Fukujuji Hospital, Japan.
[Method] Retrospective revie w of the medical records of 22 persons who were normal with plain chest X-ray at an outbreak at a private school, with which total 46 TB cases and 93 infected persons were detected by either symptomatic visits or contact examinations done mainly at public health centers. Among the 44 persons who visited Fukujuji Hospital, 4 persons were symptomatic visits, 3 persons were detected as TB cases by the contact examination at public health centers and 3persons visited Fukujuji Hospital for the purpose of contact examination before examinations at the public health centers. Eight of these 10 persons were with abnormal chest plain Xray findings and the remaining two persons were normal with plain chest X-ray findings (group A). Among the 34 persons who were referred to Fukujuji Hospital from public health centers as the infected person without diseases, one person showed abnormal chest plain X-ray and 33 persons showed normal chest plain X-ray (group B). Group A persons were examined in June and Group B persons were examined in July.
[Result] The 2 persons in the group A were with abnormal CT findings. They were not diagnosed as TB by the CT findings but followed up after sputum examinations. Both of them were diagnosed as TB by the positive TB culture. Among the 33 persons in the group B, 20 persons were tested with CT scan at the examination done before starting treatment of latent tuberuclous infection and six of these 20persons were with abnormal findings and were judged as TB diseases.
[Discussions] In the case of outbreak with many TB cases and infected persons, CT should be considered for the detection of TB cases among contacts.View full abstractDownload PDF (4780K) -
Tomotada IWAMOTO, Kazue NAKANAGA, Norihisa ISHII, Shiomi YOSHIDA, Haji ...2008 Volume 83 Issue 5 Pages 417-422
Published: May 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] To clarify the genetic microheterogeneity of Mycobacterium lentiflavum and identify the predominant genotype.
[Materia ls and Methods] Clinical isolates of M. l entifiavumused in this study were obtained from sixteen patients of lung diseases. In order to assess their intraspecies variability, four gene fragments, from the 16S rDNA (1471 bp), 16S-23S ITS (282 bp), rpoB (306 bp), and hsp65 (401 bp), were sequenced.
[Results] Intraspecies variabilities were found in all of the four targeting fragments. As multilocus sequence typing with these four targets, 16 clinical isolates were divided into 3genotypes, i. e., MLST2, MLST3, and MLST4. Among them, MLST2 to which 12 clinical isolates belonged, was a predominant genotype. Three strains belonged to MLST3 and the remaining one strain belonged to MLST4. Drug susceptibility study indicated that there was no clear relation between sequence types and drug susceptibility.
[Conclusion] Multilocus sequence typing could aid in characterization and in better understanding of the epidemiology of M. lentiflavum.View full abstractDownload PDF (1109K) -
Hitoshi HOSHINO, Masako OHMORI, Kazuhiro UCHIMURA, Yuko YAMAUCHI2008 Volume 83 Issue 5 Pages 423-429
Published: May 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] To analyze the epidemiological situation of TB among the elderly in Japan.
[Methods] By using the data of TB surveillance, national survey statistics and national basic survey of life.
[Results] TB incidence in both sexes incre ased with age in all survey years. TB incidence among the jobless was higher than among employees in both sexes. TB incidence among female housekeepers was consistently lower than among other groups. TB incidence among both the employed and unemployed has declined rapidly in the last 15 years. The main mode of TB detection was the detection at clinics/hospitals irrespective of presence or absence of TB symptoms. The death rate was higher in cases with immunosuppressive therapy and cases with malignancy.
[Conclusion] Causes of higher TB incidence in the elderly unemployed population should he analyzed. Better detection of TB by improving passive case-finding f or TB sym ptomatic and high-risk groups at clinics/hospitals will be recommended. To reduce the death rate, early diagnosis of TB with immunosuppressive therapy could be strengthened, however its impact might be limited.View full abstractDownload PDF (1349K) -
Hirokazu TANIGUCHI, Saburo IZUMI2008 Volume 83 Issue 5 Pages 431-434
Published: May 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 70-year-old woman afflicted with rheumatoidarthritis was consulted another hospital because of fever andabnormality in chest X-ray. She had been treated with methotrexateand infliximab for seven months. She was diagnosedas methotrexate-induced pneumonia, and was administratedlarge therapeutic doses of corticosteroid, but finding of herchest X-ray exacerbated. Her sputum examination was positivefor Mycobacterium tuberculosis complex by nucleic-acidamplification test, and she was diagnosed as miliary tuberculosis.She was treated with INH, RFP, CB, and PZA, andshowed good clinical response to treatment. When infliximabis prescribed, we have to bear in mind possible complicationof tuberculosis.View full abstractDownload PDF (2615K)
- |<
- <
- 1
- >
- >|