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Volume 83, Issue 8
Displaying 1-6 of 6 articles from this issue
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Tadahiko FUJINO, Hisae FUSEGAWA, Mai NISHIUMI, Yasuyuki OKUBO, Toru KA ...2008 Volume 83 Issue 8 Pages 567-572
Published: August 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] We compared the time needed for sputum negative conversion of tubercle bacilli among patients with active tuberculosis to clarify factors affecting the hospitalization period.
[Subjec ts and Methods] We retrospectively reviewed 1260patients definitely diagnosed as active tuberculosis between Jan.1996 and Dec.2003. Smears were examined by fluorescent staining procedure, and cultures were tested by egg-based Ogawa and Kudo-PD solid media. Sputum smears and cultures were examined at least once a month. All patients received standard chemotherapy including isoniazid (INH), rifampicin (RFP), ethambutol hydrochloride (EB) [or streptomycin sulfate (SM)], and pyrazinamide (PZA). Time needed for sputum conversion was defined as the period from the initiation of chemotherapy to the first documented negative smear and culture. Multivariate analysis was performed to document factors that were independently associated with hospitalization period.
[Results] Factors correlated with longer conversion time were high amount of bacilli discharge, severe radiographic findings, and drug sensitivity at the initiation of treatment. Patients with bacilli discharge Gaffky 9-10 required 3 months (median) [3.9 months (mean)], and those with culture 3 +required 2 months (median) [2.8 months (mean)] for conversion. Patients with large and widespread cavities, classified as I or II 3 according to the Classification by the Japanese Society for Tuberculosis, required conversion time of 3months (median) [2.8 months (mean)]. Cases with initial drug resistance to any of the drugs required 2 months (median)[2.2 months (mean)] for conversion. Factors associated with prolongation of hospitalization were the amount of bacilli in sputum at the initiation of chemotherapy, past history of tuberculosis, presence of cavities and size of lesion observed on chest X-ray, drug resistance, and presence of extra-pulmonary lesions. Gender, complication with chronic renal failure, and alcoholism did not affect the hospitalization period.
[Conclusion] Patients with huge amount of bacilli discharge, extensive cavitary lesion, or initial drug resistance required more than 2 months for sputum negative conversion. In these cases, hospitalization period shorter than 2 months is inadequate, even if chemotherapy is initiated. For complete eradication of tuberculosis, we must ensure adequate chemotherapy and hospitalization period to eliminate further sources of infection. Our study shows that hospitalization period should be cautiously determined based on the disappearance of bacilli in sputum.View full abstractDownload PDF (1090K) -
Satoru FUJIUCHI, Michiko SAKUNAMI, Yasushi YAMAMOTO, Alcinori TAKEDA, ...2008 Volume 83 Issue 8 Pages 573-575
Published: August 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Objective] To clarify the clinical feature of chronic necrotizing pulmonary aspergillosis (CNPA) complicated with non-tuberculous mycobacteriosis (NTM).
[Subjects and methods] Forty-one CNPA cases underlying NTM were analyzed according to their clinical backgrounds.
[Results] Concerning the radiological type of prior NTM, CNPA cases were classified into two groups; 1) resembling pulmonary tuberculosis that usually shows cavitary lesion and 2) micronodule and bronchiectasis pattern, and more than half of cases (61.0%) were classified as the latter type. Average duration between prior NTM and CNPA was 1354 days. Isolation of Aspergillus spp. from sputum was 15 out of 41(36.6%). Positive rates for Aspergillus galactomannan antigen and anti-aspergillus antibody were 58.5%, 46.3% respectively. With regard to subspecies of mycobacteria, M.avium was most frequent (82.9%). Since 6.8% of NTM cases develop CNPA within 10 years, careful observation of CNPA was required for the management of NTM.View full abstractDownload PDF (562K) -
Shiomi YOSHIDA, Katsuhiro SUZUKI, Kazunari TSUYUGUCHI, Motohisa TOMITA ...2008 Volume 83 Issue 8 Pages 577-583
Published: August 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] Evaluation of rifampicin-resistance by the line probe assay, for rifampicin-susceptible Mycobacterium tuberculosis strains which were classified as rifampicinresistant by the phenotypic drug susceptibility testings.
[Materials and Methods] A total of 15 clinical isolates from NHO Kinki-chuo Chest Medical Center consisting of 6rifampicin-resistant strains by the line probe assay despite susceptible result by the drug susceptibility testings, and 9clinical isolates which showed the fluctuating results on repeated drug susceptibility testings. After we conducted 3drug susceptibility testings and the line probe assay, we have examined the sequence analysis for confirming mutations in the rpoB gene.
[Results] All strains were determined rifampicin-susceptible or intermediate by the drug susceptibility testings with Minimum Inhibitory Concentration (MIC) which ranged from 0.25 to 4μg/ml by BrothMIC MTB-1, whereas these isolates indicated rifampicin-resistance by the line probe assay and revealed mutations in the hot-spot region (69 bp) by the sequence analysis.
[Conclu sion] We verified that the line probe assay might be useful for the correct determination of drug susceptibility, especially about the low-level rifampicin-resistant M. tuberculosis strains.View full abstractDownload PDF (1576K) -
Seijiro MINAMOTO, Kazunari TSUYUGUCHI, Katsuhiro SUZUKI, Masaji OKADA, ...2008 Volume 83 Issue 8 Pages 585-590
Published: August 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSMycobacterium avium complex (MAC) pulmonary infection is usually seen in elderly persons. We encountered a rare case of MAC pulmonary disease seen in a 19-year-old adolescent. The patient had received bone marrow transplantation at the age of 16 for myelodysplastic syndrome. Subsequently, he developed constrictive bronchiolitis and has been treated with corticosteroid and taclorimus. At age 19, small or fine nodules and a cavitary nodule in right lung were detected on the chest radiograph and computed tomography. Afterwards, Mycobacterium avium was detected by bronchoscopic examination and sputum examination and he was diagnosed as MAC pulmonary infection. MAC pulmonary infection in a young person at the age of 19 is an extremely rare case, in which constrictive bronchiolitis, immunosuppression by corticosteroid and tacrolimus, and diabetes mellitus were considered as critical predisposing factors.View full abstractDownload PDF (6557K) -
Akihiro OHKADO, Chieko TAKAFIASHI, Masahide HORIBA, Yoshiro MURASE, Sa ...2008 Volume 83 Issue 8 Pages 591-598
Published: August 15, 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESS[Purpose] To obtain basic data about the present practices on storage and transport of isolated M. tuberculosis at public and private health institutions in Japan.
[Method] Survey forms regarding the practices on storage and transport of isolated M. tuberculosis were distributed and collected by post-mail in January 2007 to 76 local public health institutions, 145 public health centres, and 150 public or private hospitals. The questionnaire was adopted from the guidelines proposed by the Ministry of Health, Labour, and Welfare in 2006 on storage and transport of isolated M. tuberculosis.
[Results] The respondents of the survey were as follows: 96.1% (73/76) from local public health institutions, 93.8%(136/145) from public health centres, and 73.3 % (110/150)from hospitals. In general, local public health institutions conformed well to the proposed standards, however public health centres and hospitals were not compliant to some standards.
[Summary] Based on the survey conducted on the practice of storage and transport of isolated M. tuberculosis, certain discrepancy was found among public health centres and hospitals.View full abstractDownload PDF (2650K) -
2008 Volume 83 Issue 8 Pages 599
Published: 2008
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSDownload PDF (67K)
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