Yoshiyama T, Mori T
Research Institute of Tuberculosis, Tokyo, Japan.
Kekkaku. 1992 Nov;67(11):709-13.
The frequency of the modes of bacteriological examinations other than direct sputum smear were observed for a total of 955 "smear-positive" pulmonary tuberculosis cases which were notified at 7 health centres in the Metropolitan and suburban areas during 1986-1990. Of them 21 cases (2.2%) were examined for the specimens obtained by bronchofiberscopic procedures, and in 4 cases (0.4%) gastric juice was taken. The proportion of the non-sputum positivity as seen above was higher in females than in males, but it was uniform across all age group. Non-cavitary cases showed higher proportion of the non-sputum positivity than cavitary cases. There was wide variation in the frequency of these aggressive modes of examination among health centres, probably indicating the difference in the extent to which hospitals are interested in these modes of examination in each health center area. In addition to the above observed cases, there were 60 cases with direct smear positive finding of mycobacteria other than tuberculosis (MOTT). They account for 5.9% of all of 1,015 new notifications of AFB-smear positive cases. It is possible that these non-sputum "smear positive" cases, as well as the MOTT-smear positive cases may be underestimated in our study, because of the notification form not necessarily requesting to enter the type of bacteriological examinations. They may contribute to the recent upward trend of incidence rate of smear positive tuberculosis in Japan to a considerable extent.(ABSTRACT TRUNCATED AT 250 WORDS)
对1986 - 1990年期间在东京都及郊区7个保健中心报告的955例“涂片阳性”肺结核病例进行了观察，以了解除直接痰涂片外的细菌学检查模式的频率。其中21例（2.2%）通过纤维支气管镜检查获取标本进行了检查，4例（0.4%）采集了胃液。上述非痰标本阳性率女性高于男性，但在各年龄组中是一致的。非空洞型病例的非痰标本阳性率高于空洞型病例。这些积极的检查模式在各保健中心的频率差异很大，这可能表明每个保健中心地区医院对这些检查模式的关注程度不同。除上述观察病例外，还有60例结核分枝杆菌以外的分枝杆菌（非结核分枝杆菌）直接涂片阳性病例。它们占1015例抗酸杆菌涂片阳性新报告病例总数的5.9%。在我们的研究中，这些非痰“涂片阳性”病例以及非结核分枝杆菌涂片阳性病例有可能被低估，因为报告表格不一定要求填写细菌学检查类型。它们可能在很大程度上促成了日本近期涂片阳性肺结核发病率的上升趋势。（摘要截短为250字）
