Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Int J Tuberc Lung Dis. 2012 Jun;16(6):799-804. doi: 10.5588/ijtld.11.0252. Epub 2012 Apr 9.
It is challenging to differentiate between intestinal tuberculosis (ITB) and Crohn's disease in areas where TB is still prevalent. The use of diagnostic tools and verifying the drug resistance patterns of ITB can be helpful for its correct diagnosis.
To determine the diagnostic sensitivity of a culture assay using colonoscopic biopsy specimens and the drug resistance patterns of Mycobacterium tuberculosis isolated from ITB.
Data from 400 patients diagnosed with ITB were retrospectively analysed.
Of the 400 patients, 170 (42.5%) were males; the median age at diagnosis was 40 years. The sensitivity of culture was 44.1% (145/329). Resistance to at least one anti-tuberculosis drug was identified in 13 (17.6%) and multidrug-resistant TB (MDR-TB) was diagnosed in two (2.7%) of the 74 patients for whom drug susceptibility testing was performed. Including M. tuberculosis isolated from respiratory specimens, the proportion of MDR-TB was 4.4% (5/113); previous anti-tuberculosis treatment was an independent risk factor for MDR-TB (26.7% vs. 1.0%, P < 0.01).
Culture of colonoscopic biopsy specimens shows substantial diagnostic sensitivity; the frequency of MDR-TB is higher in previously treated cases than in new cases.
在结核病仍然流行的地区，鉴别肠结核（ITB）和克罗恩病具有挑战性。使用诊断工具和验证 ITB 的耐药模式有助于正确诊断。
确定使用结肠镜活检标本进行培养检测以及从 ITB 中分离的结核分枝杆菌的耐药模式的诊断灵敏度。
回顾性分析了 400 例诊断为 ITB 的患者的数据。
400 例患者中，170 例（42.5%）为男性；诊断时的中位年龄为 40 岁。培养的灵敏度为 44.1%（145/329）。对至少一种抗结核药物耐药的患者有 13 例（17.6%），对 74 例进行药物敏感性试验的患者中诊断出耐多药结核病（MDR-TB）2 例（2.7%）。包括从呼吸道标本中分离的结核分枝杆菌，MDR-TB 的比例为 4.4%（5/113）；既往抗结核治疗是 MDR-TB 的独立危险因素（26.7% vs. 1.0%，P<0.01）。
结肠镜活检标本的培养显示出相当高的诊断灵敏度；在既往治疗的病例中，MDR-TB 的频率高于新病例。
