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[从细菌学角度——以药敏试验为重点]

[From the views of bacteriology--focusing on drug susceptibility test].

作者信息

Ogata H

机构信息

JATA, Fukujuji Hospital, Tokyo, Japan.

出版信息

Kekkaku. 1996 Jan;71(1):37-41.

PMID:8808267
Abstract

Totally 2630 culture positive pulmonary tuberculosis cases were admitted in our hospital during 17 years from 1976 to 1992. Clinical and bacteriology status of this cases were compered retrospectively between 3 groups; 1938 cases with initial treatment, 513 cases with retreatment excluding chronic tubercle bacilli excreters (CTBEs) and 179 chronic tubercle bacilli excreters. Mean age of the groups of CTBEs is 50.9 years. Sex ratio of it is 4.3:1. These figures are similar to those of the group of the cases with retreatment. Mean age of these groups is higher than 45 years in group of cases with initial treatment. Sex ratio in these group is higher than 3.1:1 in group of cases with initial treatment. Proportion of cases with complication of DM in group of CTBEs is 16.1%, statistically significantly higher than 10% in group of cases with initial treatment and 9% in group of cases with retreatment. Most CTBEs show resistant to both INH and RFP in drug susceptibility test if 0.1 gamma is adopted as clinical concentration of resistance to INH. 40% of CTBEs show susceptibility to SM and 35% of CTBEs show susceptibility to EB in the test. However in a large proportion of these cases with susceptibility result in each of these drugs, more than 34% in SM and more than 40% in EB, effect of the drugs was not observed clinically. Therefore previous treatment history as well as the result of drug susceptibility test should be considered in choice of anti-tuberculosis drug for treatment of CTBEs.

摘要

1976年至1992年的17年间,我院共收治2630例痰菌阳性肺结核患者。回顾性比较了3组患者的临床和细菌学状况:初治患者1938例,非慢性排菌者复治患者513例,慢性排菌者179例。慢性排菌者组的平均年龄为50.9岁,男女比例为4.3:1。这些数据与复治患者组相似。这些组的平均年龄高于初治患者组的45岁。初治患者组的男女比例高于3.1:1。慢性排菌者组糖尿病并发症的比例为16.1%,统计学上显著高于初治患者组的10%和复治患者组的9%。如果采用0.1γ作为异烟肼临床耐药浓度,大多数慢性排菌者在药敏试验中对异烟肼和利福平均耐药。40%的慢性排菌者对链霉素敏感,35%的慢性排菌者对乙胺丁醇敏感。然而,在这些对每种药物敏感的病例中,很大一部分(链霉素超过34%,乙胺丁醇超过40%)在临床上未观察到药物疗效。因此,在选择抗结核药物治疗慢性排菌者时,应考虑既往治疗史以及药敏试验结果。

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