化学療法剤二重三重耐性結核菌に関する臨床的研究
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概要
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In examining the resistance to chemotherapeutic drugs of the tubercle bacilli isolated from the sputum-positive patients with abvanced tuberculosis who had received a long course of chemotherapy, tests were performed to determine if tubercle bacilli had acquired resistance to one kind of drug only or to a combination of two or three kinds of drugs. The tests were carried out several times in chronological sequence, so that the manner in which tubercle bacilli acquired resistance to different kinds of drugs might be investigated. The resuts of the studies are summarized as follows : (1) Fairly large percentages of tubercle bacilli developed double resistance to a combination of streptomycin and PAS following the administration of comparatively small doses of them. Small percentages of tubercle bacilli acquired double or treble resistance to a combination of drugs including INAH. (2) The growth in a culture medium of the tubercle bacilli that had acquired double resistance to a combination of any two drugs was shown to be slower than that of the tubercle bacilli that had acquired resistance to either one of the drugs making up the combination. There was a marked slowing down in the growth of the tubercle bacilli that had acquired double or treble resistance to a combination of drugs including INAH. (3) Studies of patients whose sputa are still positive following a chemotherapy consisting in the use of a combination of more than two kinds of drugs showed that there were four different patterns in the manner in which tubercle bacilli developed resistance to chemetheiapeutic drugs. (4) In many of the patients treated with a combination of streptomycin and PAS, tubercle bacilli developed double resistance simultaneously with the development of resistance to either one of the drugs making up the combination.However, in many of the tubercle bacilli from the patients receiving a treatment with INAH and PAS or streptomycin and IHAH, the development of double resistance took place later than did the resistance to either one of the drugs making up the combination. (5) The present studies have made it clear that the test for the development of double resistance may be of value in determining the relative therapeutic effects of two kinds of drugs on a tuberculous lesion or in diagnosing the character of a lesion. This suggests that the method of administering chemotherapeutic drugs that now obtains leaves much to be desired, indicating that it is necessary to reevaluate it in the light of the findings of researchers.
- 千葉大学の論文
- 1959-01-28