「非定型抗酸菌症」発生率の地域差について

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It was reported previously by the present group (1-3) that the frequency of isolation of my cobacteria other than tubercle bacilli (‘atypical’ mycobacteria) and the incidence of mycobacterioses due to these mycobacteria are higher in the hospitals locating in the South coast of the Honshu island. It was shown also that more than 90% of the mycobacterioses in this country were due to M. avium-intracellulare complex and that the lung disease due to M. kansasii was found only in the Tokyo area and its neighbourhood. In the present study, the prevalence rate of the “atypical” mycobacterioses was compared among the hospitals locating in various places of this country. A morning sputum specimen was added with an equal volume of a 4% NaOH solution and dissolved by shaking at room temperature for 15 to 20 minutes. The sputum was inoculated to the Ogawa egg medium. Growing organisms were screened for ‘atypical’ mycobacteria by the use of the PNB medium (4) or the salicylate medium (5). The acid-fastness and the photochromogenicity were also tested in individual hospitals. The organisms that grew on the PNB or salicylate medium were sent to the Chubu hospital and were identified according to the methods previously described (2). ‘Atypical’ mycobacterioses were defined by the following conditions: (a) The excretion of ‘atypical’ mycobacteria more than three times in the period of the first 6 months after hospitalization; (b) presence of lung lesion in the chest X-ray picture; (c) coincidence of the excretion of ‘atypical’ mycobacteria and clinical symptoms. The location of the 13 participating hospitals are shown in Fig. 1. The prevalence rate was the highest in five hospitals, Tokyo, Chubu, Kinki, Tenryuso, and Kochi, which are located in the Southern Pacific coast of Japan (Table 1). The species of mycobacteria other than tubercle bacilli which caused lung disease in patients are shown in Table 2. Furthermore, it was shown that tuberculous patients who were hospitalized for long time were infected with ‘atypical’ mycobacteria (Table 3). All causative organisms which caused ‘secondary’ infection belonged to M. aviurnintracellulare complex.
日本結核病学会の論文

「非定型抗酸菌症」発生率の地域差について

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