Observations on the Drug resistance of Tubercle Bacilli before and after Anti-tuberculous Chemotherapy.

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The authors studied on the drug-resistance of tubercle bacilli in sputa of 340 patients admitted to this hospital from January, 1958 to September, 1960. "Complete resistance " was adopted, e.g. 1 γ streptomycin resistance indicates that there was as much growth of tubercle bacilli on medium with 1 r streptomycin per ml as in the control medium. Results obtained were as follow:<BR>1) Streptomycin (S.M)-, para-aminosalicylicacid (P A S) or isoniazid (INH) resistant strains of tubercle bacilli were found in sputa of 46 patients with untreated pulmonary tuberculosis in the following percentages: 6.5 % to 10 γ or more of S M, 6.6 % to 1 γ or more of PAS and 3.1 % to 1 γ or more of INH.<BR>2) Incidence of drug-resistant bacilli was examined in 48 patients with moderately or far advanced pulmonary tuberculosis who had received no prior anti-tuberculous drug therapy. The strains of tubercle bacilli cultured from the sputa of patients were uniformly sensitive to SM, PAS and INH at the time of initiation of treatment. After 180 days therapy with two (SM-PAS, SM-INH, PAS-INH) or three drugs (SM-PAS-INH), combined the incidence bacilli resistant to 10 γ or more of S M was 27.1%; 4.4% became resistant to 10 γ or more of P A S and 14.6% resistant to 1 γ or more of INH. Those cases without drug-resist ance at the end of the first course of therapy were treated with the second 180 day course, by the end of which 44.1% became resistant to 10 γ or more of SM, 15.3% to 10 γ or more of PAS and 16.6% to 1 γ or more of INH.<BR>3) Changes of drug-resistance of tubercle bacilli in the sputa of patients before and after anti-tuberculous drug therapy for 180 days were divided into three groups; i.e. increased, decreased and unchanged. In the authors' opinion, it might be meaningless to examine the resistance to 1 γ PAS or 0.1 γ INH and that bacilli with these low resistance should be included in the unchanged group, because many bacilli resistant to 1 γ PAS or 0.1 γ INH lost theirresistance after further administration of each drug. As for SM., too, 1 γ-resistance was equalized with 0 γ. Still it was to be noted that drug resistant bacilli often showed a decrease in their resistance in spite of continued adminis tration of the same drug, and an increase of drug resistance regardless of discontinuance of the therapy.<BR>4) Concerning the relation between the changes of drug resistance of bacilli and those of the clinical status after 180 days anti-tuberculous drug therapy, more cases with increasing than with decreasing drug resistance were found in the cases with increased number of discharged bacilli or those impaired in summarized judgement ; but no remarkable correlation was found between changes of drug resistance of bacilli and those of roentgenographic findings.
一般社団法人日本結核病学会の論文

Observations on the Drug resistance of Tubercle Bacilli before and after Anti-tuberculous Chemotherapy.

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