二次抗結核薬の耐性に関する研究

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Sensitivity to secondary drugs were examined on the tubercule bacilli cultivated from the resected specimens of pulmonary tuberculosis treated with secondary drug before operation, and on the bacilli discharged form the sputum of tuberculous patients who had been treated by secondary drugs. The strain were defined as resistant if there was equal growth of tubercle bacilli on Ogawas culture media containing 10 mcg KM, 25 mcg TH, 40 mcg CS or 2.5 mcg EB. Tubercle bacilli were cultivated in 66 of 133 cavities (49.6%) and in 13 of 60 closed lesions (21.7%). The resistance to the secondary drugs was detected in 25.8% among the strain c ultivated from cavities, and in 23.1% from closed lesions (Table 1). Resistance to KM was found more frequently than that to EB, TH or CS, though each drug was given nearly the same duration before resection (Table 2). The rate of resistanc e to secondary drugs showed gradual increase according to the duration of chemotherapy; 20, ?, -in the cavitary cases treated for 1 to 6 months, 28.600 for 7 to 12months and 42.9% for 13 months or more. The rate was much lower as compared with the rate of resistance to primary drugs (Table 3). Among 26 cases who had discharged re s istant bacilli in sputum at least once during the course of preoperative chemotherapy, sensitive strains were detected in 7 lesions (26.9%)while resistant ones were found in 12 lesions (46.2%). The disagreement of resistance between tubercle bacilli in sputum and in the lesion was seen far less in the case of primary drugs than in the case of secondary drugs (Table 4). Concerning the rate of resistance to second a ry drugs in sputum among the cases discharging bacilli continously under secondary drug treatment, resistance to CS was found rarely even when the drug was given for more than 12 months. Resistance to TH showed unstable results in each of the repeated examination under chemotherapy. Resistance to KM and EB were found in approximately 60% of the cases under chemotherapy for longer than 1 year, while resistance to primary drugs was seen in 80% or more (Table 5). It can be c oncluded that the incidence of tubercle bacilli resistant to secondary drugs was lower than that to primary drugs, both in resected specimen and in sputum.
日本結核病学会の論文

二次抗結核薬の耐性に関する研究

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