INH耐性結核菌の人体に対する毒力-2-
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概要
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Three questions were raised for investigating the virulence of INH resistant tubercle bacilli to human body. The first problem, the infectiousness of INH resistant tubercle bacilli, was discussed in the Report I of this paper. In this paper, the second question, whether the incidence of exacerbation is equal among INH resistant and sensitive cases or not, is discussed. For this purpose, 919 pulmonary tuberculous patients admitted to Tokyo Nation a l Chest Hospital (Tokyo district), National Sanatorium Ginsui-en (Kyushu district) and Hokkaido Second National Sanatorium (Hokkaido district), were investigated. Cases were divided into the following three groups; 1) 519 cases admitted at present in the above mentioned three sanatoria, and have stayed over one year and excreted tubercle bacilli for six months and over, 2) 100 cases in each of the above sanatoria who were discharged in 1950 after staying over one year, and 3) 100 cases in Tokyo district who were discharged in 1945 after staying over one year. The results were summarized as follows:<BR>1) The incidence of exacerbation among c ases who acquired INH resistance during the treatment was equal to that of the sensitive cases. No definite proof was obtained that the virulence of INH resistant bacilli is clinically attenuated, though changes in biological characteristics is seen in INH highly resistant bacilli.<BR>2) Repeated exacerbations were found among some cases discharging INH highly resistant strains, while a number of sensitive or lowly resistant cases showed no exacerbation during the period of observation. The fact suggests that the INH resistance shows no influence on exacerbation, and the incidence of exacerbation is determined by the virulence proper to a strain regardless of INH resistance or by some other factors.<BR>3) The incidence of exacerbation was remarkably l ower among cases in Hokkaido district than among cases in Tokyo and Kyushu districts, and a further study is required to explain this fact.
- 一般社団法人 日本結核病学会の論文
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