Study on the Infection with Drug Resistant Tubercle Bacilli from the Patients among the Already Tuberculin Positive Persons without Tuberculous Lesion in a Workshop

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概要

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• Study was made on the drug resistance oftubercle bacilli isolated from the patients whowere detected by the mass survey carriedout on the employees of a workshop from1951 to 1960. The incidence rate of pulmonarytuberculosis was 1.33% in 1955, and 0.35% in1960 from the persons who were already tuberculinpositive without tuberculous lesions. Atotal of 189 were admitted to our sanatoriumin these years, and among them 59 were sputumpositive. The drug resistance was tested in 47cases, and primary resistance was found in 5cases (10.6%). All of them were drug resistantto one drug. Examination was done on theirpast history of tuberculin conversion, diseases, chest X-ray films, familial diseases, and especiallytheir contact with tuberculous patients.<BR>Among 5 cases, 2 were infected before 1945, up to that time no one having received anytuberculous chemotherapeutics in Japan.<BR>One of the two (Case 4) was in contact withthe patient who was his elder brother withtuberculous cavitary lesions and was under chemotherapywith SM and PAS in 1952 and diedin 1953. In spite of the annual mass examinations given twice a year since 1951, this casewas not discovered until 1956. His chest roentgenogram showed dense shadows in the rightupper lung and the sputum was positive bysmear which was drug resistant to 100/cc SMpartially.<BR>In the other (Case 5), drug resistance wasdetected to 1/cc INH partially, although he hadnot been in contact with any patients.<BR>The remaining 3 cases were infected after1949. Among them 2 cases were drug resistar. tto SM, having been in contact with sputumpositive patients under chemotherapy with SM.Another one with drug resistant to PAS wasnot in contact with any patients.<BR>From the above, it may be considered that outof the 5 cases who were newly discovered fromthe already tuberculin positive persons withouttuberculous lesions, 2 cases were re-infectedwith development of disease, but, as observedfrom their past history of tuberculin conversion, chest X-ray film, and so on, 3 cases were primarily infected with drug resistant tuberclebacilli with development of disease after a fewyears.

• 一般社団法人 日本結核病学会の論文

著者

• 村瀬 貞雄

  結核予防会研究委員会

• 近江 明

  富士銀行衛生管理室

• 小池 昌四郎

  結核予防会結核研究所附属療養所

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• Study on the Infection with Drug Resistant Tubercle Bacilli from the Patients among the Already Tuberculin Positive Persons without Tuberculous Lesion in a Workshop

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