当院におけるMycobacterium kansasii症例の臨床的検討  [in Japanese] CLINICAL INFESTIGATION OF PULMONARY MYCOBACTERIUM KANSSASII INFECTION IN OUR HOSPITAL  [in Japanese]

Access this Article

Author(s)

Abstract

非定型抗酸菌は世界中のあらゆる地域で報告されてきている。これは, 高齢化や臨床的検索法の改良, 臨床医の認知, 病原生物への曝露機会の増加などが考えられる。日本では非定型抗酸菌症の罹患率は約10万対3であり, その80%はMACで, 残りの大部分はM.kansasiiが占めている。当院は, 西日本の福岡県にある。この研究は1996年から2000年にかけて当院のM.kansasii症例についてのものである。M.kansasii症24例の臨床的検討を行った。<BR>一次感染型の患者は, 二次感染型の患者に比べ若年であった。二次感染型の患者は合併症や基礎疾患が多くにあった。一次感染型の血清総蛋白やアルブミンは二次感染型に比べて低値であった。薬剤感受性検査では, リファンピシンは23例で10μg/<I>ml</I>に, 全例で50μg/<I>ml</I>に感受性であった。エタンブトールでは15例が2.5μg/<I>ml</I>に, 22例が5μg/<I>ml</I>に感受性であった。イソニアジドでは24例が0.1μg/<I>ml</I>に耐性で, 11例は1μg/<I>ml</I>に感受性を, 23例は5μg/<I>ml</I>に感受性を示した。リファンピシンを含むレジメで治療された患者の喀痰培養は2カ月以内に陰性化した。重篤な合併症を伴った3症例は死亡し, 他の21例は改善し治療終了後少なくとも現在まで6カ月以上再発をみていない。

There is evidence that the number of nontuberculous mycobacterium (NTM) cases is increasing at least in some areas of the world and as possible causes of the increase, the followings are pointed out; ageing of the population, improved methods for detecting organisms from clinical specimens, increased physician's awareness on the disease, increased exposure of patients to the source of the organism. In Japan, it has been estimated that the overall incidence of NTM disease is about 3 per 100, 000. About 80% of NTM are MAC, and among the remainder, <I>Mycobacterium</I> kansasii is most common in our country. Our hospital located in Fukuoka prefecture in Kyushu, western part of Japan. In this study, clinical data of 24 cases of pulmonary infection caused by <I>Mycobacterium</I> kansasii in our hospital, from 1996 to 2000 were investigated. Primary infection type patients were younger than secondary infection type. Nearly all secondary infection type patients had underlying diseases and complications. Serum total protein and albumin in primary type is lower than that in secondary type. The results of mycobacterial drug sensitivity tests were as follows; for rifampicin, 23 cases were sensitive to 10 μg/<I>ml</I>, all cases to 50μg/<I>ml</I>, for ethambutol, 15 cases were sensitive to 2.5μg/<I>ml</I>, 22 cases to 5μg/<I>ml</I>, and for isoniazid, all cases were resistant to 0.1μg/<I>ml</I>, 11 cases were sensitive to 1 μg/<I>ml</I> and 23 cases to 5 μg/<I>ml</I>. Sputum cultures of patients treated with drug regimens containing RFP converted to negative within 2 months after starting chemotherapy. Although three patients with serious complications died, other 21 patients improved and showed no relapse at least 6 months after the completion of treatment.

Journal

  • Kekkaku(Tuberculosis)

    Kekkaku(Tuberculosis) 77(1), 23-27, 2002-01-15

    JAPANESE SOCIETY FOR TUBERCULOSIS

References:  9

Cited by:  4

Codes

  • NII Article ID (NAID)
    10008113256
  • NII NACSIS-CAT ID (NCID)
    AN00073442
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    00229776
  • NDL Article ID
    026778675
  • NDL Call No.
    Z19-133
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
Page Top