著者

小橋 吉博 松島 敏春 河原 伸 多田 敦彦 宍戸 眞司 矢野 修一 重藤 えり子 横崎 恭之 冨岡 治明 竹山 博泰 西村 一孝 塩出 昌弘 上田 暢男 倉岡 敏彦 印鍮 恭輔

出版者

THE JAPANESE SOCIETY FOR TB AND NTM

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.73, no.12, pp.705-711, 1998-12-15 (Released:2011-05-24)

参考文献数

14

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In this study, we investigated 45 foreign patients who had been diagnosed as having tuberculosis in Chugoku-Shikoku area during the past 12 years. Regarding regional characteristics, in Hiroshima prefecture an epidemic of tuberculosis was experienced among patients coming from South America, but antituberculous therapy was performed for 87% of the patients because of the high coverage of the health insurance scheme. But in Okayama prefecture, most of the patients were female and came from Asian countries, such as, the Philippines. Antituberculous therapy was not performed for nine patients because of no coverage of the health insurance scheme. In the other prefectures, only a few cases of tuberculosis were experienced, but in Yamaguchi prefecture two of three foreign patients were multidrug-resistant tuberculosis.

著者

冨岡 治明

出版者

日本細菌学会

雑誌

日本細菌学雑誌 (ISSN:00214930)

巻号頁・発行日

vol.50, no.3, pp.687-701, 1995-07-25 (Released:2009-03-31)

参考文献数

50

被引用文献数

2 2

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結核をはじめとする抗酸菌症はその患者数や死亡者数が多く未だもって極めて重要な感染症であり,最近ではHIV感染者における多剤耐性結核や全身播種性Mycobacterium avium complex (MAC)症が問題になってきている。本稿では,こうした抗酸菌症のうち,特に結核とMAC症とに焦点を当て,何故にこれらの感染症が難治性であるのかという問題について,特に宿主マクロファージ(Mφ)と抗酸菌との関わりあいに焦点を当て,(1)宿主Mφ内での感染菌の挙動,言葉を変えればMφ内殺菌メカニズムからの菌のエスケープという問題と,(2)抗酸菌感染Mφの殺菌能のサイトカインカスケードを介しての制御,特にMφ不活化サイトカインによるdown-regulationという2つの観点から論じた。約めて言えば,難治性慢性感染症としての抗酸菌症の特異な病像を規定するものは,抗酸菌の極めて強いMφ内殺菌抵抗性と免疫原性であり,これが故に必然的に誘導されるTh2タイプのサイトカインカスケードの活性化が抗酸菌症の難治化にさらに拍車をかけているものと言えよう。

著者

斎藤 肇 佐藤 勝昌 冨岡 治明 井上 圭太郎 重藤 えり子

出版者

JAPANESE SOCIETY FOR TUBERCULOSIS

雑誌

結核 (ISSN:00229776)

巻号頁・発行日

vol.67, no.2, pp.89-95, 1992-02-15 (Released:2011-05-24)

参考文献数

18

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Fourty-five sputum specimens collected at the National Sanatorium Hiroshima Hospital were subjected to cultivation using either BACTEC 460 TB System (BACTEC method; Becton Dickinson Co., Towson, Md., U.S.A.) or 3% Ogawa egg medium. Test suptum was treated with four volumes of 4% NaOH for approximately two minutes, after which 0.1ml of the treated sputum was immediately inoculated onto 3% Ogawa egg medium. After neutralizing the remaining pretreated sputum with 1N HCl, and diluting with 1/15 M phosphate buffer PB; pH 6.8), it was then centrifuged at 3, 000rpm for 20min and the sediment was suspended in 1.5 ml of PB. Volumes of 0.5 ml each were inoculated into BACTEC 12B medium (4ml), containing PANTA for prevention of contamination and POES for promoting the growth of mycobacteria.In the BBCTEC method, bacterial growth was measured in terms of increases in the Growth Index (GI) values which were determined by the amount of 14CO2 released from the 14C -labelled palmitate during cultivation at 37°C (positive growth;GI≤50). Moreover, ρInitro-α-acetylamino-β-hydroxy-propiophenone (NAP)-sensitivity testing was done by transferring a part of the BACTEC 12B culture showing positive growth to a NAP vial, and thereafter subjected to further cultivation.Among the 45 sputum specimens, the number of positive specimens for mycobacterial growth in the afore mentioned cultivation methods and time required for growth were as follows: 3% Ogawa egg medium, 12 specimens (27%), seven M. tuberculosis complex strains at 12-35 days (average 21 days), five M. avium complex strains at 14-21 days (average 18 days): BACTEC method, 18 specimens (40%), 11 M. tuberculosis complex strains at 3-28 days (average 14 days), six M. avium complex strains at 3-10 days (average 6 days) and one M. scrofulaceum strain at 28 days. There were no specimens that tested positive for mycobacterial growth on 3% Ogawa egg medium but negative in BACTEC 12B medium. The BACTEC method was most efficacious in cultivating acid-fast bacilli from smear-negativeWhen NAP-sensitivity testing was done using the BACTEC method, mycobacteria in 11 test sputa were deteremined as NAP-sensitive, thereby belonging to M. tuberculosis complex. The fact that all of the organisms determined as NAP-sensitive using the BACTEC method were rough and nonphotochromogenic, and identified as M. tuberculosis complex by AccuProbeTM testing, confirmed the reliability of NAP-testing. sputa.The mycobacteria in seven sputum specimens detected using the BACTEC method were determined as NAP-resistant. Six of them were smooth and nonphotochromogenic, and identified as M. avium complex by AccuProbe testing. The one remaining strain was a scotochromogen with a smooth colony morphology, and had no reaction to either the M. tuberculosis complex- or M. avium complex-AccuProbe tests. This strain was identified as M. scrofulaceum using an α-antigen analysis.These results indicate the usefulness of the BACTEC 460 TB system in the rapid diagnosis of mycobacteria including M. tuberculosis complex and M. avium complex.