Table of Content

10 June 2002, Volume 24 Issue 6

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The analysis of characteristics of IS6110 fingerprint patterns of Mycobacterium tuberculosis strains in Jilin City

LI Shu lin,HAN Zhong bo,XU Xin shun,et al.

. 2002, 24(6):  313-316. 

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Objective To analyze the characteristics of IS6110 restriction fragment length polymorphism ( RFLP ) patterns of mycobacterium tuberculosis strains isolated from Jilin City.Methods 53 of Mycobacterium tuberculosis strains were isolated from the 53 cases with pulmonary tuberculosis,IS6110 RFLP patterns were produced by DNA fingerprinting. Mycobacterium tuberculosis strains were divided into groups according to their homology of IS6110 fingerprinting,and were analyzed.Results The characteristics of IS6110 RFLP patterns of Mycobacterium tuberculosis strains isolated from Jilin City showed:(1)The average of the copies of IS6110 was 13.(2)The homology of the strains between group A and group B existed to a great extent.They had the characteristic of "Beijing genotype strains".Strains in group C had high polymorphism.(3)The characteristics of IS6110 patterns were not related to the geographic distribution of the patients.(4)The clustering rate of strains in initial cases of drug resistance was high;as for the characteristic of the patterns,there were no differences between the strains of drug resistance and those of non drug resistance.Conclusion The main type of the IS6110 RFLP patterns of Mycobacterium tuberculosis strains in Jilin City was "Binjing genotype strains",but there was a feature specially,that was the high polymorphism.

Detecting methods of drug-resistance gene in Mycobacterium tuberculosis

LI Hong min,WANG Wei,LI Shu mei,et al.

. 2002, 24(6):  317-319. 

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Objective To investigate the relationship between drug resistance gene mutation and drug resistance level in M.tuberculosis .Methods 108 M.tuberculosis clinical isolated strains from sputum specimens were tested by PCR-SSCP and traditional drug susceptibility tests.Results The gene mutation rate of SM,RFP and INH resistance clinical isolated strains was 78.5%,68.2% and 70.5% respectively,and the mutation rate of SM,RFP and INH high concentration resistance isolated strains was 86.5%,89.3%,84.3% respectively.But the mutation rate of low level of resistance strains was 28.5%, 16.5% and 7.1%.Conclusion The gene mutation was in relation with drug resistance level of M.tuberculosis .The gene mutation rate was higher in high level of resistance isolated strains than in low level of resistance isolated strains.

Study of association between immune levels and tuberculin test responses among the cases with HIV infection

ZHENG Su hua,DUAN MU Hong jin,LI Zheng min,et al.

. 2002, 24(6):  320-323. 

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Objective To investigate the tuberculin test responses among cases with HIV infection and to evaluate association between immune levels and tuberculin positive responses to cases with HIV infection in China.Methods The prospective study was applied.55 cases and 202 controls were observed.The tuberculin tests were practised among cases and controls.The levels of CD₄、CD₈、CD₄/CD₈ of HIV infections were measured by cytometry.Results The tuberculin positive rate of case group (9.8%) was significantly lower than the control group (28.2%, P＜0.01).When the count of CD₄ cell＞200(AIDS),the reaction of Tuberculin Test was 0.When the count of CD₄ cell was more than 200,the reaction of Tuberculin Tests was strong in part of cases (＞15mm).Conclusion The tuberculin positive rate of HIV infections was significantly lower than the control group ( P＜0.01).

Immunotherapy with Mycobacterium vaccae vaccine in treating pulmonary tuberculosis -- results after 2 years’ follow-up

LU Shui hua,LIU Zhi cheng,CHEN Xu han,et al.

. 2002, 24(6):  324-326. 

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Objective To further shorten the therapeutic period of short course chemotherapy (SCC) of initially treated pulmonary tuberculosis (PTB) and to improve the Results of chemotherapy of MDR pulmonary tuberculosis by immunotherapy with Mycobacterium vaccae vaccine.Methods 142 patients of newly diagnosed pulmonary tuberculosis with bacteriological positive and 46 patients of MDR pulmonary tuberculosis were divided into immunotherapy groups (group A、C) control groups (group B、D) at randomized pair,group A (71 cases) of newly diagnosed PTB was received once monthly of injection of Mycobacterium vaccae vaccine as immunotherapy for 6 times and a 4 months chemotherapeutic regime,group B (71 cases) of newly diagnosed PTB was received a 6 months chemotherapentic regime,groups C、D of MDR pulmonary tuberculosis were received 18 months chemotherapeutic regime and group C (23 cases) was given six times injection once monthly of M.vaccae vaccine as immunotherapy.Results After 6 months,the sputum negative conversion rate of group A was 95.8%(68/71),group B was 97.2%(69/71), P＞0.05;group C was 34.8%(8/23),group D was 4.7%(1/23), P＜0.05,at the end of treatment of MDR pulmonary tuberculosis,group C was 39.1%(9/23),group D was 8.6%(2/23),at the final follow up after 2 years,the bacteriological relapse rate of group A was 6.3%(4/64),group B was 4.5%(3/66), P＞0.05;and group C was 11.1%(1/9),group D was 50.0%(1/2), P＞0.05.Conclusion As an adjunct to chemotherapy,M.vaccae vaccine was helpful for patients with pulmonary tuberculosis.

The CT findings of pulmonary tuberculosis in old age

DU Tie qiao,LIANG Hong ru,MA Xin,et al.

. 2002, 24(6):  327-329. 

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Objective To analyse the computed assisted tomographic (CT) manifestations of pulmonary tuberculosis (TB) in old people and the usefulness of CT scan in the diagnosis of pulmonary TB.Methods From August 1993 to March 2000 160 aged patients (age range: 65 89 years; mean age 72.5 years) with pulmonary TB underwent chest CT scan. High resolution CT (HRCT) were done in 112 patients. 84 patients were performed contrast enhanced CT scan. Results The characteristics of the chest CT scan in this series included: (1) The lesions were distributed in more than one lobe in 78.6% of the patients. Both the upper and lower lobe were involved in 56.4%, upper lobes were involved in 20.5%, and only involvement of the lower lobes in 23.0%. (2)Fibrosis as the predominantly manifestation was seen in 89.4%. The presentations of cavity,calcification,pleural thickness,tuberculoma were seen in 48.5%, 40.8%, 18.4%, and 6.8%, respectively. (3)Contrast enhancement CT showed that lesions were markedly enhanced in 90.5% (76/84). (4) The findings of the active lesions were presented in 76.8%, which manifested as 2～4mm centrilobular nodules and branching linear opacities,or 5～8 mm fuzzy nodules associated with thickening of the interlobular septa and the bronchial wall. (5) Pulmonary TB associated with lung cancer was seen in 9.4% (15/160) of the patients.Conclusion The characteristics of pulnonary TB in aged people included predominant fibrosis,preferring to involvement of the lower lobes, and marked lesion enhancement. The incidence of TB associated with lung cancer is relatively high. HRCT is useful for determinated the activity of pulmonary TB.

Clinical observation on the side effect of CPM

LIU He,BAI Gao chao,JIAO Xiao ling.

. 2002, 24(6):  330-331. 

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Objective To observe the side effect of CPM.Methods To investigate 61 retreatment tuberculosis patients who had used CPM and to observe their side effects of CPM.Results 61 patients used CPM.Amony them,14 patients had the side effects.The rate was 22.9%.There were total five kinds of side effects.Frequency of the side effects was renal injury,hypokalemia,Ⅷ cranial nerve’s injury,hypocalcium,part’s scleroma.The side effect often appeared after the patients using the CPM for a month.Conclusion The side effect of CPM appeared commonly in the clinic,but the renal injury and the disarrangements of electrolytic were more serious.The clinicians shall pay great aftention to this.

Calculation and prediction of the age distribution of tuberculous infection among the population in Beijing

HE Xiao xin¹,ZHANG Li xing,JIN Shui gao,et al.

. 2002, 24(6):  332-339. 

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Objective To calculate and predict the age distribution of infection with M.tuberclsis among the population in Beijing on the basis of available tuberculosis epidemic data.Methods Firstly calculating the risk of tuberculous infection for specific years according to the data of tuberculous infection, secondly establishing the mathematical relationship between the risk of tuberculous infection and the correspandine epidemic situation data with a mathematical model, thirdly calculating the risk of tuberculous infection of the other years with the model, and finally calculating the age distribution of infection among the population in Beijing. Result There was a linear regression relationship between the risk of tuberculous infection and the logarithm of registry rate of new tuberculosis patients. The prevalence of tuberculous infection among the population of Beijing in 1998, 2020 and 2040 was 44.23%、17.04% and 5.41% respectively.Conclusion Age distribution of tuberculous infection of specific population could be calculated by a mathematical model on the basis of specific data.

TB transmission parameter under modern tuberculosis control strategy

HE Guang xue.

. 2002, 24(6):  340-342. 

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Objective To explore the tuberculosis transmission parameter under modern tuberculosis control strategy (DOTS).Methods Since 15 July 1988,the BCG vaccination for newborns in Shun Yi County of Beijing was discontinued, and a series of protective measures,mainly conducted DOTS,for children were taken at the same time.PPD tuberculin tests for the nonvaccinated 6～7 years children born in 1988～1989 of first grade of primary schools,done with international standard tuberculin (2 TU PPD Rt23+Tween 80),were conducted according to WHO/IUATLD procedures in 1995.The criterion for infection was an induration of 10mm or more according to the distribution of PPD test reaction.Results The prevalence of tuberculosis infection was 1.35%.The annual risk of TB infection (ARTI) was 0.21%. At meantime, the prevalence of smear positive pulmonary tuberculosis in Shun yi County were (21.7～39.1)/10⁵ per year.So the TB transmission parameter was about 6.Conclusion The TB transmission parameter was 6 in Shun yi County of Beijing that means an infectious tuberculosis case can infect 6 persons averagely per year.This result indicated that the modern tuberculosis control strategy (DOTS) in Shun Yi County has highly effect on controlling sources of infection,reducing infection, protecting healthy population.

The evaluation of implementing the national tuberculosis control programme (1996～2000) in Zhejiang

LI Qun,YANG Shi bo,XU Xu qing,et al.

. 2002, 24(6):  343-346. 

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Objective To analyze the effect of implementing NPT in Zhejiang past five years. Methods To collect and analyze the data of implementing NTP during 1996 to 2000 in Zhejiang province.Results With strengthening the tuberculosis control measares,the infectious source finding and the effect of treating enhanced year by year.The registered rate of new smear positive case,the transferring rate and the cure rate increased from 10.9/10⁵,47.4%,84.4% to 16.2/10⁵,77.8%,91.0% respectively.The impact of case finging and treatment (ICT) increased from 24.3% to 47.7%.Conclusion Satisfactory Results were achieved of NTP in Zhejiang.But must have a balanced development in the whole province and strictly implement the "NTP 2001～2010",continonsly extend the tuberculous control measure (DOTS),and improve the overall level of TB control in Zhejiang province.

Analysis of the tuberculosis epidemiologic investigation of Guiyang county in 1998

Dong Lisheng

. 2002, 24(6):  347-349. 

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Objective Through the sample investigation and research,the tuberculosis epidemic information was obtained.The changes of the disease situation and the epidemic tendency were analysed.The Results of the prevention and cure in the past ten years were assessed.All this provided the scientific basis for making correct measures to prevent and cure tuberculosis.Methods With the method of sampling at random in the whole group at different levels in the 30 inspected spots,the professional investigation teams were organized to carry out the relevant investigation.By means of the examination of tuberculin,X ray and the tubercular bacteria in the people’s sputum,the TB pateitns were found out.Results Among 40?166 people who were examined,160 cases of active pulmonary tuberculosis were found.The morbidity amounted to 398.3/10⁵.Conclusion The tuberculosis epidemic morbidity is relatively higher in Guiyang city and it seems that the morbidity is going up.Apperently,in the country side,the morbidity is higher than that in the city while the morbidity in the urban areas is decreasing compared with that in the past ten years.

ESBL infection and drug resistance in patients with pulmonary tuberculosis

WU Long zhang,YE Xiao cong,LI Yi geng,et al.

. 2002, 24(6):  350-352. 

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Objective To investigate and compare the infecton of extended spectrum beta lactamases (ESBLs) producing strains and their antibiotic resistance in patients with pulmonary tuberculosis and non pulmonary tuberculosis.Methods Inhi bitor potentioted disc diffusion test was used to determine the ESBLs producing strains and the Sceptor Pette system was used to test antibiotic susceptibility to 21 kinds of antibiotics applied clinically.Results The positive rate of ESBLs in Klebsiella Pneumoniae and Escherichia Coli was 39% and 78% in patients,which should that the rate in pulmonary was higher than the rate in non pulmonary tuberculosis.The later was only 21% and 53%,respectively.These ESBLs producing strains had hihger resistance rate to the 1st and the 2nd generation of Cephalosporin’s,Penicillin’s,Tetracycline’s,Trime/sul and Quinollne’s,while only 41% to 63% antibiotic susceptibility rate to Aztreonam and the 3nd generation of Cephalosporin’s,but these strains had higher sensitivit to Amino glycosides.Conclusion ESBLs palys an important role in the mechanism of Gram negative bacterium antibiotics resistance to Cephalosporin’s (3rd generation) and monocycle beta lactam antibiotics.Both the detecting of ESBLs producing strains and the testing of antibiotic susceptibility should be highly emphasized.