Table of Content

10 February 2005, Volume 27 Issue 2

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Study on molecular typing of Mycobacterium tuberculosis with variable number of tandem repeats

Kan Xiaohong ¹,Wan Kanglin,Jin Yulian,et al.

Chinese Journal of Antituberculosis. 2005, 27(2):  77-81. 

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Objective To study on molecular typing of 52 Mycobacterium tuberculosis (MTB) isolates from the patients with tuberculosis in Anhui province by variable number of tandem repeats (VNTR) method, and to evaluate the value of the genotyping method in genotyping of MTB. Methods Thirteen tandem repeat loci in the total genome of MTB were analyzed by PCR and agarose gel electrophoresis method. The character of the polymorphism of DNA fingerprinting of 52 MTB strains was analyzed with BioNumerics 3 0 software. Results The 52 MTB strains were finally classified into 4 genotypes. Most (88.5%) of them belonged to one genotype, the other three genotypes scattered, accounted for 5 8%, 3 8% and 1 9% strains, respectively. Conclusion The Results showed that there perhaps exists epidemic strain clusters in MTB strains from Anhui province. This fast and simple technique, VNTR method, is better molecular typing method for MTB Genotyping.

Experiences and lessons on drug resistance surveillance of tuberculosis in Henan province

Wang Guobin, Xu Jiying, Peng Yili, et al.

Chinese Journal of Antituberculosis. 2005, 27(2):  82-85. 

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Objective To analyze the experiences and lessons in two rounds of drug resistance surveillance in Henan province for reference to the colleagues who are going to do DRS. Methods Collected and analyzed the materials from the summarized report and special report in two rounds DRS in He’nan province. Then analyzed the main problems and lined it in the tables for comparing and statistics. After discussing, the main participated working staffs gave the ideas and suggestions. Results (1) If the drug using history was not clearly asked, it would miss categorized the retreatment cases into the initial treatment group, then it would increased the drug resistant rate of initial treatment group falsely. So it must be done that drug using history should be rechecked by different leaders or senior doctors in TB dispensary, supervised by specialists from WHO, national and provincial lab, and emphasized to doctors working in dispensary again during training . (2) In the cold season or area, if the CPB was put in sample of sputum as antiseptic, the crystal of CPB and no growth of TB, contamination of other bacteria would be presented in it obviously. When stopped putting CPB into sample of sputum and changed the place of TB culture to county lab of TB dispensary, the problems mentioned above disappeared almost, and the social benefit would be increased. (3) To prevent from contamination, no growth, and baking of culturing strains, a series of measures must be done before the starting of first DRS at the county dispensary, as follows: checking, repairing or renewing the equipments for TB culture setting, up new mesures for continuous supplement of electricity and technical training to technician of TB dispensary on TB culture. (4) It is necessary that to strengthen the training for leaders and doctors working in county TB dispensary and add the times of supervising of higher supervisors at the beginning so that to prevent from selecting TB patients irregularly and make the sample better representative. (5) Using bright light magloscope for colony counting and two persons or more for rechecking, and using N·N-dimethylformamide as a replacement for rifampicin solvent, we corrected the higher sensitivity and lower specificity in the beginning of DRS and soon it were up to standard of WHO. Conclusion Paying great attention to the three principles recommended by the WHO/IUATLD’S DRS guideline and practicing it seriously is the basement of making DRS success in any country, province or area. Our experiences and lessons on previous DRS presented above were also focused on it. Do remember and practice the three principles: sample must be representative, history of anti-TB drug used should be corrected, and lab technique should be qualified and up to standard of WHO/IUATLD.

The analysis on control effect of smear-posive cases in Huairou District of Beijing

Liu Donglai.

Chinese Journal of Antituberculosis. 2005, 27(2):  86-88. 

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Objective To understand the epidemic trend of tuberculosis and take corresponding control measures through analysis of control Results of smear-positive cases in Huairou District of Beijing. Method To collect data from medical record and infectious diseases reporting card in the Huairou District TB lnstitute, and do statistical analysis.Result In 10 years period of the implementation efforts , the case rate and new case rate of tuberculisis decreased annually (The annual reduced rate was 11 1% and 9 3%,respectively). The DOTS rate and the cure rate of smear-positive new registered cases was 89 2% and 93 8% respectively. Conclusion It is feasible to impelmente DOTS strategy in mountain area.

Characteristic analysis of pulmonary tuberculosis patients complicated with diabetes between male and female in Tianjin

Luo Maohong, Wang Xiexiu, Wang Jianhua, et al.

Chinese Journal of Antituberculosis. 2005, 27(2):  89-92. 

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Object To investigate the epidemiological tendency and characteristic differences of pulmonary tuberculosis patients complicated with diabetes between male and female in Tianjin. Methods Study the data of pulmonary tuberculosis patients complicated with diabetes registered in Tianjin Tuberculosis Control Center from 1991 to 2002.To explore the annual new registration rates of pulmonary tuberculosis patients complicated with diabetes and the tendency changed with time as well as the distribution of age, area , occupation and clinical characteristic between difference gender. Results The tendency of the annual new registration in male is increased and the annual average increase rate is 4 21%, the statistical significant increased tendency is not found in female. The patients number of male :female is 2 22:1. Male patients is much more than female in age 30～39,and less than female in age 50～59; positive rate of sputum smear in male is higher than female. The more higher of positive sputum smear rate the more higher of the possibility that male is examined. The risk to got type Ⅲ、typeⅣ and typeⅤ pulmonary tuberculosis is higher in male than female. Conclusion The distribution and clinical characteristic of pulmonary tuberculosis patients complicated with diabetes are different between male and female, male is severe than female.

The bacterial strains’ distribution and antimicrobiol susceptibility analysis of 111cases of tuberculosis accompanied with lower respiratory infection

Qin Chao ,Yu Weiqin,Xia Jundi.

Chinese Journal of Antituberculosis. 2005, 27(2):  93-96. 

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Objective To determine the bacterial strains’ distribution of tuberculosis accompanied with lower respiratory infection and select sensitive drugs. Method The isolated strains from 111 cases with tuberculosis accompanied with lower respiratory infection in our hospital during 2002 and 1239 contemporary cases in another 10 hospitals in Tianjin were reviewed. We focused on the distribution of their bacterial strains and the Results of Antimicrobiol Susceptibility test on Klebsiella pneumoniae, Pseudomonas aeruginosa,Acinetobader baumannii,Serratia liquefaciens. All data were analyzed by SPSS software. Result There were 28 kinds of pathogenetic bacterial infection.The top 8 among these were Klebsiella pneumoniae(19.8%), Pseudomonas aeruginosa(13.5%), Acinetobader baumannii (9.9%),Monilia albicans (7.2%),Serratia liquefaciens (5.4%),Stap.aureus (5.4%),E.coli (4.5%) and E.cloacae (2.7%) respectively. Conclusions The four pathogenic bacterium with top high infection rates were all highly sensitive to Amikacin and Ciprofloxacin.Furthermore, Amikacin and Ciprofloxacin were both effective on tubercle bacillus and have been served as the second-line drug for antituberculosis. Therefore,they should be the first choice of the antibiotics for tuberculosis (especially for previously treated pulmonary tuberculosis ) accompanied with lower respiratory infection.

Study of interventional therapy with microwave for endobronchial tuberculosis

Chen Weisheng,Xin Lihong,Li Weiliang.

Chinese Journal of Antituberculosis. 2005, 27(2):  97-100. 

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Objective To observe and study the efficacy and safety of interventional therapy with microwave for endobronchial tuberculosis. Method Ninety-two cases of in house patient with endobronchial tuberculosis were randomly divided into two groups. The therapeutic group was treated with interventional microwave therapy and the control group was treated by local drug-infusing therapy.Results After 9 months of treatment,the therapeutic group showed both the sputum negative rate and the cure rate of pulmonary atelectasis were 100 %; the improvement rate of X-ray manifestations was 88 1% and The improvement rate of lesions founded by bronchoscopy was 85 7%, All of which were higher than that of the control group. Results Treatment of endobronchial tuberculosis with bronchoscopy-assisted interventional microwave therapy is a safe and effective method.

Clinical analysis of 42 adrenal tuberculosis cases complicated with Addison’s disease

Liu Juan ¹ ,Feng Xiaofeng,Liu Qiuyue, et al.

Chinese Journal of Antituberculosis. 2005, 27(2):  101-103. 

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Objective To investigate the clinical characteristics of Addison’s disease caused by adrenal tuberculosis. Method The clinical information of 42 cases with Addison’s disease causeel by adrenal tuberculosis were reviewed.Results Of the 42 cases with tuberculous Addison’s disease, 30 cases complicate with extra-adrenal tuberculosis; erythrocyte sedimentation rate (ESR) was increased in 26 cases among 39 cases examined; PPD test was positive in 20 cases among 27 cases examined; adrenal gland calcification and enlargement were showed in 20 (80%) and 18 cases (72%) respectively among 25 cases examined with CT scanning. Conclusion Adrenal tuberculosis was the commonest cause of Addison’s disease in our country. Usually complicated with extra-adrenal tuberculosis.Adrenal calcification, enlargment showed by CT scanning was specific signs for the diagnosis of tuberculous Addison’s disease.

The clinical study on preventing medicamentous liver lesion induced by antituberculosis drugs of silybin meglumine tablebs

Dong Anguo,Xu Jinyun,Cui Dongmei.

Chinese Journal of Antituberculosis. 2005, 27(2):  104-106. 

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Objective To study the preventive efficacy of Silybin meglumine tablets on medicamentous liver lesion by antituberculosis drugs. Methods 242 sputum positive initial treated pulmonary tuberculosis were divided into two groups, study group and control group randomly,which were both treated by chemotherapy regimen of 2HRZS(E)/4HR.The study group also took TSM. Results In the study group the morbidity of medicamentous liver lesion was 6.6%,the incidence rate of interrupting treatment was 4.1%,1.6%of cases adjusted the antituberculosis regemen. And the control group was 19.2%,14.2% and 19.2% respectively.There were very significant difference between the two groups(P<0.01).Conclusion Silybin Meglumine tablets can obviously decrease the incidence rate of liver damage of sputum positive initial treated patients induced by antituberculosis drugs and decrease or prevent the irregular chemotherapy that Results from the liver damage caused by antituberculosis drugs.

Radiographic appearance of tuberculosis in HIV patients

Li Zhifeng ,Huang Xiangyong ,Lan Ke, et al.

Chinese Journal of Antituberculosis. 2005, 27(2):  107-108. 

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Objective To evaluate the characteristics of tuberculosis in HIV patients. Methods Seventy-eight inpatients coexisted with tuberculosis and HIV infection were reviewed and analysis retrospectively. Results (1)Bilateral infiltrateds, caseous lesions or military nodules in lungs were the predominant radiographic changes of pulmonary tuberculosis in patients with HIV infection;(2)The proportion of cases with cavity on chest X-ray and sputum smear positive cases were lower in our studied group , contrarily,accompanied with higher frequencies of pleuritis, peritonitis and extra pulmonary tuberculosis.Conclusion According to our analysis of radiographic features,HIV infection was associated with a progressive manifestation of tuberculosis.

Detection of interferon-2α and tumor necrosis factor in patiens with severe acute respiretory syndrome

Ye Yixiu,Wang Wei, Wang Ansheng,et al.

Chinese Journal of Antituberculosis. 2005, 27(2):  109-110. 

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Objective To observe the levels of serum Interferon-2α(IFN-2α) and Tumor necrosis factor (TNF) in patients with Severe acute respiretory syndrome(SARS). Methods The serum IFN-2αand TNF in 66 patients with SARS were analyzed by RIA, and compared with controls. Results The levels of serum IFN-2αand TNF in patients with active period of SARS were significantly higher than those in controls. The levels of serum IFN-2αin severe type of patients were rise or fall, and TNF in severe type of patients were higher than general type. Conclusion The change of levels of serum IFN-2αand TNF suggested that cellular immunity was involved in immunoreaction. The change of IFN-2αand TNF in severe type of patients with SARS reflected the difference of immunoreaction in patients.

Analysis on the change of CD4 and CD8 lymphocytes in pulmonary tuberculosis patients

Xin Xiaohe,Qian Wusi.

Chinese Journal of Antituberculosis. 2005, 27(2):  111-112. 

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Objective To observe the change of CD4 and CD8 lymphocytes in pulmonary tuberculosis patients and to explore the trend and significance of their immune function Methods Determine the CD4 and CD8 values in 31 adult pulmonary tuberculosis patients and 12 control cases with flow cytometry. And then make a statistical analysis based on the determining Results .Results The CD4 values of the patients declined obviously, the CD8 values had no obvious difference . There was no obvious relationship between the decline extent of CD4 values and the patients’ illness condition, the condition of the discharge of bacteria. Conclusion Damage of cellular immune function existed in the adult pulmonary tuberculosis patients, which prominently manifested in the form of the decline of the CD4T lymphocytes , but it had no absolute effective impact on the occurrence and development of illness.

Analysis on effect of increasing the detection rate of TB patients by administrative intervenient measures in Yantai City

Cong Shuzhen ,Xu Jishan ,Gao Lanying.

Chinese Journal of Antituberculosis. 2005, 27(2):  113-116. 

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Object To explore the effect of comprehensive intervenient approaches on increasing TB patient detection. Meathod Comprehensive intervenient measures have been taken by strengthening the intervention of administrative and technical measures, making wide and deep propaganda and health education,strengthening case referring from hospitals , combining active finding ,evaluation , incentive and punishment. The case finding data was analyzed before and after interventions. Result The referring rate of TB cases from hospitals increased from 53.2% in 1993 before the interventions to 98.6% in 2001 after the interventions. The newly registered active TB patients rate increased from 17.5/100,000 in 1993 before the interventions to 30 4/100,000 in 2001 after the interventions. The new registration of smear positive cases rate increased from 6 1/100,000 in 1993 before the intervention to 17.9/100,000 in 2001 after the intervention (X²=57.73 P<0.001), the difference was significant . During the 8 years (1994-2001) with intervenient measures, newly registered smear positive cases rate were 127.8% more than that of the 8 years (1986-1993) before taking intervenient measures. Conclusion The city has taken comprehensive intervenient measures for the detection of TB patients, the registration, referring and reporting work were improved , which effectively increased the new registration of TB patients.

The situation of resistance to anti-TB drugs among inpatients

Shen Jian’en ¹,Yang Weina.

Chinese Journal of Antituberculosis. 2005, 27(2):  117-119. 

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Objective To investigate resistant situation to anti-TB drugs among inpatients with pulmonary TB in the Baoli Hospital of Ningbo and the difference of drug resistance among patients from cities,towns and rural area and patients floating to cities. Methods Analysis was conducted on drug resistant tests to INH,SM,RFP and EMB of patients with sputum culture positive pulmonary TB hospitalized in our hospital from January 1992 to December 2003. Results The total initial drug resistance rate was 21.4%,11.5%,14.1%19.4% and 28.6% respectively for patients from cities,towns,other parts floating to cites and rural area. The total acquired drug resistance rate was 77.8%,56.9%,75%,85.7% and 89% respectively for patients from cites,towns,other parts floating to cites and rural area. Conclusion Resistance to Anti-TB drugs was the highest among rural inpatients and then,the inpatients floating to cites,from towns and cites.