[Clinical research on multi-drug resistant and extensive drug-resistant tuberculosis in Japan].
OBJECTIVE
To know the number of patients with MDR-TB and XDR-TB newly diagnosed annually and the number of those with continuously culture-positive in spite of continued treatment.


METHODS
To fill the questionnaire sent to all the TB hospitals in Japan and to investigate the number of beds for TB, MDR-TB cases newly admitted to each hospital in 2006 and chronic bacillary cases in spite of continued treatment.


RESULTS
We sent the questionnaires to all the TB hospitals in Japan and 81% of 270 hospitals replied. As the result, 93 MDR-TB were newly hospitalized (12 cases were with XDR-TB). 76 cases of them were newly diagnosed MDR-TB. Almost after 1 year treatment, patients with XDR-TB showed lower negative conversion rate than other MDR-TB (42.9% vs 63.8%) and higher fatality rate (42.9% vs 7.2%). Excluding above 93 new MDR-TB cases, 103 cases with chronic MDR-TB including 44 cases with XDR-TB had been treated during the observation period, 84 case had been hospitalized and other 19 cases at OPD.


CONCLUSIONS
Since 2000, extensive multi-resistant (XDR) TB has been a global topic. In Japan, nation-wide survey on 2002 showed the ratio of MDR and XDR were 1.9% and 0.6% respectively out of 3122 TB stains investigated. XDR/MDR rate was higher than those in other countries. Our clinical based investigation showed total XDR/MDR rate was 28.6% (56/196) and it was similar to that of previous bacteriological survey in 2002.


CONCLUSIONS
We investigated the number of patients with MDR-TB and XDR-TB newly diagnosed in 2006 and the number of those who were continuously culture-positive. The survey showed that there were 196 patients with MDR-TB, and 56 patients of them (28.6%) were with XDR-TB. Many of them were in the districts of Kinki area and Kanto-Shinetsu area and 70% of them had been treated in the hospitals belonging to the National Hospital Organization.
Toyota
Emiko
E
NHO Tokyo National Hospital, 3-1-1, Takeoka, Kiyose-shi, Tokyo 204-8585 Japan. etoyota-in@tokyo-hosp.jp
Kawabe
Yoshiko
Y
Yotsumoto
Hideki
H
Sakatani
Mitsunori
M
Tsuyuguchi
Kazunari
K
Maekura
Ryouji
R
Fujikawa
Kenya
K
Takashima
Tetsuya
T
Ogawa
Kenji
K
Yoshiyama
Takashi
T
Sugie
Takumi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023801:Directly Observed Therapy; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011795:Surveys and Questionnaires; D013997:Time Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult