[Clinical analysis of extensively-drug resistant tuberculosis (XDR-TB) in our hospital].
OBJECTIVE
We analyzed the clinical characteristics of extensively-drug resistant tuberculosis (XDR-TB).


METHODS
Thirteen cases diagnosed with XDR-TB encountered in our hospital over the last ten years were enrolled in our study.


RESULTS
The patients included 9 males and 4 females. The mean age was 49.1 years old in males and 42.0 years old in females. Eight patients were Japanese and 5 were foreigners (Chinese, 3; Korean, 1; Nepali, 1). Nine cases had a smoking history and 6 had underlying diseases, including 1 with bacterial pneumonia, 3 with diabetes mellitus, 1 with chronic renal failure, and 1 with collagen vascular disease receiving immunosuppressive treatment. All 13 cases had been diagnosed at other hospitals. The mean period from TB diagnosis to XDR-TB diagnosis was 56.8 months, and the mean period from TB diagnosis to referral to our hospital was 81.6 months. Among the 13 cases, 3 had no drug sensitivity, 1 was sensitive to only 1 drug, 2 were sensitive to 2 drugs, 6 were sensitive to 3 drugs, and 1 was sensitive to 4 drugs. Nine of the 13 cases had surgical treatment. Six cases, all of whom had surgical treatment, showed negative conversion in sputum examinations. Three patients died, including two who had surgical treatment. Among the 3 cases with no drug sensitivity, 1 was cured after surgical treatment. Another case had been working in the same hospital with two other MDR-TB cases. Two of the three had the same RFLP pattern.


CONCLUSIONS
XDR-TB and MDR-TB are man-made diseases. We need to take measures not to create more XDR strains and induce more MDR-TB cases.
Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA). okumuram@fukujuji.org
Masao
M
Okumura
Takashi
T
Yoshiyama
Shinji
S
Maeda
Yuko
Y
Kazumi
Yuka
Y
Azuma
Masako
M
Ueyama
Kozo
K
Morimoto
Atsuyuki
A
Kurashima
Hideo
H
Ogata
Shoji
S
Kudoh
D000328:Adult; D054908:Extensively Drug-Resistant Tuberculosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged