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Updated: Jul 12, 2026

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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
カリフォルニアの結核患者における多剤耐性,1994年から2003年
Reuben M Granich1, Peter Oh, Bryan Lewis
1Division of TB Elimination, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga, USA. granichrm@state.gov
JAMA
|June 9, 2005
まとめ
多剤耐性結核 (MDR-TB) は,カリフォルニアで継続的な脅威であり,制御の努力にもかかわらず,症例の1.4%に影響を与えています. 主なリスク要因には,以前の結核治療と最近の移民が含まれ,治療の完了率が低いことが観察されました.
科学分野:
- 公衆衛生は公衆衛生である.
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
背景:
- カリフォルニアの結核 (TB) 症例は,1994年から2003年の間に33%減少した.
- 全体的な減少にもかかわらず,カリフォルニア州は2003年に全国で最も多くの結核症例を報告しました.
- 多剤耐性結核 (MDR-TB) 症例の割合は,過去10年間で変わっていない.
研究 の 目的:
- カリフォルニア州のMDR-TBの流行,傾向,地理的分布,臨床的特徴,危険因子,アウトカムを分析する.
- 1994年から2003年にかけて報告された38,291件の結核症例を,カリフォルニア州の全61の保健管轄区域で調査した.
- MDR-TBは,イソニアジドとリファミンピンの耐性として定義されました.
主な方法:
- 単変数および多変数解析が行われました.
- データは,カリフォルニアの結核の確認された症例報告の登録簿から抽出されました.
- MDR-TBに関連する要因は,統計モデリングを通じて特定されました.
主要な成果:
- 検査された結核患者の1.4% (407/28,712) がMDR-TBであったが,その割合は時間の経過とともに有意に変化しなかった (P = .87).
- MDR-TBの症例は,穴腔病変 (2x) と,以前のTB治療 (7x) がより多く見られた.
- MDR-TB患者では,治療完了率が著しく低下した (67%対非MDR-TB).
結論:
- カリフォルニア州では,制御措置にもかかわらず,MDR-TBは1〜2%の症例で持続しています.
- 治療の選択肢が限られており,MDR-TBに関連した高額な費用は,継続的な努力を必要とします.
- 強化された地域的およびグローバルな結核管理戦略は,MDR-TBの発生と感染を防ぐために極めて重要です.
関連する概念動画
Pulmonary Tuberculosis I
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Pulmonary Tuberculosis II
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Pulmonary Tuberculosis III
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
Pulmonary Tuberculosis IV
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Pulmonary Tuberculosis V
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
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Clinical Significance of Antibiotic Resistance
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...

