The Significance of Bacteriologic Examination in the Childhood Tuberculosis

Kwon, Kyung Bae; Park, Jin Young; Yoon, Bo Young; Kim, Mee Ran; Lee, Hoan Jong; Kim, Eui Jong; Kim, Sang Jae

Original Article

Journal of the Korean Pediatric Society 1994;37(2):221-230.
Published online February 15, 1994.

The Significance of Bacteriologic Examination in the Childhood Tuberculosis

Kyung Bae Kwon¹, Jin Young Park¹, Bo Young Yoon¹, Mee Ran Kim¹, Hoan Jong Lee¹, Eui Jong Kim², Sang Jae Kim³

¹Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
²Department of Clinical Pathology, Seoul National University, College of Medicine, Seoul, Korea
³Korean Institute of Tuberculosis, Korean National Tuberculosis Association, Seoul, Korea

소아 결핵 환자에서 결핵균검사의 의의

권경배^¹^, 박진영^¹^, 윤보영^¹^, 김미란^¹^, 이환종^¹^, 김의종^²^, 김상재^³

^¹서울대학교 의과대학 소아과학교실
^²서울대학교 의과대학 임상병리학교실
^³대한결핵학회

Abstract

We reviewed retrospectively the medical records of 229 cases of tuberculosis, who had been diagnosed clinically and admitted to the department of pediatrics, Seoul National University Children's Hospital, during the period of 6 years from October, 1985, to October, 1991. Patients with tuberculosis occupied 1.2%. of the hospitalized patients. Forty-three percent of the patients were under 3 years of age. Principal involvement sites were: the lungs-26.7%, the pleura-18. 8%, the central nervous system-30.6%, the abdomen-7.4%, the genito-urinary tract-1.3%, the bones and joints-3.0%, the lymph nodes-3.0%. In 147 patients with extrapulmonary tuberculosis, pulmonary lesions suggestive of tuberculosis were found in 33.3%, 9.2% of the patients had miliary dissemination. In pulmonary tuberculosis and extrapulmonary tuberculosis with lung involvement, the gastric aspirates were positive for acid-fast bacilli (AFB) by Ziehl-Neelson stain in 6.1%, and grew M. tuberculosis in 43.5%. The sputa were positive for AFB in 12.9%, culture in 18.5%. In extrapulmonary tuberculosis, the specimens from involved sites were positive for staining in 5.7%, culture in 19.3%. Twenty-one isolates of M. tuberculosis were submitted to susceptbility to 11 antituberculous drugs. Resistance to one or more drugs were found in 38.1% of the isolates. INH resistance was found in 33. 3%, RFP resistance in 28.6%. We conclude that bocteriologic documentation of tuberculosis is possible in significant proportion of the pediatric patients, drug resistance of M. tuberculosis isolated from the children is high in Korea, and continued monitoring of drug resistance is required.

Key Words: Tuberculosis, Acid fast bacilli, Antibiotic sensitivity