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Specificity of TRCReady System / K. Chikamatsu et al. 629

Abstract [Objective] To evaluate the specificity of TRC-Ready® MTB and TRCReady® MAC (Tosoh Bioscience,

Japan) for identifying M.tuberculosis complex (MTC), M. avium and M.intracellulare.

 [Method] We tested TRCReady® MTB and TRCReady®

MAC using TRCReady®_80 (Tosoh Bioscience, Japan), which

is an automated nucleic amplification test instrument, with 151 Mycobacterium species (4 MTC and 147 Non-tuberculosis Mycobacterium (NTM) type strains).

 [Results] The specificity of TRCReady® MTB was 100%,

however, TRCReady® MAC misidentified a total of six NTMs,

M. arosiense, M.chimaera, M.colombiense, M.marseillense, M. vulneris and M.yongonense, as M.intracellulare. Then, the specificity for TRCReady® MAC was 96.0% (145/151).

 [Discussion] TRCReady® MTB and TRCReady® MAC

are highly specific for identifying MTC, M.avium and M. intracellulare. Six NTM species which have been rarely

isolated in Japan showed false-positive results as M.intra-cellulare. However, when a sample was identified as M.in-tracellulare, the phenotypic characteristics like colony mor-phology would be carefully examined.

Key words : TRCReady, M. tuberculosis complex, M. avium, M. intracellulare, Mycobacterium species identification Bacteriology Division, Department of Mycobacterium Refer-ence and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association

Correspondence to: Kinuyo Chikamatsu, Bacteriology Divi-sion, Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, 3_1_24, Matsuyama, Kiyose-shi, Tokyo 204_ 8533 Japan. (E-mail: chikamatsu@jata.or.jp)

−−−−−−−−Original Article−−−−−−−−

SPECIFICITY EVALUATION OF TRCReady

®

MTB AND TRCReady

®

MAC FOR

IDENTIFYING MYCOBACTERIUM TUBERCULOSIS COMPLEX,

MYCOBACTERIUM AVIUM

AND MYCOBACTERIUM INTRACELLULARE

Kinuyo CHIKAMATSU, Yuriko IGARASHI, Akio AONO, Hiroyuki YAMADA, Akiko TAKAKI, and Satoshi MITARAI

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640 結核 第 91 巻 第 10 号 2016 年 10 月

Abstract A symposium entitled Legacies of surgery for tuberculosis and succession to the next generation was held at the 89th annual meeting of The Japanese Society for Tuberculosis in Gifu. The purpose of the symposium was to look back at the history of surgery for tuberculosis and development of surgical techniques. The contribution of those techniques to the next generation was also discussed. Many unique and universal techniques such as segmentectomy, thoracoplasty, muscle flap plombage, greater omental plom-bage, open window thoracotomy, cavernostomy, and decor-tication have matured during a long history. Based on the development of anti-tuberculous drugs, surgery seems to have a less important role. However, surgical techniques are still required for multi-drug resistant tuberculosis and non-tuberculous mycobacteriosis. Core techniques are applied in the surgery for many thoracic diseases, such as lung cancer, mycosis, pyothorax, and mesothelioma. This manuscript summarizes the presentations.

Key words: Surgical treatment, Tuberculosis, Non-tubercu-lous micobacteriosis, Micosis, Pyothorax, Air-way stenosis

1Division of Thoracic Surgery, Respiratory Disease Center,

Seirei Mikatahara General Hospital, 2Department of Chest

Surgery, National Hospital Organization Tokyo National Hospital, 3Fukujuji Hospital, 4Teradamanju Hospital, 5Section

of Chest Surgery, Fukujuji Hospital, 6Department of

Tho-racic Surgery, Saitama Medical Center, 7Department of

Tho-racic Surgery, Hyogo College of Medicine, 8Department of

Thoracic Surgery, Jichi Medical School

Correspondence to : Hiroshi Niwa, Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara Gen-eral Hospital, 3453 Mikatahara-cho, Kita-ku, Hamamatsu-shi, Shizuoka 433_8558 Japan. (E-mail: niwah@sis.seirei.or.jp) −−−−−−−−Review Article−−−−−−−−

LEGACIES OF SURGERY FOR TUBERCULOSIS AND SUCCESSION

TO THE NEXT GENERATION

1Hiroshi NIWA, 2Yutsuki NAKAJIMA, 3Takashi ARAI, 4Keiji IUCHI, 5Yuji SHIRAISHI, 6Kouji KIKUCHI, 7Seiki HASEGAWA, and 8Shunsuke ENDO

〔結語〕  高度医療と高齢化社会に伴い,肺アスペルギルス症は 結核後遺症の一型から荒廃的な肺変性疾患の一型に変遷 しつつある。外科治療に最も難渋する複雑型肺アスペル ギルス症に対しては,抗真菌薬を併用しながら,結核外 科手技を応用した空洞直達手術などを考慮すべきである。 〔文献〕 1 ) 中島由槻:抗酸菌症の治療における外科の役割と展 望―外科治療は今後も有効たり得るか? 結核. 2011 ; 86 : 911 915.

2 ) Endo S, Sohara Y, Murayama F, et al.: Surgical outcome of pulmonary resection in chronic necrotizing pulmonary aspergillosis. Ann Thorac Surg. 2001 ; 72 : 889 893. 3 ) Endo S, Otani S, Saito N, et al.: Management of massive

hemoptysis in a thoracic surgical unit. Eur J Cardiothorac Surg. 2003 ; 23 : 467 472.

4 ) Endo S, Otani S, Tezuka Y, et al.: Predictors of postoper-ative complications after radical resection for pulmonary aspergillosis. Surg Today. 2006 ; 36 : 499 503.

8. おわりに  わが国では 1950 年代後半から 1960 年代にかけて肺結 核の外科治療,特に肺切除が最も盛んに行われたが,今 日の肺癌を中心とする呼吸器外科治療手技の大半は,過 去の結核に対する外科治療にその基を発していること が,読者はこの報告をお読みいただいてご理解いただけ たであろうか。最初の 2 題は呼吸器外科 OB の先生方に よる報告であり,歴史的なことを含めわかりやすくご説 明いただいた。次の 4 題は現役で活躍しておられる先生 方の,主として自験例の詳細な分析を通してのご検討で ある。各先生方はこれらの炎症性疾患および胸膜疾患の 外科治療に関して,当該疾患を熟知したうえでそれぞれ 原則にのっとって問題を解決するために外科治療を選択 されておられる。現在の一般呼吸器外科医にとっては, 炎症性疾患および胸膜疾患について熟知することは難し い点があるとは思われるが,呼吸器内科医師等と十分協 議して適応を決め,種々の術式を選択して外科治療に邁 進していただきたいと願っている。  著者の COI(conflicts of interest)開示:本論文発表内 容に関して特になし。

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LTBI Treatment with HR / K. Ito 655

Abstract [Purpose] To conduct a literature review on clin-ical studies and national guidelines in various countries, for the purposes of facilitating discussion regarding whether latent tuberculosis infection (LTBI) treatment regimens com-posed of isoniazid and rifampicin should be introduced in Japan.

 [Methods] For clinical studies, 23 non-randomized studies and 10 randomized studies in the literature were reviewed.  [Results] In patients who had received treatments com-posed of isoniazid and rifampicin ([HR]; largely 3 months), compared with those who had received isoniazid monother-apy ([H]; largely 6 to 9 months), both frequency and sever-ity of liver dysfunction tended to be reduced, but adverse drug effects increased in general. Treatment completion rate tended to be higher in those who had received HR than in those who had received H. Preventive effects of HR seemed to be at least equivalent, or somewhat superior, to H. Many national guidelines of the European Union and other

coun-tries reviewed in this study recommended HR as an LTBI treatment regimen, and generally provided a high level of evidence.

 [Conclusion] 3HR treatment has been well studied in many clinical and randomized studies, and seems to have garnered a high level of merit in order to be introduced as one of the LTBI treatment regimens in Japan.

Key words : Tuberculosis, Latent tuberculosis infection, Isoniazid, Rifampicin, Guideline

Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association

Correspondence to : Kunihiko Ito, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, 3_ 1_24, Matsuyama, Kiyose-shi, Tokyo 204_8533 Japan.

(E-mail: ito@jata.or.jp) −−−−−−−−Review Article−−−−−−−−

TREATMENT OF LATENT TUBERCULOSIS INFECTION WITH

A COMBINATION OF ISONIAZID AND RIFAMPICIN

Kunihiko ITO tuberculosis infection in HIV infected persons. Cochrane

Database Syst Rev. 2010 ; 20 : CD000171.

55) 日本結核病学会予防委員会・治療委員会:潜在性結核 感染症治療指針. 結核. 2013 ; 88 : 497 512.

56) Benator D, Bhattacharya M, Bozeman L, et al.: Tuberculosis Trials Consortium. Rifapentine and isoniazid once a week versus rifampicin and isoniazid twice a week for treatment of drug-susceptible pulmonary tuberculosis in HIV-negative patients: a randomised clinical trial. Lancet. 2002 ; 360 : 528 534.

57) AFSSAPS: Recommandations nationals Prévention et prise en charge des tuberculoses survenant sous anti-TNFαα. Juillet 2005. (In French). http://ansm.sante.fr/var/ansm_site/stor age/original/application/0d7318ac8b672f9dbac0a7690a213e

ac.pdf (accessed at 2016/3/14)

58) Malakauskas K, Zablockis R, Venalis A : Tuberkuliozės prevencijos ir gydymo rekomendacijos skiriant naviko nekrozės faktoriaus alfa blokatorius-Lietuvos pulmonologų ir reumatologų sutarimas [Recommendations for the Pre-vention and Management of Tuberculosis in Patients Treated With Tumor Necrosis Factor Alpha Inhibitors-A Consensus of Lithuanian Pulmonologists and Rheumatologists]. Me-dicina (Kaunas). 2011 ; 47 : 187 191. (In Lithuanian with English abstract/参照はabstractのみ)

59) Connie GME, Erika S, Mauritis V, et al.: Monitoring latent tuberculosis infection diagnosis and management in the Netherland. Eur Respir J. 2016 ; 47 : 1327 1330.

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