• 대한임상검사과학회지
• /
• 제40권1호
• /
• pp.1-5
• /
• 2008

Thirty two of bathroom water samples from public bathroom in Seoul areas were examined using acid-fast staining, Lowenstein-Jensen (L-J) medium culture and PCR-restriction fragment length polymorphism (PCR-RFLP). In 6.25% (2/32) bathroom water samples, acid-fast bacilli were detected by AFB stain, and in 21.9% (7/32) bathroom water samples, acid fast bacilli grew on L-J media. Of them, six acid-fast bacilli were identified as Mycobacterium avium, and the other AFB as Mycobacterium szulgai by PCR-RFLP. These results are suggested that accidental nontuberculosis mycobacterial infection to a weakness person will be possible in public area.

• 대한의용생체공학회:의공학회지
• /
• 제30권3호
• /
• pp.191-198
• /
• 2009

Phlegm smear testing for acid-fast bacilli (AFB) requires careful examination of tubercle bacilli under a microscope to distinguish between positive and negative findings. The biggest weakness of this method is the visual limitations of the examiners. It is also time-consuming, and mistakes may easily occur. This paper proposes a method of identifying tubercle bacilli that uses a computer instead of a human. To address the challenges of AFB testing, this study designs and investigates image systems that can be used to identify tubercle bacilli. The proposed system uses an electronic microscope to capture digital images that are then processed through feature extraction, image segmentation, image recognition, and neural networks to analyze tubercle bacilli. The proposed system can detect the amount of tubercle bacilli and find their locations. This paper analyzes 184 tubercle bacilli images. Fifty images are used to train the artificial neural network, and the rest are used for testing. The proposed system has a 95.6% successful identification rate, and only takes 0.8 seconds to identify an image.

• 대한의생명과학회지
• /
• 제6권1호
• /
• pp.55-63
• /
• 2000

PCR을 이용한 임상가검물 중에서 보편화된 객담 이외에 미량의 각종 체액과 임상에서 많이 실시하지 않는 파라핀 포매 조직에서의 결핵균 검출을 실험하여 그 활용 가능성을 규명하고자 하였다. 임상가검물인 체액 65예는 항산성 염색과 배양검사, PCR을 실시하였고, 파라핀 포매 조직 50예는 항산성 염색과 병리조직학적 진단, PCR을 실시하여 다음과 같은 결론을 얻었다. 본 실험 검체 중 임상가검물인 체액에서 항산성 염색 음성인 검체 중 12.1%,배양검사에서 음성인 검체 중 3.7%에서 PCR 양성의 결과를 보였고, 파라핀 포매 조직에서는 항산성 염색 음성인 검체 중 20.0%에서 PCR양성의 결과를 얻어 PCR이 민감도와 특이도가 높음을 확인할 수 있었다.

• Journal of Chest Surgery
• /
• 제54권5호
• /
• pp.408-411
• /
• 2021

Tuberculosis (TB)-infected giant bullae are rare. A 55-year-old man was referred when an infected bulla did not respond to empirical treatment. Computed tomography showed a giant bulla in the right upper lobe with an air-fluid level and surrounding infiltrate. Sputum culture, acid-fast bacilli (AFB) stain, and polymerase chain reaction (PCR) for TB were negative. Percutaneous drainage of the bullous fluid was performed. AFB stain and PCR were positive in the drained fluid. The patient was given anti-TB drugs and later underwent obliteration of the pulmonary cavity using talc. To summarize, we report a patient with a TB-infected giant bulla that was treated successfully with anti-TB drugs and obliteration of the pulmonary cavity using talc.

• Tuberculosis and Respiratory Diseases
• /
• 제74권5호
• /
• pp.215-221
• /
• 2013

Background: Nontuberculous mycobacteria (NTM) are considered opportunistic pathogens, and several species of NTM are associated with human diseases that typically involve the pulmonary, skin/soft tissue, or lymphatic systems; such infection may also cause disseminated diseases. Recent studies have reported increasing rates of NTM-induced disease worldwide. Methods: Respiratory samples are being analyzed for acid-fast bacilli (AFB) culture and NTM identification at Dankook University Hospital in Cheonan, Korea, from September 2005 to September 2011. Identification is performed by using polymerase chain reaction-restriction fragment length polymorphism analysis targeting a novel region of the rpoB gene. Results: A total of 25,133 specimens were received for AFB culture, of which 1,014 (4.0%) were NTM-positive. A total of 267 samples from 186 patients were tested for NTM identifications, and 232 samples from 157 patients were positive for NTM species. Among the patients who tested positive for NTM, 65.6% were men and the average age was 63.3 years. Mycobacterium avium complex, the most commonly detected NTM pathogen, was found in 65.9% of the 232 samples. The annual average percentage of NTM isolates from AFB culture-positive specimens was 31.3%: the highest rate was seen in 2011 (44.3%), followed by 2009 (37.4%) and 2010 (37.2%). An upward trend in NTM incidence was found during the study period. Conclusion: The prevalence of pulmonary NTM isolates continues to increase in Cheonan, suggesting that pulmonary NTM disease is becoming increasingly common.

• 대한의생명과학회지
• /
• 제22권1호
• /
• pp.24-28
• /
• 2016

Tuberculosis (TB) remains an unsolved community health problem since identification of its causing microorganism called Mycobacterium tuberculosis (MTB) by Robert Koch in 1882. Annually, eight million TB cases are newly reported and 2~3 million patients die from TB. Pulmonary TB is highly infectious and untreated pulmonary TB patients are believed to infect >10 people in a year. The conventional methods for diagnosis of TB are chest X-ray and isolation of the causing microorganisms from patient specimens. Screening of TB is conducted with smeared sputum in slides, and TB is confirmed by identification of MTB in cultured specimens. One of the fatal pitfalls of screening detection for smeared sputum is that it is impossible to distinguish MTB and other acid-fast bacilli (AFB) because they are stained equally with Ziehl-Neelsen (ZN) stain. Culture of MTB is the most reliable method for diagnosis of TB but it takes 4~8 weeks. In this report, we suggest a fast and highly-reliable MTB detection method that distinguishes AFB in sputum samples. Purified DNA from the AFB stained slide samples offered by The Korean Institute of Tuberculosis were used to detect infected MTB in patients. PCR, real-time PCR and reverse blot hybridization assay (REBA) methods were applied to purified DNA. Conclusively, the real-time PCR method was confirmed to produce high sensitivity and we were able to further detect drug-resistant MTB with REBA.

• Tuberculosis and Respiratory Diseases
• /
• 제58권4호
• /
• pp.385-391
• /
• 2005

연구배경 : 최근 국내에서도 NTM 분리율 및 감염 빈도가 증가하고 있는 추세이다. 본 연구는 국내 한 삼차의료기관에서 1년 동안 항산균 검사가 의뢰된 호흡기 검체에서 NTM의 배양양상 및 분리비율을 살펴보고 그 임상적 의의에 대해 알아보고자 하였다. 방 법 : 2002년 1년간 서울아산병원에서 미생물검사실로 항산균 검사가 의뢰된 호흡기 검체를 대상으로 도말, 배양 및 동정 결과를 확인하고 그 임상적 의의를 분석하였다. 결 과 : 총 9,821명의 환자에서 26,820건의 항산균검사가 시행되었다. 결핵균이 동정 된 건수와 환자수의 비율은 각각 5.7%, 6.3%였고, 비결핵항산균은 각각 2.2%, 2.8% 이었다. 도말양성, 배양양성 중 결핵균 및 NTM의 비율은 각각 87.8%, 12.2%이었다. NTM 중 오염의 가능성이 높은 암색소성-저집락군은 31.8%(186/584 균주)에서 분리되었다. 암색소성-저집락군을 제외한 NTM 중 MAC, M. fortuitum complex의 분리비율이 42.1%(138/328), 19.5%(64/328)로 가장 높았다. 암색소성-저집락군을 제외한 NTM이 분리된 275명 중 미국 및 영국 흉부학회 진단기준을 만족하는 NTM 폐질환은 각각 8.4%(23명), 17.8%(49명)이었다. 결 론 : 국내 한 대학병원에서의 항산균 검사 결과 NTM의 분리 비율이 높고 일부는 NTM 폐질환의 원인이어서 항산균 도말 및 배양 양성의 경우 국내에서도 반드시 NTM의 가능성을 고려하여야 하겠다.

• Tuberculosis and Respiratory Diseases
• /
• 제79권3호
• /
• pp.153-157
• /
• 2016

Background: Vitamin D is known to have diverse effects on various systems in the body. There is evidence to suggest that a link exists between the serum vitamin D status and tuberculosis. The present study was designed to assess the alterations in serum 25-hydroxyvitamin D levels in newly diagnosed sputum acid fast bacilli (AFB) positive pulmonary tuberculosis patients and to study the association, if any, between serum vitamin D levels and different levels of sputum smear positivity. Methods: Serum 25-hydroxyvitamin D levels were estimated in 65 sputum AFB positive pulmonary tuberculosis patients and 65 age and gender-matched healthy controls. Results: The levels of serum 25 hydroxy-vitamin D in tuberculosis patients were not statistically different from the levels of serum 25 hydroxy-vitamin D in healthy controls. However, among patients with pulmonary tuberculosis, there was a significant negative correlation between the levels of serum 25 hydroxy-vitamin D and levels of sputum positivity. Conclusion: Serum vitamin D levels negatively correlates with bacterial load in patients with active pulmonary tuberculosis.

• 대한임상검사과학회지
• /
• 제47권2호
• /
• pp.83-89
• /
• 2015

결핵(Mycobacterium tuberculosis, MTB) 감염은 아직까지 전 세계에서 높은 유병률과 사망의 주요 원인이 되고 있으며 비정형 결핵(nontuberculous mycobacteria, NTM)은 최근 후천성 면역결핍증(AIDS)이나, 종양, 이식 등으로 면역력이 저하된 환자들의 임상 검체에서 분리빈도가 증가함에 따라 분리 균주의 임상적 의의가 중요시 되고 있다. 이에 항산균 염색을 이용한 객담 도말검사는 결핵균과 비정형 결핵균을 구별할 수 없다는 제한점이 있고, 균 분리배양검사는 시간이 오래 걸린다는 단점이 있어, 본 연구에서는 이러한 제한점을 가진 기존의 검사법을 대신하여 분자생물학적 방법인 중합효소 연쇄반응(polymerase chain reaction, PCR)을 이용하여 균 분리배양 검사와 비교하여 보았다. Mycobacteria를 동정하는데 항산균 염색과 3% ogawa 배지를 이용하였고, 균 분리배양 후 M. tuberculosis를 확인하기 위해서 niacin test를 실시한 결과 집락의 DNA를 추출하여 PCR후 동정된 M. tuberculosis와 niacin 양성이 일치함을 확인할 수 있었다. 또, 이 실험에서 항산성균 염색이 2+ 이상인 객담검체와 집락검체 각각에서 DNA를 추출하여 결핵균을 동정하는 방법으로 M. tuberculosis complex에 특징적으로 존재하는 insertion sequence (IS) 6110의 특정부위인 547 bp와 285 bp 부분을 증폭한 two-tube nested polymerase chain reaction을 시행하였고, 비정형 결핵균 동정법으로는 mycobacteria에 공통적으로 존재하는 rpoB 유전자 중 일부인 360 bp 부분을 증폭한 후, 제한효소 Msp I을 첨가 PCR-restriction fragment length polymorphism (RFLP)을 시행하였으며, 결핵균과 비정형 결핵균 모두 동정율에 거의 차이가 없었다. 1+인 경우는 객담검체에서 PCR한 결과가 31.2%에서 집락검체의 PCR한 결과 93.7%까지 결핵균과 비정형결핵균의 동정율이 높아졌고, trace인 경우 객담검체에서 PCR 결과가 2%에서 집락검체에서 PCR한 결과가 97.9%까지 결핵균과 비정형 결핵균의 동정율을 높일 수 있었다. 이 실험에서 항산성균 염색 1+이하 일때 객담검체와 집락검체로 PCR을 실시하면 결핵균과 비정형 결핵균의 동정율에 차이가 있고, 배양만으로는 결핵균의 동정은 가능하지만 비정형 결핵균의 동정이 가능하지 않으므로 배양검사와 PCR 검사 모두를 병행하므로써 보다 신속하고 정확한 검사결과를 내는데 도움 될 것이다.

• Journal of Yeungnam Medical Science
• /
• 제9권1호
• /
• pp.181-188
• /
• 1992

The incidence of the cutaneous tuberculosis has shown a steady decline over the past decades. This parallels the decreasing incidence of pulmonary tuberculosis. We experienced 5 cases of cutaneous tuberculosis from January 1990 to February 1991. We present herin 4 cases of cutaneous tuberculosis. They were 3 cases of vulgaris and 1 case of tuberculosis verrucosa cutis. Mantoux tests were done except one case and were reactive in all cases. Culture for Mycobactelium tuberculosis were done but Mycobacterium tuberculosis were not cultivated in the all cases. Histopathological findings showed tuberculoid granulomas in the dermis except one case and no acid fast bacilli were demonstrated on AFB stains.