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KMID : 0367419940370020221
Journal of Korean Pediatric Society
1994 Volume.37 No. 2 p.221 ~ p.230
The Significance of Bacteriologic Examination in the Childhood Tuberculosis
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Abstract
We reviewed retrospectively the medical records of 229 cases of tuberculosis, who had been diagnosed clinically and admitted to the departmet of pediatrics, Seoul National Univeristy 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 susceptibility 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 bacteriologic 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.
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