結核病簡介 - ccd.org.tw

1 100 Taiwan Guidelines for TB Diagnosis & Treatment 3rd Version - - X MYCOBACTERIUM TUBERCULOSIS ( )) Mycobacterium tuberculosis 1~10 m ~ m acid-fast bacilli 37 C PH ~ 20 Taiwan Guidelines for TB Diagnosis & Treatment 4th Version Transmission (1) (droplet) (dust) (droplet nuclei) 5 m (air-born infection) (2) Taiwan Guidelines for TB Diagnosis & Treatment 4th Version Source case Bacillary population Aerosol generation Duration Intensity Exposure Inbron defenses Immunologic defenses No infection (5%)Early Progressive Reinfection Disease (25-50%)Infection No disease (5%)Late Recrudescent (10%)DiseaseInfectiousInfectedClass IIDiseaseClass IIIcontactClass I Latent infection vs.

2 Disease ( ) ( ) ( ) ( ) 65 - 80 % / / / 10-20% 1 2-3 - - - - - - - - .. - - - X - 5 - - - ( )- - - - -Solid media Lewenstein Jensen (LJ) Media, 7H10, 7H11 agar selective media-Liquid media MGIT 960 7H9 Bactec 460TB 7H12 ( ) Taiwan Guidelines for TB Diagnosis & Treatment 4th Version Mase SR, Int J tuberc Lung Dis2007.

3 11(5): 485-95 ( ) ( ) 100% Mycobacterium tuberculosisLewenstein-Jensen(LJ) Media7H10 AgarMGIT960 1/3 20-24 1 >104/cc >10 /cc 80% 85% 98% 2 5 2 ( ) X X - - / - - / - - - - - ( )- - - ( ) - - (< 10%)- ( )- - - - X / 2,229 227 X - 36% 162 20% X X Nagpaul DR, Proceedings of the 9th Eastern Region Tuberculosis Conferenceand 29th National Conference on Tuberculosis and Chest Diseases.

4 1974 Delhi,as cited in Toman s tuberculosis. Case detection, treatment and monitoring, 2ndEdition: World Health Organization, 2004 X 54 54 , ( ) 15 ( ) X fluoroquinolones aminoglycosides Taiwan Guidelines for TB Diagnosis & Treatment 4th Version X X