All issues > Volume 37(2); 1994

Original Article

J Korean Pediatr Soc. 1994;37(2):221-230. Published online February 15, 1994.

The Significance of Bacteriologic Examination in the Childhood Tuberculosis

Kyung Bae KB Kwon¹, Jin Young JY Park¹, Bo Young BY Yoon¹, Mee Ran MR Kim¹, Hoan Jong HJ Lee¹, Eui Jong EJ Kim², Sang Jae SJ 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

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.

Keywords :Tuberculosis, Acid fast bacilli, Antibiotic sensitivity