Studies on Cultivation and Drug-Resistance of Tubercle Bacilli Isolated from Renal Tuberculosis

Lee, Kee Hyuck; Choo, Kun Weon

Abstract

Author performed clinical studies at random on 19 patients with renal tuberculosis who were admitted for the period of April 1958 through February 1959 to Department of Urology at Seoul National University Hospital as to tuberculosis bacterial cultures and their resistance tests using pre- and postnephrectomy urine and diseased tissue itself. The results in this study were summarized as follows: 1. All except one case had received antituberculosis medication for not more than 6 months. 2. To all cases beginning at the time of admission preoperation medications consisting of SM 1.0 gm, PAS 12gm, and INH 300mg, and these regimen were given throughout study. 3. The culture positivity rates were 79% in prenephrectomy bladder urine. 90% in caseous material from diseased renal cavity and 44% in postnephrectomy bladder urine. The lower were the culture positivity rate in prenephrectomy bladder urine, the longer the preceding period of antituberculosis drugs given. Culture positivity rate of caseous material from diseased renal cavity, however, was persistently high irrespective of the length of the antituberculosis medication and the culture positivity rate of postnephrectomy bladder urine appeared to be dependent more on the presence or absence of the remaining renal tuberculosis rather than on the period of antituberculosis medication. 5. From the repeated culture of prenephrectomy bladder urine over short period of time, in the same individual results were rather inconstant and this seemed to be independent upon the use of antituberculosis drugs. 6. Cultural studies on urine and diseased renal tissue yielded the same results whether it was checked on the day of specimen collection or after less than 7 day's refrigerated storage. 7. While doing cultural studies from prenephrectomy bladder urine on patients who received antituberculosis drugs one case was found to need more than two months to grow and this trend seemed to be more so in cases of cultures from diseased renal tissues. 8. Resistance was shown as to SM in 9 cases out of 10 cases on whom prenephrectomy bladder urines were checked, in 5 out of 6 cases on whom tuberculosis culturers were done from diseased renal caseous tissues and in 2 cases out of each group possessed resistance to PAS as well. 9. Resistance to SM was to be easily acquired and afterward the degree of resistance seemed to increase rapidly from the use of SM of short duration. 10. Cases with positive microscopic finding and negative cultures were seen only in prenephrectomy bladder urine and this fact was thought not to be specifically related to the antituberculosis treatment. 11. Cases with negative microscopic finding and positive cultures were seen in patient who received only long antituberculosis treatment and these were characterized by small number of colonies. 12. The appearance of resistant strain was found not to be specifically related with the status of microscopical finding on prenephrectomy bladder urine nor with cultural studies on the same specimen.