• Tuberculosis and Respiratory Diseases
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• v.79 no.3
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• pp.127-133
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• 2016

Tuberculosis (TB) is one of the most important occupational risks for healthcare workers (HCWs) in South Korea. Many policies regarding the control and prevention of TB in healthcare settings recommend that HCWs are tested for latent tuberculosis infection (LTBI) in addition to active TB. Moreover, the Korean Tuberculosis Prevention Act also recommends that HCWs receive regular testing for LTBI. However, there are no specific or detailed guidelines for dealing with LTBI in HCWs. Herein, we discuss the diagnosis and treatment of LTBI in HCWs and focus particularly on the baseline screening of hired HCWs, routine follow-up, and contact investigation.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.558-567
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• 2000

Background : Recently, serologic techniques for tuberculosis have been developed and some of them, which are focusing on detection of serum antibodies mainly directed against specific 38-kDa Mycobacterium tuberculosis, have already been introduced into the markel. In this study, diagnostic significance of a new serologic test(ELISA kit) for pulmonary tuberculosis was evaluated. Method : Serologic test with newly developed ELISA kit was performed upon 474 individuals, who include 333 active pulmonary tuberculosis patients, 80 healthy cases, and 61 tuberculosis contact cases. This serologic test was based on the ELISA technique and designed to detect antibodies to mixed complex antigens including 38-kDa, which were developed by Erume Biotech Co., Seoul. Active pulmonary tuberculosis was diagnosed by sputum AFB smear and culture methods. Results : The seropositivities using this ELISA kit were 82.1% and 73.6% in smear-positive and negative groups among active pulmonary tuberculosis, respectively. And, it also showed that seronegativities were 97.5% and 85.2% in healthy and contact groups, respectively. As a whole, the results of our study using the ELISA kit as a diagnostic method for pulmonary tuberculosis showed 80.0% sensitivity for active pulmonary tuberculosis, 97.5% specificity, 96.1% positive predictive value, and 65.0% negative predictive value when the prevalence of tuberuclosis in the samples was 60.1%. Conclusion : Our results reveal that the detection of antibody its reaction with 38-kDa antigen of M. tuberculosis is not sufficient to be accepted as single diagnostic method for pulmonary tuberculosis. However, they suggest that ELISA kit may be considered as an adjunctive test to standard diagnostic techniques of pulmonary tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.452-458
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• 2005

Background : In Korea, polymerase chain reaction (PCR) test for M. tuberculosis has been used for the diagnosis of acid-fast bacilli (AFB) smear-negative tuberculosis in order to increase diagnostic sensitivity. However, there have been no data dealing with the clinical utility of PCR in AFB smear-positive patients to differentiate between M. tuberculosis and nontuberculous mycobacteria. Method : We retrospectively analyzed the PCR test results which have been performed in patients who had AFB smear-positive sputum but had ambiguous clinical manifestations of active tuberculosis. PCR test was done using $AMPLICOR^{\hat{a}}$ M. tuberculosis kit. The sensitivity, specificity, and positive and negative predictive values of the PCR test were calculated based on culture and final clinical diagnosis result. Results : Fifty-six consecutive patients (62 PCR tests) were included in the study. Active tuberculosis was diagnosed in 23 patients (41.0%), while 9 patients had NTM infection (16.0%). The sensitivity, specificity, positive- and negative-predictive value of PCR test were 88.8%, 86.8%, 76.1% and 94.3%, respectively, according to the culture result. In comparison, they were 91.3%, 100%, 100%, 94.3%, respectively, according to the final clinical diagnosis. All 15 patients with NTM isolates, including 6 patients who had other lung diseases but expectorated NTM isolate, were negative for PCR test. Conclusion : Even though tuberculosis is still prevalent in Korea, PCR test is useful to differentiate between M. tuberculosis and NTM in patients with AFB-smear positive sputum but with ambiguous clinical manifestations of active tuberculosis.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1178-1187
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• 1998

Background : Recently the incidence of tuberculosis is increasing in many countries and control of the disease is further threatened by the emergence of multi-drug resistant tuberculosis. So rapid detection of drug resistance is very important. Pyrazinamide (PZA) is a first-line chemotherapeutic agent for tuberculosis. Now in Korea, we perform PZase activity test instead of actual pyrazinamide susceptibility test for the detection of PZA resistant M. tuberculosis. Recently the pncA gene, encoding the PZase of M. tuberculosis, was completely sequenced. And it was reported that the mutation of pncA gene would be associated with PZA resistance of M. tuberculosis. Therefore we performed this study to evaluate the possibility for the rapid detection of PZA resistant M. tuberculosis using PCR-SSCP of pncA gene. Method : 44 cultured clinical isolates of M. tuberculosis, BCG Tokyo strain. BCG French strain, and one M. bovis isolate were studied. We used H37Rv as the reference strain, The PZase activity test was done at the reference laboratory of Korean Tuberculosis Institute. DNA was extracted by bead-beater method and 561 bp fragment including pncA gene was amplified by PCR. The PCR product were digested by BstB I enzyme. SSCP was done using MDE gel. Of the 44 strains of M. tuberculosis, 22 strains were PZase-positive and other 22 strains were PZase negative. Results : Of the 22 PZase positive strains, 18 strains(82%) showed the same mobility compared with that of H37Rv and 4(18%) showed different mobility. Of the 22 PZase-negative strains, 19(86%) strains showed the same mobility pattern compared with that of H37Rv and 3(14%) showed different mobility. Naturally PZA-resistant BeG-French strain, BCG-Tokyo strain, and one M. bovis isolate showed the same band pattern each other, but their mobility were different from that of H37Rv. The results of PZase activity test and PCR-SSCP of pncA of M. tuberculosis were statistically significantly correlated each other (p<0.01). Conclusion : The PCR-SSCP after BstB I restriction of pncA gene of M. tuberculosis may be a useful method for the rapid detection of PZA-resistant M. tuberculosis.

• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.181-202
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• 1994

This study was conducted in order to grasp the condition of the student's knowledge and attitude about tuberculosis. And to offer the basic materials for the prevent tuberculosis in elementary school. The objects were comprised 395 of volunteered 6th grade students who study in two elementary schools. The material of this study was the questionaire(chronbach $\alpha=.9016$) suited to the purposed of this research which has been made through studying references. All the questionaire were collected immediately without explanation. The data was collected from 13rd to 25th of May on 1994. Analysis of the data was done utilizing SPSS for percentage, mean, ANOVA and pearson-Correlation Coefficient. The Result are as follows; 1. General features of the objects of study. Sex distribution was similar. Salary of 1000-1500 thousand won were highest (40.2%), nuclear family was highest (87.1%), fathers of graduated high school were the highest(44.0%), mothers of graduated high school were the highest(56.8%). And there was nobody about tuberculosis patient in one's close relatives were highest(95.4%). 2. The conditions of attitude about tuberculosis. Having experience of tuberculin test were highest(59.0%). Less than 9mm indulation among the tuberculin tested group were 85.1%, more than indulation were 14.9%. Have a B. C. G. injection among the less than 9mm indulation were 83.2%. Leave alone among the more than 10mm indulation were 56.0%. Think it too much trouble to do not tuberculine test were 63.0%. Do not take a chest X-ray in the past were 60.3%. And take a chest X-ray in the past were 39.7%. Health educated group was 74.3%. If tuberculosis sign was developed, notified to parent was 73.8%. 3. The condition of knowledge about tuberculosis. When 5 points was given to 'very affiming' and 1 point was given to 'very deny', the total average was 3.54. And symptom of tuberculosis secion was 3.67, vaccination of tuberculosis section was 3.66, tuberculine test section was 3.56, epidemiology of tuberculosis section was 3.54, infection of tuberculosis section was 3.38. And every section showed affirmative correlation(P<.001). 4. Correlation between the general features and attitude variables. High incomed group may have more attitude on tuberculin test than low incomed group($x^2=16.$ 190, P<.01). High educated group may have more attitude on tuberculin test than low educated group(Father : $x^2=28.530$, P<.001, Mother: $x^2=26.060$, P<.001). High educated group may have more attitude on health education than low educated group(Father: $x^2=20.$ 767, P<.000, Mother: $x^2=10.639$, P<.05). Nuclear family may have more attitude on notify to parent than others($x^2=51.45$, P<.000). Tuberculosis patient in one's close associates have more attitude on notify to parent than others($x^2=51.$ 45, P<.000). 5. Difference between the general features and knowledge of tuberculosis. High incomed group were highest score in knowledge (F=3.99, P<.01). High educated group were highest score in knowledge(Father : F=8.81, P<.000, Mother: F=9.09, P<.000). 6. Difference between the attitude and knowledge of tuberculosis. Tuberculin tested group were highest score in knowledge(t=9.88, P<.000). Taken chest X-ray group were highest score in knowledge (t=2.07, P<.05). Received health education group were highest score in knowledge(t=6.83, P<.000). Notified symptoms to teachers and parent group were highest score in knowledge(F=3.89, P<.01).

• Tuberculosis and Respiratory Diseases
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• v.64 no.6
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• pp.422-426
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• 2008

Background: Mycobacterium abscessus is the most pathogenic and drug-resistant rapid-growing mycobacterium. Clarithromycin or azithromycin are the only regular oral antimycobacterial agents that have an effect on M. abscessus. We tried to detect the clarithromycin-resistant strains from the clinical isolates of M. abscessus. Methods: We tried to isolate the clarithromycin-resistant strains from 220 clinical isolates of M. abscessus by performing using reverse hybridization assay (RHA) and the broth microdilution test (BMT). Results: Seven resistant strains (3.2%) from all the tested clinical isolates were detected by BMT. Three of these resistant strains were also detected by RHA and it was confirmed that they had point mutants. Conclusion: These results showed that clarithromycin resistance in M. abscessus clinical isolates is related to a point mutation and other unknown mechanisms.

• Tuberculosis and Respiratory Diseases
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• v.47 no.5
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• pp.586-597
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• 1999

Background: Many diagnostic tests have developed to diagnose tuberculosis and other mycobacterial diseases but the diagnosis of tuberculosis relies largely on radiological findings and acid-fast staining of sputum and/or culture. Recently, new serologic diagnostic methods, which are safe and easy to use have been introduced into Korea. In this study, the usefulness of serologic diagnosis for tuberculosis and the disease pattern induced variation of the test were evaluated. Methods: Serological assay was performed upon 108 patients with two test kits, the ICT tuberculosis and the BioSign$^{TM}$TB, which are based upon a rapid immunochromatographic assay technique, capable of being interpreted within 15 minutes. The case groups consisted of 61 patients with active pulmonary tuberculosis(36 patients), extrapulmonary tuberculosis(3 patients), or both(22 patients). Control groups consisted of 47 patients with inactive old pulmonary tuberculosis(17 patients), nontuberculous pulmonary disease(16 patients) and nonpulmonary cardiac disease(14 patients). Results : The diagnostic sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of the ICT tuberculosis were 64.3%, 91.5%, 90.0% and 68.3% respectively. The diagnostic sensitivity, specificity, PPV and NPV of the BioSign$^{TM}$TB were 76.5%, 95.3%, 94.1 % and 78.8% respectively. Differences in sensitivity were not significant between patients with previous history of tuberculosis or patients without prior history of tuberculosis. The ICT tuberculosis test showed higher sensitivity in pulmonary tuberculosis patients(76.5%) than extrapulmonary tuberculosis patients(33.3%). There was no difference in sensitivity between patients with or without cavitary lesion by chest X-ray. Conclusion: Considering high specificity and PPV, serologic diagnosis using a rapid immunochromatographic assay device is another helpful diagnostic method in the diagnosis of tuberculosis, when combined with previous diagnostic methods such as chest X-ray, microbiologic study but it has limitation in terms of confirming the diagnosis for tuberculosis as the only diagnostic method because of relatively low sensitivity and NPV.

• Tuberculosis and Respiratory Diseases
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• v.81 no.1
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• pp.59-72
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• 2018

Background: It remains uncertain if $interferon-{\gamma}$ release assays (IGRAs) are superior to the tuberculin skin test (TST) for the diagnosis of active tuberculosis (TB) or latent tuberculosis infection (LTBI) in immunosuppressed populations including people with human immunodeficiency virus (HIV) infection. The purpose of this study was to systematically review the performance of IGRAs and the TST in people with HIV with active TB or LTBI in low and high prevalence TB countries. Methods: We searched the MEDLINE database from 1966 through to January 2017 for studies that compared results of the TST with either the commercial QuantiFERON-TB Gold in Tube (QFTGT) assay or previous assay versions, the T-SPOT.TB assay or in-house IGRAs. Data were summarized by TB prevalence. Tests for concordance and differences in proportions were undertaken as appropriate. The variation in study methodology was appraised. Results: Thirty-two studies including 4,856 HIV subjects met the search criteria. Fourteen studies compared the tests in subjects with LTBI in low TB prevalence settings. The QFTGT had a similar rate of reactivity to the TST, although the first-generation version of that assay was reactive more commonly. IGRAs were more frequently positive than the TST in HIV infected subjects with active TB. There was considerable study methodology and population heterogeneity, and generally low concordance between tests. Both the TST and IGRAs were affected by CD4 T-cell immunodeficiency. Conclusion: Our review of comparative data does not provide robust evidence to support the assertion that the IGRAs are superior to the TST when used in HIV infected subjects to diagnose either active TB or LTBI.

• The Journal of Internal Korean Medicine
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• v.44 no.5
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• pp.1011-1016
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• 2023

We have experienced a case in which herbal medicine was administered to treat drug-induced liver damage and would like to introduce it. A 49-year-old man exhibited a positive result in the interferon-gamma release assay. He had never suffered from tuberculosis in the past, and the route and time of infection could not be confirmed. He had no respiratory or systemic symptoms suggestive of active tuberculosis, and a chest X-ray examination showed no active lung lesions, so he was diagnosed with latent tuberculosis infection. He was confirmed to be within the normal range in the liver function test, renal function test, and complete blood cell count test, and started taking rifampin (600 mg qd). In the screening test performed on the 19th day of taking the drug, other test items were normal, but alanine aminotransferase (ALT) increased to 50 U/L (reference value: 4-40 U/L). In a test performed on the 29th day of taking the drug, ALT was clearly elevated to 102 U/L. Ursodeoxycholic acid and Injinho-tang were taken together with rifampin, and the patient's progress was observed. In a test performed 14 days later, ALT decreased to 26 U/L, within the normal range. It is presumed that Injinho-tang may have partially contributed to alleviating liver damage in this case.

• Journal of the Korean Society of School Health
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• v.33 no.3
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• pp.164-174
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• 2020

Purpose: The purpose of this study was to identify the factors affecting tuberculosis prevention behaviors in North Korean adolescent refugees. Methods: From September 16 to October 8, 2019, a survey was conducted to collect data from 143 North Korean adolescent refugees aged 13 to <25 at alternative and general schools in Seoul and Gyeonggi Province. The scale developed by Park (2008) and adapted by Cha (2012) was used to rate tuberculosis prevention behaviors in daily life with the aim of preventing high school students from getting infected with tuberculosis. The collected data were processed through frequency analysis, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression, using SPSS 25.0. Results: The mean score was 13.65 for knowledge of tuberculosis, 44.23 for attitudes towards tuberculosis, and 41.33 for tuberculosis prevention behaviors. Significant differences were found according to gender, country of origin, duration of stay in South Korea, tuberculosis examination, pre-entry chest x-ray, education about tuberculosis, alcohol intake, and subjective health status. A positive correlation was found between knowledge, attitudes, and prevention behaviors. The factors affecting tuberculosis prevention behaviors were attitudes (β=.38, p<001) and subjective health status (β=.26, p<.001). Conclusion: It is necessary to provide attitude-based education that can reinforce positive attitudes in order to improve North Korean adolescent refugees' tuberculosis prevention behaviors. This is expected to help them pay more attention to health care and become better at prevention behaviors. It is, therefore, necessary to develop a tuberculosis prevention education program with the aim of making them more knowledgeable about tuberculosis and providing them with systematic and sustainable education.