よむ、つかう、まなぶ。
【参考資料３】【英版R4.1.17】Nippon AMR One Health Report (NAOR) 2020 (30 ページ)
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5) Mycobacterium tuberculosis
Source: The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association
Looking at major antituberculosis antibiotics—isoniazid (INH), rifampicin (RFP), and ethambutol (EB)—
among patients with culture-positive pulmonary tuberculosis who were newly notified between 2011 and 2019,
resistance to INH has been on the rise in recent years, while RFP and EB resistance rates have remained mostly at
the same level. Although a rise of up to 1.1 percentage points was seen in streptomycin (SM) resistance in 2017,
it has mostly remained at the same level since 2018. The number of newly reported cases with multidrug-resistant
tuberculosis that are resistant at least to both INH and RFP remained in the range of approximately 50 to 60 (0.40.7%) per year.
Table 34. Newly Notified Patients with Culture-positive Pulmonary Tuberculosis: Trends in Drug
Susceptibility at the Time of Notification
2011
2012
2013
2014
2015
2016
2017
2018
2019
10,915
11,261
10,523
10,259
10,035
9878
9,580
9,016
8,110
INH-resistant, n
(%)*
386
(4.8)
380
(4.6)
369
(4.8)
349
(4.6)
372
(4.9)
369
(4.8)
383
(4.9)
377
(5.0)
359
(5.4)
RFP-resistant, n
(%)*
86
(1.1)
73
(0.9)
64
(0.8)
76
(1.0)
77
(1.0)
74
(1.0)
80
(1.0)
87
(1.1)
65
(1.0)
INH & RFP-resistant†, n
(%)*
60
(0.7)
60
(0.7)
47
(0.4)
56
(0.5)
48
(0.5)
49
(0.6)
52
(0.7)
55
(0.6)
44
(0.7)
SM-resistant, n
(%)§
-
509
(6.1)
475
(6.2)
469
(6.2)
476
(6.3)
461
(6.0)
557
(7.1)
471
(6.3)
428
(6.5)
EB-resistant, n
(%)¶
-
151
(1.8)
106
(1.4)
130
(1.7)
129
(1.7)
100
(1.3)
106
(1.3)
130
(1.7)
126
(1.9)
Culture-positive patients, N
* The denominator was defined as the number of patients with recorded INH- and RFP-susceptibility testing results among all culturepositive patients: 8,046 (73.7%) patients in 2011, 8,347 (74.1%) patients in 2012, 7,701 (73.2%) patients in 2013, 7,645 (74.5%) patients
in 2014, 7,630 (76.0%) patients in 2015, 7,732 (78.3%) patients in 2016, 7,891 (82.4%) patients in 2017, 7,570 (84.0%) patients in 2018
and 6,658 (82.1%) patients in 2019.
-: Not under surveillance
† INH- and RFP- resistant tuberculosis bacteria are referred to as "multidrug-resistant."
§ The proportion appeared here showed the share in patients with INH- and RFP-susceptibility testing results, excluding those who were not
tested for SM-susceptibility or those with the unknown test result: 54 patients in 2012, 48 patients in 2013, 52 patients in 2014, 48 patients
in 2015, 47 patients in 2016, 51 patients in 2017, 47 patients in 2018 and 41 patients in 2019.
¶ The proportion appeared here showed the share in patients with INH- and RFP-susceptibility testing results, excluding those who were not
tested for EB-susceptibility or those with the unknown test result: 14 in 2012, 13 in 2013, 13 in 2014, 19 in 2015, 17 in 2016, 14 in 2017,
13 in 2018 and 8 in 2019).
29
Source: The Research Institute of Tuberculosis, Japan Anti-tuberculosis Association
Looking at major antituberculosis antibiotics—isoniazid (INH), rifampicin (RFP), and ethambutol (EB)—
among patients with culture-positive pulmonary tuberculosis who were newly notified between 2011 and 2019,
resistance to INH has been on the rise in recent years, while RFP and EB resistance rates have remained mostly at
the same level. Although a rise of up to 1.1 percentage points was seen in streptomycin (SM) resistance in 2017,
it has mostly remained at the same level since 2018. The number of newly reported cases with multidrug-resistant
tuberculosis that are resistant at least to both INH and RFP remained in the range of approximately 50 to 60 (0.40.7%) per year.
Table 34. Newly Notified Patients with Culture-positive Pulmonary Tuberculosis: Trends in Drug
Susceptibility at the Time of Notification
2011
2012
2013
2014
2015
2016
2017
2018
2019
10,915
11,261
10,523
10,259
10,035
9878
9,580
9,016
8,110
INH-resistant, n
(%)*
386
(4.8)
380
(4.6)
369
(4.8)
349
(4.6)
372
(4.9)
369
(4.8)
383
(4.9)
377
(5.0)
359
(5.4)
RFP-resistant, n
(%)*
86
(1.1)
73
(0.9)
64
(0.8)
76
(1.0)
77
(1.0)
74
(1.0)
80
(1.0)
87
(1.1)
65
(1.0)
INH & RFP-resistant†, n
(%)*
60
(0.7)
60
(0.7)
47
(0.4)
56
(0.5)
48
(0.5)
49
(0.6)
52
(0.7)
55
(0.6)
44
(0.7)
SM-resistant, n
(%)§
-
509
(6.1)
475
(6.2)
469
(6.2)
476
(6.3)
461
(6.0)
557
(7.1)
471
(6.3)
428
(6.5)
EB-resistant, n
(%)¶
-
151
(1.8)
106
(1.4)
130
(1.7)
129
(1.7)
100
(1.3)
106
(1.3)
130
(1.7)
126
(1.9)
Culture-positive patients, N
* The denominator was defined as the number of patients with recorded INH- and RFP-susceptibility testing results among all culturepositive patients: 8,046 (73.7%) patients in 2011, 8,347 (74.1%) patients in 2012, 7,701 (73.2%) patients in 2013, 7,645 (74.5%) patients
in 2014, 7,630 (76.0%) patients in 2015, 7,732 (78.3%) patients in 2016, 7,891 (82.4%) patients in 2017, 7,570 (84.0%) patients in 2018
and 6,658 (82.1%) patients in 2019.
-: Not under surveillance
† INH- and RFP- resistant tuberculosis bacteria are referred to as "multidrug-resistant."
§ The proportion appeared here showed the share in patients with INH- and RFP-susceptibility testing results, excluding those who were not
tested for SM-susceptibility or those with the unknown test result: 54 patients in 2012, 48 patients in 2013, 52 patients in 2014, 48 patients
in 2015, 47 patients in 2016, 51 patients in 2017, 47 patients in 2018 and 41 patients in 2019.
¶ The proportion appeared here showed the share in patients with INH- and RFP-susceptibility testing results, excluding those who were not
tested for EB-susceptibility or those with the unknown test result: 14 in 2012, 13 in 2013, 13 in 2014, 19 in 2015, 17 in 2016, 14 in 2017,
13 in 2018 and 8 in 2019).
29