Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals

국내 민간병원에서 치료한 다제내성결핵 환자의 치료 결과 및 예후 인자

  • Park, Jin-Kyeong (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Koh, Won-Jung (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Kim, Deog-Kyeom (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Kim, Eun-Kyung (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Kim, Yu-Il (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Kim, Hee-Jin (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Kim, Tae-Hyung (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Kim, Jae-Yeol (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Park, Moo-Suk (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Park, I-Nae (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Park, Jae-Seuk (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Lee, Ki-Man (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Song, Sook-Hee (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Lee, Jin-Hwa (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Lee, Seung-Heon (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Lee, Hyuk-Pyo (Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Yim, Jae-Joon (2KoreanKorean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Lim, Jae-Min (2KoreanKorean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • JeGal, Yang-Jin (2KoreanKorean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Jung, Ki-Hwan (2KoreanKorean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Huh, Jin-Won (2KoreanKorean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Choi, Jae-Chol (2KoreanKorean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases) ;
  • Shim, Tae-Sun (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 박진경 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 고원중 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 김덕겸 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 김은경 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 김유일 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 김희진 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 김태형 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 김재열 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 박무석 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 박이내 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 박재석 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 이기만 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 송숙희 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 이진화 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 이승헌 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 이혁표 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 임재준 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 임재민 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 제갈양진 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 정기환 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 허진원 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 최재철 (대한결핵 및 호흡기학회 결핵연구회) ;
  • 심태선 (울산대학교 의과대학 서울아산병원 호흡기내과학교실)
  • Received : 2010.06.08
  • Accepted : 2010.06.29
  • Published : 2010.08.30
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Abstract

Background: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control. In Korea, about 75~80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000. Methods: On a retrospective basis, we enrolled 170 newly diagnosed with or retreated for multidrug-resistant TB (MDR-TB) in 2004 from 21 private hospitals. We extracted the following demographics and treatment history from patient medical records: initial treatment outcomes, cumulative survival rates, treatment outcomes, and prognostic factors. Results: Of the 170 patients, the majority were male (64.1%), the mean age was 44.5 years old, and mean body-mass-index was $20.2kg/m^2$. None of the patients tested positive for HIV. Eleven (6.5%) were confirmed to have extensively drug-resistant TB (XDR-TB) at treatment initiation. Treatment success rates were not different between XDR-TB (36.4%, 4/11) and non-XDR MDR-TB (51.6%, 82/159). Default rate was high, 21.8% (37/170). Far advanced disease on X-ray was a significant negative predictor of treatment success; advanced disease and low BMI were risk factors for all-cause mortality. Conclusion: In private hospitals in Korea, the proportion of XDR-TB in MDR-TB was comparable to previous data. The treatment success rate of MDR-/XDR-TB remains poor and the failure rate was quite high. Adequate TB control policies should be strengthened to prevent the further development and spread of MDR-/XDR-TB in Korea.

Keywords

References

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