Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

The resistance rate of anti-tuberculosis drug isolated from initial tuberculosis patients at a general hospital in Daejeon area

대전지역 일개 종합병원 초진결핵 환자들로부터 분리(分離)된 결핵균(結核菌)의 약제(藥劑) 내성률(耐性率)

  • Lee, Dong-Hoon (Dept. of Public Health and Welfare Graduate school of Konyang University) ;
  • Kim, Sang-Ha (Dept. of Laboratory Medicine of Sangju Hospital, The Republic of National Red Cross) ;
  • Kim, Young-Kwon (Dept. of Biomedical Laboratory Science of Konyang University)
  • 이동훈 (건양대학교병원 진단검사의학과) ;
  • 김상하 (대한적십자사상주병원 진단검사의학과) ;
  • 김영권 (건양대학교 임상병리학과)
  • Received : 2011.09.22
  • Accepted : 2011.11.10
  • Published : 2011.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

According to the nationwide survey of tuberculosis from 1965 to 1995, the incidence and drug resistance rate of tuberculosis have been decreased in Korea, but the prevalence of multidrug resistance of Mycobacterium tuberculosis is still a serious problem. The purpose of this study is to investigate the drug resistance rate and pattern of tuberculosis in Daejeon from 2001 to 2008. Of the total 581cases where the drug susceptibility test was performed, resistance to at least one anti-TB drug was found in 104 cases(17.9%) of these, 68(11.7%) were resistant to at least INH and 41(7.1%) were resistant to at least RFP. Single-drug resistance was found for isolates from 37(6.4%) ; 18(3.1%) of these were resistant to INH and 5(0.9%) to RFP. Multidrug resistance, where TB was resistant to at least isoniazid and refampin, was found in 35 cases(6.0%). and Factors associated with MDR-TB included age under 40-60.The drug-resistance rate of pulmonary TB, especially MDR-TB, is higher in the initial treated patients at a private referral hospital than in those in the pubulic sector. Initial drug resistance is common and the drug susceptibility test is informative for pulmonary TB patients who have not received previous TB treatment. The need for an improved control program, coupled with early diagnosis of MDR-TB, to reduce the spread and development of resistance. Multidrug resistance rate is still problem in korea. Efforts to decrease multidrug resistance rate either independently or in cooperation with the pubulic sector will be needed.

1965년부터 1995까지 결핵의 전국적인 조사에 의하면, 한국에서 결핵의 발생과 약제 내성율은 감소하였지만 다재약제내성율의 유행은 여전히 심각한 문제이다. 본 연구의 목적은 2001 년부터 2008까지 대전에 약제 내성율과 성향을 조사하였다. 총 581건의 약제감수성 검사가 수행 되었으며 이중 하나이상의 항결핵제의 약물에 내성이 있는 경우가 104건(17.9%)이였고 적어도 INH에 내성이 있는 경우가 68건 (11.7 %), RFP내성이 41건(7.1 %)이였다. 단일 약제 내성율은 37건 (6.4 %) 분리되었으며 이들 중 INH에서 18건 (3.1 %) RFP에서 5건(0.9 %)이 분리 되었다. 적어도 isoniazid와 refampin에 내성인 다제내성결핵은 35건(6.0 %)에서 발견되었다. 그리고 MDR - TB와 관련된 나이요인에 40-60 세 포함되었다. 폐결핵의 약제내성율, 특히 MDR - TB의 약제내성율은 공공의료분야보다 민간 병원의 초치료 환자에서 높게 나왔다. 초기 약제내성은 일반적이며 약제감수성 검사는 이전 결핵 치료를 받지 않은 폐결핵 환자에 대해 유용성이 있다. 내성의 확산과 증가를 줄이기 위해 MDR - TB의 조기 진단과 함께 향상된 제어프로그램이 필요하다. 다제내성율은 여전히 한국에서 문제이다. 독립적으로 혹은 공공의료분야와 공동으로 다제내성율을 감소하기 위한 노력이 필요하다.

Keywords

References

  1. Department of Health and Human Services, Tuberculosis Association: Seventh National Tuberculosis Survey, 1995.
  2. Hongyoungpyo. Tuberculosis in Korea yesterday, today, tomorrow. Tuberculosis and Respiratory Diseases 1997; 44:1-10. https://doi.org/10.4046/trd.1997.44.1.1
  3. Espinal MA, Laszlo A, Simonsen L, Boulahbal F, Kim SJ, Reniero A, et al. Global trends in resist ance to antituberculosis Health Organization-Inte rnational Union against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis dr ug Resistance Surveillance. N engl J M ed 2001 ;344:1294-303. https://doi.org/10.1056/NEJM200104263441706
  4. Pao CC, Lin SS, Wu SY, Juang WM: The detec tion of mycobacteria DNA sequences in uncultured clinical specimens with cloned Mycobacterium tuberculosis DNA as probes.Tubercle 69:2.1988.
  5. Bai GH, Anti-tuberculosis drug resistance in kor ea. CDMR 2005;16:101-7.
  6. Dye C, Espinal MA, Watt CJ, Mbiaga C, Willia ms BG, Worldwide incidence of multidrug-re sistant tuberculosis. J Infect Dis 2002;185:1197-2 02. https://doi.org/10.1086/339818
  7. Jangcheolhun, yieunyeop, baksungyu, jeongseokhun. 1981-2004 rate of resistant tuberculosis public health trend of re-treatment tuberculosis patients. Tuberculosis and Respiratory Diseases 2005; 59:619-624. https://doi.org/10.4046/trd.2005.59.6.619
  8. Ryuwoojin. Surveillance of tuberculosis in South Korea. Tuberculosis and Respiratory Diseases 2000; 48:298-307. https://doi.org/10.4046/trd.2000.48.3.298
  9. World Health Organization Treatment of tubercul osis : guidelines for National programmes. 3rd, Geneva, Switzerland : WHO;2003.
  10. Korean Academy of Tuberculosis and Respiratory Disease. Guideline for the management of pulmonary tuberculosis. Seoul :korea Academy of Tuberculosis and Respiratory Diseases; 2005.
  11. Bakyounggil, bakyunseong, baejeongim, gimhuijin, ryuwoojin 0.2003 to 2005, including private hospitals and clinics year Renewal of Mycobacterium tuberculosis isolated from tuberculosis naeseongryul party. Tuberculosis and Respiratory Diseases 2008; 6 4:87-94. https://doi.org/10.4046/trd.2008.64.2.87
  12. Jeongyoungju, bakyinae, hongsangbeom, ohyeonmok, imchaeman etc. TB patients in a private hospital in Korea's medical siltae. RESULTS nucleus and respiratory diseases 2006; 60:194-204.
  13. Jung YJ, Park IN, Hong SB, Oh YM, LIm CM, Lee SD, et al. The clinical characters,diagnosis, treatment, and outcomes of patients with tube rculosis at a private university hospital in korea. Tuberc Respir Dis 2006;60:194- 204. https://doi.org/10.4046/trd.2006.60.2.194
  14. Sonchunhui, yangdugyeong, nomisuk, jeongjinsuk, yihyeok, yiginam. Part sanjiyeok tuberculosis patients admitted to a tertiary hospital in the association between predictors and drug naeseongryul, Tuberculosis and Lake Intake diseases 2001; 51:416-25.
  15. Choi JC, Lim SY, Suh GY, Chung MP, Kim H, Kwon OJ,et al, Drug resistance rates of Mycob acterium tubercuolosis at a private referral cent er in korea, Korean Med Sci 2007;22:677-81. https://doi.org/10.3346/jkms.2007.22.4.677
  16. Koziel H, Koziel MJ. Pulmonary complications of diabetes mellitus. Infect Dis Clin North Am 1995;9:65-96.
  17. Bashar M. Alcabes P, Rom WN, Condos R. Inc reased incidence of multidrug resistant tubercu losis in diabetic patient on the Bellevue Chest Service, 1987-1997. Chest 2001;120:1514-9. https://doi.org/10.1378/chest.120.5.1514
  18. Gimdogyun, gimmiok, gimtaehyeong, sonjangwon, yunhoju, sindongho. Surveyed in auniversity hospital in Seoul naeseongryul and risk factors for tuberculosis drugs. Tuberculosis and Respiratory Diseases 2005; 58:243-7. https://doi.org/10.4046/trd.2005.58.3.243