Browse > Article

Pulmonary Resection Combined with Isoniazid-and Rifampin-based Drug Therapy for Patients with Multidrug-resistant Tuberculosis  

Park, Seung-Kyu (Department of chest surgery, National Masan Tuberculosis Hospital)
Kim, Jin-Hee (Department of chest surgery, National Masan Tuberculosis Hospital)
Kim, Jun-Ho (Department of chest surgery, National Masan Tuberculosis Hospital)
Publication Information
Tuberculosis and Respiratory Diseases / v.59, no.2, 2005 , pp. 179-185 More about this Journal
Abstract
Background : To evaluate the clinical efficacy of pulmonary resection combined with first-line antituberculous drug therapy in patients with well-localized, cavities-containing pulmonary multidrug-resistant tuberculosis (MDR-TB). Method : From February 1998, seventeen patients with well-localized, cavities-containing pulmonary MDR-TB were enrolled and followed prospectively up to December 2004. After radical pulmonary resection, the patients were treated with antituberculous drugs comprising of isoniazid (H), rifampin (R), pyrazinamide (Z), ethambutol (E), and streptomycin (S) (3HERZS/3HERS/6HER). Results : All recovered isolates of M. tuberculosis were resistant to both isoniazid and rifampin, and to a mean of 4.8 antituberculous drugs (range, 2 to 7 drugs). Surgical procedures included lobectomy (13 patients), lobectomy plus segmentectomy (3 patients), and pneumonectomy (1 patient). The median time for postoperative sputum smear and culture conversion was 2 days (range, 1 to 23 days). Fifteen (94%) patients had durable cures (mean follow-up period, 39.0 months). One patient failed to convert her sputum and was successfully switched to second-line therapy; one patient developed active disease again almost 7 years later, likely due to re-infection with a new M. tuberculosis strain. Conclusion : Radical resection combined with administration of first-line antituberculous agents was effective in patients with well-localized, cavities-containing pulmonary MDR-TB.
Keywords
Pulmonary tuberculosis; MDR-TB; Lung surgery;
Citations & Related Records

Times Cited By SCOPUS : 1
연도 인용수 순위
1 Iseman MD, Madsen L, Goble M, Pomerantz M. Surgical intervention of pulmonary disease caused by drug-resistant Mycobacterium tuberuclosis. Am Rev Respir Dis 1990;141:623-5   DOI   ScienceOn
2 Kwon ES, Ha HC, Hwang SH, Lee HY, Park SK, Song SD. Pulmonary resection in the treatment of multidrug-resistant tuberculosis. Tuberc Respir Dis 1998;45:1143-53   DOI
3 van Rie A, Warren R, Richardson M, Victor TC, Gie RP, Enarson DA, et al. Exogenous reinfection as a cause of recurrent tuberculosis after curative treatment. N Engl J Med 1999;341:1174-9   DOI   ScienceOn
4 Pomerantz M. Madsen L, Goble M, Iseman MD. Surgical management of resistant mycobacterial tuberculosis and other mycobacterial pulmonary infections. Ann Thorac Surg 1991;52:1108-11   DOI   ScienceOn
5 Kaplan G, Post FA, Moreira AL, Wainwright H, Kreiswirth BN, Tanverdi M, et al. Mycobacterium tuberculosis growth at the cavity surface: a microenvironment with failed immunity. Infect Immun 2003;71:7099-108   DOI   ScienceOn
6 Sim YS. Update in refractory pulmonary tuberculosis. J Korean Med Assoc 1998;39:1277-86
7 Pomerantz M, Brown J. The surgical management of tuberculosis. Semin Thorac Cardiovasc Surg 1995;7:108-11
8 Yoon J, Urban C, Terzian C, Mariano N, Rahal JJ. In vitro double and triple synergistic activities of polymyxin B, imipenem, and rifampin against multidrug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2004;48:753-7   DOI   ScienceOn
9 Park SK, Choi IH, Song SD. Clinical course of cavitary lesions in pulmonary tuberculosis. Tuberc Respir Dis 1996;43:323-30   DOI
10 Park SK, Choi IH, Kim CM, Kim CT, Song SD. Clinical study of pulmonary tuberculosis for admitted patients at National Masan Tuberculosis Hospital. Tuberc Respir Dis 1997;44:241-50   DOI
11 Dye C, Espinal MA, Watt CJ, Mbiaga C, Williams BG. Worldwide incidence of multidrug-resistant tuberculosis. J Infect Dis 2002;185:1197-202   DOI   ScienceOn
12 van Leuven M, de Groot M, Shean KP, von Oppell UO, Willcox PA. Pulmonary resection as an adjunct in the treatment of multiple drug-resistant tuberculosis. Ann Thorac Surg 1997;63:1368-73   DOI
13 Park SK, Lee CM, Heu JP, Song SD. A retrospective study for the outcome of pulmonary resection in 49 patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2002;6:143-9
14 Fish DN, Choi MK, Jung R. Synergic activity of cephalosporins plus fluoroquinolones against Pseudomonas aeruginosa with resistance to one or both drugs. J Antimicrob Chemother 2002;50:1045-9   DOI   ScienceOn
15 Urban C, Segal-Maurer S, Rahal JJ. Considerations in control and treatment of nosocomial infections due to multidrug resistant Acinetobacter baumannii. Clin Infect Dis 2003;36:1268-74   DOI   ScienceOn
16 Kim AJ, Kuh JH, Kim KS. Surgical treatment of pulmonary tuberculosis. Korean J Thorac Cardiovasc Surg 1996;29:397-402
17 Sim SB, Kim OJ, Kim BS, Jang DC. Clinical evaluation of posititve sputum AFB cases following pulmonary resection of pulmonary tuberculosis. Korean J Thorac Cardiovasc Surg 1992;25:856-62
18 Pomerantz M, Brown JM. Surgery in the treatment of multidrug-resistant tuberculosis. Clin Chest Med 1997;18:123-30   DOI   ScienceOn
19 Sung SW, Kang CH, Kim YT, Kim JH. Surgical management of multidrug resistant pulmonary tuberculosis. Korean J Thorac Cardiovasc Surg 1999;32:287-93
20 Jun HJ, Hahn DK, Park SK, Song SD, Choi PC, Woo JS. Clinical evaluation of surgical resection of surgical resection on pulmonary tuberculosis: multiple drug resistant tuberculosis. Korean J Thorac Cardiovasc Surg 1997;30:786-92
21 Post FA, Willcox PA, Mathema B, Steyn LM, Shean K, Ramaswamy SV, et al. Genetic polymorphisms in Mycobacterium tuberculosis isolates from patients with chronic multidrug-resistant tuberculosis. J Infect Dis 2004;190:99-106   DOI   ScienceOn
22 Iseman MD. Treatment of multidrug-resistant tuberculosis. N Engl J Med 1993;329:784-91   DOI   PUBMED   ScienceOn
23 Canetti G, Grosset J. Percentage of isoniazid-resistant and streptomycin-resistant variants in wild strains of Mycobacterium tuberculosis on Loewenstein-Jensen medium. Ann Inst Pasteur 1961;101:28-46
24 Song W, Woo HJ, Kim JS, Lee KM. In vitro activity of beta-lactams in combination with other antimicrobial agents against resistant strains of Pseudomonas aeruginosa. Int J Antimicrob Agents 2003;21:8-12   DOI   ScienceOn
25 Park SK, Lee IH, Kim BJ. Clinical observational study of pulmonary tuberculosis for admitted patients at a National Tuberculosis Hospital: comparison with the previous results in 1995. Tuberc Respir Dis 2005;58:392-8   DOI
26 Report on the 7th tuberculosis prevalence survey in Korea. Ministry of Health and Welfare, Korean National Tuberculosis Association; 1996. p.1-180