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http://dx.doi.org/10.4046/trd.2010.69.2.95

Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals  

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)
Publication Information
Tuberculosis and Respiratory Diseases / v.69, no.2, 2010 , pp. 95-102 More about this Journal
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
Tuberculosis, Multidrug-Resistant; Extensively Drug-Resistant Tuberculosis; Korea; Hospitals, Private;
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