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KMID : 0383820100690020095
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Tuberculosis and Respiratory Diseases
2010 Volume.69 No. 2 p.95 ~ p.102
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Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals
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Park Jin-Kyeong
Koh Won-Jung
Kim Deog-Kyeom
Kim Eun-Kyung
Kim Yu-Il
Kim Hee-Jin
Kim Tae-Hyung
Kim Jae-Yeol
Park Moo-Suk
Park I-Nae
Park Jae-Seuk
Lee Kee-Man
Song Sook-Hee
Lee Jin-Hwa
Lee Seung-Heon
Lee Hyuk-Pyo
Lim Jae-Joon
Lim Jae-Min
Jegal Yang-Jin
Jung Ki-Hwan
Choi Jae-Chol
Shim Tae-Sun
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Abstract
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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 20.2 kg/m2. 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.
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KEYWORD
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Tuberculosis, Multidrug-Resistant, Extensively Drug-Resistant Tuberculosis, Korea, Hospitals, Private
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