Drug Resistance Rates of Mycobacterium tuberculosis at a Private Referral Center in Korea

Abstract

The goals of this study were to identify first-line drug resistance in new and previously treated tuberculosis (TB) cases and to determine risk factors for multidrug-resistant TB (MDR-TB) at a private referral center in Korea. All patients with culture-confirmed pulmonary TB over a 2-yr period between July 2002 and June 2004 were prospectively included in this study. In total, 637 patients were included; 512 (80.4%) were new cases, and 125 (19.6%) were previously treated cases. Resistance to at least one first-line drug was identified in 11.7% of new cases and 41.6% of previously treated cases. MDR-TB was detected in 3.9% of new cases and 27.2% of previously treated cases. The proportion of extensively drug-resistant TB among MDR-TB patients was 16.7% (9/54). Factors associated with MDR-TB included age under 45 yr, previous TB treatment, and the presence of cavitation on chest radiography. Rates of first-line drug resistance are high, particularly in previously treated patients, in the private sector in Korea. This underscores the need for an improved control program, coupled with early diagnosis of MDR-TB, to reduce the spread and development of resistance.

A Study to Assess Association of Previous Treatment with Development of Multi Drug Resistance among TB Patients of Tertiary Care Hospital of India

“…Previous treatment of tuberculosis has been consistently reported as the risk factor within various clinical conditions and populations. 12,13,14,15 The present study also revealed that previous treatment of tuberculosis (n=285, 98.95%) was strongly associated with MDR TB. A reported history of previous treatment of tuberculosis, although unconfirmed, suggests that MDR-TB was acquired during a previous treatment episode; such acquired drug resistance may indicate failure of TB control efforts due to inadequate case management, interruptions in drug supply, or inadequate drug regimens.…”

Treatment Outcomes for HIV‐Uninfected Patients with Multidrug‐Resistant and Extensively Drug‐Resistant Tuberculosis

“…An increasing number of cases of XDR TB are being reported globally [29]. In Korea, 15%-20% of patients with MDR TB meet the criteria for XDR TB in both the public and private sector [7,30,31]. Recently published studies have demonstrated that the occurrence of XDR TB is an independent poor prognostic factor in HIV-uninfected patients with MDR TB [5][6][7].…”

Significant risk and associated factors of active tuberculosis infection in Korean patients with inflammatory bowel disease using anti-TNF agents

“…In the present study, we could not find a prophylactic effect of anti-TB medications; 12.5% (2/16) of patients with LTBI who took prophylactic anti-TB medication still developed active TB, whereas 14.3% (2/14) of patients with LTBI who did not take prophylaxis had active TB during anti-TNF therapy (Figure 1). Although the exact reason for the lack of efficacy of prophylaxis in this study is unclear, the emergence of drug-resistant TB in Korea might be a possible explanation [31,32] . Guidelines recommend delaying to begin anti-TNF for at least 3 wk when LTBI is confirmed [16,33] .…”