Extensively Drug-Resistant Tuberculosis in South Korea: Risk Factors and Treatment Outcomes among Patients at a Tertiary Referral Hospital

Abstract

XDR TB was found to be associated with the cumulative duration of previous treatment with second-line TB drugs among subjects in a tertiary care TB hospital. Patients with XDR TB were more likely to not respond to therapy, and successful conversion of sputum culture results to negative was correlated with initial susceptibility to both fluoroquinolones and kanamycin but not to streptomycin.

Risk Factors for Poor Treatment Outcomes in Patients With MDR-TB and XDR-TB in China: Retrospective Multicenter Investigation

“…Although this survey was not conducted in communities, it may also provide an objective reflection of the high prevalence of XDR-TB in China in general because in China most patients with TB are treated in Tuberculosis Specialized Hospitals. In our study, the percentage of females in the XDR group was 39.1%, significantly higher than in the Other MDR group (P=0.034), and similar to a study in Korea and in South Africa [21,26]. Why there are higher percentages of females among XDR patients than Other MDR patients remains unknown and should be further investigated.…”

“…The percentage of XDR-TB was higher than in the previous surveillance data in China [16][17][18][19], in Taiwan [20], and in other countries [9,21,22], and it was similar to the 23.9% which was reported from South Africa in TB and HIV co-infected patients [23][24][25], similar to the 23.59% from nationwide population-based survey in China [5] and to 20.0% found in the study from Shandong [6]. The high prevalence of XDR-TB could be explained by the fact that our study subjects were from provincial Tuberculosis Specialized Hospitals, where the patients might tend to be selected as being relatively difficult cases.…”

“…Two reasons might contribute to capreomycin and amikacin, in addition to resistance to isoniazid and rifamplicin, as well as ofloxacin. This is significantly higher than the percentages from other studies [21,28]. In China, the above seven drugs are the most commonly used ones to treat TB and DR-TB.…”

Une thérapie prometteuse contre les souches ultrarésistantes deM. tuberculosis

“…L'analyse a ensuite été étendue à une série de 13 isolats cliniques ultrarésistants provenant du Korean Institute of Tuberculosis à Séoul (Corée du Sud) [8]. Les concentrations minimales inhibitrices (CMI) ont été déterminées par la méthode de microdilution en utilisant des concentrations fixes d'acide clavulanique [9].…”

The quest for a new vaccine against tuberculosis

“…These are MDR-TB strains that are also resistant to a fluoroquinolone and at least one second-line injectable drug such as kanamycin, capreomycin or amikacin [4]. The emergence of XDR-TB is posing a major threat in many parts of the world [5], primarily in countries such as South Africa, where health authorities are testing new antibiotic regimens to treat TB and more restricted containment measures to prevent the spread of XDR-TB strains [6].…”