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Yoon, Lee, Park, Jeong, Park, Han, Lee, Jung, Kim, Kim, Um, Lee, Son, Hong, Lee, Roh, and Kim: The Current Status of Multidrug-Resistant Tuberculosis in One Tertiary Hospital in Busan, 2005~2009
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2011; 71(2): 120-125.

Published online: 31 August 2011

DOI: https://doi.org/10.4046/trd.2011.71.2.120

The Current Status of Multidrug-Resistant Tuberculosis in One Tertiary Hospital in Busan, 2005~2009

Neul-Bom Yoon, M.D.1, Sung-Woo Lee, M.D.1, Su-Min Park, M.D.1, Il-Hwan Jeong, M.D.1, So-Young Park, M.D.1, Song-Yee Han, M.D.1, Yu-Rim Lee, M.D.1, Jin-Kyu Jung, M.D.1, Joon-Mo Kim, M.D.1, Su Young Kim, M.D.1, Soo-Jung Um, M.D.1, Soo-Keol Lee, M.D.1, Choonhee Son, M.D.1, Young Hee Hong, B.S.1, Ki-Nam Lee, M.D.2, Mee Sook Roh, M.D.3, Kyeong Hee Kim, M.D.4

1Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.

2Department of Radiology, Dong-A University College of Medicine, Busan, Korea.

3Department of Pathology, Dong-A University College of Medicine, Busan, Korea.

4Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea.

Address for correspondence: Soo-Jung Um, M.D. Department of Internal Medicine, Dong-A University College of Medicine, Dongdaesin-dong 3-ga, Seo-gu, Busan 602-715, Korea. Phone: 82-51-240-2769, Fax: 82-51-242-5842, sjum@dau.ac.kr

Received 7 March 2011       Accepted 25 July 2011

Copyright © 2011. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Although the prevalence of pulmonary tuberculosis has progressively decreased all over the world, drug-resistant tuberculosis is major obstacle in treating tuberculosis. This study was performed to examine the current prevalence and risk factors of drug resistant tuberculosis in a single tertiary hospital in Busan, Korea.

Methods

We enrolled 367 patients with active pulmonary tuberculosis on a retrospective basis who had undergone mycobacterium culture and drug sensitivity tests between January 2005 and December 2009. We analyzed all clinical and radiographic parameters to find predictors related to drug resistant tuberculosis.

Results

At least one incident of drug resistance was found in 75 (20.4%) patients. Isoniazid (18.8%) was the most frequent resistant drug, followed by rifampin (10.9%), ethambutol (7.1%), streptomycin (4.9%), and fluoroquinolone (2.7%). Resistance to second-line drugs was found in 37 (10.1%) patients. Multidrug resistance and extensively drug resistance was evident in 39 (10.6%) and 4 (1.1%) patients, respectively. Using multiple logistic regression analysis, history of previous treatment including relapse (odd ratio [OR], 11.3; 95% confidence interval [CI], 4.92~26.08; p<0.01), treatment failure (OR, 24.1; 95% CI, 5.65~102.79; p<0.01) and an age of below 46 years-old (OR, 3.8; 95% CI, 1.62~8.65; p<0.01) were found to be independent predictors of multidrug resistant tuberculosis.

Conclusion

We found that the prevalence of drug resistant tuberculosis was considerably high. A careful consideration for possible drug resistant tuberculosis is warranted in patients with a history of previous treatment or for younger patients.

Keywords: Prevalence, Tuberculosis, Multidrug-Resistant

Figures and Tables

Figure 1
The distribution of patients with multidrug-resistant tuberculosis according to the age group. MDR: multidrug-resistance.
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Table 1
Characteristics of patients
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Values are presented as number (%) unless otherwise indicated.

CV: cardiovascular.

Table 2
Resistance rates of anti-tuberculosis drugs
trd-71-120-i002

Values are presented as number (%).

MDR: multidrug-resistance; XDR: extensively drug-resistance; INH: isoniazid; RFP: rifampin; EMB: ethambutol; SM: streptomycin.

Table 3
Variables associated with multidrug-resistant tuberculosis
trd-71-120-i003

Values are presented as number (%).

MDR: multidrug-resistance; OR: odd ratio; CI: confidence interval.

Acknowledgements

This study was supported by research funds from Dong-A University.

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