Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals. (original) (raw)

Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals.
[Jin Kyeong Park](/articles/search%5Fresult.php?term=author&f%5Fname=Jin Kyeong&l%5Fname=Park), [Won Jung Koh](/articles/search%5Fresult.php?term=author&f%5Fname=Won Jung&l%5Fname=Koh), [Deog Kyeom Kim](/articles/search%5Fresult.php?term=author&f%5Fname=Deog Kyeom&l%5Fname=Kim), [Eun Kyung Kim](/articles/search%5Fresult.php?term=author&f%5Fname=Eun Kyung&l%5Fname=Kim), [Yu Il Kim](/articles/search%5Fresult.php?term=author&f%5Fname=Yu Il&l%5Fname=Kim), [Hee Jin Kim](/articles/search%5Fresult.php?term=author&f%5Fname=Hee Jin&l%5Fname=Kim), [Tae Hyung Kim](/articles/search%5Fresult.php?term=author&f%5Fname=Tae Hyung&l%5Fname=Kim), [Jae Yeol Kim](/articles/search%5Fresult.php?term=author&f%5Fname=Jae Yeol&l%5Fname=Kim), [Moo Suk Park](/articles/search%5Fresult.php?term=author&f%5Fname=Moo Suk&l%5Fname=Park), [I Nae Park](/articles/search%5Fresult.php?term=author&f%5Fname=I Nae&l%5Fname=Park), [Jae Seuk Park](/articles/search%5Fresult.php?term=author&f%5Fname=Jae Seuk&l%5Fname=Park), [Ki Man Lee](/articles/search%5Fresult.php?term=author&f%5Fname=Ki Man&l%5Fname=Lee), [Sook Hee Song](/articles/search%5Fresult.php?term=author&f%5Fname=Sook Hee&l%5Fname=Song), [Jin Hwa Lee](/articles/search%5Fresult.php?term=author&f%5Fname=Jin Hwa&l%5Fname=Lee), [Seung Heon Lee](/articles/search%5Fresult.php?term=author&f%5Fname=Seung Heon&l%5Fname=Lee), [Hyuk Pyo Lee](/articles/search%5Fresult.php?term=author&f%5Fname=Hyuk Pyo&l%5Fname=Lee), [Jae Joon Yim](/articles/search%5Fresult.php?term=author&f%5Fname=Jae Joon&l%5Fname=Yim), Jaemin Lim, [Yang Jin Jegal](/articles/search%5Fresult.php?term=author&f%5Fname=Yang Jin&l%5Fname=Jegal), [Ki Hwan Jung](/articles/search%5Fresult.php?term=author&f%5Fname=Ki Hwan&l%5Fname=Jung), [Jin Won Huh](/articles/search%5Fresult.php?term=author&f%5Fname=Jin Won&l%5Fname=Huh), [Jae Chol Choi](/articles/search%5Fresult.php?term=author&f%5Fname=Jae Chol&l%5Fname=Choi), [Tae Sun Shim](/articles/search%5Fresult.php?term=author&f%5Fname=Tae Sun&l%5Fname=Shim)
1Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. shimts@amc.seoul.kr 2Korean TB Study Group, Korean Academy of Tuberculosis and Respiratory Diseases, Seoul, Korea. 3Department of Pulmonary and Critical Care Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Abstract
BACKGROUNDThe 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.
Key Words: Tuberculosis, Multidrug-Resistant, Extensively Drug-Resistant Tuberculosis, Korea, Hospitals, Private