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Treatment outcomes and prognostic factors in patients with multidrug-resistant tuberculosis in Korean private hospitals

Title
Treatment outcomes and prognostic factors in patients with multidrug-resistant tuberculosis in Korean private hospitals
Authors
Park J.K.Koh W.-J.Kim D.K.Kim E.K.Kim Y.I.Kim H.J.Kim T.-H.Kim J.Y.Park M.S.Park I.-N.Park J.S.Lee K.M.Song S.H.Lee J.H.Lee S.H.Lee H.P.Yim J.-J.Lim J.Jegal Y.J.Jung K.H.Huh J.W.Choi J.C.Shim T.S.
Ewha Authors
이진화
SCOPUS Author ID
이진화scopus
Issue Date
2010
Journal Title
Tuberculosis and Respiratory Diseases
ISSN
1738-3536JCR Link
Citation
vol. 69, no. 2, pp. 95 - 102
Indexed
SCOPUS; KCI scopus
Abstract
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. Copyright©2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.
DOI
10.4046/trd.2010.69.2.95
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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