일개 부산지역 3차 병원에서 관찰한 다제내성 결핵의 실태, 2005∼2009 (The Current Status of Multidrug-Resistant Tuberculosis in One Tertiary Hospital in Busan, 2005∼2009)

서지정보

· 발행기관 : 대한결핵및호흡기학회
· 수록지 정보 : Tuberculosis and Respiratory Diseases / 71권 / 2호 / 120 ~ 125페이지
· 저자명 : 윤늘봄, 엄수정, 이성우, 박수민, 정일환, 박소영, 한송이, 이유림, 정진규, 김준모, 김수영, 이수걸, 손춘희, 홍영희, 이기남, 노미숙, 김경희

초록

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.

영어초록

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.

참고자료

· 없음