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Tuberc Respir Dis > Volume 69(2); 2010 > Article
Tuberculosis and Respiratory Diseases 2010;69(2):95-102.
DOI: https://doi.org/10.4046/trd.2010.69.2.95    Published online August 1, 2010.
Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals.
Jin Kyeong Park, , Won Jung Koh, , Deog Kyeom Kim, , Eun Kyung Kim, , Yu Il Kim, , Hee Jin Kim, , Tae Hyung Kim, , Jae Yeol Kim, , Moo Suk Park, , I Nae Park, , Jae Seuk Park, , Ki Man Lee, , Sook Hee Song, , Jin Hwa Lee, , Seung Heon Lee, , Hyuk Pyo Lee, , Jae Joon Yim, , Jaemin Lim, , Yang Jin Jegal, , Ki Hwan Jung, , Jin Won Huh, , Jae Chol Choi, , Tae Sun 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
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.
Key Words: Tuberculosis, Multidrug-Resistant, Extensively Drug-Resistant Tuberculosis, Korea, Hospitals, Private


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