Risk Factors for Poor Outcomes in Patients with Multi-Drug Resistant Tuberculosis in South Korea.
10.7599/hmr.2016.36.4.262
- Author:
Jun Ho YANG
1
;
Hyun Oh PARK
;
Joung Hun BYUN
;
Sung Hwan KIM
;
Sung Ho MOON
;
Jong Duk KIM
;
Dea Yeon KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, College of Medicine and Institute of Health Sciences, Gyeongsang National University hospital, Changwon, Republic of Korea. romejuliet@naver.com
- Publication Type:Original Article
- Keywords:
Tuberculosis;
Multidrug-resistant tuberculosis;
Risk factors;
fluoroquinolone
- MeSH:
Body Mass Index;
Humans;
Korea*;
Ofloxacin;
Public Health;
Retrospective Studies;
Risk Factors*;
Thinness;
Treatment Outcome;
Tuberculosis;
Tuberculosis, Multidrug-Resistant*
- From:Hanyang Medical Reviews
2016;36(4):262-268
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Multidrug-resistant tuberculosis (MDR-TB) is an important public health problem in South Korea. MDR-TB is difficult to control, and treatment is less effective than for drug-sensitive tuberculosis. The aim of this report is to determine the risk factors for poor outcomes for MDR-TB. METHODS: We retrospectively and consecutively analyzed the clinical outcomes of MDR-TB patients registered at a single tuberculosis-specialized hospital in South Korea from January 2005 to February 2011. We used standard treatment outcome definitions for MDR-TB and used the combination of “defaulted”, “treatment failed”, and “died” as a composite poor outcome variable. We analyzed the risk factors associated with poor outcome. RESULTS: Among the 258 patients sampled, 91 (35.3%) had MDR-TB on their first tuberculosis infection, while 167 patients (64.7%) who had previously been treated for tuberculosis had MDR-TB over the study period. Treatment outcomes revealed that 207 patients (80.2%) were cured of their infection, 15 (5.8%) completed their treatment, one (0.4%) defaulted treatment, 6 (2.3%) died, and treatment failed for 29 patients (11.3%). Multivariate Cox proportional-hazards regression analysis found that poor outcome were associated with a body mass index <18.5 kg/m2 (hazard ratio [HR]: 2.57; 95% confidence interval [CI]: 1.28-5.15, p = 0.008), being susceptible to four or fewer drugs at the start of treatment (HR: 3.89; 95% CI: 1.38-10.96, p = 0.01), and ofloxacin resistance (HR: 2.49; 95% CI: 1.06-5.81, p = 0.035). CONCLUSIONS: Being underweight, susceptibility to four or fewer drugs, and ofloxacin resistance are independent prognostic factors of poor outcome for MDR-TB patients.
