Characteristics and Treatment Outcomes of Isoniazid Mono-Resistant Tuberculosis:A Retrospective Study
10.3349/ymj.2020.61.12.1034
- Author:
Se Hyun KWAK
1
;
Ji Soo CHOI
;
Eun Hye LEE
;
Su Hwan LEE
;
Ah Young LEEM
;
Sang Hoon LEE
;
Song Yee KIM
;
Kyung Soo CHUNG
;
Eun Young KIM
;
Ji Ye JUNG
;
Moo Suk PARK
;
Young Sam KIM
;
Joon CHANG
;
Young Ae KANG
Author Information
1. Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Publication Type:Original Article
- From:Yonsei Medical Journal
2020;61(12):1034-1041
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Isoniazid (INH) mono-resistant tuberculosis (Hr-TB) is a highly prevalent type of drug-resistant TB, possibly associated with unfavorable treatment outcomes. However, definitive guidelines on an optimal treatment regimen and duration for Hr-TB are currently under discussion. We evaluated the characteristics and treatment outcomes of Hr-TB patients.
Materials and Methods:We retrospectively reviewed the medical records of Hr-TB patients treated at a South Korean tertiary referral hospital from January 2005 to December 2018.
Results:We included 195 Hr-TB patients. 113 (57.9%) were male, and the median age was 56.6 [interquartile range, 40.2–68.6] years. Mutations in katG were the most frequent [54 (56.3%)], followed by those in the inhA [34 (35.4%)]. Favorable and unfavorable outcomes were noted in 164 (84.1%) and 31 (15.9%) patients, respectively. Smoking history [odds ratio (OR)=5.606, 95% confidence interval (CI): 1.695–18.543, p=0.005], low albumin level (OR=0.246, 95% CI: 0.104–0.578, p=0.001), and positive acid-fast bacilli culture at 2 months (OR=7.853, 95% CI: 1.246–49.506, p=0.028) were associated with unfavorable outcomes.
Conclusion:A tailored strategy targeting high-risk patients is imperative for improved treatment outcomes. Further research on the rapid and accurate detection of resistance to INH and other companion drugs is warranted.
