Hwang S S, Kim H-R, Kim H J, Kim M J, Lee S M, Yoo C-G, Kim Y W, Han S K, Shim Y-S, Yim J-J
Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea.
Eur Respir J. 2009 Mar;33(3):581-5. doi: 10.1183/09031936.00099608.
Recently, resistance to additional first-line and injectable drugs was reported to be an independent risk factor for adverse outcomes in multidrug-resistant (MDR) tuberculosis (TB) patients. The aim of the present study was to confirm these observations in MDR-TB patients without HIV infection. MDR-TB patients treated at a tertiary referral hospital in South Korea between January 1996 and December 2005 were included. The unadjusted and adjusted odds ratios of adverse treatment outcome were calculated for resistance to each drug and combination of drugs using simple or multiple logistic regressions. None of the resistance to additional first-line or injectable drugs was associated with higher odds for adverse treatment outcome in 155 MDR but nonextensively drug-resistant (non-XDR) TB patients. However, streptomycin resistance was associated with 12 times the odds for adverse treatment outcome in 42 extensively drug-resistant (XDR) TB patients. Neither combinations of first-line drugs nor those of injectable drugs were associated with increased odds for adverse treatment outcomes in non-XDR MDR-TB patients or XDR-TB patients. Only streptomycin resistance among the first-line or injectable drugs was associated with adverse treatment outcomes in extensively drug-resistant tuberculosis patients without HIV infection.
最近，据报道，对其他一线和注射用药物的耐药性是耐多药（MDR）结核病（TB）患者不良结局的独立危险因素。本研究的目的是在未感染艾滋病毒的耐多药结核病患者中证实这些观察结果。纳入了1996年1月至2005年12月期间在韩国一家三级转诊医院接受治疗的耐多药结核病患者。使用简单或多元逻辑回归计算每种药物及药物组合耐药时不良治疗结局的未调整和调整比值比。在155例耐多药但非广泛耐药（非XDR）的结核病患者中，对其他一线或注射用药物的耐药性均与不良治疗结局的较高比值无关。然而，在42例广泛耐药（XDR）结核病患者中，链霉素耐药与不良治疗结局的比值高12倍。在非XDR耐多药结核病患者或XDR结核病患者中，一线药物组合或注射用药物组合均与不良治疗结局的比值增加无关。在未感染艾滋病毒的广泛耐药结核病患者中，仅一线或注射用药物中的链霉素耐药与不良治疗结局有关。
