Kim Chang Ki, Shin So Youn, Kim Hee Jin, Lee Kyungwon
Department of Laboratory Medicine, Hanyang University Guri Hospital, Guri, Korea.
Korean Institute of Tuberculosis, Cheongju, Korea.
Ann Lab Med. 2017 Jul;37(4):323-326. doi: 10.3343/alm.2017.37.4.323.
We aimed to analyze the drug resistance patterns of multidrug-resistant and extensively drug-resistant tuberculosis (TB) and the difference of drug resistance among various settings for health care in Korea. The data of drug susceptibility testing in 2009 was analyzed in order to secure sufficient number of patients from various settings in Korea. Patients were categorized by types of institutions into four groups, which comprised new and previously treated patients from public health care centers (PHC), the private sector, and Double-barred Cross clinics (DBC). The resistance rates to first-line drugs were uniformly high in every group. While the resistance rates to second-line drugs were not as high as first-line drugs, there was a pattern that drug resistance rates were lowest for PHC and highest for DBC. The differences of the resistance rates were more prominent for oral second-line drugs. Our findings implied that drug resistance to oral second-line drugs was significantly amplified during multidrug-resistant-TB treatment in Korea. Therefore, an individualized approach is recommended for treating drug-resistant-TB based on susceptibility testing results to prevent acquisition or amplification of drug resistance.
我们旨在分析耐多药和广泛耐药结核病（TB）的耐药模式以及韩国不同医疗环境下的耐药差异。分析了2009年药物敏感性测试的数据，以便从韩国不同环境中获取足够数量的患者。患者按机构类型分为四组，包括来自公共卫生保健中心（PHC）、私营部门和双杠交叉诊所（DBC）的新患者和既往治疗过的患者。每组对一线药物的耐药率均普遍较高。虽然对二线药物的耐药率不如一线药物高，但存在一种模式，即PHC的耐药率最低，DBC的耐药率最高。口服二线药物的耐药率差异更为显著。我们的研究结果表明，在韩国耐多药结核病治疗期间，对口服二线药物的耐药性显著增加。因此，建议根据药敏试验结果采用个体化方法治疗耐药结核病，以防止耐药性的获得或增加。
