Kim Hyun Jung, Yoon Hyung Ho, Eun Byung Wook, Ahn Youngmin, Ryoo Sungweon, Kim Hee Jin
Department of Pediatrics, Eulji General Hospital, Eulji University, Seoul, Korea.
Department of Pediatrics, Eulji University School of Medicine, Daejeon, Korea.
J Korean Med Sci. 2017 Jun;32(6):954-960. doi: 10.3346/jkms.2017.32.6.954.
The incidence of drug-resistant tuberculosis (DR-TB) in pediatric populations is a critical indicator of national TB management and treatment strategies. Limited data exist regarding the rate of pediatric DR-TB. In this study, we aimed to analyze the status of DR-TB in Korean children from 2007 to 2013. We analyzed specimens submitted to the Korean Institute of Tuberculosis using Mycobacterium tuberculosis culture and drug susceptibility tests (DSTs) from January 2007 through December 2013. Specimens from patients ≤ 19 years of age were included. Among the 2,690 cases, 297 cases were excluded because of insufficient data, leaving 2,393 cases for the final analysis. In total, resistance to one or more TB drugs was 13.5%. The resistance rates of each of the drugs were as follows: isoniazid (INH) 10.2%, rifampin (RFP) 5.1%, ethambutol (EMB) 3.7%, and pyrazinamide (PZA) 3.1%. The resistance rate of multidrug-resistant TB (MDR-TB) was 4.2%, and that of extensively drug-resistant TB (XDR-TB) was 0.8%. The overall drug resistance rate demonstrated significant increase throughout the study period (P < 0.001) but showed no significant difference compared to previous study from 1999 to 2007. The drug resistance rate of PZA in ≤ 15 years of age group was significantly greater than that of > 15 years (P < 0.001). The drug resistance rate has increased throughout the study period.
儿童人群中耐多药结核病（DR-TB）的发病率是国家结核病管理和治疗策略的关键指标。关于儿童耐多药结核病的发生率，现有数据有限。在本研究中，我们旨在分析2007年至2013年韩国儿童耐多药结核病的状况。我们对2007年1月至2013年12月期间提交给韩国结核病研究所的标本进行了结核分枝杆菌培养和药敏试验（DST）分析。纳入了年龄≤19岁患者的标本。在2690例病例中，有297例因数据不足而被排除，最终分析时剩下2393例。总体而言，对一种或多种抗结核药物耐药的比例为13.5%。每种药物的耐药率如下：异烟肼（INH）10.2%，利福平（RFP）5.1%，乙胺丁醇（EMB）3.7%，吡嗪酰胺（PZA）3.1%。耐多药结核病（MDR-TB）的耐药率为4.2%，广泛耐药结核病（XDR-TB）的耐药率为0.8%。在整个研究期间，总体耐药率呈显著上升趋势（P<0.001），但与1999年至2007年的先前研究相比无显著差异。≤15岁年龄组的吡嗪酰胺耐药率显著高于>15岁年龄组（P<0.001）。在整个研究期间，耐药率有所上升。
