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2018 - 2021年韩国耐多药和利福平单耐药结核病的临床特征:一项全国性横断面研究

Clinical Profiles of Multidrug-Resistant and Rifampicin-Monoresistant Tuberculosis in Korea, 2018-2021: A Nationwide Cross-Sectional Study.

作者信息

Min Jinsoo, Ko Yousang, Kim Hyung Woo, Koo Hyeon-Kyoung, Oh Jee Youn, Jeon Doosoo, Lee Taehoon, Kim Young-Chul, Lim Sung Chul, Lee Sung Soon, Park Jae Seuk, Kim Ju Sang

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea.

出版信息

Tuberc Respir Dis (Seoul). 2025 Jan;88(1):159-169. doi: 10.4046/trd.2024.0049. Epub 2024 Sep 23.

Abstract

BACKGROUND

This study aimed to identify the clinical characteristics of multidrug-resistant/ rifampicin-resistant tuberculosis (MDR/RR-TB) in the Republic of Korea.

METHODS

Data of notified people with tuberculosis between July 2018 and December 2021 were retrieved from the Korea Tuberculosis Cohort database. MDR/RR-TB was further categorized according to isoniazid susceptibility as follows: multidrug-resistant tuberculosis (MDR-TB), rifampicin-monoresistant tuberculosis (RMR-TB), and RR-TB if susceptibility to isoniazid was unknown. Multivariable logistic regression analysis was conducted to identify the factors associated with MDR/RR-TB.

RESULTS

Between 2018 and 2021, the proportion of MDR/RR-TB cases among all TB cases and TB cases with known drug susceptibility test results was 2.1% (502/24,447). The proportions of MDR/RR-TB and MDR-TB cases among TB cases with known drug susceptibility test results were 3.3% (502/15,071) and 1.9% (292/15,071), respectively. Among all cases of rifampicin resistance, 31.7% (159/502) were RMR-TB and 10.2% (51/502) were RR-TB. Multivariable logistic regression analyses revealed that younger age, foreigners, and prior tuberculosis history were significantly associated with MDR/ RR-TB.

CONCLUSION

Rapid identification of rifampicin resistance targeting the high-risk populations, such as younger generations, foreign-born individuals, and previously treated patients are necessary for patient-centered care.

摘要

背景

本研究旨在确定韩国耐多药/利福平耐药结核病(MDR/RR-TB)的临床特征。

方法

从韩国结核病队列数据库中检索2018年7月至2021年12月期间报告的结核病患者数据。MDR/RR-TB根据异烟肼敏感性进一步分类如下:耐多药结核病(MDR-TB)、利福平单耐药结核病(RMR-TB),以及异烟肼敏感性未知时的RR-TB。进行多变量逻辑回归分析以确定与MDR/RR-TB相关的因素。

结果

2018年至2021年期间,所有结核病病例以及已知药敏试验结果的结核病病例中MDR/RR-TB病例的比例为2.1%(502/24447)。已知药敏试验结果的结核病病例中MDR/RR-TB和MDR-TB病例的比例分别为3.3%(502/15071)和1.9%(292/15071)。在所有利福平耐药病例中,31.7%(159/502)为RMR-TB,10.2%(51/502)为RR-TB。多变量逻辑回归分析显示,年龄较小、外国人以及既往结核病史与MDR/RR-TB显著相关。

结论

为了以患者为中心进行治疗,有必要针对年轻一代、外国出生者和既往治疗患者等高风险人群快速识别利福平耐药情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd04/11704723/dac4827cc1ab/trd-2024-0049f1.jpg

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