Yum H, Song Y, Jeon S, Choi S, Lee B, Kim D
Department of Internal Medicine Paik Hospital, Inje University, Seoul, Korea.
Korean J Intern Med. 1995 Jan;10(1):38-42. doi: 10.3904/kjim.1995.10.1.38.
In the past decade, the incidence of tuberculosis has been decreased in Korea and the nationwide survey of tuberculosis from 1965 through 1990 suggested a declining tendency of resistant organisms. But the prevalence rate of multidrug resistance of Mycobacterium tuberculosis is still a serious problem in Korea, and the aim of this study is to check the drug resistance pattern in the patients visiting University Hospital, the 3rd referral center.
We reviewed 1279 cases (522 female, 757 male, mean age 39.4 +/- 16.7) of bacteriologically proven tuberculosis seen during the period from 1986 to 1992 retrospectively. Of 1093 patients, who were indentified in previous medical history, 454 (41.5%) had a history of prior antituberculous chemotherapy.
Resistance rate (resistant to 1 or more drugs) was 33.9%. Eleven percent of patients had resistance to a single drug (INH: 80.6%). Twenty two percent of patients had resistance to 2 or more drugs. Resistance rate is higher (47.4%) in the patients with a history of prior treatment than without a history (25.5%).
These data suggest that the high rate of multidrug resistance in Korea did not show any decreasing tendency. So, mycobacterial culture and sensitivity tests should be recommended at initial treatment of tuberculosis and potent antituberculosis drugs are strongly recommended.
在过去十年中，韩国结核病发病率有所下降，1965年至1990年的全国结核病调查显示耐药菌呈下降趋势。但在韩国，结核分枝杆菌多重耐药的患病率仍是一个严重问题，本研究旨在检查作为第三转诊中心的大学医院就诊患者的耐药模式。
我们回顾性分析了1986年至1992年期间1279例经细菌学证实的结核病病例（522例女性，757例男性，平均年龄39.4±16.7岁）。在1093例有既往病史的患者中，454例（41.5%）有过抗结核化疗史。
耐药率（对一种或多种药物耐药）为33.9%。11%的患者对单一药物耐药（异烟肼：80.6%）。22%的患者对两种或更多药物耐药。有既往治疗史的患者耐药率（47.4%）高于无既往治疗史的患者（25.5%）。
这些数据表明，韩国的高多重耐药率没有任何下降趋势。因此，建议在结核病初始治疗时进行分枝杆菌培养和药敏试验，并强烈推荐使用强效抗结核药物。
