다제약제내성 결핵의 유병율 = Prevalence of Multidrug Resistant Tuberculosis

다국어 초록 (Multilingual Abstract)

Background : Multidrug-resistant tuberculosis (MDRTB) is defined as the reduction in susceptibility of Mycobacterium tuberculosis to Isoniazid and Rifampin with or without resistance to additional drugs. The development of MDRTB is a big problem not only to the patients but also to the society given with its lower cure rate. The purpose of this study is to investigate the prevalence and the clinical features of MDRTB at a university hospital and to establish the proper therapeutic plan.
Method : The incidence of MDRTB among 161 patients diagnosed as pulmonary tuberculosis by the AFB culture between January 1997 and June 2000, and the relationship of MDRTB with the history of previous therapy, associated diseases, bronchial involvement, and the consequence of treatment were studied retrospectively.
Results : Forty eight (29.8%) patients were resistant to at least one drug and 27 (16.8%) patients suffered from MDRTB. Among the MDRTB patients, 22 had the previous history of therapy. More than 30 percent of all the patients had associated diseases, such as diabetes mellitus, malignancy, chronic liver disease, systemic erythematous lupus or psychosis. Endobronchial lesions suggesting bronchial involvement of tuberculosis were found in 37 (35%) patients. Out of the 16 patients eligible for the efficacy of treatment among 27 MDRTB patients, nine (56.3%) patients were treated successfully but seven (43.8%) were failed.
Conclusion : Prevalence of MDRTB was high especially in patients with previous therapy history and the result of treatment was modest in this study. It is imperative to prevent the emergence of drug resistance by the proper delivery of chemotherapy and the development of new drugs.