Authors: Jeon, D.S.¹; Kim, D.H.²; Kang, H.S.²; Hwang, S.H.²; Min, J.H.²; Kim, J.H.²; Sung, N.M.²; Carroll, M.W.³; Park, S.K.¹

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 5, May 2009 , pp. 594-600(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: A tuberculosis (TB) referral hospital in South Korea.

OBJECTIVE: To evaluate predictors of treatment outcomes and survival among non-human immunodeficiency virus (HIV) infected patients with extensively drug-resistant TB (XDR-TB).

DESIGN: Patients who were diagnosed with XDR-TB at the National Masan Tuberculosis Hospital from January 2001 to December 2005 were included in this study. We conducted a retrospective review of their medical records and mortality data.

RESULTS: A total of 176 non-HIV-infected patients with XDR-TB were included. TB-related mortality was 48% (84/176), and the median survival time from the diagnosis date of XDR-TB was 51 months (range 0-127, 95%CI 32.53-69.47). Cure and treatment completion were classified as favourable outcome and treatment failure, death during treatment and default as poor outcome. Previous TB treatment with second-line drugs (aOR 2.76, 95%CI 1.02-7.44) and cavitary disease (aOR 3.01, 95%CI 1.12-8.08) were independent risk factors for poor outcome. Use of linezolid (aOR 0.10, 95%CI 0.01-0.69) and surgical resection (aOR 0.18, 95%CI 0.04-0.78) were associated with favourable outcome.

CONCLUSION: There was high mortality in non-HIV-infected patients with XDR-TB at a TB referral hospital in South Korea. Adjunctive surgical treatment and linezolid improved the outcome for selected patients with XDR-TB.

Keywords: tuberculosis; multidrug-resistant; extensively drug-resistant tuberculosis

Document Type: Regular paper

Affiliations: 1: National Masan Tuberculosis Hospital, Masan, South Korea; and International Tuberculosis Research Center, Masan, South Korea 2: National Masan Tuberculosis Hospital, Masan, South Korea 3: Tuberculosis Research Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA

Publication date: 2009-05-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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