Treatment Outcomes and Long-term Survival in Patients with Extensively Drug-resistant Tuberculosis
Treatment Outcomes and Long-term Survival in Patients with Extensively Drug-resistant Tuberculosis
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DOI：
10.1164/rccm.200801-132oc
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发表时间：
2008-11-15
影响因子：
24.7
通讯作者：
Shim, Tae Sun
中科院分区：
文献类型：
--
作者：
Kim, Doh Hyung;Kim, Hee Jin;Shim, Tae Sun
理论基础：广泛耐药结核病(XDR-TB)在全球范围内的发病率不断上升，已成为对公共卫生和结核病(TB)控制的威胁。目的：回顾分析韩国HIV阴性耐多药结核病(MDR-TB)队列中广泛耐药结核病患者的负担、临床特征、治疗结果和长期生存率。方法：回顾2000-2002年间新诊断或重新治疗的耐多药结核病患者的病历。在治疗开始后，对队列进行了3至7年的监测。分析初始治疗结果和累积存活率，定义治疗成功和生存的预测因素。测量和主要结果：在1,407例耐多药结核病患者中，75例(5.3%)在治疗开始时患有广泛耐药结核病。广泛耐药结核患者的治疗成功率较低(29.3vs.46.2%；P=0.004)，全因死亡率(49.3vs.19.4%；P<；0.001)和结核病相关疾病死亡率(41.3vs.11.8%；P=0.001)较高。
Rationale: The increasing worldwide incidence of extensively drug-resistant tuberculosis (XDR-TB) has emerged as a threat to public health and tuberculosis (TB) control. Treatment outcomes have varied among studies, and data on long-term survival are still scarce.Objectives: To retrospectively assess the burden, clinical characteristics, treatment outcomes, and long-term survival rate of patients with XDR-TB in a cohort of patients with HIV-negative multidrug-resistant tuberculosis (MDR-TB) in South Korea.Methods: Medical records were reviewed of patients newly diagnosed with or retreated for MDR-TB from 2000 to 2002. The cohort was monitored for 3 to 7 years after the initiation of treatment. Initial treatment outcomes and cumulative survival rates were analyzed, and predictors of treatment success and survival were defined.Measurements and Main Results: Of 1,407 patients with MDR-TB 75 (5.3%) had XDR-TB at treatment initiation. The default rate was high (453/1,407; 32%), and patients with XDR-TB had lower treatment success (29.3 vs. 46.2%; P = 0.004) and higher all-cause (49.3 vs. 19.4%; P < 0.001) and TB-related disease mortality (41.3 vs. 11.8%; P