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Multidrug-resistant pulmonary tuberculosis among young Korean soldiers in a communal setting.

Lee SW, Jeon K, Kim KH, Min KH - J. Korean Med. Sci. (2009)

Bottom Line: All patients with culture-confirmed pulmonary tuberculosis during their service at the Armed Forces Capital Hospital from January 2001 to December 2006 were enrolled in the study.Drug resistant Mycobacterium tuberculosis was isolated from 18 patients (12.2%) and multidrug-resistant M. tuberculosis was isolated from 12 patients (8.1%).The prevalence of drug resistant tuberculosis among young soldiers in the Korean military was moderately high and the majority of resistant cases were found in patients who had undergone previous treatment of tuberculosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea.

ABSTRACT
The goal of this study was to evaluate the prevalence of first-line anti-tuberculosis drug resistance and risk factors associated with multidrug-resistant tuberculosis (MDR TB) among young soldiers in the Korean military, which has a strict tuberculosis control program. All patients with culture-confirmed pulmonary tuberculosis during their service at the Armed Forces Capital Hospital from January 2001 to December 2006 were enrolled in the study. Drug resistant Mycobacterium tuberculosis was isolated from 18 patients (12.2%) and multidrug-resistant M. tuberculosis was isolated from 12 patients (8.1%). Previous treatment of tuberculosis and the presence of a cavity on the patient's chest computed tomography scan were associated with MDR TB; military rank, smoking habits, and positive acid-fast bacilli smears were not associated with MDR TB. In a multiple logistic regression analysis, previous treatment of tuberculosis was a significant independent risk factor for MDR TB (odds ratio 6.12, 95% confidence interval 1.53-24.46). The prevalence of drug resistant tuberculosis among young soldiers in the Korean military was moderately high and the majority of resistant cases were found in patients who had undergone previous treatment of tuberculosis. Based on our results, we suggest that relapsed tuberculosis cases within communal settings should be cautiously managed until the drug susceptibility tests report is completed, even if previous treatment results were satisfactory.

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Multi-drug resistance (MDR) among pulmonary tuberculosis (TB) cases according to military rank.
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Figure 1: Multi-drug resistance (MDR) among pulmonary tuberculosis (TB) cases according to military rank.

Mentions: There was no relationship between the development of MDR TB and military rank (P=0.225, test for trends; Fig. 1). In addition, no significant differences were observed in terms of smoking history or sputum smear results between groups (P=0.658 and 0.367, respectively; Table 2). Patients with MDR TB were more likely to have received previous treatment of tuberculosis compared to patients with non-MDR TB (58.3% vs. 16.2%, P=0.002; Table 2). In addition, patients with MDR TB were more likely to have exhibited a cavity on the chest CT (75.0%) compared to patients with non-MDR TB (39.7%, P=0.018; Table 2). In the multiple logistic regression analysis, previous treatment of tuberculosis was a significant independent risk factor for MDR TB (odds ratio 6.12, 95% confidence interval 1.53-24.46). However, military rank, smoking, positive AFB smear and cavity on chest CT were not associated with development of MDR TB (Table 2).


Multidrug-resistant pulmonary tuberculosis among young Korean soldiers in a communal setting.

Lee SW, Jeon K, Kim KH, Min KH - J. Korean Med. Sci. (2009)

Multi-drug resistance (MDR) among pulmonary tuberculosis (TB) cases according to military rank.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2719201&req=5

Figure 1: Multi-drug resistance (MDR) among pulmonary tuberculosis (TB) cases according to military rank.
Mentions: There was no relationship between the development of MDR TB and military rank (P=0.225, test for trends; Fig. 1). In addition, no significant differences were observed in terms of smoking history or sputum smear results between groups (P=0.658 and 0.367, respectively; Table 2). Patients with MDR TB were more likely to have received previous treatment of tuberculosis compared to patients with non-MDR TB (58.3% vs. 16.2%, P=0.002; Table 2). In addition, patients with MDR TB were more likely to have exhibited a cavity on the chest CT (75.0%) compared to patients with non-MDR TB (39.7%, P=0.018; Table 2). In the multiple logistic regression analysis, previous treatment of tuberculosis was a significant independent risk factor for MDR TB (odds ratio 6.12, 95% confidence interval 1.53-24.46). However, military rank, smoking, positive AFB smear and cavity on chest CT were not associated with development of MDR TB (Table 2).

Bottom Line: All patients with culture-confirmed pulmonary tuberculosis during their service at the Armed Forces Capital Hospital from January 2001 to December 2006 were enrolled in the study.Drug resistant Mycobacterium tuberculosis was isolated from 18 patients (12.2%) and multidrug-resistant M. tuberculosis was isolated from 12 patients (8.1%).The prevalence of drug resistant tuberculosis among young soldiers in the Korean military was moderately high and the majority of resistant cases were found in patients who had undergone previous treatment of tuberculosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Armed Forces Capital Hospital, Seongnam, Korea.

ABSTRACT
The goal of this study was to evaluate the prevalence of first-line anti-tuberculosis drug resistance and risk factors associated with multidrug-resistant tuberculosis (MDR TB) among young soldiers in the Korean military, which has a strict tuberculosis control program. All patients with culture-confirmed pulmonary tuberculosis during their service at the Armed Forces Capital Hospital from January 2001 to December 2006 were enrolled in the study. Drug resistant Mycobacterium tuberculosis was isolated from 18 patients (12.2%) and multidrug-resistant M. tuberculosis was isolated from 12 patients (8.1%). Previous treatment of tuberculosis and the presence of a cavity on the patient's chest computed tomography scan were associated with MDR TB; military rank, smoking habits, and positive acid-fast bacilli smears were not associated with MDR TB. In a multiple logistic regression analysis, previous treatment of tuberculosis was a significant independent risk factor for MDR TB (odds ratio 6.12, 95% confidence interval 1.53-24.46). The prevalence of drug resistant tuberculosis among young soldiers in the Korean military was moderately high and the majority of resistant cases were found in patients who had undergone previous treatment of tuberculosis. Based on our results, we suggest that relapsed tuberculosis cases within communal settings should be cautiously managed until the drug susceptibility tests report is completed, even if previous treatment results were satisfactory.

Show MeSH
Related in: MedlinePlus