Korean J Intern Med.  2019 Mar;34(2):344-352. 10.3904/kjim.2018.052.

Trend of multidrug and fluoroquinolone resistance in Mycobacterium tuberculosis isolates from 2010 to 2014 in Korea: a multicenter study

Affiliations
  • 1Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. sooli10@hanmail.net
  • 2Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
  • 3Department of Internal Medicine, Dong-A University Hospital, Busan, Korea.
  • 4Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea.
  • 5Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
  • 6Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
  • 7Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea.

Abstract

BACKGROUND/AIMS
This study was conducted to evaluate the recent prevalence and trend of anti-tuberculosis (TB) drug resistance with a focus on multidrug-resistance (MDR) and fluoroquinolone resistance in South Korea.
METHODS
We retrospectively reviewed the drug susceptibility testing results of culture-confirmed Mycobacterium tuberculosis isolates collected from 2010 to 2014 at seven tertiary hospitals in South Korea.
RESULTS
A total of 5,599 cases were included: 4,927 (88.0%) were new cases and 672 (12.0%) were previously treated cases. The MDR rate has significantly decreased from 6.0% in 2010 to 3.0% in 2014 among new cases, and from 28.6% in 2010 to 18.4% in 2014 among previously treated cases (p < 0.001 and p = 0.027, respectively). The resistance rate to any fluoroquinolone was 0.8% (43/5,221) in non-MDR-TB patients, as compared to 26.2% (99/378) in MDR-TB patients (p < 0.001). There was no significant change in the trend of fluoroquinolone resistance among both nonMDR-TB and MDR-TB patients. Among the 43 non-MDR-TB patients with fluoroquinolone resistance, 38 (88.4%) had fluoroquinolone mono-resistant isolates.
CONCLUSIONS
The prevalence of MDR-TB has significantly decreased from 2010 to 2014. The prevalence of fluoroquinolone resistance among non-MDR-TB patients was low, but the existence of fluoroquinolone mono-resistant TB may be a warning on the widespread use of fluoroquinolone in the community.

Keyword

Drug resistance; Tuberculosis; Tuberculosis, multidrug-resistant; Fluoroquinolones; Korea
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