Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals

Background: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control.In Korea, about 75∼80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000.Methods: On a retrospective basis, we enrolled 170 newly diagnosed with or retreated for multidrug-resistant TB (MDR-TB) in 2004 from 21 private hospitals.We extracted the following demographics and treatment history from patient medical records: initial treatment outcomes, cumulative survival rates, treatment outcomes, and prognostic factors.Results: Of the 170 patients, the majority were male (64.1%), the mean age was 44.5 years old, and mean bodymass-index was 20.2 kg/m 2 .None of the patients tested positive for HIV.Eleven (6.5%) were confirmed to have extensively drug-resistant TB (XDR-TB) at treatment initiation.Treatment success rates were not different between XDR-TB (36.4%, 4/11) and non-XDR MDR-TB (51.6%, 82/159).Default rate was high, 21.8% (37/170).Far advanced disease on X-ray was a significant negative predictor of treatment success; advanced disease and low BMI were risk factors for all-cause mortality.Conclusion: In private hospitals in Korea, the proportion of XDR-TB in MDR-TB was comparable to previous data.The treatment success rate of MDR-/XDR-TB remains poor and the failure rate was quite high.Adequate TB control policies should be strengthened to prevent the further development and spread of MDR-/XDR-TB in Korea.