Age-stratified anti-tuberculosis drug resistance profiles in South Korea: a multicenter retrospective study

• Published in: BMC infectious diseases Vol. 20; no. 1; p. 446
• Main Authors: Lee, Eung Gu, Min, Jinsoo, Kang, Ji Young, Kim, Sung Kyoung, Kim, Jin Woo, Kim, Yong Hyun, Yoon, Hyoung Kyu, Lee, Sang Haak, Kim, Hyung Woo, Kim, Ju Sang
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23.06.2020; BioMed Central; BMC
• Subjects: Adolescent; Adult; Age; Age Factors; Age groups; Analysis; Antibiotics; Antitubercular Agents - therapeutic use; Chi-square test; Direct reduction; Drug resistance; Drug Resistance, Multiple, Bacterial - drug effects; Drug therapy; Drug-resistant tuberculosis; Drugs; Elderly population; Female; Fluoroquinolone; Fluoroquinolones; Fluoroquinolones - therapeutic use; Humans; Infectious diseases; Isoniazid; Isoniazid - therapeutic use; Laboratories; Male; Microbial drug resistance; Middle Aged; Multidrug resistance; Multidrug resistant organisms; Multidrug-resistant tuberculosis; Mycobacterium tuberculosis - drug effects; Patient compliance; Patients; Public health; Republic of Korea; Retrospective Studies; Rifabutin; Rifampicin; Rifampin; Rifampin - therapeutic use; Socioeconomic factors; Statistical tests; Subgroups; Treatment Outcome; Trends; Tuberculosis; Tuberculosis, Multidrug-Resistant - drug therapy; Young Adult; Republic of Korea; South Korea; Drug-resistant tuberculosis; Multidrug-resistant tuberculosis; Fluoroquinolone; Rifampicin; Elderly population; Isoniazid
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-020-05157-6

The emergence of drug-resistant tuberculosis (DR-TB) is a major healthcare concern worldwide. Here, we analyzed age-related trends in DR-TB rates in South Korea. Drug susceptibility test results were collected from patients with culture-confirmed TB between 2015 and 2018 from eight university-affiliated hospitals. Patients were divided into three subgroups: younger (15-34 years), middle (35-59 years), and older (≥60 years) to compare drug-resistance patterns. To evaluate trends in age-stratified drug-resistance, chi-square test for linear trends was performed. Among enrolled native patients aged ≥15 years, 4.1% (179/4417), 1.2% (53/4417) and 7.2% (316/4417) were multidrug-resistant TB (MDR-TB), rifampicin-mono-resistant TB (RR-TB), and isoniazid-mono-resistant TB (Hr-TB), respectively. Proportions of Hr-TB cases were 5.4% (40/734), 7.2% (114/1593), and 7.8% (162/2090) in the younger, middle and older age groups, respectively. MDR/RR-TB case rates decreased significantly with age from 8.6% (63/734) in younger age group to 3.3% (68/2090) in older age group. Fluoroquinolone resistance was highest among second-line drugs, and there were no differences in resistance to fluoroquinolones and second-line injectable drugs among the three age groups. The number of MDR/RR-TB cases was highest in young patients. Effective public health interventions should include increased focus on rifampicin resistance in young patients.