TY - JOUR
T1 - Characteristics and treatment outcomes of isoniazid mono-resistant tuberculosis
T2 - A retrospective study
AU - Kwak, Se Hyun
AU - Choi, Ji Soo
AU - Lee, Eun Hye
AU - Lee, Su Hwan
AU - Leem, Ah Young
AU - Lee, Sang Hoon
AU - Kim, Song Yee
AU - Chung, Kyung Soo
AU - Kim, Eun Young
AU - Jung, Ji Ye
AU - Park, Moo Suk
AU - Kim, Young Sam
AU - Chang, Joon
AU - Kang, Young Ae
N1 - Publisher Copyright:
© Yonsei University College of Medicine 2020.
PY - 2020
Y1 - 2020
N2 - Purpose: Isoniazid (INH) mono-resistant tuberculosis (Hr-TB) is a highly prevalent type of drug-resistant TB, possibly associated with unfavorable treatment outcomes. However, definitive guidelines on an optimal treatment regimen and duration for Hr-TB are currently under discussion. We evaluated the characteristics and treatment outcomes of Hr-TB patients. Materials and Methods: We retrospectively reviewed the medical records of Hr-TB patients treated at a South Korean tertiary re-ferral hospital from January 2005 to December 2018. Results: We included 195 Hr-TB patients. 113 (57.9%) were male, and the median age was 56.6 [interquartile range, 40.2–68.6] years. Mutations in katG were the most frequent [54 (56.3%)], followed by those in the inhA [34 (35.4%)]. Favorable and unfavorable outcomes were noted in 164 (84.1%) and 31 (15.9%) patients, respectively. Smoking history [odds ratio (OR)=5.606, 95% con-fidence interval (CI): 1.695–18.543, p=0.005], low albumin level (OR=0.246, 95% CI: 0.104–0.578, p=0.001), and positive acid-fast bacilli culture at 2 months (OR=7.853, 95% CI: 1.246–49.506, p=0.028) were associated with unfavorable outcomes. Conclusion: A tailored strategy targeting high-risk patients is imperative for improved treatment outcomes. Further research on the rapid and accurate detection of resistance to INH and other companion drugs is warranted.
AB - Purpose: Isoniazid (INH) mono-resistant tuberculosis (Hr-TB) is a highly prevalent type of drug-resistant TB, possibly associated with unfavorable treatment outcomes. However, definitive guidelines on an optimal treatment regimen and duration for Hr-TB are currently under discussion. We evaluated the characteristics and treatment outcomes of Hr-TB patients. Materials and Methods: We retrospectively reviewed the medical records of Hr-TB patients treated at a South Korean tertiary re-ferral hospital from January 2005 to December 2018. Results: We included 195 Hr-TB patients. 113 (57.9%) were male, and the median age was 56.6 [interquartile range, 40.2–68.6] years. Mutations in katG were the most frequent [54 (56.3%)], followed by those in the inhA [34 (35.4%)]. Favorable and unfavorable outcomes were noted in 164 (84.1%) and 31 (15.9%) patients, respectively. Smoking history [odds ratio (OR)=5.606, 95% con-fidence interval (CI): 1.695–18.543, p=0.005], low albumin level (OR=0.246, 95% CI: 0.104–0.578, p=0.001), and positive acid-fast bacilli culture at 2 months (OR=7.853, 95% CI: 1.246–49.506, p=0.028) were associated with unfavorable outcomes. Conclusion: A tailored strategy targeting high-risk patients is imperative for improved treatment outcomes. Further research on the rapid and accurate detection of resistance to INH and other companion drugs is warranted.
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U2 - 10.3349/ymj.2020.61.12.1034
DO - 10.3349/ymj.2020.61.12.1034
M3 - Article
C2 - 33251777
AN - SCOPUS:85097037723
SN - 0513-5796
VL - 61
SP - 1034
EP - 1041
JO - Yonsei Medical Journal
JF - Yonsei Medical Journal
IS - 12
ER -
