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Drug resistance of Mycobacterium tuberculosis in children

Korean Journal of Pediatrics 2009;52(1):61-67.
Published online January 15, 2009.
Drug resistance of Mycobacterium tuberculosis in children
Soo Jin Lee1, Young Min Ahn1, Hee Jin Kim2
1Departments of Pediatrics, College of Medicine, Eulji University, Daejeon, Korea
2Department of Epidemiology, The Korean Institute of Tuberculosis, Seoul, Korea
소아 결핵 환자에서의 항결핵제 내성 II
이수진1, 안영민1, 김희진2
1을지대학교 의과대학 소아과학교실
2대한결핵협회 결핵연구원
Correspondence: 
Young Min Ahn, Email: aym3216@eulji.ac.kr
Abstract
Purpose
: The rate of drug-resistant tuberculosis (DR-TB) in children is an indicator of the effectiveness of TB control programs in the community. This study aimed to assess the prevalence of DR-TB in children and evaluate TB management.
Methods
: Between January 1999 and July 2007, drug susceptibility tests for anti-TB drugs were employed for patients aged less than 19 years with culture-positive TB.
Results
: A total of 607 cases (16.6%) were resistant to at least one anti-TB drug as follows: isoniazid (INH; 13.8%), rifampin (8.9%), pyrazinamide (4.2%), streptomycin (3.7%), ethambutol (EMB; 5.9%), and para-aminosalicylic acid (PAS; 1.9%). Multidrug-resistant (MDR) TB was found in 276 cases (7.6%); extensive drug resistant (XDR) TB, in 5 cases (0.2%). The rate of resistance to at least one anti-TB drug in children aged >15 years (16.1%) was significantly lower than that in children aged <15 years (20.5%) (P=0.016). The rate of resistance to at least one anti-TB drug and multidrug-resistance in this survey decreased significantly (P<0.001) as compared to the previous survey (1987-1995). The rate of resistance to INH, EMB, and PAS also significantly decreased (P<0.05).
Conclusion
: The rate of DR-TB in children in Korea has decreased over time; however, it remains higher than that in other countries. MDR-TB and XDR-TB are the emerging problems in Korean children. Therefore, the selection of effective drugs through drug susceptibility tests and evaluating risk factors of resistant TB is essential to successful therapy and a decreased incidence of DR-TB.
Key Words: Tuberculosis, Drug-resistant, Multidrug-resistant tuberculosis, Children


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