Clinical profiles of multidrug-resistant and rifampicin-monoresistant tuberculosis in Korea, 2018-2021: a nationwide cross-sectional study

Jinsoo Min; Yousang Ko; Hyung Woo Kim; Hyeon-Kyoung Koo; Jee Youn Oh; Doosoo Jeon; Taehoon Lee; Young-Chul Kim; Sung Chul Lim; Sung Soon Lee; Jae Seuk Park; Ju Sang Kim

doi:10.4046/trd.2024.0049

Clinical profiles of multidrug-resistant and rifampicin-monoresistant tuberculosis in Korea, 2018-2021: a nationwide cross-sectional study

Tuberc Respir Dis (Seoul). 2024 Sep 23. doi: 10.4046/trd.2024.0049. Online ahead of print.

Authors

Jinsoo Min¹, Yousang Ko², Hyung Woo Kim³, Hyeon-Kyoung Koo⁴, Jee Youn Oh⁵, Doosoo Jeon⁶, Taehoon Lee⁷, Young-Chul Kim⁸, Sung Chul Lim⁹, Sung Soon Lee⁴, Jae Seuk Park¹⁰, Ju Sang Kim³

Affiliations

¹ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
² Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
³ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
⁴ Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
⁵ Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
⁶ Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
⁷ Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
⁸ Department of Internal Medicine, Chonnam National University Medical School, and Chonnam National University Hwasun Hospital, Hwasun, Jeonnam, Republic of Korea.
⁹ Department of Internal Medicine, Chonnam National University, Gwanju, Republic of Korea.
¹⁰ Division of Pulmonology, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.

PMID: 39308276
DOI: 10.4046/trd.2024.0049

Abstract

Background: This study aimed to identify the clinical characteristics of multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) in the Republic of Korea.

Methods: Data of notified people with tuberculosis between July 2018 and December 2021 were retrieved from the Korea Tuberculosis Cohort database. MDR/RR-TB was further categorized according to isoniazid susceptibility as follows: (1) MDR-TB, (2) rifampicin-monoresistant tuberculosis (RMR-TB), and (3) RR-TB if susceptibility to isoniazid was unknown. Multivariable logistic regression analysis was conducted to identify the factors associated with MDR/RR-TB.

Results: Between 2018 and 2021, the proportion of MDR/RR-TB cases among all TB cases and TB cases with known drug susceptibility test results was 2.1% (502/24,447). The proportions of MDR/RR-TB and MDR-TB cases among TB cases with known drug susceptibility test results were 3.3% (502/15,071) and 1.9% (292/15,071), respectively. Among all cases of rifampicin resistance, 31.7% (159/502) were RMR-TB and 10.2% (51/502) were RR-TB. Multivariable logistic regression analyses revealed that younger age, foreigners, and prior tuberculosis history were significantly associated with MDR/RR-TB.

Conclusion: Rapid identification of rifampicin resistance targeting the high-risk populations, such as younger generations, foreign-born individuals, and previously treated patients are necessary for patient-centered care.

Keywords: Rifampicin, MDR/RR-TB, Prevalence.