초회다제내성 결핵의 위험요인

Risk Factors for Primary Multidrug Resistant Tuberculosis

  • 투고 : 2005.09.13
  • 심사 : 2005.10.12
  • 발행 : 2005.12.30

초록

목 적 : 결핵약으로 치료 받은 적이 없으면서 최소한 아이소니아지드와 리팜핀에 동시에 내성이 있는 결핵균에 감염된 결핵을 초회다제내성 결핵이라 하며 이는 다제내성결핵균에 감염되어 발병한다. 근래에 초회내성결핵은 결핵관리 프로그램의 수행에 있어 중요한 지표로 사용되고 있다. 저자들은 초회다제내성 결핵의 위험요인을 알아내기 위해 환자대조군 연구를 시행하였다. 방 법 : 2001년 1월 1일부터 2003년 6월 30일 동안 국립마산병원에 입원한 29명의 초회다제내성결핵 환자들을 대상으로 환자군을 설정하였고, 대조군은 같은 기간 동안 본원에 입원한 모든 약제에 감성인 결핵환자들을 대상으로 하였다. 초회다제내성 결핵에 대한 의심되는 위험요인들의 교차비를 계산하였다. 결 과 : 다변량로지스틱회귀분석 결과 당뇨병이 초회다제내성 결핵과 통계적으로 유의한 연관성이 있었다(교차비 2.68; 95% 신뢰구간 1.05-6.86). 결 론 : 초회다제내성 결핵의 위험인자로서 당뇨병을 의심할 수 있었으며 향후 추구 연구가 요구된다.

Background : Primary multidrug-resistant tuberculosis is defined as Mycobacterium tuberculosis isolates that are resistant to at least isoniazid and rifampin in never-been-treated tuberculosis patients, and this malady is caused by the transmission of a resistant strain from one patient, who is infected with a resistant Mycobacterium tuberculosis strain, to another patient. The prevalence of primary multidrug-resistant tuberculosis could be a good indicator of the performance of tuberculosis control programs in recent years. We conducted a case-control study to identify the risk factors for primary multidrug-resistant tuberculosis. Methods : From January 1, 2001 to, June 30, 2003, by conducting prospective laboratory-based surveillance, we identified 29 hospitalized patients with P-MDRTB and these patients constituted a case group in this study. The controls were represented by all the patients with culture-confirmed drug susceptible tuberculosis who were admitted to National Masan Hospital during the same study period. The odds ratios for the patients with primary multidrug-resistant tuberculosis, as compared with those of the patients with drug susceptible tuberculosis, were calculated for each categorical variable with 95% confidence intervals. Results : Multivariate logistic regression showed that the presence of diabetes mellitus (odds ratio 2.68; 95% confidence interval, 1.05-6.86) was independently associated with having primary multidrug-resistant tuberculosis. Conclusion : This study has shown that diabetes mellitus might be one of the risk factors for primary multidrug-resistant tuberculosis.

키워드

참고문헌

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