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J Korean Med Sci. 2017 Jul;32(7):1105-1110. doi: 10.3346/jkms.2017.32.7.1105.

Characteristics of Drug Resistant Tuberculosis in Sanatoria of North Korea.

Author information

1
Clinical Research Center, Masan National Tuberculosis Hospital, Changwon, Korea.
2
Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
3
Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
4
Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.
5
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
6
Clinical Research Center, Masan National Tuberculosis Hospital, Changwon, Korea. paratb@gmail.com.

Abstract

Although several reports about drug-resistant tuberculosis (TB) in North Korea have been published, a nationwide surveillance on this disease remains to be performed. This study aims to analyze the drug resistance patterns of Mycobacterium tuberculosis among the patients in the sanatoria of North Korea, especially during the period when second-line drugs (SLDs) had not yet been officially supplied to this country. The Eugene Bell Foundation (EBF) transferred 947 sputum specimens obtained from 667 patients from 2007 to 2009 to the Clinical Research Center, Masan National Tuberculosis Hospital (MNTH), South Korea. Four hundred ninety-two patients were culture positive for TB (73.8%). Drug susceptibility test (DST) was performed for the bacilli isolated from 489 patients. Over 3 quarters of the cases (76.9%) were multidrug-resistant (MDR)-TB. Additionally, 2 patients had extremely drug-resistant (XDR)-TB. Very high resistance to first-line drugs and low resistance to fluoroquinolones (FQs) and injectable drugs (IDs) except for streptomycin (S) were detected. A small but significant regional variation in resistance pattern was observed. Big city regions had higher rate of MDR-TB, higher resistance to FQs and IDs than relatively isolated regions. In conclusion, significant number of drug-resistant TB was detected in North Korean sanatoria, and small but significant regional variations in resistance pattern were noticeable. However, the data in this study do not represent the nationwide drug resistance pattern in North Korea. Further large-scale evaluations are necessary to estimate the resistance pattern of TB in North Korea.

KEYWORDS:

Drug Resistance; North Korea; Tuberculosis

PMID:
28581266
PMCID:
PMC5461313
[Available on 2017-07-01]
DOI:
10.3346/jkms.2017.32.7.1105
[Indexed for MEDLINE]
Free PMC Article

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