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Multi-center Study on Cost Effectiveness of Anti-Tuberculosis Drug Susceptibility Test
Seok Hoon Jeong, M.D.1, Dae Dong Lee, M.D.2, Jae-Cheol Choi, M.D.2, Sunjoo Kim, M.D.3, Jeong Hwan Shin, M.D.4Joseph Jeong, M.D.5, Eun Yup Lee, M.D.2, Seung Hwan Oh, M.D.2, Gill-Han Bai, Ph.D.6, Chulhun L. Chang, M.D.2,6,7
1Department of Laboratory Medicine, Kosin University College of Medicine, Busan2Department of Laboratory Medicine, College of Medicine, Pusan National University, Busan3Department of Laboratory Medicine, School of Medicine, Gyeongsang National Universit
Vol.37 Num.1 (p16~21)
Background:The anti-mycobacterial susceptibility test is performed on only a small percentage of clinical isolates in Korea. The aim of this study is to propose an anti-mycobacterial susceptibility testing scheme, which is not only economic and practical but also fully informative to physicians.
Materials and Methods:The anti-mycobacterial susceptibility test results of 502 strains, isolated from five university-affiliated hospitals, were analysed. The interpretation of the results and the need for second-line drug susceptibility test were judged according to the recommendation of NCCLS M24-A guidelines.
Results:The isolates from 10% (38/363) of treatment-navie patients and 61% (85/139) of re- treatment patients showed resistance to at least one of the anti-mycobactial agents; 3% (11/363) and 44% (61/139) of isolates from each group were multi-drug resistant. According to the recommendation by NCCLS, the percentage of patients not needing the susceptibility test results for second-line drugs were 96% for treatment-naive and 47% for re-treatment patients.
Conclusion:Since the susceptibility test against first-line drug is sufficient for 95% of treatment- navie patients with tuberculosis patients, susceptibility test against second-line drugs may be performed only when it is necessary. As for the re-treatment patients with tuberculosis, susceptibility test for both first-line and second-line drugs should be performed simultaneously.
Keywords : Mycobacterium tuberculosis, Anti-tuberculosis susceptibility test, Cost effectiveness