Characteristics and Treatment Outcomes of Isoniazid Mono-Resistant Tuberculosis: A Retrospective Study

• Published in: Yonsei medical journal 2020, 61(12), , pp.1034-1041
• Main Authors: Kwak, Se Hyun, Choi, Ji Soo, Lee, Eun Hye, Lee, Su Hwan, Leem, Ah Young, Lee, Sang Hoon, Kim, Song Yee, Chung, Kyung Soo, Kim, Eun Young, Jung, Ji Ye, Park, Moo Suk, Kim, Young Sam, Chang, Joon, Kang, Young Ae
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antitubercular Agents - pharmacology; Antitubercular Agents - therapeutic use; Female; Humans; Isoniazid - pharmacology; Isoniazid - therapeutic use; Male; Middle Aged; Mutation; Mycobacterium tuberculosis - drug effects; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - isolation & purification; Original; Prevalence; Republic of Korea - epidemiology; Retrospective Studies; Treatment Outcome; Tuberculosis - drug therapy; Tuberculosis, Multidrug-Resistant - drug therapy; 의학일반
• ISSN: 0513-5796; 1976-2437
• DOI: 10.3349/ymj.2020.61.12.1034

Isoniazid (INH) mono-resistant tuberculosis (Hr-TB) is a highly prevalent type of drug-resistant TB, possibly associated with unfavorable treatment outcomes. However, definitive guidelines on an optimal treatment regimen and duration for Hr-TB are currently under discussion. We evaluated the characteristics and treatment outcomes of Hr-TB patients. We retrospectively reviewed the medical records of Hr-TB patients treated at a South Korean tertiary referral hospital from January 2005 to December 2018. We included 195 Hr-TB patients. 113 (57.9%) were male, and the median age was 56.6 [interquartile range, 40.2-68.6] years. Mutations in were the most frequent [54 (56.3%)], followed by those in the [34 (35.4%)]. Favorable and unfavorable outcomes were noted in 164 (84.1%) and 31 (15.9%) patients, respectively. Smoking history [odds ratio (OR)=5.606, 95% confidence interval (CI): 1.695-18.543, =0.005], low albumin level (OR=0.246, 95% CI: 0.104-0.578, =0.001), and positive acid-fast bacilli culture at 2 months (OR=7.853, 95% CI: 1.246-49.506, =0.028) were associated with unfavorable outcomes. A tailored strategy targeting high-risk patients is imperative for improved treatment outcomes. Further research on the rapid and accurate detection of resistance to INH and other companion drugs is warranted.