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결핵균 약제감수성 검사의 비용효율성에 관한다기관 연구

Multi-center Study on Cost Effectiveness of Anti-Tuberculosis Drug Susceptibility Test

김선주|장철훈|신정환|오승환|최재철|정윤성|이은엽|이대동|배길한|정석훈
대한감염학회 (The Korean Society Of Infectious Diseases)|2005.02|Infection and Chemotherapy|제37권 제1호|pp. 12-21

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참고문헌

주제분류내과학

초록

목 적 : 우리나라에서의 결핵균 감수성 검사는 검출 균주의 일부에서만 시행되고 있다. 본 연구에서는 모든 검출 균주들에 대해서 감수성검사를 실시하면서, 진료에 필요한 결과를 충분히 제공하고 경제적이면서 현실적인 감수성검사 방안을 제시하고자 한다.재료 및 방법 : 5개 대학병원에서 일정기간 연속적으로 의뢰된 502균주의 감수성 결과를 분석하였다. 검사결과의 해석 및 2차 약제 감수성검사의 필요성은 NCCLS approved standard M24-A의 권고 기준에 따라 판단하였다.결 과 : 최소한 1가지 이상의 약제에 내성을 보인 경우는 초치료 환자의 10% (38/363), 재치료 환자의 61% (85/139)였으며, 다약제 내성을 보인 경우는 초치료 환자의 3% (11/363), 재치료 환자의 44% (61/139)였다. NCCLS 권고에 따라 2차 약제에 대한 감수성 검사를 시행하지 않아도 되는 경우는 초치료 환자의 96%, 재치료 환자의 47%였다.결 론:초치료 환자는 95%에서 1차 약제에 대한 검사만으로 충분하므로 필요한 경우에만 2차 약제를 추가로 검사하고 재치료 환자에서는 1, 2차 약제를 동시에 검사할 필요가 있을 것으로 생각한다.

Abstract

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.

참고문헌 (18)

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관련 논문AI추천

호흡기 검체에서 분리된 결핵균의 항결핵제 내성 실태: 국내 다기관 연구김자영, 박연준, 신종희, 이남용, 이미애, 장철훈대한임상미생물학회 · Annals of Clinical Microbiology2013 · 제16권 제1호Comparison of Anti-mycobacterial Drug Susceptibility Test Results by Institutes and Methods김영진, 김형회, 박승규, 오승환, 이은엽, 장철훈, 황상현대한임상미생물학회 · Annals of Clinical Microbiology2008 · 제11권 제1호항결핵제 감수성 결핵에서의 내성 변화 추이정무상, Kyutaeg Lee대한임상검사과학회 · 대한임상검사과학회지2021 · 제53권 제2호결핵균의 항결핵제 감수성 시험방법에 관한 고찰최철석대한임상검사과학회 · 대한임상검사과학회지1997 · 제29권 제1호내성 결핵균의 실태 및 치료임재준대한내과학회 · 대한내과학회지2009 · 제77권 제2호결핵균의 항결핵제 내성 전환 패턴정무상, Kyutaeg Lee대한임상검사과학회 · 대한임상검사과학회지2022 · 제54권 제2호

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