Ann Lab Med 2017; 37(4): 323-326  
Drug Resistance Patterns of Multidrug- and Extensively Drug-Resistant Tuberculosis in Korea: Amplification of Resistance to Oral Second-line Drugs
Chang-Ki Kim, M.D.1,*, So Youn Shin, M.D.2, Hee Jin Kim, M.D.2, and Kyungwon Lee, M.D.3
Department of Laboratory Medicine1, Hanyang University Guri Hospital, Guri; Korean Institute of Tuberculosis2, Cheongju; Department of Laboratory Medicine3, Yonsei University College of Medicine, Seoul, Korea
Correspondence to: So Youn Shin
Korean Institute of Tuberculosis, 168-5 Osongsaengmyung 4-ro, Osong-eup, Heungdeok-gu, Cheongju 28158, Korea
Tel: +82-43-249-4940
Fax: +82-43-249-4971
E-mail: leukoso@daum.net
* Present affiliation: Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Korea
Received: September 19, 2016; Revised: December 6, 2016; Accepted: March 22, 2017; Published online: July 1, 2017.
© The Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
We aimed to analyze the drug resistance patterns of multidrug-resistant and extensively drug-resistant tuberculosis (TB) and the difference of drug resistance among various settings for health care in Korea. The data of drug susceptibility testing in 2009 was analyzed in order to secure sufficient number of patients from various settings in Korea. Patients were categorized by types of institutions into four groups, which comprised new and previously treated patients from public health care centers (PHC), the private sector, and Double-barred Cross clinics (DBC). The resistance rates to first-line drugs were uniformly high in every group. While the resistance rates to second-line drugs were not as high as first-line drugs, there was a pattern that drug resistance rates were lowest for PHC and highest for DBC. The differences of the resistance rates were more prominent for oral second-line drugs. Our findings implied that drug resistance to oral second-line drugs was significantly amplified during multidrug-resistant-TB treatment in Korea. Therefore, an individualized approach is recommended for treating drug-resistant-TB based on susceptibility testing results to prevent acquisition or amplification of drug resistance.
Keywords: Multidrug-resistant tuberculosis, Extensively drug-resistant tuberculosis, Drug susceptibility testing


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