Impact of Molecular Drug Susceptibility Testing on the Time to Multidrug-resistant Tuberculosis Treatment Initiation

• DOI: 10.3346/jkms.2020.35.e284
• Publication Date: 2020-08-04T01:18:15Z
• Authors: Doosoo Jeon; Hyungseok Kang; Yong-Soo Kwon; Jae-Joon Yim; Tae Sun Shim
• Keywords: Interquartile range; Extensively drug-resistant tuberculosis; Multi-drug-resistant tuberculosis; Bedaquiline; Medical record

BACKGROUND The purpose of this study was to evaluate the current status and trends in coverage molecular drug susceptibility testing (mDST), impact mDST on time multidrug-resistant tuberculosis (MDR-TB) treatment initiation Korea. METHODS We included confirmed rifampin-resistant (RR)/MDR-TB patients who submitted application forms for novel uses National TB Expert Review Committee from September 1, 2016 November 30, 2019. retrospectively reviewed their medical records. RESULTS Of 621 MDR/RR-TB patients, performed 442 (71.2%); Xpert MTB/RIF (Xpert) alone 109 (17.6%), MTBDRplus line probe assay (LPA) 199 (32.0%), both LPA 134 (21.6%) patients. rate has gradually increased 70% 2015, 50.7% 2016, 67.9% 2017, 75.2% 2018, 79.4% 2019 (P trend < 0.001). Median MDR-TB 35 days (interquartile range25-75 0-72), which decreased during period Independent predictors shorter were retreatment case (adjusted hazard ratio [aHR], 1.30; 95% confidence interval [CI], 1.10-1.54), (aHR, 2.42; CI, 2.03-2.88), 1.83; 1.55-2.16). Transfer another healthcare facility inversely related 0.74; 0.63-0.88). CONCLUSION is increasing contributes reducing initiation. Further efforts are needed achieve universal access properly integrate into routine clinical practice.