Document Detail


Clinical characteristics of pulmonary tuberculosis patients from a southern Taiwan hospital-based survey.
MedLine Citation:
PMID:  18218565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study aimed to identify the clinical characteristics of culture-positive pulmonary tuberculosis (TB) patients from a southern Taiwan hospital-based survey between August 1, 2003 and July 31, 2006. Demographics, symptoms, susceptibility patterns, sputum acid-fast bacilli (AFB) stain status and treatment outcomes were recorded. The medical records of 154 patients who presented to the Kaohsiung Municipal Hsiao-Kang Hospital were analyzed retrospectively. The mean age of patients was 59.5 years; 115 patients were male and 39 were female. Diabetes mellitus (48/154; 31.2%) was the most frequent risk factor for pulmonary TB infection. Nearly all patients (139/154; 90.3%) had a cough. Fever was only seen in 27.9% and hemoptysis in 14.9% of patients. The combined resistance rates of Mycobacterium tuberculosis to the tested first-line agents were as follows: isoniazid, 3.2%; rifampin, 7.8%; ethambutol, 5.8%; and streptomycin, 2.6%. The combined resistance rate to any one of four first-line drugs was 12.3%. The combined resistance rate to ofloxacin was 3.9%. The combined resistance rate of multidrug resistant-TB was 1.9%. Sputum AFB stains were positive in 68.2% of cases. Analysis of treatment outcomes showed overall treatment success at 76.6%. The proportions of patients who died, defaulted treatment or in whom treatment failed were 16.2%, 3.9% and 0.0%, respectively. In conclusion, our study showed: (1) a higher frequency of pulmonary TB in male subjects than in other areas of Taiwan; (2) a higher frequency of cough and lower frequency of fever and hemoptysis than previous studies; (3) that the combined resistance rates to isoniazid and streptomycin were lower than both average levels in Taiwan and the global combined drug resistance rate; and (4) a higher proportion of patients responding to treatment and lower proportions of patients suffering mortality, defaulting treatment or not responding to treatment compared with other areas of Taiwan. With regard to resistance rates, the combined resistance rate to ethambutol was similar to the average level in Taiwan and higher than the global combined drug resistance rate. However, the combined resistance rate to rifampin was higher than both the average level in Taiwan and the global combined drug resistance rate. The combined resistance rates to at least any one of four first-line drugs and multidrug resistant-TB were lower than the average levels in Taiwan and higher than the global combined drug resistance rate. Our results may help to identify local variations in the disease and improve the effectiveness of TB infection control programs.
Authors:
Chuan-Sheng Wang; Huang-Chi Chen; Chih-Jen Yang; Jong-Rung Tsai; Inn-Wen Chong; Jhi-Jhu Hwang; Ming-Shyan Huang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Kaohsiung journal of medical sciences     Volume:  24     ISSN:  1607-551X     ISO Abbreviation:  Kaohsiung J. Med. Sci.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-25     Completed Date:  2008-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100960562     Medline TA:  Kaohsiung J Med Sci     Country:  China (Republic : 1949- )    
Other Details:
Languages:  eng     Pagination:  17-24     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Taiwan / epidemiology
Treatment Outcome
Tuberculosis, Multidrug-Resistant / drug therapy,  epidemiology*
Tuberculosis, Pulmonary / drug therapy,  epidemiology*

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