Tuberc Respir Dis.  2016 Jan;79(1):1-4. 10.4046/trd.2016.79.1.1.

Issues Related to the Updated 2014 Korean Guidelines for Tuberculosis

• Park JS

• KMID: 2320749
• DOI: http://doi.org/10.4046/trd.2016.79.1.1

Abstract

Tuberculosis (TB) remains a major public health problem in South Korea. The Joint Committee for the Development of Korean Guidelines for Tuberculosis published the Korean Guidelines for Tuberculosis in 2011 to provide evidence-based practical recommendations to health care workers caring for patients with TB in South Korea. After reviewing recent national and international scientific data on TB, the committee updated the Korean guidelines for TB in 2014. This article presents some practical issues related to the 2014 updated guidelines: namely use of the Mycobacterium tuberculosis - polymerase chain reaction assay and the Xpert MTB/RIF assay in the diagnosis of TB, as well as medical treatment for patients with multidrug-resistant TB.

Keyword

Tuberculosis; Guidelines; Multidrug-Resistant Tuberculosis

MeSH Terms

Delivery of Health Care
Diagnosis
Humans
Joints
Korea
Mycobacterium tuberculosis
Polymerase Chain Reaction
Public Health
Tuberculosis*
Tuberculosis, Multidrug-Resistant

Figure

• 

  Figure 1 Algorithm for anti-tuberculosis (TB) drug selection to build up multidrug resistant TB treatment regimen. *Para-aminosalicylic acid should be selected only if prothionamide and cycloserine cannot be used or are unlikely to be effective and if an additional drug is needed to have at least four effective second-line drugs in the regimen. †Group 1 or 5 drugs may be selected if the preceding drugs are not sufficient to make an effective regimen.

Reference

1. Kim JH, Yim JJ. Achievements in and challenges of tuberculosis control in South Korea. Emerg Infect Dis. 2015; 21:1913–1920.

2. Joint Committee for the Development of Korean Guidelines for Tuberculosis. Korea Centers for Disease Control and Prevention. Korean guidelines for tuberculosis. 1st ed. Seoul and Cheongwon: Joint Committee for the Development of Korean Guidelines for Tuberculosis, Korea Centers for Disease Control and Prevention;2011.

3. Joint Committee for the Revision of Korean Guidelines for Tuberculosis. Korea Centers for Disease Control and Prevention. Korean guidelines for tuberculosis. 2nd ed. Seoul and Cheongwon: Joint Committee for the Revision of Korean Guidelines for Tuberculosis, Korea Centers for Disease Control and Prevention;2014.

4. Singh A, Kashyap VK. Specific and rapid detection of Mycobacterium tuberculosis complex in clinical samples by polymerase chain reaction. Interdiscip Perspect Infect Dis. 2012; 2012:654694.

5. Koh WJ, Chang B, Jeong BH, Jeon K, Kim SY, Lee NY, et al. Increasing recovery of nontuberculous mycobacteria from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea. Tuberc Respir Dis. 2013; 75:199–204.

6. Dinnes J, Deeks J, Kunst H, Gibson A, Cummins E, Waugh N, et al. A systematic review of rapid diagnostic tests for the detection of tuberculosis infection. Health Technol Assess. 2007; 11:1–196.

7. Gupta RK, Lawn SD, Booth H, Morris-Jones S. What is the role for Xpert(R) MTB/RIF in high-resource settings? Experience from a central London hospital. Int J Tuberc Lung Dis. 2014; 18:1323–1326.

8. Sohn H, Aero AD, Menzies D, Behr M, Schwartzman K, Alvarez GG, et al. Xpert MTB/RIF testing in a low tuberculosis incidence, high-resource setting: limitations in accuracy and clinical impact. Clin Infect Dis. 2014; 58:970–976.

9. Boehme CC, Nabeta P, Hillemann D, Nicol MP, Shenai S, Krapp F, et al. Rapid molecular detection of tuberculosis and rifampin resistance. N Engl J Med. 2010; 363:1005–1015.

10. Barnes PF, Bloch AB, Davidson PT, Snider DE Jr. Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med. 1991; 324:1644–1650.

11. Lawn SD, Mwaba P, Bates M, Piatek A, Alexander H, Marais BJ, et al. Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point-of-care test. Lancet Infect Dis. 2013; 13:349–361.

12. Somoskovi A, Parsons LM, Salfinger M. The molecular basis of resistance to isoniazid, rifampin, and pyrazinamide in Mycobacterium tuberculosis. Respir Res. 2001; 2:164–168.

13. Weyer K, Mirzayev F, Migliori GB, Van Gemert W, D'Ambrosio L, Zignol M, et al. Rapid molecular TB diagnosis: evidence, policy making and global implementation of Xpert MTB/RIF. Eur Respir J. 2013; 42:252–271.

14. Park YS, Hong SJ, Boo YK, Hwang ES, Kim HJ, Cho SH, et al. The national status of tuberculosis using nationwide medical records survey of patients with tuberculosis in Korea. Tuberc Respir Dis. 2012; 73:48–55.

15. Millman AJ, Dowdy DW, Miller CR, Brownell R, Metcalfe JZ, Cattamanchi A, et al. Rapid molecular testing for TB to guide respiratory isolation in the U.S.: a cost-benefit analysis. PLoS One. 2013; 8:e79669.

16. Orenstein EW, Basu S, Shah NS, Andrews JR, Friedland GH, Moll AP, et al. Treatment outcomes among patients with multidrug-resistant tuberculosis: systematic review and metaanalysis. Lancet Infect Dis. 2009; 9:153–161.

17. World Health Organization. Guidelines for the programmatic management of drug-resistant tuberculosis, 2011 update. Geneva: World Health Organization;2011.

18. World Health Organization. Policy guidance on drug susceptibility testing (DST) of second-line anti-tuberculosis drugs. Geneva: World Health Organization;2008.

19. Ahuja SD, Ashkin D, Avendano M, Banerjee R, Bauer M, Bayona JN, et al. Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients. PLoS Med. 2012; 9:e1001300.

20. Chang KC, Yew WW, Tam CM, Leung CC. WHO group 5 drugs and difficult multidrug-resistant tuberculosis: a systematic review with cohort analysis and meta-analysis. Antimicrob Agents Chemother. 2013; 57:4097–4104.