Drug resistance among tuberculosis patients attending diagnostic and treatment centres in Makassar, Indonesia
Abstract:SETTING: Government tuberculosis (TB) diagnostic and treatment centres, Makassar, Indonesia.
OBJECTIVE: To determine the proportions and patterns of resistance to commonly used TB drugs (isoniazid [INH], rifampicin, ethambutol and streptomycin) among pulmonary TB patients and assess potential risk factors for drug resistance.
DESIGN: Cross-sectional study.
RESULTS: Of 657 recruited patients, 234 were culture-positive. Drug susceptibility testing (DST) results were available for 216 patients. Among these, 197 were infected with Mycobacterium tuberculosis complex (145 new and 52 previously treated). Isolates from 89 new (61.4%) and 31 previously treated (59.6%) patients were susceptible to all four drugs. Resistance to INH was high among both patient groups (28.3% of new vs. 34.6% of previously treated). Multidrug-resistant TB (MDR-TB) cases accounted for respectively 4.1% and 19.2% of these patients. Resistance to >2 drugs was high among previously treated patients (19.2%). MDR-TB cases were more likely to have a history of excess alcohol use (adjusted OR 4.01, 95%CI 1.28–12.53) and previous TB treatment (adjusted OR 6.28, 95%CI 2.01–19.64).
CONCLUSIONS: Regardless of previous treatment history, many culture-positive TB patients were infected with INH-resistant isolates, and a significant proportion of previously treated patients were infected with MDR-TB. Treating culture-positive TB patients, especially previously treated patients, based on DST results should therefore be considered.
Document Type: Regular Paper
Affiliations: 1: Novartis Institute for Tropical Diseases–Eijkman Institute–Hasanuddin University Clinical Research Initiative (NEHCRI), Kemerdekaan, South Sulawesi, Makassar, Indonesia 2: Medical Faculty, Hasanuddin University, South Sulawesi, Makassar, Indonesia 3: Novartis Institute for Tropical Diseases, Singapore, Singapore
Publication date: April 1, 2011
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