Factors Associated with Acid Fast Bacilli and Sputum Culture Conversion in Patients with Multidrug-Resistant Tuberculosis in Surabaya

Naomi Rahmasena, I. A. Marhana, Muhammad Yamin Sunaryo Suwandi, T. Kusmiati, Tuksin Jearanaiwitayakul
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Abstract

Introduction: Indonesia is a high incidence country of multidrug-resistant tuberculosis. There are approximately 11,000 MDR TB cases, 2.8% of them are new cases and 16% of them are relapse cases. Although guidelines for MDR-TB are frequently designed, medication freely provided, and centers for treatment duly expanded, studies on time to sputum culture conversion have been very limited in Indonesia. Therefore the aim of the study is to identify risk factors that effect on sputum and culture conversion.Methods: Data on short-term regimen for MDR TB in Dr. Soetomo General Hospital from January 1st – December 31st, 2018 were collected with a total sampling approach, and fulfill the inclusion and exclusion. Data were analyzed by computer software IBM SPSS Statistic 24 for windows. Results: Male is more likely to have delayed sputum conversion and culture conversion but no statistical difference is observed (p>0.05). Smoking history is more likely to have delayed sputum and culture conversion but only in sputum smear test shows a significant difference (p≤ 0.05). Alcohol consumption has delay effect on sputum and culture conversion but there is statistically difference in only culture conversion (p<0.05). The high baseline smear test also affects delay the sputum and culture conversion but only in sputum smear reveals a significant effect (p<0.05).Conclusion: In this present study, we identified sex, smoking history, high bacillary loads as significant factors on sputum conversion. In addition, we revealed that alcohol-consumption history is a significant factor affecting on culture conversion.
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泗水耐多药结核病患者抗酸杆菌和痰培养转化相关因素
印度尼西亚是耐多药结核病的高发国家。大约有1.1万例耐多药结核病病例,其中2.8%为新发病例,16%为复发病例。虽然经常设计耐多药结核病指南,免费提供药物,适当扩大治疗中心,但在印度尼西亚,关于痰培养转化时间的研究非常有限。因此,本研究的目的是确定影响痰液和培养转化的危险因素。方法:采用全抽样方法收集2018年1月1日- 12月31日Dr. Soetomo总医院耐多药结核病短期治疗方案数据,并进行纳入和排除。采用IBM SPSS Statistic 24 for windows软件对数据进行分析。结果:男性患者痰转化和培养转化延迟发生率较高,但差异无统计学意义(p>0.05)。有吸烟史者更有可能出现痰液和培养转化延迟,但仅在痰涂片检查中有显著差异(p≤0.05)。饮酒对痰液和培养物转化均有延迟作用,但仅培养物转化有统计学差异(p<0.05)。高基线涂片检查也影响延迟痰液和培养转化,但仅在痰涂片中显示显著影响(p<0.05)。结论:在本研究中,我们发现性别、吸烟史、高细菌载量是痰转化的重要因素。此外,我们发现饮酒历史是影响文化转换的重要因素。
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