Government tuberculosis (TB) diagnostic and treatment centres, Makassar, Indonesia.
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.
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).
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.
The International Journal of Tuberculosis and Lung Disease 04/2011; 15(4):489-95. DOI:10.5588/ijtld.09.0730 · 2.76 Impact Factor