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All Journal Jurnal Respirologi Indonesia Jurnal Respirasi (JR)
Hatim, Faiza
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Health Professions Medicine & Pharmacology Public Health

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Emerging Bedaquiline Resistance in Pulmonary Tuberculosis Patients of a Tertiary Hospital in Jakarta, Indonesia Isbaniah, Fathiyah; Haryanto, Budi; Lubis, Nabila Assakinah; Maharani, Cindy Refina; Agustin, Heidy; Hatim, Faiza; Sutarto, Riyadi; Handayani, Raden Rara Diah; Islam, Muhammad Nashirul; Heldian, Muhammad Hibban; Faizal, Fathia Amalia; Herawati, Aulia Rizkia
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.20-26

Abstract

Introduction: Tuberculosis (TB) continues to pose significant health and economic challenges globally. Drug-resistant TB (DR-TB), particularly resistance to bedaquiline (BDQ), threatens the efficacy of current treatment regimens. Limited phenotypic drug susceptibility testing (DST) capacity exacerbates the issue, delaying appropriate interventions. This study examined BDQ resistance patterns among pulmonary DR-TB patients in Indonesia, where evidence on BDQ resistance remains scarce. Methods: A retrospective analysis of 393 DR-TB cases was conducted using data from the National TB Database (SITB) at Persahabatan National Respiratory Referral Hospital, Jakarta, Indonesia, between 2021 and 2023. Patients were classified based on the World Health Organization (WHO) 2022 DR-TB guidelines. Resistance patterns were determined through phenotypic DST using the BACTEC Mycobacteria Growth Indicator Tube (MGIT) system. Descriptive statistics summarized patient demographics and resistance profiles. Results: Among the 393 patients, 10 (2.54%) demonstrated BDQ resistance, with 8 cases arising without prior BDQ exposure. Mono/poly-resistance to Rifampicin and/or Isoniazid was the most prevalent pattern (44.29%). Multidrug-resistant TB (MDR-TB) was observed in 40.20% of cases, while pre-extensively DR and extensively DR-TB constituted 7.90% and 0.25%, respectively. Comorbidities, predominantly diabetes mellitus (DM), were identified in 33.59% of patients. Conclusion: This study revealed an alarming BDQ resistance rate (2.50% in MDR-TB cases), underscoring the urgent need for improved access to DST and TB management infrastructure in Indonesia. Strengthening diagnostic capacity and monitoring systems is critical to mitigating the spread of resistance and supporting effective treatment strategies.
Clinical, Immunological, and Microbiological Aspects of Non-tuberculous Mycobacterium (NTM) Nurfitri, Rina Diana; Isbaniah, Fathiyah; Nurwidya, Fariz; Imaniar, Rania; Hatim, Faiza; Dharmawan, Ibrahim Nur Insan Putra
Jurnal Respirologi Indonesia Vol 46 No 1 (2026)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/3rsgyg73

Abstract

Non-tuberculous mycobacteria (NTM) refer to all mycobacterial species except those causing tuberculosis and leprosy. These bacteria are acid-fast. The bacteria are environmental bacteria that act opportunistically in humans. The infection can lead to disease, primarily affecting the lungs in susceptible hosts. Risk factors for NTM infection include defects in the body's defence mechanisms (e.g., ciliary defects), changes in lung structure (e.g., bronchiectasis), and immune system abnormalities (e.g., immunosuppressant use), which can be congenital or acquired. The bacteria possess pathogen-associated molecular patterns (PAMPs) and cell wall components that differ from those of Mycobacterium tuberculosis (M. tuberculosis), one of which is the glycopeptidolipid (GPL) component. Different species have distinct cell wall components, enabling them to modulate the immune system in various ways by interacting with multiple pathogen recognition receptors, including toll-like receptors and fibronectin. The cell-mediated immune response plays a role in the response to NTM infection. Alveolar macrophages, as the first line of defence, release interleukin (IL)-12, activating the T-helper-1 (Th1) axis and natural killer (NK) cells, followed by the release of tumour necrosis factor- α (TNF-α), interferon (IFN)-γ, and IL-17. The clinical symptoms of NTM lung disease (NTM-LD) are similar to those of Mycobacterium tuberculosis (M. tuberculosis). Two radiological findings are commonly observed: fibro-cavitary lesions and nodular bronchiectasis. Diagnosis must meet clinical, radiological, and microbiological criteria. The decision to start therapy should consider host factors, clinical conditions, and species type. The treatment approach involves multi-drug therapy and long-term administration, depending on species, disease extent, drug susceptibility testing results, and comorbidities.
Co-Authors Agustin, Heidy Budi Haryanto Dharmawan, Ibrahim Nur Insan Putra Faizal, Fathia Amalia Fariz, Nurwidya Handayani, Raden Rara Diah Heldian, Muhammad Hibban Herawati, Aulia Rizkia Imaniar, Rania Isbaniah, Fathiyah Islam, Muhammad Nashirul Lubis, Nabila Assakinah Maharani, Cindy Refina Nurfitri, Rina Diana Sutarto, Riyadi