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All Journal Jurnal Respirasi (JR) Respiratory Science
Sutarto, Riyadi
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Health Professions Medicine & Pharmacology Public Health

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Factors Associated with Delayed 2-Month Sputum Smear Conversion in MDR-TB Patients Treated with All-Oral Regimen at Persahabatan Hospital Sitinjak, Sahat Anugerah Immanuel; Harfiani, Erna; Tjang, Yanto Sandy; Muktamiroh, Hikmah; Sutarto, Riyadi
Respiratory Science Vol. 6 No. 1 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i1.183

Abstract

Background: The emergence of multidrug-resistant tuberculosis (MDR-TB) presents significant challenges in achieving treatment success. Sputum conversion time, an essential indicator of treatment progress, varies among patients and may be influenced by demographic and clinical factors. This study aimed to identify factors associated with sputum conversion time in MDR-TB patients treated with all-oral regimens at Persahabatan Hospital during the 2021–2022 period. Method: This retrospective cohort study analyzed data from 154 MDR-TB patients treated with all-oral regimens at Persahabatan Hospital. Patients were categorized by sputum conversion time (≤2 months or >2 months). Independent variables included age, sex, diabetes mellitus, anemia, previous TB treatment, pulmonary cavitation, education level, marital status, and initial sputum AFB results. Inclusion criteria were primary pulmonary MDR-TB patients confirmed via sputum culture, aged ≥20 years, and treated per Indonesian national guidelines. Logistic regression analyses identified significant factors. Results: Among the nine factors studied, four significantly influenced sputum conversion time: elderly age, anemia, pulmonary cavitation, and initial sputum AFB results. Older age (≥60 years) was protective against delayed conversion, while anemia, pulmonary cavitation, and higher initial sputum AFB results were associated with prolonged conversion times. Conclusion: Factors such as anemia, pulmonary cavitation, and initial sputum results are associated with delayed sputum conversion, with elderly age as a protective factor against delayed sputum conversion.
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.
Co-Authors Agustin, Heidy Budi Haryanto Erna Harfiani Faizal, Fathia Amalia Handayani, Raden Rara Diah Hatim, Faiza Heldian, Muhammad Hibban Herawati, Aulia Rizkia Isbaniah, Fathiyah Islam, Muhammad Nashirul Lubis, Nabila Assakinah Maharani, Cindy Refina Sitinjak, Sahat Anugerah Immanuel Yanto Sandy Tjang