First-Line Anti-Tuberculosis Drug Resistance Pattern
Introduction: An important concern regarding TB currently is the case of anti-TB drug resistance; hence research on resistance patterns and risk factors is essential. This study aimed to identify the pattern of first-line anti-TB drug resistance.
Methods: This descriptive retrospective study was conducted at MDR-TB polyclinic Dr. Soetomo General Hospital, Surabaya, in 2017-2019. Only complete medical records were included. The variables were first-line anti-TB drug resistance (isoniazid, rifampicin, ethambutol, streptomycin) and patients’ characteristics (age, gender, treatment history, and comorbidities). The drug resistance test was performed using certified culture methods.
Results: Among 239 patients, the incidences of resistance to H, R, E, and S were 79.08%, 94.14%, 25.94%, and 20.08%, respectively. The most common patterns were HR (42.26%), R (18.83%), and HRE (12.55%). The largest age group was 45-54 years old (38%). The dominant gender was male (56.49%). The most treatment history category was relapsed patients (48%) and there were more patients with comorbidity (57%).
Conclusion: The highest incidence rate of resistance was rifampicin and the most common resistance pattern was HR. Most of the patients were of working age, male, relapse patients, and had comorbidities. An appropriate TB therapy treatment plays an important role in preventing resistance.
WHO. Tuberculosis. Geneva, 2021. [cited December 23, 2021]. Available from [WebPage]
WHO. Global Tuberculosis Report 2018. Geneva, [cited December 23, 2021]. Available from [WebPage]
WHO. WHO Consolidated Guidelines on Drug-Resistant Tuberculosis Treatment. Geneva, 2019 [cited December 23, 2021]. Available from [WebPage]
Paul R. The Threat of Multidrug-Resistant Tuberculosis. J Glob Infect Dis 2018; 10: 119–120. [CrossRef]
WHO. Tuberculosis: Multidrug-Resistant Tuberculosis (MDR-TB). Geneva, 2018. [cited December 23, 2021]. Available from [WebPage]
Soedarsono. Tuberculosis: Development of New Drugs and Treatment Regimens. Jurnal Respirasi. 2021; 7(1): 36-45. [WebPage]
Sinha P, Srivastava GN, Gupta A, et al. Association of Risk Factors and Drug Resistance Pattern in Tuberculosis Patients in North India. J Glob Infect Dis 2017; 9: 139–145. [CrossRef]
Glasauer S, Altmann D, Hauer B, et al. First-Line Tuberculosis Drug Resistance Patterns and Associated Risk Factors in Germany, 2008-2017. PLoS One 2019; 14: e0217597. [CrossRef]
Workicho A, Kassahun W, Alemseged F. Risk Factors for Multidrug-Resistant Tuberculosis among Tuberculosis Patients: A Case-Control Study. Infect Drug Resist 2017; 10: 91–96. [CrossRef]
Adiwinata R, Rasidi J, Marpaung M. Clinical Profile and Treatment Evaluation of Rifampicin-Resistant and Multidrug-Resistant Tuberculosis Patients at Dr. Kanujoso Djatiwibowo Public Hospital, Balikpapan. J Respirologi Indones 2018; 38: 135–142. [CrossRef]
Wijayanto M, Arnanda R, Thamrin Edo. Risk Factors for Development of Multidrug-Resistant Tuberculosis among Relapsed Patients in West Papua, Indonesia: A Descriptive and Analytical Study. Int J Appl Pharm 2019; 11: 50–55. [CrossRef]
Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/755/2019 tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tuberkulosis. HK.01.07/MENKES/755/ 2019, Indonesia, 2019. [cited December 24, 2021]. Available from [WebPage]
Mesfin EA, Beyene D, Tesfaye A, et al. Drug-Resistance Patterns of Mycobacterium tuberculosis Strains and Associated Risk Factors among Multi Drug-Resistant Tuberculosis Suspected Patients from Ethiopia. PLoS One 2018; 13: e0197737. [CrossRef] [PubMed]
Adejumo OA, Olusola-Faleye B, Adepoju V, et al. Prevalence of Rifampicin Resistant Tuberculosis and Associated Factors among Presumptive Tuberculosis Patients in a Secondary /Referral
Hospital in Lagos Nigeria. Afr Health Sci 2018; 18: 472–478. [CrossRef]
Li Q, Zhao G, Wu L, et al. Prevalence and Patterns of Drug Resistance among Pulmonary Tuberculosis Patients in Hangzhou, China. Antimicrob Resist Infect Control 2018; 7: 61. [CrossRef]
Allué-Guardia A, García JI, Torrelles JB. Evolution of Drug-Resistant Mycobacterium tuberculosis Strains and Their Adaptation to the Human Lung Environment. Front Microbiol 2021; 12: 612675. [CrossRef]
Song W, Li Y, Ma X, et al. Primary Drug Resistance of Mycobacterium tuberculosis in Shandong, China, 2004–2018. Respir Res 2019; 20: 223. [CrossRef]
Soedarsono S, Mertaniasih NM, Sulistyowati T. First Line Anti-Tuberculosis Drug Resistance Pattern In Multidrug-Resistant Pulmonary Tuberculosis Patients Correlate with Acid Fast Bacilli Microscopy Grading. Indones J Trop Infect Dis 2020; 8: 1–8. [CrossRef]
Putri VA, Yovi IY, Fauzia D. Profil Pasien Tuberculosis Multidrug Resistance (TB-MDR) di Poliklinik TB-MDR RSUD Arifin Achmad Provinsi Riau Periode April 2013-Juni 2014. J Online Mhs Fak Kedokt Univ Riau 2015; 2: 1–17. [CrossRef]
Ibrahim E, Baess AI, Al Messery MA. Pattern of Prevalence, Risk Factors and Treatment Outcomes among Egyptian Patients with Multidrug Resistant Tuberculosis. Egypt J Chest Dis Tuberc 2017; 66: 405–411. [CrossRef]
Cao Z, Lan Y, Chen L, et al. Resistance to First-Line Antituberculosis Drugs and Prevalence of pncA Mutations in Clinical Isolates of Mycobacterium tuberculosis from Zunyi, Guizhou Province of China. Infect Drug Resist 2019; 12: 3093–3102. [PubMed]
Development O for EC and. OECD Data: Working Age Population. Paris, 2021. [GoogleScholar]
More SW, Parande MA, Kamble SW, et al. Profile of Drug-Resistant Tuberculosis in Western Maharashtra. J Fam Med Prim Care 2017; 6: 29–33. [CrossRef] [PubMed]
Naidoo K, Dookie N. Insights into Recurrent Tuberculosis: Relapse Versus Reinfection and Related Risk Factors. In: Tuberculosis. 2018. Epub ahead of print 26 September 2018. [GoogleScholar]
Rumende CM. Risk Factors for Multidrug-resistant Tuberculosis. Acta Medica Indonesiana 2018; 50: 1–2. [PubMed]
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