ORIGINAL ARTICLE

Predictors of multidrug resistance among pulmonary tuberculosis patients in a tertiary hospital in North Sumatera, Indonesia

R. Lia Kusumawati , Tryna Tania, Edward McNeil, Virasakdi Chongsuvivatwong

R. Lia Kusumawati
Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik Hospital, Medan, Indonesia.. Email: liaiswara@yahoo.com

Tryna Tania
Resident in Department of Microbiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Edward McNeil
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand.

Virasakdi Chongsuvivatwong
Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand.
Online First: April 02, 2018 | Cite this Article
Kusumawati, R., Tania, T., McNeil, E., Chongsuvivatwong, V. 2018. Predictors of multidrug resistance among pulmonary tuberculosis patients in a tertiary hospital in North Sumatera, Indonesia. Bali Medical Journal 7(1): 68-73. DOI:10.15562/bmj.v7i1.813


Background: Previous tuberculosis treatment for tuberculosis is known to confer a higher risk of multidrug-resistant tuberculosis (MDR-TB). Indonesia is ranked eighth among the 27 "high-burden" MDR-TB countries.

Objectives: This study aimed to determine the predictors of multi-drug resistance among patients with pulmonary tuberculosis in Indonesia.

Methods: This retrospective study was conducted in a tertiary referral teaching hospital in Medan, North Sumatera Province, Indonesia. Laboratory data and medical histories of all pulmonary tuberculosis patients attending the hospital were reviewed. Patients with culture positive for Mycobacterium tuberculosis and processed for drug-susceptibility testing (DST) to first-line anti-tuberculosis drugs between January 2010 and December 2013 were included. Logistic regression was used to determine significant predictors of MDR-TB based on odds ratios (OR) and 95% confidence intervals (CI).

Results: Of 6,174 patients with suspected pulmonary tuberculosis, 842 were confirmed positive by culture, of which DST results were reported for 765. Of these, 115 (15%) had diabetes mellitus, 73 (9.5%) were HIV-infected, and 98 (12.8%) were MDR-TB. Multivariate analysis indicated that patients with a history of previous tuberculosis treatment (OR = 3.75; 95% C.I. = 2.40 - 5.86 and aged 25 to 45 years (OR = 2.37; 95% C.I. = 1.07 - 5.27) were significant predictors of MDR-TB.

Conclusions: Previous tuberculosis treatment and age 25-45 were significant predictors of MDR-TB. Treating patients with previous tuberculosis treatment based on DST results should therefore be considered. 

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