Mycobacterium tuberculosis resistance pattern against first-line drugs in patients from urban area

AbstractObjective/BackgroundTuberculosis (TB) infection is still a major public health burden in Indonesia. TB cases in Indonesia constitute 35% of all the TB cases detected worldwide and the prevalence of TB drug resistance in this country is approximately 3%. The aim of this study was to evaluate the resistance of Mycobacterium tuberculosis to first-line TB drugs among isolates from clinical specimens from a hospital in an urban area.MethodsThis laboratory-based study was conducted in Tangerang District, Indonesia, from January 2011 to December 2014. Sputum and other clinical specimens were obtained from patients with pulmonary and extrapulmonary TB. The specimens were stained with Ziehl–Neelsen, inoculated on Löwenstein–Jensen media for 6–8weeks, and tested for sensitivity against first-line TB drugs [isoniazid (INH), rifampicin (RIF), ethambutol (EMB), and streptomycin (SM)].ResultsAll TB patients in this study lived in urban areas with male preponderance. Of the 127 M. tuberculosis isolates collected, 22% showed resistance to first-line TB drugs. Among these resistant isolates, 20.5% showed resistance to at least one of the first-line TB drugs and 0.8% showed multidrug resistance (MDR). Resistance to EMB, INH, RIF, and SM was seen in 6.3% 6.3%, 4.7%, and 1.6% of isolates, respectively. Polyresistance to EMB and INH, EMB and RIF, and EMB, INH, and RIF was seen in 0.8% of the isolates, respectively.ConclusionOur study confirms that drug resistance, including MDR, observed against all first-line TB drugs was a real threat in the management of TB infection in Indonesia. The resistance pattern identified in this study could assist clinicians in providing appropriate treatment regimen to TB patients and improve their clinical outcome

The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia

Central nervous system (CNS) infections have become serious problems that contribute to morbidity and mortality in developing countries. In the recent years, antimicrobial resistance has arisen parallel with the changing trend of infectious pathogens, which resulted in the unavailability of an ideal antimicrobial agent. This study was designed to evaluate the central nervous system pathogens and their susceptibility profile using routine microbiological data. The data of CSF culture and susceptibility testing were collected from January 2010 to August 2015. The majority of eligible sample 68/99 (68.7%) had history of neurosurgical procedures. The most common pathogens isolated were coagulase negative staphylococci (CoNS) 39/99 (39.4%) followed by Acinetobacter baumanii 10/99 (10.1%), Pseudomonas aeruginosa 7/99 (7.1%), Sphingomonas paucimobilis 5/99 (5.0%), and Aeromonas salmonocida 4/99 (4.0%). Almost of all Gram positive cocci were susceptible to tigecycline, linezolide, vancomycin, and trimethoprim/sulfamethoxazole. Most Gram negative bacilli (GNB) in this study were multi-drug resistant with high susceptibility level to amikacin, tigecycline, and trimethoprim/sulfamethoxazole. The overall susceptibility testing to cephalosporins was low, ranging 34.2% to 58.5%. The susceptibility to several antifungal remained high for Candida spp. and Cryptococcus neoformans. The present study notifies the changing pathogens trend of CNS infections along with their antimicrobial susceptibility level in our hospital. There is a need of local antimicrobial recommendation and surveillance system to control the usage of antimicrobial and selection of empirical antimicrobial therapy