Risk Factors and Prognosis of Nontuberculous Mycobacteria Infection in a High Prevalence of Tuberculosis Setting

Leli Saptawati, Yusuf Ari Mashuri, Betty Suryawati, Harsono Harsono, Riska Pradiptakirana

Abstract

Background: The prevalence and incidence of Non­tuberculous Mycobacteria (NTM) infections in the world in general have continued to in­cre­ase in the last two to three decades. Until now i­den­tification and testing of NTM sensitivity in Indonesia is still very difficult to do in daily health services. Thus, NTM infection is still a ne­glected case and misdiagnosis often occurs. In these conditions, one of the things that is very im­portant to help clinicians in the management of NTM infections is information about patient characteristics and how the relationship of risk factors for NTM infection with prognosis.

Subjects and Method: The study was con­duc­ted retrospectively using data on the medical re­cords of patients with positive culture of NTM at the Surakarta Center for Community Lung Health (BBKPM) for 3 years (2016-2018). A total of 134 samples were selected for this study with total sampling. The dependent variable is the prognosis of infection. The independent variables were gender, age, occupation, history of inhaled corticosteroid use, antibiotic therapy, and under­lying disease. Data were analyzed using multiple logistic regression.

Results: The number of samples is 143 medical records. Most of the patients in this study were male (62.90%) and aged less than 60 years (79.70%). The majority of patients work not as far­mers (80.40%). Most patients had no history of inhaled corticosteroid use (89.50%). The­ra­pe­utic factors indicate that the majority of patients receive combined antibiotic therapy (68.5%). As many as 42% of patients with NTM infection have an underlying disease. Underlying disease in patients is mostly in the form of diabetes me­l­litus (DM) in 13.3% and in the former tuber­cu­losis in 4.9%. Based on the Chi-Square test, a sig­nificant relationship was found between the­ra­peutic factors, history of inhaled corti­cos­teroid use, and type of work, and the patient's prog­no­sis. Based on mult­ivariable testing, the factor of antibiotic therapy is the most influential variable on a pa­tient's prognosis.

Conclusion: Risk factors related to the patient's prog­nosis are occupation, use of inhaled cor­tico­steroids and antibiotic therapy.

Keywords: Nontuberculous Mycobacteria, risk factors, prognosis, Center for Community Lung Health

Correspondence:

Leli Saptawati. Department of Microbiology, Fa­culty of Medicine, Universitas Sebelas Maret, In­do­nesia. Jl. Ir. Soetami no. 36A Kentingan Su­ra­karta, Indonesia. Email: llsapt_md@yahoo.­co.­id. Mobile: (0271) 632489.

Journal of Epidemiology and Public Health (2020), 5(1): 79-87
https://doi.org/10.26911/jepublichealth.2020.05.01.08

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