BACTERIAL AND FUNGAL INFECTIONS IN PULMONARY TUBERCULOSIS PATIENTS AND THE DRUG SENSITIVITY TEST PATTERNS.

BACKGROUND

Other microbial infections in pulmonary tuberculosis (TB) patients pose significant challenges, complicating treatment outcomes and potentially increasing mortality rates. This study aims to characterize the bacterial and fungal infections profiles in pulmonary TB patients.

MATERIALS AND

METHODS

A retrospective cross-sectional analysis was conducted at Adam Malik Hospital in Medan, Indonesia, from June 2020 to May 2022, involving inpatients diagnosed with drug-sensitive or drug-resistant TB. The data was analyzed from total sampling subjects based on medical records.

RESULTS

From 125 pulmonary TB patients, 64% had drug-sensitive TB (DS-TB) and 36% had drug-resistant TB (DR-TB), with the majority being male and underweight. Microbial analysis showed 33.6% (n=42) of the subjects exhibited bacterial growth, 8.8% (n=11) had fungal growth and 30.4% (n=38) had mixed infection. Of 80 DS-TB patients, 80% had bacterial and fungal infections compared to 60% of 45 DR-TB patients, with Klebsiella pneumoniae and Candida albicans as the most common microbes. %<Microbial growth patterns were significantly different between DS-TB and DR-TB patients, with 38.8% (n=31) of DS-TB patients displaying mixed bacterial and fungal growth, in contrast to only 15.6% (n=7) of DR-TB patients. There were no significant differences in antibiotic resistance; however, antifungal sensitivity testing revealed a significant difference in response between DS-TB and DR-TB patients, particularly to Flucytosine, Fluconazole, and Micafungin.

CONCLUSIONS

There is a considerable presence of bacterial and fungal infections, with Klebsiella pneumoniae and Candida albicans being the most prevalent. The antifungal sensitivity testing suggesting a need for personalized antifungal treatment strategies between DS-TB and DR-TB patients.