Sains Malaysiana 47(3)(2018): 543–549

http://dx.doi.org/10.17576/jsm-2018-4703-15

Infeksi Mycobacterium tuberculosis: Data Demografi dan Perbandingan Ujian Kerentanan Anti-Tuberkulosis

(Mycobacterium tuberculosis Infection: Demographic Data and Comparison of Anti-Tuberculosis Susceptibility Test)

NORAZIAH MOHAMAD ZIN^1*, ALFIZAH HANAFIAH² & NUR HIDAYAH MASOD¹

¹Program Sains Bioperubatan, Pusat Sains Kesihatan dan Gunaan, Fakulti Sains Kesihatan, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Wilayah Persekutuan, Malaysia

²Jabatan Mikrobiologi dan Immunologi Perubatan, Fakulti Perubatan, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Wilayah Persekutuan, Malaysia

Received: 11 March 2016/Accepted: 6 October 2017

ABSTRAK

Tuberkulosis merupakan masalah utama dalam kesihatan awam di kebanyakan negara membangun termasuklah Malaysia. Di Malaysia, bilangan kes kematian disebabkan tuberkulosis menurun tetapi yang membimbangkan adalah apabila terdapat peningkatan kes kerintangan Mycobacterium tuberculosis terhadap ubat-ubatan sedia ada. Dalam kajian ini, data demografik pesakit telah dianalisis dan kerintangan M. tuberculosis terhadap agen anti-tuberkulosis (Isoniazid, Streptomycin, Rifampicin dan Ethambutol) telah dikenal pasti dengan menggunakan ujian kerentanan plat MYCOTB. Sejumlah 40 pencilan klinikal M. tuberculosis yang dipencil daripada pesakit di PPUKM telah dipilih secara rawak. Dalam kalangan pesakit tuberkulosis, seramai 62.5% adalah lelaki (purata umur: 36.9+17.9 tahun) manakala 37.5% adalah wanita (purata umur: 42.6+16.6 tahun). Pesakit berbangsa Melayu mencatatkan peratusan tertinggi iaitu 60%, diikuti pesakit India 15%, Cina 5% dan lain-lain bangsa 20%. Pemencilan M. tuberculosis daripada sampel klinikal adalah masing-masing 60%, 17.5%, 7.5%, 7.5%, 5% dan 2.5% daripada kahak, aspirat trakea, nanah, darah, larvaj bronkoalveolar dan tisu. Ini berhubung kait dengan pesakit Tuberculosis yang majoritinya (67.5%) hadir dengan simptom batuk berpanjangan. Keputusan ujian kerentanan antara MYCOTB dan BACTEC MGIT 960 telah dibandingkan. Purata masa yang diperlukan untuk ujian kerentanan anti-TB menggunakan plat MYCOTB dan BACTEC MGIT 960 ialah masing-masing 2 dan 40.5 minit. Kos setiap sampel bagi plat MYCOTB dan BACTEC MGIT 960 adalah masing-masing RM16.65 dan RM42.87. Sebagai kesimpulan, berdasarkan data demografik, jangkitan TB dalam kalangan pesakit lelaki kaum Melayu adalah yang tertinggi sementara kahak merupakan spesimen yang paling banyak diterima. Penggunaan plat MYCOTB adalah lebih baik berbanding BACTEC MGIT 960 dan keputusan ujian kerentanan menunjukkan pencilan klinikal tersebut adalah 100% rentan kepada agen anti-TB yang diuji. Data yang diperoleh boleh digunakan sebagai maklumat dalam pengemaskinian panduan diagnosis dan rawatan TB pada masa hadapan.

Kata kunci: BACTEC MGIT 960; Mycobacterium tuberculosis; plat MYCOTB ; tuberkulosis

ABSTRACT

Tuberculosis (TB) is a major health problem in many developing countries including Malaysia. In Malaysia, the number of death due to tuberculosis has decreased, but there is rising concern on the increase of drug resistance (multi drug resistance tuberculosis) cases. In this study, patients’ demographic data were analyzed and the susceptibility of Mycobacterium tuberculosis against anti-tuberculosis agents (isoniazid, streptomycin, rifampicin and ethambutol) was determined using susceptibility MYCOTB plates. A total of 40 clinical M. tuberculosis isolates, isolated from patients in PPUKM were randomly selected. Among these, 62.5% were male (mean age: 36.9±17.9 years) and 37.5% were female (mean age: 42.6±16.6 years). Malay patients accounted for the highest percentage of TB cases which was 60%, followed by Indians 15%, 5% Chinese and 20% other ethnics. The isolation of M. tuberculosis from clinical samples were 60%, 17.5%, 7.5%, 7.5%, 5% and 2.5% from sputum, tracheal aspirate, pus, blood, BAL and tissue, respectively. This is correlated with the majority of the patients (67.5%) infected with M. tuberculosis having persistent cough symptoms. The results from MYCOTB and BACTEC MGIT 960 susceptibility testing were compared. The average time taken to do the anti-TB susceptibility test by using MYCOTB plate and BACTEC MGIT 960 was 2 and 40.5 min, respectively. Cost per sample for MYCOTB and BACTEC MGIT 960 was RM16.65 and RM42.80, respectively. To conclude, based on our demographic data, TB infection was the highest amongst male Malay patients and the main specimens that been received was sputum sample. MYCOTB plate was more preferable than BACTEC MGIT 960 for the susceptibility testing and all clinical samples were 100% susceptible to all tested anti-TB agents. Data gathered from this study can be used as guideline for the management of TB diagnosis and treatment in the future.

Keywords: BACTEC MGIT 960; Mycobacterium tuberculosis; MYCOTB plate; tuberculosis

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*Corresponding author; email: noraziah.zin@ukm.edu.my