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

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)(2017)(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.