Clinical and Demographic Characteristics Differences between M. tuberculosis and M. bovis Infection in Bronchoalveolar Lavage Pulmonary TB Patients, Indonesia

Budi Yanti, Soetjipto Soetjipto, Ni Made Mertaniasih, Muhammad Amin


Background: Some species of the Mycobacterium tuberculosis complex (MTBC) which can cause tuberculosis, particularly M. tuberculosis and M. bovis, may have different virulence property and therefore associated with various clinical severity in tuberculosis (TB) patients. The aim of this study was to determine the differences in clinical and demographic characteristics between M. tuberculosis and M. bovis infection among Indonesian TB patients.
Methods: Thirty-one new and active TB patients were confirmed to have acid fast bacilli (AFB) sputum positive and/or Xpert MTB/RIF positive for M. tuberculosis from Dr. Soewandhie Hospital, Surabaya, Indonesia. Interviews were conducted to record the clinical and demographics required. The MTBC were isolated from bronchoalveolar lavage fluid (BALF) and determined by primer-specific PCR targeting TbD1 and RD9 region gene. The degree of lung tissue damage was classified using NICE Scoring System.
Results: The MTBC were detected in all patients on whom 19 and 12 isolates were classified as M. tuberculosis and M. bovis respectively. There was a different on 74.2% of productive age subjects (21-50 years) with M. tuberculosis infection (P<0.05). There was no difference in clinical characteristics of tuberculosis. The degree of lung damage was significantly different between M. tuberculosis and M. bovis (OR: 17.00; 95% CI: 2.55-112.98;, P=0.002).
Conclusions: M. tuberculosis is likely different in ages and increases the risk of severe lung damage seventeen times among TB patients from Indonesia. Distinguishing the clinical characteristics of these two species infections still difficult thus it is necessary for laboratory tests to be integrated with the National Tuberculosis Control Program in this country to determine between this species. (J Respir Indo. 2019; 39(4): 238-44)


M. tuberculosis, M. bovis, Bronchoalveolar lavage, clinical, demographic

Full Text:



Brites, D. & Gagneux, S. Old and new selective pressures on Mycobacterium tuberculosis. Infect Genet Evol. 2012; 12(4): 678-685.

Grange, J. Mycobacterium bovis infection in human beings. Tuberculosis. 2001;81(1/2):71-77.

Cossivi, O., Meslin, F., Dabora, C. & Grange, J. Epidemiology of Mycobacterium bovis infection in animals and humans, with particular reference to Africa. Rev. sci. tech. Off. int. Epiz. 1995;14(3): 733-746.

Olea-Popelka, F; Muwonge, A; Perera, A; Dean, A.S; Mumford, Elizabeth; Erlacher-Vindel, E; Forcella, S; Silk, J.B; Ditiu, Lucica; Raviglione, M; Cossivi, O; Lobue, P; Paula, I.F. Zoonotic tuberculosis in human beings caused by Mycobacterium bovis—a call for action. Lancet Infect Dis. 2016: 1-5.

Garnier T, Eiglmeier K, Camus JC, Medina N, Mansoor H, Pryor M, Duthoy S, Grondin S, Lacroix C, Monsempe C, Simon S, Harris B, Atkin R, Dogget J, Mayes R, Keating L, Wheeler PR, Parkhill J, Barrel BG, Cole ST, Gordon SV, Hewinson RG. The complete genome sequence of Mycobacterium bovis. PNAS. 2003; 100(13): 7877-7882.

WHO. Global Tuberculosis Report; 2018.

World Health Organization. WHO estimates of the global burden of foodborne diseases. 2015.

Putra, P., Besung, N. & Mahatmi, H. Deteksi Antibodi Mycobacterium tuberculosa bovis pada Sapi di Wilayah Kabupaten Buleleng, Bangli, dan Karangasem Provinsi Bali. Jurnal Ilmu dan Kesehatan Hewan. 2016; 1(16):1-6.

Rieder HL, van Deun A, Kam KM, Kim SJ, Chonde TM, Trebucq A, Urbanczik R. Priorities for tuberculosis bacteriology services in low-income countries. 2007. France: Norwegian Agency for Development Cooperation (Norad).

Parsons LM, Brosch R, Cole ST, Somoskovi, A, Loder A, Bretzel G, van Soolingen D, Hale YM, Salfinger M. Rapid and simple approach for identification of Mycobacterium tuberculosis complex isolates by PCR-based genomic deletion analysis. J Clin Microbiol. 2002;40(7): 2339–2345.

Kurashima A, Morimoto K, Horibe M, Hoshino Y, Shiraishi Y, Kudoh S. A Methode for visual scoring of pulmonary Mycobacterium avium complex disease: "NICE scoring system". Mycobact Dis. 2003;3(1):1-5.

Wisaksana, Rudi; Sumantri, Rahmat; Indrati, Agnes R; Zwitser, Aleta; Jusuf, Hadi; Mast, Quirijin de; Crevel, Reinout van; Ven, Andre van der. Anemia and iron homeostasis in a cohort of HIV- infected patients in Indonesia. BMC Infectious Diseases. 2016; 213(11):1-10.

Linea V, M., Aasebu, U., Wilsguard, T. & Melbye, H. Low oxygen saturation and mortality in an adult cohort: the Tromsø study. BMC Pulmonary Medicine. 2015; 15(9):1-12.

Lewinshon DM, Leonard MK, LoBue PA, Chon DL, Daley CL, Richeldi L, Salfinger M, Shinnick TM, Sterling TR, Warshaver DM, Woods GL. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clin Infect Dis. 2017; 64: 111-115.

WHO. Xpert. MTB/RIF Implementation Manual: Technical and Operational ‘how-to Practical Considerations. Geneva: WHO Press; 2014.

Shanmuganathan, R. & Shanmuganathan, I. D. Clinical Manifestation and Risk Factors of Tuberculosis Infection in Malaysia: Case Study of a Community Clinic. Global Journal of Health Science. 2015; 7(4):110-120.

RISKESDAS. RISET KESEHATAN DASAR, Jakarta: Badan Penelitian dan Pengembangan Kesehatan, Kementrian Kesehatan.2013.

Neyrolles, O. & Quintana-Murci, L. Sexual Inequality in Tuberculosis. Plos Medicine. 2009;6(2):1-6.

Bigwan E, I; Ohaeri M, C; Ven T, S; Sheyin, Z; Umar, A; Olukose, J; Wuyep, P; Gyang, B; Chollom S, C. Socio-economic dependence on the incidence of tuberculosis in Jos, North central Nigeria. Science Journal of Public Health. 2013; 1(5): 235-238.

ATS. Diagnostic Standards and Classification of Tuberculosis in Adults and Children. Am J Respir Crit Care Med. 2000; 161: 1376–1395.

Bartlett, J. G., Breiman, R. F., Mandell, L. A. & File, T. M., 1998. Community-Acquired Pneumonia in Adults: Guidelines for Management. Clinical Infectious Diseases , 26(4), p. 811–838

Korb VC, Chuturgoon AA, Moodley D. Mycobacterium tuberculosis: Manipulator of Protective Immunity. Int. J. Mol. Sci. 2016;17(131):2-15.

Malone KM, Gordon SV. Mycobacterium tuberculosis Complex members adapted to wild and domestics animal. In: S. Gagneux, ed. Strain variation in the Mycobacterium tuberculosis complex; its role in Biology and Epidemiology and control. Switzerland: Springer.2017; 135-154.



  • There are currently no refbacks.

Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845

An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License