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

Abstract

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)