Triwahju Astuti,1 Tri Yudani Mardining Raras,2 Dian Nugrahenny,3 Rahadi Widodo1
1Departemen Pulmonologi dan Kedokteran Respirasi, Fakultas Kedokteran Universitas Brawijaya, Malang
2Laboratorium Biomedik, Fakultas Kedokteran Universitas Brawijaya, Malang
3Laboratorium Farmakologi, Fakultas Kedokteran Universitas Brawijaya, Malang
Background: In suspected MDR-TB patients with smear AFB remains positive after treatment, the results of mycobacterial culture are not always positive. Some studies showed the use of certain clinical characteristics for predicting result of the cultures. Besides that, it was noted that suPAR level relates with mycobacterial load in sputum. This study evaluates the use of suPAR level and clinical characteristics as predicting factors for the result of culture in suspected MDR-TB patients.
Methods: By cross sectional study, in 30 suspected MDR-TB patients, we examined suPAR plasma level and sputum mycobacterial culture. The data were analyzed by ANOVA and correlation test.
Results: We found positive cultures of M. tuberculosis in 15 (50%) patients, negative cultures in 14 (46,67%) patients, and the growth of Mycobacterium Other Than Tuberculosis in 1 (3,33%) patient. The positive cultures include 5 MDR-TB, 2 monoresistant, and 8 pansensitive to OAT patients. Level of suPAR > 8 ng/mL can be used to predict positive results in conjuction with four factors: age < 50 years old, relaps case, AFB smear grade +2 or +3, and ERS > 70 mm/hour. If any 3 or more predicting factors, the result of positive culture was more likely (PPV 100%, NPV 82,3%, sensitivity 80%, specificity 100%).
Conclusion: Plasma suPAR level > 8 ng/mL and four clinical factors can be used as predicting factors for the result of mycobacterial culture in suspected MDR-TB patients. (J Respir Indo. 2017; 37: 53-9)
Keywords: Lung tuberculosis, MDR-TB, suPAR, culture