BACKGROUND : Pulmonary tuberculosis (TB) is among the top 10 causes of death worldwide. Prolonged use and noncompliance with TB treatment have a potential risk for pulmonary fungal coinfection. This study aimed to evaluate fungal coinfection in pulmonary TB patients in Indonesia referred to the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia, Jakarta, during 2018–2022. METHODS : A cross-sectional study was conducted to compare 5 years of data collected at the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia. A total of 7,440 sputum specimens from various clinical sites were examined from 2018 to 2022. Sputum specimens from TB patients were prepared for microscopic examination using ZN staining to detect AFB. Culture and antimicrobial susceptibility of TB were performed on LJ agar. Fungal detected on microscopic examination and culture were assessed as coinfections. RESULTS : ZN staining to detect M. tuberculosis in clinical specimens has high specificity (98.4%) but low sensitivity (60.6%). Drug resistance in TB patients remains a problem, which can increase the risk of fungal infections. In 2018–2019, TB and fungal coinfections were more common in polyresistant TB cases. In 2020–2021, TB and fungal coinfections were found in all resistant TB cases, most commonly in XDR-TB cases. In 2022, TB and fungal coinfections were found in monoresistant and polyresistant patients. Candida spp. was found in 6.2% of positive TB cases, and all were found in resistant TB. CONCLUSIONS Increasing MDR- and XDR-TB are risk factors for fungal coinfection and must be detected early for better TB management in Indonesia.
antimicrobial susceptibility ; culture ; fungal infections ; sputum ; tuberculosis

Objective: To evaluate antibacterial activity of the Indonesian water soluble green tea extract,Camellia sinensis, against clinical isolates of methicillin-resistant Staphylococcus aureus (S. aureus) (MRSA) and multi-drug resistant Pseudomonas aeruginosa (MDR-P. aeruginosa).
Methods:Antimicrobial activity of green tea extract was determined by the disc diffusion method and the minimum inhibitory concentration (MIC) was determined by the twofold serial broth dilutions method. The tested bacteria using in this study were the standard strains and multi-drug resistant clinical isolates of S. aureus and P. aeruginosa, obtained from Laboratory of Clinical Microbiology, Faculty of Medicine, University of Indonesia.
Results:The results showed that the inhibition zone diameter of green tea extracts for S. aureus ATCC 25923 and MRSA were (18.970±0.287) mm, and (19.130±0.250) mm respectively. While the inhibition zone diameter for P. aeruginosa ATCC 27853 and MDR-P. aeruginosa were (17.550±0.393) mm and (17.670±0.398) mm respectively. The MIC of green tea extracts against S. aureus ATCC 25923 and MRSA were 400 μg/mL and 400 μg/mL, respectively, whereas the MIC for P. aeruginosa ATCC 27853 and MDR-P. aeruginosa were 800 μg/mL, and 800 μg/mL, respectively.
Conclusions: Camellia sinensis leaves extract could be useful in combating emerging drug-resistance caused by MRSA and P. aeruginosa.