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