771. Drug Resistance Tuberculosis (DR-TB), Comorbidities and Risk Factors Identified in a Prospective Multicenter Cohort Study in Indonesia

Background The numbers of patients with drug resistance TB (DR-TB) increased annually by over 20% globally in the last decade. However, data on the prevalence of DR-TB in Indonesia are limited. The objective of this study to estimate the proportion of DR-TB in new and previously treated TB cases, and to identify comorbidities and risk factors. Methods This study has been conducted at seven hospitals throughout Indonesia since March 2017. Clinically TB patients ≥18-year-old were enrolled and followed until 6 months after treatment completed. Demography and clinical data were recorded; sputum, blood, urine, and PBMC were collected at several time points. AFB smear, sputum culture, Xpert MTB/RIF, and drug sensitivity tests were performed. Drug resistance TB is determined by Xpert MTB/RIF. Results Of 151 enrolled patients, 103 (68%) were confirmed M. tuberculosis by Xpert MTB/RIF, and 47 (46%) were confirmed rifampicin resistance. The distribution of DR-TB in each study site is shown in Figure 1. Among those with comorbidities (38%), comorbidity with diabetes (based on HbA1c level and diabetes history), HIV, and cancer was 9%, 26%, and 7%. Demography, nutrition status, contact and treatment history, and comorbidities are shown in Table 1. DR-TB primary infection contributes to 23% of DR-TB cases. Biomarkers that may predict treatment failure and TB-genotyping are underway. Conclusion The proportion of DR-TB in both new and previously treated patients in our cohort was significantly higher than the estimated number from the WHO and Ministry of Health. TB is a serious threat for public health and mitigation plan must be implemented at all levels. Table 1: Demography, Nutrition Status, Contact History, TB Treatment History and Comorbid Status 520 560 570 580 590 All Demography  Age (Median, IQR) 38 (20) 41 (21) 42 (25) 37 (45) 22 (3) 40 (25)  Male (n, %) 9 (75) 16 (47) 26 (67) 9 (82) 4 (57) 64 (62) BMI  <18.5 7 (58) 17 (50) 20 (51) 5 (45) 5 (71) 54 (52)  18.5 to <25 5 (42) 13 (38) 13 (33) 5 (45) 2 (29) 38 (37)  ≥25 0 4 (12) 6 (15) 1 (10) 0 11 (11) Contact history with TB patients 2 (17) 1 (3) 8 (21) 2 (18) 2 (29) 15 (15) TB treatment history  New 10 (83) 12 (35) 13 (33) 10 (91) 5 (71) 50 (49)  Previously treated 2 (17) 22 (65) 26 (67) 1 (9) 2 (29) 53 (51) Comorbid  HIV 2 (18) 0 0 2 (18) 0 4 (4)  DM 1 (9) 14 (41) 13 (33) 0 1 (14) 29 (28) Disclosures All authors: No reported disclosures.