Vol 13, Issue 10, 2020 Online - 2455-3891 Print - 0974-2441 THE SENSITIVITY TEST OF MYCOBACTERIUM TUBERCULOSIS ISOLATES FROM SUSPECT TUBERCULOSIS PATIENTS TO THE SEROMUCOUS OF SNAIL AND CHITOSAN AS AN ALTERNATIVE ANTI-TUBERCULOSIS DRUGS ABSTRACT Objective: The purpose of this research is to study the sensitivity of Mycobacterium tuberculosis (MTB) isolates from suspect TB patients to seromucous of snail and chitosan as an alternative to anti-TB drugs. Methods: The research methods include management specimen, freeze-drying of snail seromucous; formulation of dosage preparation; identification of MTB isolates; and sensitivity testing of MTB isolates to snail seromucous, chitosan, and streptomycin, isoniazid, rifampicin, and ethambutol (SIRE). Results: The characteristics of respondents by sex and age are the majority of male respondents and productive adult age that is 26 years–52 years. MTB isolates used in the study were obtained from the results of the screening of sputum samples of suspect TB patients through microscopic smear examination and molecular rapid test using GeneXpert tools. MTB isolates in patients suspect TB are resistant against seromucous of snails and chitosan that it is compared with SIRE. The dosage of snail seromucous is 8000 mg/l, chitosan 2% is 800 mg/l, and SIRE, respectively (rifampicin 8000 mg/l, isoniazid 20 mg/l, ethambutol 200 mg/l, streptomycin 800 mg/l). Conclusion: MTB isolates from patients suspect who TB is resistant to seromucous of snail (8000 mg/l) and chitosan (800 mg/l). Keywords: Sensitivity, Isolates, Mycobacterium tuberculosis, Snail seromucous, Chitosan, Streptomycin, Isoniazid, Rifampicin, Ethambutol. INTRODUCTION Tuberculosis (TB) is an infection caused by Mycobacterium tuberculosis (MTB) and transmission through droplets of sputum sufferers or suspect TB in the air. Organs that are infected are generally the lungs so that it is called pulmonary TB, but it can also attack other organs, namely, lymph, brain membranes, skin, bones, joints, intestines, and kidneys, so it is called extrapulmonary disease. TB can be identified through suspected TB, including coughing continuously for 2–3 weeks or more accompanied by blood, shortness of breath, weak body, decreased appetite, weight loss, night sweats even without activity, and fever for more than a month. TB treatment lasts long enough that is at least 6 months of treatment which has an impact on the emergence of germ resistance and TB treatment does not work because patients drop out of treatment or take medication irregularly so that multi drugs resistance tuberculosis (MDR-Tb) occurs. Most MDR-Tb occurs due to lack of adherence in the treatment of T. The resistance that occurs can be in the form of primary resistance and secondary resistance. Early detection of MDR-Tb and starting therapy as early as possible is an important factor for achieving therapeutic success. TB can be cured by administering appropriate anti-tuberculosis drugs (ATD). First-line treatment for TB usually uses isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), and ethambutol (EB) or streptomycin (SM) as the main choice. There are side effects in MDR-TB therapy and the correlation between cure rates and resistance to anti- tuberculosis medication so that a psychological, social management approach is needed in MDR-TB patients and the presence of a bacterial profile related to resistance against antibiotics against TB treatment. Snails (Achatina fulica Ferussac) contain bioactive compounds found in seromucous or hemolymph. Seromucous of snails have bioactivity as HeLa antitumor and are non-toxic to lymphocyte cells, it can even stimulate lymphocyte proliferation. Snails seromucous as glycoprotein containing carbohydrate; fraction α-1 globulin oromucoid; glycans, peptides, glycopeptides, and chondroitin sulfate. The snail chondroitin sulfate can function as immunomodulation and immunosuppressant [1]. Another substance of snails seromucous is content of glycosaminoglycans, heparin, heparin sulfate, sulfate dermal, and hyaluronic acid; can function as stabilizer cofactors and/ or coreceptor for growth factors, cytokines, and chemokines; enzyme activity regulator; molecular labeling in response to cellular damage in the process of wound healing, infection, tumorigenesis; target for bacterial, viral, and parasitic virulence factors; as well as the immune system [2]. Achasin protein in the snail has important biological functions, among others, as a bacterial binding protein (enzyme) receptor [3]. The concentration snail mucus 100% and 5% snail slime cream have an effective effect on accelerating the duration of healing of second-degree (A) burns [4]. Chitosan is a polysaccharide that is found in abundant quantities in nature, especially in waste shrimp shells, crab skin. Chitosan is β-(1.4)- 2 amino-2 deoxy D-glucopyranose as a product of chitin deacetylation. The uniqueness of chitosan is polycationic so that it can suppress the growth rate of diarrheagenic Escherichia coli in vitro [5]. Synbiotic (Chitooligosaccharide and Lactobacillus acidophilus) bio preparation in yogurt can reduce cholesterol levels in vitro and in vivo [6,7]. Chitosan has been widely used in biomedical and pharmaceutical fields because it is biodegradable, non-toxic, non-immunogenic, and biocompatible with animal body tissues [8]. The combination of 100% snail mucous © 2020 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2020.v13i10.38266 Research Article YUSUP SUBAGIO SUTANTO 1,2 *, MAGDALENA SUTANTO 3 , AGNES SRI HARTI 4 , NONY PUSPAWATI 5 1 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Sebelas Maret University of Surakarta, Indonesia. Email: dr_yusupsubagio@yahoo.com Received: 12 May 2020, Revised and Accepted: 13 July 2020 23 District General Hospital of Surakarta City, Indonesia. 4 Departemen of Nursing, Kusuma Husada University of Surakarta, Indonesia. 5 Department of Faculty of Health Science, University of Setia Budi (Universitas Setia Budi), Surakarta, Indonesia.