{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:51:32Z","timestamp":1781779892365,"version":"3.54.5"},"reference-count":20,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>(1) Background: Indonesia faces the dual challenge of a high tuberculosis (TB) burden and increasing drug resistance. Conventional molecular diagnostics frequently fail to detect isoniazid resistance and nontuberculous mycobacteria (NTM). This study evaluates a domestic multiplex Open PCR system in Medan, Indonesia. (2) Methods: From July to November 2025, 1569 sputum specimens from suspected TB patients were analysed using the Indigen MTB\/NTM\/DR-TB Real-time PCR Kit Gen 2. (3) Results: Mycobacterial DNA was detected in 421 specimens (26.8%). Among these, 396 (94.1%) were drug-susceptible TB, while 16 (3.8%) showed resistance, predominantly INH mono-resistance (n = 14; 0.89% of total). Additionally, 9 cases (2.1%) involved NTM or TB-NTM co-infections. Tertiary hospitals showed significantly higher positivity rates (33.5%) than primary care (18.9%; p &lt; 0.001). TB status was significantly associated with male (p = 0.0052) and older age (p = 0.006), whereas resistance profiles and NTM distribution were consistent across all demographic groups (p &gt; 0.80). (4) Conclusions: This study describes the implementation and diagnostic yield of a domestic multiplex Open PCR system in Medan, Indonesia. By bridging diagnostic gaps across a decentralized referral network, this facilitates rapid and targeted therapy. Integrating multiplex domestic innovations into national diagnostic algorithms is essential for achieving Indonesia\u2019s TB elimination targets.<\/jats:p>","DOI":"10.3390\/tropicalmed11060168","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:59:38Z","timestamp":1781773178000},"page":"168","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementation of Open PCR System for the Detection of TB\/DR-TB and NTM in Sputum Samples from Suspected Pulmonary Tuberculosis Patients in Medan, Indonesia"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0459-1026","authenticated-orcid":false,"given":"R Lia","family":"Kusumawati","sequence":"first","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"},{"name":"Prof. Dr. Chairuddin Panusunan Lubis Universitas Sumatera Utara Teaching Hospital, Universitas Sumatera Utara, Medan 20155, Indonesia"},{"name":"PCR-WGS Microbiology Laboratory, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7041-3044","authenticated-orcid":false,"given":"Mirzan","family":"Hasibuan","sequence":"additional","affiliation":[{"name":"Prof. Dr. Chairuddin Panusunan Lubis Universitas Sumatera Utara Teaching Hospital, Universitas Sumatera Utara, Medan 20155, Indonesia"},{"name":"PCR-WGS Microbiology Laboratory, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisrina","family":"Tari","sequence":"additional","affiliation":[{"name":"PCR-WGS Microbiology Laboratory, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema Nazri","family":"Yanni","sequence":"additional","affiliation":[{"name":"Prof. Dr. Chairuddin Panusunan Lubis Universitas Sumatera Utara Teaching Hospital, Universitas Sumatera Utara, Medan 20155, Indonesia"},{"name":"Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Isa","family":"Ginting","sequence":"additional","affiliation":[{"name":"Prof. Dr. Chairuddin Panusunan Lubis Universitas Sumatera Utara Teaching Hospital, Universitas Sumatera Utara, Medan 20155, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0295-8824","authenticated-orcid":false,"given":"Cynthia","family":"Gozali","sequence":"additional","affiliation":[{"name":"Division of Materials Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, 8916-5 Takayama, Ikoma, Nara 630-0192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tryna","family":"Tania","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, RS Cipto Mangunkusumo, Jakarta 10430, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025). 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