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All Journal Jurnal Kedokteran Brawijaya International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Sari Pediatri Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan Indonesian Journal of Rheumatology Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Dewi Kartika Turbawaty
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Bandung
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Impact of Comorbidity on Length of Stay of Hospitalized Pneumonia in Children Suardi, Adi Utomo; Turbawati, Dewi Kartika
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (599.482 KB)

Abstract

 Background: The incidence of pneumonia in children under-five in West Java is high. The average length of stay (LOS) often exceeds the standards set by the Indonesia-Disease Related Group (INA-DRG) because of the comorbidities. It can cause financial loss for the hospital. This study was conducted to analyze the impact of comorbidity on LOS.Methods: Data was collected from medical records of 296 hospitalized pneumonia under-five children in the Department of Child Health Dr. Hasan Sadikin General Hospital Bandung in the period from January–December 2012 that consisted of patient’s identity, LOS, primary diagnosis, and comorbid diagnosis. Data was selected through inclusion and exclusion criteria and statistically analyzed using the chi-square and  Spearman correlation test.Results: Out of 218 subjects, those who had major comorbidities and minor comorbidities was 79 (36.2%) and 39 (17.9%), respectively. The average LOS of those who had major  and minor comorbidities was 8.33±8.252 days and 5.95±3.554 days, respectively. Congenital heart disease had the highest and most significant Risk Ratio (RR) with average LOS was 8.00±4.889 days with RR: 1.895 (95% CI:1.339–2.682, p=0.001).Conclusions: Subjects have higher average LOS than the LOS set by the INA-DRG. Congenital heart disease is the most common comorbidity and has the highest and the most significant risk ratio. [AMJ.2017;4(1):42–6]DOI: 10.15850/amj.v4n1.1019
Monocyte to Lymphocyte Ratio in Peripheral Blood of Tuberculous Meningitis with HIV Patients in Tertiary Hospital in West Java Amalia, Ridha; Turbawaty, Dewi Kartika; Sugianli, Adhi Kristianto; Aminah, Siti
International Journal of Integrated Health Sciences Vol 6, No 1 (2018)
Publisher : International Journal of Integrated Health Sciences

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (85.27 KB) | DOI: 10.15850/ijihs.v6n1.1140

Abstract

Objective: To describe peripheral blood monocyte to lymphocyte (ML) ratio in tuberculous meningitis (TBM) patients with human immunodeficiency virus (HIV) infection in Dr. Hasan Sadikin General Hospital Bandung as a tertiary hospital in West Java Province, Indonesia.Method: A cross-sectional study with retrospective data approach was done in Dr. Hasan Sadikin General Hospital, Bandung. Data were collected from TBM patients who were hospitalized in Dr. Hasan Sadikin General Hospital, Bandung in the period of 2014–2016. The sample size was determined using total sampling method. General data, clinical manifestation data, and laboratory finding data were collected. The ML ratio was collected and presented into three groups of percentile (25th, 25–75th and 75th) based on the pre-defined cut-off.Result: Six subjects (40%) had an ML ratio of ≤0.47 and 3 subjects had an ML ratio of ≥1.22 in TBM with HIV population. Among TBM with HIV-negative population, there were 16 subjects had ML ratio ≤0.47, and 19 subjects had ML ratio ≥1.22.Conclusion: The ML ratio in TBM with HIV infection has become additional tool for detecting the development of TBM with HIV-infected, as well as TBM with non-HIV-infected. Therefore, it could help directing the patients with clinical suspicious of TBM into the diagnosis algorithm and treatment of TBM, to have better outcome.Keywords: Human immunodeficiency virus infection,lymphocyte, monocyte, monocyte to lymphocyte ratio, tuberculous meningitis DOI: 10.15850/ijihs.v6n1.1140
KORELASI JUMLAH CLUSTER OF DIFFERENTIATION 4 DENGAN JENIS BAKTERI PENYEBAB INFEKSI PARU DARI KULTUR BILASAN BRONKOALVEOLAR PADA PASIEN HUMAN IMMUNODEFICIENCY VIRUS Melindah, Melindah; Santoso, Prayudi; Supriatna, Yana Akhmad; Turbawati, Dewi Kartika
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (252.827 KB) | DOI: 10.15395/mkb.v48n1.731

Abstract

Infeksi paru bakteri adalah penyebab utama morbiditas dan mortalitas pasien human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Infeksi HIV menyebabkan disfungsi sistem kekebalan yang dimanifestasikan penurunan jumlah cluster of differentiation 4 (CD4). Tujuan penelitian menentukan hubungan jumlah CD4 dengan jenis bakteri penyebab infeksi paru dari kultur bilasan bronkoalveolar pasien HIV di RS Dr. Hasan Sadikin Bandung. Penelitian analitik observasional dengan rancangan potong lintang. Pengambilan sampel sejak November 2011 sampai Oktober 2013 di Departemen Ilmu Penyakit Dalam RS Dr. Hasan Sadikin Bandung. Subjek 39 orang memenuhi kriteria inklusi, didapatkan usia rata-rata 32 tahun. Jumlah median CD4 18 (rentang, 0?190) sel/mm3. Hasil kultur jenis bakteri batang gram negatif 29/39 sampel dan kokus gram positif 10/39 sampel. Spesies terbanyak Pseudomonas aeruginosa 11/39 sampel, Klebsiella pneumoniae 11/39 sampel dan Streptococcus viridans 10/39 sampel. Analisis statistik berdasarkan point biserial correlation terdapat korelasi lemah (r=0,232) dan tidak bermakna antara CD4 dan jenis bakteri penyebab dengan nilai p=0,209 (p>0,05). Arah korelasi menunjukkan semakin kecil jumlah CD4 semakin besar kemungkinan bakteri batang gram negatif sebagai penyebab infeksi paru. Penelitian ini menunjukkan korelasi lemah antara jumlah CD4 dan jenis bakteri penyebab infeksi paru dari bilasan bronkoalveolar pada pasien infeksi HIV di RS Dr. Hasan Sadikin Bandung. [MKB. 2016;48(1):32?8]Kata kunci: Bilasan bronkoalveolar, human immunodeficiency virus (HIV), infeksi paru bakteri, jumlah CD4Correlation between Cluster of Differentiation 4 Cell Counts and Types of Bacteria Causing Lung Infection from Cultured Washing of Bronchoalveolar Lavage in Human Immunodeficiency Virus PatientsAbstractBacterial lung infection is the leading cause of morbidity and mortality of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). HIV infection causes immune system dysfunction, which is manifested by decreased cluster of differentiation 4 (CD4) cell counts. The purpose of this study was to determine the correlation between CD4 cell counts and the type of bacteria that caused lung infection from cultured washing of bronchoalveolar lavage in HIV patients in Dr. Hasan Sadikin Hospital Bandung. This was an observational analytic study with a cross-sectional design. Subjects were collected from November 2011 to October 2013 in Internal Departement Dr. Hasan Sadikin Hospital Bandung. There were 39 subjects enrolled with the average age of patients was 32 years. The median CD4 cell counts was 18 (range, 0?190) cell/mm3. The type of gram-negative rods bacteria was 29/39 samples and gram-positive cocci was 10/39 samples. Most species were Pseudomonas aeruginosa 11/39 samples, Klebsiella pneumoniae 11/39 samples and Streptococcus viridans 10/39 samples. Statistical analysis based on a point biserial correlation showed weak (r=0.232) and no significant correlation between CD4 cell counts and the type of bacteria (p>0.05). The weak correlation was the smaller the number of CD4 cell counts, the greater possibility of the gram-negative rod bacteria being the cause of the infection. This study concluded that there is only a weak and no correlation between the number of CD4 cell counts and the type of bacteria causing the lung infection obtained from bronchoalveolar lavage in patients with HIV in Dr. Hasan Sadikin Hospital Bandung. [MKB. 2016;48(1):32?8]Key words: Bacterial lung infection, bronchoalveolar lavage, CD4 cell counts, human immunodeficiency virus
UJI DIAGNOSTIK PEMERIKSAAN KADAR TRANSFORMING GROWTH FACTOR BETA 1 CAIRAN PLEURA PADA PLEURITIS TUBERKULOSIS Wahyuningrum, Woro Hapsari; Indrati, Agnes Rengga; Rachmayati, Sylvia; Turbawaty, Dewi Kartika
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (179.438 KB) | DOI: 10.15395/mkb.v49n4.1152

Abstract

Sulitnya penegakan diagnosis pleuritis tuberkulosis (TB) disebabkan oleh gambaran klinis yang tidak spesifik dan rendahnya sensitivitas pemeriksaan bakteriologik, akibat cairan pleura yang bersifat pausibasiler.Transforming growth factor beta 1 (TGF-?1) mampu menekan respons imun seluler terhadap M. tuberculosis, berperan dalam aktivasi TB laten, kerusakan jaringan, dan fibrosis. Penelitian ini bertujuan mengetahui peranan pemeriksaankadarTGF-?1 cairan pleura dalam penegakan diagnosis pleuritis TB. Penelitian ini adalah uji diagnostik, pengambilan data secara potong lintang. Bahan pemeriksaan berupa cairan pleura yang disimpan dalam ultra low freezer dari pasien rawat inap di RSUP Dr. Hasan Sadikin (RSHS) Bandung dan Rumah Sakit Paru Dr. H.A Rotinsulu Bandung periode Oktober 2014 ? Maret 2015. Total subjek penelitian 68, terdiri dari 17 pleuritis TB confirmed, 22 pleuritis TB probable, dan 29 pleuritis non TB.Kadar TGF-?1 cairan pleura pleuritis TB: 41,4 (10,4 ?19.481) pg/mL. Pemeriksaan kadar TGF-?1 menunjukkan sensitivitas 66,7%, spesifisitas 65,5% pada nilai cut-off  >37 pg/mL. Sensitivitas pemeriksaan kadar  TGF-?1 lebih tinggi bila dibanding dengan pemeriksaan bakteriologik. Hasil negatif pada pemeriksaan bakteriologik dari subjek pleuritis TB probable, 77,3% di antaranya memberikan hasil positif pada pemeriksaan kadar TGF-?1.  Pemeriksaan ini dapat digunakan sebagai tambahan modalitas pemeriksaan laboratorium untuk mendiagnosis pleuritis TB, terutama bila didapatkan hasil negatif pada pemeriksaan bakteriologik, namun kecurigaan pleuritis TB sangat kuat.Kata kunci: Kadar TGF-?1, pemeriksaan bakteriologik, pleuritis TB  Diagnostic Value of Pleural Fluid Transforming Growth Factor Beta 1 Level in Tuberculous PleurisyTuberculous(TB) pleurisy was difficult to be diagnosed as it has nonspecific symptoms and low sensitivity in  bacteriological tests which are caused by paucibacillary of pleural fluid. Transforming Growth Factor Beta 1 (TGF-?1) could suppress  the immune response to M. tuberculosis infection, activating latent TB infection that involves tissue damages and fibrosis. This study aimed to determine the role of pleural fluid TGF-?1 level in diagnosing TB pleurisy. This was a cross-sectional specific descriptive observational study involving a total subjects of 68 that consisted of  17 confirmed TB pleurisy, 22 probable TB pleurisy, and 29 non-TB pleurisy. Pleural fluid collected in October 2014 ? March 2015 from the subjects was stored in an ultra low freezer. The which.level of TGF-?1 in pleural fluid in TB pleurisy was 41,4(10,4 ? 19.481) pg/mL. Pleural  fluid TGF-?1 level showed a sensitivity of 66,7%, specificity of 65,5% and a cut-off value >37pg/mL. The sensitivity level of pleural fluid TGF-?1 was higher than that of the bacteriological test. Pleural fluid TGF-?1 level can be used as an adjunct modality of laboratory test for diagnosing TB pleurisy, especially for patient with high suspiscion of TB pleurisy but yield negative result in the bacteriological test.Key words: Bacteriological tests, TB pleurisy, TGF-?1 levels
Gambaran Validitas Pemeriksaan Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Metode Rapid Immunochromatography pada Bahan Pemeriksaan Sputum dan Serum Penderita Tuberkulosis Paru Subroto, Hendra; Parwati, Ida; Turbawaty, Dewi Kartika; Alisjahbana, Bachti
Majalah Kedokteran Bandung Vol 49, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.856 KB) | DOI: 10.15395/mkb.v49n3.1120

Abstract

Penegakan diagnosis tuberkulosis (TB) paru penting dalam mengurangi morbiditas dan mortalitas. Diagnosis laboratorium TB paru berdasar atas pemeriksaan BTA dan kultur M. tuberculosis memiliki sensitivitas rendah. Terdapat pemeriksaan cocktail antigen TB rapid immunochromatography (ICT) yang mendeteksi antigen ESAT-6, CFP-10, MPT-64 yang disekresikan oleh M. tuberculosis. Tujuan penelitian menganalisis validitas pemeriksaan cocktail antigen TB metode rapid ICT sputum dan serum penderita TB paru terhadap kultur Ogawa. Penelitian dilaksanakan Juli–Oktober 2014 di RSUP Dr. Hasan Sadikin Bandung. Bentuk penelitian adalah observasional deskriptif khusus dengan rancangan penelitian potong lintang. Subjek penelitian penderita yang datang ke Poliklinik Pulmonologi atau Poliklinik DOTS, didiagnosis TB paru. Sebanyak 68 sputum dan serum dari 33 kultur sputum M. tuberculosis positif dan 35 kultur negatif dilakukan pemeriksaan cocktail antigen TB rapid ICT. Angka positivitas cocktail antigen TB rapid ICT sputum 54,4%; serum tanpa pemanasan 0%. Pada serum dilakukan pemanasan pada suhu 56oC selama 30 menit untuk menghilangkan aktivitas antibodi dan didapatkan angka positivitas sebesar 19,1%. Nilai sensitivitas dan spesifisitas pemeriksaan untuk sputum 93,9% dan 82,8%, untuk serum tanpa pemanasan 0% dan 100%, serta serum dengan pemanasan 24,2% dan 85,7%.  Validitas pemeriksaan sputum memiliki sensitivitas tinggi dan spesifisitas sedang, untuk serum memiliki sensitivitas rendah dan spesifisitas tinggi. [MKB. 2017;49(3):178–85]Kata kunci: Cocktail antigen TB rapid ICT, kultur Ogawa, mikroskopik BTA, tuberkulosis paru, serum, sputum Validity of Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Rapid Immunochromatography Method on Sputum and Serum Samples from Patient with Pulmonary TuberculosisEarly diagnosis of pulmonary tuberculosis (TB) is very important in reducing morbidity and mortality. The current diagnosis of TB includes direct staining (acid fast bacilli) or M. tuberculosis culture, but these examinations have a low sensitivity. An assay using rapid ICT cocktail antigen TB is currently available for diagnosing TB. This method can detect ESAT-6, CFP-10, and MPT-64 antigen which is secreted by M. tuberculosis. The aim of this study was to analyze the validity of cocktail antigen TB rapid ICT using sputum and serum with Ogawa culture. This was a cross-sectional descriptive observational study. Sputum and serum were collected from patients who were diagnosed as lung TB suspects in the lung and DOTS Clinic of Dr. Hasan Sadikin General Hospital Bandung during the period of July–December 2014 in . Cocktail antigen TB detection assay using two kind of samples (sputum and serum) were evaluated. A total of 68 subjects of33 subjects presented positive culture and 35 presented negative cultures. Positivity rates for sputum and serum were 54.4% and 0%, respectively. Heated sputum assay had a sensitivity of 93.9% and specificity of 82.8%, Serum assay presented a sensitivity of 0% and specificity  of100%.  Serum were modified by heating at 56oC for 30 minutes. The positivity rate of heated serum was 19.1%. The result of modified serum assay showed a sensitivity  of 24.2% and specificity of 85.7%. Conclusion: the sensitivity of the sputum assay is high and the specificity is medium. The sensitivity of this serum assay is low and the specificity is high. [MKB. 2017;49(3):178–85]Key words: Acid fast bacilli, cocktail antigen TB rapid ICT, pulmonary tuberculosis, Ogawa culture, sputum, serum
Kesesuaian antara Metode Microscopic Observation Drug Susceptibility Assay dan Ogawa pada Biakan Mycobacterium tuberculosis Dewi B., Ni Sayu; Parwati, Ida; Alisjahbana, Bachti; Turbawaty, Dewi Kartika
Majalah Kedokteran Bandung Vol 43, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tuberkulosis (TB) merupakan masalah kesehatan masyarakat di berbagai negara di dunia. Diagnosis pasti TB ditegakkan berdasarkan penemuan kuman M. tuberculosis pada pemeriksaan mikroskopik atau biakan sputum. Biakan merupakan baku emas, namun metode yang digunakan saat ini membutuhkan waktu minimal 8 minggu. Microscopic observation drug susceptibility assay (MODS) merupakan metode biakan untuk M. tuberculosis menggunakan media cair yang dapat sekaligus menguji kepekaan obat TB secara mikroskopik. Tujuan penelitian ini adalah untuk mengetahui kesesuaian metode MODS dengan metode Ogawa (media padat) untuk biakan M. tuberculosis pada penderita TB paru. Penelitian cross sectional telah dilakukan di Departemen Patologi Klinik RSUP Dr. Hasan Sadikin Bandung dan pemeriksaan spesimen dilakukan di Balai Pengembangan Laboratorium Kesehatan (BPLK) Provinsi Jawa Barat periode April–Agustus 2010. Subjek penelitian sebanyak 133 penderita yang didiagnosis tersangka TB paru. Setiap spesimen ditanam pada dua media, media cair MODS dan media padat Ogawa. Analisis statistik kesesuaian metode MODS dengan Ogawa menggunakan uji koefisien Kappa. Terdapat 172 spesimen dari 133 subjek. Kesesuaian antara hasil biakan M. tuberculosis metode MODS dan Ogawa didapatkan nilai Kappa 0,91 yang berarti terdapat kesesuaian yang tinggi antara metode MODS dan Ogawa. Perbandingan waktu pertumbuhan M. tuberculosis secara bermakna lebih cepat (p = 0,000) pada metode MODS, yaitu 10,1 hari (rentang 4–21 hari), dibandingkan dengan metode Ogawa, yaitu 24,8 hari (rentang 14–35 hari). Simpulan, metode MODS dan Ogawa mempunyai angka keberhasilan diagnostik yang relatif sama, keunggulan metode MODS adalah pertumbuhan M. tuberculosis lebih cepat dibandingkan dengan metode Ogawa. [MKB. 2011;43(2):83–8].Kata kunci: Microscopic observation drug susceptibility assay (MODS), M. tuberculosis, Ogawa, sputumConformity Method Between Microscopic Observation Drug Susceptibility Assay and Ogawa Mycobacterium CultureTuberculosis (TB) is a problem of public health that causing high morbidity and mortality rates in various countries in the world. The diagnosis of pulmonary tuberculosis in adults can be established based on the discovery of M. tuberculosis on smear or culture of sputum. Culture is the gold standard but the availlable method is time consuming, it is need minimal eight weeks. Microscopic observation drug susceptibility assay (MODS) is one of methods for M. tuberculosis culture using liquid medium that can be a simultaneously test for M. tuberculosis drug sensitivity. The purpose of this study was to determine the conformity of the MODS method compared with Ogawa method for cultivation of M. tuberculosis in pulmonary TB patients. The cross sectional research has been conducted at Clinical Pathology Department of Dr. Hasan Sadikin Hospital, Bandung and examination of the specimen done at Health Laboratory Development Unit (BPLK), West Java Province between April to August 2010. The subjects were patients who diagnosed as pulmonary TB suspect. Each collected specimen was cultured in liquid media MODS and solid media Ogawa. To analyze the conformity of MODS and Ogawa method, Kappa coefficient of agreement was used. There were 172 specimens collected from 133 subjects. The conformity between culture results of M. tuberculosis in MODS method and in Ogawa’s method using Kappa coefficient, was high (Kappa index 0.91). The difference of growth time of M. tuberculosis significant (p=0.000), in MODS was 10.1 days (range 4–21 days) and in Ogawa method was 24.8 days (range 14–35 days). Conclusion, MODS and Ogawa’s method have the relatively similar diagnostic success rate, the advantage of MODS method is, the growth of M. tuberculosis is faster than in Ogawa method. [MKB. 2011;43(2):83–8].Key words: Microscopic observation drug susceptibility assay (MODS), M. tuberculosis, Ogawa, sputum DOI: http://dx.doi.org/10.15395/mkb.v43n2.48
Correlation of Serum Potassium Status and HEART Score in Acute Coronary Syndrome Patients Verina Logito; Nida Suraya; Dewi Kartika Turbawati
Althea Medical Journal Vol 8, No 4 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v8n4.2397

Abstract

Background: Patients with acute coronary syndrome (ACS) often experience hypokalemia which increase the risk of ventricular arrhythmia. The HEART Score can identify the prognosis of ACS. This study aimed to examine the correlation between serum potassium and HEART Score on ACS.Methods: This was a cross-sectional observational, correlative analytic study. The data were taken retrospectively using secondary data. Inclusion criteria were all ACS patients who had been examined for serum potassium parameters at the Emergency Room of Dr. Hasan Sadikin General Hospital Bandung in 2019. The HEART Score was calculated based on history (H), electrocardiogram (E), Age (A), risk factors (R), and troponin (T). Subjects were divided into low risk, intermediate risk, and high risk groups based on the HEART Score value.Results: Fifty-two ACS subjects were mostly male with a mean±SD age of 59±9 years. All subjects had moderate and high HEART scores, with 79% subjects having normokalemia. There was no correlation between HEART Score and serum potassium levels (r = -0.083, p=0.279).Conclusion: There is no relationship between serum potassium and the HEART Score that may need to determine the prognosis in ACS patients. Further study is imperative to explore serum potassium levels which might begin to decline 24 hours after the acute attack. 
Impact of Comorbidity on Length of Stay of Hospitalized Pneumonia in Children Nur Mala Il A'la; Adi Utomo Suardi; Dewi Kartika Turbawati
Althea Medical Journal Vol 4, No 1 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (599.482 KB)

Abstract

 Background: The incidence of pneumonia in children under-five in West Java is high. The average length of stay (LOS) often exceeds the standards set by the Indonesia-Disease Related Group (INA-DRG) because of the comorbidities. It can cause financial loss for the hospital. This study was conducted to analyze the impact of comorbidity on LOS.Methods: Data was collected from medical records of 296 hospitalized pneumonia under-five children in the Department of Child Health Dr. Hasan Sadikin General Hospital Bandung in the period from January–December 2012 that consisted of patient’s identity, LOS, primary diagnosis, and comorbid diagnosis. Data was selected through inclusion and exclusion criteria and statistically analyzed using the chi-square and  Spearman correlation test.Results: Out of 218 subjects, those who had major comorbidities and minor comorbidities was 79 (36.2%) and 39 (17.9%), respectively. The average LOS of those who had major  and minor comorbidities was 8.33±8.252 days and 5.95±3.554 days, respectively. Congenital heart disease had the highest and most significant Risk Ratio (RR) with average LOS was 8.00±4.889 days with RR: 1.895 (95% CI:1.339–2.682, p=0.001).Conclusions: Subjects have higher average LOS than the LOS set by the INA-DRG. Congenital heart disease is the most common comorbidity and has the highest and the most significant risk ratio. [AMJ.2017;4(1):42–6]DOI: 10.15850/amj.v4n1.1019
Validity of Mycobacterium tuberculosis Antigens Cocktail: ESAT-6, CFP-10 and MPT64 in Sputum and Cerebrospinal Fluid for Pulmonary Tuberculosis and Tuberculous Meningitis Diagnosis Dewi Kartika Turbawaty; Nenny Gustiani; Livia Noviani; Ida Parwati
International Journal of Integrated Health Sciences Vol 3, No 2 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Abstract

Objective: Rapid and accurate TB diagnostics play an important role in detecting the disease. Currently, antigens secreted (ESAT-6, CFP-10 and MPT64) by M. tuberculosis and encoded by genes “Region of Difference” (RD)1, RD2 and RD3 give an opportunity for rapid TB diagnosis. Genomic region RD1-RD3 was deleted in M. bovis BCG strains and absent in mycobacteria other than M. tuberculosis. This property is advantageous because it enable to create a specific diagnostic tools for M. tuberculosis infection. The aim of this study is to determine the validity of TB antigens cocktail (ESAT-6, CFP-10 and MPT64) for pulmonary tuberculosis and TB meningitis diagnosis. Methods: This is a descriptive observational study design. The study was conducted at the Clinical Pathology Laboratory of Dr. Hasan Sadikin General Hospital during September 2012 until March 2013 for the pulmonary tuberculosis study and from January 2014 to May 2014 for the TB meningitis study. The TB antigen cocktail rapid immunochromatography (ICT) test was done on all of the samples. The sputum and CSF were cultured as gold standards. Results: There were 149 pulmonary and 41 TB meningitis subjects. The sensitivity of TB antigens cocktail rapid ICT for diagnosing pulmonary tuberculosis was 95.7% with a specificity of 87.2%. Of 41 TB meningitis subjects, based on Marais criteria, there were 6 (16%) subjects with a definite TB meningitis, 26 (63%) subjects with probable TB meningitis and 9 (21%) subjects with possible TB meningitis. The sensitivity and specificity of TB antigens cocktail rapid ICT for TB meningitis diagnosis were 83.3% and 68.5% respectively. Conclusions: In this study, rapid ICT TB antigens cocktail (ESAT-6, CFP-10 and MPT64) from sputum sample has good validity for diagnosing a pulmonary tuberculosis, and from CSF sample has moderate validity to diagnose TB meningitis. Keywords: M. tuberculosis culture, pulmonary TB, TB meningitis, TB antigens cocktail (ESAT-6, CFP-10 and MPT64) rapid ICT DOI: 10.15850/ijihs.v3n2.585
Methicillin-Resistant Staphylococcus aureus (MRSA) Patterns and Antibiotic Susceptibility in Surgical and Non-Surgical Patients in a Tertiary Hospital in Indonesia Dewi Kartika Turbawaty; Verina Logito; Anna Tjandrawati
Majalah Kedokteran Bandung Vol 53, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n3.2396

Abstract

Methicillin-Resistant Staphylococcus aureus (MRSA) in the hospital is found mainly in surgical patients, which increases morbidity and mortality. Currently, vancomycin is the drug of choice for the treatment of MRSA infections. The increasing use of vancomycin and its inappropriate administration may increase the resistance of S. aureus to vancomycin. This study aimed to describe the distribution of MRSA and types of antibiotics that are still sensitive to MRSA in surgical and non-surgical patients. This cross-sectional, observational, retrospective descriptive study was conducted at the Microbiology Laboratory, Dr. Hasan Sadikin General Hospital, in 2019 using secondary data on the results of culture examination and antibiotic susceptibility of positive S. aureus culture isolates from all types of isolates from surgical and non-surgical patients. All specimens were cultured in appropriate media. Identification of S. aureus was performed by Gram staining to identify bacterial morphology, and automatic tools. Antibiotic susceptibility test was performed using an automatic machine. Seventy-five isolates (17%) were identified to be MRSA with 46 (53%) of them retrieved from surgical patients. Most of the MRSA isolates came from pus and were mostly due to skin infections. Antibiotic susceptibility results showed two Vancomycin-Resistant Staphylococcus aureus (VRSA) isolates from surgical patients. The positive culture of the MRSA and VRSA was dominated by surgical patients with pus coming from surgical wound infection, burn, and other skin infection as the most common sources. Thus, the proportion of MRSA isolates in the hospital in 2019 is 17% and two VRSA isolates are identified in the same year. The surgical ward was the primary origin of most MRSA isolates. Further studies are necessary to identify the MRSA incidence rate, evaluation and periodic monitoring of antibiotic use, and active surveillance in the surgical patient rooms.
Co-Authors Adhi Kristianto Sugianli Adhi Kristianto Sugianli Adi Utomo Suardi Adi Utomo Suardi Agnes Rengga Indrati Akhmad Imron, Akhmad Amalia, Ridha Anna Tjandrawati Astri Astuti Bachti Alisjahbana Basti Andriyoko Coriejati Rita Delita Prihatni Fransisca Mulyadi Hendra Subroto, Hendra Heti Kus Erni Ida Parwati Ida Parwati Irawati, Indri Khairunnissa, Khairunnissa Laniyati Hamijoyo, Laniyati Leni Lismayanti Livia Noviani Melindah, Melindah Mulya Nurmansyah Ardisasmita Nadjwa Zamalek Dalimoenthe Nenny Gustiani Ni Sayu Dewi B. Nida Suraya Nida Suraya Nina Tristina Nur Mala Il A'la Patrick Philo Prayudi Santoso Raissa Yolanda Raja Iqbal Mulya Harahap Rizki Dumpatna Sara Puspita Sheila Sumargo, Sheila Siti Aminah Sylvia Rachmayati Tena Rosmiati Iskandar Tetty Yuniaty Tiene Rostini, Tiene Ulfah, Nuri Dzulfiani Verina Logito Verina Logito Wahyuningrum, Woro Hapsari Yana Akhmad Supriatna, Yana Akhmad