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"Latar Belakang : Pasien kanker paru rentan terhadap infeksi jamur. Candida dan Aspergillus merupakan jenis jamur paling banyak yang menyebabkan infeksi jamur pada pasien kanker. Penelitian ini bertujuan untuk mengetahui profil klinis, spektrum jamur dan imunoglobulin G spesifik Aspergillus pada pasien kanker paru yang belum dikemoterapi di RSUP Persahabatan.Metode : Penelitian ini berdesain potong lintang. Subjek penelitian adalah pasien KPKBSK yang sudah tegak jenis dan belum dikemoterapi yang berobat di RSUP Persahabatan. Dahak dan serum diperiksakan biakan jamur dan IgG spesifik Aspergillus di Departemen Parasitologi Fakultas Kedokteran Universitas Indonesia. Hasil biakan jamur dan IgG spesifif Aspergillus dianalisis untuk mengetahui hubungannya dengan demografi.Hasil : Subjek penelitian sebanyak 77 pasien. Hasil biakan dahak yang tumbuh jamur sebanyak 76 subjek (98,7%). Jumlah isolat jamur yang tumbuh ≥ dua spesies sebanyak 35 pasien (45,5%). Isolat jamur yang paling banyak tumbuh adalah Candida albicans (72,3%) dan Aspergillus niger (33,8%). Hasil IgG spesifik Aspergillus pada subjek penelitian yang positif sebanyak 22,1%. Terdapat hubungan bermakna antara umur dan leukosit dengan IgG spesifik Aspergillus dan antara umur dan jenis kelamin dengan biakan Aspergillus.Kesimpulan : Isolat jamur yang ditemukan di antaranya adalah Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis dan Candida kruseii. Terdapat hasil IgG spesifik Aspergillus positif pada subjek penelitian sebanyak 22,1%. Umur dan nilai leukosit berhubungan dengan IgG spesifik Aspergillus dengan nilai (p = 0,048) dan (p = 0,014), sedangkan umur dan jenis kelamin berhubungan dengan biakan Aspergillus dengan nilai (p = 0,027) dan (p = 0,035).

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Background: Lung cancer patients are prone to fungal infections. Candida and Aspergillus are the most common cause of fungal infections in cancer patients. This study aimed to determine the clinical profile, fungal detection spectrum and level of Aspergillus specific immunoglobulin-G (igG) of new lung cancer patients prior to chemotherapy at Persahabatan Hospital.

Methods: We performed a cross-sectional study, involving NSCLC patients in Persahabatan Hospital whose type of cancer had been established and had not received chemotherapy as subjects. Sputum and serum of the patients was examined for fungus and Aspergillus specific IgG cultures in the Department of Parasitology Faculty of Medicine, Universitas Indonesia. The results of Aspergillus specific fungi and IgG were analyzed to determine their relationship with demographics.

Results: The study included 77 patients as subjects. Sputum culture detected fungi growth in 76 subjects (98.7%). Fungal isolates that grew ≥ 2 species were present in 35 patients (45.5%). Candida albicans (72.3%) and Aspergillus niger (33.8%) were found from the cultures. Positive Aspergillus specific IgG was present in 22.1% of the subjects. There was a significant relationship between age, leukocytes concentration, and level of Aspergillus specific IgG and between age, sex and Aspergillus culture.

Conclusion: The fungi isolates in this study were Candida albicans, Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus, Penicillium spp. Candida glabrata, Candida paraspillosis, Candida tropicalis and Candida kruseii. Aspergillus specific IgG results were positive in 22.1% of subjects. Age and leukocyte value are associated with Aspergillus specific IgG with (p=0.048) and (p=0.014), and age and sex are associated with Aspergillus culture with (p=0.027) and (p=0.035)."

"Latar Belakang Kanker paru adalah jenis kanker dengan jumlah penderita terbanyak baik di dunia maupun di Indonesia. Pengobatan kanker paru saat ini diyakini bersifat multimodalitas yang melibatkan berbagai jenis terapi, tetapi prognosis masih kurang baik. Pasien kanker paru juga cenderung mengalami penurunan kualitas hidup. Akibatnya banyak pasien mencari dan mencoba pengobatan lain selain terapi konvensional. Salah satunya yang sering digunakan adalah complementary and alternative medicine (CAM). Namun, penelitian mengenai CAM sendiri masih sangat terbatas di Indonesia. Hal ini menjadi penting karena CAM merupakan terapi yang meliputi komponen yang luas, tetapi tidak semua penggunaan dan manfaatnya sudah terbukti secara klinis. Oleh karena itu, peneliti ingin mencari tahu penggunaan CAM pada penderita kanker paru di Indonesia dan dampaknya terhadap kualitas hidup. Metode Penelitian ini menggunakan desain studi cross-section dan dilakukan di Poli Rawat Jalan Onkologi Paru RSUP Persahabatan. Karakteristik sosiodemografi dan data penggunaan CAM pasien diperoleh dari wawancara, sedangkan karakteristik klinis diperoleh dari rekam medis pasien. Tingkat kualitas hidup diukur dengan kuesioner EORTC QLQ-C30 versi Bahasa Indonesia. Hasil Prevalensi pengguna CAM oleh pasien kanker paru di RS Persahabatan adalah 70% dengan jenis CAM yang paling banyak digunakan adalah suplementasi diet, vitamin, dan herbal Indonesia. Hasil analisis karakteristik subjek menunjukan tingkat pendidikan (p=0,013) dan tingkat penghasilan per bulan (p=0,003) berhubungan dengan penggunaan CAM oleh pasien kanker paru di RS Persahabatan. Namun, tidak ditemukan hubungan bermakna secara statistik antara penggunaan CAM dengan tingkat kualitas hidup subjek (p=0,374). Kesimpulan Penggunaan CAM tidak memiliki hubungan bermakna secara uji statistik dengan tingkat kualitas hidup pasien kanker paru.

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Introduction Lung cancer is the most common cancer both in the world and in Indonesia. Lung cancer treatment is currently believed to be multi-modality involving various types of therapy, but the prognosis is still unfavorable. Lung cancer patients also tend to experience a decrease in quality of life. As a result, many patients seek and try other treatments besides conventional therapy. One of them that is often used is complementary and alternative medicine (CAM). However, research on CAM itself is still very limited in Indonesia. This is important because CAM is a therapy that includes a wide range of components, but not all of its uses and benefits have been clinically proven. Therefore, researcher wanted to find out the use of CAM in lung cancer patients in Indonesia and its impact on quality of life. Method This study used a cross-section design and was conducted at the Lung Oncology Outpatient Clinic of RSUP Persahabatan. Sociodemographic characteristics and CAM use data were obtained from patient interviews, while clinical characteristics were obtained from patients' medical records. The level of quality of life was measured with the Indonesian version of the EORTC QLQ-C30 questionnaire. Results The prevalence of CAM use by lung cancer patients at RSUP Persahabatan was 70% with the most widely used types are dietary supplementation, vitamins, and Indonesian herbs. The results of the analysis of subject characteristics showed that the level of education (p=0.013) and the level of income per month (p=0.003) were associated with the use of CAM by lung cancer patients. However, there was no significant association between the use of CAM and the level of quality of life of the subject (p=0.374). Conclusion CAM use is not related statistically to the quality of life of lung cancer patients."

"Latar belakang: Pasien kanker paru berpotensi mengalami infeksi oportunistik yang dapat memperburuk luaran klinis, bahkan kematian. Salah satu penyebab infeksi oportunistik itu adalah jamur Aspergillus sp. Diagnosis dini masih menjadi tantangan, tetapi sangat penting dilakukan agar tata laksana dapat dioptimalkan. Tujuan: Penelitian ini bertujuan untuk mengetahui korelasi klinis dengan hasil kultur jamur Aspergillus pada pasien kanker paru karsinoma bukan sel kecil (KPKBSK) di RSUP Persahabatan serta uji kepekaannya terhadap vorikonazol. Metode: Studi potong lintang ini dilakukan pada pasien KPKBSK yang memenuhi kriteria inklusi. Prosedur biakan jamur dari sputum induksi dilakukan pada medium Agar Sabouraud Dekstrosa (ASD) menggunakan metode high volume. Identifikasi spesies dilakukan dengan pemeriksaan mikroskopik, dilanjutkan dengan uji kepekaan Aspergillus menggunakan metode difusi cakram. Data klinis pasien diperoleh dari rekam medis. Hasil: Dari 70 pasien KPKBSK yang memenuhi kriteria inklusi, terdapat pasien laki-laki 61,4%, dengan rerata usia 59,83  9,18 tahun. Profil klinis lain menunjukkan jenis adenokarsinoma 74,3%, stadium lanjut kanker paru 78,6%, tampilan status 1 40%, perokok aktif 60%, dan indeks brinkman berat 31,4%. Gejala klinis berupa sesak napas 81,4%, nyeri dada 71,4%, berat badan turun 71,4%, batuk 45,7%, hemoptisis 28,6%, dan demam 8,6%. Riwayat komorbid berupa diabetes melitus 18,6%, bekas tuberkulosis 12,9%, dan asma/penyakit paru obstruktif kronik 1,4%. Proporsi Aspergillus yang diisolasi dari sputum induksi didapatkan pada 43 pasien (61,4%), dengan 67 isolat. Distribusi spesies Aspergillus terdiri atas Aspergillus niger 22,1%, Aspergillus fumigatus 17,9%, dan Aspergillus flavus 7,9%. Analisis statistik menunjukkan terdapat hubungan bermakna antara jenis kelamin laki-laki, gejala klinis batuk dan demam dengan hasil kultur Aspergillus (p<0.05). Uji kepekaan 59 isolat Aspergillus sp. terhadap vorikonazol menunjukkan hasil sensitif 57,6%, intermediet 34,6%, dan resisten 19,3%. Simpulan: Pada penelitian ini terdapat hubungan bermakna antara jenis kelamin laki-laki, gejala klinis batuk, dan demam dengan hasil kultur Aspergillus (p<0.05). Tiga puluh sembilan dari 59 isolat Aspergillus spp. masih sensitif terhadap vorikonazol.

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Background: Lung cancer patients have the potential to experience opportunistic infections that can worsen clinical outcomes, even death. One of the causes of opportunistic infection is the fungus Aspergillus sp. Early diagnosis remains a challenge, but it is necessary for optimal management.

Objective: This study aims to determine the clinical correlation with the results of Aspergillus culture in patients with non-small cell lung carcinoma (NSCLC) at Persahabatan Hospital and their susceptibility to voriconazole.

Methods: This cross-sectional study was carried out on NSCLC patients who met the inclusion criteria. The procedure of fungal culture from induced sputum was performed on Sabouraud Dextrose Agar (SDA) medium using the high volume method. Species identification was conducted with microscopic examination, followed by Aspergillus susceptibility test using the disc diffusion method. Patients’ clinical data obtained from medical records.

Results: Out of 70 NSCLC patients who met the inclusion criteria, there were male patients 61.4%, with a mean age of 59.83 ± 9.18 years. Clinical profiles of NSCLC patients were adenocarcinoma 74.3%, advanced lung cancer 78.6%, performance status 1 40%, active smokers 60%, and severe Brinkman index 31.4%. Clinical symptoms of shortness of breath 81.4%, chest pain 71.4%, weight loss 71.4%, cough 45.7%, hemoptysis 28.6%, and fever 8,6%. A history of comorbid diabetes mellitus 18.6%, former tuberculosis 12.9%, and asthma/chronic obstructive pulmonary disease 1.4%. The proportion of Aspergillus isolated from induction sputum was found in 43 patients (61.4%), as many as 67 isolates. The distribution of Aspergillus species consisted of Aspergillus niger 22.1%, Aspergillus fumigatus 17.9%, and Aspergillus flavus 7.9%. Statistical analysis showed that there was a significant relationship between male gender, clinical symptoms of cough, and fever with the results of Aspergillus culture (p <0.05). Susceptibility test for 59 isolates of Aspergillus sp. to voriconazole showed sensitivity of 57.6%, intermediate 34.6%, and resistance 19.3%.

Conclusion: In this study, there was a significant relationship between male gender, clinical symptoms of cough, and fever with Aspergillus culture results (p <0.05). Thirty-nine out of 59 Aspergillus spp. isolates were still sensitive to voriconazole."

"ABSTRAKLatar Belakang:Penelitian ini merupakan studi awal untuk menetapkan proporsi pneumonitis radiasi pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan.Metode: Penelitian ini menggunakan desain retrospektif pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan antara Juni 2013-Juli 2015. Pengambilan data melalui rekam medik dan dilakukan evaluasi ulang foto toraks 1 bulan pasca radiasi.Hasil: Terdapat 33 pasien kanker paru yang memenuhi kriteria inklusi. Karakteristik subyek meliputi usia ≥51 tahun (63,6%), laki-laki (66,7%), riwayat merokok (75,8%), IB sedang (60%), dosis radiasi 300-4000 (60,6%), fraksi radiasi 10-19 (60,6%), tidak mempunyai riwayat kemoterapi (54,5%), kanker paru jenis adenokarsinoma (66,7%) dan stage IV (84,84%). Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4% yang terdiri dari gambaran hazy ground glass opacities, hazy ground glass opacities dan fibrosis serta fibrosis. Ditemukan perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi (p<0,05).Kesimpulan: Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4%. Terdapat perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi.

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ABSTRACTIntroduction: This is a preliminary study to determine proportion radiation pneumonitis in lung cancer patients who got radiaton in Persahabatan Hospital.Method: This was a retrospective study in lung cancer patients who got radiation in Persahabatan Hospital between June 2013 ? July 2015. Interpretation data were from medical record and did reevaluation chest x ray 1 month after radiation.Result: There were 33 lung cancer patients were filled inclusion criteria. Subjects characteristic were age ≥51 years (63,6%), male (66,7%), history of smoking (75,8%), moderate IB (60%), radiation doses 3000-4000 (60,6%), radiation fractions 10-19 (60,6%), had no history of chemotheraphy (54,5%), adenocarcinoma (66,7%) and stage IV (84,84%). Proportion radiation pneumonitis based on chest x ray were 39,4% that include hazy ground glass opacities, hazy ground glass opacitiesand fibrosis and only fibrosis. There were significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05).Conclusion: Proportion radiation pneumonitis based on chest x ray are 39,4%. There are significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05)."

"Infeksi jamur infasif atau mikosis infasif pada pasien dengan kondisi sistem imunitas rendah mengakibatkan sejumlah besar morbiditas dan mortalitas. Infeksi tersebut dapat terjadi di lingkungan rumah sakit, komunitas, maupun keduanya. Sejumlah spesies jamur dapat terkonsentrasi pada lingkungan udara rumah sakit, dan dianggap sebagai agen infeksi yang mudah terhirup oleh pasien. Penelitian ini bertujuan untuk mengetahui profil jamur udara pada ruang rawat beberapa rumah sakit di Jakarta serta kaitannya dengan kelas perawatan. Metode penelitian berdisain potong lintang ini menggunakan pengambilan sampel secara konsekutif dari beberapa rumah sakit di Jakarta. Cawan petri yang mengandung media agar saboraud dekstrosa diletakkan di dalam ruangan rawat RS dan dibiarkan terbuka selama 15 menit, setelah itu dilakukan inkubasi dalam suhu kamar selama minimal tiga hari. Selanjutnya dilakukan proses identifikasi spesies untuk mengetahui profil jamur.Hasil dalam penelitian ini, jamur yang diisolasi dari ruang perawatan rumah sakit pada umumnya terdiri atas lebih dari dua spesies, diantaranya: Aspergillus niger (67.5%), Candida sp. (40%), Aspergillus fumigatus (30%), Rhodoturula sp. dan Penicillium marnefei dalam jumlah sedikit. Pengamatan terhadap hubungan profil jamur dan jenis kelas ruang rawat menunjukkan bahwa semakin tinggi kelas ruang rawat rumah sakit, semakin sedikit jumlah dan ragam spesies jamur yang tumbuh.Simpulan. Profil jamur yang diisolasi dari ruang perawatan rumah sakit dalam penelitian ini terdiri atas Aspergillus niger, Candida sp, Aspergillus fumigatus, Rhodoturula sp dan Penicillium marnefei. Hubungan profil jamur dan jenis kelas ruang rawat menunjukkan bahwa semakin tinggi kelas ruang rawat rumah sakit, semakin sedikit jumlah dan ragam spesies jamur yang tumbuh.

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Introduction. Invasive fungal infections (invasive mycoses) in immunodeficient patients yields in more than significant number of morbidity and mortality. Such infections occur on both hospital and community settings. Several fungal species might be concentrated in the air among hospitals, and considered as infectious agent that is easily inhaled by patients. This study aims on investigating the profile of airborne fungal species in several inpatient wards chosen from several hospitals in Jakarta and the correlation between those species and the class of the wards itself. Methods this is a cross-sectional study using consecutive samplings taken from several chosen Jakarta hospitals. Petri dish containing dextrose saboraud agar are placed about 1m height above the ground and exposed to open air for 15 minutes. Afterwards, the plates are incubated at room temperature for minimum of three days. Then, samples were analyzed inside the mycology lab for species identification to investigate presenting fungal profile.

Results in this study, common species that are isolated from the respective wards consists of at least two species, including Aspergillus niger (67.5%), Candida species (40%) and Aspergillus fumigatus (30%). Other infectious species such as Rhodotorula sp and Penicillium marnefei are found as well in few numbers. Observation on the relation of fungal profile and class of inpatient wards indicates that the higher the ward class, the less number and diversity of species growing inside the plates.

Conclusion, fungal profile that are isolated from the hospital inpatient wards in this study consists of Aspergillus niger, Candida sp, Aspergillus fumigatus, Rhodoturula sp dan Penicillium marnefei. The correlation between the fungal profile and class of inpatient wards indicated that the higher the class of hospital wards, the less number and diversity of airborne fungi growing on the plates."

"Latar belakang: Pasien tuberkulosis (TB) paru rentan mengalami infeksi oportunistik, termasuk oleh Aspergillus (aspergilosis paru). Keberadaan Aspergillus dikonfirmasi dengan uji kultur. Uji kepekaan Aspergillus terhadap obat anti-jamur (OAJ) dilakukan untuk mengetahui pilihan OAJ yang tepat. Itrakonazol merupakan salah satu OAJ pilihan untuk aspergilosis paru. Resistensi OAJ dapat disertai gejala klinis yang luas. Penelitian ini bertujuan untuk mengetahui karakteristik klinis pasien dikaitkan dengan hasil uji kepekaan Aspergillus terhadap itrakonazol.Metode: Penelitian potong-lintang ini dilakukan pada Juli-November 2021 dan merupakan bagian dari penelitian sebelumnya. Isolasi Aspergillus dari sputum pasien TB paru dilakukan menggunakan medium agar Sabouraud. Karakteristik klinis yang diteliti meliputi usia, jenis kelamin, indeks massa tubuh (IMT), dan gejala. Adapun uji kepekaan jamur dilakukan dengan metode cakram sesuai protokol.Hasil: Penelitian ini menyertakan 28 isolat Aspergillus sp. yang berasal dari sputum 28 pasien TB paru. Jumlah pasien laki-laki lebih dominan (24 orang). Rerata usia 50 ± 15,1 tahun, dengan kelompok usia terbanyak < 60 tahun (21 pasien). Sebanyak 12 pasien (42,9%) memiliki IMT rendah. Gejala klinis yang didapatkan meliputi: batuk (42,9%), batuk darah (35,7%), sesak (39,3%), nyeri dada (14,3%), dan rasa lelah (35,7%). Kultur sputum menunjukkan pertumbuhan 28 isolat Aspergillus, terdiri atas: 14 isolat Aspergillus fumigatus, 6 isolat Aspergillus flavus, dan 8 isolat Aspergillus niger. Uji kepekaan Aspergillus terhadap itrakonazol menunjukkan 23 isolat sensitif, 3 isolat intermediat, dan 2 isolat resisten. Analisis statistik menunjukkan tidak terdapat hubungan bermakna antara karakteristik klinis pasien dengan hasil uji kepekaan jamur.Kesimpulan: Tidak terdapat hubungan bermakna antara karakteristik klinis pasien dengan hasil uji kepekaan Aspergillus terhadap itrakonazol dalam penelitian ini.

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Introduction: Pulmonary tuberculosis (TB) patients are susceptible to opportunistic infections, including Aspergillus infections (aspergillosis). The presence of Aspergillus was confirmed by a culture test, followed by its susceptibility study to antifungal. Antifungal resistance is generally accompanied by serious symptoms, so clinical observations are important for better clinical awareness. This study aims to determine the relationship between clinical characteristics and susceptibility study of Aspergillus to itraconazole.

Method: This cross-sectional study was carried out from July-November 2021, as part of the previous study on aspergillosis in TB patients. Aspergillus was isolated from the sputum of pulmonary TB patients using Saboraud's agar dextrose medium. Clinical characteristics obtained through patient’s history including age, gender, body mass index, and symptoms The fungal susceptibility test was carried out by disc diffusion method according to the protocol after treatment.

Result: This study included 28 isolates of Aspergillus from the sputum of 28 pulmonary TB patients. The number of males were dominant (24 from 28 patients) than females. The mean age was 50 ± 15.1 years, with the commonest age group < 60 years (21 patients). Total of 12 patients (42.9%) had a low body mass index. Clinical symptoms included: cough (42.9%), hemoptysis (35.7%), dyspnea (39.3%), chest pain (14.3%), and fatigue (35.7%). %). The sputum culture showed 14 Aspergillus fumigatus isolates, 6 Aspergillus flavus isolates, and 8 Aspergillus niger. The susceptibility test of Aspergillus to itraconazole revealed 23 sensitive isolates, 3 intermediate isolates, and 2 resistant isolates. Statistical analysis showed that there was no relationship between the patient’s clinical characteristics and the antifungal susceptibility test of itraconazole.

Conclusion: There was no significant correlation between the patient’s clinical characteristics and the antifungal susceptibility test to itraconazole in this study"