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"Biofilm merupakan struktur yang dibentuk oleh komunitas mikroorganisme yang saling terikat dan terfiksasi dengan melekat pada suatu permukaan dalam matriks polimer ekstraseluler yang dihasilkan oleh mikroorganime tersebut. Pembentukan biofilm dilaporkan cukup tinggi pada kanul trakeostomi dan berhubungan dengan inflamasi kronis, serta infeksi oleh mikroorganisme yang resisten terhadap antimikroba. Beberapa metode pemeriksaan deteksi biofilm telah diperkenalkan, termasuk diantaranya adalah metode microtiter plate assay (MPA), congo red agar (CRA), dan congo red agar modifikasi (CRA modifikasi). Penelitian ini merupakan uji diagnostik dengan desain potong lintang yang bertujuan untuk mengevaluasi kinerja diagnostik pemeriksaan deteksi biofilm bakterial metode CRA dan CRA modifikasi yang dianggap lebih sederhana dan mudah terhadap metode MPA yang dianggap sebagai baku emas. Deteksi biofilm bakterial metode MPA, CRA, dan CRA modifikasi pada penelitian ini dikerjakan pada 100 isolat bakteri yang diperoleh dari biakan spesimen swab kanul trakeostomi pasien dewasa Poliklinik Telinga Hidung Tenggorok Rumah Sakit Cipto Mangunkusumo pada Juni-Juli 2020. Pembentukan biofilm bakterial terdeteksi sebesar 25% berdasarkan metode MPA dengan bakteri penyusun terbanyak adalah Pseudomonas aeruginosa. Sensitivitas, spesifisitas, nilai prediksi positif (NPP), nilai prediksi negatif (NPN), dan akurasi metode CRA didapati sebesar 36%, 63%, 24%, 75%, 56%. Metode CRA modifikasi didapati tidak memiliki kinerja diagnostik yang lebih baik dibandingkan dengan metode CRA, yaitu dengan sensitivitas, spesifisitas, NPP, NPN, dan akurasi sebesar 52%, 35%, 21%, 68%, 39%. Kesesuaian hasil interobserver deteksi biofilm bakterial metode CRA dan CRA modifikasi didapati sangat kuat (Kappa 0,927, p = 0,035 untuk metode CRA dan Kappa = 0,856, p = 0,042 untuk metode CRA modifikasi).

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Biofilm is a structured formed by a community of microorganisms that are bound to each other and fixated by adhering to a surface in the extracellular polymer matrix produced by these microorganisms. Biofilm formation has been reported high in tracheostomy cannule and related to chronic inflammation, as well as infection with antimicrobial-resistant microorganisms. There are several biofilm detection methods, including Microtiter Plate Assay (MPA) Method, Congo Red Agar (CRA)iMethod, and modified Congo Red Agar (modified CRA) Method. This study is a diagnostic study with cross sectional design that aims to evaluate the diagnostic performance of bacterial biofilm detection by CRA and modified CRA method, which are considered easier and simpler than MPA method, which is considered as the gold standard. Bacterial biofilm detection using CRA, modified CRA, and MPA method in this study was carried out on 100 bacterial isolates obtained from tracheostomy cannule swab cultures of adult patients at Otorhinolaryngology Outpatient Clinic Dr. Cipto Mangunkusumo Hospital in June-July 2020. Bacterial biofilm formation was detected by 25% based on MPA methods with the most bacterial constituent is Pseudomonas aeruginosa. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CRA methods were 36%, 63%, 24%, 75%, 56%. Modified CRA method did not have a better diagnostic performance than CRA method, with sensitivity, specificity, NPP, NPN, and accuracy were 52%, 35%, 21%, 68%, 39%. The concordance of interobserver bacterial biofilm detection using the CRA and modified CRA methods was found to be very strong (Kappa 0.927, p = 0.035 for the CRA method and Kappa = 0.856, p = 0.042 for the modified CRA method)"

"Deteksi Streptococcus pneumoniae (pneumokokus) dilakukan dengan metode biakan dan PCR. Tujuan penelitian menentukan batas kemampuan tehnik PCR gen psaA mendeteksi inokulum pneumokokus dalam media cair sebelum inkubasi dan setelah inkubasi 24 jam. Penelitian secara eksperimental menggunakan S.pneumoniae ATCC (American Type Culture Collection) 49619 yang ditumbuhkan pada media agar darah domba. Sepuluh mililiter suspensi bakteri dengan densitas 6x107/ml, 6x106/ml, 6x105/ml, 6x104/ml, 6x103/ml, 6x102/ml, 60/ml, 6/ml dimasukkan dalam media cair BD BACTEC™ Plus Aerobic/F Culture Vials. Masing-masing densitas diinokulasikan ke dalam 20 media cair tersebut. Selanjutnya, dari tiap media cair yang telah diinokulasi, sebelum inkubasi maupun setelah inkubasi 24 jam, dilakukan pewarnaan Gram, diinokulasikan pada media agar darah domba, serta uji PCR untuk mendeteksi gen psaA. Bila ditemukan pertumbuhan koloni pneumokokus pada media agar darah, dilanjutkan uji katalase dan sensitivitas optochin. Uji PCR psaA "positif" bila ditemukan amplikon dengan berat molekul 838 pasang basa. Metode biakan dan PCR dinyatakan "mampu mendeteksi pneumokokus" bila > 60% dari 20 replicate memberikan hasil positif. Dari masing-masing 20 replicate dengan densitas bakteri dalam inokulum awal 6x107/ml, 6x106/ml, 6x105/ml, 6x104/ml, 6x103/ml, 6x102/ml, 60/ml, 6/ml sebelum inkubasi, jumlah replicate yang terdeteksi gen psaA berturut-turut adalah 9/20 replicate (45%), 9/20 (45%), 3/20 (15%), 1/20 (5%), 0/20 (0%), 0/20 (0%), 0/20 (0%), 0/20 (0%). Setelah inkubasi 24 jam berturut-turut adalah 20/20 replicate (100%), 18/20 (90%), 11/20 (55%), 8/20 (40%), 4/20 (20%), 2/20 (10%), 0/20 (0%), 0/20 (0%). Dari data kadar DNA ekstrak terlihat uji PCR psaA penelitian ini membutuhkan kadar DNA ≥ 84 ng/µL. Hasil penelitian menunjukkan diperlukan inkubasi 24 jam agar terdeteksi oleh uji PCR psaA dengan densitas pneumokokus dalam inokulum awal minimal 6x106/ml. Kelemahan penelitian adalah proses ekstraksi DNA tidak optimal sehingga kadar DNA ekstrak sangat bervariasi dan menyebabkan gen psaA tidak terdeteksi sebelum inkubasi.

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Streptococcus pneumoniae (pneumococcal) detection can be done by culture and PCR methods. The purpose of this study was to determine the limits of psaA gene PCR in detecting pneumococcal inoculum prior to incubation and after 24 hours of incubation of liquid media. This experimental study used Streptococcus pneumoniae ATCC (American Type Culture Collection) 49619 which was grown on sheep blood agar. Ten mililiter of bacterial suspensions with initial density of 6x107/ml, 6x106/ml, 6x105/ml, 6x104/ml, 6x103/ml, 6x102/ml, 60/ml, 6/ml were inoculated into liquid media, BD BACTEC™ Plus Aerobic/F Culture Vials. Each bacterial density was inoculated into these 20 liquid medias. From each inoculated BD BACTEC™ Plus Aerobic/F Culture Vial, prior to incubation and after 24 hours of incubation, Gram staining, subculturing on sheep blood agar, and psaA gene PCR were done. When pneumococcal colonies were found on sheep blood agar, the colonies were tested for catalase and optochin sensitivity. PsaA gene were determined as "positive" when amplicons with molecular weight 838 pairs of bases were found.

Culture and PCR methods were determined as able to detect pneumococcus when > 60% of 20 replicates yield positive results. The psaA PCR positive result rate of initial bacterial density of 6x107/ml, 6x106/ml, 6x105/ml, 6x104/ml, 6x103/ml, 6x102/ml, 60/ml, 6/ml prior to incubation were 9/20 replicate (45%), 9/20 (45%), 3/20 (15%), 1/20 (5%), 0/20 (0%), 0/20 (0%), 0/20 (0%), 0/20 (0%), respectively. After 24 hours of incubations were 20/20 replicate (100%), 18/20 (90%), 11/20 (55%), 8/20 (40%), 4/20 (20%), 2/20 (10%), 0/20 (0%), 0/20 (0%), respectively. From the DNA extract data, it could be determined that this PCR method required a DNA concentration of ≥ 84 ng/µL.

Results showed a 24-hours incubation was needed in order to detect psaA by PCR and with the initial bacteria density of 6x106 organisms/ml in the inoculum. The weakness of study was DNA extraction process not optimal, shown by the variability of DNA concentration in the extracts which affected the ability of PCR to detect psaA gene prior to incubation."

"Streptococcus pneumoniae merupakan bakteri utama penyebab pneumonia pada anak dan kelompok usia lanjut. Sputum merupakan spesimen paling banyak diteliti untuk diagnosis pneumonia. Uji Polymerase Chain Reaction (PCR) untuk deteksi Streptococcus pneumoniae dapat menggunakan gen pneumococcal surface adhesin A (psaA) dengan primernya. Penelitian ini bertujuan untuk menilai kemampuan primer P1 gen psaA dalam mendeteksi Streptococcus pneumoniae pada isolat dari biakan sputum. Dilakukan uji PCR terhadap 32 isolat dengan morfologi khas Streptococcus pneumoniae. Empat belas dari 32 isolat adalah Streptococcus pneumoniae. Hasil yang didapatkan sama dengan hasil metoda biakan. Kemampuan deteksi primer untuk gen psaA adalah baik dengan sensitivitas dan spesifisitas 100%.

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Streptococcus pneumoniae is the leading cause of pneumonia in children and the elderly. Sputum is the most frequently studied specimen for the diagnosis of pneumonia. Polymerase chain reaction (PCR) conducted to diagnose Streptococcus pneumoniae can use pneumococcal surface adhesin A (psaA) gene with its primer. This study aimed to evaluate the P1 primer for psaA gene ability in detecting Streptococcus pneumoniae from sputum isolates. PCR was conducted on 32 Streptococcus pneumoniae look-alike isolates. Fourteen isolates were identified as Streptococcus pneumoniae. The result was unanimous with the culture. The ability of primer for psaA was good with 100 % sensitivity and specificity."

"ABSTRAKPendahuluan: Jumlah pasien HIV/AIDS berkembang khususnya di Indonesia, salah satu faktor yang menghambat penanganan pasien adalah diagnosis yang kurang baik. Pemerintah telah memfasilitasi tes diagnostik di setiap puskesmas dengan kombinasi tes cepat anti-HIV menggunakan strategi tiga World Health Organization WHO . Penggunaan kombinasi reagen yang baik diharapkan dapat meningkatkan akurasi dari tes tersebut dalam mendiagnosis HIV/AIDS.Data diperoleh dari bank sampel Rumah Sakit dr. Cipto Mangunkusumo Departemen Patologi Klinik.Metode: Kombinasi dari tiga reagen dipilih berdasarkan persyaratan WHO. Hasil kombinasi reagen dibandingkan dengan status sampel yang dikonfirmasi dengan Western Blot, sehingga dapat dilakukan perhitungan sensitivitas, spesifisitas, dan diskordansi setiap kombinasi.Hasil: Dari sensitivitas, spesifisitas serta diskordansi berbagai kombinasi diperoleh dua kombinasi terbaik dengan hasil yang sama, yaitu SD Bioline HIV -1/2 3.0 Alere -HIV 1 2 Antibody Rapid Oncoprobe Utama - Vikia HIV 1/2 BioMerieux dan Advance Quality Rapid Anti-HIV 1 2 Test Intec - Abon HIV 1/2/O Abon - Vikia HIV 1/2 BioMerieux dengan sensitivitas dan spesifisitas 100 dan nilai diskordansi rendah yaitu 1,53 . Berdasarkan WHO diskordansi masih dianggap baik bila di bawah 5 .Diskusi: Dari kombinasi reagen yang tidak mengikuti persyaratan strategi tiga WHO, ternyata sensitivitas dan spesifisitas dapat mencapai 100 , namun angka diskordansi menunjukkan angka yang sangat tinggi, yaitu 4,3 . Dapat disimpulkan bahwa penerapan persyaratan WHO pada kombinasi reagen meningkatkan sensitivitas, spesifisitas, dan mengurangi diskordansi, sehingga akurasi diagnosis dapat ditingkatkan.

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ABSTRACT

Introduction The number of patients with HIV AIDS develops, especially in Indonesia, One of the factors is unfavorable diagnosis. Government facilitated the diagnostic tests in every health center with a combination of anti HIV rapid test using strategy III of World Health Organization WHO . The use of a good combination of reagents is expected to improve the accuracy in the diagnosis of HIV AIDS. Data is obtained from the sample bank rsquo s in Department of Clinical Pathology Rumah Sakit dr. Cipto Mangunkusumo.Method The combination of three reagents has been selected based on the requirements of WHO. The result is compared to the sample status confirmed by Western Blot, which can be calculated the sensitivity, specificity, and discordant of any combination.Results Based on sensitivity, specificity and discordant from various combinations, it is obtained two best combinations with the same result, namely SD Bioline HIV 1 2 3.0 Alere HIV 1 2 Rapid Antibody Main Oncoprobe Vikia HIV 1 2 bioMerieux and Advance Quality Rapid Anti HIV 1 2 Test Intec ndash Abon HIV 1 2 O Shredded Vikia HIV 1 2 bioMerieux with a sensitivity and specificity of 100 and the discordant value at 1.53 . Based on the WHO the discordant value is still considered as good as long as it is below 5 . Discussion If the combination do not follow the requirements of WHO using strategy III, the sensitivity and specificity can reach 100 , but the discordant value indicate high number, whichis 4.3 . As conclusion, application of the requirements of the WHO on a combination of reagents can increased sensitivity, specificity, and reduce the discordant, so the accuracy of diagnosis can be improved. "

"Latar Belakang: Infeksi Helicobacter pylori merupakan infeksi kronis bakterial yang berhubungan dengan penyakit gastroduodenal. Berdasarkan konsensus Bangkok, pemeriksaan diagnostik infeksi H.pylori hendaknya dilakukan pada semua pasien dispepsia kronis. Urea breath test (UBT) merupakan pemeriksaan referens non-invasif dengan biaya cukup mahal. Rapid test antigen feses merupakan pemeriksaan yang praktis dengan biaya lebih terjangkau. Penelitian ini bertujuan mengevaluasi peran diagnostik rapid test antigen H.pylori dalam feses terhadap UBT pada pasien dispepsia. Metode: Penelitian ini merupakan uji potong lintang terhadap pasien dispepsia di RSUPN Cipto Mangunkusumo selama bulan Agustus-Oktober 2018. Sebanyak 70 subjek diambil secara consecutive sampling dan dilakukan pemeriksaan rapid test SD Bioline H.pylori Ag^® dan Urea [¹³C] Breath Test Kit-Heliforce^®. Hasil: Rerata usia subjek penelitian adalah 46,2 ± 14,23 tahun (18-70 tahun) dan terdapat 17,14% subjek positif terinfeksi H.pylori berdasarkan hasil UBT. Sensitivitas, spesifisitas, nilai prediksi positif, dan nilai prediksi negatif rapid test secara berurutan adalah 41,67%, 100%, 100%, dan 89,23%. Simpulan: Rapid test antigen H.pylori dalam feses memiliki sensitvitas yang kurang baik tetapi memiliki spesifisitas, NPP, dan NPN yang cukup baik; praktis digunakan; dan harganya jauh lebih terjangkau sehingga masih dapat dipertimbangkan untuk digunakan pada daerah dengan keterbatasan ekonomi dan fasilitas.

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Background: Helicobacter pylori infection is a chronic bacterial infection associated with gastroduodenal diseases. Based on the Bangkok consensus, a diagnostic test of H.pylori infection should be carried out in all patients with chronic dyspepsia. Urea breath test (UBT) is a non-invasive reference test with a fairly expensive cost. Stool antigen rapid test is a practical test with a more affordable cost. We aimed to evaluate the diagnostic role of the H.pylori stool antigen rapid test against UBT in dyspeptic patients.

Methods: This was a cross-sectional study of dyspeptic patients at RSUPN Cipto Mangunkusumo during August-October 2018. A total of 70 subjects were taken by consecutive sampling method and tested with rapid test SD Bioline H.pylori Ag^® and Urea [¹³C] Breath Test Kit-Heliforce^®.

Results: The mean age of the subjects was 46.2 ± 14.23 years (18-70 years) and there were 17.14% subjects positively infected with H.pylori based on UBT results. Sensitivity, specificity, positive predictive value, and negative predictive value of the rapid test were 41.67%, 100%, 100%, and 89.23% respectively.

Conclusion: Helicobacter pylori stool antigen rapid test had poor sensitivity but had a good specificity, PPV, and NPV; practical use; and more affordable price so that it could still be considered to be used in areas with economic and facilities limitations."

"Rapid swab antigen SARS-CoV-2 merupakan pemeriksaan alternatif dalam mendeteksi SARS-CoV-2. Salah satu faktor yang mempengaruhi pemeriksaan rapid swab antigen SARS-CoV-ialah viral load yang direpresentasikan dengan cycle threshold (CT) pada pemeriksaan rRT-PCR. Hasil CT yang tinggi membuat sensitivitas pemeriksaan rapid swab antigen SARS-CoV-2 rendah. Tujuan utama pada penelitian ialah untuk menentukan nilai CT tertinggi pada pemeriksaan rRT-PCR yang mampu memberikan hasil reaktif pada pemeriksaan COVID-19 Ag (Standard Q SD Biosensor). Penelitian merupakan penelitian observasional dengan metode potong lintang dilakukan pada poliklinik demam RS dr. Cipto Mangunkusumo pada tanggal Juli 2020- Desember 2021. Total subjek dalam penelitian berjumlah 235 terdiri dari 24,7% subjek dengan rRT-PCR SARS-CoV-2 positif dan 75,3% subjek dengan rRT-PCR SARS-CoV-2 negatif. Median CT tertinggi pada pemeriksaan rRT-PCR SARS-CoV-2 yang mampu memberikan hasil reaktif pada pemeriksaan COVID-19 Ag (Standard Q SD Biosensor) ialah 28,22 (13,33- 39,16), sedangkan median CT tertinggi pada COVID-19 Ag (Standard Q SD Biosensor) non-reaktif ialah 34,45 (26,08-39,65). Sensitivitas, spesifisitas, NPV, PPV, dan LR positif dan LR negatif hasil COVID-19 Ag (Standard Q SD Biosensor) pada CT ≤ 40 adalah 63.8%, 99.4%, 89.3%, 97.4%, 112.9, dan 0.4. Pada CT ≤ 33 sensitivitas, spesifisitas, NPV, PPV, dan LR positif dan LR negatif ialah 77.1%, 99.4%, 95.7%, 96.4%, 136.5, dan 0.2 sedangkan pada CT ≤ 25 sensitivitas, spesifisitas, NPV, PPV, dan LR positif dan LR negatif adalah 92.3%, 99.4%, 99.4%, 92.3%, 163.4, dan 0.1. Titik potong CT rRT-PCR SARS-CoV-2 tertinggi ialah 26,06 dengan hasil sensitivitas 100% dan spesifisitas 99,4%. Pemeriksaan COVID-19 Ag (Standard Q SD Biosensor) dapat dipakai untuk keperluan diagnosis, contact tracing atau community surveilance.

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SARS-CoV-2 rapid antigen swab is an alternative test for detecting SARS-CoV-2 infection. One of the factors that influence the examination is viral load, which is represented by the cycle threshold (CT) in the rRT-PCR examination. The higher CT value will result in lower sensitivity of SARS-CoV-2 rapid antigen swab examination. The main objective of the study was to determine the highest CT value in rRT-PCR examination which still able to give reactive results on the COVID-19 Ag test (Standard Q SD Biosensor). The study was a cross-sectional study carried out at the fever polyclinic in dr. Cipto Mangunkusumo Hospital between July 2020 - December 2021. The study consisted of 235 subjects, 24.7% of subjects were SARS-CoV-2 positives and 75.3% of subjects were negative for SARS-CoV-2 infections. Median highest CT value in the SARS-CoV-2 rRT-PCR examination which able to give reactive results on the COVID-19 Ag (Standard Q SD Biosensor) test was 28.22 (13.33-39.16) while the median CT value on the non-reactive COVID-19 Ag (Standard Q SD Biosensor) was 34.45 (26.08-39.65). The sensitivity, specificity, NPV, PPV, and LR positive and LR negative results of COVID-19 Ag (Standard Q SD Biosensor) were 63.8%, 99.4%, 89.3%, 97.4%, 112.9, and 0.4 at CT value ≤ 40. The sensitivity, specificity, NPV, PPV, and LR positive and LR negative at CT value ≤ 33 were 77.1%, 99.4%, 95.7%, 96.4%, 136.5, and 0.2, while at CT ≤ 25 sensitivity, specificity, NPV, PPV, and LR positive and LR negative were 92.3%, 99.4%, 99.4%, 92.3%, 163.4, and 0.1. The cut-off point for the highest CT value was 26.06 with a sensitivity of 100% and a specificity of 99.4%. In conclusion, COVID-19 Ag (Standard Q SD Biosensor) was acceptable for diagnosis, contact tracing or community surveillance."

"Infeksi yang disebabkan oleh methicillin-resistant Staphylococcus aureus (MRSA) telah menyebabkan beban mortalitas dan morbiditas yang bermakna. Mengingat hal tersebut, sangat penting untuk dapat mendeteksi MRSA dengan cepat dan akurat. Saat ini deteksi MRSA dapat dilakukan dengan dua cara, yaitu metode fenotipik dan genotipik. Pada penelitian ini, metode fenotipik dilakukan dengan uji kepekaan antibiotik menggunakan oksasilin dan sefoksitin, sementara metode genotipik dilakukan dengan polymerase chain reaction (PCR) gen nuc dan mecA. Gen nuc merupakan penanda genetik S. aureus, sedangkan gen mecA adalah gen yang mengkode penicillin-binding protein 2a (PBP2a). Protein ini memiliki afinitas rendah terhadap antibiotik β-laktam, sehingga menyebabkan resistensi terhadap antibiotik seperti metisilin, oksasilin, dan sefoksitin. Penelitian ini bertujuan untuk membandingkan metode fenotipik terhadap metode genotipik yang merupakan baku emas dalam mendeteksi MRSA. Sebanyak 136 isolat S. aureus diikutsertakan dalam penelitian ini. Dilakukan PCR untuk mengamplifikasi gen nuc dan mecA dengan hasil: 37 sampel terdeteksi sebagai MRSA (nuc+, mecA+), 96 sampel sebagai methicillinsensitive Staphylococcus aureus atau MSSA (nuc+, mecA-), and 3 sampel sebagai bukan S. aureus (nuc-). Persentase MRSA yang dideteksi dengan metode genotipik adalah sebesar 27,8%. Deteksi MRSA dengan metode fenotipik dilakukan dengan uji kepekaan antibiotik menggunakan oksasilin dan sefoksitin. Tidak terdapat perbedaan hasil uji kepekaan antara kedua antibiotik tersebut. Secara keseluruhan, hasil deteksi MRSA dengan metode fenotipik konsisten dengan metode genotipik, dengan dideteksinya MRSA sebesar 27,8%. Hal tersebut mengartikan bahwa sensitivitas dan spesifisitas metode fenotipik terhadap metode genotipik adalah sebesar 100%.

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Methicillin-resistant Staphylococcus aureus (MRSA) infection has caused significant morbidity and mortality burden. Therefore, detecting MRSA accurately as early as possible is very important. There are two methods used in detecting MRSA, which are phenotypic and genotypic methods. In this study, phenotypic method was done by antibiotic susceptibility test using oxacillin and cefoxitin, while genytopic method was carried out by amplifying nuc and mecA gene with polymerase chain reaction (PCR). Nuc gene is a genetic marker for S. aureus, and mecA gene is responsible in the coding of penicillin-binding protein 2a (PBP2a). This protein has a low affinity to β-lactam antibiotics, thus causing antibiotic resistance to the antibiotics, such as methicillin, oxacillin, and cefoxitin.

This study was aimed to compare phenotycipic method to genotypic method as the gold standard, to detect MRSA. There were 136 S. aureus isolates included in this study. PCR to amplify nuc and mecA gene was conducted with the results of the following: 37 samples detected as MRSA (nuc+, mecA+), 96 samples as methicillin-sensitive Staphylococcus aureus or MSSA (nuc+, mecA-), and 3 samples as non-S. aureus (nuc-). The percentage of MRSA detected by genotypic method was 27,8%.

The detection of MRSA through the phenotypic method was done by antibiotic susceptibility test using oxacillin and cefoxitin. Susceptibility test between these antibiotics showed no difference in result. In general, the result of phenotypic method was consistent to the results from the genotypic method, by detecting 27,8% MRSA. Therefore, the sensitivity and specificity of phenotypic method compared to the genotypic method were 100%."

"Streptococcus pneumoniae dapat menyebabkan terjadinya community-acquired pneumonia, meningitis, dan bakteremia pada semua golongan usia. Penelitian tentang S. pneumoniae di Indonesia masih jarang dilakukan. Uji biakan sebagai metode baku masih memiliki kendala dalam penerapan kondisi optimal untuk pertumbuhan S. pneumoniae, yaitu pada lingkungan atmosfer 5% CO2 (carbon dioxide), dan spesimen dari pasien seringkali diperoleh setelah pemberian antibiotik sehingga memberikan hasil negatif. Metode molekular saat ini lebih banyak diterapkan karena dianggap lebih sensitif, dapat menghemat waktu, dan mengurangi biaya. Gen psaA mengkode protein psaA (pneumococcal surface adhesin A) yang berperan dalam proses virulensi bakteri, dan ditemukan pada keseluruhan serotipe S. pneumoniae. Penelitian ini dilakukan untuk identifikasi gen psaA Streptococcus pneumoniae langsung dari sputum dengan metode PCR. Sebanyak 176 sputum dikutsertakan dalam penelitian ini. Hasil uji biakan berdasarkan uji optochin dan uji kelarutan dalam garam empedu menunjukkan hasil positif S. pneumoniae pada 3 sputum. Hasil uji PCR menunjukkan gen psaA positif pada 3 sputum yang juga positif pada hasil biakan (100%), sehingga diperoleh sensitivitas dan spesifisitas 100%.

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Streptococcus pneumoniae could cause community acquired pneumoniae, meningitis and bacteremia at all age groups. In Indonesia study about S.pneumoniae is still rare. Culture method as gold standard still has some limitations in optimal condition appliance for S pneumoniae growth, which is 5% CO2 atmosphere condition, and patient specimen is often obtained after antibiotic treatment therefore gives negatve result. Molecular method nowadays is more often performed due to better sensitivity, take less time and cost effective. psaA gene codes psaA protein that roles in bacterial virulent process and can be found in all S. pneumoniae serotypes.

This study aimed to identify Streptococccus pneumoniae psaA gene straightly from sputum by PCR method. This study included 176 sputum samples, from culture results there were 3 sputum S. pneumoniae by performing optochin test and bile salt solubility test. There were 3 sputum psaA gene positive has positive from culture results (100%) therefore sensitivity and specificity are 100%."

"ABSTRAK Kalium merupakan kation intraseluler utama dalam tubuh yang penting untuk kelangsungan fungsi sel terutama menjaga rangsang elektrik jantung dan otot. Perubahan kadar kalium dalam darah sangat mempengaruhi kerja otot jantung dan fungsi sel sehingga diperlukan pemeriksaan kadar kalium yang tepat dan akurat agar terapi dan monitoring pasien tepat. Hasil pemeriksaan kalium sangat dipengaruhi oleh faktor pra-analitik. Spesimen yang direkomendasikan untuk pemeriksaan kalium adalah plasma heparin. Penelitian ini ingin melihat perbedaan kadar kalium yang diperiksa menggunakan spesimen berupa serum dari tabung vakum berisi clot activator tabung II , plasma dari tabung vakum berisi litium heparin tabung III , dan plasma dari tabung vakum berisi litium heparin dengan gel separator tabung IV . Penelitian ini juga ingin mengetahui perbedaan kadar kalium yang diperiksa menggunakan spesimen dari tabung berisi clot activator pada pengambilan darah pertama tabung I dan kedua tabung II . Desain penelitian adalah potong lintang dengan subjek penelitian 80 orang. Perbedaan kadar kalium yang bermakna statistik terdapat antara tabung II dan III p=0.001 , serta antara tabung II dan IV p=0.01 . Persentase perbedaan rerata dengan standar kadar kalium serum, antara tabung II dan III adalah 6.8, dan tabung II dan IV adalah 7.7, sedangkan terhadap standar kadar kalium plasma litium heparin yaitu 7.3 dan 8.3. Angka tersebut melebihi batas desirable bias 1.81 , yang berarti ada kemaknaan klinis pada perbedaan kadar kalium antara tabung II dan III serta tabung II dan IV. Hasil uji t-berpasangan pada tabung I dan II didapatkan perbedaan kadar kalium yang bermakna secara statistik ABSTRACT Potassium is a the most intracellular cation in the body that essential for the continuity of cell function, especially keeping the electrically stimulated heart and muscle. Changes in blood potassium levels greatly affect the work of the heart muscle and cell function so it is necessary to check the exact potassium levels and accurate for proper patient therapy and monitoring. Results of potassium assay is strongly influenced by pre analytic factors. Recommended specimen for potassium assay is plasma heparin. Aim this study wanted to see differences in potassium levels examined using serum specimens from vacuum tubes containing clot activators tube II , plasma specimens from vacuum tubes containing lithium heparin tube III , and plasma specimens from a vacuum tube containing lithium heparin with a separator gel tube IV . The study also wanted to know the difference in potassium levels examined using specimens from tubes containing clot activators on first blood collection tube I and second tube II . The study design was cross sectional with 80 subjects. The difference in potassium levels was statistically significant between tubes II and III p 0.001 , and between tubes II and IV p 0.01 . Mean percentage difference with standard serum potassium level, between tubes II and III was 6.8, and tubes II and IV were 7.7, whereas to the heparin lithium plasma potassium level of 7.3 and 8.3. This figure exceeds the desirable limit of bias 1.81 , which means there is clinical significance on the difference in potassium levels between tubes II and III and tubes II and IV. The result of paired t test on tube I and II showed that the difference of potassium content was statistically significant p"