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"Background: The prevalence of Helicobacter pylori (H. pylori) infection in the world is quite high, especially in developing countries. Usually the patient shows no specific symptoms and chronic gastritis therefore becomes chronically infected The complication of the injéction is the development of peptic ulcer; which is a predisposing factor for gastric carcinoma. Early diagnosis is an important step to avoid these complications by providing immediate accurate therapy. Methods: In this study the CLO, MIU (Motility Indole Urease) tests and culture were conducted on 131 biopsy samples of the stomach antrum mucous tissue taken from chronic dyspepsia patients from several hospitals in Jakarta. In the CLO test, biopsy tissue was put in a small well agar to be incubated at room temperature. In the MIU test the biopsy tissue sample was submerged in the small MlU tube agar with a depth of approximately 2/3 rds from the surface, and then incubated at room temperature. Another piece of biopsy tissue was cultured micro-aerophylicalty The CLO and MlU tests are considered positive if the color changes from yellow to red and are considered negative if there is no color change within 24 hours. Results: Compared to culture, the CLO test demonstrated 38% sensitivity; 96% specificity, 94% positive predictive value and 52% negative predictive value, whereas the results of the MIU test against culture method showed 76% sensitivity 89% specificity 88% positive predictive value, and 78% negative predictive value. Conclusion: The MIU test that showed high sensitivity and specyficity and thus could be further developed as an alternative diagnostic method for H. pylori infection."

"Background: real-time RT-PCR was recommended by WHO for COVID-19 diagnosis. The cycle threshold (Ct) values were expected to have an association with clinical manifestation. However, the diagnostic modalities such as quantitative molecular detection and virus isolation were not yet available for the routine test. This study has been conducted to analyze the relationship between the Ct values of qualitative rRT-PCR and the clinical manifestation and to describe the factors determining the result. Methods: from March to April 2020, specimens were sent to our laboratory from different healthcare centers in Jakarta. The patient's characteristic and clinical manifestation were extracted from the specimen's epidemiology forms. The specimens extracted and tested using rRT-PCR, and the Ct value were collected. The data were analyzed using the appropriate statistic test.Results: from 339 positive results, the mild to moderate case was 176 (52%) and the severe cases was 163 (48%). Female was dominant in the mild to moderate cases (58%), while the male was prevalent in the severe cases (60%). The median age for mild to moderate case was 35 years old and severe cases was 49 years old. Statistical analysis found relationship between both group with gender (p = 0.001) and age (p < 0.001), but not with the Ct value. Conclusion: many variables in specimen sampling and processing could affect the Ct value result. In addition, the disease's severity was depended with the host immune response, regardless the number of virus. There was suggested no significant difference between the Ct values of mild-moderate and severe COVID-19, and thus should not be loosely interpreted."

"Latar Belakang: Pasien sirosis hati berisiko mengalami infeksi bakteri cairan asites melalui jalur translokasi patogen di dalam saluran cerna. Kategori infeksi bakteri cairan asites netrositik meliputi PBS dan ANKN. Baku emas pemeriksaan meliputi jumlah PMN, kultur bakteri dan DNA ribosomal RNA 16S untuk mengkaji adanya patogen bakteri pada cairan asites sirosis hati. Data populasi sel alat analisa hematologi otomatis belum optimal digunakan dan perlu dikaji dalam hal kemampuan mendeteksi infeksi bakteri cairan asites.Tujuan: Mengetahui proporsi, pola patogen, kepekaan terhadap antibiotik pada infeksi bakteri cairan asites sirosis hati dan kemampuan diagnostik 5 parameter hematologi dalam data populasi sel alat analisa hematologi otomatis dengan baku emas jumlah PMN, kultur bakteri dan atau identifikasi adanya materi genetik bakteri dengan DNA ribosomal RNA 16S pada cairan asites.Metode: Penelitian potong lintang pada subjek asites sirosis hati oleh sebab apapun berusia ≥ 18 tahun di 3 rumah sakit rujukan tersier di Jakarta selama 4 Januari - 30 April 2021. Variabel independen terdiri dari HFLC, IG, ANC, NESFL, Delta Ret-Hb, parameter tambahan RNL dengan baku emas jumlah PMN ≥ 250, kultur bakteri positif & atau rt- PCR DNA ribosomal RNA 16S positif dengan nilai CT ≤ 31.1 pada cairan asites netrositik.Hasil: 93% subjek adalah sirosis hati dekompensata CPS ≥ 8. Proporsi infeksi bakteri cairan asites dengan baku emas kultur: PBS 4.1%, ANKN 10.3%, bakterasites 7.1%; kultur dan DNA ribosomal RNA 16S bakteri: PBS 7.1%, ANKN 7.1%, bakterasites 45.9%. Kultur bakteri yang tumbuh 11.2% : gram negatif 54.5%, gram positif 45.4%, tidak ditemukan bakteri anaerob & E. coli. ESBL ditemukan pada E. aerogenes & P. aeruginosa. Nilai diagnostik tunggal diperoleh pada parameter IG (sensitivitas 64.3%, spesifitas 75%), ANC (64.2%, 70.2%) dan RNL (71.4%, 71.4%). Nilai diagnostik gabungan memberikan hasil terbaik pada IG, HFLC, NESFL dengan AUC 0.80 IK 95% 0.68 – 0.92 p <0.001, sensitivitas 66%, spesifitas 84%, yang berasosiasi negatif dengan infeksi bakteri cairan asites netrositik dan menghasilkan sistem skor dengan nilai AUC, sensitivitas dan spesifitas yang sama.Simpulan: Hasil kultur & DNA bakteri memberikan proporsi infeksi bakteri cairan asites (PBS, ANKN, bakterasites) 60.1% dengan bakteri gram positif & negatif yang hampir seimbang. Ditemukan resistensi ESBL. IG, ANC & RNL memiliki nilai diagnostik tunggal. IG, HFLC dan NESFL memiliki nilai diagnostik gabungan serta menghasilkan sistem skor untuk infeksi bakteri cairan asites netrositik (PBS, ANKN).

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ackground: Liver cirrhosis posseses risks to sustain ascitic bacterial infection in peritoneal cavity through GI tract pathogen translocation. Neutrocytic ascites bacterial infection includes SBP & CNNA. Diagnostic gold standards for them are ascitic fluid PMN count, bacterial culture and 16S RNA Ribosomal DNA. Cell population data of automated hematology analyzer is not widely used nor evaluated as part of diagnostic process in ascitic bacterial infection.

Objective: To determine proportion, microbial pattern, antibiotic susceptibility, diagnostic values of 5 hematological parameters in cell population data of automated hematology analyzer toward gold standard of ascitic fluid bacterial infection : PMN count, bacterial culture positivity and or positivity identification of 16S RNA ribosomal DNA in liver cirrhosis ascitic fluid .

Methods: Cross sectional study of ascitic liver cirrhosis due to any cause in ≥ 18 years old subject conducted in 3 tertiary referral hospitals in Jakarta during 4 January to 30 April 2021. Independent variables consist of HFLC, IG, ANC, NESFL, Delta Ret-Hb with gold standard ascitic fluid of PMN count ≥ 250, bacterial culture positivity and or rt-PCR 16S RNA Ribosomal DNA positivity with CT value ≤ 31.1 in neutrocytic ascitic fluid.

Results: There are 93% decompensated liver cirrhosis whose CP ≥ 8. Proportion according to culture: SBP 4.1%, CNNA 10.3%, bacterascites 7.1%, while culture and or 16S ribosomal DNA : SBP 7.1%, CNNA 7.1%, bacterascites 45.9%. Proportion of 11.2% positive bacterial culture consists of gram negative 54.5%, gram positive 45.4% & none of anaerobic bacteria nor E. coli. ESBL is detected in E. aerogenes & P. aeruginosa. Individual diagnostic value includes IG (sensitivity 64.3%, specifity 75%), ANC (64.2%, 70.2%) and additional parameter of LNR (71.4%, 71.4%) . The best combination diagnostic value is found in IG, HFLC, NESFL with AUC 0.80, 95% CI 0.68 – 0.92 p <0.001, sensitivity 66%, spesifity 84% which contains negative association to neutrocytic ascites bacterial infection. It produces a score system with similar AUC, sensitivity and specifity.

Conclusions: Culture and bacterial DNA results in ascitic bacterial infection (SBP, CNNA, bacterascites) 60.1% with almost equal proportion of gram positive & negative bacterial culture with ESBL resistance. IG, ANC & LNR have individual diagnostic value in neutrocytic ascitic bacterial infection, otherwise IG, HFLC and NESFL are combined cell population data parameters and yield a score system for neutrocytic ascites bacterial infection (SBP,CNNA)."