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"Latar Belakang: Infeksi MRSA merupakan salah satu penyebab infeksi didapat di rumah sakit dan berhubungan dengan mortalitas, morbiditas, lama rawat dan biaya perawatan yang tinggi. Prevalens infeksi MRSA pasien ICU di RSUP Persahabatan mengalami kenaikan pada semester 2 tahun 2022 sebanyak 25,27% (naik 68,46%) dibandingkan semester 1 tahun. Penyebaran MRSA di ruang perawatan intensif/intensive care unit (ICU) sebagai tolak ukur infeksi di rumah sakit. Tenaga kesehatan berisiko tinggi tertular dan menularkan MRSA di rumah sakit sehingga diperlukan skrining kolonisasi MRSA. Penelitian ini bertujuan untuk mengetahui proporsi dan faktor-faktor yang memengaruhi kolonisasi MRSA pada tenaga kesehatan di ICU RSUP Persahabatan.Metode: Penelitian ini menggunakan desain potong lintang yang di lakukan di ICU RSUP Persahabatan pada bulan Mei 2023. Subjek penelitian yang memiliki kriteria inklusi dan tidak ada kriteria eksklusi mengisi kuesioner mengenai faktor risiko individu, pekerjaan dan demografi. Pemeriksaan usap hidung dilakukan pada 150 subjek penelitian terdiri dari dokter dan perawat di ICU. Deteksi MRSA dengan pemeriksaan PCR menggunakan XPERT® MRSA NXG untuk mendeteksi gen SCCMecA atau MecC. Selanjutnya karakteristik subjek, proporsi MRSA pada dokter dan perawat serta faktor-faktor yang memengaruhi dievaluasi.Hasil: Penelitian ini diikuti 150 subjek penelitian. Proporsi kolonisasi MRSA pada dokter dan perawat sebesar 4%. Proporsi kolonisasi MRSA pada dokter sebesar 1(0,66%), pada perawat sebesar 5(3,3%). Variabel – variabel independen pada penelitian ini tidak mempunyai hubungan yang bermakna dengan kolonisasi MRSA (p>0.05). Namun dalam penelitian ini terdapat proporsi kolonisasi MRSA yang besar di ruang ICU Tulip yaitu sebesar 4(18,2%) dari 21 subjek penelitian.Kesimpulan: Terdapat proporsi kolonisasi MRSA pada tenaga kesehatan yang rendah di ICU, namun didapatkan peningkatan proporsi kolonisasi MRSA pada tenaga kesehatan di ruang ICU Tulip. Perawat dan laki-laki menunjukkan risiko kolonisasi MRSA yang lebih tinggi.

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Background: MRSA infection is one of the causes of hospital-acquired infections and is associated with mortality, morbidity, long length of stay, and high treatment costs. The prevalence of MRSA infection in ICU patients at Persahabatan Hospital increased within the second six month of 2022 by 25.27% (up 68.46%) compared to the first six month of 2022. The disseminated of MRSA in intensive care units (ICU) as a measure of infection in hospitals. Health care workers are at high risk of colonizing and transmitting MRSA in hospitals, screening of carriers is required for prevention of MRSA infection. The aims of this study are to determine the proportion and factors asscociated with MRSA colonization in health care workers in the ICU at Persahabatan Hospital.

Method: This study used a cross-sectional design and was carried out in the ICU at Persahabatan Hospital in May 2023. Respondens who had inclusion criteria and no exclusion criteria filled out a questionnaire regarding individual, occupational, and demographic risk factors. Nasal swab were collected from 150 respondens who followed by doctors and nurses in the ICU. MRSA detection by PCR examination using XPERT® MRSA NXG to detect the SCCMecA or MecC gene. Furthermore, subject characteristics, the proportion of MRSA in doctors and nurses and associated factors were evaluated.

Results: There were 150 respondents in this study. The proportion of MRSA colonization among doctors and nurses was 4%. The proportion of MRSA colonization in doctors were 1 (0.66%), and the proportion of MRSA in nurses were 5 (3.3%). There were no independent variables that significantly associated MRSA colonization (p > 0.05). However, there was a large proportion of MRSA colonization found in the Tulip ICU, 4 (18.2%) of the 21 respondents. Conclusion: There was a low proportion of MRSA colonization among health care workers in the ICU, but there was an increase in the proportion of MRSA colonization among health care workers in the Tulip ICU. Nurses and men showed a higher risk of MRSA colonization."

"Latar Belakang: Tenaga kesehatan (nakes) menjadi garda terdepan dalam pelayanan kesehatan di saat pandemi COVID-19. Tidak hanya dokter, perawat atau bidan dan nakes penunjang seperti petugas radiologi rentan untuk risiko terinfeksi COVID-19. Zona kerja nakes merupakan salah satu faktor yang berpengaruh terhadap risiko terinfeksi COVID-19. Penelitian ini bertujuan untuk mengetahui faktor risiko kejadian COVID-19 pada nakes yang bekerja di perawatan isolasi COVID-19.Metode Penelitian: Penelitian ini merupakan studi potong lintang dengan metode total sampling pada tenaga kesehatan yang bekerja di ruang rawat inap isolasi COVID-19 periode Maret sampai Desember 2020. Respons kuesioner penelitian elektronik yang disebarkan akan ditabulasi dan dianalisis.Hasil Penelitian: Subjek penelitian yang memenuhi kriteria inklusi sebanyak 292 orang dengan mayoritas berusia ≥30 tahun (75,7%), profesi nondokter (91,8%), bekerja di zona kerja non-ICU (70,2%) dan hasil PCR COVID-19 negatif (64%). Zona kerja non-ICU, jenis kelamin, kekerapan kadang-kadang, jarang dan tidak pernah dalam penggunaan APD level 3 serta pelatihan PPI dari RS dalam hal standar APD era pandemi bermakna meningkatkan peluang risiko kejadian COVID-19. Sedangkan, kepatuhan protokol kesehatan dalam hal kontak erat dengan selain orang serumah, salah satu tidak memakai masker dan lama kontak >15 menit, pemasangan kanula hidung dan kontak dengan kolega positif COVID-19 bermakna menurunkan peluang risiko kejadian COVID-19.

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k Berbahasa Inggris:

Background: : Health workers are at the forefront of health services during the COVID-19 pandemic. Not only doctors, nurses or midwives and supporting health workers such as radiology officers are vulnerable to being infected with COVID-19. The health worker's work zone is one of the factors that influences the risk of contracting COVID-19. This study aims to determine the risk factors for the occurrence of COVID-19 in health workers who work in isolation care for COVID-19.

Methods: This research is a cross-sectional study using total sampling method on healthcare workers who work in the COVID-19 isolation ward from March to December 2020. The responses of the distributed electronic research questionnaire will be tabulated and analyzed.

Results: There were 292 subjects who met the inclusion criteria with the majority aged ≥30 years (75.7%), non-doctors (91.8%), working in non-ICU work zones (70.2%) and negative COVID-19 PCR results (64%). Non-ICU working zone, gender, frequency of sometimes, rarely and never in the use of level 3 PPE as well as PPI training from hospitals in terms of PPE standards in the pandemic era significantly increased the risk of COVID-19 incident. Meanwhile, adherence to health protocols in terms of close contact with other than people in the household, one of them does not wear a mask and the duration of contact is >15 minutes, installation of nasal cannulae and contact with positive COVID-19 colleagues significantly reduced the COVID-19 incident."

"Latar Belakang : Data World Health Organization (WHO) tahun 2019 menunjukkan infeksi saluran napas bawah menjadi penyebab kematian keempat di dunia dengan angka kematian 6.1%. Pneumonia merupakan salah satu infeksi saluran napas bawah yang disebabkan oleh mikroorganisme. Jenis pneumonia yang banyak di masyarakat adalah pneumonia komunitas. Tingginya angka kejadian penumonia komunitas yang disebabkan oleh bakteri menyebabkan meningkatnya kebutuhan antibiotik sebagai pengobatan. Pemberian antibiotik dapat berupa empirical antibiotic treatment (EAT) atau pathogen-directed treatment (PDT). Penelitian ini bertujuan untuk melihat keberhasilan pengobatan pasien pneumonia komunitas rawat inap dengan EAT atau PDT.Metode : Penelitian ini merupakan penelitian observasional menggunakan desain kohort retrospektif dengan pengambilan data rekam medis di RSUP Persahabatan. Subjek peneltian ini adalah pasien pneumonia komunitas rawat inap periode 1 Januari 2021 hingga 31 Desember 2022. Pemilihan sampel menggunakan metode total sampling.Hasil : Subjek penelitian terdiri dari 220 pasien EAT dan 62 pasien PDT. Mayoritas bakteri yang ditemukan pada biakan sputum adalah gram negatif (82%) dengan jenis terbanyak adalah Klebsiella pneumonia (29.3%), Acinetobacter baumanii (16.7%) dan Eschericia coli (15.3%). Antibiotik terbanyak pada EAT adalah levofloksasin (87.3%) dan pada PDT adalah meropenem (34%). Keberhasilan pengobatan pasien dengan EAT sebesar 74.5% yang dipengaruhi oleh skor PSI (OR 5.318 (IK 95% 2.046 - 13.820, p=<.001), lama perawatan (OR 1.949 (IK 95% 1.043 - 3.641, p=0.035) dan riwayat penggunaan ventilator (OR 29.364 (IK 95% 12.80 - 67.34, p= <.001). Keberhasilan pengobatan pasien dengan PDT sebesar 46.8% yang dipengaruhi oleh riwayat penggunaan ventilator (OR 9.615 (IK 95% 2.712-34.08, p=<.001) dan hasil biakan sputum Acinetobacter baumanii (OR 2.608 (IK 95% 1.089 - 6.246), p = 0.028).Kesimpulan : Keberhasilan pengobatan pasien dengan EAT sebesar 74.5% dipengaruhi oleh skor PSI, lama perawatan dan riwayat penggunaan ventilator. Keberhasilan pengobatan pasien dengan PDT sebesar 46.8% dipengaruhi oleh riwayat penggunaan ventilator dan biakan sputum Acinetobacter baumanii.

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Background: Data from the World Health Organization (WHO) in 2019 shows that lower respiratory tract infections are the fourth cause of death in the world with a mortality rate of 6.1%. Pneumonia is a lower respiratory tract infection caused by microorganisms. The type of pneumonia that is common is community-acquired pneumonia. The high incidence of community-acquired pneumonia caused by bacteria causes an increased need for antibiotics as treatment. Antibiotics can be given as empirical antibiotic treatment (EAT) or pathogen-directed treatment (PDT). This study aims to see the success rate of inpatient community-acquired pneumonia with EAT or PDT.

Methods : This study was an observational study using a retrospective cohort design by collecting medical record data at Persahabatan Hospital. The subjects of this study were inpatient community-acquired pneumonia patients for the period January 1, 2021 to December 31, 2022. The total sampling method was selected for the study.

Results : The subjects in this study consisted of 220 EAT patients and 62 PDT patients. The majority of bacteria found were gram-negative (82%) with the most common types were Klebsiella pneumonia (29.3%), Acinetobacter baumannii (16.7%) and Escherichia coli (15.3%). The most antibiotics in EAT was levofloxacin (87.3%) and in PDT was meropenem (34%). The success rate of patients with EAT was 74.5%, which was affected by PSI score (OR 5.318 (IK 95% 2.046 - 13.820, p=<.001), length of stay (OR 1.949 (IK 95% 1.043 - 3.641, p=0.035) and history of ventilator use (OR 29.364 (IK 95% 12.80 - 67.34, p= <.001). The success rate of PDT was 46.8%, influenced by the history of ventilator use (OR 9.615 (IK 95% 2.712-34.08, p=<.001) and Acinetobacter baumanii in sputum culture (OR 2.608 (IK 95% 1.089 - 6.246), p = 0.028).

Conclusions : The success rate of patients with EAT was 74.5%, influenced by PSI score, length of stay and history of ventilator use while those with PDT were 46.8%, influenced by the history of ventilator use and Acinetobacter baumanii in sputum culture.

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"Latar belakang: Penyakit Paru Obstruktif Kronik (PPOK) merupakan penyakit tidak menular yang menjadi salah satu masalah di Indonesia dan dunia. Kepatuhan pasien PPOK dalam menggunakan inhaler ditemukan relatif buruk dengan tingkat ketidakpatuhan berkisar antara 50 dan 80%. Penelitian ini bertujuan untuk menelusuri faktor-faktor yang dapat memengaruhi kepatuhan pasien PPOK dalam penggunaan inhaler. Metode: Penelitian ini adalah potong lintang menggunakan total 75 subjek yang dilakukan di poli asma-PPOK di RSUP Persahabatan Jakarta. Kuesioner yang digunakan merupakan adaptasi dari kuesioner test of adherence to inhaler (TAI) yang telah dilakukan alih bahasa,uji validitas, dan reliabiliatas. Hasil: Dari total seluruh subjek, 57,3% memiliki kepatuhan baik, 26,7% memiliki kepatuhan sedang, dan 16% memiliki kepatuhan buruk. Sebanyak 68% subjek memiliki ketidakpatuhan sporadis, 46,7% subjek memiliki ketidakpatuhan disengaja, dan 56% subjek memiliki ketidakpatuhan tidak disengaja. Faktor yang berhubungan dengan kepatuhan subjek adalah jumlah device yang digunakan (p=0,025), jumlah eksaserbasi per tahun (p=0,002), durasi kontrol (p=0,009), lama pengobatan (p=0,013), nilai mMRC (p=0,011), dan nilai CAT (p=0,030). Kesimpulan: Faktor yang berhubungan dengan kepatuhan pasien PPOK terhadap penggunaan inhaler adalah jumlah device inhaler yang digunakan, durasi saat kontrol, dan lama pengobatan yang telah dijalani. Kepatuhan terhadap penggunaan inhaler berhubungan dengan jumlah eksaserbasi per tahun, nilai mMRC, dan nilai CAT. Perlu dilakukan penelitian lebih lanjut dengan sampel yang lebih luas serta kuesioner yang lebih objektif.

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Background: Chronic obstructive pulmonary disease (COPD) is a non-communicable disease that is a problem in Indonesia and the world. COPD patients' compliance in using inhalers was found to be relatively poor with non-compliance rates ranging between 50 and 80%. This study aims to explore factors that may influence COPD patients' adherence in using inhalers. Methods: This study was a cross-sectional study using a total of 75 subjects conducted at the asthma-COPD clinic at Persahabatan Central General Hospital Jakarta. The questionnaire used was an adaptation of the test of adherence to inhaler (TAI) questionnaire which had been translated, tested for validity, and tested for reliability. Results: Of the total subjects, 57.3% had good compliance, 26.7% had moderate compliance, and 16% had poor compliance. A total of 68% of subjects had sporadic noncompliance, 46.7% of subjects had deliberate noncompliance, and 56% of subjects had unintentional noncompliance. Factors associated with adherence were the number of devices used (p=0.025), number of exacerbations per year (p=0.002), duration of control (p=0.009), length of treatment (p=0.013), mMRC score (p=0.011), and CAT score (p=0.030). Conclusion: Factors associated with COPD patients' adherence to inhaler use were the number of inhaler devices used, duration at control, and length of treatment. Adherence is associated with the number of exacerbations per year, mMRC scores, and CAT scores. Further research needs to be done with a wider sample and a more objective questionnaire."

"Latar belakang: Kasus baru kanker paru semakin bertambah dan mulai banyak dialami usia muda. Pendekatan skrining dalam upaya deteksi dini dilanjutkan tindakan diagnostik yang cepat dan akurat memberikan penderita memeroleh kualitas hidup yang lebih baik dalam perjalanan penyakitnya. Biopsi paru transtorakal menggunakan jarum halus dan core menghasilkan akurasi berkisar 85%-90% dengan keunggulan tindakan minimal invasif. Variasi akurasi diagnostik dan belum terdapat data proporsi hasil biopsi transtorakal di RS Persahabatan, membuat kami melakukan penelitian ini. Metode: Kami melakukan pencatatan data sampel periode Januari 2021-September 2023 pada bulan Januari-Februari 2024. Data yang dicatat yaitu karakteristik pasien keganasan rongga toraks belum tegak jenis yang dilakukan tindakan biopsi jarum halus dan core transtorakal dengan panduan CT scan. Sebanyak 765 pasien dalam periode tindakan didapatkan 563 pasien yang sesuai kriteria inklusi dan eksklusi. Data kemudian dianalisis untuk menilai kepositifan biopsi jarum halus dan core transtorakal serta faktor yang memengaruhinya. Hasil: Sejumlah 563 subjek terdiri atas laki-laki 67,9% dan perempuan 32,1%. Usia paling muda 18 tahun dan paling tua 88 tahun dengan median usia 56 tahun. Subjek dengan keluhan respirasi 83,7% dan nonrespirasi 16,3%. Perokok merupakan mayoritas subjek sebesar 58,4%. Lokasi target biopsi paling banyak di paru 75,3% sedangkan mediastinum 24,7%. Nilai HU kami kelompokkan menjadi ≥ 30 sebanyak 91,3% dan < 30 sebanyak 8,7%. Panjang minimal kedalaman tusuk 0,7 cm dan maksimal 11,21 cm dengan median 4,2 cm. Posisi saat tindakan biopsi yaitu terlentang 67,5%, tengkurap 24,5% dan lateral dekubitus 8%. Proporsi kepositifan biopsi jarum halus 80,8% sementara biopsi core 77,6%. Selanjutnya karakteristik tersebut kami lakukan analisis bivariat didapatkan nilai HU memengaruhi kepositifan biopsi jarum halus (p < 0,05). Kesimpulan: Proporsi biopsi jarum halus dan core transtorakal di RS Persahabatan sangat baik. Nilai HU memengaruhi kepositifan biopsi TTNA namun, tidak pada biopsi core. Kedalaman tusuk dan posisi bukan faktor yang memengaruhi kepositifan biopsi TTNA dan core.

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Background: New cases of lung cancer are increasing and are starting to occur at a young age. A screening approach in an effort for early detection followed by rapid and accurate diagnosis provides patients with a better quality of life throughout their disease. Transthoracic lung biopsy using a fine needle and core produces an accuracy of around 85%-90% with the advantage of being minimally invasive. Variations in diagnostic accuracy and no database availability yet on the proportion of transthoracic biopsy results at Persahabatan Hospital prompted us to conduct this research. Methods: We recorded data from January 2021-September 2023 in January-February 2024. The data recorded were the characteristics of patients with unconfirmed type thoracic cavity malignancies who underwent fine needle and transthoracic core biopsies CT scan guided. A total of 765 patients during the action period 563 patients met the inclusion and exclusion criteria. The data is then processed to assess the positivity of transthoracic fine needle and core biopsies and the factors that influence it. Result: A total of 563 subjects consisted of 67.9% men and 32.1% women. The youngest age is 18 years and the oldest is 88 years with a median age of 56 years. Subjects with respiratory complaints were 83.7% and non-respiratory 16.3%. Smokers constituted the majority of our subjects at 58.4%. The most common biopsy target locations were the lungs, 75.3%, while the mediastinum was 24.7%. Hounsfield units are divided into ≥ 30 as many as 91.3% and < 30 as many as 8.7%. The minimum length of the puncture depth is 0.7 cm and the maximum is 11.21 cm with 4.2 cm as the median. The position during the biopsy was supination 67.5%, prone 24.5%, and lateral decubitus 8%. The positive proportion of fine needle biopsy was 80.8% while core biopsy was 77.6%. We conducted a bivariate analysis of these characteristics and found that the HU value influenced the positivity of fine needle biopsy (p < 0.05). Conclusion: The proportion of fine needle and core transthoracic lung biopsies at Persahabatan Hospital is decent. The HU value influences the positivity of TTNA biopsy but not core biopsy. Puncture depth and position were not a factor influencing the positivity of TTNA and core biopsies."

"Latar Belakang: Jumlah kasus KPKBSK diperkirakan 85% dari seluruh kasus kanker paru dan 40% diantaranya adalah jenis adenokarsinoma. Sebanyak 10%-30% pasien adenokarsinoma mengalami mutasi EGFR dan mendapatkan terapi EGFR-TKI. Mayoritas pasien KPKBSK memiliki respons dan toleransi baik terhadap terapi EGFR- TKI tetapi sebagian kecil pasien mengalami penyakit paru interstisial akibat EGFR- TKI. Penelitian ini bertujuan untuk mengetahui proporsi gambaran penyakit paru interstisial pada pasien KPKBSK dengan terapi EGFR-TKI di RSUP Persahabatan.Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendeketan kohort retrospektif yang dilakukan bulan Januari 2021 hingga Juni 2022. Subjek penelitian adalah pasien KPKBSK yang mendapatkan terapi EGFR-TKI. Subjek penelitian dipilih sesuai kriteria inklusi dan eksklusi. Pengambilan data melalu data sekunder berupa rekam medis dan hasil CT scan toraks pasien yang kontrol di poliklinik onkologi RSUP Persahabatan.Hasil: Pada penelitian ini diperoleh 73 subjek penelitian, pasien KPKBSK dengan mutasi EGFR yang mendapatkan terapi EGFR-TKI di RSUP Persahabatan. Sebanyak 12 dari 73 subjek penelitian mengalami gambaran ILD yang dievaluasi berdasarkan CT scan toraks RECIST I dan II dengan karakteristik jenis kelamin laki-laki (22,2%), kelompok usia 40-59 tahun (19,4%), perokok (24,1%), indeks brinkman berat (42,9%) dan mendapatkan terapi afatinib (26,1%). Proporsi gambaran ILD pada pasien KBPKBSK dengan terapi EGFR-TKI adalah opasitas retikular (58,3%), parenchymal band (33,3%), ground-glass opacities (25%), traction bronchiectasis (25%) dan crazy paving pattern (8,3%). Hasil analisis bivariat dan multivariat menunjukkan tidak terdapat perbedaan antara faktor-faktor seperti jenis kelamin, usia, jenis EGFR-TKI, riwayat merokok, indeks brinkman, riwayat penyakit paru dan tampilan status terhadap gambaran ILD.Kesimpulan: Gambaran ILD pada pasien KPKBSK dengan terapi EGFR-TKI meliputi opasitas retikular, parenchymal band, ground-glass opacities, traction bronchiectasis dan crazy paving pattern. Tidak terdapat perbedaan bermakna secara statistik antara faktor-faktor yang memengaruhi terhadap gambaran ILD.

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Background: The number of cases of NSCLC is estimated around 85% of all lung cancer cases and 40% among them are adenocarcinoma. Approximately 10%-30% of adenocarcinoma patients have EGFR mutations and receive EGFR-TKI therapy. The majority of NSCLC patients have a good response and tolerance to EGFR-TKI therapy, but a small group of patients experience EGFR-TKI induced interstitial lung disease. This study aims to determine the proportion of features of interstitial lung disease ini NSCLC patients treated with EGFR-TKI at Persahabatan Hospital.

Methods: This study was an analytic observational with a retrospective cohort approach that was conducted from January 2021 until June 2022. The subject were NSCLC patients who received EGFR-TKI treatment. The inclusion and exclusion criteria were used to determine which subjects will be included in the study. Data collection through secondary data from medical record and chest CT scan results of patients controlled at oncology polyclinic at Persahabatan Hospital.

Result : In this study, there were 73 subjects of NSCLC with EGFR mutations and received EGFR-TKI therapy at Persahabatan Hospital. There were 12 out of 73 subjects had ILD features which were evaluated based on RECIST I and II chest CT scan with predominant of male (22.2%), age group 40-59 years old (19.4%), smokers (24.1%), severe Brinkman index (42.9%) and received afatinib (26.1%). The proportion of ILD features in NSCLC patients with EGFR-TKI therapy are reticular opacities (58.3%), parenchymal bands (33.3%), ground-glass opacities (25%), traction bronchiectasis (25%) and crazy paving pattern (8.3%). The results of bivariate and multivariate analyzes showed that there was no differences between factors such as sex, age, type of GEFR-TKI, smoking history, Brinkman index, history of lung disease and performance status with features of ILD.

Conclusion: Features of ILD in NSCLC patients with EGFR-TKI therapy include reticular opacities, parenchymal bands, ground-glass opacities, traction bronchiectasis and crazy paving pattern. There is no statistically significa"