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"Latar belakang: Infeksi saluran kemih ISK merupakan salah satu penyakit infeksi yang paling sering pada anak usia 2 bulan ndash; 2 tahun. Infeksi saluran kemih sulit dideteksi karena gejalanya yang tidak khas. Diagnosis pasti dengan biakan urin membutuhkan waktu yang lama, sedangkan pemeriksaan urinalisis sulit mendeteksi ISK karena pengosongan kandung kemih yang cepat. Pewarnaan Gram urin lebih mudah dilakukan, cepat, dan murah sehingga diajukan sebagai metode diagnosis alternatif. Tujuan: Mengetahui kesesuaian pemeriksaan pewarnaan Gram urin dibandingkan dengan biakan urin dalam mendiagnosis ISK pada anak usia 2 bulan - 2 tahun. Metode: Studi potong lintang, di RSCM Jakarta, bulan Mei hingga Desember 2016. Penelitian melibatkan 59 anak usia 2 bulan ndash; 2 tahun dengan klinis tersangka ISK. Urin diambil dengan teknik kateterisasi peruretra. Sampel urin diperiksakan pewarnaan Gram, biakan urin dan urinalisis. Biakan urin sebagai baku emas pemeriksaan, dinyatakan sebagai ISK apabila tumbuh kuman dengan koloni >50.000 cfu/mL. Pewarnaan Gram dinyatakan positif ISK apabila ditemukan satu jenis bakteri per lapang pandang besar. Hasil: Prevalens ISK pada penelitian ini sebesar 38,9. Sensitivitas pewarnaan Gram urin sebesar 47,8 IK 95 26,8-69,4, spesifisitas 97,2 IK 95 85,5-99,9, NDP 91,7 IK 95 60,3-98,8, NDN 74,5 IK 95 60,3-98,8, LR 17,2 IK 95 2,4-124,6, LR - 0,54 IK 95 0,36-0,8, akurasi 78. Simpulan: Terdapat kesesuaian antara pemeriksaan pewarnaan Gram urin dengan biakan urin dalam mendiagnosis ISK. Terapi antibiotik dapat segera diberikan apabila hasil pemeriksaan Gram urin positif menunjukkan hasil positif. Pemberian antibiotik dapat ditunda menunggu hasil biakan urin, apabila gejala klinis ISK tidak terlalu khas dan tidak ditemukan bakteri dari pewarnaan Gram urin.

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Background: Urinary tract infection UTI one of the most common disease in children age 2 months 2 years. Urinary tract infection in children is often difficult to diagnose because of the atypical symptoms. The definitive diagnosis with urine culture has its limitations because it takes a long time to get results, while it is difficult to detect UTI using urinalysis due to the rapid bladder emptying. Gram staining of urine is thought to be easier, faster, and cheaper, therefore it is proposed as an alternative method for early diagnosis of UTI.

Objective: To compare the diagnostic accuracy of urine Gram staining with urine culture to diagnose UTI in children aged 2 months to 2 years.

Methods: A cross sectional study was conducted at Cipto Mangunkusumo Hospital from May to December 2016. The study involved 59 children aged 2 months 2 years drawn through consecutive sampling method with clinically suspected UTI. Urine sample was taken with per urethra catheterization techniques. Urine samples were examined by Gram staining, urine culture and urinalysis. Urine culture as a gold standard examination is expressed as UTI when colonies of bacterias grow 50,000 cfu mL. Gram stain tested positive for UTI if one type of bacteria is found per high power field.

Results: The prevalence of UTI in this study is 38.9. The sensitivity of urine Gram staining is 47.8 95 CI 26.8 to 69.4, specificity of 97.2 95 CI 85.5 to 99.9, NDP 91.7 CI 95 from 60.3 to 98.8, NDN 74.5 95 CI 60.3 to 98.8, LR 17.2 95 CI 2.4 to 124.6, LR 0.54 95 CI 0.36 to 0.8, and accuracy of 78.

Conclusion There is a correlation between the urine Gram staining with urine culture in diagnosing UTI in children aged 2 months 2 years. Antibiotics may be administered immediately when urine Gram staining shows positive result. Antibiotics for UTI may be delayed until the results of urine culture, if clinical symptoms of UTI is not very distinctive and urine Gram staining shows negative result."

"Latar belakang: Diagnosis tuberkulosis (TB) pada anak sulit ditegakkan karena gejala tidak khas dan sulit memperoleh sampel sputum. Pemeriksaan antigen lipoarabinomannan (LAM) urin telah direkomendasikan oleh WHO. Namun, penelitian pada anak tanpa HIV di Indonesia masih sangat terbatas. Mengingat kesulitan dalam mendapatkan sampel sputum pada anak tanpa HIV, diperlukan metode diagnostik non-sputum yang mudah dilakukan, memberikan hasil cepat, serta dapat diterapkan langsung di lokasi pasien (point-of-care testing atau POCT). Tujuan: Menilai dan membandingkan akurasi diagnostik dua alat deteksi LAM urin yaitu Abbott Determine TB LAMAg TM (Abbott LAM) dan Fujifilm SILVAMP TB LAM TM (Fuji LAM) untuk mendiagnosis TB pada anak.Metode: Penelitian ini merupakan studi potong lintang yang melibatkan anak berusia 0 - 18 tahun dengan dugaan TB di tiga rumah sakit rujukan nasional. Data dikumpulkan melalui anamnesis, pemeriksaan fisis, serta pengambilan sampel urin menggunakan metode midstream atau urine collector. Sampel urin kemudian diperiksa menggunakan Abbott LAM dan Fuji LAM, lalu dibandingkan dengan standar diagnosis TB menurut Pedoman Kemenkes RI 2023 (TB klinis dan TB terkonfirmasi bakteriologis) serta standar pemeriksaan bakteriologis (GeneXpert®).Hasil: Pada periode Oktober hingga Desember 2024, sebanyak 77 pasien dianalisis, dengan 18 pasien terkonfirmasi bakteriologis dan 22 pasien didiagnosis TB secara klinis.Dibandingkan dengan alur diagnosis Kemenkes RI 2023 sebagai standar: Abbott LAM memiliki sensitivitas 52% dan spesifisitas 48,6%, Fuji LAM memiliki sensitivitas 22,5% dan spesifisitas 97,3%. Dibandingkan dengan pemeriksaan bakteriologis sebagai standar: Sensitivitas dan spesifisitas Abbott LAM menurun menjadi 47,1% dan 42,5%, sensitivitas dan spesifisitas Fuji LAM meningkat menjadi 47% dan 97,5%.Kesimpulan: Kedua alat memiliki sensitivitas yang lebih rendah dari standar minimal WHO (65%), sehingga tidak direkomendasikan untuk skrining atau diagnosis awal TB pada anak. Namun, Fuji LAM menunjukkan spesifisitas tinggi dan berpotensi menjadi alat diagnostik penguat dalam mendeteksi TB pada anak yang menunjukkan gejala, terutama bagi anak yang mengalami kesulitan dalam memperoleh sampel untuk pemeriksaan bakteriologis

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Background: Diagnosing tuberculosis (TB) in children is challenging due to non-specific symptoms and difficulties in obtaining sputum samples. The World Health Organization (WHO) has recommended urinary lipoarabinomannan (LAM) antigen testing for TB detection. However, studies on HIV-negative children in Indonesia remain very limited. Given the challenges in obtaining sputum samples from HIV-negative children, a non-sputum diagnostic method that is easy to perform, provides rapid results, and can be implemented at the point of care (POCT) is needed.

Objective: To evaluate and compare the diagnostic accuracy of two urinary LAM detection tests, Abbott Determine TB LAM Ag™ (Abbott LAM) and Fujifilm SILVAMP TB LAM™ (Fuji LAM), for diagnosing TB in children.

Methods: This cross-sectional study involved children aged 0–18 years with suspected TB from three national referral hospitals. Data collection included medical history, physical examination, and urine sample collection using either the midstream method or a urine collector. Urine samples were tested using Abbott LAM and Fuji LAM, and results were compared with the 2023 Indonesian Ministry of Health TB diagnostic guidelines (clinical TB and bacteriologically confirmed TB) as well as the bacteriological testing standard (GeneXpert®).

Results: Between October and December 2024, a total of 77 patients were analyzed, including 18 bacteriologically confirmed TB cases and 22 clinically diagnosed TB cases. When compared to the 2023 Indonesian Ministry of Health TB diagnostic algorithm, Abbott LAM showed a sensitivity of 52% and specificity of 48.6%, while Fuji LAM had a sensitivity of 22.5% and specificity of 97.3%. When using bacteriological testing (GeneXpert®) as the reference standard, the sensitivity and specificity of Abbott LAM decreased to 47.1% and 42.5%, respectively, whereas Fuji LAM demonstrated improved performance with a sensitivity of 47% and specificity of 97.5%.

Conclusion: Both tests demonstrated lower sensitivity than the WHO-recommended minimum standard (65%), making them unsuitable for screening or initial TB diagnosis in children. However, Fuji LAM exhibited high specificity, suggesting that it may serve as a valuable additional diagnostic tool for children with TB symptoms who face challenges in providing sputum samples for bacteriological confirmation."