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"ABSTRAKPendahuluan:Gejala klinis tuberkulosis (TB) pada HIV seringkali tidak khas sehingga diagnosis menjadi sulit. Hal ini mengakibatkan underdiagnosis atau overdiagnosis dengan konsekuensi meningkatnya morbiditas dan mortalitas. Hingga saat ini, gejala dan tanda yang berhubungan dengan diagnosis TB paru belum banyak diteliti. Penelitian ini dilakukan untuk mengetahui nilai diagnostik dari gabungan gejala (batuk, penurunan berat badan, demam, dan rontgen toraks) dalam diagnosis TB paru pada pasien HIV dan nilai tambah biakan MGIT 960 dalam meningkatkan kemampuan diagnosis TB paru pada pasien HIV.Metode:Penelitian potong lintang terhadap pasien HIV dengan kecurigaan TB yang datang ke Poli HIV atau pasien ruang rawat Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta dari Oktober 2011 hingga April 2012. Hubungan gejala klinis dan radiologis dengan diagnosis TB (biakan Lowenstein Jensen) dianalisis dengan regresi logistik. Kemudian ditentukan kontribusi masing masing determinan diagnosis terhadap diagnosis TB. Kemampuan biakan MGIT 960 dalam menegakkan diagnosis TB dinilai dengan membuat kurva ROC dan menghitung AUC. Analisis data dilakukan dengan menggunakan program SPSS versi 16.0.Hasil:Subjek penelitian umumnya laki-laki (63%) dengan median usia 32 (rentang 18-52) tahun, status gizi baik (43%), CD4 <50 μl sebanyak 48%. Risiko transmisi terbanyak adalah pengguna narkoba suntik (penasun) (51%). Dari analisis multivariat, demam dan penurunan berat badan mancapai kemaknaan secara statistik. Nilai area under curve (AUC) manifestasi klinis adalah 71,9%. Penambahan biakan BTA MGIT 960 akan meningkatkan AUC 24,9% menjadi 95,7%.Simpulan:Gabungan gejala demam dan penurunan berat badan mampu memprediksi diagnosis TB paru pada pasien HIV. Penambahan biakan BTA MGIT 960 bermanfaat meningkatkan kemampuan gabungan gejala klinis dalam diagnosis TB paru pada pasien HIV."

"[ABSTRAKLatar belakang. Sepsis neonatorum awitan dini (SNAD) adalah sindrom klinisakibat respon sistemik terhadap infeksi pada awal kehidupan. Diagnosis SNADseringkali sulit karena gejala klinisnya tidak spesifik.Tujuan. Mengetahui sensitivitas dan spesifisitas biakan usap telinga dalamdiagnosis SNAD.Metode. Subjek penelitian adalah neonatus yang lahir di RSCM Jakarta dan RSUTangerang Selatan dengan diagnosis SNAD. Dilakukan pengambilan biakan dariusapan telinga dan darah bayi.Hasil. Diantara 50 subjek, terdapat 2 neonatus dengan biakan darah positif, dan 32neonatus dengan biakan usap telinga positif. Hanya 1 subjek yang memilikikesesuaian jenis kuman yang tumbuh dari biakan darah dan biakan usap telinga.Bakteri yang tumbuh pada biakan usap telinga sebagian besar adalah Gram postif(62%). Biakan usap telinga mempunyai sensitivitas 64,7%, spesifisitas 36,4%,nilai duga positif 34,3%, nilai duga negatif 66,6%, rasio kemungkinan positif1,02, rasio kemungkinan negatif 0,97, dan, akurasi 46% untuk mendeteksi SNAD.Simpulan. Ditemukan hasil biakan darah positif pada 2 subjek. Biakan usaptelinga memiliki sensitivitas 64,7%, spesifisitas 36,4%, nilai duga positif 34,3%,nilai duga negatif 66,6%, rasio kemungkinan positif 1,02, rasio kemungkinannegatif 0,97, dan akurasi 46% untuk mendeteksi SNAD.

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ABSTRACTBackground. Early-onset neonatal sepsis (EOS) is a clinical syndrome due tosystemic response to infection in early life. EOS is often difficult to diagnosedbecause the clinical symptoms are not specific.Objective. The study aim to determine sensitivity and specificity of ear swabsculture in the diagnosis of EOS.Methods. Neonates born in the CMH Jakarta and Tangerang Selatan Hospitalwho developed sepsis were studied. Swabs were collected for culture from baby’sear. Bacterias isolated from ear swabs cultured were correlated with those fromblood culture.Results. Among 50 neonates studied, 2 neonates had positive blood cultured and32 neonates had positive ear swabs cultured. Only one subject had suitabilitytypes of bacterias that grew from blood and ear swabs. Bacteria grew from earswab cultured were predominantly Gram-positive (62%). Ear swabs cultured hadsensitivity 64.7%, specificity 36.4%, positive predictive value (PPV) 34.3%,negative predictive value (NPV) 66.6%, positive likelihood ratio (PLR) 1.02,negative likelihood ratio (NLR) 0.97, and accuracy 46% to detect EOS.Conclusions. This study showed positive blood culture results were found in twosubjects. Ear swabs cultured had a sensitivity 64.7%, specificity 36.4%, PPV34.3%, NPV 66.6%, PLR 1.02, NLR 0.97, and accuracy 46% to detect EOS, Background. Early-onset neonatal sepsis (EOS) is a clinical syndrome due tosystemic response to infection in early life. EOS is often difficult to diagnosedbecause the clinical symptoms are not specific.Objective. The study aim to determine sensitivity and specificity of ear swabsculture in the diagnosis of EOS.Methods. Neonates born in the CMH Jakarta and Tangerang Selatan Hospitalwho developed sepsis were studied. Swabs were collected for culture from baby’sear. Bacterias isolated from ear swabs cultured were correlated with those fromblood culture.Results. Among 50 neonates studied, 2 neonates had positive blood cultured and32 neonates had positive ear swabs cultured. Only one subject had suitabilitytypes of bacterias that grew from blood and ear swabs. Bacteria grew from earswab cultured were predominantly Gram-positive (62%). Ear swabs cultured hadsensitivity 64.7%, specificity 36.4%, positive predictive value (PPV) 34.3%,negative predictive value (NPV) 66.6%, positive likelihood ratio (PLR) 1.02,negative likelihood ratio (NLR) 0.97, and accuracy 46% to detect EOS.Conclusions. This study showed positive blood culture results were found in twosubjects. Ear swabs cultured had a sensitivity 64.7%, specificity 36.4%, PPV34.3%, NPV 66.6%, PLR 1.02, NLR 0.97, and accuracy 46% to detect EOS]"

"[ABSTRAKLatar Belakang: Pengobatan TB MDR memiliki hasil yang buruk dengan keberhasilan hanya 48% di dunia. Salah satu indikator keberhasilan pengobatan adalah konversi dini. Identifikasi faktor yang mempengaruhi konversi merupakan hal yang penting. Metode: Penelitian ini dilakukan secara kohort retrospektif dengan menggunakan rekam medik pasien TB MDR di RSUP Persahabatan Jakarta yang berobat selama bulan Agustus 2009 - Desember 2013.Hasil: Dari 436 pasien terdapat 248 pasien laki-laki (56.6%). Sebanyak 256 pasien (58,7%) mengalami konversi biakan dalam dua bulan pengobatan. Nilai tengah waktu konversi adalah 44 hari. Faktor yang memperlambat lama konversi adalah jenis kelamin perempuan (aHR 0,808; [95%CI 0,659-0,991]), IMT pasien kurang (0,792; [0,637-0,983]), ditemukan gambaran kavitas pada foto toraks (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), riwayat pengobatan OAT sebelumnya dengan lini kedua (0,597;[0,415-0,858]), jumlah resisten obat > 2 OAT (0,614;[0,429-0,879]), kelompok pasien Pre XDR dan TB XDR (0,486;[0,305-0,776]), dan jumlah limfosit rendah (0,681;[0,524-0,885]).Kesimpulan: Jenis kelamin perempuan, IMT kurang, gambaran kavitas pada foto toraks, tingginya bacterial load, riwayat pengobatan OAT sebelumnya dengan lini kedua, jumlah resisten obat > 2 OAT, kelompok pasien Pre XDR dan TB XDR serta limpositopenia berhubungan dengan lamanya konversi pada pasien TB MDR.

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ABSTRACTIntroduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.;Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients., Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.]"

"Tujuan : Membandingkan hasil biakan bakteri dari spesimen kornea yang diambil dengan metode kerokan dilanjutkan mikrohomogenisasi dan hasil biakan bakteri dari spesimen kornea yang diambil dengan apusan kornea. Desain: Penelitian ini adalah perbandingan potong lintang comparative cross sectional , Metode: Delapan belas subjek yang dibagi menjadi 2 kelompok terandomisasi, Kelompok A kerokan dilakukan pertama, apusan kedua , dan kelompok B apusan dilakukan pertama, kerokan kedua . Pada analisis data kedua metode kerokan dan apusan dipisahkan kemudian dibandingkan. Hasil: Proporsi Gram sesuai biakan pada teknik Kerokan-Mikrohomogenisasi sebesar 6/13 46.2 , proporsi Gram sesuai biakan pada teknik Apusan sebesar 5/13 38.5 . Nilai p uji McNemar adalah 1.000 p> 0.05 . Proporsi biakan positif pada teknik Kerokan-Mikrohomogenisasi sebesar 13/18 72.2 , proporsi biakan positif pada teknik apusan sebesar 9/18 50 . Nilai p uji McNemar adalah 0.219 p> 0.05 . Nilai uji kesesuaian Kappa dari teknik kerokan mikrohomogenisasi terhadap apusan kornea adalah 0.333. Kesimpulan: Hasil biakan bakteri dari spesimen kornea yang diambil dengan metode Kerokan dilanjutkan Mikrohomogenisasi memiliki angka biakan positif yang lebih besar dibandingkan biakan bakteri dari spesimen kornea yang diambil dengan apusan kornea namun tidak bermakna secara statistik. Kata kunci : apusan kornea; biakan bakteri; kerokan mikrohomogenisasi

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Purpose To compare the results of bacterial culture that specimens was taken by the corneal scrapings followed by microhomogenization method and bacterial culture that specimens was taken by corneal swabs. Methods This study was cross sectional comparisons, which 18 subjects were divided into two randomized groups Group A scrapings performed first, smear performed second , and group B smear performed first, scrapings performed second . In data analysis both methods scrapings and swabs are separated then compared. Results The proportion of Gram corresponding culture in scrapings Microhomogenization technique was 6 13 46.2 , the proportion of Gram corresponding cultures in smear technique was 5 13 38.5 . McNemar test p value is 1.000 p 0.05 . The proportion of positive cultures in scrapings Microhomogenization technique was 13 18 72.2 , the proportion of culture positive on smear technique was 9 18 50 . McNemar test p value is 0219 p 0.05 . Kappa suitability test value is 0.333. Conclusion The results of bacterial culture that specimens was taken by the corneal scrapings followed by microhomogenization have a culture positive larger than bacteria cultures that specimens was taken by a swab of the cornea but not statistically significant. Keywords bacterial cultures corneal swabs scrapings microhomogenization "

"Latar Belakang: Diagnosis definitif Helicobacter pylori H.pylori hingga kini masih merupakan masalah. Biakan untuk isolasi dan identifikasi bakteri ini sulit. Uji cepat urease direkomendasikan sebagai uji diagnostik lini pertama pasien dispepsia. Tujuan: Mengembangkan komposisi medium biakan dan deteksi cepat H.pylori pada spesimen biopsi lambung pasien dispepsia. Metode: Desain penelitian merupakan studi potong lintang dan eksperimental laboratorium. Sampel diambil dengan cara consecutive sampling sebanyak 68 spesimen biopsi lambung 34 antrum, 34 korpus, masing-masing untuk biakan dan uji MIU. Sebagai pembanding digunakan histopatologi dan PCR. Mula-mula dilakukan optimasi medium biakan dan MIU konsentrasi merah fenol, pH, urea dan suhu inkubasi. Selanjutnya kondisi optimal yang diperoleh diaplikasikan pada spesimen biopsi pasien dispepsia. Hasil: Medium biakan agar darah Columbia ditambah vankomisin 5 mg / 500 mL dan darah domba 7 belum optimal, namun dapat digunakan untuk isolasi dan identifikasi. Hasil MIU modifikasi sebagai berikut: konsentrasi merah fenol 0,001 ; urea 4 ; pH medium 7; Suhu inkubasi optimal 35-370 C. Proporsi positif hasil uji MIU sebesar 35,29 12/34, biakan 32,35 11/34, PCR 32,35 11/34 dan histopatologi 20,59 7/34. Kesimpulan: Pemeriksaan MIU meningkatkan positivitas hasil pemeriksaan sebesar 14,7 bila dibandingkan dengan histopatologi.

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Background: Until now, definitive diagnostic of H.pylori is still a problem. Culture for isolation and identification of this pathogen is difficult. Rapid urease test is recommended as a first line diagnostic test.

Aim: To obtain optimal composition for culture medium and Motility Indol Urease MIU test for the detection of H. pylori in dyspeptic patient biopsy specimens.

Method: A cross sectional and experimental laboratory study was performed. Sixty eight gastric biopsy samples 34 antrum, 34 corpus were collected by consecutive sampling method for culture and MIU test. Histopathology and PCR were conducted for comparison. Initially, we performed the optimation of culture medium and MIU test phenol red and urea concentration, pH, and temperature. The optimal condition obtained was then applied to the specimens.

Result: Columbia agar supplemented with vancomycin 5 mg 500 mL and 7 sheep blood was unable to create an optimal condition, but it can be used for isolation and identification. Modified MIU was performed by this following condition phenol red 0,001 urea 4 pH 7 incubation temperature 35 37oC. Positive proportion of MIU was 35.29 12 34, culture 32.35 11 34, PCR 32,35 11 34 and histopathology 20.59 7 34.

Conclusion: MIU test was able to improve the positivity rate by 14,7 compared to histopathology."

"Latar belakang: Pasien asma dapat mengalami sensitisasi terhadap Aspergillus sp. yang dapat menyebabkan aspergilosis bronkopulmoner alergika (ABPA). Kondisi ABPA, penggunaan steroid, dan kerusakan fungsi paru dapat meningkatkan risiko aspergilosis paru kronik (APK). Pemeriksaan baku emas mikologi APK adalah kultur jamur, yang memerlukan sumber daya terlatih dan waktu lama. Pemeriksaan imunokromatografi (ICT) Aspergillus dengan mekanisme lateral flow assay yang mudah dilakukan dan memerlukan sampel sedikit dapat menjadi alternatif baru deteksi Aspergillus sp. pada pasien asma persisten.Metode: Penelitian ini dilaksanakan pada Juni-November 2021, menyertakan 50 pasien asma persisten di RS Persahabatan yang direkrut pada penelitian sebelumnya. Bahan klinis terdiri atas 50 serum pasien untuk pemeriksaan ICT Aspergillus dan 15 sampel sputum untuk kultur jamur. Pemeriksaan dilakukan di laboratorium Departemen Parasitologi FKUI.Hasil: Demografi 50 subjek didominasi perempuan (78%) dan rerata usia subjek 55,8 tahun (SD±13,14). Hasil positif ICT Aspergillus ditemukan pada 16% (8 subjek). Pertumbuhan 17 isolat Aspergillus didapatkan pada sputum yang berasal dari 11 pasien, terdiri atas: Aspergillus niger (8 isolat), Aspergillus sp. (5 isolat), Aspergillus flavus (3 isolat), dan Aspergillus terreus (1 isolat). Tiga pasien memiliki hasil positif pada kultur dan ICT Aspergillus. Delapan dari pasien dengan hasil kultur positif memiliki hasil ICT negatif, meski 4 di antaranya memiliki 2 isolat Aspergillus.Kesimpulan: Pemeriksaan ICT Aspergillus menunjukkan hasil positif 16% pada 50 pasien asma yang diteliti. Kultur jamur pada sputum 11 dari 15 pasien menunjukkan pertumbuhan Aspergillus sebanyak 17 isolat, dengan spesies terbanyak A. niger. Tidak terdapat kaitan bermakna antara pemeriksaan ICT Aspergillus dengan hasil kultur jamur Aspergillus pada pasien asma persisten.

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Introduction: Asthma patients can be sensitized to fungi, including Aspergillus sp. which can cause allergic bronchopulmonary aspergillosis (ABPA). The certain conditions such as ABPA, steroid consumption, and lung function disturbance can increase the risk of chronic pulmonary aspergillosis (CPA). The gold standard for mycology examination for CPA diagnosis is fungal culture, which is time-consumed and need special resources. Immunochromatography test (ICT) Aspergillus could be a new alternative for CPA diagnosis, including for asthma patients.

Method: There were 50 persistent asthma patients from Persahabatan General Hospital who were recruited in previous study. Fifty sera were tested for ICT Aspergillus and 15 sputum samples for fungal culture.

Result: Demography of 50 subjects was dominated by women (78%) and mean age was 55.8 years (SD±13.14). Positive ICT test result was 16%, and 17 Aspergillus isolated from sputum of 11 out of 15 patients, consisted of Aspergillus niger (8 isolates), diikuti Aspergillus sp. (5 isolates), Aspergillus flavus (3 isolates), and Aspergillus terreus (1 isolate). There were 3 patients with positive results in both ICT and Aspergillus culture. Eight patients with Aspergillus confirmation had negative ICT results, despite 4 out of 8 had 2 Aspergillus isolates.

Conclusion: Aspergillus ICT in this study showed a positivity rate of 16%. There were 17 Aspergillus isolates from the sputum of 11 out of 15 patients, with A. niger as the most common species. There was no significant relationship between Aspergillus ICT examination and fungal culture results in persistent asthmatic 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."

"Infeksi saluran kemih (ISK) pada anak memiliki manifestasi klinis yang tidak khas dan bervariasi sehingga sulit terdiagnosis secara dini. Biakan urin memerlukan waktu hingga lima hari sehingga dapat menyebabkan keterlambatan terapi serta tingginya komplikasi ISK pada anak. Kelainan urinalisis yang saat ini digunakan masih memiliki spesifisitas yang rendah. Penelitian ini merupakan studi diagnostik NGAL urin, kelainan urinalisis, dan kombinasi keduanya, khususnya pada anak usia 2–5 tahun. Penelitian dilakukan menggunakan desain potong lintang pada anak dengan tersangka ISK, yaitu anak dengan salah satu gejala ISK (demam lebih dari 380C, muntah, diare, sakit pinggang, atau gejala lokal saluran kemih) disertai kelainan urinalisis (leukosituria, dan/atau nitrit positif dan/atau leukosit esterase positif) yang berusia 2–5 tahun dan dirawat di Rumah Sakit Dr. Cipto Mangunkusumo. Uji diagnostik pemeriksaan NGAL urin, kelainan urinalisis, dan kombinasi keduanya dibandingkan dengan biakan urin sebagai baku emas. Kombinasi ketiga kelainan urinalisis berupa leukosituria, nitrit dan leukosit esterase positif memiliki sensitivitas 38,1% dan spesifisitas 94,9%. NGAL urin diketahui memiliki sensitivitas 85,7% (IK95%: 63,6–96,9%), spesifisitas 74,3% (IK 95%: 57,8–86,9%), positive predictive value 64,3% (IK95%: 50,6–75,9%), dan negative predictive value 90,6% (IK95%: 76,9–96,5%) pada anak dengan minimal satu kelainan urinalisis. Pemeriksaan NGAL urin hanya meningkatkan spesifisitas kelainan urinalisis berupa leukosituria saja dan tidak meningkatkan spesifisitas pada yang telah memiliki tiga kelainan urinalisis. NGAL urin tidak dianjurkan untuk meningkatkan spesifisitas urinalisis dalam diagnosis ISK pada anak usia 2–5 tahun. Gabungan tiga kelainan urinalisis tanpa NGAL urin sudah memiliki spesifisitas yang baik. Perlu dilakukan penelitian biomarker lain yang dapat mendiagnosis dini ISK dengan lebih baik.

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Urinary tract infection (UTI) in children has unspecific clinical manifestations leading to difficulties in its early diagnosis. Using urine culture as the gold standard for diagnosing urinary tract infection may need five days to know and may lead to delayed treatment and high complication rates. Urinalysis abnormalities are used to diagnose UTI early but still have low specificity. This study evaluated the diagnostic value of using urinary NGAL, urinary abnormalities, and their combinations, especially in children aged 2–5 years old. This cross-sectional diagnostic study was conducted in children aged 2–5 years old who were suspected to have UTI (fever more than 380C, vomit, diarrhea, abdominal pain, flank pain, or local UTI symptoms with abnormalities in urinalysis including leukocyturia and/or positive nitrite and/or positive leukocyte esterase) who were hospitalized at Dr. Cipto Mangunkusumo Hospital. The diagnostic test was performed to urinary NGAL, urinary abnormalities, and their combination compared with urine culture as the gold standard for UTI diagnosis. Combination of urinary abnormalities (leukocyturia, positive nitrite, and positive leukocyte esterase) can have sensitivity 38.1% and specificity 94.9%. Urinary NGAL has sensitivity 85.7% (IK 95%: 63.6–96.9%), specificity 74.3% (IK 95%: 57.8–86.9%), positive predictive value 64.3% (IK 95%: 50.6–75.9%), and negative predictive value 90.6% (IK 95%: 76.9–96.5%). Combination of urinary NGAL and urinary abnormality can only increase specificity urinalysis which only shows leukocyturia from 74.3% to 97.4% but not increase specificity of three urinary abnormalities. Urinary NGAL is not recommended to increase urinalysis specificity to make early diagnosis of UTI in children aged 2–5 years old. The three combination of urinalysis abnormalities without urinary NGAL have had a good specificity. Further research about other biomarkers to make early diagnosis of UTI in children is needed."

"Latar Belakang: Diagnosis definitif Helicobacter pylori (H.pylori) hingga kini masih merupakan masalah. Biakan untuk isolasi dan identifikasi bakteri ini sulit. Uji cepat urease direkomendasikan sebagai uji diagnostik lini pertama pasien dispepsia. Tujuan: Mengembangkan komposisi medium biakan dan deteksi cepat H.pylori pada spesimen biopsi lambung pasien dispepsia. Metode: Desain penelitian merupakan studi potong lintang dan eksperimental laboratorium. Sampel diambil dengan cara consecutive sampling sebanyak 68 spesimen biopsi lambung (34 antrum, 34 korpus), masing-masing untuk biakan dan uji MIU. Sebagai pembanding digunakan histopatologi dan PCR. Mula-mula dilakukan optimasi medium biakan dan MIU (konsentrasi merah fenol, pH, urea dan suhu inkubasi). Selanjutnya kondisi optimal yang diperoleh diaplikasikan pada spesimen biopsi pasien dispepsia. Hasil: Medium biakan agar darah Columbia ditambah vankomisin 5 mg/500 mL dan darah domba 7% belum optimal, namun dapat digunakan untuk isolasi dan identifikasi. Hasil MIU modifikasi sebagai berikut: konsentrasi merah fenol 0,001%; urea 4%; pH medium 7; Suhu inkubasi optimal 35-370 C. Proporsi positif hasil uji MIU sebesar 35,29% (12/34), biakan 32,35%(11/34), PCR 32,35%(11/34) dan histopatologi 20,59% (7/34). Kesimpulan: Pemeriksaan MIU meningkatkan positivitas hasil pemeriksaan sebesar 14,7% bila dibandingkan dengan histopatologi.

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Background: Until now, definitive diagnostic of H.pylori is still a problem. Culture for isolation and identification of this pathogen is difficult. Rapid urease test is recommended as a first-line diagnostic test. Aim: to obtain optimal composition for culture medium and Motility-Indol-Urease (MIU) test for the detection of H. pylori in dyspeptic patient biopsy specimens. Method: A cross sectional and experimental laboratory study was performed. Sixty eight gastric biopsy samples (34 antrum, 34 corpus) were collected by consecutive sampling method for culture and MIU test. Histopathology and PCR were conducted for comparison. Initially, we performed the optimation of culture medium and MIU test (phenol red and urea concentration, pH, and temperature). The optimal condition obtained was then applied to the specimens. Result: Columbia agar supplemented with vancomycin 5 mg / 500 mL and 7% sheep blood was unable to create an optimal condition, but it can be used for isolation and identification. Modified MIU was performed by this following condition: phenol red 0,001%; urea 4%; pH 7; incubation temperature 35-37oC. Positive proportion of MIU was 35.29% (12/34), culture 32.35% (11/34), PCR 32,35% (11/34) and histopathology 20.59% (7/34). Conclusion: MIU test was able to improve the positivity rate by 14,7% compared to histopathology. "