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Profile Of Pleural Fluid Adenosine Deaminase And Protein Levels In Tuberculous Pleural Effusion At Adam Malik Hospital Indonesia Marisi Ester Nova Sihite; Syamsul Bihar
Jurnal Impresi Indonesia Vol. 4 No. 7 (2025): Jurnal Impresi Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i7.6873

Abstract

Tuberculosis remains one of the most prevalent infectious diseases worldwide. In addition to affecting the lungs, Mycobacterium tuberculosis infection can also cause extrapulmonary tuberculosis, including pleural effusion. Tuberculous pleural effusion is a relatively common condition, with an incidence ranging from three to thirty percent of total tuberculosis cases. Diagnosing tuberculous pleural effusion presents a clinical challenge due to nonspecific symptoms and limitations of conventional diagnostic methods. Biomarker testing, such as measuring Adenosine Deaminase levels in pleural fluid, has been widely used as a diagnostic method due to its high sensitivity and specificity in distinguishing tuberculous pleural effusion from other causes. Method: This study aims to analyze Adenosine Deaminase levels and pleural fluid protein levels in patients with pleural effusion. A descriptive study with a cross-sectional approach was conducted on thirty-five samples that met the inclusion criteria. Result: The results showed that the mean Adenosine Deaminase level was sixty-one point nine seven grams per liter, with a standard deviation of fifty-eight point three one four and a median value of forty-one grams per liter. The mean pleural fluid protein level was four point five grams per deciliter, with a standard deviation of one point five six and a median value of four point three one grams per deciliter. Conclusion: The analysis revealed significant differences in Adenosine Deaminase and pleural fluid protein levels based on nutritional status, comorbid diseases, and bacteriological examination results. Furthermore, a positive and significant correlation was found between Adenosine Deaminase and pleural fluid protein levels, where an increase in Adenosine Deaminase levels was associated with higher pleural fluid protein levels. Clinical factors such as nutritional status, comorbid diseases, and bacteriological examination results play a role in determining the levels of these biomarkers.
Optimizing Diagnosis and Antibiotic Therapy in Ventilator-Associated Pneumonia: A Comparative Study of Tracheal Secretion Cultures in Critically III Patients Muhammad Rizky Assilmy Lubis; Syamsul Bihar
Jurnal Impresi Indonesia Vol. 4 No. 7 (2025): Jurnal Impresi Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i7.6875

Abstract

Invasive mechanical ventilation in pneumonia patients often leads to complications, including ventilator-associated pneumonia (VAP), which is associated with specific bacterial pathogens and antibiotic resistance. Tracheal secretion cultures are essential for identifying bacterial patterns and assessing antibiotic resistance in these patients. This study aims to analyze the bacterial patterns and antibiotic resistance in tracheal secretion cultures of pneumonia patients undergoing invasive mechanical ventilation in a hospital setting. This cross-sectional study involved 95 samples from patients receiving care in the intensive care unit (ICU) who met predefined inclusion and exclusion criteria. Samples were collected through endotracheal aspiration or bronchoalveolar lavage procedures. Bacterial identification was conducted using both conventional and automated methods, while antibiotic resistance was assessed using the disk diffusion method. The study found that Gram-negative bacteria, primarily Acinetobacter baumannii and Pseudomonas aeruginosa, dominated the bacterial cultures. These pathogens are known for their high adaptability in hospital environments and their association with prolonged hospitalization and increased mortality. High resistance to ?-lactam antibiotics and fluoroquinolones was observed, although antibiotics like amikacin and meropenem remained effective. Chi-square analysis showed a significant correlation between bacterial species and antibiotic resistance patterns. The findings highlight the importance of accurate microbiological diagnosis to guide appropriate empirical therapy and emphasize the need for strict antibiotic stewardship programs and continuous resistance surveillance in ICU settings. Further studies are necessary to optimize infection control and antibiotic therapy protocols for patients requiring prolonged mechanical ventilation.