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Predictive Positive Value Xpert MTB/RIF in Detecting Mycobacterium tuberculosis on Adult Pulmonary Tuberculosis Patients in Dr. Soetomo Referral Hospital Surabaya Indonesia Akirasena, Mayoori; Mertaniasih, Ni Made; Soedarsono; Permatasari, Ariani
Indonesian Journal of Tropical and Infectious Disease Vol. 12 No. 2 (2024)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v12i2.52755

Abstract

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Mtb) and transmitted via droplets. Southeast Asia is the largest contributor of TB, and Indonesia itself has the second-highest number in the world with an incidence of approximately 824000 cases. The most common symptoms of active TB are cough, fever, weight loss, and night sweats. The diagnosis can be established upon the confirmation that one of the specimens contains M. tuberculosis. Xpert MTB/RIF provides results in less than 2 hours, whereas culture takes approximately 2-6 weeks. This research aims to evaluate the characteristics and determine the Predictive Positive Value (PPV) percentage of GeneXpert MTB/RIF, utilizing parameters derived from the gold standard examination results, namely culture. This research method is descriptive- analytic based on secondary data extracted from medical records of patients receiving care at the multi-drug resistant TB (MDR-TB) Outpatient Management at Dr. Soetomo Referral Hospital Surabaya from the period January 2019 – April 2022. The results showed that the PPV level of GeneXpert MTB/RIF in detecting the presence of M. tuberculosis is 90%. The diagnosis of pulmonary TB is also supported by the chest X-ray infiltrate's appearance and clinical symptoms of cough, weight loss, fever, and night sweats. Smoking and diabetes are the most common comorbid and risk factors in TB. The conclusion of this study is that the PPV for diagnosing adult pulmonary TB using the Xpert MTB/RIF is relatively high. This suggests the potential use of this method as a diagnosing tool for accurately diagnosing pulmonary tuberculosis.
Case Report: Survival of A Coronavirus Disease-2019 (Covid-19) Patient with Acute Respiratory Distress Syndrome (ARDS) in Dr. Soetomo Hospital, Surabaya, Indonesia Soedarsono, Soedarsono; Semedi, Bambang Pudjo; Setiawati, Rosy; Meliana, Resti Yudhawati; Kusmiati, Tutik; Permatasari, Ariani; Bakhtiar, Arief; Syafa'ah, Irmi; Indrawanto, Dwi Wahyu
Folia Medica Indonesiana Vol. 56 No. 3 (2020): September
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2027.315 KB) | DOI: 10.20473/fmi.v56i3.24584

Abstract

An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China has spread rapidly in multiple countries of the world and has become a pandemic. Currently, there is no vaccine or specific antiviral for COVID-19. A study reported 7.3% of critical patients admitted to ICU, 71% of them required mechanical ventilation, and 38.5% of them were survived. Herein, we reported a 54 year old man with Acute Respiratory Distress Syndrome (ARDS) of COVID-19 who survived the disease. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasopharyngeal and oropharingeal swabs were positive for SARS-CoV-2. Diagnosis of ARDS was also according to clinical symptoms, laboratory, chest radiograph, and chest CT scan. Alcaligenes faecalis and Candida albicans were also identified from sputum culture. Treatment for this patient was causal and supportive therapy, including antibiotic, antiviral, and antifungal therapy according to the culture results, fluid resuscitation, and oxygen supply from the mechanical ventilator. This patient was survived and discharged on hospital day-29. A fibrosis in parenchyma pulmonary and sensory peripheral neuropathy occurred after survived from ARDS. Monitoring of clinical, laboratory, and chest radiograph were continued after the patient discharged from the hospital. This case highlights the importance of early diagnosis and effective treatment to the care of COVID-19 patient.
Profile of Nontuberculous Mycobacteria and Mycobacterium tuberculosis Detected in the Sputum of Pulmonary Tuberculosis Re-treatment Patients at Dr. Soetomo General Hospital Mochammad Afif Ziaulhaq; Mertaniasih, Ni Made; Meliana, Resti Yudhawati; Permatasari, Ariani
Indonesian Journal of Tropical and Infectious Disease Vol. 13 No. 1 (2025)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v13i1.64176

Abstract

Tuberculosis (TB) remains one of the leading infectious diseases worldwide. Despite global efforts to control TB, it remains a major public health issue, affecting 10.6 million people annually in 2021, with significant morbidity and mortality, particularly in resource-limited settings. Effective treatment of TB requires strict adherence to long-term medication, but challenges such as  treatment failure, relapse, and loss to follow-up complicate outcomes. This is especially concerning for patients with comorbidities such as diabetes, HIV, or hypertension, which not only increase the risk of TB but also hinder its treatment and elevate the likelihood of nontuberculous mycobacteria (NTM) infections. This study aimed to analyze 326 pulmonary TB retreatment cases at Dr. Soetomo General Academic Hospital from October 2023 to April 2024. The retrospective design identified that 323 cases involved MTB and 3 involved NTM. The findings show that loss to follow-up was the most common reason for retreatment, particularly among males and older adults. Comorbidities were found to exacerbate treatment challenges, with some retreatment cases lasting up to 24 months. The study concludes that loss to follow-up remains a major risk factor for TB retreatment, particularly in MTB cases, and highlights the importance of managing comorbidities to improve treatment outcomes.
Resistance Pattern of Anti-TB Drugs in Drug-Resistant TB of Pulmonary Tuberculosis Patients in Dr. Soetomo Academic Hospital, Surabaya, Indonesia Marsha Maritsa, Olivia; Mertaniasih, Ni Made; Permatasari, Ariani; Kusmiati, Tutik
Indonesian Journal of Tropical and Infectious Disease Vol. 13 No. 2 (2025)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v13i2.66525

Abstract

Pulmonary tuberculosis is an infectious disease that can be transmitted through the air due to infection with Mycobacterium tuberculosis bacteria. According to the WHO, TB is the second-highest cause of death in infectious diseases in the world. This study aims to determine patterns of anti-TB drug resistance in drugresistant TB patients in Dr. Soetomo Academic Hospital from January 2022 to December 2023. This was a descriptive retrospective using patient medical record data in Dr. Soetomo Academic Hospital for the period January 2022 - December 2023. This study included 261 drug resistant pulmonary TB patients, the majority of whom were new TB patients (61.3%). Anti-TB drug resistancewas most prevalent in RR-TB (43.7%), with the highest number of new cases (28.4%). Drug susceptibility test showed High-dose Isoniazid (INHHD) had a high resistance rate (56%). Isoniazid (H) had a high resistance rate (66%). Pyrazinamide (Z) showed high sensitivity (66%). Levofloxacin (Lfx) showed high sensitivity (89%). High-dose Moxifloxacin (MfxHD) high sensitivity level (94%). Moxifloxacin (Mfx) high sensitivity level (92%). Bedaquiline (Bdq) high sensitivity level (98%). Linezolid (Lzd) high sensitivity level (99%). Clofazimine (Cfz) high sensitivity level (97%). Amikacin (Amk) high sensitivity level (100%). Drug-resistant pulmonary TB patients recently show a high drug sensitivity pattern to the second-line anti-TB drugs. MTB has become resistant to Isoniazid. However, it is still sensitive to Pyrazinamide by 66% and Levofloxacin by 89%. Moxifloxacin, Bedaquilin, Linezolid, Clofazimine, and Amikacin have high sensitivity >90%.