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All Journal Universa Medicina Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Jurnal Penyakit Dalam Indonesia
Ahmad, Armen
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Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Nilai Diagnostik Italian Score untuk Memprediksi Infeksi Bakteri Extended Spectrum Beta-Lactamase (ESBL) pada Pasien Sepsis di RSUP Dr. M. Djamil Padang Fadrian, Fadrian; Ahmad, Armen; Khairat, Khairat
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Abstract

Introduction. Infections caused by Extended-Spectrum Beta-Lactamase (ESBL) bacteria, especially in septic patients, require adequate management. Giving definitive antibiotics according to culture results takes a long time. Therefore, a clinical scoring system is needed to predict ESBL bacterial infection, one of which is the Italian score. Methods. This research used a cross-sectional design and was conducted in the inpatient room of RSUP Dr. M. Djamil Padang for 6 months. The samples in this study were septic patients who underwent culture examination at RSUP Dr. M. Djamil Padang who met the research inclusion and exclusion criteria. Sampling was carried out using consecutive sampling, and the total sample obtained was 34 samples. Selected samples will have an Italian score calculated, and specimens will be taken for clinical culture examination. Data analysis and processing will involve 2x2 tables and ROC curves. Results. Among a total of 34 participants with an equal distribution of male and female subjects (50% each), the average age was 59 years (standard deviation [SD] 14.15). Microbiological culture results revealed that 26 subjects (76.47%) were identified as positive for ESBL, while 8 subjects (23.53%) were classified as non-ESBL. Based on the Italian score, 22 patients were found to be ESBL-positive, and 12 were non-ESBL. The diagnostic performance of the Italian score yielded a sensitivity of 80.77%, specificity of 87.5%, positive predictive value (PPV) of 95.45%, and negative predictive value (NPV) of 58.33%. The accuracy of the Italian score in predicting ESBL bacterial infections among septic patients at RSUP Dr. M. Djamil Padang was demonstrated by an area under the curve (AUC) of 0.820 (95% confidence interval [CI] 0.75-1.00; p=0.002). Conclusion. The Italian score demonstrated significant performance as a tool in predicting the risk of ESBL bacterial infection.
In-hospital mortality and its determinant factors among patients with sepsis Fadrian, Fadrian; Decroli, Eva; Ahmad, Armen; Kam, Alexander; Muharramah, Disa Hijratul; Pradana, Genta; Putri, Vidola Yasena
Universa Medicina Vol. 44 No. 1 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.3-15

Abstract

BACKGROUNDSepsis is a heterogeneous syndrome characterized by a variety of clinical features. Multiple studies have identified sepsis as the leading cause of death in hospitalized patients. A comprehensive report on the incidence, clinical characteristics, and predictors of sepsis is important. This study aimed to determine the relative importance of predictors of in-hospital mortality in sepsis. METHODSA retrospective cohort study at Dr. M. Djamil Central General Hospital focused on sepsis patients. A total of 200 participants, aged 18 and older, were included based on specific criteria and recruited through consecutive sampling. Data was gathered from medical records and laboratory results to identify factors influencing mortality in sepsis patients. These factors were classified into sociodemographic, intrinsic, and extrinsic categories. Statistical analysis utilized simple and multiple logistic regression. A p-value of less than 0.05 indicated statistical significance for predicting in-hospital mortality in sepsis. RESULTSThe sepsis patient mortality rate was 69.50%. Hospital-acquired pneumonia (HAP) emerged as the most common infectious diagnosis, impacting 47.50% of the patients. Type 2 diabetes mellitus (Type 2 DM) was identified as the most frequent comorbidity, present in 36.50% of cases. Multivariate analysis indicated that HAP (adjusted odds ratio [aOR] 2.32; 95% confidence interval [CI] 1.19–4.49; p=0.013) and hyperlactatemia (aOR 2.11; 95% CI 1.06–4.18; p=0.032) significantly increased the risk of mortality in sepsis patients. CONCLUSIONHospital-acquired pneumonia was the primary predictor of mortality in sepsis patients. Timely prediction and evaluation of sepsis outcomes are essential for developing strategies to reduce mortality rates.
Different Sepsis Patient Outcomes Due to Multidrug-Resistant Organisms (MDRO): A Study of Empirical Antibiotic Sensitivity Test Results Fadrian, Fadrian; Ahmad, Armen; Harvindra, Astrid; Putri, Vidola Yasena
Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Vol. 11 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Tadulako

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22487/htj.v11i3.1740

Abstract

Background: Sepsis, a severe immune response to infection, has a concerning global mortality rate of 85%, predominantly due to Gram-negative bacteria. The rise of antibiotic resistance in these organisms complicates treatment, leading to higher mortality and prolonged hospital stays. Effective empirical antibiotics can mitigate these outcomes. Objective: This study compares outcomes of sepsis patients infected with multidrug-resistant organisms (MDRO) based on empirical antibiotic sensitivity testing, focusing on mortality and length of stay (LOS) within 14 days of sepsis onset. Methods: A prospective cohort observational study at Dr. M. Djamil General Hospital included 94 participants. Patients who died within 14 days were excluded from the LOS analysis to prevent bias. Initial assessments included culture sampling and organ dysfunction. Results: The study revealed no significant difference in mortality based on antibiotic sensitivity (p=0.283), but the LOS was significantly shorter in those treated with sensitive antibiotics (p<0.016). Conclusion: LOS was significantly affected by antibiotic sensitivity, with patients receiving effective antibiotics experiencing shorter stays, though mortality differences were not statistically significant in the 14-day window
Co-Authors Eva Decroli Fadrian, Fadrian Genta Pradana, Genta Harvindra, Astrid Kam, Alexander Khairat, Khairat Muharramah, Disa Hijratul Putri, Vidola Yasena