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All Journal Journal of Biomedicine and Translational Research Indonesian Journal of Tropical and Infectious Disease Universa Medicina Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Jurnal Penyakit Dalam Indonesia
Ahmad, Armen
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Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences 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

Show Abstract | Download Original | Original Source | Check in Google Scholar

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
Diagnostic value of Peguero-Lo Presti electrocardiographic criteria for diagnosing concentric left ventricular hypertrophy in hypertensive patients at Dr. M. Djamil General Hospital Padang Poedjijo, Yanuar Surya Saputra; Hanif, Akmal M.; Wahyudi; Murni, Arina Widya; Ahmad, Armen; Faheri, Eifel; Elvira, Dwitya; Kurniawan, Eka
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 3, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss3.art5

Abstract

Background: Hypertension is a risk factor for morbidity and mortality from cardiovascular disease. Left ventricular hypertrophy (LVH) is the main target organ due to hypertension, which is a predictor of the development of cardiovascular diseases such as heart failure. Echocardiography is the gold standard examination for determining heart geometry, and concentric LVH is often found in hypertensive patients. Electrocardiography (ECG) is a widely available, low-cost, and rapid modality for diagnosing LVH in healthcare facilities. The Peguero–Lo Presti (PLP) criteria in ECG examination have better sensitivity and specificity compared to other criteria. Objectives: This study aims to determine the diagnostic value of PLP ECG to diagnose concentric LVH.Methods: This research is an analytical observational study with a cross-sectional approach carried out at the inpatient installation of Dr. M. Djamil General Hospital Padang for 6 months, starting from April to September 2024. The study subjects who met the inclusion and exclusion criteria were 90 samples selected by consecutive sampling. An ECG examination was conducted using PLP criteria and echocardiography with the M-mode method to assess left ventricle (LV) geometry. Data were analysed using a 2x2 table to obtain sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.Results: From 90 samples, LVH geometry was found concentric in 65.50%, eccentric 4.40%, concentric remodelling 11.10%, and normal 18.90%. In the diagnostic test, PLP criteria had 79.66% sensitivity, 90.32% specificity, 94.00% PPV, 70.00% NPV, and 83.33% accuracy to diagnose concentric LVH in hypertensive patients.Conclusion: Peguero Lo-Presti criteria on ECG can be used for screening and early diagnosis of concentric LVH in hypertensive patients.
Comparison of the Diagnostic Value of Presepsin and Procalcitonin as Markers of Bacterial Sepsis Fadrian, Fadrian; Ahmad, Armen; Sadeli, Rezki Pratama; Putri, Vidola Yasena; Agustian, Dede Rahman
Indonesian Journal of Tropical and Infectious Disease Vol. 14 No. 1 (2026): January - April Edition
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v14i1.69526

Abstract

Sepsis is a severe condition caused by an improper immune response during infections. Early diagnosis is challenging due to the low specificity and effectiveness of current diagnostic tools. Procalcitonin is a biomarker with both advantages and limitations. Presepsin has emerged as a potential alternative, offering cost-effectiveness, fewer confounding factors, and a quicker response. This study evaluates the diagnostic capabilities of presepsin and procalcitonin in bacterial sepsis. The study involved patients with sepsis who were treated in the Internal Medicine Department at M. Djamil Hospital, Padang, Indonesia. All participants were adults over 18, excluding those with conditions that could affect the biomarkers. A total of 63 patients were assessed. The mean presepsin level in bacterial sepsis was 205.91 pg/mL (±162.65 SD), while procalcitonin averaged 62.83 ng/mL (±80.48 SD). Blood cultures revealed bacterial infections in 18 patients (28.60%). Among them, eight had Gram-positive (44.40%) and ten had Gram-negative bacteria (55.60%). Presepsin demonstrated variable accuracy in identifying bacterial sepsis and bacteremia. The Area Under the Curve (AUC) for bacterial sepsis was 0.60 (95% CI 0.44-0.75), for Gram-positive bacteremia it was 0.63 (95% CI 0.35-0.90), and for Gram-negative bacteremia it was 0.37 (95% CI 0.10-0.65). In contrast, procalcitonin showed an AUC of 0.51 (95% CI 0.35-0.67) for bacterial sepsis, 0.22 (95% CI 0.01-0.46) for Gram-positive bacteremia, and 0.78 (95% CI 0.54-1.00) for Gram-negative bacteremia. Presepsin has a higher diagnostic value than procalcitonin in detecting bacterial sepsis. Procalcitonin has the highest AUC value in all categories for detecting Gram-negative bacteremia.
Comparison Clinical Outcomes of Sepsis Caused by Multidrug-Resistant (MDR) and Non-MDR Klebsiella pneumoniae Fadrian, Fadrian; Ahmad, Armen; Linosefa, Linosefa; Simanjuntak, Rohayat Bilmahdi; Putri, Vidola Yasena
Journal of Biomedicine and Translational Research Vol 12, No 1 (2026): April 2026
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v12i1.29019

Abstract

Background: Klebsiella pneumoniae is a common pathogen causing sepsis and is associated with high morbidity and mortality. The emergence of multidrug-resistant organisms (MDROs), particularly extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-KP) and carbapenem-resistant K. pneumoniae (CRKP), has limited antimicrobial therapy options and may worsen clinical outcomes such as mortality and length of hospital stay (LOS). Objective: This study aims to compare the clinical characteristics and outcomes of sepsis caused by multidrug-resistant K. pneumoniae and non-resistant strains, focusing on mortality and LOS.Methods: An observational analytical study with a cohort design was conducted at Dr. M. Djamil General Hospital in Padang from October 2024 to January 2025. Subjects diagnosed with sepsis due to pneumonia and confirmed positive for K. pneumoniae through blood or respiratory cultures were included using consecutive sampling. Isolates were categorized into MDR (ESBL-KP and CRKP) and non-MDR. Clinical data were analyzed descriptively to described subject characteristics, while bivariate analysis (chi-square and independent t-test) evaluated associations between resistance profiles and outcomes, focusing on mortality and LOS (p < 0.05). Results: Of the 70 subjects, 39 (55.7%) had confirmed infection with MDR strains and 31 (44.3%) with non-MDR.Mortality was highest in the CRKP (56.5%), followed by non-MDR (38.7%) and ESBL-KP (25.0%). Statistical analysis revealed a notable association between the resistance profiles of K. pneumoniae and mortality (p < 0.001 for both CRKP and ESBL-KP vs non-MDR). However, there were no statistically significant differences in mean hospital LOS across the groups (CRKP: 16.30 ± 9.81 days; ESBL-KP: 13.63 ± 9.77 days; non-MDR: 16.06 ± 9.49 days; all p > 0.05). Conclusion: Sepsis caused by multidrug-resistant K. pneumoniae, including both ESBL and CRKP, is significantly associated with increased mortality. Early identification and appropriate antimicrobial management are essential to improve subject outcomes. 
Co-Authors Agustian, Dede Rahman Akmal M. Hanif Arina Widya Murni Dwitya Elvira, Dwitya Eva Decroli Fadrian, Fadrian Faheri, Eifel Genta Pradana, Genta Harvindra, Astrid Kam, Alexander Khairat, Khairat Kurniawan, Eka Linosefa Linosefa Muharramah, Disa Hijratul Poedjijo, Yanuar Surya Saputra Putri, Vidola Yasena Sadeli, Rezki Pratama Simanjuntak, Rohayat Bilmahdi WAHYUDI