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Lengkong, Andriessanto
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Determinant of Complete Blood Count on Long Bone Diaphysis Fractures of Lower Extremity Indrowiyono, Hanny R.; Noersasongko, A. Djarot; Lengkong, Andriessanto; Oley, Maximillian Ch.; Hatibie, Mendy J.; Langi, F.L. Fredrik G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.34537

Abstract

Abstrak: Fraktur ekstremitas bawah memiliki prevalensi yang tinggi di antara jenis fraktur lainnya akibat kecelakaan. Pemeriksaan darah lengkap berperan penting dalam proliferasi osteoblas yang merupakan langkah awal dalam penyembuhan tulang. Penelitian ini bertujuan untuk membuktikan hubungan antara penyembuhan tulang dengan determinan darah lengkap dan hubungan determinan darah lengkap dengan jenis fraktur, lokasi fraktur, faktor-faktor demografik, dan parameter darah tepi pada pasien fraktur diafisis tulang panjang ekstremitas bawah. Penelitian ini dilaksanakan di RSUP Prof. Dr. R. D. Kandou, Manado menggunakan studi kohort (analitik observasional) dengan 10 pasien fraktur terbuka (grade I-II) dan 14 pasien fraktur tertutup. Semua pasien dilakukan pemeriksaan fisik dan pemeriksaan laboratorium darah lengkap. Hasil penelitian mendapatkan pasien laki-laki lebih banyak dibanding perempuan, median usia 30 tahun. Hasil analisis regresi mendapatkan perbedaan hasil darah lengkap pada fraktur terbuka dan fraktur tertutup (leukosit dan neutrofil batang) dan hasil bermakna pada perbedaan lokasi fraktur di femur dan tibia. Simpulan penelitian ini ialah penderita fraktur diafisis ekstremitas bawah terbuka memiliki infeksi lebih tinggi dengan ditandai peningkatan leukosit dan neutrofil batangKata kunci: kadar darah lengkap; fraktur diafisis; tulang panjang Abstract: Lower limb fracture has a high prevalence among other types of fractures due to accidents. Complete blood count has an important role in the proliferation of osteoblasts which is the first step in bone healing. This study was aimed to prove the relationship between bone healing and determinants of complete blood count and to prove the relationship between determinants of complete blood count and fracture type, fracture location, demographic factors, and peripheral blood parameters in patients with diaphysis fractures of the long bones of lower extremities. This study was conducted at Prof. Dr. R. D. Kandou Hospital, Manado using a cohort study (observational and analytical) with 10 open fracture patients (grade I-II) and 14 closed fracture patients. All patients were subjected to physical examination and complete blood count laboratory. The results showed that male subjects were predominant and the median age was 30 years. The regression analysis showed that there were differences in complete blood count between open fractures and closed fractures (leukocytes and band neutrophil) and significant differences in the location of fractures in the femur and tibia. In conclusion, leukocyte and segmented neutrophils levels are increased in patients with open lower limb diaphysis fracturesKeywords: complete blood count; long bone; diaphysis fracture
Pola Bakteri dan Resistensi Antimikroba pada Infeksi Terkait Fraktur Terbuka di RSUP Prof. Dr. R. D. Kandou Manado Senduk, Ryan A.; Lengkong, Andriessanto; Sunaryo, Haryanto
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.54339

Abstract

Abstract: Fracture-related infection is a serious complication in orthopedic trauma, both in terms of infection and surgery. The use of antibiotics is a crucial component in the management of fracture-related infection, however, it can also lead to antibiotic resistance. This study aimed to evaluate the patterns of bacteria and antimicrobial resistance in open fracture-related infections at Prof. Dr. R. D. Kandou Hospital in Manado. This was a descriptive study with a cross-sectional design. Samples consisted of patients with open fracture-related infections and had microbiological culture and drug sensitivity data. Secondary data were collected and analyzed using categorical and numerical data. The results obtained 20 subjects with the average age of 42.8±19.0 years, dominated by males (80%), and the most common location of fracture was tibia/fibula (65%). The highest multidrug resistance rates by bacterial type were found in Klebsiella and Enterobacter (medians of 9 and 7, respectively). Based on bacterial type and antimicrobial resistance, the most common bacteria were Staphylococcus aureus and Enterobacter (30%), followed by MRSA and Klebsiella (15%), Acinetobacter baumanni and Pseudomonas (1%). The highest percentage of antibiotic resistance was found in ampicillin-sulbactam, ciprofloxacin, and gentamicin. Meanwhile, the highest distribution of antibiotic sensitivity was found in trimethoprim sulfamethoxazole, amikacin, clindamycin, and meropenem. In conclusion, open fracture cases are most commonly associated with Staphylococcus aureus and Enterobacter. Antibiotic resistance is predominantly observed in ampicillin sulbactam, ciprofloxacin, and gentamicin. Keywords: infection; open fracture; antibiotics; bacterial resistance   Abstrak: Infeksi terkait fraktur merupakan komplikasi serius dalam trauma ortopedi, baik dari segi infeksi maupun pembedahan. Penggunaan antibiotik menjadi salah satu bagian dalam penatalaksanaan infeksi, namun hal ini dapat mengakibatkan resistensi antibiotik. Penelitian ini bertujuan untuk mengevaluasi pola bakteri dan resistensi antimikroba pada infeksi terkait fraktur terbuka di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang. Sampel penelitian ialah pasien dengan infeksi terkait fraktur terbuka yang memiliki data hasil pemeriksaan kultur mikroba dan sensitivitas obat. Pengumpulan data melalui data sekunder dan dianalisis melalui data kategorik dan numerik. Hasil penelitian mendapatkan 20 subjek, dengan rerata usia 42,8±19,0 tahun. Majoritas subjek ialah laki-laki (80%), dan jenis fraktur terbanyak di tibia/fibula (65%). Hasil multidrug resistance tertinggi menurut jenis bakteri ialah pada Klebsiella dan Enterobacter dengan median masing-masing 9 dan 7. Berdasarkan jenis bakteri dan resistensi antimikroba, yang terbanyak yaitu Staphylo-coccus aureus dan Enterobacter (30%), diikuti MRSA dan Klebsiella (15%), Acinetobacter baumanni dan Pseudomonas (1%). Distribusi resistensi antibiotik tertinggi pada ampicilin-sulbactam, ciprofloxacin, dan gentamisin, sedangkan distribusi sensitivitas antibiotik tertinggi pada trimethoprim sulfomethoxa-zole, amikasin, clindamycin, dan meropenem. Simpulan penelitian ini ialah pada kasus patah tulang terbuka jenis bakteri terbanyak ialah Staphylococcus aureus dan Enterobacter. Resistensi antibiotik didominasi oleh ampicillin sulbactam, ciproflocacin, dan gentamicin. Kata kunci: infeksi; fraktur terbuka; antibiotik; resistensi bakteri