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All Journal Universa Medicina The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Journal Medical Informatics Technology
Khie Chen
Divisi Infeksi Dan Penyakit Tropis, Departemen Ilmu Penyakit Dalam, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta
Computer Science & IT Dentistry Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Correlation of the Quality of Antibiotic Usage by Utilising Gyssens Flow and The Success of Treatment in Negative Gram MDR Sepsis in Tertiary Hospital Lardo, Soroy; Chen, Lie Khie; Santoso, Widayat Djoko; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Multi Drug Resistance (MDR) antibiotics have become a global health threat to the community. The use of appropriate antibiotics makes preventive and curative measures very important for the success of overcoming MDR and intervening the complexity of resistance, at least slowing the rate of occurrence of MDR. This study aimed to identify the difference in the quality of antibiotic use quality of use using gyssens flowchart and the success in sepsis patients’ treatment due to gram-negative MDR bacteria with non-MDR bacterial infections in tertiary hospitals. Methods. A retrospective cohort study was conducted using secondary data from patient with age more or equal than 18 years who were hospitalized in inpatient unit or ICU in Indonesia Army Central Hospital Gatot Soebroto from 2017-2019. Both the MDR and non-MDR gram-negative inclusion groups were assessed for the quality of antibiotic using the Gyssen flowchart. Results. There was a significant difference between antibiotic quality on gram negative MDR bacteria and non-MDR (20.6% vs. 13.6%; RR 1.517 (CI 95% 1.1 – 2.1); p value = 0.015) which showed that gram-negative MDR experienced 1.517 times better quality than non-MDR. This study also found that there was a significant difference between therapeutic success on gram negative MDR bacteria and non-MDR (57.4% vs. 39.1%; RR 1,431 (CI 95% 1.0 – 2.1); p value = 0.02). Conclusions. There is a better quality on the utilization of antibiotics with Gyssens index patients resulted from MDR negative gram bacterial infection in comparison to non-MDR in tertiary hospital. There is also a better success in treating the sepsis patient with MDR negative gram bacterial infection in comparison with non-MDR.
Clinical Characteristic and Prevalence of Invasive Candidiasis Patient in Cipto Mangunkusumo Hospital Kalista, Kemal Fariz; Chen, Lie Khie; Wahyuningsih, Retno; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Introduction. Incidence of invasive fungal infections (IFI) are reportedly increasing in many countries. Candida is the most common cause of IFI. This study was conducted to determine the prevalence, clinical characteristics, and etiologic pathogen in adult patients with invasive candidiasis (IC) at Cipto Mangunkusumo Hhospital. Methods. This was a cross sectional study with restropective data collection fromof septic patients that’ medical records hospitalized in January 2012 until June 2014. Subjects were selected based on EORTC/MSG 2008 diagnostic criteria for IC. Demographic data, clinical and supporting data, diagnosis, etiologic pathogens, antibiotics, antifungal, outcome, and length of stay were recorded. Results. The IC prevalence at Cipto Mangunkusumo hospital was 12,3% (91 patients from total of 738 sepsis patients). Subjects consisted of 35 proven, 31 probable, and 25 possible invasive candidiasis patients. Candidemia was the most common form of IC and C. albicans was the most common etiologic pathogen. Mean age were 47,9 years, dominated with medical, non-neutropenic, and septic shock patient. Most patients had malignancy with lung infection. The most common medical intervention was urinary catheter. Most patients were given 3rd generation cephalosporin and the most common antifungal used was fluconazole. Forty four percent of IC patients did not get systemic antifungal treatment. Mortality rate was 64.8% and median length of stay were 27 days. Conclusions. IC prevalence was 12,3%. Mortality due to IC was high and C. albicans was the most common etiologic pathogen.
Coronavirus Disease 2019: Review of Current Literatures Susilo, Adityo; Rumende, C. Martin; Pitoyo, Ceva W; Santoso, Widayat Djoko; Yulianti, Mira; Herikurniawan, Herikurniawan; Sinto, Robert; Singh, Gurmeet; Nainggolan, Leonard; Nelwan, Erni J; Chen, Lie Khie; Widhani, Alvina; Wijaya, Edwin; Wicaksana, Bramantya; Maksum, Maradewi; Annisa, Firda; Jasirwan, Chyntia OM; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 1
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Correlation between Proper Antibiotics Administration to Community Acquired Pneumonia Patients Based on Alur Gyssens with Clinical Response Rumende, Cleopas Martin; Chen, Lie Khie; Karuniawati, Anis; Bratanata, Joyce; Falasiva, Rezyta; Sitorus, Truly Panca; Susanto, Erwin Christian
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 2
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Introduction. The proper of antibiotics treatment will increase the improvement of the patient with community-acquired pneumonia (CAP) and also counteract antimicrobial resistance. Community-Acquired Pneumonia is commonly found in Indonesia with an incidence of 2.4%. This study aimed to determine the proper of antibiotic selection for CAP based on IDSA-ATS 2007 guidelines with Gyssens method and evaluate the relationship between the proper of antibiotic treatment with the clinical response of patients. Methods. A retrospective cohort study was conducted with secondary data from the previous study. Study was conducted in three hospitals in Jakarta, namely Cipto Mangunkusumo General Hospital, Budhi Asih Hospital, and Gatot Subroto Hospital between September 2016 and November 2017. Results. From 151 patients, the appropriate of the first antibiotic treatment, including category 0 and 1 was found in 38 patients (25.2%), while for inappropriate one (category II-V) was in 113 patients (74.8%) mainly due too short antibiotic treatment. For the second antibiotic given to 54 patients, appropriate treatment was found in 15 patients (9.9%). There was no correlation between the accuracy of both antibiotics treatment in CAP based on Gyssens method with clinical response of the patients (first antibiotic treatment: RR=0,970 (95% CI: 0,80 – 1,16), p=0,738; second antibiotic treatment: RR=1,194 (95% CI: 0,648 – 2,20), p=1,00). Conclusion. There was no correlation between the accuracy of antibiotics treatment in CAP based on Gyssens method with clinical response of the patients.
Peran Procalcitonin sebagai Penanda Inflamasi Sistemik pada Sepsis Dharaniyadewi, Dana; Lie, Khie Chen; Suwarto, Suhendro
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 2
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Terapi antibiotika awal dan tepat merupakan faktor yang penting untuk kesintasan pasien sehingga diperlukan pemeriksaan yang cepat dan akurat untuk deteksi adanya bakteri di sirkulasi. PCT merupakan biomarker yang paling sering dipelajari dan rutin digunakan dalam praktik klinik dan rekomendasi saat ini di beberapa negara. Kadar PCT serum meningkat pada sepsis. Kadar PCT normal di bawah 0,5 ng/mL dan kadar PCT > 2 ng/mL memiliki risiko tinggi untuk sepsis. PCT lebih unggul daripada CRP untuk diagnosis dan prognosis sepsis pada pasien kritis tetapi penggunaannya harus tetap diiringi dengan penilaian secara klinis. Hal ini terutama penting pada awal infeksi atau pasien dengan infeksi fokal dan pasien pembedahan. PCT mungkin lebih baik untuk menyingkirkan diagnosis sepsis daripada untuk diagnosis sepsis itu sendiri pada pasien kritis terutama jika dilakukan pemeriksaan PCT serial. Pemeriksaan PCT juga dapat digunakan untuk membantu dalam penggunaan antibiotika. Pemeriksaan PCT dapat digunakan untuk menghindari penggunaan antibiotika yang tidak diperlukan pada pasien kritis dengan gejala SIRS tanpa infeksi; walaupun demikian, emeriksaan PCT tetap harus diinterpretasikan sesuai dengan temuan klinis dan parameter laboratoris lainnya.
Gastric Outlet Obstruction sebagai Keluhan Awal Limfoma Gaster: Sebuah Laporan Kasus Chen, Lie Khie; Mohammad, Nurhidayat; Rumondor, Bayu B; Muzellina, Virly Nanda
Jurnal Penyakit Dalam Indonesia
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Gastric lymphoma often presents with non-specific symptoms, contributing to delayed diagnosis. Gastric Outlet Obstruction (GOO) is a potential complication that may occur in patients with gastric lymphoma. A 62-year-old male patient presented with persistent weakness, nausea, and vomiting. His symptoms began with long-standing abdominal discomfort, which had not been further evaluated. Esophagogastroduodenoscopy (EGD) revealed GOO secondary to a mass, which, after pathological and immunohistochemical evaluation, was diagnosed as diffuse large B-cell lymphoma (DLBCL). The patient was subsequently given a nasojejunal feeding tube and treated with R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and oral prednisone). The non-specific nature of gastric lymphoma symptoms often results in diagnostic delays, resulting in diagnoses at more advanced stages. Gastric lymphoma complicated by GOO poses distinct challenges, particularly in managing nutritional support, which can impair the patient’s performance status and, in turn, influence treatment response and overall survival. Due to the non-specific nature of initial symptoms, many patients with gastric lymphoma are diagnosed at later stages. Therefore, early screening for patients with atypical dyspepsia symptoms is essential to rule out malignancies, including gastric lymphoma.
Risk Factors for Multidrug-Resistant Bacterial Infections in Hospital-Acquired Pneumonia at Cipto Mangunkusumo Hospital Murwaningrum, Artati; Kamelia, Telly; Chen, Khie; Loho, Tonny; Abdullah, Murdani
Journal Medical Informatics Technology Volume 2 No. 4, December 2024
Publisher : SAFE-Network

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37034/medinftech.v2i4.94

Abstract

Multidrug-resistant (MDR) hospital-acquired pneumonia (HAP) is linked to high mortality, extended hospital stays, and increased healthcare costs. Identifying risk factors for MDR HAP is essential to formulate effective management strategies. This study analyzed the proportion of risk factors associated with MDR bacterial infections in HAP patients treated at Cipto Mangunkusumo General Hospital. Using a retrospective cohort design, data were collected from medical records of HAP patients hospitalized between 2015 and 2016. A total of 68 patients met the inclusion criteria, while 10 were excluded due to fungal or non-pathogenic bacterial growth in sputum cultures. Patients were categorized as infected with MDR or non-MDR bacteria based on the resistance profile of their initial sputum cultures. Descriptive analysis was conducted using Microsoft Excel to calculate proportions of risk factors, without applying inferential statistical tests due to the limited sample size. The incidence of HAP was 6.12 per 1000 admissions in 2015 and 6.15 in 2016. MDR bacterial infections were observed in 95% of cases in 2015 and 82.1% in 2016. Key risk factors for MDR infections included prior antibiotic use within 90 days (100%), albumin levels <2.5 g/dL (100%), Charlson Comorbidity Index ≥3 (95.9%), age >60 years (95.2%), hospitalization >5 days (92.5%), nasogastric tube (NGT) insertion (92.1%), prior ICU/HCU admission within 90 days (81.8%), and steroid use >10 mg/day for >14 days (28.6%). These results emphasize that most HAP cases were caused by MDR bacteria, with prior antibiotic use and low albumin as predominant risk factors, necessitating targeted interventions for at-risk populations.
Co-Authors A.A. Ketut Agung Cahyawan W Adeputri Tanesha Idhayu Adeputri Tanesha Idhayu Adityo Susilo, Adityo Alvina Widhani, Alvina Andree Kurniawan Anis Karuniawati Anna Ariane, Anna Annisa, Firda Ari F Syam Ari Fahrial Syam Artati Murwaningrum, Artati Bramantya Wicaksana C Martin Rumende C Martin Rumende C. Martin Rumende, C. Martin Ceva W. Pitoyo Cleopas Martin Rumende Cleopas Martin Rumende Cleopas Martin Rumende Cleopas Martin Rumende Cleopas Martin Rumende Cynthia Olivia Maurine Jasirwan Dana Dharaniyadewi Dana Dharaniyadewi, Dana Danasasmita, Gantira Diana Aulia Diana Aulia Diany N Taher Djoko Widodo Djumhana A Edwin Wijaya Edwin Wijaya, Edwin Erni J Nelwan, Erni J Erni Juwita Nelwan, Erni Juwita Erwin Christian Susanto Esthika Dewiasty Esthika Dewiasty, Esthika Evy Yunihastuti Falasiva, Rezyta Firda Annisa Gantira Wijayakusumah Danasasmita Gurmeet Singh Gurmeet Singh Herdiman T Pohan Herdiman T Pohan Herdiman T. Pohan Herikurniawan Herikurniawan Herikurniawan, Herikurniawan Ina Sutanto Timan Inge Sutanto Jasirwan, Chyntia OM Joko Widodo Joyce Bratanata Joyce Bratanata, Joyce Jumhana Atmakusuma Kemal Fariz Kalista, Kemal Fariz Leonard Nainggolan M Usman SM Maksum, Maradewi Maradewi Maksum Marcellus Simadibrata Marcellus Simadibrata Mira Yulianti Mira Yulianti, Mira Mohammad, Nurhidayat Murdani Abdullah Murdani Abdullah Murdani Abdullah Murdani Abdullah Muzellina, Virly Nanda Nata Pratama Nathanael, Jason Nully Juariah M Pasaribu, Adeline Prima Yuriandro Pringgodigdo Nugroho, Pringgodigdo Resti Mulya Sari Retno Wahyuningsih Retno Wahyuningsih Rezyta Falasiva Robert Sinto Robert Sinto Robert Sinto Ronald Irwanto Rumondor, Bayu B Shakinah, Sharifah Sitorus, Truly Panca Soroy Lardo Suhendro Suhendro Suhendro Suhendro Suhendro Suhendro Suhendro Suhendro Suhendro Suwarto Suhendro Suwarto, Suhendro Susanto, Erwin Christian Telly Kamelia Timan, Ina Sutanto Tonny Loho Truely Panca Sitorus Vera Yuwono Wicaksana, Bramantya Widayat Djoko Santoso Widayat Djoko Santoso Widayat Djoko Santoso, Widayat Djoko Wirawan Hambali Wirawan Hambali, Wirawan Wulyo Rajabto