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All Journal Jurnal Kedokteran Brawijaya The Indonesian Biomedical Journal Paediatrica Indonesiana Majalah Kesehatan FKUB Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Pediatric Sciences Journal
Eko Sulistijono
Department Of Pediactrics, Division Of Neonatology, Saiful Anwar General Hospital, Universitas Brawijaya, Jl. Veteran, Malang
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Journal : Paediatrica Indonesiana

 1 
Risk factors of late onset sepsis caused by extended spectrum beta-lactamase (ESBL) - producing bacteria in preterm infants Irene Ratridewi; Savitri Laksmi Winaputri; Eko Sulistijono; Fireka Imsa Sastia Juniantika
Paediatrica Indonesiana Vol 63 No 1sup (2023): Supplementary Issue March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.1sup.2023.21-28

Abstract

Background High incidence of late-onset sepsis (LOS) in preterm infants contributes to neonatal morbidity. Therapeutic outcomes of LOS have deteriorated as a result of increased antibiotic resistance problems, mainly from ESBL isolates. Controlling risk factors is important in reducing morbidity and mortality as well as providing guidance for antibiotic selection. Objectives To determine the risk factors of LOS due to ESBL-producing bacteria in preterm infants. Methods This is a retrospective study. The inclusion criteria was neonates diagnosed with late-onset neonatal sepsis by clinical signs and a positive blood culture. The blood culture result and characteristics patients as secondary data were extracted from medical records within the hospital facilities and the institutional database of the Neonatology Department of Universitas Brawijaya (January 2019 to March 2021). Statistical analysis was done to compare characteristics of the patients in the ESBL positive group to those in the ESBL negative group to assess the potential risk factors. Results Among 124 preterm infants with LOS, 62 of them were ESBL-positive case subjects and the other 62 were non-ESBL-producing control subjects. Gram-negative bacteria were the most common pathogens identified, with 96% (n=59) of them being the ESBL-producing strain, predominated by Klebsiella pneumoniae (n=56). Factors significantly correlated with the occurrence of LOS-ESBL included prior history of invasive procedures (OR 3.13; 95%CI 1.45 to 6.73; P=0.00), central access insertion (OR 9.54; 95%CI 3.7 to 24.2; P=0.00), and parenteral nutrition (OR 6.03; 95%CI 2.77 to 13.16; P=0.00). Central access insertion had the strongest influence (Exp(B) 6.98; P= 0.00). Conclusion Prior invasive procedures, central access insertion, and parenteral nutrition had significant correlations with the occurrence of LOS-ESBL in preterm infants. Central access insertion is a predictive factor for LOS-ESBL.
Combination of red cell distribution width and procalcitonin as diagnostic biomarkers of neonatal sepsis in preterm infants Irene Ratridewi; Savitri Laksmi Winaputri; Eko Sulistijono; Brigitta I. R. V. Corebima; Achmad Yunus
Paediatrica Indonesiana Vol 63 No 1sup (2023): Supplementary Issue March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.1sup.2023.29-34

Abstract

Background Diagnosis of neonatal sepsis is still challenging. Several diagnostics test have been developed to help diagnose of neonatal sepsis, but sometimes it could not be done routinely in limited facilities. Procalcitonin (PCT) and red cell distribution width (RDW) have been reported to have correlations with the risk of developing sepsis. Objective To evaluate the diagnostic value of combined of PCT and RDW as markers for neonatal sepsis in preterm infants. Methods A cross sectional study was conducted in the neonatal ward, Syaiful Anwar hospital, Malang, East Java. The subjects were preterm infants with neonatal sepsis. Blood culture were taken as the gold standard and RDW and PCT levels were assessed as the comparison. All of the test were performed at the begining of the study. The incidence of sepsis was reported as the main outcome. The data obtained were processed and analyzed using the receiver operating characteristic (ROC) method to obtain the area under curve (AUC) value. Results Fifty-five preterm infants presenting neonatal sepsis were enrolled in this study. The combination of RDW and PCT showed AUC 0.814 (P=0.199) with sensitivity and specificity 78.9% and 80.6%, respectively in diagnosing neonatal sepsis compared to blood culture. Conclusion Combination of RDW and PCT as markers of sepsis in preterm infants have good sensitivity and specificity.
Identifying key clinical markers for congenital cytomegalovirus infections: a PCR-confirmed case-control study Corebima, Brigitta IRV; Iskandar, Agustin; Sulistijono, Eko; Amalia, Najwa; Fauziah, Dina; Sanjaya, Hayyu Rafina
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.463-70

Abstract

Background Congenital cytomegalovirus (CCMV) infection is the leading cause of congenital infections worldwide. Clinical manifestations of CCMV are highly variable and make the clinical diagnosis difficult, especially in settings where advanced diagnostic tools are not available. Objective To identify a cluster of clinical manifestations indicative of CCMV and analyze for correlations with PCR-confirmed diagnoses. Methods This case-control study was conducted at a tertiary care hospital in Malang, East Java, and included 40 neonates clinically suspected to have CCMV. PCR specimens from urine or saliva were collected and analyzed to evaluate clinical manifestations of suspected CCMV. Demographic and clinical data were organized and analyzed using SPSS. Results Of neonates with suspected CCMV, 32.5% (n=13) had PCR-confirmed CCMV. The median age for PCR testing post-suspected CCMV was 8.50 (range 3.75 to 24.25) days. Significant correlations emerged between PCR-confirmed CCMV and symptoms such as microcephaly, jaundice, purpura, thrombocytopenia, acute liver injury, hepatomegaly, feeding difficulties, and anemia. However, seizures, low birth weight, ventriculomegaly, and intrauterine growth restriction did not show significant associations, indicating their limited utility as solitary markers for CCMV. The clinical symptoms associated with CCMV were confirmed by PCR, emphasizing the significance of certain sign and symptom clusters, such as microcephaly with thrombocytopenia (OR 41.60; P<0.001), or the traditional triad of jaundice, purpura, and hepatosplenomegaly/acute liver injury (OR 41.60; P<0.001). Conclusion Several clinical manifestations are significantly associated with PCR-confirmed CCMV infection, underscoring the diagnostic value of specific symptom combinations in identifying CCMV infection. These combinations are microcephaly and thrombocytopenia and the classic triad of jaundice, purpura, and hepatosplenomegaly/acute liver injury. 
Co-Authors Achmad Yunus Agustin Iskandar Amalia, Najwa Arief Fadillah Aryati Aryati Astrid Kristina K Atiek Wulandari Brigitta Corebima Brigitta I. R. V. Corebima Brigitta Ida Resita Vebrianti Corebima Brigitta Ida RVC Choirul Anam AM Diponegoro Corebima, Brigitta IRV Dina Fauziah Endang Sri Wahyuni Ervin Monica Evalina Fajriani Fajriani, Evalina Fireka Imsa Sastia Juniantika Harjoedi Adji Tjahjono, Harjoedi Adji Hidayat Sujuti HMS Chandra Kusuma Ingga Gebyarani Irene Ratridewi M Fahrul Udin Masroer, Muchamad Muhammad Irvan Avandi Muhammad Rivai Ningsih, Rusdian Niati Nisak Humairoh Pranidya, Nada Putri Primawardani, Putri Primayuni Dhia Hasanah Rara Aulia Sanjaya, Hayyu Rafina Satrio Wibowo Savitri Laksmi Winaputri Setya Mithra Hartiastuti Setya Trista Kusumawahyuni Siti Lintang K Talita Clarissa Sinatra Vanisia Hayu Firdayanti Yesi Adisti Pramitasari