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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Irda Handayani
Department Of Clinical Pathology, Faculty Of Medicine, Hasanuddin University/Wahidin Sudirohusodo Hospital, Makassar, Indonesia.
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Analysis of Neutrophil/Lymphocyte Ratio and Culture Results on Clinical Severity of Patients with CAP Nurul Afiah; Irda Handayani; Nursin Abd. Kadir
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 2 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i2.1987

Abstract

Community-Acquired Pneumonia (CAP) is an acute infection with high morbidity and mortality, especially among toddlers and elders in Indonesia. Culture is the gold standard for infectious diseases, which requires a long time. Therefore, a rapid, inexpensive, easy-to-use marker such as NLR is needed. To analyze the relationship of NLR and culture results with the clinical severity of CAP. A retrospective study with a cross-sectional design was performed using secondary data from CAP patients at Dr. Wahidin Sudirohusodo Hospital from January 1st, 2018 to July 31st, 2021. The study conducted on 113 samples showed no significant differences between NLR and clinical severity of CAP (p-value of 0.071). However, the mean value of NLR in severe CAP was higher (6±4.74) than in moderate CAP (2.58±1.8) with no significant correlation (p-value 0.071). There was a significant difference in culture on the clinical severity of CAP (p-value 0.005). A positive correlation was found between culture and clinical severity of CAP (p-value 0.004) with weak correlation strength (r=0.266). NLR is an early detection marker of infection. Stimulation of growth hormone causes an increase in neutrophil count, apoptosis acceleration, and lymphocyte redistribution; therefore, increased neutrophils are common in severe clinical conditions. The insignificant relationship between NLR and clinical severity might be caused by the therapeutic intervention given. The ATS/IDSA guidelines stated that culture results were positive in 4-15%. The mean NLR value in severe CAP was slightly higher than that of moderate CAP, but no significant difference was found. There was a weak correlation between culture results and the clinical severity of CAP patients.
Profile of Rapid Molecular Test of Tuberculosis Using Xpert MTB/RIF Faigah Aprilia Sy Faraid; Irda Handayani; Tenri Esa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1425

Abstract

Tuberculosis (TB) ranked the 10th highest cause of death in the world in 2016 according to the World Health Organization (WHO). To date, TB remains a top priority and is one of the goals in Sustainability Development Goals (SDGs), suggesting an urgent need of rapid detection methods for proper diagnosis and treatment. Rapid molecular test using Xpert MTB/RIF is one of the detection methods for TB diagnosis and it is expected to be able to early detect TB cases and anti-tuberculosis drug resistance. The purpose of this study was to determine the profile of rapid molecular test of tuberculosis using Xpert MTB/RIF device in the period of September 2017-August 2018 at Dr. Wahidin Sudirohusodo Hospital, Makassar. This study was retrospective research with a cross-sectional method using secondary data of rapid molecular test of Xpert MTB/RIF in the period of September 2017-August 2018. Data were statistically analyzed using SPSS version 22 and Chi-Square test with a significance value of 0.05. From 527 sputum samples, 96.8% adult TB was predominantly found. The "MTB not detected", "MTB detected”, and "MTB detected with Rif resistance” result was predominantly found in the 74.6% TB non-HIV group; 42.4% TB-HIV group, and 3.8% Non-HIV TB group. There were remarkably higher number of "MTB not detected” results of rapid molecular tests using Xpert MTB/RIF device in the group of pediatric and adult TB. The proportion of "MTB not detected" was higher in the TB-Non-HIV group; while the "MTB detected, Rif-sensitive" was higher in the TB-HIV group and the "MTB detected, Rif-resistance" was higher in the TB-Non-HIV group. It was recommended to carry out further research by performing diagnostic tests consisting of Acid-Fast Bacilli, rapid molecular test with Xpert MTB/RIF, and MTB culture.
PREVALENCE AND CHARACTERISTIC MULTIDRUG RESISTANT ORGANISMS IN INTENSIVE CARE UNIT OF Dr. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR Sitti Khadijah; Irda Handayani; Nurhayana Sennang
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1453

Abstract

Antibiotic is antibacterial substance produced by microorganisms which is supress other organisms growth. First antibiotic (penicillin) was found in 1928 by Alexander Fleming,who is a microbiologist from England. In 1930, penicillin begins given to infected patient. However, there is a resistant to penicillin called penicillinase. Antibiotic resistant is an increase of bacteria ability to antibiotic which is given. This cause bacteria does not responsive to antibiotic. When this organisms spread in community will threaten people and emerge new infection, which is more difficult to cure and increase cost of treatment. It will prolong patient's length of stay, and increase mortality rates. Multidrug resistant organisms is microorganisms, most of it is bacteria, resistant to one or more class of antibiotic. In spite of, term of certain MDRO describe to resistant of one agent. For example, methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), Vancomycin resistant Staphylococcus aureus (VRSA) dan Multidrug resistant Acinetobacter baumannii (MDRAB). These patogens are resistant to antimicrobe agent often used. This high resistant organisms necesssary to be more noticed in healthcare facilities. Except MRSA and VRE, there is other kind of MDRO such as Enterobacteriaceae produces- Extended spectrum beta-lactamase (ESBL) dan Klabsiella penumoniae carbapenemase producer (KPC). Multidrug resistant organisms implicates significant to infection management which is not found yet whether only limited handle based on prior isolation manual. Statistical data showed that prevalence of MDRO in Indonesia increases every year. Prevalence of MRSA in 1986 is 2,5% dan increased to 23,5% in 2006. Prevalence of Enterobacteriaceaeproduces ESBL in Harapan Kita hospital gain 16% which main caused in pediatric intensive care unit (PICU) is Klebsiella pneumoniae (14%) and second most agent caused is E. Coli (19%) (Winarto,2009). There was a research study in 2010 about Staphylococcus aureus sensitivity to vancomycin in Margono Soekarjo Purwokerto Hospital, Jawa Tengah, and it was found VRSA in 10 from 60 samples (15,6%) by stetoscope membrane. In United States by year 2000, it was 25,9% Enterococcus isolated by blood samples proved that resistant to vancomycin. Hospitalcare facilities are very vary by physical and functional characteristics of intensive care unit, burn injury unit, neonatal intensive care unit (NICU). A patient maybe infected to MDRO. A patient who had been infected may contaminate the infection to others sick or healthy people. Medical officer maybe one of elemen risk spreading infection when they ignore the rules of infection precaution and five moments handwash. Five moments consist of before contact to patient, before doing a patient, after doing a patient, after contact to patient, and after contact to patient's neighbourhood.
The Correlation between RDW, PDW, and NLR with the SOFA Score in Septic Patients Linda Mayliana Kusumaningrum Nurtadjudin; Irda Handayani; Agus Alim Abdullah; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1960

Abstract

Sepsis is one of the main causes of mortality in the intensive care unit. The SOFA score is used to assess organ dysfunction. There are several markers of sepsis such as the combination of RDW, PDW, and NLR to help predict the outcome of sepsis. To determine the role of RDW, PDW, and NLR associated with SOFA scores as prognostic markers in sepsis. A retrospective study with a cross-sectional approach has been conducted using secondary data from the medical records of sepsis patients from January 2018 to December 31, 2020, who met the inclusion criteria and were admitted to the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar. The sample size was 109 people consisting of 62 (56.9%) males and 47 (43.1%) females. The highest age range is 56–65 years (37.6%). A total of 97 people (89%) died and 12 (11%) improved. There is a positive correlation between changes in RDW and changes in SOFA scores (p=0.031), there is a positive correlation between changes in PDW and changes in SOFA scores (p=0.000), and there is a positive correlation between changes in NLR and changes in SOFA scores (p=0.000). The increase of RDW caused by systemic inflammation can predict disease progression. The state of increased proinflammatory cytokines inhibits the proliferation and maturation of erythrocytes; hence, it causes an increase in RDW. The acceleration of platelet destruction due to the suppression of cytokines in the bone marrow increases PDW. The increase in NLR occurs due to the rise in the inflammatory response, which results in suppressed cellular immunity. RDW, PDW, and NLR are positively correlated with changes in SOFA scores. PDW and NLR have a significant correlation with the outcome. RDW, PDW, and NLR can be used as prognostic markers in septic patients
Co-Authors Agus Alim Abdullah Ariani Said Asvin Nurulita Asvin Nurulita Asvin Nurulita Benny Rusli Esa, Tenri Faigah Aprilia Sy Faraid Hardjoeno, Hardjoeno Kadir, Nursin Abdul Linda Mayliana Kusumaningrum Nurtadjudin Maghfirah, Andi Itha Mansyur Arif Muhiddin, Rachmawati Nurhayana Sennang Nurhayana Sennang Nursin Abd. Kadir Nurul Afiah Patricia M. Tauran Rusli, B. Sherly Purnamawaty Sitti Khadijah Suriyanti Suriyanti Uleng Bahrun Uleng Bahrun Uswatun Hasanah Vina Zakiah Latuconsina