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All Journal Smart Medical Journal Indonesian Journal of Medicine Jurnal Respirasi (JR) Jurnal Epidemiologi Kesehatan Indonesia
Leli Saptawati
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Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Factors Associated with the Outcomes of Patients with Hospital-Acquired Pneumonia (HAP) at Dr. Moewardi General Hospital, Surakarta Nawanindha, Natasha; Saptawati, Leli; Widyaningsih, Vitri
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.186-194

Abstract

Introduction: Hospital-acquired pneumonia (HAP) is a common infection with a poor prognosis. Previous studies on factors influencing HAP outcomes have yielded inconsistent findings. Therefore, further research is needed to determine risk factors that affect HAP outcomes. This study evaluated the factors associated with HAP outcomes to enable timely interventions to reduce mortality, costs, and length of stay (LOS). Methods: This cross-sectional study was conducted at Dr. Moewardi General Hospital, Surakarta, using medical record data from January to December 2022. The data included age, gender, malnutrition, anemia, level of consciousness, comorbidities, bacterial culture, and multidrug-resistant organisms (MDROs). The analyses were performed using the Chi-squared and Mann-Whitney U tests, followed by multiple logistic and linear regression tests to determine the correlation between risk factors and outcomes (recovery, death, and LOS). Results: This study included 102 patients with HAP, the majority being males (64.7%) aged 60 years old and above. Additionally, most patients did not exhibit malnutrition (87.3%) or anemia (96.1%), had normal levels of consciousness (67.6%) and mild comorbidities (60.8%), were not infected with MDROs (66.7%), and were predominantly infected by Klebsiella pneumoniae (21.6%). The multiple logistic regression test revealed that decreased consciousness was significantly associated with increased mortality (p < 0.001). Meanwhile, age 60 years old and above was significantly associated with a shorter LOS (p = 0.05). Conclusion: The majority of HAP cases occurred in men aged 60 years and above. Furthermore, there was a significant relationship between decreased consciousness and increased mortality, as well as between the age of 60 years and above and a shorter LOS.
The Agreement of Immunoglobulin Gamma Release Assay (IGRA)/ T-SPOT Tuberculosis and Tuberculin Skin Test to Detect Latent TB Infection in Diabetes Mellitus Patients Reviono, Reviono; Sutanto, Yusup Subagio; Harsini, Harsini; Saptawati, Leli; Marwoto, Marwoto; Suryawati, Betty; Redhono, Dhani; Sebayang, Pribadi M
Indonesian Journal of Medicine Vol. 6 No. 3 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (33.167 KB) | DOI: 10.26911/theijmed.2021.6.3.422

Abstract

Background: WHO identifies diabetes mellitus (DM) as a neglected risk factor for tuberculosis (TB). Currently, there is no gold standard test for latent TB infection (LTBI). Centers for Disease Control and Prevention (CDC) recommends using Tuberculin Skin Test (TST) and Immunoglobulin Gamma Release Assay (IGRA) to diagnose LTBI. TST is an LTBI classic diagnostic tool that has low sensitivity and specificity. But it is still preferred in diagnosing LTBI due to its lower price, and more health facilities can perform the examination compared to IGRA (T-SPOT.TB). The study aimed to measure the agreement of TST and T-SPOT.TB testing in detecting LBTI in DM and the correlation of HbA1c with TST and T-SPOT.TB.Subjects and Method: Subjects were DM patients who underwent TST and T-SPOT.TB testing. If the results of TST and T-SPOT.TB was positive, the test would be continued with Xpert MTB/RIF microbiological testing. TST used PPD RT23 2TU. T-SPOT.TB was performed toward peripheral blood mononuclear cells. The degree of agreement between TST and T-SPOT.TB testing was calculated using the Test of Agreement (Kappa Cohen). The degree of correlation between the two variables was calculated by using Pearson correlation.Results: The selected 30 study subjects with DM undergoing antidiabetic therapy showed 6 (20%) detected LTBI and 24 (80%) without LTBI using TST and T-SPOT.TB test. There was a substantial agreement level between TST and T-SPOT.TB testing in detecting LTBI among diabetes mellitus patients undergoing anti-diabetic therapy with kappa value= 0.62 (p<0.001). HbA1c increased T-SPOT (r= 0.07; p= 0.716) and TST (r= 0.11; p= 0.956).Conclusion: TST testing may substitute T-SPOT.TB to detect LTBI among diabetes patients undergoing antidiabetic therapy.Keywords: latent tuberculosis infection, diabetes mellitus, TST, Immunoglobulin Gamma Release Assay (IGRA), T-SPOT.TBCorrespondence: Reviono. Department of Pulmonology and Medical Respiratory, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Indonesia. Email: reviono@staff.uns.ac.id.Indonesian Journal of Medicine (2021), 06(03): 298-306https://doi.­org/10.26911­/theijmed.2021.06.03.07
Factors Associated with Outcomes of Acinetobacter baumannii Infection in Ventilator-Associated Pneumonia in the ICU of Dr. Moewardi General Hospital, Surakarta Putra, Lutfi Lafil Cahya; Saptawati, Leli; Setijanto, Eko; Maryani, Maryani; Maarif, Athok Shofiudin
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.201-207

Abstract

Introduction: Acinetobacter baumannii is a nosocomial pathogen with high mortality rates in intensive care units (ICUs) and is commonly associated with ventilator-associated pneumonia (VAP). Due to declines in physiological and immune functions, A. baumannii can trigger septic shock complications, thereby increasing mortality risk. This study aimed to identify the risk factors associated with outcomes in VAP patients in the ICU of Dr. Moewardi General Hospital, Surakarta. Methods: This retrospective cohort study was conducted at Dr. Moewardi General Hospital, Surakarta, using patient medical records. Data were analyzed with Chi-square and Mann-Whitney U tests, followed by multiple logistic and linear regression to determine correlations between risk factors and outcomes (recovery, mortality, length of stay/LOS). Results: This study included 80 patients with VAP caused by A. baumannii. Most patients were under 60 years old (52.5%), had good nutritional status (75%), were on ventilators for less than 10 days (63.75%), and had mild comorbidities (51.25%). Moderate-severe comorbidities (p=0.001) and malnutrition (p=0.005) were significantly associated with increased mortality. In addition, ventilator use ≥10 days was significantly associated with LOS (p<0.001). Conclusion: Moderate-severe comorbidities and malnutrition were risk factors for mortality in patients with A. baumannii-related VAP, while ventilator use ≥10 days was a risk factor for prolonged hospitalization. Identifying these factors can help medical personnel manage conditions that worsen VAP outcomes and reduce the risk of A. baumannii-related mortality.
Evaluasi Metode GeneXpert MTB/RIF dengan Sampel Raw Sputum untuk Mendeteksi Tuberkulosis Paru Susilawati, Tri Nugraha; Saptawati, Leli; Damayanti, Kusmadewi Eka; Larasati, Riska
Jurnal Epidemiologi Kesehatan Indonesia Vol. 2, No. 1
Publisher : UI Scholars Hub

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

Abstract

Tuberkulosis (TB) merupakan penyakit menular yang masih menjadi masalah utama di Indonesia dan dunia. Tantangan utama dalam mendiagnosis TB secara konvensional yaitu rendahnya sensitivitas deteksi pada pemeriksaan mikroskopis dan lamanya waktu yang diperlukan untuk kultur. Penelitian ini bertujuan untuk mengevaluasi metode GeneXpert MTB/RIF untuk mendeteksiMycobacterium tuberculosis dengan sampel dahak langsung di RSUD Dr. Moewardi (RSDM), Surakarta. Analisis observasional dengan pendekatan kohort retrospektif menggunakan data sekunder hasil pemeriksaan GeneXpert MTB/RIF pada sampel dahak langsung di Laboratorium Mikrobiologi Klinik RSDM pada tahun 2012 2015. Sampel didapatkan dari pasien yang memenuhi kriteria suspek multidrug-resistant tuberculosis (MDR-TB) dan sampel tersebut telah dikultur di Balai Laboratorium Kesehatan (BLK), Jawa Tengah. Data dianalisis dengan OpenEpi versi 3, Epi Info 7, dan MedCalc. Pada penelitian ini didapatkan sensitivitas, spesifisitas, nilai duga positif dan negatif (NDP dan NDN) serta akurasi metode GeneXpert MTB/RIF sebesar 93,62%, 27,17%, 68,89%, 71,21%, dan 69,21%. Prevalensi TB paru pada sampel yang diperiksa sebesar 63,27%. Rendahnya spesifisitas GeneXpert MTB/RIF mengindikasikan perlunya kultur sebagai baku emas. Namun demikian, perlu standarisasi pemrosesan sampel dahak dalam segi teknik dan waktu pengambilan sampel disertai data klinis yang memadai untuk melihat riwayat terapi yang telah diberikan pada pasien.
Effect of Secondary Infections and Risk Factors on the Outcome of Covid-19 Patients in the Intensive Care Unit Salma, Aisyah Dhiya; -, Arifin; Saptawati, Leli
Smart Medical Journal Vol 6, No 2 (2023): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i2.58142

Abstract

Introduction: Coronavirus Disease 2019 (Covid-19) is an infection caused by a virus with a high virulence level, which has progressively become a pandemic. Several studies have shown that risk factors and comorbidities associated with the disease can lead to severe and critical pneumonia requiring ICU treatment. This indicates that a proper understanding is needed in selecting the right therapy and determining patient prognosis. Therefore, this study aims to analyze the risk factors affecting the outcome of Covid-19 patients in the ICU of Regional General Hospital Dr. Moewardi Surakarta.Methods: This was a retrospective cross-sectional study with a total sampling technique. The risk factors analyzed included old age, hypertension, cardiovascular disease, diabetes mellitus, Invasive Mechanical Ventilators (IMV) use, and secondary infections. Data collection was carried out by reading medical records, as well as blood and/or sputum culture results of Covid-19 patients at the study location from March-October 2020. The data obtained were then analyzed using the chi-square statistical analysis and logistic regression (α = 0.05) with SPSS software version 21.Results: Based on the chi-square test, ventilator type (p<0.001), and secondary infection (p=0.004) were statistically associated with the outcome of Covid-19 patients. Meanwhile, age (p=0.739), hypertension (p=0.202), cardiovascular disease (p=0.073), and diabetes mellitus (p=0.124) had no statistical relationship. The logistic regression test results showed that IMV was a risk factor for Covid-19 death and secondary infection was associated with mortality.Conclusion: The ventilator type and secondary infection had a significant relationship with the outcome of Covid-19 patients. Furthermore, IMV use was a risk factor for mortality among infected people.
Co-Authors -, Arifin . Marwoto . Marwoto . Pudjiastuti . Pudjiastuti Arina Setyaningrum Aviaddina Ramadhani Dhani Redhono, Dhani Dio Dara Virgiansari Dwi Hidayah Dwi Hidayah Eko Setijanto Harsono Harsono Henrikus Jeffrey F .L Hutami Sri Ummiyati Kusmadewi Eka Damayanti Larasati, Riska Maarif, Athok Shofiudin Marufah, Siti marwoto marwoto Maryani Maryani Mashuri, Yusuf Ari Mochammad Imron Awalludin Nawanindha, Natasha Pradiptakirana, Riska Pratiwi, Yani Dwi Putra, Lutfi Lafil Cahya Ratih Dewi Yudhani Ratih Puspita Febrinasari Reviono Reviono Rizka Solehah Salma, Aisyah Dhiya Sarah Luthfiani Sebayang, Pribadi M Sheilla Elfira San Pambayun Siti Marufah SURYAWATI, BETTY SURYAWATI, BETTY Suyatmi . Tri Nugraha Susilawati Vitri Widyaningsih Yani Dwi Pratiwi Yulia Sari Yusup Subagio Sutanto