INDRA YOVI
Department Of Pulmonology, Faculty Of Medicine, Universitas Riau/Arifin Achmad General Hospital, Pekanbaru –Indonesia

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Bacterial Profile and Antimicrobial Resistance Patterns of Pleural Empyema in Pekanbaru Hospitals Yovi, Indra; Safari, Dodi; Syah, Nur Afrainin; Anggraini, Dewi; Hanifah, Zulfa Nur; Shapira, Vanesya Zahrani; Elliyanti, Aisyah
Jurnal Respirologi Indonesia Vol 44 No 1 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i1.590

Abstract

Background: Empyema is a problem worldwide due to its high incidence, mortality, and morbidity rates. So, administering antibiotics is mandatory to treat the disease. It should be sensitive to the causal microorganisms and avoid resistant ones for treatment efficacy. This research aimed to determine bacterial profile and antimicrobial resistance, which can be fundamental foundations for clinical practices in the treatment of patients, especially in Pekanbaru.Methods: This was a cross-sectional study from medical records at Arifin Achmad and Eka Hospitals from January 1, 2015, to December 31, 2022, including culture and antibiotic resistance test results with samples from pleural fluid and antibiotic susceptibility test using VITEK 2.0.Results: A total of 197 pleural fluid specimens were obtained. Gram-negative bacteria were found to be the most prevalent at 79.7%, namely Klebsiella pneumoniae (18.5%), Escherichia coli (12.0%), and Pseudomonas aeruginosa (11.0%). Gram-positive bacteria were found at 12.2%, the most common being Staphylococcus aureus (6.1%) and Enterococcus faecalis (2.0%). Antibiotic sensitivity tests for Gram-negative bacteria showed that amikacin and tigecycline were the most sensitive, and Gram-positive bacteria showed the most sensitivity to linezolid, tigecycline, and vancomycin. The resistance of Klebsiella pneumoniae and Escherichia coli to cephalosporins was 18.5% and 75.0%, respectively. The resistance of Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa to carbapenems was 8.0%, 13.0%, and 53.0%, respectively.Conclusion: Gram-negative is the most common microorganism found in pleural empyema. The resistance of multiresistant bacteria to antibiotics is high and requires supervision to apply appropriate antibiotic administration based on local antimicrobial patterns and the need to strengthen antimicrobial stewardship programs. 
C-Reactive Protein and Procalcitonin as Markers for Post-Bronchoscopic Complications: A Literature Review Indriani, Sri Indah; Yovi, Indra; Syaf, Syarlidina; Simatupang, Elvando Tunggul Mauliate
Jurnal Respirologi Indonesia Vol 44 No 2 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i2.638

Abstract

In the respiratory system, bronchoscopy is a basic procedure utilized for both diagnostic and therapeutic purposes. Despite being a generally safe procedure, bronchoscopy can result in complications that range in severity from moderate to severe. Pulmonary infection is among the potential complications that can happen after a bronchoscopy procedure. An incidence of 0.2% to 5.2% has been described typically for complications such as empyema, lung abscess, and pneumonia that may develop after bronchoscopy procedures. Although these complications are uncommon, their prognosis can be quite bad. The risk of pulmonary infection, specifically pneumonia, has been related in several studies to sepsis and mortality in patients enduring bronchoscopy procedures. The initiation of the infection exposure process into the lung can be assisted through a variety of factors, including the underlying diagnosis and the type of intervention performed during the bronchoscopy procedure. A critical complication that needs additional consideration is the potential transmission of infection through bronchoscopy procedures. It is beneficial to consider prophylactic antibiotics before a procedure due to the possibility that infectious agents will be transferred from one patient to another. Antibiotic prophylaxis may involve the utilization of C-reactive protein (CRP) and Procalcitonin (PCT) testing as determining parameters. Serial PCT and CRP 24–96 hours post-bronchoscopy procedure might help to determine one of the post-bronchoscopy complications.
Hypoxemia During Bronchoscopy and The Risk Factors Related Putri, Chyntia Triana; Indriani, Sri Indah; Yovi, Indra
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i1.651

Abstract

Background: Hypoxemia, a common complication of bronchoscopy, often occurs even with oxygen supplementation, particularly during procedures performed under sedation, with reported incidences ranging from 2.5% to 69%. Hypoxemia during bronchoscopy which is defined as desaturation under 90% or more than 5% decreasing of basal SpO2, becomes a concern due to possible fatal complications. This study aims to determine the incidence of hypoxemia during bronchoscopy and identify its predisposing risk factors. Methods: An analytic observational study with a cross-sectional design was held in our center from October 2022 until June 2023. As many as 100 consecutive patients who underwent bronchoscopy and met inclusion criteria were evaluated prospectively. The patient’s oxygen saturation was monitored by finger pulse oximetry during the procedure. Demographic characteristics, comorbidities, lung function, PaO2 value, ASA score, types of intervention, sedative agents, duration of sedation and procedure were recorded. The risk factors for hypoxemia during bronchoscopy were evaluated. Results: The incidence of hypoxemia during bronchoscopy in our center was 15%. Bivariate analysis showed pleural effusion as a comorbidity (9 patients; 60%), restrictive-obstructive lung function test (10 patients; 66.7%) and PaO2 value (76.87±8.219) were statistically significant (P<0.05) related to the existence of hypoxemia during bronchoscopy. Three other factors such as age, ASA score and duration of procedure with P<0.25 were included in multivariate analysis and found that the most influencing factor was the restrictive-obstructive lung function test (P=0.001; OR=13.845). Conclusion: Comorbidity (pleural effusion), lung function (restrictive-obstructive) and PaO2 value were some factors significantly related to hypoxemia during bronchoscopy with lung function being the most influencing factor.
Profile of Pulmonary Tuberculosis After COVID-19 at Toba District, North Sumatra Province Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda; Yovi, Indra; Simbolon, Rohani Lasmaria; Fauzi, Zarfiardy Aksa
Jurnal Respirologi Indonesia Vol 44 No 4 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i4.716

Abstract

Background: Worldwide cases of pulmonary tuberculosis (PTB) have significantly increased since the COVID-19 pandemic. Indonesia accounted for 6,811,818 of the 767,518,723 cases reported by the World Health Organization. While the Indonesian Ministry of Health reported 824,000 cases, the Global Tuberculosis Report in 2022 reported 10.6 million cases. The pandemic has hampered the goal of eliminating PTB globally, with cases diagnosed after COVID-19 having a 7.15-fold increased risk of contracting the illness.Methods: This cross-sectional study was conducted using total sampling to identify the profile of patients with PTB after having COVID-19 based on age, gender, classification, and type of PTB, as well as the duration of occurrence of PTB after COVID-19. The data collected were from COVID-19 patients from 2020 to 2022, then compared with PTB data. All data were compared to ensure that COVID-19 and PTB patient data were the same.Results: Of the 2544 patients recorded, 29 (1.1%) were infected with PTB after COVID-19 infection. The mean age of patients was 34±18.9 and was dominated by men (68.9%). Most of the cases were drug-sensitive TB (96.6%) and clinically diagnosed TB (55.2%). Age had a statistically significant association with the occurrence of TB cases after COVID-19 infection (P<0.0001). The mean time from the initial diagnosis of COVID-19 to the diagnosis of confirmed TB was approximately 203±34.3 days (6.7 months).Conclusion: After COVID-19, patients have the potential to be infected with TB. Screening former COVID-19 patients can be one solution to finding early cases of PTB.
COVID-19 dan Tuberkulosis Paru, Antara Koinfeksi dan Reaktivasi dari Laten Tuberkulosis: Sebuah Kajian Sistematis Simanjuntak, Arya Marganda; Yovi, Indra; Marbun, Patricia Dean Ully; Elisabet, Adinda
Majalah Kedokteran Indonesia Vol 73 No 2 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.2-2023-1006

Abstract

Introduction: Globally, cases of pulmonary tuberculosis (PTB) are rising by 4%, while new cases have declined in many nations, most notably by 14% in Indonesia. During the COVID-19 pandemic, the number of undiagnosed and untreated PTB patients could rise and infect more people. In particular, CD8+ lymphocytes were decreased in COVID-19. Perhaps this is the cause of the rise in cases, but there is no data to show it. Aim: Determine current data about the PTB with COVID-19 coinfection and possible reactivation of PTB after COVID-19 infection in LTB patient. Methods: This systematic review is based on PRISMA statements using Pubmed, EBSCOHost, Science Direct and Cochrane from December 2019 to July 2022. Inclusion and exclusion criteria were set to select studies that included. We analyze risk of bias of all included studies with JBI critical appraisal tools. Results: This study had 107,425 patients in total from 20 studies. All studies were deemed to have low overall author bias risks. A critical component of PTB defense is CD8+. By reducing lymphocytes, COVID-19 can encourage the growth of PTB, which might therefore result in coinfection or the reactivation of existing PTB. Conclusion: COVID-19 possibly increase case of PTB in form of co-infection or reactivation of PTB in LTB patients. This needs special attention for patients that have infected by COVID-19 to followed up for risk developing PTB.
Bagaimana Bekas Tuberkulosis Dapat Menginduksi Kanker Paru? Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda; Yovi, Indra; Simbolon, Rohani Lasmaria; Munir, Sri Melati; Wijaya, Dewi
Majalah Kedokteran Indonesia Vol 73 No 6 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.6-2024-1087

Abstract

In 2022, there will be 10.6 million cases of tuberculosis, which is a serious problem worldwide. Thailand's cohort research after the COVID-19 pandemic found a 7-fold risk of tuberculosis infection in COVID-19 patients, pointing to a probable rise in TB cases. In order to completely eradicate TB, care must be given to patients both before and after infection, guaranteeing public health against TB infection.1,2
Flexi-rigid Pleuroscopy in Diagnostics of Malignancy: A Narrative Literature Review Salmiyah; Indra Yovi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 2 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i2.925

Abstract

Pleuroscopy is a less invasive treatment that allows access to the pleural cavity with the use of both visual and surgical equipment. This technique can be conducted with local anesthesia and mild sedation. Pleuroscopy is a medical procedure used for both diagnosis and treatment in the pleural cavity. Pleuroscopy enables direct observation of the pleural surface, enhancing the safety of procedures such as pleural biopsy, pleural fluid drainage, and pleurodesis. One purpose is to assist in verifying the diagnosis of cancer. This review was aimed to describe the use of flexi-rigid pleuroscopy in malignancy.