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INDONESIA
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Published by Perhimpunan Dokter Spesialis Patologi Klinik Indonesia
ISSN : 08544263     EISSN : 24774685     DOI : https://dx.doi.org/10.24293
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) is a journal published by “Association of Clinical Pathologist” professional association. This journal displays articles in the Clinical Pathology and Medical Laboratory scope. Clinical Pathology has a couple of subdivisions, namely: Clinical Chemistry, Hematology, Immunology and Serology, Microbiology and Infectious Disease, Hepatology, Cardiovascular, Endocrinology, Blood Transfusion, Nephrology, and Molecular Biology. Scientific articles of these topics, mainly emphasize on the laboratory examinations, pathophysiology, and pathogenesis in a disease.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 1,328 Documents
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Antibiotic Susceptibility Pattern of Extended-Spectrum Beta-Lactamase-Producing Klebsiella Pneumoniae and Escherichia Coli Erlina Wahyu Elmawati; Dewi Indah Noviana Pratiwi; Noor Muthmainah; Agung Biworo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1634

Abstract

Extended-Spectrum Beta-Lactamase (ESBL) producing bacteria is a type of resistance that leads to complex management of patients in intensive care due to their resistance to first, second, and third-generation Cephalosporin and monobactam antibiotics. The most ESBL-producing bacteria are found in the family Enterobacteriaceae, especially Klebsiella pneumoniae and Escherichia coli. The purpose of this research was to determine the sensitivity pattern of ESBLproducing bacteria in Intensive Care Units (ICUs) of Ulin Hospital, Banjarmasin, in the period of 2016-2018. This research was a descriptive study with a cross-sectional approach using data from the laboratory medical records of patients with positive ESBL in the ICUs of Ulin Hospital, Banjarmasin, between 2016 and 2018. The research sample was taken by the total sampling method. This research obtained 216 isolates of ESBL-producing bacteria consisting of 155 (71.8%) isolates of Klebsiella pneumoniae and 61 (28.2%) Escherichia coli. It was found that the Cephalosporin antibiotics (Cefazolin, Ceftazidime, Ceftriaxone, and Cefepime) and monobactam antibiotic (Aztreonam) had the lowest sensitivity. Aminoglycoside antibiotics (Amikacin), Carbapenem (Ertapenem and Meropenem), and Tetracycline (Tigesycline) were the most sensitive antibiotics. It was concluded that both Klebsiella pneumoniae and Escherichia coli were the most dominant ESBL-producing bacteria and showed good sensitivity to the Amikacin, Ertapenem, Meropenem, and Tigecycline.
Interleukin-34 and Disease Activity in Systemic Lupus Erythematosus Patients Rizki Luly Ya Fatwa Pulungan; Ratna Akbari Ganie; Zuhrial Zubir
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1636

Abstract

Systemic Lupus Erythematosus (SLE) is characterized by exacerbation and remission, which needs close monitoring of the disease activity. Systemic lupus erythematosus disease activity can be determined by the SLE Disease Activity Index (SLEDAI) score. Evaluation of the disease activity is essential to be a guidance for treatment. Interleukin-34 (IL-34) is related to the pathogenesis of SLE. Serum IL-34 can be a candidate marker to evaluate SLE disease activity, and it is correlated with the SLEDAI score. This study aimed to determine the correlation between IL-34 level and disease activity in SLE patients based on the SLEDAI (Mex-SLEDAI) score. An observational analytical study with a cross-sectional design was carried out in six months (June-November 2019) in 27 SLE patients in the Department of Internal Medicine, Faculty of Medicine, Sumatera Utara University/Adam Malik General Hospital, Medan. Systemic lupus erythematosus disease activity was measured based on the Mex-SLEDAI score. Serum and urine were collected to obtain the Mex-SLEDAI score and IL-34 level. IL-34 level was measured in all subjects by using Enzyme-Linked Immunosorbent Assay (ELISA). Spearman correlation test was used todetermine the correlation between IL-34 level and disease activity in SLE patients based on the SLEDAI (Mex-SLEDAI) score. There was a significant correlation between IL-34 level and disease activity in SLE patients based on SLEDAI (Mex-SLEDAI) score (r=0.965, p < 0.001). Further studies were needed with a sample of SLE patients in a balanced proportion based on their disease activity to obtain representative IL-34 levels in SLE patients based on their disease activity.
Susceptibility Pattern of ESBL Urine Specimens in Non-Intensive Care Room at Ulin General Hospital Alicia Fitri Wulandhany; Dewi Indah Noviana Pratiwi; Noor Muthmainah; Agung Biworo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1637

Abstract

Beta-lactam antibiotic resistance can occur in ESBL-producing bacteria such as E.coli and K.pneumoniae, which can cause UTI. One of the risk factors for infection is the non-intensive care space density level. The objective of this study was to determine the sensitivity pattern of ESBL-producing bacteria in urine specimens of patients in the non-intensive care of Ulin General Hospital, Banjarmasin, in the period of 2016-2018. A descriptive study with a cross-sectional design using data results of urine culture and antibiotic susceptibility patterns data in non-intensive care patients at Ulin General Hospital from 2016 to 2018. The urine test results showed 96 positive isolates of ESBL-producing bacteria, consisting of ESBL-E.coli (69.8%) and ESBL-K.pneumonia (30.2%). Antibiotics with low sensitivity tests were Penicillin, Cephalosporin, Monobactam, and Penicillin/beta-lactam inhibitor combinations. Contrastingly, antibiotics with high sensitivity were Aminoglycoside, Carbapenem, and Glycylcycline. It was concluded from this study that the ESBL-producing bacteria in urine specimens for non-intensive care patients of Banjarmasin Ulin General Hospital in the period of 2016-2018 showed varying sensitivity to antibiotics
Plasma Osteopontin Correlates with Glycemic Control in Type 2 Diabetes Mellitus Patients Maria Diah Pramudianti; Briggite Rina Aninda Sidharta; Josua Sinambela; Medityas Winda Krissinta
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1638

Abstract

Diabetes Mellitus (DM) is a metabolic disease characterized by hyperglycemia due to abnormal secretions and/or insulin activity. Osteopontin (OPN) is an important component of inflammation and insulin resistance, and vitamin D decreases insulin resistance. This study aimed to analyze the correlation between OPN and glycemic control and total 25-OH vitamin D in type 2 DM. An observational analytic study with a cross-sectional approach was performed in Dr. Moewardi Hospital, Surakarta, from May to September 2018. Plasma OPN levels were measured by a sandwich enzyme immunoassay kit from Elabscience 96T Human OPN (USA), and a total of 25-OH vitamin D was evaluated using the ELFA method from Biomerieux SA (France). Data were tested by Pearson correlation (r). Type 2 DM subjects consisted of 45 (54.2%) males and 38 (45.8%) females, 36 (43.45%) well- and 47 (56.65%) poorly-controlled. The average age was 56.81±9.76 years old. The mean of OPN level in poorly-controlled cases was significantly higher (20.27±3.20 ng/mL) than well-controlled ones (15.04±3.34 ng/mL) with p=0.001. There was no significant difference in total 25-OH vitamin D between well- and poorly-controlled groups (19.84±6.65 vs. 17.24±6.78 ng/mL, respectively, p=0.085). The correlation of OPN with glycemic control (fasting glucose, 2-hour post-prandial glucose, HbA1c) and total 25-OH vitamin D in all subjects with type 2 DM were r=0.241 (p=0.028), r=0.378 (p=0.0001) r=0.529 (p=0.0001) and r=-0.151 (p=0.173), respectively. This study suggested that plasma OPN level was correlated with glycemic control but not with serum total 25-OH vitamin D in type 2 DM. Further research was needed in populations of other types of DM and other research variables related to inflammation or insulin resistance.
C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients Brigitte Rina Aninda Sidharta; JB. Suparyatmo; Avanti Fitri Astuti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1639

Abstract

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity and mortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increases in bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determine C-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values of CRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Department of Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusion criteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patients with liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years. Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in the maintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line (22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positive culture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-off value of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivity of 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, Positive Likelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used as a screening marker for fungal infections in patients with acute leukemia.
Antibiotics Susceptibility Pattern of MRSA at Intensive Care Room of Ulin General Hospital Banjarmasin Shania Indah Chineko; Dewi Indah Noviana Pratiwi; Rahmiati Rahmiati; Noor Muthmainnah; Alfi Yasmina
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1649

Abstract

Infection caused by Methicillin-Resistant Staphylococcus aureus (MRSA) is a healthcare-associated infection that receives the most significant attention worldwide due to its resistance. Administration of precise and rational antibiotics can prevent high MRSA rates in hospitals. This study aimed to determine the antibiotic susceptibility pattern of MRSA at the intensive care room of Ulin General Hospital, Banjarmasin, between 2016 and 2018. This study was an observational analytic study by taking the results of culture and antibiotic susceptibility pattern data of the MRSA isolated from patients treated at the intensive care room retrospectively. The results showed 37 data of patients suffering from MRSA at the intensive care room in 2016-2018, with a percentage of 23.81%, 25.81%, and 35.19%, respectively. The most common sources of MRSA isolate in this study were sputum (32.39%), blood (29.27%), and pus (16.67%). From 2016 to 2017, there was a decreased susceptibility to macrolide antibiotics, aminoglycosides such as Gentamicin, and quinolones such as Moxifloxacin. In 2018, there was an increased susceptibility pattern of some antibiotics compared to the previous period. Antibiotics with the highest susceptibility in period of 2016-2018 were Linezolid, Quinupristin/Dalfopristin, Tigecycline, Nitrofurantoin, and Trimethoprim/Sulfamethoxazole. Also, the antibiotic with the lowest susceptibility was Tetracycline. It was concluded that there had been changes in some antibiotics' susceptibility pattern to MRSA within 2016-2018.
Antibiotics Susceptibility Pattern in Diabetic Ulcer Patients Mita Rahma Yani; Dewi Indah Noviana Pratiwi; Rahmiati Rahmiati; Noor Muthmainah; Alfi Yasmina
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1652

Abstract

Diabetic ulcers are a chronic complication of diabetes mellitus and have a high risk of infection. Severe ulcer infections are a significant cause of lower-extremity amputations in addition to trauma. Therefore, therapy for diabetic ulcer infections must be performed immediately. This study aimed to determine the bacterial susceptibility pattern to the antibiotic in diabetic ulcer patients. This study was retrospective observational descriptive by taking the results of swab culture and antibiotic susceptibility patterns data in diabetic ulcer patients at Ulin General Hospital, Banjarmasin, in 2016-2018. The results showed 41 (62.1%) monomicrobial infections and 25 (37.9%) polymicrobial infections. The number of Gram-negative bacilli (57.4%) was higher than Gram-positive cocci (42.6%). The most common bacterial isolates on pus culture were Staphylococcus aureus (26.6%), Klebsiella pneumonia (19.1%), and Escherichia coli (12.8%). Antibiotic susceptibility test results showed that Gram-positive bacteria were sensitive to Tigecycline (100%), Nitrofurantoin (96.9%), and Linezolid (96.8%). Gram-negative bacteria were susceptible to Ertapenem (92.7%), Meropenem, and Amikacin (90.6%). S.aureus isolates were sensitive 100% to Meropenem and Tigecycline. K.peneumoniae and E.coli isolates were susceptible 100% to Meropenem and Amikacin. It was concluded in this study that the prevalence of Gram-negative bacteria in diabetic ulcer infection was higher than Gram-positive bacteria. The most common isolated Gram-negative bacteria were K.pneumoniae and E.coli, while the most common Gram-positive bacteria were S.aureus. The most sensitive antibiotics for K.pneumoniae and E.coli were Meropenem and Amikacin, while the most sensitive antibiotics for S.aureus were Linezolid and Tigecycline.
Guidelines for Author and Subcribes Form Dian Wahyu Utami
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.v26i2.1656

Abstract

Correlation between Hemostasis Profile and Sepsis Outcome Sisi Melansi; Eny Rahmawati; Susilawati Susilawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1658

Abstract

Sepsis is an organ dysfunction caused by infection. Excessive cytokine activation, which causes hemostasis disorder is rated by Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), fibrinogen, and D-dimer tests. Hemostasis disorder can affect several sepsis outcomes (mortality and duration of treatment period). This study aimed to determine the correlation between hemostasis profile and sepsis outcome. This research was an analytical-observational with retrospective cohort study design with subjects consisting of 76 sepsis patients at Dr. Mohammad Hoesin Hospital, Palembang. The data were obtained by medical record observation and analyzed by Chi-Square and Spearman tests. From 76 sepsis patients, 76.7% of subjects had normal PT; 88.2% had normal aPTT; 71.1% had elevated fibrinogen, and 100% had elevated D-dimer. The patients' sepsis outcomes showed that 67.1% survived, and 32.9% has died, and the duration of the treatment period without much differences is as long as ≤ 12 days and > 12 days. The statistical analysis showed that there was no significant relationship between PT, mortality, duration of the treatment period (p=1.000; p=0.418), between aPTT, mortality, duration of the treatment period (p=0.709; p=0.480), between fibrinogen, mortality, duration of the treatment period (p=0.350; p=1.000), and there was a weak negative correlation between D-dimer mortality and duration of the treatment period (p=0.459; p=0.939). It could be concluded that there was no significant correlation between hemostasis profile and sepsis outcome.
Cancer Risk Assessment and Screening; A Challenge for Clinical Pathology Service? Siti Boedina Kresno
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1660

Abstract

There is evidence demonstrating that cancer etiology is multi-factorial and modification of risk factors has achieved cancer prevention. There is therefore a need to advance the understanding of cancer etiology through interaction effects between risk factors when estimating the contribution of an individual to the cancer burden in a population. It has been known that cancer may arise from genetic susceptibility to the disease as an intrinsic factor; however, non-intrinsic factors drive most cancer risk as well and highlight the need for cancer prevention. Are our clinical pathologists aware of these facts?. Are they ready to understand and to provide an excellent test with good expertise?. Hereditary cancer testing is typically performed using gene panels, which may be either cancer-specific or pan-cancer to assess risk for a defined or broader range of cancers, respectively. Given the clinical implications of hereditary cancer testing, diagnostic laboratories must develop high-quality panel tests, which serve a broad, genetically diverse patient population. The result will determine a patient's eligibility for targeted therapy, for instance, or lead a patient to prophylactic surgery, chemoprevention, and surveillance. This review will introduce the definitions of intrinsic and non-intrinsic risk factors, which have been employed in recent work and how evidence for their effects on the cancer burden in human subjects has been obtained. Genetic testing of cancer susceptibility genes by use of liquid biopsies and New Generation Sequencing (NGS) is now widely applied in clinical practice to predict the risk of developing cancer, help diagnosis, and treatment monitoring.

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