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All Journal Indonesian Journal of Tropical and Infectious Disease Ina Kidney Biomolecular and Health Science Journal CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL

Artaria Tjempakasari, Artaria

Airlangga University

Author-ID : 508667

Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Articles

BACTERIA CAUSED SEPSIS BIOMARKERS Tjempakasari, Artaria; Nasronudin, Nasronudin
Indonesian Journal of Tropical and Infectious Disease Vol 5, No 3 (2014)
Publisher : Institute of Topical Disease

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Sepsis is a clinical condition of patients with serious infections that show a systemic inflammatory response, with or without a positiveÂ blood culture. sepsis is one of the most frequent causes of death in patients in intensive care units. We are at urgent need for biomarkersÂ and reliable measurements that can be applied to risk stratification of septic patients and that would easily identify those patients at theÂ highest risk of a poor outcome. Such markers would be of fundamental importance to decision making for early intervention therapy. Pro-inflammatory cytokines such as tumor necrosis factor-ï¡ (TNF- ï¡), interleukins-1,-6,-8 (IL-1, IL-6, IL-8) are postulated to play aÂ major role in the pathogenesis of the syndrome. C-reactive protein (CRP) and procalcitonin (PCT) are among a few biomarkers thatincorporated into clinical practice although their precise role in the pathopysiology of sepsis and organ dysfunction still unclear.

BACTERIA CAUSED SEPSIS BIOMARKERS Artaria Tjempakasari; Nasronudin Nasronudin
Indonesian Journal of Tropical and Infectious Disease Vol. 5 No. 3 (2014)
Publisher : Institute of Topical Disease Universitas Airlangga

Sepsis is a clinical condition of patients with serious infections that show a systemic inflammatory response, with or without a positive blood culture. sepsis is one of the most frequent causes of death in patients in intensive care units. We are at urgent need for biomarkers and reliable measurements that can be applied to risk stratification of septic patients and that would easily identify those patients at the highest risk of a poor outcome. Such markers would be of fundamental importance to decision making for early intervention therapy. Pro-inflammatory cytokines such as tumor necrosis factor- (TNF- ), interleukins-1,-6,-8 (IL-1, IL-6, IL-8) are postulated to play a major role in the pathogenesis of the syndrome. C-reactive protein (CRP) and procalcitonin (PCT) are among a few biomarkers thatincorporated into clinical practice although their precise role in the pathopysiology of sepsis and organ dysfunction still unclear.

Prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) Carrier in Hemodialysis Patients at Dr. Soetomo Academic General Hospital Eko Oktiawan Wicaksono; Artaria Tjempakasari; Widodo Widodo
Indonesian Journal of Tropical and Infectious Disease Vol. 8 No. 3 (2020)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v8i3.16796

Chronic kidney disease (CKD) is now a global epidemic, and the prevalence is increasing worldwide. Hemodialysis is one of the ways to treat by kidney function replacement. Infection is the number two cause of death in patients with hemodialysis (HD). Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of bacteriemia in patients with dialysis. The epidemiological data of MRSA carriers in CKD in Indonesia are still scarce. This study was to determine the prevalence of MRSA carriers in patients at The Kidney and Hypertension Outpatient-clinic and Hemodialysis Installation at Dr. Soetomo Academic General Hospital, Surabaya Indonesia. The study design was descriptive-analytic with a cross- sectional study design. Sampling was collected consecutively. Data on the general characteristics of the research subjects will be analyzed using a Chi-Squared test. There were 150 CKD stage five patients included in this study, the number of patients has MRSA carrier were 6 (4%), among them, subjects underwent HD MRSA carrier were 2 subjects(2.7%), while for non-HD patients with MRSA were 4 subjects (5.3 %). There were no significant diﬀerences in MRSA carriers between HD and non HD groups (p=0.404). Comorbid factors that accompany MRSA carriers are diabetes mellitus, hypertension, kidney stones, gout, and systemic lupus erythematosus (SLE). This study found, there were no significant diﬀerences in the incidence of MRSA carriers in stage five CKD non HD or HD groups. MRSA colonization exists in stage five CKD suﬀerers, so awareness of MRSA colonization

Risk Factors for Urinary Tract Infection in Hospitalized Patients Hadiati Setyorini; Nunuk Mardiana; Artaria Tjempakasari
Biomolecular and Health Science Journal Vol. 2 No. 1 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Introduction: Urinary tract infection (UTI) is the most common infection that can be fatal and has higher rate mortality especially in some patient. This study is aim to analyze risk factors for urinary tract infection in hospitalized patients for prevention and more aggressive approach can be taken.Methods: Consecutively, medical records of 285 patients with urinary analysis was recorded for risk factors and urine culture results if suspected UTI. Risk factors for sex, age, urinary catheter, urolithiasis, DM, and immobilization was analyzed with bivariate analysis and multivariate analysis.Results: From 285 patients, 92 patients had UTI with average age was 52.45 years old, 48 (56.49%) were female. Most common pathogen were E. coli (41.3%), Enterobacter sp. (8.8%) and Enterococcus faecalis (7.6 %). From bivariate analysis, geriatric age (>60 years) has RR 1.421 (95% CI 1.015-1.989, p=0.046) and immobilization has RR 1.861 (95% CI 1.266-2.738, p=0.007), whereas sex (RR 1.190 95% CI 0.851 – 1.664, p=0.310), diabetes (RR 1.171 95% CI 0.833 – 1.645, p=0.367), insulin usage (RR 0.900 95% CI 0.519 – 1.561, p= 0.703), glycosuria (RR 1.152 95% CI 0.741 – 1.791, p=0.522), and CKD (RR 1.475 95% CI 0.896 – 2.430, p= 0.126) give insignificant result. From multivariate analysis, urinary catheter has OR 4.506 (95% CI 2.312-8.872, p=0.000), urolithiasis with OR 4.970 (95% CI 1.931-12.787, p=0.001), and hyperglycemia has OR 2.871 (95% CI 1.485-5.551, p=0.002).Conclusion: Geriatric age and immobilization are risk factors for urinary tract infection, and urinary catheter, urolithiasis, and hyperglycemia are independent risk factors for urinary tract infection.

A Female Patient With Clinical Symptoms as Recurrent Urinary Tract Infection Caused By Urinary Tract Tuberculosis Rastita Widyasari; Artaria Tjempakasari; Chandra Irwanadi Mohani
Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v1i1.16829

Background : Urinary tract tuberculosis (TB) is one type of extrapulmonary TB. The prevalence in developed countries is around 15-20% of all cases of extrapulmonary TB.1 The insidious onset and non-specific constitutional symptoms of urinary tuberculosis often lead to delayed diagnosis and rapid progression to a non-functioning kidney.2-3 The only way to limit renal function loss and destruction is by early diagnosis and therapy.4Case: 34-year-old woman, came with complaints of urinary pain accompanied by right flank pain 10 months prior. Patient also had complaint of weight loss but ignoring complaints of night sweats. Patient repeatedly diagnosed as a urinary tract infection and received many kinds of antibiotic therapy but her complaints were not getting better. Urine production was about 1700 cc/24 hours. From general physical examination, there was a lack of nutritional status with BMI 17.1 kg/m2. Vesicular lung sound without rhonchi heard in both lung fields. From the urinalysis examination there were pyuria and haematuria without bacteriuri. Laboratory examination showed value of BUN was 17 mg/dl and creatinine 0.9 mg/dl. From aerob urine culture we found sterile urine. But we found positive result of Mycobacterium tuberculosis (MTB) urine cultures which was sensitive to isoniazid, rifampicin, pyrazinamide, and ethambutol. Abdominal ultrasound showed severe ecstasis of right pelviocalyceal system without stones,mass, nor cyst. We had additional data from intravenous pyelogram (IVP) which showed a non-visualized dextra pelviocalyceal system and delayed bladder emptying function at 120th minutes. From computed tomography stonographic, we found severe right hydronephrosis, proximal to distal right hydroureter, and thickening of bladder wall (± 1.61 cm) on the right antero-lateral side. To find out the cause of thickening of bladder wall, we did bladder biopsy which showed the mononuclear inflammatory cell stroma. Patients were diagnosed with urinary tract TB and received category 1 of oral anti tuberculosis therapy (Rifampicin, Isoniazid, Pyrazinamid, and Ethambutol) for 12 months and underwent right DJ stent implantation to manage the ectasys.Conclusion : Urinary tract TB often showed unspecified complaints and can be suggested as recurrent urinary tract infections. Early diagnosis and optimal management were needed to prevent anatomical and functional complications.

Risk Factors for New-Onset Diabetes After Transpant in Kidney Transplant Recipients Dana Pramudya; Aditiawardana Aditiawardana; Artaria Tjempakasari; Chandra Irwanadi; Nunuk Mardiana; Pranawa Pranawa; Widodo Widodo
Indonesian Journal of Kidney and Hypertension Vol 2 No 1 (2019): January - April 2019
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

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Background New-onset diabetes after transplant (NODAT) is one of the metabolic complications of kidney transplant surgery. The incident of NODAT varies highly, from 5% up to 53%. Some factors increase the risk for NODAT, such as age, gender, immunosuppressant drugs, among others. The progressivity of NODAT leads to increased cardiovascular risks, making the identification of risk factors crucial. Method Medical records of 56 patients who have undergone kidney transplant throughout 1998 - 2015 were evaluated. Data obtained from the records include age, gender, history of hypertension, dyslipidemia, the use of calcineurin inhibitors (CNI), and familial history of diabetes. Bivariate analysis with crosstabs (for nominal data) was used to analyze the data, with a threshold of p < 0.25 and followed up with multivariate analysis using logistic regression. Result The mean age of subjects was 53.85±12.92 years, with 80.4% of the subjects were male. Pre-transplant hypertension was 46.4%. The CNI used were tacrolimus in 46.4% and cyclosporine in 53.6% of patients. Around 25% of patients have a familial history of diabetes and the mean triglyceride level was 165.83±77.5 mg/dl. NODAT occurred in 18 patients and the majority of occurrence happened in the first year post-transplant. Bivariate analysis shows no significant risk factors, however clinically significant risk factors were gender (male), the CNI drug used (tacrolimus), and familial history of diabetes. Further multivariate analysis showed OR for gender (male) with OR 6.532 (0.735- 58.051), age with OR 5.249 (0.658-41.853)}, and the use of tacrolimus with OR 3.217 (0.895-11.571). Conclusion In this study, the clinically significant risk factors for NODAT were male gender, age, and the use of tacrolimus. However, these risk factors did not show statistical significance. Further study with bigger sample size is needed.

Association between the Biofilm of Double-Lumen Catheter and Blood Culture in Hemodialysis Patients with Suspected Central Line-Associated Bloodstream Infection Dicky Pendi Alaudin Sangadji; Aditiawardana Aditiawardana; Artaria Tjempakasari; Lindawati Alimsardjono
Indonesian Journal of Kidney and Hypertension Vol 3 No 1 (2020): January - April 2020
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Abstract Background One complication of double lumen catheter (DLC) for hemodialysis (HD) is central line associated bloodstream infection (CLABSI). Blood culture examination is still the gold standard for diagnosis. CLABSI is also often associated with biofilm formation. Biofilms can cause recurrent bacteremia and antibiotic resistance thereby increasing mortality and morbidity. Until now in Dr. Soetomo General Hospital, there have been no objective data or research on the relationship between biofilms and blood cultures in patients with systemic infections associated with catheters. Objective: This study aims to analyze the relationship between the biofilms of double lumen catheter and blood cultures in hemodialysis patients with suspected CLABSI. Method: This was an analytic observational study with cross sectional design to determine the relationship of biofilms and blood culture in HD patients with suspected CLABSI at Dr. Soetomo General Hospital in August 2019 - November 2019. Inclusion criteria: patients aged >18 years with routine HD and suspected CLABSI, also were willing to participate in the study with informed consent. Exclusion criteria: other sources of infection. Biofilm examination on DLC using the test tube method was measured with a nephelometer. Biofilm results is positive if ≤ 0.36 MF and negative if > 0.36 MF. Blood was cultured with a 3D BacT/ALERT tool in the Clinical Microbiology Installation Laboratory of Dr. Soetomo General Hospital. Results: Of the 33 subjects, 45.5% were men and 54.5% were women, with an average age of 49.06 ± 1.5 years. The most common cause of CKD is hypertension (54.5%). The median length of HD was 3 months, ranging from 1-8 months. DLC were mostly inserted at subclavia dextra (87.9%) and installed with a mean duration of 77.94 ± 5.22 days. The majority (66.7%) had normal nutritional status. The mean albumin level was 3.28 ± 0.07 g/dL. There was biofilm growth in 16 subjects (48.5%). The evaluation of blood culture revealed 15 positive results (45.5%). The analysis between biofilm density and CLABSI found significant differences between the two groups (p=0.024). From chi-square test, the association of biofilms with blood culture in HD patients with suspected CLABSI obtained a p value of 0.001. Conclusion: Patients with suspected CLABSI and positive bacteria growth in blood cultures had biofilm in DLC. In addition, the density of biofilms in DLC is higher CLABSI cases. Keywords: chronic kidney disease, CKD, Double lumen catheter, Biofilm, Blood culture, Infection, CLABSI

Co-Authors Aditiawardana Aditiawardana, Aditiawardana Ardityo R Ardhany, Ardityo R Chandra Irwanadi Chandra Irwanadi Mohani Chandra Irwanadi, Chandra Dana Pramudya Dicky Pendi Alaudin Sangadji Djoko Santoso Eko Oktiawan Wicaksono Hadiati Setyorini Lindawati Alimsardjono M Thaha, M Nasronudin Nasronudin Nasronudin Nasronudin Nunuk Mardiana, Nunuk Pranawa Pranawa pranawa pranawa, pranawa Rastita Widyasari Tri P Asmarawati, Tri P Widodo Widodo Widodo Widodo Widodo Widodo

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