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All Journal Universa Medicina Jurnal Penyakit Dalam Indonesia
Widayat Djoko Santoso, Widayat Djoko
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Serum lactate as predictor and diagnostic biomarker of plasma leakage in adult dengue patients Bur, Rika; Suwarto, Suhendro; Santoso, Widayat Djoko; Harimurti, Kuntjoro
Universa Medicina Vol 35, No 3 (2016)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2016.v35.213-221

Abstract

Background Dengue fever (DF) and dengue hemorrhagic fever (DHF) are differentiated by the occurrence in DHF of plasma leakage into the interstitial space as shown by pleural and peritoneal effusion, hemoconcentration, and intravascular hypovolemia. Perfusion dysfunction causes anaerobic metabolism, which leads to increased serum lactate. This study was to determine serum lactate as prognostic predictor and diagnostic biomarker of plasma leakage in adult dengue patients.Methods A cross-sectional retrospective cohort study was conducted on 57 adult dengue patients hospitalized in the internal medicine ward of Cipto Mangunkusumo Hospital and Persahabatan Hospital in Jakarta. Serum lactate was examined to determine its mean difference between DF and DHF. The data was analyzed by independent t-test and the cut-off points were identified for presence as well as absence of plasma leakage, then the receiver operating characteristics (ROC) curve was used to determine sensitivity and specificity.Results Mean serum lactate was significantly higher in DHF than in DF. From the ROC curve, the cut-off point for serum lactate as prognostic predictor on day 3 of fever was ³2.65 mmol/L with AUC of 0.626 (95% CI 0.480-0.772; p=0.108). The cut-off point for diagnostic biomarker of plasma leakage on day 5 of fever was 2.55 mmol/L with sensitivity 66.6%, specificity 54.2%, and AUC 0.668 (95% CI 0.550-0.826; p=0.016).Conclusion There was a significant difference in serum lactate between DF and DHF. In the critical phase, serum lactate of 2.55 mmol/L could be used as plasma leakage diagnostic marker of low accuracy.
Correlation of the Quality of Antibiotic Usage by Utilising Gyssens Flow and The Success of Treatment in Negative Gram MDR Sepsis in Tertiary Hospital Lardo, Soroy; Chen, Lie Khie; Santoso, Widayat Djoko; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
Publisher : UI Scholars Hub

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Introduction. Multi Drug Resistance (MDR) antibiotics have become a global health threat to the community. The use of appropriate antibiotics makes preventive and curative measures very important for the success of overcoming MDR and intervening the complexity of resistance, at least slowing the rate of occurrence of MDR. This study aimed to identify the difference in the quality of antibiotic use quality of use using gyssens flowchart and the success in sepsis patients’ treatment due to gram-negative MDR bacteria with non-MDR bacterial infections in tertiary hospitals. Methods. A retrospective cohort study was conducted using secondary data from patient with age more or equal than 18 years who were hospitalized in inpatient unit or ICU in Indonesia Army Central Hospital Gatot Soebroto from 2017-2019. Both the MDR and non-MDR gram-negative inclusion groups were assessed for the quality of antibiotic using the Gyssen flowchart. Results. There was a significant difference between antibiotic quality on gram negative MDR bacteria and non-MDR (20.6% vs. 13.6%; RR 1.517 (CI 95% 1.1 – 2.1); p value = 0.015) which showed that gram-negative MDR experienced 1.517 times better quality than non-MDR. This study also found that there was a significant difference between therapeutic success on gram negative MDR bacteria and non-MDR (57.4% vs. 39.1%; RR 1,431 (CI 95% 1.0 – 2.1); p value = 0.02). Conclusions. There is a better quality on the utilization of antibiotics with Gyssens index patients resulted from MDR negative gram bacterial infection in comparison to non-MDR in tertiary hospital. There is also a better success in treating the sepsis patient with MDR negative gram bacterial infection in comparison with non-MDR.
Factors Related to 30 day Mortality in Critically Ill Patients withInvasive Candidiasis in Cipto Mangunkusumo Hospital Ardian, Ardi; Pitoyo, Ceva W; Adhitianingsih, Dita; Santoso, Widayat Djoko; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Mortality rate of invasive candidiasis is still high, approximately 30-70%. Every study has a variety mortality rate depend on study design and sample. There is no data in Indonesia about profile and mortality factors analysis in critically ill patients with invasive candidiasis. Methods. The Study design was cross sectional. We studied 102 hospitalized critically ill patients with invasive candidiasis. The demographic, clinical and laboratory data, the risk factors for invasive candidiasis and the outcome of each patient in 30 days were recorded. An analysis bivariate with chi square or Fisher’s test was carried out to analyse some factors such as age > 60 years old, severe sepsis, APACHE score > 20, respiratory failure, renal failure, delayed antifungal treatment > 72 hours after positive culture, Charlson index score, and ICU or non ICU patients. The logistic regression of multivariate analysis was carried out to identify the most influence of all mortality factors. Results. Among 102 identified sample, the majority was male (52.9%), the median age was 53 years old and the mortality rate was 68,6%. Laboratory candida findings came from blood sample (candidemia) (98.03%), liquor cerebrospinal (1.5%) and retina exudate (1.5%). The most common candida species were candida non albicans especially Candida tropicalis (34.3%) and Candida parapsilosis (34.3%). The risk factors for invasive candidiasis from this study related to underlying disease were sepsis (78.9%), malignancy (42.15%), diabetes mellitus (29.4%) and related to therapy or treatment were the usage of broad spectrum antibiotic (99%), central vein catheter (77.5%), and parenteral nutrition (70.6%). The result from multivariate analysis, severe sepsis (p 0.001, OR 7.7, IK95% 2.4 – 24.7), Charlson Index ≥3 (p 0.022, OR 3.5, IK95% 1.2–10.2), and respiratory failure (p 0.066, OR 2.7 IK95% 0.9 – 8.0) were independently associated with mortality. Conclusions. In Cipto Mangunkusumo hospital, most critically ill patients with invasive candidiasis was male, median age was 53 years old, and mortality rate was 68,6%. The most species candida caused infection were Candida tropicalis and Candida parapsilosis. The most risk factors of invasive candidiasis from underlying disease was sepsis and from the treatment was the usage of broad spectrum antibiotic. Severe sepsis, and Charlson index ≥3 were associated with a 30 day mortality in critically ill patients with invasive candidiasis.
Coronavirus Disease 2019: Review of Current Literatures Susilo, Adityo; Rumende, C. Martin; Pitoyo, Ceva W; Santoso, Widayat Djoko; Yulianti, Mira; Herikurniawan, Herikurniawan; Sinto, Robert; Singh, Gurmeet; Nainggolan, Leonard; Nelwan, Erni J; Chen, Lie Khie; Widhani, Alvina; Wijaya, Edwin; Wicaksana, Bramantya; Maksum, Maradewi; Annisa, Firda; Jasirwan, Chyntia OM; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 1
Publisher : UI Scholars Hub

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Comparison of Absolute Neutrophil Count between Hospital and Community Acquired Methicillin-Resistant Staphylococcus aureus Infection Kurniyanto, Kurniyanto; Santoso, Widayat Djoko; Nainggolan, Leonard; Kurniawan, Juferdy
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 4
Publisher : UI Scholars Hub

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Introduction. The virulence factors from community acquired-methicillin resistant Staphylococcus aureus (CA-MRSA) mainly due to toxins like Panton Valentin Leukocidin (PVL) and Phenol Soluble Modulin (PSM). Both of toxins cause decrease of value through neutrophil lysis. This study aimed to identify different value of absolute neutrophil count between hospital and community acquired MRSA. Methods. A cross sectional was conducted which included subjects who were infected by MRSA and hospitalized during 2012-2017. Classification of MRSA were divided due to its sensitivity and resistance to non-beta lactam antibiotics. Isolate that resistance to ≤ 2 antibiotics were classified as CA-MRSA. The others with resistance to ≥ 3 antibiotics were classified as hospital acquired MRSA. Absolute neutrophils count (ANC) were collected 24 hours from the positive MRSA culture. Data were analyzed by using independent T test and Mann-Whitney test. Results. We collected 62 subjects infected by MRSA which 35 subjects were HA-MRSA and 27 subjects were CA-MRSA. The median of ANC from CA-MRSA was 7,410.7 (1,147.3-26,560.2) and HA-MRSA was 16,198.0 (3,921.6-28,794.1) with p value < 0.001. Conclusion. There was a different value of absolute neutrophil count in infections due to community and hospital acquired MRSA.
Co-Authors Adityo Susilo, Adityo Alvina Widhani, Alvina Annisa, Firda Ardi Ardian, Ardi C. Martin Rumende, C. Martin Ceva W Pitoyo Cleopas Martin Rumende Dita Adhitianingsih, Dita Edwin Wijaya, Edwin Erni J Nelwan, Erni J Evy Yunihastuti Gurmeet Singh Herikurniawan, Herikurniawan Jasirwan, Chyntia OM Juferdy Kurniawan Kuntjoro Harimurti Kurniyanto, Kurniyanto Leonard Nainggolan Lie Khie Chen Maksum, Maradewi Mira Yulianti, Mira Rika Bur Robert Sinto Siti Setiati Soroy Lardo Suhendro Suwarto, Suhendro Wicaksana, Bramantya