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Papers by ida parwati

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY

The definitive diagnosis of pulmonary tuberculosis is the discovery of Mycobacterium tuberculosis... more The definitive diagnosis of pulmonary tuberculosis is the discovery of Mycobacterium tuberculosis from sputum culture, but theconventional culture methods using Ogawa media require between 3âˆ’10 weeks detection time. Therefore it is needed a prompt diagnostictools to shorten the detection time. Tetrazolium microplate assay (TEMA) that used tetrazolium bromide as a growth indicator also usemitochondrial dehydrogenate enzymes in the mitochondria of living M. tuberculosis may reduce yellow tetrazolium bromide into purpleformazan crystals. The aim of this study was to know the validity and speed of time detection of M. tuberculosis growth by analyzingit. This study was carried out from November 2012 up to February 2013, which obtained 105 subjects conducted in the Departmentof Clinical Pathology at Dr. Hasan Sadikin Hospital with a cross sectional study design. The subjects consisting of sputum sample frompatients who suspected pulmonary TB which is examined for culture of M. tuberculo...

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY

Nowadays in Indonesia, three times (first spot-second in the morning-third spot) microscope sputu... more Nowadays in Indonesia, three times (first spot-second in the morning-third spot) microscope sputum examination to find acid fastbacilli is used to diagnose pulmonary tuberculosis (TB). WHO policy (2007) recommends a reduction of sputum smears from three upto two times. The International Standards for Tuberculosis (2009) stated that the suspected pulmonary TB patients should have at leasttwo sputum specimens for microscopic examination with one early morning sputum. The aim of this study is to know whether pulmonaryTB can be confirmed only by two sputum specimen in the investigation. The subjects consist of patients who were examined three timesof their sputum at the Microbiology Laboratory of Clinical Pathology Department, at Hasan Sadikin Hospital from 2011–2012 (2 yearsperiod). This study used analytical retrospective method, with investigation agreement between the two first sputum (one of the specimenwas the morning sputum) with the third sputum using kappa coefficient and McNem...

Global Medical & Health Communication (GMHC)

The interaction between the mannose receptor, which is encoded by the macrophage mannose receptor... more The interaction between the mannose receptor, which is encoded by the macrophage mannose receptor (MMR) gene, and the most virulent antigen (the mannose-capped lipoarabinomannan) cell wall of virulent strains of Mycobacterium tuberculosis trigger an innate and adaptive immune response. It also produces pro and anti-inflammatory cytokines, which play a role in the pathogenesis of tuberculosis (TB) infection. Therefore, MMR gene polymorphism is a risk factor and is associated with the prognosis for active pulmonary TB. This study aimed to determine the correlation between MMR gene polymorphism and active or latent pulmonary tuberculosis. In this phase, MMR gene polymorphism was analyzed using a case-control design consisting of 74 control group subjects (patients with latent TB) and 74 case groups (patients with active pulmonary TB). The subject’s MMR gene DNA sequencing examination. The study was conducted at the Teaching Hospital, Faculty of Medicine, Universitas Padjadjaran Bandun...

Infection and Drug Resistance

Coronavirus disease 2019 (COVID-19) is a new pandemic affecting the respiratory system and caused... more Coronavirus disease 2019 (COVID-19) is a new pandemic affecting the respiratory system and caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition to the increased use of antibiotics, the length of stay of hospitalized patients affects the risk of bacterial infections among the COVID-19 patients. However, this pandemic has interrupted antibiotic surveillance activity and led to an information gap about the prevalence and characteristics of bacterial infection. This study aims to describe the antibiotic resistance in COVID-19 patients with culture-proven bacterial infection using a laboratory-based surveillance approach. Patients and Methods: A retrospective study with a cross-sectional design was conducted on adult patients that confirmed positive for COVID-19 according to the International Classification of Diseases 10th Revision (ICD-10). From March 2020 to October 2021, data were obtained from the hospital information system and merged with the culture and antibiotic susceptibility test from laboratory information system at Hasan Sadikin General Hospital. The outcome is the prevalence percentage of resistance to selected antibiotics in patients with COVID-19. The resistance percentage is considered high when equal to or more than 20%. Results: There was 2786 adult patient confirmed for COVID-19 according to the ICD-10, and 26.3% (n = 733) of them submitted clinical specimen for culture. The prevalence of bacterial infection among COVID-19 patients was 16.4%, predominating Gramnegative bacteria (GNB). The respiratory specimen dominated the positive growth culture. The GNB were predominantly discovered among the respiratory and non-respiratory specimens. High range resistance to ampicillin-sulbactam (24-100%), ceftriaxone (22-81%), cefotaxime (22-73%) and ciprofloxacin (20-86%) are observed among the GNB. Conclusion: There is high resistance to fluoroquinolone and cephalosporins in identified isolate, commonly used as the first-line empirical treatment for respiratory and non-respiratory infection in Indonesia. The continuous antibiotic surveillance is mandatory and crucial to prevent the long-term effects of the COVID-19 pandemic, particularly bacterial infection.

Majalah Kedokteran Bandung, 2021

Thalassemia is an inherited genetic disease caused by the disruption in globin chain synthesis. I... more Thalassemia is an inherited genetic disease caused by the disruption in globin chain synthesis. Inefective erythropoiesis in thalassemia leads to moderate to severe anemia, requiring routine blood transfusions. To evaluate erythropoiesis, immature reticulocyte fractions (IRF) can be measured using the hematology analyzer, avoiding the need of invasive bone marrow examination. The purpose of this study was to analyze the differences in the IRF percentage between moderate and severe anemia in transfusion-dependent thalassemia (TDT) patients. This was a cross-sectional comparative observational analytic study conducted at the Pediatric Thalassemia Clinic of Dr. Hasan Sadikin General Hospital Bandung in August-September 2020. The IRF was examined using the fluorescence flowcytometry method with whole blood sample added by EDTA anticoagulant. The statistical analysis used in this study was unpaired t-test and Mann Whitney's test. Subjects were 93 TDT pediatric patients, consisting of 48 boys (52%) and 45 girls (48%). The majority (72%) of the patients had been diagnosed with thalassemia for more than 5 years with moderate anemia (40%) and severe anemia (60%). The median IRF percentage in moderate anemia was 6.4% (range 0-22.7) while the range in severe anemia was 11.7% (range 4.1-35.8), suggesting a statistically significant difference (p<0.001) in the IRF percentage between moderate and severe anemia in transfusion-dependent thalassemia patients. To conclude, the more severe the anemia experienced by a thalassemia patient is, the higher the percentage of IRF.

The project assessed the difference in point prevalence of antimicrobial resistance (AMR) when us... more The project assessed the difference in point prevalence of antimicrobial resistance (AMR) when using routine laboratory-based surveillance and active population-based surveillance (survey). The data are restricted to the prevalence of AMR in isolates of Escherichia coli and Klebsiella pneumoniae cultured from urine samples from all patients presenting with signs and/or symptoms of a urinary tract infection in either the outpatient or the inpatient setting. Laboratory-based surveillance used Vitek methodology to assess resistance, while the population-based surveillance used the conventional culture methods using MacConkey agar plates incubated for 18 hours. Resistance was defined by applying CLSI breakpoints (2012).. The data from both sources covered exactly the same period (1 April 2014 - 31 May 2015) in which there were no reports of outbreaks in the hospital setting. Data structureThe file is in a .csv format out...

JCM Accepts, published online ahead of print on 4 August 2010 2 Summary 1 Five Mycobacterium tube... more JCM Accepts, published online ahead of print on 4 August 2010 2 Summary 1 Five Mycobacterium tuberculosis isolates were obtained from three body sites from a Dutch 2 patient. The isolates displayed a single genotype by 24-locus MIRU-VNTR typing (except of a 3 single locus not amplified from one isolate), but were differentiated by small variations in IS6110 4 fingerprints, spoligotypes, 6 hypervariable MIRU-VNTR loci and/or DiversiLab profiles, 5 revealing patterns of micro-evolution in a clonal infection. 6 Case Report 7 A 56 year-old woman born in the Netherlands, a low TB-incidence country, presented with 8 diffuse nodular abnormalities on her chest X-ray. She had no history of TB. The tuberculin skin 9 test was 0 mm. Bronchoscopy was performed and sarcoidosis was diagnosed. Treatment of 10 sarcoidosis was started and given for a year and a half. Five years later she returned with an 11 inflammatory finger. Under suspicion of relapse of her sarcoidosis, treatment with prednisone 12

Background: Fluorescence microscopy (FM) has not been implemented widely in TB endemic settings a... more Background: Fluorescence microscopy (FM) has not been implemented widely in TB endemic settings and little evaluation has been done in HIV-infected patients. We evaluated diagnostic performance, time and costs of FM with light-emitting diodes technology (LED-FM), compared with conventional (Zieh-Neelsen) microscopy in a hospital in Indonesia which acts as referral centre for HIV-infected patients. Method: We included pulmonary tuberculosis suspects from the outpatient and HIV clinic. Direct and concentrated sputum smears were examined using LED-FM and ZN microscopy by two technicians who were blinded for the HIV-status and the result of the comparative test. Mean reading time per slide was recorded and cost of each slide was calculated. Mycobacteria culture served as the reference standard. Results: Among 404 tuberculosis suspects from the outpatient clinic and 256 from the HIV clinic, mycobacteria culture was positive in 12.6 % and 27%, respectively. The optimal sensitivity of LED-...

Majalah Kedokteran Bandung, 2019

Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in reproductive-age wom... more Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in reproductive-age women, which is characterized by hyperandrogenism, anovulation, and polycystic ovaries. Some evidence suggested that leptin also causes PCOS due to its role in female reproductive system. The physiological function of leptin controls the balance of energy and suppresses the center of appetite. Patients with PCOS maybe underweight, normoweight, overweight, and obese, based on their body mass index (BMI), but obesity is a common clinical situation in PCOS. Obesity occurs when the level of leptin increases but cannot decrease appetite, resulting in leptin resistance. This study aimed to discover the connection between BMI and the level of leptin in patients with PCOS. This was a cross-sectional observational analytic performed in Dr. Hasan Sadikin General Hospital Bandung between April 25 and July 10, 2018. Subjects included 46 PCOS patients who were diagnosed based on Rotterdam criteria by gy...

Journal of Physics: Conference Series, 2020

The incidence of tuberculosis in Indonesia increases every year, resulted in increased cases of t... more The incidence of tuberculosis in Indonesia increases every year, resulted in increased cases of tuberculous lymphadenitis. The histopathological picture is often similar to other types of lymphadenitis. This study was an in-depth exploration of the anatomical pathology of Langhans datia cells and necrosis in tuberculous lymphadenitis. This research used secondary data from medical record of the lymph node paraffin blocks in the Anatomical Pathology Department of Sadikin Hasan General Hospital Bandung from January to December 2017. There are 322 medical records of tuberculosis lymphadenitis patients, consisting of 179 types of tuberculous lymphadenitis, 144 types of non-lymphadenitis specific, and nine types of granulomatous lymphadenitis. In all kinds of lymphadenitis, necrosis shows a general picture, whereas datia Langhans are more dominant in the tuberculous and granulomatous lymphadenitis type. The description of necrosing in lymphadenitis is tuberculous type 176(98.3%), non-spe...

Majalah Kedokteran Bandung, 2020

Tuberculous (TB) meningitis is the most severe type of extrapulmonary TB with high morbidity and ... more Tuberculous (TB) meningitis is the most severe type of extrapulmonary TB with high morbidity and mortality rates. Many factors affect patient outcome, including the intracranial inflammation process. In acute inflammation, recruitment of a high number of polymorphonuclear (PMN) cells can cause edema which may eventually increase the intracranial pressure. This increase in intracranial pressure may lead to functional decline, disability, and even death. This study aimed to explore the association between the PMN percentage in cerebrospinal fluid (CSF) and TB meningitis patient outcome as measured by the Glasgow Outcome Scale at Dr. Hasan Sadikin General Hospital Bandung, which is a tertiary hospital in Indonesia. This was a retrospective cohort study using patient medical record data from 2017. All TB meningitis patients over 18 years old were included. Patients with missing PMN results in medical record were excluded, which led to a total 88 subjects participating in this study. Var...

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY, 2018

Prostate cancer is one of the most common malignancy of males found worldwide including in Asia, ... more Prostate cancer is one of the most common malignancy of males found worldwide including in Asia, and is the second most commoncause of male death in Western countries. Specific cause of prostate cancer is not yet elucidated, but there are several risk factors as well.The diagnosis of prostate cancer is confirmed by digital rectal examination (DRE), prostate-specific antigen (PSA), and a biopsy withtrans-rectal ultrasonography (TRUS). However, the sensitivity of DRE and PSA examinations are low and not good enough to detectprostate cancer. Currently there is a new test called Engrailed-2 (EN2) examination with enzyme-linked immunosorbent assay (ELISA)micro method. The test is simple and uninvasive one. This study is aimed to know the validity of urinary EN2 protein level measurementto detect prostate cancer by analysing. This study was conducted at Dr. Hasan Sadikin Hospital Bandung between November 2012 untilMarch 2013. This study was a diagnostic test with cross sectional design. T...

Malaysian Journal of Microbiology, 2017

Aims: Urinary tract infection (UTI) is a common infection that can occur in inpatient and outpati... more Aims: Urinary tract infection (UTI) is a common infection that can occur in inpatient and outpatient setting. The current guideline is using urine culture as standard for UTI diagnosis. Recently, urine flow cytometry method with dedicated bacterial channel is intended as useful tools for UTI diagnostic. In our study, we determine the cutoff value of white blood cell (WBC) and bacterial count of fluorescence flow cytometry as an estimation of the successful of urine culture in symptomatic UTI population. Methodology and results: The study was held from January until April 2015 at secondary and tertiary hospital in Bandung, Indonesia. A number of 215 UTI patients were enrolled. Urine specimens were analyzed using automated flow cytometry urine analyzer (UX2000, Sysmex Corp., Japan) and results were compared with urine culture, as gold standard. The cutoff value of WBC and bacterial count were determined using ROC to generate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). The combination of bacterial count ≥ 277.4 bacteria/uL, WBC count ≥ 300.7 cells/uL, in symptomatic UTI patients, achieved sensitivity of 82.7%, specificity of 87.5%, PPV of 96.6% and NPV of 53.8%. This combination can be use as estimation of positive culture as high as 96.6%. Conclusion, significance and impact of study: In microbiology aspect, quantitative bacterial count and WBC count of urine flow cytometry can be useful to estimate the success of culture-proven UTI, which can help in clinician decisionmaking and better patient management.

BMJ Open, 2018

ObjectiveTo assess the test characteristics of a urine dipstick test in predicting a positive uri... more ObjectiveTo assess the test characteristics of a urine dipstick test in predicting a positive urine culture in an outpatient setting in Indonesia.DesignCross-sectional study.SettingTwo outpatient clinics in Medan, Indonesia.Participants616 consecutively enrolled participants suspected of having a urinary tract infection.Outcome measuresThe primary outcome is the estimates of accuracy (sensitivity, specificity, predictive values) where urine culture is the reference test. The secondary outcome is the post-test probability of a positive urine culture.ResultsThe optimal test characteristics were obtained when index test positivity was defined as any leucocyte esterase reaction and/or a nitrite reaction and reference test positivity was defined as a urine culture with a growth of at least 103colony-forming units/mL (sensitivity: 88.2% (95% CI 81.6 to 93.1), negative predictive value: 93.0% (95% CI 88.9 to 95.9)). The post-test probability of a positive urine culture after a negative uri...

Diagnostic Microbiology and Infectious Disease, 2018

Objective. We evaluated microbiological diagnosis of tuberculous (TB) meningitis in a referral ho... more Objective. We evaluated microbiological diagnosis of tuberculous (TB) meningitis in a referral hospital in Indonesia. Methods. Over a ten-year period, we examined cerebrospinal fluid (CSF) samples of 1180 adult meningitis suspects. Sensitivity of different methods was compared, and results were stratified for HIV status, disease severity, and CSF volume. Results. TB meningitis was bacteriologically confirmed in 501 patients. Using clinical diagnosis as reference standard (n=713), sensitivity of different methods was 12.2% (86/703) for microscopy, 42% (73/174) for Xpert MTB/RIF, 46.0% (163/354) for solid culture, 48.8% (332/680) for liquid culture, and 64.0% (212/331) for in-house PCR. Head to head comparisons in 654 patients showed a higher yield of in-house PCR (32.3%) compared to culture (15.6%, p<0.01). Microscopic observation of drug susceptibility (MODS) culture more rapidly became positive compared to other culture methods. Yield of culture was lower in HIV-infected (39/105) than in HIV-negative patients (N=316/585; p<0.01). Molecular and culture methods gave higher yields in patients with more severe disease (p<0.01). CSF volume of ≥6 ml increased the yield of culture (42.8% versus 12.1% for CSF <6 ml, p<0.01) and ZNmicroscopy (18.3% versus 1.9% for CSF <6 ml, p<0.01). CSF centrifugation had no clear effect on sensitivity of Xpert MTB/RIF. Conclusions. ZN-microscopy lacks sensitivity for diagnosis of TB meningitis. For molecular assays, inhouse IS6110-PCR is more sensitive than Xpert MTB/RIF. MODS culture has a clear advantage in terms of speed. Large CSF volumes are necessary for all tests. The effect of CSF processing for Xpert MTB/RIF needs further study.

M = male; F = female; pos = positive; neg = negative; n/a = not available.*&lt... more M = male; F = female; pos = positive; neg = negative; n/a = not available.*cell numbers are in cells/mL; protein in mg/dL; glucose ratio = CSF glucose∶blood glucose.**TB-toxo = tuberculosis and toxoplasmosis, TB-crypto = tuberculosis and cryptococcosis.φtoxoplasmosis, based on toxoplasma PCR;εTB meningitis, based on either culture or real time PCR;νcryptococcosis based on either direct staing, culture, or antigen testing.</p

Journal of the Indonesian Medical Association, Jul 12, 2011

There are various laboratory tests used to diagnose dengue viral infections. However, not all dia... more There are various laboratory tests used to diagnose dengue viral infections. However, not all diagnostic laboratories have those capabilities. Routine hematology tests such as platelet and leukocyte counts are still used by clinicians as supportive tests to diagnose dengue infections because they are available in most primary health centers or small laboratories. This study evaluated the diagnostic use of platelet and leukocyte counts, which are easier and cheaper than dengue NS1 antigen and IgM antibodies, and the appropriate laboratory tests in regard to day(s) of fever. This study used acute specimens from all dengue and non-dengue cases that had been confirmed by a series of dengue diagnostic tests. All the specimens were collected from several studies conducted by US-NAMRU-2, Dr. Hasan Sadikin Hospital/Medical Faculty, Padjadjaran University, and National Institute of Health Research and Development (NIHRD) from 2000 to 2009. This study revealed either thrombocytopenia or leucopenia is an accurate parameter to determine dengue infections starting from day 4 of illness. NS1 test was helpful for diagnosis especially in first and second day of fever whereas IgM antibody is recommended to be used starting from day 5 of fever. J Indon Med Assoc. 2011;61:326-32. Keywords: dengue, thrombocytopenia, leucopenia, NS1 antigen, dengue IgM antibody

Acta medica Indonesiana, 2009

To investigate the hematologic manifestation and the relationship of the abnormalities with morta... more To investigate the hematologic manifestation and the relationship of the abnormalities with mortality. We examined hematologic data from 10 Avian influenza patients in Hasan Sadikin Hospital Bandung between November 2005 and March 2007. The mortality rate was 70%. Anemia was found in 30% (3 of 10 patients). Leukopenia was found in 60% (6 of 10 patients. Lymphopenia and neutropenia were found in 50% (4 of 8 patients) and 62.5% (5 of 8 patients). Sixty percent (6 of 10 patients) had thrombocytopenia. Anemia was not correlated with mortality (OR=0.08). Leukopenia, neutropenia and lymphopenia were correlated with mortality (OR=5, OR=8 and OR=12, respectively). Thrombocytopenia was also correlated with mortality (OR=5). Leukopenia, neutropenia, lymphopenia and thrombocytopenia were common findings among avian influenza patients in Hasan Sadikin Hospital. Decreased white blood cells and platelets were correlated with mortality.

International Journal of TROPICAL DISEASE & Health, 2014

Laboratory for Health Research and Community Service, Faculty of Medicine, Universitas Padjadjara... more Laboratory for Health Research and Community Service, Faculty of Medicine, Universitas Padjadjaran / Hasan Sadikin Hospital, Bandung 40161, Indonesia. Department of Neurology, Faculty of Medicine, Universitas Padjadjaran / Hasan Sadikin Hospital, Bandung 40161, Indonesia. LSHTM TB Centre and Department of Clinical Research, London School of Hygiene and Tropical Medicine, London WC1E 7HT, England. Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran / Hasan Sadikin Hospital, Bandung 40161, Indonesia. Department of Medicine, Radboud University Medical Centre, Nijmegen 6500 HB, The Netherlands.

Global Medical & Health Communication, 2018

A granuloma is one of host cellular immune response form to intracellular and persistent pathogen... more A granuloma is one of host cellular immune response form to intracellular and persistent pathogens, and result in the aggregation of several activated immune cells. Intracellular pathogens manipulate host immune responses to avoid immune reactions. M. tuberculosis is the intracellular and persister pathogen, which can stimulate granuloma formation. The formation this granulomas still have different opinions, whether it is the host's way to isolate M. tuberculosis , or how these pathogens are to escape immune responses. Early secretory antigenic target (ESAT)-6 is a typical secretory protein produced by the locus of the gene region of difference (RD)-1 M. tuberculosis . ESAT-6 plays a role in the immunopathogenesis of tuberculosis. This study aims to compare ESAT-6 antigen expression from M. tuberculosis between granulomas with necrosis and granulomas without necrosis. This study was an analytic observation study with a cross-sectional design. Forty-six lymph node paraffin blocks...

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY

Global Medical & Health Communication (GMHC)

Infection and Drug Resistance

Majalah Kedokteran Bandung, 2021

Majalah Kedokteran Bandung, 2019

Journal of Physics: Conference Series, 2020

Majalah Kedokteran Bandung, 2020

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY, 2018

Malaysian Journal of Microbiology, 2017

BMJ Open, 2018

Diagnostic Microbiology and Infectious Disease, 2018

Journal of the Indonesian Medical Association, Jul 12, 2011

Acta medica Indonesiana, 2009

International Journal of TROPICAL DISEASE & Health, 2014

Global Medical & Health Communication, 2018