Latar belakang. Adanya peningkatan insiden infeksi Acinetobacter baumannii yang disertai peningkatan kejadian resistensi antibiotik, peningkatan morbiditas dan mortalitas, dan terbatasnya laporan kejadian infeksi bakteri ini pada pasien anak.Tujuan. Mengetahui gambaran infeksi Acinetobacter baumannii dan pola sensitifitasnya terhadap antibiotik di Departemen Ilmu Kesehatan Anak RSUPN Dr Cipto Mangunkusumo.Metode. Merupakan penelitian deskriptif retrosfektif melalui penelusuran data hasil biakan darah di laboratorium dan rekam medis dari Januari-Desember 2012.Hasil. Didapatkan 47 isolat darah Acinetobacter baumannii dari 32 pasien. Penelusuran rekam medis mendapatkan 24 data pasien lengkap. Semuanya merupakan pasien ruang NICU, sebagian besar laki-laki (18/24) dan neonatus kurang bulan (18/24). Gambaran klinis menunjukkan rerata frekuensi denyut jantung 148 kali/menit, frekuensi napas 55 kali/menit, suhu aksila 37,10C, kadar leukosit 12767,8/mm3, kadar trombosit 58491,3/mm3, kadar procalcitonin 17,6 ng/mL, dan CRP 88,5 mg/L. Rerata lama perawatan sebelum terjadi infeksi 23,9 hari. Sebagian besar pasien menggunakan alat medis seperti ventilator, CPAP, jalur vena sentral, jalur vena perifir, dan pipa nasogastrik dengan rerata lama pemakaian masing-masing 17,9, 4,5, 20,9, 13,3, dan 17,3 hari. Semua pasien mendapat antibiotik sebelum infeksi dengan rerata lama pemberian 22,5 hari. Uji kepekaan antibiotik mendapatkan 23 isolat (23/24) merupakan MDR. Resistensi antibiotik didapatkan pada golongan aminoglikosida, carbapenem, quinolon, sefalosporin, penisilin-beta lactamase inhibitor, dan tigesiklin. Sebagian besar penderita meninggal dalam perawatan (18/24).Kesimpulan. Semua pasien yang menderita infeksi Acinetobacter baumannii dirawat di ruang NICU, sebagian besar pasien merupakan kasus MDR.

Dengue hemorrhagic fever is a disease caused by the dengue virus which is rapidly developing in countries with tropical climates such as Indonesia. This study aims to identify risk factors for dengue virus infection in children in the working area of Primary Health Care in the South of Denpasar. This research is an analytic observational study with a cross-sectional approach. Data were obtained from respondent's answers to previously validated questionnaires and then data were analyzed univariate and bivariate using statistical applications, namely SPSS. There were 75 respondents who participated in this study with an average age of 12 ± 3,094 years. The characteristics of the respondents were dominated by boys (73,3%) and domicile in urban areas (68%). Most children live in densely populated areas (66,6%) with adequate environmental sanitation, only 45,3% of the total respondents. In addition, children are at risk of being infected with the dengue virus and experiencing dengue fever in urban neighborhoods with dense population mobility (PR: 2,716; CI95%: 2,067; p: 0,011). Based on the results of this study, it can be concluded that the environment in which they live is a risk factor for dengue virus infection in children, so that it requires focused preventive efforts to prevent dengue virus infection.

No abstract

Background: Dengue infection is a mosquito induced viral infection with the highest virility level in the world. This disease is an international emergency problem and creates economic and social burdens around the world. Therefore, this study aims to determine the characteristics of dengue virus infection in pediatric patients in 2016 based on several parameters. Methods: A cross-sectional study was conducted among 96 pediatric patients with dengue virus infection who were treated at Sanglah General Hospital, Bali in 2016 period. A secondary data obtained from the collection of medical records of patients were used in this study. Data were analyzed using Microsoft Excel 2010 for Windows software.Results: Most of patients were female (54.17%), aged 5-18 years (67.71%), and with normal BMI status (42.71%). Most subject comes with bleeding signs and have positive tourniquets tests (64.58%), followed by abdominal clinical symptoms with nausea (50.00%), and neurological status with headache (41.67%). The length of stay of patients were mostly 3-5 days (73.96%) and the results of the axial temperature examination at the time of hospital admission were dominant <37ºC (65.63%). Based on laboratory examination, most subject has hemoglobin examination of 11-13 g/dl (57.29%), platelet examination results 50,000-100,000 (65.63%), hematocrit examination results <41% (44.79%), and leukocyte examination results <5,000/µl (59.38%). Most subjects are patient with Grade I DHF (56.25%%).Conclusion: The most predominant characteristics of pediatric patients with dengue virus infection was female, bleeding signs, nausea, headache, 3-5 days length of stay, atypical hematological parameters such as on hematocrit, platelet, and leucocyte examination. Latar Belakang: Penyakit infeksi dengue merupakan penyakit infeksi virus vektor nyamuk dengan tingkat penyebaran tertinggi di dunia. Penyakit ini seringkali menjadi masalah darurat antarnegara serta menimbulkan beban ekonomi dan sosial di dunia. Oleh karena itu, penelitian ini bertujuan untuk mengetahui karakteristik infeksi virus dengue pada pasien anak tahun 2016 berdasarkan beberapa parameter.Metode: Sebuah studi potong lintang dilakukan pada 96 pasien anak-anak dengan infeksi virus dengue yang dirawat di Rumah Sakit Umum Pusat Sanglah, Bali pada periode tahun 2016. Data sekunder yang diperoleh dari rekam medis pasien digunakan dalam penelitian ini. Data dianalisis menggunakan piranti lunak Microsoft Excel 2010 untuk Windows.Hasil: Sebagian besar pasien adalah perempuan (54,17%), berusia 5-18 tahun (67,71%), dan dengan status BMI normal (42,71%). Sebagian besar subjek datang dengan tanda-tanda perdarahan dan memiliki tes tourniquets positif (64,58%), diikuti oleh gejala klinis perut mual (50,00%), dan status neurologis dengan sakit kepala (41,67%). Lama tinggal pasien sebagian besar 3-5 hari (73,96%) dan hasil pemeriksaan suhu aksial saat masuk rumah sakit didominasi <37ºC (65,63%). Berdasarkan pemeriksaan laboratorium, sebagian besar subjek memiliki pemeriksaan hemoglobin 11-13 g/dl (57,29%), hasil pemeriksaan trombosit 50.000-100.000 (65,63%), hasil pemeriksaan hematokrit <41% (44,79%), dan hasil pemeriksaan leukosit <5.000 / μl (59,38%). Sebagian besar subyek adalah pasien dengan DBD kelas I (56,25%%).Kesimpulan: Karakteristik yang paling dominan dari pasien anak dengan infeksi virus dengue adalah wanita, tanda-tanda perdarahan, mual, sakit kepala, 3-5 hari tinggal, parameter hematologis khusus seperti pada hematokrit, trombosit, dan pemeriksaan leukosit.

Background: The most serious manifestation of rheumatic fever is carditis, as it can lead to chronic rheumatic heart disease. Neutrophil-to-lymphocyte ratio, platelet-to lymphocyte ratio and mean platelet volume have been accepted as novel indicators of the continuing inflammation that is correlated with the severity of valvular involvement in patients with rheumatic carditis. Objective: As a diagnostic study to investigate the correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume with the severity of carditis in children with rheumatic fever. Methods: This was a cross-sectional study at Sanglah Hospital, Bali. Data were collected retrospectively from medical records. Severity of carditis was characterised by a clinical, audible murmur during physical examination and demonstration of valvular involvement by echocardiography. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume were calculated from complete blood count. The correlation between parameters was assessed using Spearman’s correlation tests. Results: From January 2018 to December 2020, we found 45 cases admitted to Sanglah Hospital. Carditis was present in 40 (88.9%) subjects. Neutrophil-to-lymphocyte ratio had a strong positive correlation with severity of carditis (r = 0.66, p = 0.001), while platelet-to-lymphocyte ratio had a weak positive correlation with the severity of carditis (r = 0.23, p = 0.13) and mean platelet volume had a very weak negative correlation with the severity of carditis (r = −0.01, p = 0.95). Using a cut-off of 3.4, neutrophil-to-lymphocyte ratio predicted severe carditis with a sensitivity of 81.8% and specificity of 91.3%. Conclusion: There was a positive correlation between neutrophil-to-lymphocyte ratio and severity of carditis in children with rheumatic fever. Neutrophil-to-lymphocyte ratio might be used as a diagnostic tool to predict the diagnosis of carditis severity.

Background Early detection of development disorder is an effort to recognize disorders in every developmental stage. Parents’ concern can be helpful in identifying children in need of assessment and can be used as a prescreening test to reduce the number of children who require formal screening.Objective To examine diagnostic value of parents’ evaluation of developmental status (PEDS) instrument in order to determine developmental disorders in infant.Methods One hundred and seventy infants, 3-12 months old who visited Pediatric Outpatient Clinic were recruited. The parents filled in the PEDS questionnaire and the results were compared with those of Bayley Scales of Infant Development Second Edition (BSID-II) as a gold standard. The diagnostic properties of PEDS were then calculated.Results PEDS showed a sensitivity of 83.9% (95% CI 67.8 to 93.8), a specificity of 81.3% (95% CI 74.2 to 87.1), a positive predictive value of 50.0% (95% CI 40.6 to 59.4), a negative predictive value of 95.8% (95% CI 91.2 to 98.0), a likelihood ratio positive of 4.5 (95% CI 3.1 to 6.6), a likelihood ratio negative of 0.2 (95% CI 0.1 to 0.4), a pre-test probability of 18.2% and a post-test probability of 49.9% (95% CI 40.6 to 59.3).Conclusion PEDS can be used as an initial screening test to detect developmental disorders in 3-12 month infants. [Paediatr Indones. 2010;50:6-10].

Introduction: Dengue Hemorrhagic Fever (DHF) is a disease caused by the Dengue virus from the Flavivirus genus, Flaviviridae family, with four serotypes (DEN-1. DEN-2, DEN-3, and DEN-4). Primary dengue fever Grade 1 should receive serious attention by monitoring the patient's clinical manifestations so that patients get the right therapy immediately. If it is not treated quickly and adequately, the patient can experience an emergency with signs of shock and cause death.Method: The writing methodology used is a literature review. The literature source consists of relevant journals and books from the search engines PubMed, Google Scholar, and Proquest.Results: Dengue virus infection can be asymptomatic and symptomatic. Symptomatic dengue virus infection generally has a clinical spectrum grouped into 3, namely undifferentiated fever, dengue fever, and dengue hemorrhagic fever. Dengue fever (DD) patients who have no comorbidities and social indications can be treated as outpatients. Patients are given symptomatic treatment in the form of antipyretics such as paracetamol at a dose of 10-15 mg/kg/body weight, repeated 4-6 hours if fever. The management of dengue hemorrhagic fever (DHF) is symptomatic and supportive. Supportive therapy in the form of fluid replacement, which is the main point in managing DHF.Conclusion: In patients with dengue hemorrhagic fever grade I, close monitoring is needed regarding their clinical condition. This is because grade 1 dengue has the potential to be a more critical clinical condition. Early treatment will determine a better outcome.  Pendahuluan: Demam Berdarah (DB) disebabkan oleh vírus Dengue (genus Flavivirus), dengan empat serotipe utama, yaitu DEN1. DEN2, DEN3 dan DEN4. Penyakit DB utamannya Demam berdarah dengue (DBD) Grade 1 harus mendapat perhatian serius, salah satunya dengan melakukan monitoring manifestasi klinis pasien agar pasien mendapatkan terapi yang tepat dengan segera. Apabila tidak diatasi dengan tepat dan cepat pasien dapat mengalami kegawatan dengan tanda-tanda syok dan dapat menyebabkan kematian. Tinjauan Pustaka ini bertujuan untuk memberikan informasi terbaru mengenai tanda-tanda klinis DBD grade 1 agar praktisi dapat memberikan penanganan terbaik sebelum jatuh pada kondisi kritisMetode: Dalam penulisan ini digunakan metode tinjauan pustaka. Sumber bacaan berasal jurnal-jurnal dan buku-buku yang relevan dan sesuai dari PubMed dan Google Scholar.Hasil: Manifestai klinis DB dapat tidak bergejala (asimtomatik) dan bergejala simtomatik. Pasien dengan gejala dengue secara umum memiliki tiga jenis spektrum klinis yaitu demam yang tidak terdiferensiasi, demam dengue, dan demam berdarah dengue.. Pasien demam dengue (DD) yang tidak memiliki komorbiditas dan indikasi sosial dapat diperlakukan sebagai pasien rawat jalan. Pasien diberikan pengobatan simptomatik berupa anitpiretik seperti parasetamol dengan dosis 10-15 mg/kg/BB/dosis, diulang 4-6 jam bila demam. Tatalaksana demam berdarah dengue (DBD) diberikan secara simtomatis (sesuai gejala) dan suportif. Penanganan suportif dapat diberikan berupa cairan tambahan yang merupakan poin utama dalam penatatalaksanaan DBD.Kesimpulan: Pada pasien demam berdarah dengue derajat I diperlukan pemantauan yang ketat terkait kondisi klinis pasien. Hal ini dikarenakan DBD grade 1 berpontensi menjadi kondisi klinis yang lebih kritis. Penanganan dini akan menentukan outcome yang lebih baik.

Background Global morbidities due to dengue viral infection increase yearly. The pediatric mortality rate from dengue shock syndrome (DSS) remains high. Early identification of the risk of recurrent shock may serve to increase awareness and reduce mortality. The Dengue Recurrent Shock Prediction Score (DRSPS) is a tool to predict recurrent shock in children with DSS, but the optimal cut-off point in our population is still unknown. Objective To assess the validity of the DRSPS by determining the optimal cut-off point that can be used in Indonesia Methods This cross-sectional prospective study was done at Sanglah Hospital, Denpasar, Bali, from January 2019. Risk of reccurent shock were classify based on DRSPS in all DSS patient, and they were observed whether they will experienced recurrent shock or not. Results Of 56 children with DSS, 27 subjects had recurrent shock and 29 subjects did not. The optimal DRSPS cut-off point was -189.9 for predicting recurrent shock, with 87.4% area under the curve (AUC), 81.5% sensitivity and 82.8% specificity. Conclusion The optimal cut-off point of DRSPS was -189.9 and it has good validity. The results of this study are expected not only to be used as the basis for further study, but to increase physician awareness in treating DSS patients.