Background Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. However, epidemiology of SARI in tertiary hospitals in Indonesia is unknown. This study sought to assess the burden, clinical characteristics, and etiologies of SARI and concordance of clinical diagnosis with confirmed etiology. Methods Data and samples were collected from subjects presenting with SARI as part of the acute febrile Illness requiring hospitalization study (AFIRE). In tertiary hospitals, clinical diagnosis was ascertained from chart review. Samples were analyzed to determine the “true” etiology of SARI at hospitals and Indonesia Research Partnership on Infectious Diseases (INA‐RESPOND) laboratory. Distribution and characteristics of SARI by true etiology and accuracy of clinical diagnosis were assessed. Results Four hundred and twenty of 1464 AFIRE subjects presented with SARI; etiology was identified in 242 (57.6%), including 121 (28.8%) viruses and bacteria associated with systemic infections, 70 (16.7%) respiratory bacteria and viruses other than influenza virus, and 51 (12.1%) influenza virus cases. None of these influenza patients were accurately diagnosed as having influenza during hospitalization. Conclusions Influenza was misdiagnosed among all patients presenting with SARI to Indonesian tertiary hospitals in the AFIRE study. Diagnostic approaches and empiric management should be guided by known epidemiology. Public health strategies to address the high burden of influenza should include broad implementation of SARI screening, vaccination programs, clinician education and awareness campaigns, improved diagnostic capacity, and support for effective point‐of‐care tests.
Background. Pneumonia is still a major global problem with high morbidity and mortality. The increasing number of pneumonia cases caused by bacteria, especially multidrug-resistant pathogens, increasing age of the population, patients with chronic disease (comorbid), and inappropriate antimicrobial therapy at initial administration make the treatment become less effective. These issues finally contribute to higher morbidity and mortality in cases of hospitalized pneumonia patients. Therefore, it is crucial to know the microbial pattern and select the therapy according to local antimicrobial sensitivity patterns. Method. A cross-sectional study was conducted for hospitalized pneumonia patients between January 2015 and December 2016 in Indonesia National Referral Infectious Disease Hospital. Data were collected from medical records to show patient characteristics, antimicrobial treatment data, culture examination, and bacterial sensitivity. Results. A total of 99 pneumonia patients required hospitalization and underwent sputum culture examination. The patients were mostly above 65 years old (32.3%) and male (57.6%). The most common comorbidities were pulmonary tuberculosis (21%), and the others were heart failure, chronic obstructive pulmonary disease (COPD), and HIV/AIDS. Based on the sputum culture, fungi were identified in most specimens (56%), while the bacteria identified were Klebsiella pneumoniae (14%), Acinetobacter sp. (12%), and Pseudomonas sp. (8%). Third-generation cephalosporin, such as ceftriaxone (50%), was commonly used as an antibiotic for pneumonia treatment. Conclusion. Most common bacteria isolated from sputum culture were Klebsiella pneumoniae which were more sensitive to the beta-lactam and aminoglycoside groups. The higher risk factors were age above 65 years old, being male, and having tuberculosis.
Background and Objectives: Diphtheria is a potentially fatal disease caused by toxigenic bacterial infection, particularly from Corynebacterium diphtheriae (C. diphtheriae). Isolation of C. diphtheriae is technically lacking in sensitivity, and Elek’s test to detect toxin production has several difficulties associated with its application. Duplex real-time PCR to throat swab of suspected diphtheria patients can detect both bacteria and toxin-encoding genes simultaneously, faster, with higher sensitivity and specificity. Materials and Methods: A total of 89 consecutive throat swabs from suspected diphtheria patients were collected from Sulianti Saroso Infectious Disease Hospital, Jakarta, during 2018 to 2019. Two pairs of primers and probes, targeting the rpoB gene of C. diphtheriae and the A-subunit of the diphtheria toxin gene, were used in this study. Parameters including annealing temperature, concentration of primers and probes, inhibitors, cross-reaction and detection limit were all optimized. Elek’s toxigenicity test and clinical data were analyzed for comparison. Results: The optimum annealing temperature was 55°C. The concentrations of Cd primer, Tox primer, Cd probe and Tox probe were 0.4, 0.6, 0.5 and 0.625 µM, respectively. DNA elution and template volumes were 50 µL and 5 µL. The detection limit was 2 CFU/mL. No cross-reaction with other microorganisms was observed. Of the 89 samples, duplex real-time PCR gave better results than the standard test, with 19 (21.3%) and 10 (11.2%) patients diagnosed with diphtheria, respectively. Conclusion: Duplex real-time PCR increases the rate of laboratory diagnosis of diphtheria, compared to the standard method to detect potentially toxigenic C. diphtheriae.
Latar Belakang. Penggunaan antibiotik yang tepat dapat meminimalkan terjadinya resistensi antibiotika. selain penghematan secara ekonomi. Oleh karena itu perlu adanya pemantauan dan evaluasi penggunaan antibiotik di fasilitas kesehatan dan feedback terhadap peresepan antibiotik. Tujuan penelitian ini adalah untuk mengevaluasi secara kuantitatif penggunaan antibiotik baik jenis dan jumlah antibiotik berdasarkan klasifikasi Anatomical Therapeutic Chemical (ATC) dengan pengukuran Defined Daily Dose (DDD) sebagai metode terstandar pengukuran kuantitas penggunaan antibiotik. Metode. Penelitian ini adalah observasional deskriptif, menggunakan rancangan potong lintang pada periode Januari-Juni 2019 pada RSPI Prof. Dr. Sulianti Saroso. Kriteria inklusi berupa kasus pasien dewasa bukan kasus TB yang dirawat di ruang rawat inap non ICU dan penggunaan antibiotiknya masuk ke dalam klasifikasi Anatomical Therapueutic Chemical (ATC). Berdasarkan data rekam medik terkumpul dalam lembar pengumpul data. Hasil. Sebanyak 96 status rekam medik dengan 51 kasus penyakit infeksi non bedah dan 45 kasus infeksi bedah yang menggunakan antibiotik. Difteri merupakan kasus infeksi non bedah terbanyak yaitu 10.5%. Distribusi penggunaan antibiotik golongan beta laktam kombinasi inhibitor betalaktamase sebanyak 37.28%, golongan sefalosporin 33.90%, golongan penisilin sebanyak 10,17%. Berdasarkan nilai DDD/patient day antibiotik Penicillin Prokain memiliki nilai tertiggi yaitu sebesar 97.22 dan nilai DDD/patient day terendah yaitu pada antibiotik meropenem yaitu sebesar 0.22. Kesimpulan. Pada penelitian ini, kuantitas antibiotik berdasarkan nilai DDD/100 patient day tertinggi adalah Penisilin Prokain, seiring dengan difteri sebagai kasus penyakit infeksi non bedah terbanyak pada periode Januari-Juni 2019. Mengingat penelitian dilakukan pada saat kejadian luar biasa difteri, perlu dilakukan penelitian lebih lanjut pada periode berikutnya sebagai data pembanding kuantitas antibiotik di masa depan.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.