Artaria Tjempakasari, Artaria
Tropical and Infectious Disease Division - Department of Internal Medicine, Dr. Soetomo General Hospital - Faculty of Medicine Universitas Ailangga, Surabaya, Indonesia

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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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Abstract

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.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.692 KB) | DOI: 10.20473/ijtid.v5i3.238

Abstract

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.
Risk Factors for New-Onset Diabetes After Transpant in Kidney Transplant Recipients Pramudya, Dana; Aditiawardana, Aditiawardana; Tjempakasari, Artaria; Irwanadi, Chandra; Mardiana, Nunuk; 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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Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (785.728 KB) | DOI: 10.20473/bhsj.v2i1.11549

Abstract

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.
ASSOCIATION BETWEEN THE BIOFILM OF DOUBLE-LUMEN CATHETER AND BLOOD CULTURE IN HEMODIALYSIS PATIENTS WITH SUSPECTED CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTION Sangadji, Dicky Pendi Alaudin; Aditiawardana, Aditiawardana; Tjempakasari, Artaria; Alimsardjono, Lindawati
Indonesian Journal of Kidney and Hypertension Vol 3 No 1 (2020): January - April 2020
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v3i1.38

Abstract

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