Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang. Meningkatnya kasus HIV-AIDS human immunodeficiency virus-acquired immunodeficiency syndrome secara global memicu kewaspadaan akan peningkatan infeksi oportunistik, salah satunya infeksi Pneumocystis jirovecii yang mengakibatkan pneumonia PjP. Infeksi PjP merupakan kasus yang sulit ditangani terkait rendahnya sensitivitas uji diagnostik diiringi dengan peningkatan kasus resistensi terhadap antibiotik. Di Indonesia belum terdapat data demografis, epidemiologi molekuler maupun data resistensi mengenai kasus infeksi PjP. Mengantisipasi masalah tersebut, dalam penelitian ini dikembangkan uji diagnostik PjP pada ODHA Orang Dengan HIV-AIDS terduga pneumonia melalui pendekatan molekular terhadap gen MSG Major Surface Glycoprotein disertai dengan karakterisasi gen DHPS dihidropteroat sintase dan gen mtLSU mitochondrial large subunit yang berkorelasi dengan genotipe resisten dan virulensi P. jirovecii. Tujuan penelitian. Memperoleh suatu uji deteksi infeksi PjP, data genotipe resistensi dan virulensi PjP melalui pendekatan secara molekuler yang dapat dimanfaatkan sebagai dasar data demografi dan epidemiologi molekuler PjP di Indonesia. Metode penelitian. Pengembangan uji diagnosis molekuler PjP terhadap gen MSG dilakukan dengan metode real- time PCR yang diujikan terhadap 100 sampel sputum. Pola genotipe resistensi dilakukan melalui amplifikasi gen DHPS dilanjutkan dengan restriction fragment length polymorphism RFLP . Virulensi daerah hot spot gen mtLSU dianalisis dengan metode PCR dan sekuensing DNA. Hasil. Secara demografi, diketahui prevalensi PjP pada ODHA terduga pneumonia di Jakarta mencapai 20,0, laki-laki 75, rentang usia terbanyak 31-40 tahun 35, dominan 80 pada kisaran sel limfosit T CD4 200-349 sel/L. Sebanyak 12 pasien menunjukkan gen DHPS positif, lima pasien 41,66 merupakan genotipe wild type WT dan 7 pasien lainnya 58,32 merupakan genotipe resisten, terdiri dari 16,67 genotipe-3 dan 41,66 genotipe campuran WT dan genotipe 1. Analisis virulensi berdasarkan gen mtLSU diperoleh 30 strain PjP positif yang didominasi oleh variasi-3. Status imun pasien lebih berkaitan dengan genotipe resistensi dibandingkan dengan jenis varian. Kesimpulan. Uji real-time PCR yang dikembangkan mampu memberikan nilai diagnostik yang lebih baik dibandingkan pewarnaan Giemsa. Terdapat 3 genotipe gen resistensi WT, genotipe 1 dan 3 dan 7 varian P. jirovecii yang bersirkulasi di Jakarta. Genotipe resistensi lebih berkaitan terhadap kondisi klinis pasien dibandingkan dengan jenis varian.

---

Background. The global rise of HIV-AIDS cases increase the alertness against oportunistic infections, one of them is Pneumocystic jirovecii pneumonia PjP. PjP infection is a one of a tough infection to be cured due to low sensitivity of its diagnostic method following the escalation of PjP resistance against antibiotics. There is no demografic, molecular epidemiology nor antibiotics resistance data were available related to PjP infection in Indonesia. Thus, this study was conducted to develop a molecular test to diagnose PjP infection in HIV-AIDS suspected pneumonia patients based on MSG Major Surface Glycoprotein gene detection, followed by characterization of DHPS dihydropteroat syinthetase and mtLSU mitochondrial large subunit genes represent genoype resistance and P. jirovecii virulence. Research objective. To obtain a molecular test in diagnosing PjP infection and information of P. jirovecii genotype resistance and virulence based on molecular characteristics, which can be used further as demographic and molecular epidemiology basis data of PjP in Indonesia. Research methods. Molecular diagnostic test aimed for MSG gene of P. jirovecii detection was done through real-time PCR against 100 sputum samples. Genotype resistance and P. jirovecii polymorphism patterns was done through DHPS and mtLSU genes amplification followed by restriction fragment length polymorphism RFLP and DNA sequencing analysis. Virulence of the hot spot area are of the mtLSU gene was analyzed by PCR method and DNA sequencing. Results. The prevalence of PjP infection in HIV-AIDS suspected pneumonia patients in Jakarta was 20.0, male 75 within 31-40 y.o 35, dominant 80 from patients with CD4 T-lymphocytes of 200-349 cells/L. Molecular real-time PCR methods give five times sensitivity higher than Giemsa stain. Twelve patients showed positive DHPS gene, five patients 41.67 were wild type WT genotypes and 7 other patients 58.32 were resistant genotypes, with 16.66 was genotype-3 and other 41.66 was mixed genotypes WT and genotype 1. Virulence analysis based on mtLSU gene show 30 positive strains which dominated by variant-3. The patients immune status is more related to the resistance genotype compared to the variant type. Conclusion. The developed real-time PCR method is proven to able to give better diagnostic value than Giemsa stain. There are 3 genotypes of resistance genes WT, genotypes 1 and 3 and 7 variants of P. jirovecii circulating in Jakarta. Resistance genotypes are more related to the clinical condition of patients compared to variant types. "

"Latar Belakang: Pneumocystis jirovecii (P. jirovecii) adalah patogen jamur oportunistik yang dapat terdeteksi di saluran napas bawah. Kolonisasi P. jirovecii dapat berkembang menjadi infeksi yang disebut sebagai pneumocystis pneumonia (PCP). Infeksi PCP umumnya terdeteksi di pasien HIV. Pasien tanpa HIV juga dapat mengalami infeksi PCP terutama pada pasien keganasan. Penelitian ini bertujuan untuk mendeteksi kolonisasi P. Jirovecii pada sampel bilasan bronkus dengan pemeriksaan polymerase chain reaction (PCR). Metode: Penelitian ini merupakan penelitian potong lintang dengan deskriptif analitik yang pada pasien terduga kanker paru di RSUP Persahabatan. Subjek penelitian adalah pasien terduga kanker paru yang akan menjalani bronkoskopi sesuai kriteria inklusi. Sampel bilasan bronkus dikirim ke Laboratorium Departemen Parasitologi FKUI untuk ekstraksi DNA dan laboratorium BRIN untuk pemeriksaan PCR konvensional. Penelitian ini menggunakan gen MtLSU dan mTSSU. Hasil: Pada penelitian ini terdapat 72 subjek penelitian. Subjek penelitian terdiri atas 51 laki-laki (70,8%). Rerata usia subjek penelitian adalah 56,6 (9,95) tahun. Subjek penelitian sebagian besar memiliki IMT normal (18,5-22,9 kg/m2). Subjek penelitian sebagian besar adalah perokok baik perokok aktif atau bekas perokok yaitu sebanyak 50 orang (69,4%). Sebanyak 23 orang (31,9%) diantaranya memiliki IB berat (IB >600 batang per tahun). Subjek penelitian yang memiliki riwayat pengobatan TB, baik terkonfirmasi bakteriologis maupun diagnosis klinis, sebanyak 23 orang (31,9%). Sebanyak 26 orang (36,1%) memiliki 1 komorbid sedangkan 10 orang (13,9%) memiliki lebih dari 1 komorbid. Berdasarkan pemeriksaan histopatologi atau sitologi bilasan bronkus, dari 72 subjek penelitian terdapat 50 orang (69,4%) terdiagnosis kanker paru, 15 orang (20,9%) bukan kanker paru, dan 7 orang (9,7%) belum diketahui diagnosisnya. Dari 72 sampel yang diperiksa, tidak ada yang menunjukan hasil PCR positif (0%). Kesimpulan: Proporsi P. Jirovecii yang terdeteksi melalui pemeriksaan PCR pada sampel bilasan bronkus pasien terduga kanker paru sebesar 0%. Pemeriksaan PCR untuk mendeteksi P. Jirovecii tidak disarankan untuk pasien kanker yang baru terdiagnosis dan belum dilakukan pengobatan.

---

Background: Pneumocystis jirovecii (P. jirovecii) is an opportunistic fungal pathogen that can be detected in the human lower respiratory tract without signs or symptoms of acute pneumonia or colonization. P. jirovecii colonization can develop into an infection known as pneumocystis pneumonia (PCP). PCP infection is commonly detected in HIV patients. However, patients without HIV can also experience PCP infection, especially in malignant patients. This study aims to detect P. Jirovecii colonization in bronchial lavage samples using polymerase chain reaction (PCR). Methods: This research is a cross-sectional study with descriptive analytics on patients suspected of lung cancer at Persahabatan Hospital. The research subjects were patients with suspected lung cancer who were selected according to the inclusion criteria. Data on clinical, radiological, laboratory and histopathological characteristics were taken from medical records. The patient will have a bronchial lavage sample taken during bronchoscopy for diagnostic purposes. The samples will be examined at the Parasitology Department Laboratory Universitas Indonesia for DNA extraction and the BRIN laboratory for PCR examination. Results: In this study there were 72 research subjects. The research subjects consisted of 51 men (70.8%). The mean age of the research subjects was 56.6 (9.95) years. Most of the research subjects had normal BMI (18.5-22.9 kg/m2). Most of the research subjects were smokers, either active smokers or former smokers, namely 50 people (69.4%). A total of 23 people (31.9%) had severe IB (IB >600 cigarettes per year). There were 23 research subjects who had a history of TB treatment, whether confirmed bacteriologically or clinically diagnosed, as many as 23 people (31.9%). A total of 26 people (36.1%) had 1 comorbid while 10 people (13.9%) had more than 1 comorbid. Based on histopathological or cytological examination of bronchial lavage, of the 72 research subjects, 50 people (69.4%) were diagnosed with lung cancer, 15 people (20.9%) had no lung cancer, and 7 people (9.7%) had no known diagnosis. Of the 72 samples examined, none showed positive PCR results (0%). Conclusion: The proportion of P. Jirovecii detected by conventional PCR examination in bronchial lavage samples from patients suspected of lung cancer was 0%. PCR examination to detect P. Jirovecii is not recommended for cancer patients who have just been diagnosed and have not received treatment."

"Identifikasi Pneumocystis jirovecii pada pasien dengan koinfeksi tuberkulosis (TB) paru masih menjadi tantangan karena gambaran klinis maupun radiologis keduanya yang mirip dan P. jirovecii tidak dapat dikultur. Identifikasi P. jirovecii di Indonesia masih berdasarkan pemeriksaan mikroskopik yang seringkali kurang sensitif. Oleh karena itu, dikembangkan teknik real time PCR yang lebih sensitif dan spesifik dengan gen target mitochondrial large subunit (mtLSU) dan mitochondrial small subunit (mtSSU) rRNA. Penelitian ini bertujuan untuk mengoptimasi deteksi gen mitochondrial large dan small subunit rRNA dalam mengidentifikasi P. jirovecii pada pasien terkait TB paru. Penelitian ini menggunakan 26 sampel sputum pasien terkait TB paru. Optimasi teknik real time PCR berupa optimasi konsentrasi primer, probe, suhu penempelan, volume cetakan DNA dan uji reaksi silang dilakukan untuk mendapatkan kondisi yang optimal dalam amplifikasi gen mtLSU dan mtSSU rRNA. Hasil penelitian menunjukkan hasil optimasi deteksi kedua gen tersebut dapat mengidentifikasi P. jirovecii 1 dari 26 sampel (3,84%). Uji real time PCR yang telah di optimasi dalam penelitian ini dapat mendeteksi P. jirovecii pada sampel klinis pasien terkait TB paru.

---

Identification of Pneumocystis jirovecii in patients with co-infected pulmonary tuberculosis (TB) is still a challenge because the clinical and radiological features of both are similar and P. jirovecii cannot be cultured. Identification of P. jirovecii in Indonesia is still based on microscopic examination which is often less sensitive. Therefore, a more sensitive and specific real time PCR technique was developed with mitochondrial large subunit (mtLSU) and mitochondrial small subunit (mtSSU) rRNA target genes. This study aimed to optimize the detection of mitochondrial large and small subunit rRNA genes to identify P. jirovecii in pulmonary TB-related patients. A total of 26 sputum samples of pulmonary TB-related patients were collected. Real time PCR technique optimization including the optimization of primer and probe concentrations, annealing temperature, DNA template volume and cross-reaction testing, was carried out to obtain optimal conditions for mtLSU and mtSSU rRNA gene amplification.  The results showed that the optimization of detection for both genes could identify P. jirovecii in 1 out of 26 samples (3.84%). The optimized real time PCR test in this study can detect P. jirovecii in clinical samples of pulmonary TB-related patients."

"ABSTRAKPneumocystis jirovecii adalah penyebab infeksi oportunistik di saluran pernapasanbawah pada individu dengan sistem kekebalan tubuh yang lemah, terutama padapasien HIV. Pemeriksaan infeksi P.jirovecii di Indonesia masih berdasarkanpemeriksaan klinis dan mikroskopis, yang memerlukan waktu yang cukup lama,kurang sensitif dan spesifik. Karena alasan tersebut dalam penelitian inidikembangkan uji molekuler real time PCR (rPCR) yang lebih sensitif danspesifik. Uji rPCR telah berhasil dioptimasi dengan kemampuan deteksi minimumDNA 6,55 copy/μl dan tidak bereaksi silang dengan mikroorganisme yang diujipada penelitian ini. Dibandingkan dengan uji mikroskopis, uji rPCR memberikanhasil positif 20% lebih tinggi daripada uji mikroskopis. Uji rPCR dapatmendeteksi P.jirovecii pada sampel klinis sputum dan sputum induksi dari pasienHIV dengan pneumonia dengan jumlah sel CD4+ > 200 maupun ≤ 200. Olehkarena itu, uji rPCR yang telah dioptimasi dalam studi ini dapat mendeteksiP.jirovecii pada sampel klinis sputum dan sputum induksi dari pasien HIV denganpneumonia dengan jumlah sel CD4+ > 200 maupun ≤ 200

---

ABSTRACTPneumocystis jirovecii is the cause of opportunistic infections in the lowerrespiratory tract in individuals with weakened immune systems, especially inpatients with HIV. Examination P.jirovecii infection in Indonesia was based onclinical and microscopic examination, requiring considerable time, less sensitiveand specific. Because of these reasons in this study developed a molecular testreal time PCR (rPCR) is more sensitive and specific. rPCR test has beensuccessfully optimized with minimum DNA detection capabilities 6.55 copy/μLand do not cross-react with the microorganisms were tested in this study.Compared with microscopic test, test rPCR gives positive result 20% higher thanthe microscopic test. rPCR test can detect P.jirovecii on clinical samples ofsputum and sputum induction of HIV patients with pneumonia with CD4+ cellcounts > 200 or ≤ 200. Therefore, rPCR test which has been optimized in thisstudy can detect P.jirovecii in clinical sputum samples and sputum induction ofHIV patients with pneumonia with CD4+ cell counts > 200 or ≤ 200"

"ABSTRAKNama : Eka Titiyani AmortiyanaProgram Studi: Ilmu Kesehatan MasyarakatJudul : Perokok Aktif Terhadap Kejadian Infeksi Ulang Pneumonia PadaBalita Di Wilayah Puskesmas Kecamatan Pesanggrahan JakartaSelatanPneumonia masih menjadi masalah kesehatan masyarakat di Indonesia terutama padabalita. Balita dengan imunitas yang lemah sangat rentan terhadap penyakit, sehinggamenyebabkan bakteri pneumonia cepat berkembang dan berakibat menjadi infeksiulang pneumonia. Merokok dan lingkungan fisik rumah yang tidak sehatmemungkinkan berdampak pada kesehatan balita, seperti jenis atap rumah tidakgenteng asbes , dinding kayu dan lantai tanah beralas karpet. Penelitian inibertujuan untuk mengetahui pengaruh perokok aktif terhadap infeksi ulangpneumonia pada balita di wilayah Puskesmas Kecamatan Pesanggrahan JakartaSelatan. Metode penelitian cross sectional dengan sampel penelitian balita umur 2bulan ndash; 59 bulan yang beriwayat pernah menderita pneumonia dalam satu tahunterakhir dan tercatat pada rekam medik Puskesmas Kecamatan Pesanggrahan,menggunakan kuesioner KPLDH tahun 2016. Hasil penelitian menunjukkan bahwa,perokok aktif berisiko 1,449 kali lebih tinggi 0,807 ndash; 2,601 , setelah di adjust olehjenis kelamin, bahan bakar masak dan variabel interaksi. Promosi kesehatan sangatdiperlukan untuk mempromosikan tentang pneumonia, lingkungan bersih dan tanpaasap rokok di rumah-rumah dan wilayah Puskesmas Kecamatan Pesanggrahan.Kata kunci:Infeksi, Pneumonia, Balita, Lingkungan

---

ABSTRACTName Eka Titiyani AmortiyanaStudy Program Ilmu Kesehatan MasyarakatTitle Influence of Smokers Active In The Home Environment On TheIncidence Of Recurrent Pneumonia Infections In Under Five InPuskesmas Kecamatan Pesanggrahan Jakarta SelatanPneumonia is still a public health problem in Indonesia, especially in children underfive.Children under five who have a weak immune causing susceptibility to disease amajor causes of recurrent of pneumonia. The existence of smokers and the physicalenvironment of unhealthy homes may have an impact on the health of children underfive, such as the type of roof of the house is not tile asbestos , wooden walls andground floor with carpet. This study aims to determine the effect of smokers in thehome environment against recurrent of pneumonia in under five in the area ofPuskesmas Kecamatan Pesanggrahan South Jakarta. Methods of cross sectional studywith a 2 month until 59 months age study sample of pneumonia and recorded in themedical record of Puskesmas Kecamatan Pesanggrahan, using the questionnaire inenvironmental factors KPLDH in 2016. The results showed that, active smokers had1.449 times higher risk 0.807 2.601 , after adjusted by sex, cooking fuel andinteraction variables. Health promotion is needed to convey for promotingpneumonia, cleaning environment to be free from smoke free environment fromsmoker in house environment at Puskesmas Kecamatan Pesanggrahan JakartaSelatan.Keywords Infection, Pneumonia, Under Five, Environment."

"Latar belakang: Kanker paru menjadi penyebab kematian terbanyak di dunia.Prevalensi kanker paru terus meningkat seiring dengan peningkatan angka harapanhidup dan menyebarkan faktor risiko kanker. Pasien kanker paru yang sebagianbesar berupa KPKBSK rentan untuk mengalami infeksi oportunistik yang terjadipada saat sistem imun tubuh rendah. Salah satu jamur oportunistik yang dapatmenginfeksi adalah Pneumosistis jirovecii yang menyebabkan PneumosistisPneumonia (PCP). Deteksi dini pada populasi rentan penting dilakukan untukmencegah keparahan penyakit. Saat ini, insidensi dan prevalensi PCP pada pasienkanker paru di Indonesia belum cukup jelas akibat rendahnya pemantauan danpelaporan kasus.Tujuan: Penelitian ini dilakukan untuk mengetahui prevalensi dan gambaran klinisPCP pada pasien KPKBSK yang belum di kemoterapi di RSUP Persahabatan,Jakarta.Metode: Penelitian merupakan penelitian potong lintang dengan subjek merupakanpasien KPKBSK yang belum di kemoterapi di RSUP Persahabatan. Pasiendilakukan induksi sputum menggunakan NaCl 3% yang kemudian dilakukanprosedur nested-PCR untuk deteksi PCP melalui primer pada gen mtLSU rRNA.Data pasien didapatkan dari rekam medis pasien.Hasil: Total subjek yang mengikuti penelitian sebesar 56 pasien 1 pasien tanpa datahistopatologi. Didapatkan prevalensi PCP pada penelitian sebesar 17,9% (10pasien). Profil klinis pasien KPKBSK di RSUP Persahabatan yang belumdikemoterapi terbanyak pada usia 18-65 tahun sebesar 75,0% (42 pasien), jeniskelamin laki-laki sebesar 62,5% (35 pasien), tampilan status 1 sebesar 39,2% (22pasien), perokok aktif sebesar 62,5% (35 pasien), Indeks Brinkman kategori ringansebesar 44,6% (25 pasien), histopatologi terbanyak berupa adenokarsinoma sebesar78,2% (43 pasien), dan staging terbanyak pada stadium lanjut sebesar 76,8% (43pasien). Tidak terdapat hubungan yang signifikan (p > 0,05) antara karakteristiksosiodemografis, staging, dan kebiasaan merokok dengan koinfeksi PCP padapasien KPKBSK yang belum di kemoterapi.Simpulan: Prevalensi PCP pada pasien KPKBSK yang belum di kemoterapisebesar 17,9%. Karakteristik pasien terbanyak adalah usia 18-65 tahun, laki-laki,tampilan status 1, perokok aktif, Indeks Brinkman kategori ringan, histopatologiadenokarsinoma, serta staging stadium lanjut. Tidak ada hubungan antarakarakteristik tersebut dengan kejadian PCP pada pasien pada penelitian.

---

Background: Lung cancer has become the leading cause of mortality in the world.

Lung cancer prevalence and incidence keep growing for the past years attributed by

increased in life expectance and distribution of lung cancer risk factors. Most lung

cancer patients, including NSCLC type, are prone to get opportunistic infections

when the body immune system weakens. Pneumocystis jirovecii is one of fungal

aetiologies to cause this infection in immunocompromised hosts, called

Pneumocystic Pneumonia (PCP). Early detection is crucial in susceptible patients

to prevent disease progression. PCP incidence and prevalence in NSCLC patients

Indonesia is still unknown which could be caused by inadequate case surveillance

and reports

Objectives: This study aimed to determine PCP prevalence in NSCLC patients

without chemotherapy and its clinical profile in Persahabatan Hospital, Jakarta.

Methods: This cross-sectional study included NSCLC patients who had not

undergone chemotherapy treatments (naïve). Sputum induction with 3% NaCl from

patients were tested for PCP with nested-PCR targeting mtLSU rRNA gene.

Patients’ characteristics data were obtained from medical records.

Results: Data from 56 patients with NSCLC were collected including 1 patient

without histology type identified. From this research, about 17,9% patients were

tested positive for PCP. Naïve NSCLC patients in Persahabatan Hospital

characteristics 75,0% (42 patients) were aged between 18 and 65 years, 62,5% (35

patients) were males, 39,2% (22 patients) had score 1 on performance status, 62,5%

(35 patients) were active smokers, 44,6% (25 patients) had mild Brinkman Index,

most common histopathology type were adenocarcinoma attributed for 78,2% cases

(43 patients), and most patients were on advanced stage for about 76,8% (43

patients). There were no significant association (p > 0,05) between

sociodemography, staging, and smoking behaviour and PCP co-infection in naïve

NSCLC patients.

Conclusion: PCP prevalence in naïve NSCLC patients were 17,9%. Most patients

were aged between 18 to 65 years old, male, score 1 on performance status, active

smokers, mild Brinkman Index, adenocarcinoma type, and were on advanced stage.

No significant association between those factors and PCP in patients."

"Latar Belakang: Gen p21 adalah mediator aktivitas supresor tumor p53 dimana gen p21 C98A memiliki peran dalam perbaikan DNA dan apoptosis. Penelitian ini bertujuan untuk mengetahui gambaran polimorfisme p21 C98A pada penderita karsinoma sel skuamosa kepala leher dan sampel individu sehat di Indonesia. Metode: Penelitian ini dianalisis dengan metode PCR-RFLP menggunakan 50 sampel penderita KSSKL dan 50 sampel individu sehat. Hasil: Genotip CA adalah variasi yang paling dominan pada penderita KSSKL dan individu sehat. Kesimpulan: Tidak ditemukan hubungan secara bermakna antara polimorfisme genetik p21 C98A dengan penderita KSSKL.

---

Background: p21 gene is a mediator of p53 tumor suppressor activity where p21 C98A genes have a role in DNA repair and apoptosis. This study aims to describe polymorphism p21 C98A of head and neck squamous cell carcinoma and healthy control in Indonesia.

Methods: This study was analyzed by PCR RFLP method using 50 samples of HNSCC patients and 50 samples of healthy control.

Results: Genotype CA is the most common variations occurred in HNSCC patients and healthy control.

Conclusion: There is no significant difference distribution between genetic polymorphisms p21 C98A with HNSCC patient samples."

"This study was designed to optimalize the use of opididymal or ejaculate sperm and plasma for in vitro fertilization,that sperm agglutination was found at preparation. The rate of sperm agglutination was calculated the head-to-head sperm agglutination that were incubated in KR-HEPES medium in 38.5 oC with 5% CO2 at 1,3,5 and 7 hours culture in vitro....."

"Pneumonia komunitas adalah penyebab kematian terbesar di Indonesia. Sistem skor PSI dan CURB-65 telah digunakan dalam menentukan keparahan penyakit dan keputusan tempat rawat berdasarkan risiko kematian dalam 30 hari. Tujuan penelitian ini adalah membandingkan sistem skor modifikasi PSI dan modifikasi CURB-65 pada pasien CAP sebagai prediktor mortalitas 30 hari di RS Persahabatan. Penelitian ini adalah kohort prospektif yang dilakukan pada pasien CAP yang dirawat di RS Persahabatan sejak bulan Oktober 2012-Maret 2013. Gejala klinis nilai laboratorium, foto toraks, penyakit penyerta skor PSI dan CURB-65 serta hasil akhir berupa kematian dicatat untuk dianalisis. Selama 30 hari subjek penelitian diikuti. Sebanyak 167 pasien CAP mengikuti penelitian ini didapatkan angka kematian sebesar 18,6%. Sensitivitas PSI sama dengan CURB-65 yaitu sebesar 77,4%. Spesifisitas PSI sedikit lebih tinggi dari pada CURB-65 (58,1% vs 53,7% p < 0,001). Risiko relatif mortalitas berdasarkan PSI pada kelompok risiko tinggi sebesar 3,64 kali dibandingkan kelompok risiko rendah, sedangkan risiko relatif mortalitas berdasarkan CURB-65 pada kelompok risiko tinggi sebesar 3,15 kali dibandingkan kelompok risiko rendah. Skor CURB-65 dapat dipertimbangkan sebagai prediktor mortalitas pada pasien CAP yang di rawat inap.

---

Community Acquired Pneumonia (CAP) is the first leading disease with the highest mortality in hospitalized patient in Indonesia. Pneumonia severity assessment systems such as the pneumonia severity index (PSI) and CURB-65 were designed to predict severity of illness and site of care base on 30-d mortality. The purpose of this study is to comparing the PSI with CURB-65 in patient admitted with CAP as predictor 30 days mortality in Persahabatan Hospital, Jakarta. This is a prospective cohort study in hospitalized community acquired pneumonia patients in Persahabatan Hospital since October 2012- Maret 2013. Clinical symptoms, laboratory findings, chest x-ray , comorbidities, score of PSI and CURB-65, 30 days mortality were recorded for analysis. Thirty days mortality outcome were recorded to analysis which score system as the best to predict 30 days mortality. One hundred and sixtty seven patients CAP were studied with an overall 30-d mortality of 18,6%. Sensitivity of PSI were simillar with CURB-65 for predicting patients who died within 30 d (77,4% ; p < 0.001). Specificity of PSI was slighty higher than CURB-65 (58,1% vs 53,7% p < 0,001). Score PSI have risk mortality 3,64 times in high risk group CAP than low risk group CAP. Score CURB-65 have risk mortality 3,15 times in high risk group CAP than low risk CAP. CURB-65 modification was considerable to predict mortality in CAP patients hospitalized."