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"Latar Belakang:Tuberkulosis resisten obat (TB-RO) merupakan ancaman bagi seluruh dunia termasuk Indonesia, karena memerlukan waktu lama dan biaya yang besar dalam mengobati penyakit tersebut meskipun telah ditangani dengan baik. Data penelitian di luar negeri menunjukkan bahwa terdapat kekambuhan TB-RO, tapi datanya sangat terbatas. Di Indonesia belum ada data tentang angka kekambuhan TB-RO.Tujuan: Mengevaluasi pasien TB resisten obat (TB-RO) pasca pengobatan yang datang kontrol pada bulan ke 6, 12, 18, dan 24 di RSUP Persabatan Jakarta.Metode: Penelitian menggunakan desain penelitian potong lintang terhadap pasien TB-RO yang telah dinyatakan sembuh dan pengobatan lengkap yang datang kontrol di poli MDR RSUP Persahatan Jakarta mulai bulan April 2017 sampai Desember 2017. Dilakukan anamnesis, pemeriksaan fisis, pemeriksaan foto toraks dan biakan sputum. Mencatat data pengobatan dan hasil-hasil pemeriksaan terkait data yang diperlukan dalam dalam rekam medis pasien.Hasil: Didapatkan 60 subjek penelitian dengan rerata usia 42,3 + 12,5 tahun, berjenis kelamin laki-laki 31 (51,7%) dan perempuan 29 (48,3%), dengan rerata IMT 21,75+ 4,34. Dari hasil foto toraks didapatkan gambaran dominan lesi luas dan hasil kultur sputum semua pasien yang diteliti tidak ditemukan pertumbuhan Mycobacterium tuberculosis.Kesimpulan: Tidak ditemukan kekambuhan pada pasien TB resisten obat yang yang telah dinyatakan sembuh dan pengobatan lengkap yang datang kontrol pasca pengobatan di RSUP Persahabatan Jakarta.

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Objective: This study aimed to evaluate DR-TB patients which was biannually performed for two-years (e.g. at the 6th, 12th, 18th, and 24th mos) after treatment completion.

Methods: This cross-sectional study involved DR-TB patients completing their treatment at Persahabatan General Hospital Jakarta, Indonesia, between April and December 2017. The post-treatment evaluation during the 6th, 12th, 18th, and 24th mos included clinical, chest x-ray (CXR) and sputum culture examination.

Results: Sixty patients were observed in this study, 31 (51.7%) were males and 29 (48.3%) were females. The mean age was 42.3+12.5 yo and the mean body mass index was 21.75+4.34. Fourty nine (81.7%) patients showed extensive lesions per CXR and none of the patient showed Mycobacterium tuberculosis growth per sputum culture.

Conclusion: There was no recurrence of DR-TB from patients completing their treatment at Persahabatan General Hospital Jakarta, Indonesia during two-years post-treatment evaluation."

"Coronavirus Disease 2019 (COVID-19) merupakan pandemi dengan morbiditas dan mortalitas yang tinggi. COVID-19 dapat mencetuskan badai sitokin, suatu reaksi hiperinflamasi yang menyebabkan acute respiratory distress syndrome dan kegagalan multiorgan. Zink dipertimbangkan sebagai terapi supportif pada COVID-19 karena memiliki potensi sebagai immunomodulator, antivirus serta antiinflamasi. Penelitian ini dilakukan untuk mengetahui hubungan kadar zink pada saat masuk perawatan dengan manifestasi derajat penyakit COVID-19 serta luaran buruk COVID-19. Derajat penyakitditentukan berdasarkan manifestasi klinis sesuai kriteria WHO saat masuk perawatan sedangkan luaran buruk bila subjek pernah dirawat di ruang intensif, menggunakan ventilator selama perawatan atau meninggal. Pada penelitian ini didapatkan total 87 kasus yang terbagi menjadi kelompok derajat tidak berat sebanyak 74 kasus dan kelompok derajat berat sebanyak 13 kasus. Berdasarkan luaran didapatkan kelompok luaran buruk sebanyak 22 kasus dan luaran baik 65 kasus. Rerata kadar zink lebih rendah padakelompok derajat berat dan kelompok luaran buruk. Ditemukan hubungan yang bermakna secara statistik pada rerata kadar zink dengan luaran COVID-19 sedangkan dengan derajat penyakit cenderung bermakna secara statistik. Kadar zink terhadap luaran burukCOVID-19 memiliki luas Area Under the Curve (AUC) 81,6%, dengan nilai titik potong kadar zink 56,05 ug/dL yang memiliki sensitivitas 77,3% dan spesifitas 73,8%. Pasien dengan kadar zink ≤56,05 ug/dL berisiko 8,79 kali lebih tinggi mengalami luaran buruk COVID-19 dibandingkan pasien dengan kadar zink >56,05 ug/dL setelah diadjust dengan usia, komorbid penyakit jantung, dan diabetes mellitus. Diperlukan penelitian lanjutan dengan jumlah sampel yang cukup untuk memperkuat hasil penelitian ini.

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Coronavirus Disease 2019 (COVID-19) is a pandemic with high morbidity and mortality. COVID-19 can trigger a cytokine storm, a hyperinflammatory reaction that causes acute respiratory distress syndrome and multiorgan failure. Zinc was considered as a supportive therapy for COVID-19 because it has potential as an immunomodulator, antiviral and anti-inflammatory. This study aims to analyze the association between zinc level at the time of admission on disease severity and poor outcome of COVID-19. Disease severity was determined based on clinical manifestations according to WHO criteria on admission, while poor outcome was defined as a history of intensive care unit stay, intubated during treatment or deceased. There were 87 subjects consist of 74 cases of non-severe group and 13 cases of severe group. As for the outcome, there were 22 cases of poor outcome and 65 cases of good outcome. The mean of zinc level was lower in severe and poor

outcome group. There was a significant association between zinc level and poor outcome, while disease severity tended to be statistically significant. An Area Under the Curve (AUC) of zinc level and COVID-19 poor outcome was 81,6%, with a cut point of 56,05

ug/dL, sensitivity and specificity was 77.3% and 73.8%. Patients whose zinc level ≤56.05ug/dL had a 8.79-fold higher risk of poor outcome compared to patients whose zinc level > 56.05 ug/dL after age, heart disease, and diabetes mellitus adjustment. Further studies a sufficient number of sample are needed to support this study."

"Latar belakang: Pengendalian infeksi dan penelusuran kontak erat di tempat risiko tinggi seperti asrama merupakan hal penting untuk mengontrol penularan Tuberkulosis TB . Penelitian ini menggunakan metode potong lintang untuk penelusuran household contact dengan pasien TB di satu asrama. Metode: Lima puluh tujuh mahasiswi perempuan berusia 20-22 tahun yang tinggal di satu asrama dengan pasien TB paru BTA positif selama lebih dari 3 bulan. Subjek dianamnesis mengenai gejala dan riwayat TB, riwayat BCG lalu diperiksakan foto toraks, sputum Xpert M.TB Rif dan uji Interferon gamma release assay IGRA . Penelitian ini juga mengukur Air change per hour ACH untuk menentukan baik atau tidaknya ventilasi udara. Hasil penelitian: Terdapat 57 subjek dengan riwayat imunisasi BCG terdapat pada 84 subjek. Satu subjek 2 terbukti TB ekstra paru efusi pleura dari foto toraks. Empat subjek 7 tanpa gejala dan riwayat TB mendapatkan hasil uji IGRA positif. Xpert M.TB Rif semua subjek adalah negatif. Nilai ACH adalah 8x/jam jauh dibawah nilai standar World health organization WHO yaitu 12x/jam. Kesimpulan: Penelusuran kontak erat di asrama mampu mendeteksi TB laten sebanyak 7 dan TB TB ekstra paru sebanyak 2 .

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Background Infection control and contact tracing in the high risk place such as dormitory is important for controlling Tuberculosis TB transmission. This is a cross sectional study of contact investigation of a pulmonary TB patient in a college dormitory. Methods Fifty seven female students ages 20 22 years old who live in the same dormitory with the TB patient acid fast bacilli positive for more than three months. Subjects were interviewed regarding past and present TB history, Bacillus Calmette Guerin BCG vaccination followed by chest x ray, Xpert M.TB RIF sputum and Interferon gamma release assay IGRA test. This study also measured an Air change per hour ACH to determine a good ventilation. Results There were 57 subjects in this study with BCG was vaccinated in 84 subjects. Two 1 57 proven for extra pulmonary TB pleuritis TB from chest x ray. Four subjects 7 without past and present TB history exhibited positive IGRA result. All subjects showed negative Xpert M.TB RIF. The ACH level is 8x hour below the World health organization WHO standard 12x hour. Conclusion Contact investigation of the dormitory have able to indicate 7 subjects for LTBI and 2 for TB pleuritis TB ."

"ABSTRAKPendahuluan: Infeksi paru merupakan penyebab morbiditas dan mortalitas terbesar di Intensive Care Unit ICU. Pasien ICU umumnya dalam kondisi critically ill dan riwayat penggunaan antibiotic sebelumnya sehingga memiliki risiko resistensi terhadap antibiotik yang berpengaruh terhadap luaran pasien.Sistem skoring digunakan di ICU untuk menilai derajat keparahan penyakit dan luaran pasien. Penelitian ini menilai eta kuman pasien infeksi paru dan hubungannya dengan derajat keparahan penyakit yang dinilai dengan skor APACHE II. Metode: Penelitian ini menggunakan metode potong lintang yang dilaksanakan pada bulan Agustus-September 2017 di ICU RSUP Persahabatan. Total subjek terdiri atas 59 subjek dengan cara pengambilan sampel consecutive sampling. Semua pasien didiagnosis infeksi paru oleh dokter spesialis dan dikonfirmasi melalui foto toraks kemudian dinilai derajat keparahan penyakit dengan skor APACHE II dan dilakukan biakan dan resistensi mikroorganisme. Hasil: Kuman yang banyak ditemukan merupakan gram negative (37,2%) dengan risiko mortalitas tertinggi 75% jenis Acinetobacter pada skor (APACHE II 30-34). Rerata skor APACHE II 15,78+ 6,04 dengancut off point skor APACHE II 16,5 dan skor APACHE II >16 memiliki mortalitas terbesar (64%) (p=0,032). Diagnosis infeksi paru dengan mortalitas terbesar didapatkan pada CAP (56%). Kesimpulan: Acinetobacter baumanii merupakan kuman terbanyak yang menyebabkan kematian pada pasien infeksi paru dan skor APACHE II merupakan prediktor yang baik dalam menilai derajat keparahan penyakit dan luaran pasien.

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ABSTRACT<>br>Introduction: Lung infection are the most common cause of high mortality and morbidity in Intensive Care Unit (ICU). Patients in ICU mostly critically ill with history of antibiotic use and risk of drug resistant that will influence the outcome of the patients. Scoring system used in ICU to measure severity of the disease and the outcome of the patients. This study asseses the microbiological pattern of patients with lung infection and severity of the disease using APACHE II Score. Methods: This study used cross sectional methods that heldbetween August 2017-September 2017in Persahabatan Hospital Intensive Care Unit. Total subjects consisted of 59 patients with lung infection base on consecutive sampling. All of the patients diagnosed with lung infection from specialist and confirmed with radiological findings, measured the APACHE II Score and performed sputum culture and resistance. Results: The most common isolation found in lung infection patients was gram negative (37,2%) with mortality risk of Acinetobacter baumanii75% (APACHE II Score 30-34). Mean APACHE II Score was 15,78+ 6,04 with cut off point APACHE II Score 16,5 and APACHE II Score > 16 has the highest mortality (64%) (p=0,032). Diagnose of lung infection with the highest mortality found in patients with CAP (56%). Conclusions: Acinetobacter baumanii are the most common cause of mortality in lung infection patients. The APACHE II Score has good predictor in measure severity of the diseases and the outcome of the patients."

"Latar belakang dan tujuan : Semua jenis paduan pengobatan TB RO bukan tanpa efek samping sehingga direkomendasikan implementasi farmakovigilans dan pengawasan serta tata laksana keamanan obat secara aktif terhadap efek samping. Penelitian ini dilakukan untuk mengetahui angka kejadian efek samping yang paling sering yakni efek gastrointestinal (GI) dan efek samping yang dapat berakibat fatal yakni efek kardiovaskular yang terjadi pada pasien TB RO yang mendapatkan paduan jangka pendek (STR) di poliklinik Rumah Sakit Umum Pusat (RSUP) Persahabatan.Metode : Penelitian ini merupakan studi observasional dengan desain kohort prospektif yang dilakukan bulan Agustus 2019-Januari 2021 dengan metode consecutive sampling pada pasien TB RO yang mendapatkan STR di poliklinik paru RSUP Persahabatan. Pasien dalam pengobatan STR akan diikuti selama masa pengobatan 9-11 bulan untuk evaluasi subjektif dan objektifnya sampai terjadinya luaran pengobatan.Hasil : Subjek penelitian yang memenuhi kriteria inklusi sebanyak 68 orang dengan karakteristik dasar yaitu median usia 37 tahun, laki-laki (67,6%), status gizi kurang (52,9%) dan komorbid diabetes (17,6%). Luaran putus berobat cukup tinggi (26,5%) Hampir seluruh subjek mengalami efek gastrointestinal (95,6%) seluruhnya muncul pada fase intensif dan dominan derajat ringan. Efek samping GI akan semakin menurun setelah fase intensif. Hanya sebagian subjek yang mengalami efek kardiovaskular (41,2%) dan trennya semakin lama kejadiannya semakin meningkat. Terdapat satu subjek dengan luaran meninggal dunia pada efek samping kardio derajat berat. Pada efek samping GI tidak ada kecenderungan faktor yang menyebabkan, sementara durasi pengobatan yang mencapai 9 bulan yang mempengaruhi efek samping kardiovaskular (p=0,001).Kesimpulan : Pada penelitian ini efek samping GI terjadi pada hampir seluruh pasien namun trennya akan menurun setelah fase intensif. Sementara efek samping kardiovaskular dapat berakibat fatal dan trennya akan meningkat seiring berjalannya pengobatan. Durasi pengobatan yang lebih panjang dapat secara bermakna menyebabkan timbulnya efek samping kardiovaskular.

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Background : All types of drug-resistant (DR) tuberculosis (TB) treatment are not without effects, thus implementation of pharmacovigilance and active drug safety monitoring and management against adverse events are highly recommended. This study was conducted to determine the incidence gastrointestinal (GI) adverse events and cardiovascular adverse events that occur in DR TB outpatients who received short-term regimen (STR) at the Persahabatan General Hospital.

Methods : This study was an observational study with a prospective cohort design that was conducted between August 2019 and January 2021 with consecutive sampling of DR TB outpatients who received STR at Persahabatan General Hospital. Patients on STR treatment will be followed for a 9 to 11 months treatment period for subjective and objective evaluation of treatment outcomes

Result : There were 68 subjects eligible for this study with general characteristics median age of 37 years, male (67.6%), malnutrition status (52.9%), and having diabetes comorbid (17.6%). The default case was quite high in this study (25.6%). Almost all subjects experienced GI adverse events (95.6%) which appeared in the intensive phase with predominant mild degree of GI symptoms. The GI adverse events was decrease after the intensive phase. Only some of the subjects experienced cardiovascular effects (41.2%) and the trend increasing over time. There was one death as treatment outcome in a sever cardiovascular adverse events. In GI adverse events, there was no trend of causal factors, while the treatment duration of up to 9 months correlated with cardiovascular side effects (p = 0.001).

Results : In this study, it was found that GI adverse events were common but its occurrence decreased over time after intensive phase. The cardiovascular adverse events could be fatal and tis occurrence showed to be increase as treatment progresses."

"[ABSTRAKLatar Belakang: Pengobatan TB MDR memiliki hasil yang buruk dengan keberhasilan hanya 48% di dunia. Salah satu indikator keberhasilan pengobatan adalah konversi dini. Identifikasi faktor yang mempengaruhi konversi merupakan hal yang penting. Metode: Penelitian ini dilakukan secara kohort retrospektif dengan menggunakan rekam medik pasien TB MDR di RSUP Persahabatan Jakarta yang berobat selama bulan Agustus 2009 - Desember 2013.Hasil: Dari 436 pasien terdapat 248 pasien laki-laki (56.6%). Sebanyak 256 pasien (58,7%) mengalami konversi biakan dalam dua bulan pengobatan. Nilai tengah waktu konversi adalah 44 hari. Faktor yang memperlambat lama konversi adalah jenis kelamin perempuan (aHR 0,808; [95%CI 0,659-0,991]), IMT pasien kurang (0,792; [0,637-0,983]), ditemukan gambaran kavitas pada foto toraks (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), riwayat pengobatan OAT sebelumnya dengan lini kedua (0,597;[0,415-0,858]), jumlah resisten obat > 2 OAT (0,614;[0,429-0,879]), kelompok pasien Pre XDR dan TB XDR (0,486;[0,305-0,776]), dan jumlah limfosit rendah (0,681;[0,524-0,885]).Kesimpulan: Jenis kelamin perempuan, IMT kurang, gambaran kavitas pada foto toraks, tingginya bacterial load, riwayat pengobatan OAT sebelumnya dengan lini kedua, jumlah resisten obat > 2 OAT, kelompok pasien Pre XDR dan TB XDR serta limpositopenia berhubungan dengan lamanya konversi pada pasien TB MDR.

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ABSTRACTIntroduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.;Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients., Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.]"

"Latar Belakang: Infeksi tuberkulosis laten ITBL merupakan ancaman bagi para petugas kesehatan terutama yang sehari-harinya kontak dengan penderita Tuberkulosis TB. Infeksi TB telah dapat dideteksi sejak lebih dari 100 tahun yang lalu dengan uji tuberkulin tuberculin skin test, TST. Sebagai alternatif terhadap uji tuberkulin saat ini telah tersedia pemeriksaan in vitro berupa pemeriksaan interferon gamma release assay IGRA. Tujuan: Penelitian ini bertujuan untuk membandingkan TST dan IGRA dalam mendiagnosis TB laten pada petugas kesehatan di Rumah Sakit Umum Pusat Persahabatan Jakarta. Metode: Penelitian dilakukan dengan disain potong lintang. Hasil: Prevalens ITBL pada petugas kesehatan di RSUP Persahabatan adalah 66. Sejumlah 67 subjek dilakukan pemeriksaan IGRA dan TST dengan hasil 27 40 subjek dengan hasil pemeriksaan IGRA positif, 42 63 subjek dengan hasil pemeriksaan TST positif dan 44 66 subjek dengan hasil pemeriksaan IGRA dan atau TST positif, dengan kesesuaian sedang ?=0,459. Tidak ada hubungan antara usia dan parut BCG dengan hasil pemeriksaan TST maupun IGRA. Kesimpulan: proporsi ITBL berdasarkan TST lebih besar dibadingkan IGRA dengan kesesuaian sedang

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Introduction: Latent tuberculosis infection LTBI is a threat to the healthcare workers, especially who close contact with tuberculosis TB patients. Tuberculosis infection has been detected since more than 100 years ago with the tuberculin test TST. As an alternative to the tuberculin test now is currently available in vitro examination of interferon gamma release assay IGRA.

Objective: to compare TST and IGRA in the diagnosis of LTBI among healthcare workers in Persahabatan HospitalJakarta.

Method: The study is conducted with a cross sectional design.

Results: The prevalence of latent TB among health care workers in Persahabatan general Hospital was 66 .Of the 67 subjects examined, there were 27 40 subjects with IGRA positive, 42 63 subjects with TST positive and 44 66 subjects with IGRA and or TST positive, with moderate agreement 0,459 . There was no correlation between age and BCG scar with the results of the TST or IGRA.

Conclusion: High proportion of LTBI more positive with TST compare to IGRA, with moderate agreement"

"ABSTRAKLatar belakang dan tujuan: Gangguan elektrolit merupakan salah satu efek samping yang spaling sering ditemukan pada pasien tuberkulosis multidrug-resistant TB MDR yang mendapatkan obat anti tuberkulosis OAT mengandung obat suntik lini kedua. Tujuan penelitian ini adalah untuk mengetahui proporsi gangguan elektrolit pada pasien yang mendapatkan OAT suntik lini kedua serta faktor-faktor yang berhubungan dengan gangguan tersebut.Metode: Penelitian ini merupakan penelitian potong lintang, retrospektif, berbasis rekam medis pada pasien TB MDR di RSUP Persahabatan selama pengobatan fase intensif dari Juli 2015-Juni 2016 dan mendapatkan OAT dengan regimen kanamisin ataukapreomisin, pirazinamid, etambutol, levofloksacin,sikloserin dan etionamid. Hasil: Sebanyak 121 pasien ikut pada penelitian ini. Gangguan elektrolit didapatkan pada 114 pasien 94,2. Rerata waktu terjadinya gangguan elektrolit setelah pengobatan adalah 2,0 bulan. Hipokalemia merupakan jenis gangguan elektrolit yang paling banyak ditemukan 57,9. Hipokalemia berhubungan dengan jenis kelamin dan jenis OAT suntik yang digunakan. Insidens hipokalemia lebih banyak ditemukan pada pasien perempuan 72 dibandingkan dengan laki-laki 47,9 dengan OR 2,8 KI 95 : 1,3-6,1 dan pada pasien yang mendapatkan kapreomisin 68,5 dibandingkan yang mendapatkan kanamisin 49,2 dengan OR 2,2 KI 95 : 1,1-4,7 . Hasil ini bermakna secara statistik. Faktor usia, status gizi, diabetes melitus, gangguan fungsi ginjal dan infeksi HIV tidak berhubungan dengan hipokalemia pada penelitian ini. Kesimpulan: Hipokalemia merupakan gangguan elektrolit yang paling sering terjadi pada pasien TB MDR yang mendapatkan OAT MDR mengandung obat suntik lini kedua. Jenis kelamin perempuan dan kapreomisin merupakan faktor risiko terjadinya hipokalemia namun diperlukan penelitian lebih lanjut untuk mengidentifikasi faktor risiko lainnya yang dapat mempengaruhi kejadian hipokalemia pada pasin TB MDR.

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ABSTRACT<>br>Background: Electrolyte imbalance is one of the adverse reactions mostly found in patients with multidrugs resistant tuberculosis MDR TB who treated by injectable agent. The aim of this study is to know the proportion of electrolyte imbalance in MDR TB patients receiving second line injection of antituberculosis drugs and the contributing factors. Methods: This study is a cross sectional, retrospective, medical record based study among MDR TB patients in Persahabatan Hospital during intensive phase from July 2015 to June 2016 who received intensive phase treatment consist of kanamycin or capreomycin, pirazinamid, ethambutol, levofloxacin, cycloserine and ethionamide.Results One hundred and twenty one patients were included in this study. The proportion of electrolyte imbalance was found in 114 patients 94.2. The mean duration of therapy at the time incidence of electrolyte imbalance was 2.0 months. Hypokalemia 57,9 were the most electrolyte imbalance frequently found. Hypokalemia was associated with gender and type of antituberculosis injection drugs. The incidence of hypokalemia significantly high among female 72.0 patients than male 47.9 with OR 2.8 CI 95 1.3 6.1 and also in patients receiving capreomysin 68.5 than kanamycin 49.2 with OR 2.2 CI 95 1.1 4.7. Age, nutrition status, diabetes melitus, renal disfunction and HIV have no association with hypokalemiain our study. Conclusion: Hypokalemia was the most frequent electrolyte imbalance found among patient receiving MDR antituberculosis regimen. Female gender and capreomycin injection using were associated with the incidence of hypokalemia. However, more clinical researchs are needed to identify other risk factors contributing of hypokalemia state in MDR TB patients."

"Latar belakang dan tujuan: Petugas kesehatan adalah populasi yang rentan terhadap infeksi Tuberkulosis (TB). Salah satu penilaian dalam kontrol infeksi TB adalah melakukan evaluasi pada petugas kesehatan, terutama yang kontak dengan pasien TB. Interferon gamma release assays (IGRA) adalah suatu alat untuk pemeriksaan infeksi TB laten. Tujuan dari penelitian ini adalah untuk menetapkan angka proporsi infeksi TB laten pada petugas kesehatan di Rumah Sakit Rujukan Respirasi Nasional Persahabatan.Metode: Penelitian ini adalah penelitian potong lintang yang dilakukan pada 95 subjek dengan cara concecutive sampling. Subjek akan dilakukan anamnesis, foto toraks dan Xpert MTB/RIF untuk menyingkirkan diagnosis TB aktif dan TB MDR.Hasil: Hasil IGRA positif didapatkan pada 37 subjek (38,9%) dan negatif pada 58 subjek (61,1%). Tidak ditemukan kasus TB aktif atau TB MDR. Didapatkan hubungan yang signifikan antara hasil pemeriksaan IGRA dengan lokasi kerja (P = 0,004).Kesimpulan: Proporsi infeksi TB laten pada petugas kesehatan di Rumah Sakit Rujukan Respirasi Nasional Persahabatan dengan pemeriksaan IGRA adalah 38,9%.

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Background: Healthcare workers (HCW) are group of population that are prone to tuberculosis (TB) infection. One of the tuberculosis infection control measure is the evaluation of HCW, especially those who have contact with TB patient. Interferon gamma release assays (IGRA) is a method for diagnosing latent TB infection (LTBI). The aim of this trial is to determine the proportion of LTBI in HCW in Persahabatan Hospital, a high burden TB hospital in Indonesia.Methods: This cross sectional study was conducted among 95 HCW in Persahabatan Hospital who have contact with TB patient. Sample was recruited by consecutive sampling. The participants were subject to history taking, chest X ray and Xpert MTB/RIF to exclude the diagnosis of active TB infection or multi drug resistant (MDR) TB.Results: Positive IGRA was found in 37 HCW (38,9%) and negative IGRA was found in 58 HCW (61,1%). There were no active TB and MDR TB in HCW. There was a significant association between IGRA result and the work place (P = 0,004).Conclusion: Proportion of LTBI in HCW in Persahabatan Hospital by using IGRA was 38,9%."