Pengetahuan dan Sikap Ahli Teknologi Laboratorium Medik terhadap Standar Operasional Prosedur Penanganan Sampel Sputum

<p align="justify">Medical Laboratory Technologist (MLT) is the medical team that examined the laboratory, including the sputum specimen, where the sputum specimen is infected that MLT must treat with care, to avoid a work accident or nosocomial infection. The purpose of this research was to find out whether there is a correlation between knowledge and attitude of MLT towards standard operating procedure (SOP) for handling Tuberculosis (TB) sputum samples. This research was conducted through an online questionnaire with a google form, where this questionnaire is filled in at the location of each MLT who works at health centers and hospitals in the Cibinong District area. Sampling techniques in the research of using purposive sampling. The research period was from June to August 2020. This research used primary data with a cross-sectional design involving 46 MLT respondents. A method of data analysis is a quantitative analysis and measured using multiple linear regression analysis. The results showed positive influence work knowledge and attitudes towards the application of SOP for handling TB sputum samples because it has the significant value of 0,012&lt;0,05 and Fcount 4,90&gt;Ftable 3,41 with the results of the coefficient of determination (R-square) of 0,186 (18,6%), therefore, we conclude that there is a correlation between MLT knowledge and attitudes towards the SOP of the handling TB sputum samples with a percentage of 18%.</p>

A comparison of digital chest radiography and Xpert® MTB/RIF in active case finding for tuberculosis

OBJECTIVE: To compare two community screening tests for TB: sputum examination using Xpert® MTB/RIF and chest radiography (CXR).METHOD: Men aged ≥15 years and women aged >45 years living in 96 sub-communes in Ca Mau, Viet Nam, were invited to provide a single sputum specimen that was tested using Xpert. Participants were also invited to attend a nearby location for digital radiography. Participants whose sputum was Xpert MTB-positive or whose CXR was reported as ‘consistent with TB´ were requested to provide two further sputum specimens for culture. The sensitivities of the two tests for detecting TB (defined as sputum culture-positive for Mycobacterium tuberculosis) were compared.RESULTS: There were 72 985 eligible participants, of whom 57 597 (78.9%) participated in Xpert screening, 12 752 (17.5%) had CXR and 11 235 (15.4%) had both tests. We estimated that there were 59 cases of TB, of whom 20 were Xpert MTB-positive (programmatic sensitivity 34.0%) and 47 had CXR reported as ‘consistent with TB´ (sensitivity 80.0%, P < 0.0001).CONCLUSION: In community-wide screening for TB, CXR is more sensitive than a single spontaneously expectorated sputum sample tested using Xpert, but it has a substantially lower participation rate.

Positive results for patients with COVID-19 discharged form hospital in Chongqing, China

Background: Since December 2019,more than 80 thousand patients with coronavirus disease 2019 (COVID-19) has been confirmed in China. With the increasing number of recovered patients, more attention should be paid to the follow-up of patients. Methods: In the study, 576 patients with COVID-19 discharged from hospital in Chongqing, China from January 24, 2020, to March 10, 2020 were evaluated by viral nucleic acid tests for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) to determine if they could be released from quarantine. Among the 576 patients, 61 patients (10.6%) had positive results for SARS-CoV-2. We aimed to analyze the demographics, clinical characteristics and treatment of 61 patients.Results: These positive patients were characterized by older age, chronic medical illness and mild conditions. Asymptom and normalities on chest radiograph were found in most of the positive patients with COVID-19. Also, they showed positive results by stool or sputum specimen with negative results by nasal and throat swab. The median duration of positive result for SARS-CoV-2 was varied from 3 days to 35 days after hospital discharge with no family member infection.Conclusions: Multi-site screening of SARS-CoV-2 including nasal and throat swab, stool and sputum samples could be considered to improve the diagnosis, treatment and infection control in patients with COVID-19. Our findings provide the important information and clinical evidence for the improved management of patients recovered from COVID-19

Epithelial Cells Count and the Ratio of Leukocytes and Epithelial Cells as the Criteria to Determine Qualified Specimen for Community-Acquired Pneumonia (CAP)-causing Pathogens Identification

BACKGROUND: Community-acquired pneumonia (CAP) is the most common infectious with serious rate of morbidity and mortality. Recent conventional method only described 30-50% of CAP etiology. Sputum specimen quality assessment is important to obtain an accessible CAP-causing pathogens identification.METHODS: This was a prospective descriptive study involving 100 specimens from CAP-diagnosed subjects in Budhi Asih Regional General Hospital inpatien tcare. We assessed three gram-staining criteria for specimen quality determination, and continued by bacterial identification.RESULTS: All specimens were qualified according to criteria II, while only 94 and 96 specimens were qualified according to criteria I and III, respectively. Sixty-five specimens could be identified by culture and pneumoCLART polymerase chain reaction (PCR) examination, and the 35 specimens remained unknown. Ten out of those 35 specimens were positive after analyzed by Acid-fast Bacilli (AFB) test. The pathogens we identified including Klebsiella pneumoniae (29.6%), Acinetobacter baumanii (10.2%), Enterobacter cloacae (4.6%), Pseudomonas aeruginosa (4.6%), Staphyloccocus aureus (4.6%), Moraxella catarrhalis (3.7%), Enterobacter aerogenes (2.8%), Escherichia coli (2.8%), Streptococcus pneumoniae (1.9%), Mycoplasma pneumoniae (1.9%) and Citrobacter koseri (0.9%).CONCLUSION: There were no significant differences among the three criteria for sputum specimen quality assessment, based on culture and pneumoCLART examination. We suggest that criteria II could be used to avoid many specimen rejections while good quality specimens still attained for accessible bacteria identification.KEYWORDS: community-acquired pneumonia, sputum, gram stain, pathogens, bacteria

Prognosis of nontuberculous mycobacterial pulmonary disease according to the method of microbiologic diagnosis

Background Current microbiologic criteria for nontuberculous pulmonary disease (NTM-PD) require cultures with two separate sputum specimens or one non-sputum specimen. However, data on NTM-PD prognosis following non-sputum culture-based diagnosis are limited. We compared the prognosis of NTM-PD diagnosed using non-sputum and sputum cultures. Methods We analyzed 1020 patients in whom NTM was isolated; they were divided into the sputum NTM isolation (n=170), sputum NTM-PD (n=688), and non-sputum NTM-PD groups (n=162). Initiation of therapy and radiographic aggravation was compared between groups. Results Overall median observation time was 44.3 months (interquartile range, 28.0–70.2). Fewer non-sputum NTM-PD patients initiated treatment than sputum NTM-PD patients (p<0.001). Moreover, fewer non-sputum NTM-PD patients exhibited radiographic aggravation than sputum NTM-PD patients (p=0.001). Both time to radiographic aggravation and initiation of therapy were significantly shorter in the sputum NTM-PD group (log-rank test; p=0.011 and p<0.001, respectively). Sputum NTM-PD patients showed higher initiation of therapy (aHR, 1.38; 95% CI, 1.02–1.87) and risk of radiographic aggravation (aHR, 1.47; 95% CI, 1.02–2.10) than non-sputum NTM-PD patients. Conclusion Prognosis of NTM-PD patients diagnosed with a non-sputum culture was better than that of NTM-PD patients diagnosed with a sputum culture. The disease course may differ depending on the diagnostic method.

Antimicrobial Susceptibility Pattern of Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Isolated from Sputum in a Tertiary Care Hospital

Introduction Acinetobacter calcoaceticus-Acinetobacter baumanni (ACB) complex is one of the commonest cause of hospital acquired and ventilator associated pneumonia. Multidrug resistant Acinetobacter species have become a matter of huge concern. This study was done to find out the antibiotic susceptibility pattern of Acinetobacter calcoaceticus-Acinetobacter baumanii complex from sputum samples. MethodsThis descriptive cross-sectional study was carried out in Clinical Microbiology laboratory from July 2018 to Jan 2019 after ethical approval. Acinetobacter calcoaceticus-Acinetobacter baumannii complex was identified on the basis of its microscopy and morphological characteristics followed by biochemical tests. Antibiotic sensitivity test of isolated pathogens was done using Muller Hinton Agar by Kirby-Bauer method. ResultsOf the 384 culture positive sputum specimen, 76 (19.80%) were Acinetobacter calcoaceticus-Acinetobacter baumannii complex. Most of the isolates were resistant to commonly used antibiotics, 72.36% of the isolates were multidrug resistance and 3.95% isolates were resistant to tigecycline. ConclusionThis study provides valuable information regarding prevalence of Acinetobacter calcoaceticus-Acinetobacter baumannii complex from sputum specimen. The alarming number of Multidrug resistance isolates is worrisome finding. Antibiotics like Tigecycline and Colistin which is still sensitive to isolates should be cautiously used only in MDR cases.