Skripsi

Studi Komparatif Pemeriksaan Deteksi Antibodi (Serologi) dengan Kultur Sputum pada Pasien Suspek Aspergilosis Paru = Comparative Study between Antibody Detection and Sputum Culture in Patient with Suspected Pulmonary Aspergillosis .

Aspergilosis paru merupakan infeksi oportunistik yang disebabkan oleh jamur Aspergillus spp. Insidensi aspergilosis paru cenderung semakin meningkat seiring dengan peningkatan penggunaan obat-obatan imunosupresan seperti kortikosteroid dan terapi sitotoksik. Sulitnya penegakan diagnosis aspergilosis paru menjadi tantangan disebabkan tanda dan gejala klinis yang tidak spesifik serta biopsi jaringan sebagai baku emas yang bersifat invasif. Pemeriksaan kultur sputum dan deteksi antibodi merupakan pemeriksaan yang rutin dilakukan pada pasien suspek aspergilosis paru yang dikirim ke Laboratorium Mikologi Departemen Parasitologi FKUI, namun belum tersedia data mengenai nilai diagnostik deteksi antibodi dalam mendiagnosis aspergilosis paru.

Tujuan penelitian ini adalah membandingkan pemeriksaan deteksi antibodi dengan crude antigen Aspergillus dengan metode imunodifusi dengan kultur sputum sebagai tes rujukan. Penelitian berdesain potong lintang dengan sampel berjumlah 689 rekam medis dari pasien suspek aspergilosis paru yang melakukan pemeriksaan kultur sputum dan deteksi antibodi di Laboratorium Mikologi Departemen Parasitologi FKUI tahun 2008–2015.
Dari analisis deskriptif didapatkan prevalensi aspergilosis paru berdasarkan hasil positif kultur sebesar 0,4%. Dari uji diagnostik deteksi antibodi dengan tabel 2x2, diperoleh nilai sensitivitas 33,33% dan spesifisitas 95,62%, serta terdapat perbedaan yang bermakna (p kurang dari 0,05) antara pemeriksaan kultur sputum dan deteksi antibodi berdasarkan uji McNemar dengan nilai kesetaraan yang lemah (Kappa = 0,026).

Kata kunci: aspergilosis paru, crude antigen Aspergillus, deteksi antibodi, immunodiffusion test, kultur sputum




Pulmonary aspergillosis is an opportunistic infection caused by Aspergillus spp. The incidence of this infection has increased significantly, in line with the growing use of immunosuppressive drugs such as corticosteroids and cytotoxic therapies. Diagnosing pulmonary aspergillosis remains a challenge due to the nonspecific clinical signs and symptoms, as well as the invasiveness of tissue biopsy, which is considered the gold standard. Sputum culture and antibody detection are routine examinations for patients suspected of having pulmonary aspergillosis, particularly those referred to the Mycology Laboratory of the Department of Parasitology, Faculty of Medicine, Universitas Indonesia (FMUI). However, data on the diagnostic value of antibody detection remain unavailable.
This study aimed to compare antibody detection using the immunodiffusion method with Aspergillus crude antigen against sputum culture as the reference test. This cross-sectional study analyzed 689 medical records of patients suspected of pulmonary aspergillosis who underwent both sputum culture and antibody detection at the Mycology Laboratory of the Department of Parasitology, FMUI, from 2008 to 2015.

Descriptive analysis showed that the prevalence of pulmonary aspergillosis based on positive culture results was 0.4%. The sensitivity and specificity of antibody detection were 33.33% and 95.62%, respectively, based on a 2×2 diagnostic table. Statistical analysis using McNemar’s test revealed a significant difference (p less than 0.05) between the two methods, with a low level of agreement (Kappa = 0.026).

Keywords: pulmonary aspergillosis, Aspergillus crude antigen, antibody detection, immunodiffusion test, sputum culture