Tesis

Uji Diagnostik Peningkatan Leukosit dalam Tinja dibandingkan dengan sTREM-1 pada Anak Diare Akut oleh karena Infeksi Bakteri = Fecal Leucocyte Test as Diagnostic Test Compare sTREM-1 for Acute Diarrhea caused by Bacterial Infection in Children.

Latar belakang: Diare merupakan masalah kesehatan paling sering pada anak.Berbagai penyebab diare dapat menyebabkan diare berlangsung lama dan bisa menjadi malnutrisi (gizi buruk).Penyebab diare bisa disebabkan oleh infeksi bakteri dan membutuhkan antibiotik sehingga diperlukan deteksi sedini mungkin. Pemeriksaan soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) dapat menduga adanya infeksi bakteri pada anak dengan diare akut. Tujuan :Mengetahui seberapa besar nilai diagnostik peningkatan leukosit dalam tinja dibandingkan dengan sTREM-1. Metode :studi potong lintang terhadap anak usia 6-60 bulan dengan diare akut tanpa komplikasi dan penyerta penyakit lain. Pada subyek dilakukan anamnesis gambaran klinis (demam, muntah, sakit perut), pemeriksaan leukosit dalam tinja dan pemeriksaan sTREM-1 sebagai referensi standard. Hasil : Anak dengan diare akut oleh karena infeksi bakteri usia 6-60 bulan dengan sTREM-1 > 470 pg/mL sebanyak 2 dari 64 subyek penelitian dan leukosit tinja > 10 / LPB sebanyak 14 dari 64 subyek penelitian, terbanyak lelaki, status nutrisi normal dan memiliki gambaran klinis demam, muntah dan tanpa sakit perut. Peningkatan leukosit tinja > 10 / LPB memiliki sensitifitas 50 %, spesifisitas 79,1 %, nilai prediksi positif 7,1 %, nilai prediksi negatif 98 %, akurasi 78 %, nilai rasio likelihood positif 2,18 dan nilai rasio likelihood negatif 0,63. Simpulan :Peningkatan leukosit tinja > 10 / LPB sebagai konfirmasi diagnostik kurang baik dalam mendiagnosis diare akut oleh karena infeksi bakteri.
Kata kunci: Leukosit tinja > 10 / LPB; sTREM-1; diare akut ; anak; infeksi bakteri


Background: Diarrhea is a health problem most often occurs in children. Various etiology of diarrhea can cause prolonged diarrhea and become malnourished (malnutrition). The etiology of diarrhea can be caused by a bacterial infection and requires antibiotics, so that detection is needed as early as possible. Examination of soluble triggering expressed receptors on myeloid cells-1 (sTREM-1) can predict bacterial infection in children with acute diarrhea. Objective: toknow how much the diagnostic value of fecal leukocytes test compared to sTREM-1. Methods: cross-sectional study of children aged 6-60 months with acute diarrhea without complications and other diseases. In the subjects, clinical manifestation was performed (fever, vomiting, abdominal pain), fecal leukocyte test and sTREM-1 test as a standard reference. Results : Children, aged 6-60 months with acute diarrhea due to bacterial infections with sTREM-1> 470 pg / mL as many as 2 of 64 subjects and fecal leukocytes > 10 / HPF as many as 14 of 64 subjects, most male, normal nutritional status and had clinical manifestation of fever, vomiting and without abdominal pain. Increased fecal leukocytes > 10 / HPF has a sensitivity of 50%, specificity 79.1%, positive predictive value 7.1%, negative predictive value 98%, accuracy 78%, positive likelihood ratio 2.18 and negative likelihood ratio 0, 63. Conclusion: Fecal leukocyte test > 10 / HPF as a diagnostic confirmation is not good in diagnosing acute diarrhea due to bacterial infection.
Keywords: Fecal leukocyte test 10 / HPF; sTREM-1; acute diarrhea; children; bacterial infection