Mayrita, Esther (2018) Performa Nilai Diagnostik Kadar Interleukin-6, Nitrit Urine, Dan Jumlah Leukosit Urine Pada Infeksi Saluran Kemih (Isk). Magister thesis, Universitas Brawijaya.
Abstract
Infeksisalurankemih (ISK) sering bersifat asimptomatik. Kultur urine sebagai standar baku pemeriksaan kurang praktis, dan mahal. Urinalisis untuk diagnosis rutin cukup praktis tetapi kurang akurat. Paparan organisme patogen di urotelium merangsang pelepasan IL-6 di urine sehingga berpotensi sebagai penanda awal ISK. Penelitian ini bertujuan mengetahui perbedaan dan korelasi antara kadar IL-6 dan Leukosit urine serta menentukan nilai diagnostik dari IL-6 urin, leukosit urine, dan nitrit pada penderita ISK. Penelitian cross sectional dilakukan di RSSA pada pasien yang dicurigai ISK dan memenuhi kriteria inklusi. Urine dianalisis dengan alat Sysmex UF-500, kultur urine, dan kadar IL-6 diukur dengan metode ELISA (Enzyme linked immunoassay). Hasil penelitian didapatkan total subyek penelitian 83 orang dengan 51 ISK kultur positif, 16 ISK kultur negatif dan 16 kontrol sehat. Uji beda Kruskal-Wallis didapatkan perbedaan yang bermakna (p<0,001) antara jumlah leukosituria dan kadar IL-6 urine pada ketiga kelompok. Tidak didapatkan korelasi antara peningkatan IL-6 urine dan leukosituria (p=0,052, r=0,214). Nilai cut off dan Area Under Curve (AUC)IL-6, dan leukosituria masing-masing >134,95ng/mL dan 60,5%; >76,6/µL dan 87%. Uji diagnostik didapatkan sensitivitas IL-6 72,55%, leukosituria 80,39%, dan nitrit 45%. Spesifisitas IL-6 56,25%, leukosituria 78,12%, dan nitrit 100%. Jumlah leukosituria dapat digunakan sebagai biomarker tunggal ISK. Kombinasi paling optimal ditemukan pada jumlah leukosituria dan/atau nitrit. IL-6 tidak disarankan sebagai biomarker tunggal ISK karena sekresinya dipengaruhi kondisi inflamasi lain. Kombinasi IL-6 dan leukosituria memberikan sensitivitas 70,59% dan spesifisitas 84,38%. Kesimpulan penelitian ini adalah kombinasi nitrit dan/atau leukosituria ataupun kombinasi IL-6 dan leukosituria dapat digunakan untuk diagnosis ISK.
English Abstract
Urinary tract infection (UTI) is often asymptomatic. Urine culture as the standard of examination is less practical, and expensive. Urinalysis for routine diagnosis sometimes less accurate. Urothelium release IL-6 in urine after exposed to pathogenic organisms and it potentially used as a marker of UTI. The aim of this study was to know the difference and correlation between IL-6 and urinary leukocytes and to determine diagnostic value of IL-6 urine, urine leukocytes, and nitrite in UTI patients. Cross sectional studies were performed in RSSA in patients suspected of UTI and meeting inclusion criteria. Urine was analyzed by Sysmex UF-500, urine culture, and IL-6 measured by ELISA method. Total subjects is 83 that consists of 51 UTI positive culture, 16 UTI negative culture and 16 healthy controls. Kruskal-Wallis comparative test showed a significant difference (p<0.001) between leukosituria and urinary IL-6 levels in all three groups. There were no correlation between increased of IL-6 urine and leukocyturia (p=0.052, r=0.214). Diagnostic test obtained sensitivity of urine IL-6 72,55%, leukocyturia 80,39%, and nitrite 45%. Specificity of IL-6 56.25%, leukosituria 78.12%, and nitrite 100%. Leukocyturia can be used as a single UTI biomarker. Combination of leukocyturia and/or nitrites give the best result. IL-6 is not recommended as a single UTI biomarker because its secretion is affected by other inflammatory conditions. Combination of IL-6 and leukocyturia gave sensitivity 70,59% and specificity 84,38%. The conclusions is combination of nitrite and/or leukocyturia or a combination of IL-6 and leukocyturia are effective for the diagnosis of UTI
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.6/MAY/p/2018/041804673 |
| Uncontrolled Keywords: | URINARY FRACT INFECTIONS, INTERLEUKIN-6, NITRITES, LEUCOCYTES |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases > 616.6 Diseases of urogenital system |
| Divisions: | Profesi Kedokteran > Spesialis Patologi Klinik, Fakultas Kedokteran |
| Depositing User: | Nur Cholis |
| Date Deposited: | 19 Mar 2019 07:20 |
| Last Modified: | 15 Jan 2021 03:19 |
| URI: | http://repository.ub.ac.id/id/eprint/165588 |
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