Perbandingan Faktor Risiko Pasien Limfadenitis Tuberkulosis antara Hasil Bakteri Tahan Asam Positif dan Negatif
Abstract
Limfadenitis tuberkulosis merupakan tuberkulosis ekstraparu (TEBP) yang paling umum di dunia. Diagnosis pasti TEBP ditegakkan dengan pemeriksaan klinis, bakteriologis, dan atau histopatologis contoh uji yang diambil dari organ tubuh yang terkena. Pemeriksaan BTA dengan Ziehl Neelsen langsung pada jaringan mempunyai sensitivitas rendah sehingga jarang dilakukan. Penelitian ini bertujuan menganalisis perbandingan faktor risiko limfadenitis tuberkulosis dengan hasil BTA positif dan negatif dari jaringan KGB berdasar atas usia, jenis kelamin, dan riwayat TB paru di Laboratorium Rumah Sakit Al-Islam Bandung tahun 2016–2017. Terdapat 18 pasien dengan hasil BTA positif dan 17 pasien dengan BTA negatif yang memenuhi kriteria inklusi. Penelitian ini menggunakan desain penelitian potong lintang dengan analisis data univariat untuk mengetahui gambaran faktor risiko pasien dan bivariat untuk melihat hasil perbandingan faktor risiko pasien. Hasil penelitian ini menunjukkan pasien dengan BTA positif banyak diderita oleh pasien usia <20 tahun (8 dari 18) dan BTA negatif 30–39 tahun (6 dari 17). Pasien wanita mendominasi BTA positif (15 dari 18) dan BTA negatif (11 dari 17) daripada laki-laki. Pasien yang tidak mempunyai riwayat TB paru mendominasi BTA positif (14 dari 18) dan BTA negatif (14 dari 17). Perbandingan faktor risiko pasien antara hasil BTA positif dan negatif berdasar atas usia (p=0,117), jenis kelamin (p=0,264), dan riwayat TB paru (p=1,000). Walaupun mempunyai sensitivitas yang rendah, pemeriksaan BTA jaringan harus dilakukan guna memberikan informasi yang maksimal untuk klinisi. Simpulan, perbandingan faktor risiko limfadenitis tuberkulosis antara hasil BTA positif tidak berbeda.
COMPARASION OF LYMPHADENITIS TUBERCULOSIS PATIENT’S RISK FACTOR BETWEEN POSITIVE AND NEGATIVE ACID-FAST BACILLUS
Lymphadenitis tuberculosis is most common extrapulmonary tuberculosis (EPTB) in the world. Definitive diagnosis in EPTB is by clinical examination, bacterial examination, and histopatological examination from sample in affected organ. AFB examination by Ziehl Neelsen directly from tissue has low sensitivity and high specificity. This study aims to examine the comparion of lymphadenitis tuberculosis patient’s risk factor between positive and negative AFB from lymph node tissue based on age, sex, and previous history of pulmonary tuberculosis in Laboratory of Al-Islam Hospital Bandung during 2016–2017. There were 18 patients with positive AFB and 17 patients with negative AFB who met inclusion criteria. This study used cross sectional design with univariate data analysis to descript the risk factor of patients and bivariate to see the comparison of patient characteristics. The result of this study showed patient with positive AFB occur more at the age of <20 (8 of 18) and negative AFB occur more at the age of 30–39 (6 of 17). Woman were dominated positive AFB (15 of 18) and negative AFB (11 of 17) than man. Patients with no previous pulmonary tuberculosis history were dominated positive AFB (14 of 18) and negative AFB (14 of 17). Comparison of lymphadenitis tuberculosis patient’s risk factor between positive and negative AFB based on age (p=0.117), sex (p=0.264), and previous history of pulmonary tuberculosis (p=1.000). Despite low sensitivity, tissue AFB examination should be performed to give maximal information for clinician. Conclusion, comparison of lymphadenitis tuberculosis risk factor between positive and negative AFB is not different.
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WHO. Global tuberculosis report 2017. [diunduh 12 April 2019]. Tersedia dari: http://apps.who.int/iris/bitstream/10665/259366/1/9789241565516eng.pdf?ua=1
Nassaji M, Azarhoush R, Ghorbani R, Kavian F. Acid fast straining in formalin fixed tissue specimen of patients with extrapulmonary tuberculosis. Int J Sci Res Publ. 2014;4(10):4–8.
García-Rodríguez JF, Álvarez-Díaz H, Lorenzo-García MV, Mariño-Callejo A, Fernández-Rial Á, Sesma-Sánchez P. Extrapulmonary tuberculosis: epidemiology and risk factors. Enferm Infecc Microbiol Clin. 2011 Aug 1;29(7):502–9.
Subuh M, Priohutomo S, Widaningrup C, Dinihari TN, Siaglan V. Pedoman Nasional Pengendalian Tuberkulosis. Jakarta: Kementrian Nasional; 2014.
Purohit M, Mustafa T. Laboratory diagnosis of extra-pulmonary tuberculosis (EPTB) in resource-constrained setting: state of the art, challenges and the need. J Clin Diagn Res. 2015;9(4):1–6.
Azizi FH, Husin UA, Rusmantini T. Gambaran karakteristik tuberkulosis paru dan ekstraparu di BBKPM Bandung tahun 2014. Prosiding Pendidikan Dokter. 2014;860–6.
Eshete A, Zeyinudin A, Ali S, Abera S, Mohammed M. M. tuberculosis in lymph node biopsy paraffin-embedded sections. Tuberc Res Treat. 2011;2011(127817):1–5.
Miller K, Harrington SM, Procop GW. Acid-fast smear and histopathology results provide guidance for the appropriate use of broad-range polymerase chain reaction and sequencing for mycobacteria. Arch Pathol Lab Med. 2015;139(8):1020–3.
Popescu MR, Calin G, Strambu I, Olaru M, Balasoiu M, Huplea V, dkk. Lymph node tuberculosis – an attempt of clinico- morphological study and review of the literature. Rom J Morphol Embryol. 2014;55(2):553–67.
Ennouri A, Zermani R, Mezni M, Marrekchi H, Atallah M. Lymph node tuberculosis. Rev Laryngol Otol Rhinol. 2016;110(2):179–81.
Nidhi P, Sapna T, Shalini M, Kumud G. FNAC in tuberculous lymphadenitis: experience from a tertiary level referral centre. Indian J Tuberc. 2011;58(3):102–7.
Salvador F, Los-Arcos I, Sánchez-Montalvá A, Tórtola T, Curran A, Villar A, dkk. Epidemiology and diagnosis of tuberculous lymphadenitis in a tuberculosis low-burden country. Medicine (Baltimore). 2015;94(4):3–8.
Sreeramareddy CT, Panduru KV, Verma SC, Joshi HS, Bates MN. Comparison of pulmonary and extrapulmonary tuberculosis in Nepal-a hospital-based retrospective study. BMC Infect Dis. 2010;8:1–7.
Rahman S, Quddus R, Arif S. A clinical study on extra-pulmonary tuberculosis. J Bangladesh Coll Physicians Surg. 2010;24(1):10–28.
DOI: https://doi.org/10.29313/jiks.v2i1.4347
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