A novel diagnosis scoring model to predict invasive pulmonary aspergillosis in the intensive care unit

Authors

• Anna Rozaliyani, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Rudyanto Sedono, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Anwar Jusuf, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Cleopas M. Rumende, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Wahju Aniwidyaningsih, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Erlina Burhan, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Prasenohadi, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Diah Handayani, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Evy Yunihastuti, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Forman E. Siagian, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Achmad M. Jayusman, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Adria Rusli, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Saleha Sungkar, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Joedo Prihartono, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Ferry Hagen, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Jacques F. Meis, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
• Retno Wahyuningsih, From the Department of Parasitology (Rozaliyani, Sungkar, Wahyuningsih); from the Department of Community Medicine (Prihartono), Faculty of Medicine, University of Indonesia; from the Department of Anesthesiology (Sedono); from the Department of Internal Medicine (Rumende, Yunihastuti), Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital; from the Department of Pulmonology and Respiratory Medicine (Rozaliyani, Jusuf, Aniwidyaningsih, Burhan, Prasenohadi, Handayani), Faculty of Medicine, Universitas Indonesia-Persahabatan Hospital; from the Department of Parasitology (Siagian, Wahyuningsih), Faculty of Medicine, Universitas Kristen Indonesia; from the Division of Pulmonology (Jayusman), Dharmais Hospital; from the Division of Pulmonology (Rusli), Soelianti Saroso Hospital, Jakarta, Indonesia; from the Department of Medical Microbiology and Infectious Diseases (Hagen), Canisius-Wilhelmina Hospital; from the Centre of Expertise in Mycology Radboudumc UMC/CWZ (Meis), Nijmegen; and from the Department of Medical Mycology (Hagen, Meis), Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands

Abstract

Objectives: To improve the quality of invasive pulmonary aspergillosis (IPA) management for intensive care unit (ICU) patients using a practical diagnostic scoring model. Methods: This nested case-control study aimed to determine the incidence of IPA in 405 ICU patients, between July 2012 and June 2014, at 6 hospitals in Jakarta, Indonesia. Phenotypic identifications and galactomannan (GM) tests of sera and lung excreta were performed in mycology laboratory, Parasitology Department, Faculty of Medicine, Universitas Indonesia in Jakarta, Indonesia. Results: The incidence of IPA in the ICUs was 7.7% (31 of 405 patients). A scoring model used for IPA diagnosis showed 4 variables as the most potential risk factors: lung excreta GM index (score 2), solid organ malignancy (score 2), pulmonary tuberculosis (score 2), and systemic corticosteroids (score 1). Patients were included in a high-risk group if their score was >2, and in a low-risk group if their score was <2. Conclusion: This study provides a novel diagnosis scoring model to predict IPA in ICU patients. Using this model, a more rapid diagnosis and treatment of IPA may be possible. The application of the diagnosis scoring should be preceded by specified pre-requisites.

Article Type

Research Article

First Page

140

Last Page

146

Recommended Citation

Rozaliyani, Anna; Sedono, Rudyanto; Jusuf, Anwar; Rumende, Cleopas M.; Aniwidyaningsih, Wahju; Burhan, Erlina; Prasenohadi; Handayani, Diah; Yunihastuti, Evy; Siagian, Forman E.; Jayusman, Achmad M.; Rusli, Adria; Sungkar, Saleha; Prihartono, Joedo; Hagen, Ferry; Meis, Jacques F.; and Wahyuningsih, Retno (2019) "A novel diagnosis scoring model to predict invasive pulmonary aspergillosis in the intensive care unit," Saudi Medical Journal: Vol. 40: Iss. 2, Article 5.
DOI: https://doi.org/10.15537/smj.2019.2.22940