Laboratory Diagnostic Approach and Interpretation in Gram-Negative Bacterial Infection: A-Case Report of Sepsis in Secondary Hospital Settings

Authors

  • Adhi Kristianto Sugianli Department of Clinical Pathology, Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin Hospital, Bandung
  • Ida Parwati Department of Clinical Pathology, Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin Hospital, Bandung

DOI:

https://doi.org/10.24293/ijcpml.v26i3.1563

Keywords:

Drug-resistant microbes, Gram-negative bacteria, sepsis laboratory diagnostic

Abstract

Gram-Negative Bacteria (GNB) have been widely reported to cause worldwide infections and life-threatening. The high prevalence of drug-resistant GNB causes the treatment of GNB to become difficult. This case report describes a stepwise laboratory approach and interpretation for Gram-negative bacteria infection in sepsis patients. An 84-year-old female patient with a history of congestive heart failure, after three weeks of hospitalization, GNB was proven as the cause of sepsis. Laboratory approach for inflammation (C-reactive protein, procalcitonin) was made and confirmed with a positive culture of several specimens (sputum, urine, and blood). The identification of bacterial-culture revealed as Carbapenem-resistance Klebsiella pneumoniae and Extended-spectrum Beta-lactamases Escherichia coli. This case highlights GNB as a potential agent to worsen the infection (sepsis) and also a useful approach for the detection of multidrug-resistant bacteria, particularly in secondary hospital settings. The application and interpretation of integrated clinical and laboratory criteria may bring out better and effective patient management.

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Author Biography

Adhi Kristianto Sugianli, Department of Clinical Pathology, Faculty of Medicine, Padjadjaran University/Dr. Hasan Sadikin Hospital, Bandung

Adhi Kristianto Sugianli is a clinical pathologist. He works at the Department of Clinical Pathology at Hasan Sadikin Hospital/Faculty of Medicine Universitas Padjadjaran, Bandung in Indonesia. After acquiring his medical degree in Indonesia, he obtained his clinical training as clinical pathologist at Universitas Padjadjaran (2008 – 2011). In 2010, he obtained a master degree in laboratory medicine from Universitas Padjadjaran. In 2013 he started working as a PhD Fellow on the SPIN-KNAW project entitled: "Novel strategies and tools for antimicrobial resistance surveillance”, known as SPIN AMR. His PhD research focuses on the microbiology aspect of infectious diseases, including antibiotic resistance surveillance methods and laboratory capacity building.

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Submitted

2019-10-21

Accepted

2020-01-30

Published

2020-09-30

How to Cite

[1]
Sugianli, A.K. and Parwati, I. 2020. Laboratory Diagnostic Approach and Interpretation in Gram-Negative Bacterial Infection: A-Case Report of Sepsis in Secondary Hospital Settings. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 26, 3 (Sep. 2020). DOI:https://doi.org/10.24293/ijcpml.v26i3.1563.

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Section

Case Report