Diagnosis Cepat Kandidemia Neonatus dengan Pemeriksaan Spesimen Darah Pulasan Giemsa

Abstract

Candidemia is one of the major problems in neonates with low birth weight (LBW). Neonatal candidemia has a high rateof morbidity and mortality. Early initiation of antifungal therapy could be decreasing the mortality, but this managementoften hampered due to late diagnosis. The gold standard for diagnosing candidemia is blood culture, but it takes a longtime about 5 days. A rapid alternative method is needed to decrease candidemia morbidity and mortality. The methodchosen in this study is Giemsa stain of blood smear which result could be read within one hour. The study wasconducted in the Department of Parasitology, Faculty of Medicine Universitas Indonesia with a total blood samples of170 from 2009-2012. Blood samples are devided in two, first is made thick blood smear than stain with giemsa, than readby microscope by 400×and 1000× magnification. The second is cultured on Sabauraud agar media and incubated inroom temperature for ten days. Thirty four patients (20%) were positive for Candida, 28 (82.4%) positive samples withboth giemsa staining and culture, while 6 (17,6%) positive culture samples but negative giemsa staining. The values ofthe sensitivity and specificity of the Giemsa stained blood smear examination were 82%, and 100%. This result showsthat Giemsa staining has a good diagnostic value for detecting neonatal candidemia.