Doctor of FPH UI Research Risk Factors and Develops a Scoring System for Diagnosis and Cost Effectiveness of Handling Invasive Candidiasis Patients

“The majority of invasive candidiasis in critically ill patients develops after admission to the intensive care unit. The most common cause of invasive fungal diseases is candida, which is a commensal organism in the human body but can turn into a pathogen,” said Rudyanto Sedono in his dissertation entitled “Risk Factors and Development of a Scoring System for Diagnosis and Cost-Effective Handling of Invasive Candidiasis Patients” at an open session for the promotion of Doctor of Epidemiology Wednesday, 5 July 2023.

Furthermore, Rudyanto stated that candida infection begins with increased colonization, changes in shape and production of enzymes that damage the host’s mucosa so that candida can enter body tissues or blood vessels. The research conducted by Rudyanto was a prospective observational study of critically ill patients treated in the intensive care unit. Blood samples, armpit swabs and rectal swabs were taken on the first, fifth and ninth days. While medical record data and direct medical costs were collected from the first day of the study to the end of the study.

A total of 142 subjects were recruited and 115 subjects were analyzed in this study. Multivariate analysis identified age > 60 years, parenteral nutrition ≥7 days, CVC ≥ 10 days, corticosteroids, PCT on day 5, changes in axillary and rectal swab morphology, and morphological changes and increased candida colonies on rectal swabs on day 9 as independent risk factors for invasive candidiasis. The risk factor can then be used as a determinant of a scoring system based on type A hospital with or without mycological examination and type C hospital. Giving antifungal drugs is said to be more cost effective than not giving antifungal drugs.

“The scoring system of risk factors can predict the incidence of invasive candidiasis which can be prevented (or reduced the risk) with effective and cost-effective antifungals,” explained Rudyanto explaining the results of his research. This study provides basic data for epidemiology and estimates of the timing of the conversion of commensal Candida albicans to pathogen. The output of this study is a predictive model for the occurrence of invasive candidiasis that can be used by doctors or health care facilities with limited laboratory tests for candida. It is also hoped that this modeling can be used to increase early awareness of invasive candidiasis. Early warning can be used as a consideration for early and appropriate management so that it can reduce mortality, morbidity, and treatment costs.

At the doctoral promotion open session which was held in the Doctoral Promotion Room of FPH UI, Prof. dr. Amal Chalik Sjaaf, S.K.M., Dr.PH .; Promoter, Prof. dr. Asri C. Adisasmita, M.P.H., M.Phil., Ph.D.; Co-Promoter, Prof. Dr. dr. Made Wiryana, Sp.An-TI., Subsp.T.I. (K)., Subsp. An.O.(K)., and Prof. Dr. dr. Ratna Djuwita, M.P.H.; as well as a team of examiners consisting of Prof. Dr. dr. Retno Wahyuningsih, M.S., SpParK.; dr. Bachti Alisjahbana, Sp.PD., K-PTI., Ph.D.; dr. Anis Karuniawati, Ph.D., Sp.MK(K).; Prof. Dr. drg. Mardiati Nadjib, M.Sc., and dr. Syahrizal Syarif, M.P.H., Ph.D.

Based on the results of the trial, Rudyanto Sedono who is a lecturer at the Department of Anesthesia and Intensive Therapy Faculty of Mediine UI was successfully declared a Doctor in Epidemiology and became the 102nd Doctor of Epidemiology graduate and 367th Doctoral graduate of FPH UI.