Deteksi IgM Terhadap Antigen Lipopolisakarida (lps) O9 Kuman Salmonella Typhi Pada Demam Tifoid

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THE DETECTION OF IGM OF SALMONELLA TYPHI O9
LIPOPOLYSACCHARIDE (LPS) ANTIGEN IN TYPHOID FEVER
Yetti Ferulina Akbar, (1), Ricke Loesnihari, (1), Tambar Kembaren (2)
(1) Department of Clinical Pathology, Faculty of Medicine,University of
North Sumatra / Adam Malik Hospital.
(2) Department of Medicine Division of Tropical Infections, Faculty of
MedicineNorth Sumatra University / Adam Malik Hospital
Abstract
Background: Typhoid fever is a systemic infectious disease caused by
Salmonella typhi. That is still widely found in many developing countries
that are mainly located in the tropical and subtropical. Clinical diagnosis of
typhoid fever is difficult because there is no typical clinical manifestation,
therefore we need laboratory tests. IMBI (Magnetic Binding Inhibition
Immunoassay) is one of serological examination or it more popularly
known as Tubex TF, a semi-quantitative examination with the principle of
detecting the presence of IgM antibodies of O9 lipopolysaccharide antigen
in Salmonella typhi.
Objective: To assess the sensitivity and specificity of the IgM antigen
examination of Salmonella typhi O9 lipopolysaccharide (LPS) with blood

culture as the gold standard
Methods: The method that was used in this study was diagnostic testing
to compare Tubex TF with blood cultures in pediatric and adult patients
who were diagnosed with suspected typhoid fever or typhoid fever based
on Nelwan criteria in Haji Adam Malik Hospital.
Results: The number of subjects are 30 people, with 27 positive Tubex TF
(90%) and 12 positive blood cultures (40%). The examination results of
Tubex TF towards blood culture showed 100% sensitivity, 16,7%
specificity, 44,4% positive predictive value and 100% negative predictive
value.
Conclusion:The results of Tubex TF serology test showed a good
sensitivity and a poor specificity, with a negative predictive value of 100%
which indicates that a negative Tubex TF examination can rule out the
diagnosis of typhoid fever.
Keyword: Salmonella, Tubex TF, blood cultures

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DETEKSI IgM TERHADAP ANTIGEN LIPOPOLISAKARIDA (LPS)
O9 KUMAN SALMONELLA TYPHI PADA DEMAM TIFOID

Yetti Ferulina Akbar, (1), Ricke Loesnihari ,(1), Tambar kembaren,(2)
(1) Departemen Patologi Klinik, Fakultas Kedokteran Universitas
Sumatera Utara/RSUP H. Adam Malik Medan.
(2) Departemen Ilmu Penyakit Dalam Divisi Tropik Infeksi, Fakultas
Kedokteran Universitas Sumatera Utara/RSUP H. Adam Malik Medan
Abstrak
Latar Belakang : Demam tifoid merupakan suatu penyakit infeksi sistemik
yang disebabkan oleh Salmonella typhi. Masih dijumpai secara luas
diberbagai negara berkembang terutama terletak didaerah tropis dan
subtropis. Diagnosa klinis demam tifoid sulit ditegakkan karena
manifestasi klinisnya tidak khas, maka diperlukan pemeriksaan
laboratorium. Salah satu pemeriksaan serologi adalah pemeriksaan
metode IMBI (Immunoassay Magnetic Binding Inhibition), atau lebih
populer dengan nama dagang Tubex TF, suatu pemeriksaan semi
kuantitatif dengan prinsip mendeteksi adanya antibodi IgM terhadap
antigen lipopolisakarida O9 pada kuman Salmonella typhi.
Objektif : Menilai sensitivitas dan spesifisitas pemeriksaan IgM terhadap
antigen lipopolisakarida (LPS) O9 kuman Salmonella typhi dengan kultur
darah sebagai gold standart
Metode : Metode yang digunakan dalam penelitian ini adalah uji

diagnostik membandingkan Tubex TF dengan kultur darah pada pasien
anak dan dewasa yang terdiagnosa suspek demam tifoid atau demam
tifoid berdasarkan kriteria Nelwan di RSUP Haji Adam Malik Medan.
Hasil : Subjek penelitian berjumlah 30 orang, dengan Tubex TF positif 27
orang (90%) dan kultur darah positif 12 orang (40%). Dari hasil
pemeriksaan TF terhadap kultur darah didapatkan sensitivitas 100% dan
spesifisistas 16,7% serta nilai prediksi positif 44,4% dan nilai prediksi
negatif 100%.
Kesimpulan : Dari hasil penelitian didapatkan uji serologi Tubex TF
memiliki sensitivitas yang baik dan spesifisitas yg kurang baik, dengan
nilai prediksi negatif 100% menunjukan pemeriksaan Tubex TF negatif
dapat menyingkirkan diagnosa demam tifoid.
Keyword : Salmonella, Tubex TF, Kultur darah