BackgroundThus far, Indonesia has recorded over 4,000,000 confirmed COVID-19 cases and 144,000 fatalities; 12.8% of cases have been in children under 18 years. Whole-genome viral sequencing (WGS) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been demonstrated to help differentiate hospital-acquired infection from community-acquired coronavirus disease 2019 (COVID-19) infection. Our study highlighted the use of WGS to investigate the origin of infection among pediatric oncology patients in Jakarta. The aim of our study was to evaluate clinical and laboratory characteristics and also the efficacy of using WGS to confirm hospital-acquired COVID-19 infection in a cluster of immunocompromised children within a single ward of a tertiary hospital in metropolitan Jakarta based on quasispecies, viral load, and admission dates.MethodReal-time reverse-transcription polymerase chain reaction (RT-PCR) from nasopharyngeal (NP) swabs was used to diagnose the patients and also guardians and healthcare workers (HCWs) in the ward, followed by WGS of RT-PCR positive cases to establish their phylogenetic relationships.ResultUsing WGS, we showed that SARS-CoV-2 transmission in a cluster of children with underlying malignancy was characterized by high similarity of whole virus genome, which suggests nosocomial transmission.

Background: Amino acid profiles in newborns is a sign of its nutritional status and it reflects the protein intake of the mother before and during pregnancy. The amino acid level is also a predictor of improved growth velocity and the only tool for diagnosis of amino acid disorder in suspected individuals. In Indonesia, based on National Basic Health Research year 2018, 48.8% of pregnant mother has anemia and 13% babies were underweight. Determining amino acid profiles is important to differentiate pathologic from normal condition in newborn population. There are only a few reports with adequate sample size on amino acid profiles in newborns from South East Asian Countries and none from the Indonesian population. Methods: This is the first descriptive study in Indonesia newborns population determining the profiles of amino acid concentration from dried blood spot (DBS) sample by liquid chromatography-tandem-mass spectrometry (LC-MS/MS) system. This study used DBS sample obtained from the newborns’ heel pricks, which is easier to store and handle in Indonesia’s landscape. This will allow samples from remote area to be safely transported to referral laboratory. Results: A total of 993 healthy newborns from 25 provinces and districts in Indonesia were included in this study. All samples were stored at -20oC and analyzed within 1 month. The amino acid concentration profile was summarized as 95% reference interval determined using nonparametric method. The result for most amino acid was only slightly different from previously reported reference from various population which was presumably caused by food preference. This study’s result is expected to be implemented in Indonesian population. Conclusions: Determining the amino acid profile in neonates using DBS is dependable. The result from this study is expected to be applied in our center and other referral hospital for inborn error of metabolism screening.

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Background Confirmatory hepatitis B surface antigen (HBsAg) is an assay used to distinguish weakly reactive from false-positive HBsAg results. Objective To determine the signal to cutoff (S/CO) value of chemiluminescence microparticle immunoassay (CMIA) HBsAg assay that should trigger follow-up confirmatory HBsAg testing. Methods All specimens with an initial S/CO value of 0.90–100.00 were subjected to repeat HBsAg testing after high-speed centrifugation. The specimens with an initial S/CO value in that range remained in the same range and were then followed up with confirmatory HBsAg testing. Result In total, 132 specimens had an S/CO value between 0.90 and 100.00 after high-speed centrifugation, followed by confirmatory HBsAg retesting. The S/CO value of HBsAg specimens for which the results required verification with confirmatory HBsAg was 0.98 (100% sensitivity, 3.3% specificity) through 9.32 (47.1% sensitivity, 100% specificity). Conclusion The HBsAg S/CO values (as determined by the chemiluminescent microparticle immunoassay [CMIA] method) that should trigger confirmatory HBsAg testing are 0.98–9.32.