IDENTIFIKASI GENOTIP CTX-M PADA Escherichia coli PENGHASIL EXTENDED SPECTRUM BETA LACTAMASE (ESBL) YANG RESISTEN PADA CEPHALOSPORIN GENERASI III DI RSUP WAHIDIN SUDIROHUSODO MAKASSAR

Penelitian ini bertujuan untuk mengetahui untuk mendaptkan gambaran tentang prevalensi kejadian Escherichia coli penghasil ESBL yang resisten terhadap cephalosporin generasi III pada pasien RSUP Dr. Wahidin Sudirohusodo Makassar dan prevalensi genotif CTX-M Escherichia coli penghasil ESBL yang resisten terhadap cephalosporin generasi III pada pasien RSUP Dr. Wahidin Sudirohusodo Makassar. Penelitian dilaksanakan diruang perawatab rawat inap, ruang ICU, ruang HCU, ruang PICU, ruang IGD anak, Infection Center, laboratorium patologi klinik RSUP Dr. Wahidin Sudirohusodo dan laboratorium mikrobiologi klinik RSP Universitas Hasanuddin Makassar periode Juni 2018 – Agustus 2018. Penelitian ini menggunakan desain eksperimental laboratorium dengan teknik pengambilan sampel secara consecutive sampling. Bakteri Escherichia coli diisolasi dari 50 pasien. Pengujian dilakukan meliputi uji sensitivitas antibiotika dengan mengunakan metode difusi agar Kirby-bauer dan vitek 2 compact, uji deteksi ESBL dengan metode Double Disc Synergy Test (DDST), Phenotypic Confirmatory Test dan Uji genotip CTX-M Polymerase Chain Reaction (PCR). Hasil penelitian menunjukkan uji sensitivitas antibiotika pada 50 sampel klinik (Urin, Sputum, Darah, Feses, Pus dan Jaringan) yang diuji terhadap antibiotika golongan sefalosporin generasi III yang telah mengalami resistensi sebesar 40 isolat (80%) baik pada Ceftriaxone, Cefotaxime dan Ceftazidine. Pada uji fenotip dengan metode DDST dan Vitek 2 compact ditemukan 40 sampel (80%) positif ESBL pada Antibiotika Cefotaxime+As.Klavulanat (30 ųg/10 ųg ) maupun Ceftazidine+As.Klavulanat (30 ųg/10 ųg ). Pada uji genotip CTX-M di temukan 41 sampel (82%) memiliki gen CTX-M penghasil ESB

EXTENDED SPECTRUM BETA LACTAMASE (ESBL); INDIKATOR RESISTENSI ANTIBIOTIKA GOLONGAN SEFALOSPORIN UNTUK PASIEN TERINFEKSI BAKTERI Pseudomonas aeruginosa di RSUP DR. WAHIDIN SUDIROHUSODO MAKASSAR

β-laktamase spektrum luas (ESBL) merupakan suatu kelompok enzim laktamase yang bertanggungjawab terhadap sebagian besar kasus resisten bakteri yang sebagian besar merupakan bakteri gram negatif, terhadap antibiotika β-laktam generasi baru yang kini telah teridentifikasi dalam jumlah besar di seluruh dunia. Penelitian ini bertujuan untuk Memperoleh data prevalensi dari resistensi antibiotika golongan sefalosporin pada bakteri Pseudomonas aeruginosa dan Mengetahui frekuensi kejadian Extended Spectrum Beta Lactamase (ESBL) pada 25 spesimen klinis di RSUP Dr. Wahidin Sudirohusodo Makassar selama periode April – Juli 2017. Pengujian yang dilakukan meliputi uji sensitivitas antimikroba yang dilakukan dengan mengguakan metode difusi agar Kirby-Bauer dan uji produksi ESBL dengan menggunakan metode double disc synergy test (DDST) dan phenotypic confirmatory test. Hasil penelitian menunjukkan bahwa bakteri Pseudomonas aeruginosa berhasil diisolasi dari semua sampel dengan tingkat keakuratan sebesar (90% - 99%). Pada uji sensitivitas antimikroba ditemukan bahwa dari 25 sampel klinik yang diuji terhadap antibiotika sefalosporin, yang telah mengalami resistensi secara berurutan dari yang terbesar adalah cefotaxime 19 sampel (76%), ceftriaxone 16 sampel (64%), dan ceftazidime 7 sampel (28%). Pada uji produksi ESBL ditemukan 21 sampel (84%) positif ESBL pada antibiotika cefotaxime+as. klavulanat, 21 sampel (84%) positif ESBL pada antibiotika ceftriaxone+as.klavunalat, dan 16 sampel (64%) positif ESBL pada antibiotika ceftriaxone

THE ASSOCIATION OF POLYMORPHISM PROMOTER VEGF PROMOTER GENE POLYMORPHISM AND VEGF SERUM LEVEL WITH THE TYPE OF AGE-RELATED MACULAR DEGENERATION

ABSTRACT Introduction: One of the potential genetic links to Age-related macular degeneration (AMD) is vascular endothelial growth factor (VEGF). The aim of this study was to investigate the association of polymorphism promoter VEGF gene and VEGF serum level with the type of AMD. Methods: Genomic DNA was extracted from peripheral blood of 66 samples, consist of wet and dry AMD, and age-matched controls. DNA was subjected to polymerase chain reaction amplification at the position -460 coupled with the restriction fragment length polymorphism. VEGF serum level was measured by Enzyme-linked Immunosorbent Assay. Results: The polymorphism promoter VEGF gene demonstrated significant association with the type of AMD (p=0.004, OR=3.1 95% CI 1.1-8.6) and the risk for increasing VEGF serum level (p=0.011, OR=3.2 95% CI 1.18.9). Despite there was no significant association between dry and wet AMD with VEGF serum level (p=0.081), but this study revealed significant increased of VEGF serum level in AMD patients, compared to those in control’s serum (p<0.001). Finally, there was coassociation between polymorphism and VEGF level with the type of AMD (p<0.001). Conclusion: This study reveals the significant association between promoter VEGF gene polymorphism and VEGF serum level with the type of AMD of Indonesian patients.  Keywords: AMD, VEGF gene polymorphism; VEGF serum level

Chronic hepatitis B in pregnant women: is hepatitis B surface antigen quantification useful for viral load prediction?

SummaryBackgroundNew cases of hepatitis B virus (HBV) infection continue to occur worldwide. Most of these are due to mother-to-child transmission (MTCT), with maternal viraemia as the most important contributing factor. The hepatitis B surface antigen (HBsAg) level, which correlates positively with viral load, has been used for treatment monitoring in chronic hepatitis B. This study evaluated the usefulness of quantitative HBsAg for viral load prediction in HBsAg-positive pregnant women.MethodsA total of 943 pregnant women in Makassar, Indonesia, were screened for HBsAg. Sixty-four women were HBsAg-positive and investigated. HBsAg level and hepatitis B e antigen (HBeAg)/hepatitis B e antibody (anti-HBe) status were determined serologically. Viral load was measured by real-time PCR. HBV DNA was sequenced and analysed for identification of genotype and basal core promoter (BCP)/precore (PC) mutations.ResultsOf 64 subjects, 12 (18.8%) were HBeAg-positive and 52 (81.3%) were HBeAg-negative. HBsAg and HBV DNA levels were significantly higher in the HBeAg-positive group (p<0.001). HBsAg and HBV DNA levels were positively correlated in the HBeAg-positive group (r = 0.659; p=0.02), but not in the HBeAg-negative group (r=0.194; p=0.168). Low HBsAg levels (<3.0 log10 IU/ml) corresponded with HBV DNA levels<6.0 log10 IU/ml (r=0.404; p=0.001), a recognized threshold for MTCT. Genotype C was more prevalent than genotype B, but not associated with HBsAg level, viral load, or HBeAg status. Two-thirds of HBeAg-negative subjects with high HBV DNA levels harboured BCP (A1762T/G1764A) and/or PC (G1896A) variants.ConclusionsHBsAg levels provide a good viral load predictor in HBeAg-positive but not HBeAg-negative pregnant women. The HBeAg-negative group had a frequent occurrence of BCP/PC variants, which may have contributed to the lack of correlation observed. Samples with a low HBsAg level, which is associated with a low risk of MTCT, do not require HBV DNA measurement

The knowledge mapping of HIV/AIDS in Indonesians living on six major islands using the Indonesian version of the HIV-KQ-18 instrument

Indonesia's total number of HIV/AIDS cases is still high. Inadequate knowledge about the risk of HIV infection will influence HIV prevention and therapy. This study aimed to map the level of HIV-related knowledge among Indonesians living on six major islands in Indonesia and investigate the relationship between socio-demographic characteristics and HIV/AIDS knowledge. This cross-sectional study used the Bahasa Indonesia version of the HIV Knowledge Questionnaire-18 items (HIV-KQ-18) Instrument. Data collection was done online through the Google form application. A total of 5,364 participants were recruited. The participants from Java had the highest degree of HIV/AIDS knowledge, which was 12.5% higher than participants from Sumatra, Kalimantan, Sulawesi, Papua, and Maluku. Linear regression showed that region, educational level, monthly expenditure, occupation, background in health sciences, and workshop attendance were significantly correlated with HIV knowledge. Participants typically understand that "HIV/AIDS transmission" only happens when sex partners are changed. Additionally, the government still needs improvement in HIV/AIDS education, particularly in the HIV incubation period, HIV transmission from pregnant women to the fetus, and condom use as one method of protection. There are disparities in HIV/AIDS knowledge levels among the major islands of Indonesia. Based on these findings, the government's health promotion program to increase public awareness of HIV/AIDS must be implemented vigorously. Additionally, in line with our research findings, it is essential to broaden the scope of HIV/AIDS education and promotion materials.</p

Adaptation and Validation of The HIV-Kq-18 HIV Knowledge Questionnaire for Healthy Indonesian Population

Background: Indonesia does not have a validated instrument to assess HIV/AIDS knowledge. The HIV-KQ-18 is one of the most extensively used instruments for assessing HIV/AIDS knowledge, and it has been translated into various languages throughout the world. This paper describes the process of adapting and validating the HIV-KQ-18, an instrument to assess the level of HIV/AIDS knowledge.Methods: In the adaptation phase, feedback for the initial Bahasa Indonesia version was gathered from two HIV activists, an obstetrician, two general practitioners, and 60 pilot participants from the physician. Additional descriptions (namely synonyms or examples) were added to the particular terms in the 6 items to make it more understandable.Results: In the validation phase 1,249 participants were recruited. The online link of HIV-KQ-18 Bahasa Indonesia was distributed to participants from six major regions in Indonesia. Internal consistency was measured using Cronbach’s alpha, while construct validity was determined using factor analysis. Based on visual observation of the scree tree in the factor analysis, one factor was preferable. The Cronbach's alpha was 0.82.Conclusion: Therefore, HIV-KQ-18 Bahasa Indonesia is a valid and reliable instrument to assess the level of HIV/AIDS knowledge in Indonesia

Adaptation and validation of the HIV Knowledge Questionnaire-18 for the general population of Indonesia

Background Despite a global decline in new HIV/AIDS cases in low-middle countries, cases are increasing in Indonesia. Low knowledge about the disease among the general population is one of the major factors responsible for this trend. Indonesia does not have a validated instrument to assess HIV/AIDS knowledge. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) has been translated into several languages and is one of the most extensively used instruments for assessing HIV/AIDS knowledge. This paper describes the process of adapting and validating the HIV-KQ-18, an instrument to assess the level of HIV/AIDS knowledge in the general population of Indonesia. Methods In the adaptation phase, feedback for the initial Bahasa Indonesia version was gathered from two HIV activists, an obstetrician, two general practitioners, and 60 pilot participants. At the validation stage, we distributed the instrument link via Google Form to 6 major regions in Indonesia. Validity was measured using known-group validity and construct validity. The construct validity was assessed using an exploratory factor analysis (EFA) with a polychoric correlation matrix. Cronbach's alpha was used to analyze the internal consistency. Results Based on the findings in the adaptation phase, additional descriptions (namely synonyms or examples) were added to 6 items to make them more understandable. In the validation phase, 1,249 participants were recruited. The a priori hypothesis in known-group validity was supported. We also found three items that did not meet the construct validity. Based on the acceleration factor approach to interpret the scree tree in the factor analysis, using only two factors was preferable. Cronbach's alpha values were 0.75 and 0.71 representing good internal reliability. Conclusion The HIV-KQ-18 Bahasa Indonesia is considered a valid and reliable instrument to assess the level of HIV/AIDS knowledge in Indonesia

Adaptation and Validation of The HIV-Kq-18 HIV Knowledge Questionnaire for Healthy Indonesian Population

Background: Indonesia does not have a validated instrument to assess HIV/AIDS knowledge. The HIV-KQ-18 is one of the most extensively used instruments for assessing HIV/AIDS knowledge, and it has been translated into various languages throughout the world. This paper describes the process of adapting and validating the HIV-KQ-18, an instrument to assess the level of HIV/AIDS knowledge.Methods: In the adaptation phase, feedback for the initial Bahasa Indonesia version was gathered from two HIV activists, an obstetrician, two general practitioners, and 60 pilot participants from the physician. Additional descriptions (namely synonyms or examples) were added to the particular terms in the 6 items to make it more understandable.Results: In the validation phase 1,249 participants were recruited. The online link of HIV-KQ-18 Bahasa Indonesia was distributed to participants from six major regions in Indonesia. Internal consistency was measured using Cronbach’s alpha, while construct validity was determined using factor analysis. Based on visual observation of the scree tree in the factor analysis, one factor was preferable. The Cronbach's alpha was 0.82.Conclusion: Therefore, HIV-KQ-18 Bahasa Indonesia is a valid and reliable instrument to assess the level of HIV/AIDS knowledge in Indonesia

Adaptation and Validation of The HIV-Kq-18 HIV Knowledge Questionnaire for Healthy Indonesian Population

Background: Indonesia does not have a validated instrument to assess HIV/AIDS knowledge. The HIV-KQ-18 is one of the most extensively used instruments for assessing HIV/AIDS knowledge, and it has been translated into various languages throughout the world. This paper describes the process of adapting and validating the HIV-KQ-18, an instrument to assess the level of HIV/AIDS knowledge.Methods: In the adaptation phase, feedback for the initial Bahasa Indonesia version was gathered from two HIV activists, an obstetrician, two general practitioners, and 60 pilot participants from the physician. Additional descriptions (namely synonyms or examples) were added to the particular terms in the 6 items to make it more understandable.Results: In the validation phase 1,249 participants were recruited. The online link of HIV-KQ-18 Bahasa Indonesia was distributed to participants from six major regions in Indonesia. Internal consistency was measured using Cronbach’s alpha, while construct validity was determined using factor analysis. Based on visual observation of the scree tree in the factor analysis, one factor was preferable. The Cronbach's alpha was 0.82.Conclusion: Therefore, HIV-KQ-18 Bahasa Indonesia is a valid and reliable instrument to assess the level of HIV/AIDS knowledge in Indonesia