Pola Kepekaan Bakteri yang Diisolasi dari Liang Telinga Penderita Otitis Media Supuratif Kronis Terhadap Antibiotik

AbstrakOtitis media supuratif kronis (OMSK) merupakan infeksi telinga tengah yang ditandai dengan keluarnya sekret dari telinga lebih dari dua bulan, sekret cair atau kental berwarna bening atau seperti nanah, frekuensi terus-menerus atau hilang timbul, dan membran timpani mengalami perforasi. Pengobatan konservatif pada OMSK adalah antibiotik topikal dan sistemik. Pola sensitivitas mikroba berubah dari waktu ke waktu, sehingga tujuan penelitian ini adalah untuk mengetahui sensitivitas antibiotik pada bakteri sekret telinga penderita OMSK. Penelitian menggunakan metode deskriptif dengan desain case series. Pengambilan data dilakukan dengan total sampling, yaitu seluruh pasien OMSK yang datang ke Rumah Sakit Universitas Kristen Indonesia, memenuhi kriteria inklusi dan eksklusi, pada bulan Agustus 2019 hingga November 2019. Dari 16 responden penderita OMSK, terdapat 10 laki-laki (62,4%), 5 berasal dari kelompok usia 0-10 tahun (31,2%), dan 16 memiliki keluhan utama keluar cairan (93,8%). Kuman terbanyak adalah Staphylococcus aureus (6 atau 35,3%), sensitivitas antibiotik tertinggi adalah Imipenem (16 atau 94.4%), diikuti gentamisin (13 atau 76,5%) dan Amikasin (13 atau 76.5%). Antibiotik resistensi tertinggi adalah kloramfenikol (13 atau 76,5%), diikuti eritromisin (13 atau 76.5%) dan amoksisilin (7 atau 70,6%).Kata kunci: Otitis media supuratif kronis (OMSK), sekret telinga, kultur, sensitifitas antibiotik. AbstractChronic suppurative otitis media (CSOM) is an infection of the middle ear characterized by secretions from the ear for more than two months, liquid or thick discharge that is clear or pus-like, continuous frequency or recurrent, with a tympanic membrane perforation. Topical and systemic antibiotics are used to treat CSOM. The pattern of microbial sensitivity can changes over time, and the purpose of this study was to evaluate the sensitivity of antibiotics in CSOM patients. This study used a descriptive method with a case series design. Total sampling was done by including all CSOM patients who came to the Indonesian Christian University Hospital from August 2019 to November 2019 based on the inclusion and exclusion criteria. Of 16 respondents with CSOM, there 10 males (62.4%), 5 were in the age group of 0-10 years (31.2%), and 16 had the main complaint of fluid discharge (93.8%). The most common bacteria were Staphylococcus aureus (6 or 35.3%), antibiotic with the highest sensitivity were imipenem (16 or 94.4%), gentamicin (13 or 76.5%) and amikacin (13 or 76.5%). Antibiotics with the highest resistance were chloramphenicol (13 or 76.5%), erythromicin (13 or 76.5%) and amoxicillin (7 or 70.6%).Keywords: Chronic suppurative otitis media (CSOM), culture, ear secretions, antibiotic susceptibility

Profil Otitis Media Supuratif Kronik di RSU Universitas Kristen Indonesia, Jakarta

Abstrak Otitis media supuratif kronis (OMSK) adalah infeksi kronis di telinga tengah. Penurunan pendengaran dapat dipengaruhi oleh lama sakit dan luas perforasi membran timpani. Penelitian ini bertujuan untuk mengetahui gambaran klinis OMSK di RSU UKI. Penelitian dilakukan secara observasional dengan pendekatan cross sectional study. Hasil penelitian menunjukkan OMSK lebih sering ditemukan pada usia >50 tahun dan usia 18-35 tahun, mengenai telinga kiri, dengan perforasi membran timpani sedang-besar, serta kurang pendengaran derajat sedangberat. Terdapat hubungan bermakna (p<0,05) antara luas perforasi membran timpani dengan derajat kurang pendengaran. Disimpulkan bahwa OMSK lebih sering ditemukan pada usia > 50 tahun, mengenai telinga kiri, dengan perforasi membran timpani sedang-besar, kurang pendengaran derajat sedang-berat. Terdapat hubungan antara luas perforasi membran timpani pada OMSK dengan derajat kurang pendengaran. Kata kunci: Luas perforasi membran timpani, derajat kurang pendengaran, otitis media supuratif kronik Abstract Chronic otitis media (COM) is a chronic infection of the middle ear. Loss of hearing could be affected by the duration of the illness and the size of perforation of the tympanic membrane. The aim of this study was to evaluate the COM’s profile in the Indonesian Christian University General Hospital, Jakarta. We performed an observational study with a cross sectional design. We found the COM was more frequent in ³50 and 18-35 year-old groups, left ear, with medium-large size of tympanic membrane perforation, degree of hearing loss is moderate to severe. There was a significant (p<0.05) association between the size of tympanic membrane perforation with the degree of hearing loss. This study found that COM was more frequent in people 50 year–old or older, left ear, medium-large perforated tympanic membrane, moderate to severe degree of hearing loss, The size of perforation of tympanic membrane was associated with the severity of hearing loss.Keywords: Size of tympanic membrane perforation, severity of hearing loss, chronic otitis medi

Hubungan antara Gangguan Pendengaran dan Kualitas Hidup pada Orang Lanjut Usia

Abstrak Menurut data USA-Bureau of the census, Indonesia diperkirakan akan mengalami pertambahan warga lansia terbesar di seluruh dunia antara tahun 1990-2025, yaitu sebanyak 414%. Sejalan dengan bertambahnya usia harapan hidup di Indonesia, masalah kesehatan bagi usia lanjut akan semakin banyak, salah satunya adalah gangguan pendengaran. Pada individu yang berusia lebih dari 65 tahun, sekitar 30% di antaranya mengalami penurunan fungsi pendengaran (presbiskusis) dan setelah usia 75 tahun, angka tersebut meningkat menjadi 50%. Masalah pendengaran dapat berpengaruh pada kualitas hidup lansia. Penelitian ini bertujuan untuk mengetahui hubungan antara gangguan pendengaran dan kualitas hidup pada lansia di Sasana Tresna Werdha Karyabakti Ria Pembangunan Cibubur. Penelitian ini menggunakan metode penelitian cross sectional. Teknik sampling pada penelitian ini adalah total sampling dengan jumlah sampel sebanyak 48 orang. Responden mengisi dua kuesioner, yaitu Hearing handicap inventory elderly-screening version (HHIE-S) dan World Health Organization quality of life (WHOQOL-BREF). Terdapat kecenderungan bahwa lansia yang memiliki gangguan pendengaran berisiko lebih besar untuk memiliki kualitas hidup yang kurang baik, walaupun hubungan tidak bermakna (odds ratio 2,0; 95% confidence interval 0,49,7; p=0,605). Diperlukan sampel penelitian yang lebih besar dan desain penelitian yang lebih baik untuk meneliti lebih lanjut hubungan antara gangguan pendengaran dan kualitas hidup pada lansia.Kata kunci: Lanjut usia, gangguan pendengaran, HHIE-S, kualitas hidup, WHOQOL-BREF Abstract According the data from USA Bureau of the census, Indonesia is expected to experience the largest increase (414%) in elderly citizens worldwide between 1990-2025. In line with the increasing life expectancy of the people in Indonesia, there will be more health problems for the elderly, for example hearing loss. In individuals aged over 65 years old, about 30% of them experience decreasing hearing ability (presbiskusis) and after 75 years old, that number increases to 50%. Hearing problem can affect to the quality of life of the elderly. This research aimed to determine the relationship of hearing loss with the quality of life for elderly in Sasana Tresna Werdha Karyabakti Ria Pembangunan Cibubur. This research used a cross sectional method with total sampling technique. All 48 respondents filled out two questionnaries: the hearing handicap inventory elderly-screening version (HHIE-S) and the World Health Organization Quality of Life (WHOQOL-BREF). From the results of the analysis, it was found that respondents with poor hearing quality had a higher risk of having poor quality of life, although the association was not significant (odds ratio 2,0; 95% confidence interval 0,4-9,7; p=0,605). Bigger study with better design is needed to evaluate the relationship between hearing loss and qulaity of life in elederly.Keywords: Elderly, hearing loss, HHIE-S, quality of life, WHOQOL-BREF

Knowledge and attitude towards pregnancy-related issues of Zika virus infection among general practitioners in Indonesia

Abstract Background The aim of this study was to assess the knowledge and attitudes towards pregnancy-related issues of Zika virus (ZIKV) infection among general practitioners (GPs), a frontline healthcare worker group, in Indonesia. Methods A cross-sectional, online survey assessing knowledge and attitudes towards ZIKV infection on multiple-item scales was sent to GPs in the Sumatra and Java islands of Indonesia. The associations between independent factors and either knowledge or attitude were assessed with logistic regressions. The correlation and association between knowledge and attitude were estimated. Results We included 457 (53.7%) out of 850 responses in the analysis. Among these, 304 (66.5%) and 111 (24.2%) respondents had a good knowledge and attitude, respectively. No demographic, workplace, professional development, or experiential characteristics related to ZIKV infection were associated with knowledge. In the multivariate analysis, only contact experience was associated with attitude. There was a significant, positive correlation between knowledge and attitude scores. Conclusions Although knowledge of pregnancy-related complications of ZIKV infection is relatively high among GPs in Indonesia, more than 75% of them had a poor attitude towards pregnancy-related issues of Zika. Strategies for enhancing the capacity of GPs to develop positive attitudes and respond to ZIKV infection are needed.https://deepblue.lib.umich.edu/bitstream/2027.42/152124/1/12879_2019_Article_4297.pd

Knowledge and attitude towards pregnancy-related issues of Zika virus infection among general practitioners in Indonesia

Abstract Background The aim of this study was to assess the knowledge and attitudes towards pregnancy-related issues of Zika virus (ZIKV) infection among general practitioners (GPs), a frontline healthcare worker group, in Indonesia. Methods A cross-sectional, online survey assessing knowledge and attitudes towards ZIKV infection on multiple-item scales was sent to GPs in the Sumatra and Java islands of Indonesia. The associations between independent factors and either knowledge or attitude were assessed with logistic regressions. The correlation and association between knowledge and attitude were estimated. Results We included 457 (53.7%) out of 850 responses in the analysis. Among these, 304 (66.5%) and 111 (24.2%) respondents had a good knowledge and attitude, respectively. No demographic, workplace, professional development, or experiential characteristics related to ZIKV infection were associated with knowledge. In the multivariate analysis, only contact experience was associated with attitude. There was a significant, positive correlation between knowledge and attitude scores. Conclusions Although knowledge of pregnancy-related complications of ZIKV infection is relatively high among GPs in Indonesia, more than 75% of them had a poor attitude towards pregnancy-related issues of Zika. Strategies for enhancing the capacity of GPs to develop positive attitudes and respond to ZIKV infection are needed.https://deepblue.lib.umich.edu/bitstream/2027.42/152124/1/12879_2019_Article_4297.pd

A multi-country analysis of COVID-19 hospitalizations by vaccination status

Background: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes. Methods: Here, we use data from an international consortium to study this question and assess whether differences between these groups are context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed. Findings: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed. Conclusions: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history. Funding: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill & Melinda Gates Foundation (OPP1209135); and the philanthropic support of the donors to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes