Evaluasi MetodeGeneXpert MTB/RIF dengan SampelRaw Sputum untuk Mendeteksi Tuberkulosis Paru

Tuberkulosis (TB) merupakan penyakit menular yang masih menjadi masalah utama di Indonesia dan dunia. Tantangan utama dalam mendiagnosis TB secara konvensional yaitu rendahnya sensitivitas deteksi pada pemeriksaan mikroskopis dan lamanya waktu yang diperlukan untuk kultur. Penelitian ini bertujuan untuk mengevaluasi metode GeneXpert MTB/RIF untuk mendeteksi Mycobacterium tuberculosis dengan sampel dahak langsung di RSUD Dr. Moewardi (RSDM), Surakarta. Analisis observasional dengan pendekatan kohort retrospektif menggunakan data sekunder hasil pemeriksaan GeneXpert MTB/RIF pada sampel dahak langsung di Laboratorium Mikrobiologi Klinik RSDM pada tahun 2012-2015. Sampel didapatkan dari pasien yang memenuhi kriteria suspek multidrug-resistant tuberculosis (MDR-TB) dan sampel tersebut telah dikultur di Balai Laboratorium Kesehatan (BLK), Jawa Tengah. Data dianalisis dengan OpenEpi versi 3, Epi Info 7, dan MedCalc. Pada penelitian ini didapatkan sensitivitas, spesifisitas, nilai duga positif dan negatif (NDP dan NDN) serta akurasi metode GeneXpert MTB/RIF sebesar 93,62%, 27,17%, 68,89%, 71,21%, dan 69,21%. Prevalensi TB paru pada sampel yang diperiksa sebesar 63,27%. Rendahnya spesifisitas GeneXpert MTB/RIF mengindikasikan perlunya kultur sebagai baku emas. Namun demikian, perlu standarisasi pemrosesan sampel dahak dalam segi teknik dan waktu pengambilan sampel disertai data klinis yang memadai untuk melihat riwayat terapi yang telah diberikan pada pasien

Analisis Molekuler Mycobacterium Tuberculosis Resisten Obat Anti Tuberkulosis pada Pasien HIV Rumah Sakit DR. MOEWARDI Surakarta

Penelitian ini bertujuan mendapatkan isolat dan data analisis molekuler Mycobacterium tuberculosis (M. tuberculosis) pada pasien HIV di Rumah Sakit Dr. Moewardi (RSDM) Surakarta, baik yang masih sensitif maupun yang sudah resisten terhadap Obat Anti Tuberkulosis. Data tersebut sekaligus untuk menunjang data koinfeksi dan melengkapi data epidemiologi molekuler human blood borne virus pada pasien tersebut. Sejak Oktober 2011 Group Riset Blood Borne Virus UNS telah mengumpulkan data dan sampel klinis dan monitoring semua pasien HIV di RSDM (baik pasien di Voluntary Counseling Testing maupun pasien bangsal). Monitoring itu sendiri direncanakan dilakukan setiap tahun hingga 2026. Semua sampel klinis akan dianalisis secara komprehensif, baik terkait status infeksi human blood borne virus, efek samping, perkembangan klinis, maupun koinfeksi dengan patogen lainnya (bakterial, jamur, dan parasit). Salah satu jenis bakterial yang diperiksa adalah M. tuberculosis, terutama yang resisten Obat Anti Tuberkulosis. Skreening tersebut dilakukan menggunakan sampel sputum dan darah, menggunakan metode konvensional maupun molekuler. Laporan ini hanya melaporkan hasil pemeriksaan molekuler dari darah saja. Pada prinsipnya, darah dari pasien HIV dideteksi dengan PCR nested multiplek yang dapat mendeteksi keberadaan Mycobacterium tuberculosis yang resisten rifampin, ethambutol, isoniazid, ofloxacin, kanamicin, dan fluoroquinolon. Produk PCR positif dan kloning sebagian gen kemudian disekuensing dan dianalisis molekuler. Semua data yang didapat akan dijadikan satu dengan data lain terkait dan akan dianalisis secara komprehensif. Isolat dan data molekuler awal hasil penelitian ini nantinya akan digunakan sebagai bahan untuk pembuatan vaksin TB dengan memanfaatkan teknologi pengembangan vaksin yang sedang dikembangkan Group Riset Vaksin – Group Riset Blood Borne Virus UNS

Risk Factors and Prognosis of Nontuberculous Mycobacteria Infection in a High Prevalence of Tuberculosis Setting

Background: The prevalence and incidence of No

Hubungan Status Infeksi Human Immunodeficiency Virus dan Kebersihan Personal dengan Jumlah Koloni Staphylococcus Aureus pada Kulit Anak di Panti Asuhan

Manifestasi klinis infeksi kulit yang disebabkan oleh bakteri piogenik salah satunya S. aureus terutama pada kondisi imunokompromais seperti infeksi HIV/AIDS. Kebersihan personal mempengaruhi peningkatan risiko transmisi S.aureus melalui kontak dari individu satu ke yang lainnya, sehingga dapat meningkatkan risiko infeksi. Penelitian ini bertujuan untuk mengetahui hubungan status HIV dan kebersihan personal dengan jumlah koloni S.aureus pada anak-anak yang tinggal di lingkungan panti asuhan. Penelitian ini merupakan studi analitik korelasi dengan rancangan cross sectional dilakukan pada dua rumah panti asuhan di kota Surakarta, Jawa Tengah, Indonesia. Penelitian dilakukan pada total 32 orang subjek anak dengan rentang usia 3-10 tahun yang terbagi menjadi dua kelompok HIV negatif dan HIV positif. Kriteria eksklusi subjek adalah riwayat kinis atopi, ada lesi kulit pada tempat pengambilan sampel dan memiliki nilai CD4+<500 sel/ mm3, kemudian kebersihan personal subjek didata. Uji normalitas dilakukan, kemudian dilanjutkan uji non parametrik dengan uji korelasi Eta. Nilai r ditentukan untuk melihat kekuatan hubungan kedua variabel dan signifikan apabila didapatkan p<0,005. Berdasarkan analisa diketahui bahwa status HIV tidak menunjukan hubungan yang signifikan dengan jumlah koloni bakteri S. aureus (x10-2) CFU (r=0,297; p=0,098). Kebersihan personal memiliki hubungan signifikan dengan jumlah bakteri S. aureus antara lain frekuensi mandi (r=0,500; p=0,004), penggunaan sabun saat mandi (r=0,480; p=0,005), berbagi gelas (r=0,392; p=0,026), berbagi handuk (r=0,570; p=0,001), memakai alas kaki saat di rumah (r=0,355; p=0,046). Kebersihan personal dan kontak alat rumah tangga secara signifikan berhubungan dengan banyaknya jumlah koloni S.aureus di kulit anak pada kedua kelompok subjek HIV positif maupun negatif

Characteristics of clinical isolates of nontuberculous mycobacteria in Java- Indonesia: A multicenter study

Background Nontuberculous mycobacterial (NTM) lung infections are a major public health concern. Diagnosis of NTM-pulmonary disease (NTM-PD) is difficult because its clinical, microbiological, and radiological features resemble to those of pulmonary tuberculosis (TB), leading to misdiagnosis. Identification at the species level is essential for diagnosis and determination of therapy, which is currently not performed routinely in Indonesian laboratories. Methodology and principal findings From January 2020 to May 2021, 94 NTM isolates were collected from three TB referral centers in Java Province. Species were identified using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS). Tests were performed to determine antibiotic susceptibility, biofilm formation ability, sliding motility characteristics, and the ability to adhere to and invade pneumocytes. After identifying the species of all the isolates, we found nine groups of NTMs: M. fortuitum group 51% (48/94), M. abscessus 38.3% (36/94), M. intracellulare 3.1% (3/94), M. neoaurum 2.1% (2/94), M. chelonae 1.1% (1/94), M. gordonae 1.1% (1/94), M. szulgai 1.1% (1/94), M. mucogenicum 1.1% (1/94), and M. arupense 1.1% (1/94). Amikacin was the most effective antibiotic against M. fortuitum group and M. abscessus. The M. fortuitum group was significantly better at forming biofilms than M. abscessus, but both had the same sliding motility capability. The ability of the M. fortuitum group to adhere to and invade pneumocytes was better than that of M. abscessus, with the number isolates of the M. fortuitum group capable of superior adhesion and invasion to that of M. abscessus. Conclusions/Significance This study shows that M. fortuitum group and M. abscessus were the most common NTM found in Java, Indonesia. The M. fortuitum group and M. abscessus were the most susceptible to amikacin; therefore, this was the empirical treatment of choice. The ability to form biofilms is directly proportional to the ability to adhere to and invade pneumocytes but not to the susceptibility profile or sliding motility characteristics

In Vitro Study of Eight Indonesian Natural Extracts as Antiviral Against Dengue Virus

800x600 Background: Dengue hemorrhagic fever (DHF) caused by a dengue viruses is still a major problem in tropical countries, including Indonesia. World Health Organization data showed that over 40% of world population are at risk of DHF.1In 2014 there were 71.668 of DHF cases in 34 provinces with 641 death.2 In Central Java in 2013, the incidence rate and fatality rate of DHF was 45.52 in 100.000 populations and 1.21% respectively.3 Until nowadays, there is no vaccine or effective therapy is available as yet.4 Thus research on discovering specific antiviral against dengue is needed. Indonesia is rich in indigenous herbal plants, which may has potential antiviral activity, such as Psidium guajava (Jambu biji), Euphorbia hirta (Patikn kerbau), Piper bettle L (Sirih), Carica papaya (Pepaya), Curcuma longa L(Kunyit/turmeric), Phyllanthus niruri L (meniran), Andrographis paniculata (Sambiloto), Cymbopogon citrates (Serai). Previous studies show that these plants have antiviral and antibacterial properties.5However, there is only limited study of these plants against dengue virus . Objective: This study aimed to know whether these plants have potential activity against dengue virus in vitro. Method: Leave extracts of eight indigenous herbal plants as mention before were originated from Solo, Central Java, the crude extracts were tested in vitro against dengue virus serotype 2 (DENV-2) strain NGC using Huh7it-1 cell line. Those crude extracts were screened for antiviral activity using doses of 20mg/ml. Candidates that showed inhibition activity were further tested in various doses to determine IC50 and CC50. Result: From eight leave extracts tested, one of them i.e Carica papaya (pepaya) inhibited virus replication up to 89,5%. Dose dependent assay with C.papaya resulted in IC50, CC50 and selectivity index 6,57 μg/mL, 244,76 μg/mL and 37, 25 μg/mL respectively. Conclusion: C.papaya has potential antiviral activity against dengue virus in vitro. Further study is needed to confirm antiviral activity in vivo. Key word : Dengue virus, natural extract, antiviral activity, Carica papaya Normal 0 false false false EN-US X-NONE X-NONE <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Tab

In Vitro Study of Eight Indonesian Natural Extracts as Antiviral Against Dengue Virus

Background: Dengue hemorrhagic fever (DHF) caused by a dengue viruses is still a major problem in tropical countries, including Indonesia. World Health Organization data showed that over 40% of world population are at risk of DHF.1In 2014 there were 71.668 of DHF cases in 34 provinces with 641 death.2 In Central Java in 2013, the incidence rate and fatality rate of DHF was 45.52 in 100.000 populations and 1.21% respectively.3 Until nowadays, there is no vaccine or effective therapy is available as yet.4 Thus research on discovering specific antiviral against dengue is needed. Indonesia is rich in indigenous herbal plants, which may has potential antiviral activity, such as Psidium guajava (Jambu biji), Euphorbia hirta (Patikn kerbau), Piper bettle L (Sirih), Carica papaya (Pepaya), Curcuma longa L(Kunyit/turmeric), Phyllanthus niruri L (meniran), Andrographis paniculata (Sambiloto), Cymbopogon citrates (Serai). Previous studies show that these plants have antiviral and antibacterial properties.5However, there is only limited study of these plants against dengue virus . Objective: This study aimed to know whether these plants have potential activity against dengue virus in vitro. Method: Leave extracts of eight indigenous herbal plants as mention before were originated from Solo, Central Java, the crude extracts were tested in vitro against dengue virus serotype 2 (DENV-2) strain NGC using Huh7it-1 cell line. Those crude extracts were screened for antiviral activity using doses of 20mg/ml. Candidates that showed inhibition activity were further tested in various doses to determine IC50 and CC50. Result: From eight leave extracts tested, one of them i.e Carica papaya (pepaya) inhibited virus replication up to 89,5%. Dose dependent assay with C.papaya resulted in IC50, CC50 and selectivity index 6,57 μg/mL, 244,76 μg/mL and 37, 25 μg/mL respectively. Conclusion: C.papaya has potential antiviral activity against dengue virus in vitro. Further study is needed to confirm antiviral activity in vivo

Infection prevention and control in Indonesian hospitals: identification of strengths, gaps, and challenges

Background Infection prevention and control (IPC) in hospitals is key to safe patient care. There is currently no data regarding the implementation of IPC in hospitals in Indonesia. The aim of this study was to assess the existing IPC level in a nationwide survey, using the World Health Organization (WHO) IPC assessment framework tool (IPCAF), and to identify strengths, gaps, and challenges. Methods A cross-sectional study was conducted from July to November 2021. Of all general hospitals in Indonesia, 20% (N = 475) were selected using stratified random sampling based on class (A, B, C and D; class D with a maximum of 50 beds and class A with ≥ 250 beds) and region. The IPCAF was translated into Indonesian and tested in four hospitals. Questions were added regarding challenges in the implementation of IPC. Quantitative IPCAF scores are reported as median (minimum–maximum). IPC levels were calculated according to WHO tools. Results In total, 355 hospitals (74.7%) participated in this study. The overall median IPCAF score was 620.0 (535.0–687.5). The level of IPC was mostly assessed as advanced (56.9% of hospitals), followed by intermediate (35.8%), basic (7.0%) and inadequate (0.3%). In the eastern region of the country, the majority of hospitals scored intermediate level. Of the eight core components, the one with the highest score was IPC guidelines. Almost all hospitals had guidelines on the most important topics, including hand hygiene. Core components with the lowest score were surveillance of healthcare-associated infections (HAIs), education and training, and multimodal strategies. Although > 90% of hospitals indicated that surveillance of HAIs was performed, 57.2% reported no availability of adequate microbiology laboratory capacity to support HAIs surveillance. The most frequently reported challenges in the implementation of IPC were communication with the management of the hospitals, followed by the unavailability of antimicrobial susceptibility testing results and insufficient staffing of full-time IPC nurses. Conclusion The IPC level in the majority of Indonesian hospitals was assessed as advanced, but there was no even distribution over the country. The IPCAF in combination with interviews identified several priority areas for interventions to improve IPC in Indonesian hospitals