Staphylococcus Aureus Colonization On An Erythrodermic Psoriasis Patient

Skin plays an important role as the physical barrier and first-line immunological defense against dangerous stimuli, including bacteria. Erythroderma is a condition of excessive skin irritation causing extensive erythema and desquamation. Erythroderma itself is caused by various underlying conditions, one of them is psoriasis vulgaris. In erythroderma, there is an extensive disruption of physical barrier leading to the exposure of various bacteria, including Staphylococcus aureus. In human, this bacteria can either colonize or infect the host if exposed to open wound. It is essential to determine this as it will affect the necessity of administering antibiotics. Laboratory examinations such as complete blood count, Gram staining, and culture can help to determine the status of this bacteria. A correlation between clinical features and laboratory examinations is paramount in deciding patient management

The Quality of Sputum Specimens as a Predictor of Isolated Bacteria From Patients With Lower Respiratory Tract Infections at a Tertiary Referral Hospital, Denpasar, Bali-Indonesia

Sputum quality is crucial in finding infectious bacteria that will be used to guide definitive antibiotic therapy. Errors in reporting isolated bacteria will affect the rate of patients' morbidity, mortality, and increase patient care costs. This study aims to find out the relationship between sputum quality and isolated bacteria at a Tertiary Referral Hospital, Denpasar, Bali-Indonesia. The study was conducted for 6 months in the Sanglah Hospital Clinical Microbiology laboratory. There were 726 sputum specimens examined and categorized based on Murray Washington criteria. After Gram examination, all specimens were inoculated on aerobic culture media. We classified 41.4% of poor-quality sputum specimens, and non-pathogenic bacteria were isolated from 70.2% of that specimen dominated by Streptococcus mitis (42.53%). Whereas, isolated pathogens were obtained from 54.4% of good-quality sputum specimens dominated by Klebsiella pneumonia (30.86%). Statistical analyses showed that there is a relationship between isolated bacteria and the sputum quality (OR = 3.844; p < 0.001). Good-quality sputum is 3.8 times more likely to isolate pathogenic bacteria than poor-quality sputum. In the Pearson Chi-Square test, the likelihood of isolating pathogenic bacteria from good-quality specimens was significant too (p < 0.001). The results of this study indicate that poor-quality sputum specimens are still found. Therefore, the capacity of good sputum collection must be improved. Supervision of the application of standard sputum culture operational procedures must be more rigorously carried out

Udayana One Health Collaborating Center (OHCC) initiated Bali’s first mass, integrated basic life support training

ABSTRACTBasic Life Support (BLS) is a first-aid training that can be utilized in case of emergency until the victims are retained by medical professionals. Mastering BLS skills can be the difference between life and death. A cardiopulmonary resuscitation (CPR) performed by a passer-by is important to ensure a successful resuscitation in out-of-hospital cardiac arrest. Yet, improving the survival rate for out-of-hospital cardiac arrest is still a major problem. Starting in 2019, Udayana One Health Collaborating Center (Udayana OHCC) will implement the first mass and integrated BLS training in Bali. The goals are to introduce BLS to more people and to produce BLS-friendly environment in Bali

Surveillance and characterisation of influenza viruses among patients with influenza-like illness in Bali, Indonesia, July 2010-June 2014.

BACKGROUND: Although Indonesia has high fatality rate of human A/H5N1 cases, epidemiological and clinical data on influenza virus circulation among humans has been limited. Within Indonesia, Bali province is of interest due to high population densities of humans, pigs and poultry. This study aims to characterize and compare the epidemiological and clinical patterns of influenza viruses in humans through surveillance among patients with influenza-like illness (ILI) in Bali, Indonesia. METHODS: ILI patients were recruited at 21 sentinel health facilities across all nine regencies in Bali, from July 2010 to June 2014. PCR-based assays were used for detection and subtyping of influenza viruses. Demographic, behavioural and clinical data were tested for associations with influenza using chi-squared tests and logistic regression. RESULTS: Of 2077 ILI patients, 291 (14.0%) tested positive for influenza A, 152 (7.3%) for influenza B, and 16 (0.77%) for both influenza A and B. Of the influenza A isolates, the majority 61.2% were A/H3N2, followed by A/H1N1-pdm09 (80; 26.1%). Two A/H5N1 were identified. Influenza positive rates were significantly higher during wet season months (28.3%), compared with the dry season (13.8%; χ2 = 61.1; df = 1; p < 0.0001). Clinical predictors for infection varied by virus type, with measured fever (≥38 °C) more strongly associated with influenza B (AOR: 1.62; 95% CI: 1.10, 2.39). CONCLUSION: Influenza circulates year-round among humans in Bali with higher activity during the wet season. High contact rates with poultry and pigs, along with influenza virus detection that could not be subtyped through conventional assays, highlight the need for molecular studies to characterize epidemiological and evolutionary dynamics of influenza in this setting

The relationship between bacterial types and antibiotic resistance with the clinical outcomes of sepsis patients in Pediatric Intensive Care Unit at Sanglah Hospital Denpasar, Bali-Indonesia

Background: Sepsis in children could significantly increase the morbidity and mortality rates particularly in the Pediatric Intensive Care Unit (PICU). Moreover, the prevalence of antibiotic resistance is continuously increasing around the world mainly caused by uncontrolled used of antibiotic. Henceforth, this study aimed to determine the relationship between bacterial type and the resistance with clinical outcome of sepsis patients in PICU.Methods: An observational analytic retrospective cohort study using medical record data from January 2015-April 2017 was conducted. All subjects were sepsis patients with positive blood cultures treated at PICU Sanglah Hospital. Factors related to mortality and relative risk (RR) were analyzed using Chi-Square Test with a significance value of p &lt;0.05 with 95% confidence interval (CI).Results: 75 subjects met the inclusion criteria, but only 63 subjects with complete data were enrolled. The gram-negative and MDR bacteria types were detected in 31 (49%) subjects and 33 (52.4%) subjects respectively. The number of deaths was 29 (46%). The most common types of gram-negative bacteria were Pseudomonas aeruginosa (16%) followed by gram-positive Staphylococcus hominis (25%). The most common multi-drug resistant (MDR) bacteria were Staphylococcus hominis. The presence of MDR bacteria significantly increase the mortality (p = 0.015, RR 2.02, 95% CI: 1.096-3.725), whereas gram-negative had no significant mortality impact (p = 0.891: RR 0.96; 95% CI: 0.564- 1.645). Compared to non-MDR bacteria, most MDR related mortality occurred during the first 10 days.Conclusion: MDR bacteria significantly increased the mortality rates in pediatric patient treated in PICU compared to non-MDR ones. </p

Perbedaan Gambaran Histopatologi Granuloma Paru Mencit Setelah Diinfeksi Mycobacterium tuberculosis dan atau Intervensi Silika

The characteristics of lung tuberculosis is granuloma, which is consisted of lymphocytes andmacrophages that show the interaction between immune cells and M.tb. Granuloma is the organizationprocess which is depend on lymphocytes invasion, adhesion molecules and chemokine fasilitation. Silicosiswhich is caused by silica, can influence granuloma in the lung. The features of granuloma is variationdepend on the elicited agent and immune reaction. The main purpose of this study was to prove thehistopathology differences of mice lung granuloma caused by M.tb infection, silica intervention and bothin 3th and 7th weeks. It was 45 mice Balb-c strain, divided into 3 groups; P1 got M.tb infection with H37Rvstrain 105 perml,P2 got silica intervention with 60 micro litre and, P3 got both of M.tb infection and silica intervention. Termination of each group were held on 3 and 7 weeks of intervention, continued byhistopathology examination. In the histopathology feature, we done semi-quantitative prosedure to measurelung damage by using Dormans scores; perivasculitis, peribronchiolitis, alveolitis and granuloma. Oneway anova to analysis the differences of histopathologycal result among these groups (P< 0,05). Resultshowed the significant differences among these group. In the 3th weeks, we found mild lung damage werehappened in all groups with granuloma, without necrosic (P1 and P2). In the 7th weeks we found severe lungdamage in P3 with necrotic and fibrotic granuloma sign, with necrosis in P1, with fibrotic in P2. Weconcluded the worst lung damage happened in 7th weeks in group which are got M.tb infection and silicaintervention, with granuloma characterictic of necrosic and fibrotic

Penerapan konsep one health dalam penanganan kasus rabies

Buku ini menggambarkan pentingnya peran masing-masing instansi yang terlibat dalam penanganan rabies sehingga kolaborasi, koordinasi dan komunikasi dapat diterapkan dengan baikviii, 84 hlm.: 23 c

The presence of the vim-2 gene of Pseudomonas aeruginosa carbapenem resistance

Pseudomonas aeruginosa is an opportunistic pathogen that causes infection in immunocompromised patients. Pseudomonas aeruginosa can cause severe acute and chronic infections in patients on ventilators and patients with burns, surgery, diabetic foot ulcers, and catheterization. vim-2 gene distributes metallo-β-lactamase with a broad spectrum of substrates against penicillins, cephalosporins, cefamycins, and carbapenems. Therefore, an attractive drug target for the treatment of β-lactam-resistant infections. This study aims to know the presence of the vim-2 P. aeruginosa carbapenem resistance gene. Pseudomonas aeruginosa is the most common microorganism that causes infection in the community and hospitals. Resistance of P. aeruginosa to various antibiotics is an increasingly common overuse or inappropriate use. vim-2 gene is of high clinical relevance due to its wide distribution and broad substrate range and therefore represents an important drug target for treating antibiotic-resistant infections. Based on the literature review, a molecular examination of the vim-2 gene is critical to be a reference in selecting appropriate antibiotics in addition to phenotypic study