Deteksi Antigen pada Kriptokokosis

AbstrakKriptokokosis merupakan infeksi sistemik yang disebabkan Cryptococcus sp. Predileksi jamur tersebut adalah susunan saraf pusat dan selaput otak. Terdapat 5 spesies Cryptococcus sp. yang menyebabkan penyakit pada manusia; yang paling banyak adalah Cr. neoformans dan Cr. gattii. Diagnosis kriptokokosis ditegakkan berdasarkan gejala klinis, pemeriksaan laboratoris serta radiologis. Pemeriksaan laboratoris dilakukan dengan identifikasi morfologi, serologi danPCR. Pemeriksaan secara morfologi dengan tinta India positif  bila jumlah sel jamur 10  sel/ml spesimen. Kultur dilakukan di media sabouraud dextrose agar (SDA) dan niger sheed agar (NSA), jamur tumbuh setelah 5-7 hari. Deteksi antigen dan antibodi dilakukan pada cairan tubuh dan tidak membutuhkan waktu lama. Deteksi antibodi Cr.neoformans memiliki kelemahan yaitu tidak menunjukkan hasil positif pada infeksi akut, IgA masih positif setelah 1-2 tahun fase penyembuhan, IgG dapat persisten, pada individu imunokompromis menunjukkan hasil yang sangat kompleks dan dalam menentukan diagnosis sering tidak konsisten. Polisakarida adalah komponen paling berperan dalam virulensi Cr. neoformans. Komponen polisakarida terutama glucuronoxylomannan merupakan petanda penting dalam diagnosis kriptokokosis secara serologis. Deteksi antigen Cr. neoformans memiliki kelebihan yaitu menunjukkan hasil positif pada infeksi akut/kronis, sensitivitas dan spesifisitas tinggi, dapat mendeteksi polisakarida hingga 10 ng/ml sehingga dengan kadarantigen yang minimal tetap dapat mendiagnosis kriptokokosis.Kata kunci: Cr. neoformans, glucuronoxylomannan, antigenAbstractCryptococcosis is systemic infection that caused by Cryptococcus sp. Predilection of this fungi is the central nervous system and brain membrane. There are 5 species of Cryptococcus sp. that cause cryptococcosis in human; but the majority are caused by Cr. neoformans and Cr. gattii. The diagnosis of cryptococcosis is made based on clinical symptoms, laboratory and radiologicalexaminations. Laboratory examinations performed by morphological identification, serology and PCR. Morphological examination with India ink is positive when the number of fungi is around 10 10  cells/ml. Cultur examination is performed in Sabouraud dextrose agar (SDA) and niger sheed agar (NSA) medium, fungi grows in 5-7 days. Antigen and antibody detection could be performed on body fluid and do not take a long time. Detection of Cr. neoformans antibody can not show positive result in acute infection, IgA still positive after 1-2 years of healing phase and IgG can be persistent. The immunocompromised person showed very complex result and inconsistent in determining the diagnosis. Polysaccharides are the most instrumental component in Cr. neoformans virulence. The component of Polysaccharide especially glucuronoxylomannan is the most important marker in thediagnosis of cryptococcosis. Antigen detection of Cr. neoformans can show positive result in acute/chronic infection, high sensitivity and specificity. Polysaccharides can be detected from 10 ng/ ml of body fluid, so in minimal level of antigen we still can diagnose cryptococcosis.Keywords: Cr. neoformans, glucuronoxylomannan, antige

The Susceptibility of Aedes aegypti In Dengue Endemic Areas, Tegal, Central Java Indonesia

Tegal district is a dengue-endemic area. One of the strategies to control Ae. aegypti is the use of insecticides. The determination of insecticide resistance in a dengue-endemic area is useful for supporting policies for Ae. aegypti control program. The aim of this study is to determine the susceptibility of Ae. aegypti in Tegal district, Central Java. Aedes aegypti larvae were collected from June to July 2018. Susceptibility bioassay of Ae. aegypti larvae against temephos and Ae. aegypti female against permethrin were conducted refers to the WHO protocol. The susceptibility of Ae. aegypti was interpreted based on WHO protocol as well. The mortality of Ae. aegypti larvae were at 0.025 ppm by 90%. The LC50 at 0.0005 ppm, and LC99 at 1.1037 ppm, respectively. The mortality rate of Ae. aegypti against permethrin was 26%. The LT50 at 6611.636 minutes, and LT99 at 5958807.272 minutes, respectively. The susceptibility of Ae. aegypti larvae were possible resistant but adult Ae. aegypti was resistant