Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 13 dokumen yang sesuai dengan query
cover
Linosefa
"[ABSTRAK
Staphylococcus spp. peragi manitol merupakan flora normal kulit terbanyak dan sering bersifat multiresisten, serta dapat menjadi salah satu penyebab healthcare associated infection (HAI). Di Indonesia, data mengenai Staphylococcus spp. peragi manitol yang resisten metisilin belum tersedia. Penelitian ini bersifat retrospektif untuk mengetahui pola kepekaan dan karakteristik genotipik (mecA dan tipe SCCmec I-V) flora normal Staphylococcus spp peragi manitol yang diisolasi dari pasien ICU Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM) tahun 2011, 2013 dan 2014. Dari 187 isolat, 15% di antaranya merupakan methicillin resistant Staphylococcus aureus (MRSA) yang sebagian besar resisten terhadap gentamisin (64,3%), klindamisin (50%), golongan fluorokuinolon (64,3-71,4%) dan tetrasiklin (57,1%). Sedangkan 55,6% merupakan Staphylococcus koagulase negatif resisten metisilin (MR-CoNS) yang sebagian besar resisten terhadap gentamisin (55%), fluorokuinolon (62,5-88,5%), eritromisin (91,3%), klindamisin (75%) dan rifampisin (82,7%). Resisten metisilin pada MRSA hampir semuanya disebabkan oleh gen mecA (96,4%), sedangkan pada MR-CoNS, gen mecA ditemukan pada 76,9% isolat. Tipe SCCmec yang paling banyak ditemukan pada kedua kelompok yaitu SCCmec tipe I. Dapat disimpulkan bahwa sebagian besar Staphylococcus spp. peragi manitol yang merupakan flora normal pasien yang dirawat di ICU RSUPNCM, merupakan pembawa gen mecA. Surveilens berkelanjutan dibutuhkan untuk mengetahui kecenderungan perubahan pola kepekaan dan pencegahan transmisi di fasilitas kesehatan.

ABSTRACT
Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.;Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.;Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities., Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.]"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
T58924
UI - Tesis Membership  Universitas Indonesia Library
cover
Iin Maemunah
"Bakteri Acinetobacter baumannii, Pseudomonas aeruginosa dan Klebsiella pneumoniae resisten multiobat penghasil biofilm merupakan masalah kesehatan serius di seluruh dunia, terutama di Indonesia sebagai negara dengan prevalensi bakteri Gram negatif resisten multiobat penghasil enzim beta laktamase tertinggi se-Asia Tenggara. Tujuan penelitian ini adalah mendapatkan metode deteksi dan mengetahui proporsi pembentukan biofilm dengan metode tabung eppendorf polypropylene yang mudah dikerjakan, reproducible dan efisien pada isolat simpan A. baumannii, P.aeruginosa dan K. pneumonia yang resisten multiobat penghasil biofilm di Laboratorium Mikrobiologi FKUI-RSCM pada periode Maret 2015-Oktober 2016. Sebanyak 71 isolat simpan yang menjadi sampel penelitian. Setiap isolat dilakuan uji deteksi pembentukan biofilm dengan media luria bertani, diinkubasi selama 30 jam, dibersihkan dari sisa sel planktonik dengan PBS steril dan diwarnai dengan crystal violet 0,1. Proporsi pembentukan biofilm pada Acinetobacter baumannii, Pseudomonas aeruginos dan Klebsiella pneumoniae masing-masing secara berurutan adalah 55,3, 53,3 dan 0. Metode deteksi pembentukan biofilm dengan tabung eppendorf polypropylene merupakan metode deteksi yang mudah dikerjakan, reproducible dan efisien, sehingga dapat dilakukan di laboratorium mikrobiologi klinik sederhana. Proporsi bakteri penghasil biofilm adalah lebih dari 50 non-Enterobactericeae resisten multiobat, tetapi tidak pada isolat K. pneumoniae resisten multiobat.

Biofilm forming multidrug resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae are a major cause of health problems in hospitalized facilities in the world, especially in Indonesia as the highest prevalence of the multidrug resistant Gram negative bacteria in Southeast Asia. The aim of this study is to get the method of detection and proportion of biofilm formation using polypropylene eppendorf tube because easy to do, reproducible and efficient from stock culture isolates of multidrug resistant A. baumannii, P.aeruginosa and K. pneumonia at clinical microbiology laboratory of FKUI RSCM during March October 2016. The are 71 stock culture isolates from the total sample, medium for biofilm cultivation was Luria Bertani, incubated for 30 hrs, washed with sterile phosphat buffer saline and stained with crystal violet 0,1. Proportion of biofilm producing of multidrug resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae were respectively 55.3, 53.5 and 0. Detection of biofilm formation using polypropylene eppendorf tube could perfom in simple clinical microbiology laboratory because easy to do, reproducible and efficient. The proportion of biofilm producing showed that more than 50 of multirug resistant of non Enterobactericeae, but no one of K. pneumoniae isolate.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T58851
UI - Tesis Membership  Universitas Indonesia Library
cover
Iin Maemunah
"Latar Belakang: Bakteri Acinetobacter baumannii, Pseudomonas aeruginosa dan Klebsiella pneumoniae resisten multiobat penghasil biofilm merupakan masalah kesehatan serius di fasilitas kesehatan di seluruh dunia, terutama di Indonesia sebagai negara dengan prevalensi bakteri Gram negatif penghasil enzim extended beta-laktamase ESBL tertinggi di atas rerata diantara berbagai negara di Asia Pasifik, belum memiliki data tentang bakteri Gram negatif penghasil biofilm. Diperlukan metode deteksi pembentukan biofilm dengan tabung eppendorf polypropelene yang mudah dikerjakan, reproducible dan efisien sehingga dapat dikerjakan di laboratorium mikrobiologi klinik sederhana.
Tujuan: Melakukan optimasi deteksi biofilm menggunakan metode tabung eppendorf polypropelene dan mengetahui proporsi pembentukan biofilm pada isolat simpan A. baumannii, P.aeruginosa dan K. pneumonia yang resisten multiobat penghasil biofilm di Laboratorium Mikrobiologi Klinis, Dept. Mikrobiologi FKUI-RSCM pada periode Maret 2015-Oktober 2016.
Metode: Penelitian dilakukan dalam 2 tahap. Tahap pertama adalah optimasi metode deteksi pembentukan biofilm dengan metode Cernohorska dkk menggunakan tabung eppendorf polypropylene. Pada tahap pertama ini dilakukan optimasi terhadap jenis media, masa inkubasi statis, bahan pencuci dari sisa-sisa sel planktonik dan konsentrasi crystal violet. Tahap kedua adalah mendapatkan proporsi bakteri penghasil biofilm dari penerapan metode deteksi pembentukan biofilm dengan tabung eppendorf polypropylene yang sudah dioptimasi terhadap 71 isolat simpan bakteri A. baumannii, P. aeruginosa dan K. pneumoniae resisten multiobat.
Hasil: Jenis media terbaik yang digunakan adalah Luria Bertani, masa inkubasi statis 30 jam, bahan pencuci dengan PBS steril dan konsentrasi crystal violet 0,1 untuk optimasi bakteri kontrol penghasil dan bukan penghasil biofilm. Proporsi pembentukan biofilm pada A. baumannii, P. aeruginos dan K. pneumoniae masing-masing secara berurutan adalah 55,3 , 53,3 dan 0.
Kesimpulan : Metode deteksi pembentukan biofilm dengan tabung eppendorf polypropylene merupakan metode deteksi yang mudah dikerjakan, reproducible dan efisien, sehingga dapat dilakukan di laboratorium mikrobiologi klinik sederhana. Proporsi bakteri penghasil biofilm adalah lebih dari 50 non-Enterobactericeae resisten multiobat, tetapi tidak pada isolat K. pneumoniae resisten multiobat.

Background: Biofilm forming multidrug resistant Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae are a major cause of health problems in hospitalized facilities in the world, especially in Indonesia as the highest prevalence of the extended beta lactamase producing multidrug resistant Gram negative bacteria in Southeast Asia. Therefore, it is important to apply biofilm detection using polypropylene eppendorf tube method as easy to do, reproducible and efficient to perform in the simple clincal microbiology laboratory.
Objective: To conduct optimization of biofilm detection using polypropylene eppendorf tube method and proportion of biofilm formation from stock culture isolates of multidrug resistant A. baumannii, P.aeruginosa and K. pneumonia at clinical microbiology laboratory of FKUI RSCM during March October 2016.
Method: This study was conducted in two phases. The first is optimization of biofilm formation method by Cernohorska et al using polypropylene eppendorf tube. The optimization is conducted in some conditions, such as medium for biofilm cultivation, long static incubation, washing solution and crystal violet concentration. The second is to get proportion of biofilm producing bacteria through application of optimized detection of biofilm formation method using polypropylene eppendorf tube to a total of 71 stock culture isolates of multidrug resistant A. baumannii, P.aeruginosa and K. pneumonia.
Results: The best medium for biofilm cultivation was Luria Bertani, long static incubation was 30 hours, washing solution was sterile PBS and crystal violet 0,1 for biofilm and non biofilm producing bacteria. Proportion of biofilm producing of multidrug resistant Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae were respectively 55.3 , 53.5 and 0.
Conclusions: Detection of biofilm formation using polypropylene eppendorf tube could perfom in simple clinical microbiology laboratory because easy to do, reproducible and efficient. The proportion of biofilm producing showed that more than 50 of multirug resistant of non Enterobactericeae, but no one of multidrug resistant K. pneumoniae.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Verawati Sulaiman
"Latar Belakang: Community Acquired Pneumonia (CAP) merupakan salah satu penyebab utama morbiditas dan mortalitas di dunia. Bakteri atipikal (Chlamydia pneumoniae, Mycoplasma pneumaniae, Legionella pneumophila) sebagai penyebab penting CAP. Sejauh ini belum ada pemeriksaan mikrobiologi yang rutin dilakukan sehingga perlu pengembangan uji, salah satunya metode molekuler multiplex real time PCR. .
Tujuan: Melakukan optimasi uji multiplex real time PCR untuk mendeteksi secara simultan dan cepat C.pneumoniae, L.pneumophila dan M.pneumoniae pada sputum pasien CAP.
Metode: Penelitian ini merupakan uji eksperimental laboratorium yang terdiri atas 3 tahap. Tahap 1 meliputi optimasi suhu penempelan, primer, probe, volume elusi akhir dan cetakan DNA. Tahap 2 untuk menentukan batas ambang deteksi DNA dan reaksi silang. Tahap 3 adalah penerapan uji multiplex real time PCR pada spesimen sputum pasien CAP.
Hasil: Uji multiplex real time PCR telah berhasil dioptimasi dengan ambang batas minimal deteksi DNA untuk Chlamydia pneumoniae, Legionella pneumophila dan Mycoplasma pneumaniae adalah 1855, 3185 dan 130 kopi DNA. Uji ini tidak bereaksi silang dengan mikroorganisme yang berpotensi menimbulkan reaksi positif palsu. Sebanyak 134 sputum telah diuji dan ditemukan positif M.pneumoniae sebanyak 1 spesimen (0,74 %).
Kesimpulan: Uji multiplex real time PCR dapat mendeteksi C.pneumoniae, M.pneumoniae, dan L.pneumophila secara simultan pada sputum pasien CAP.

Background: Community Acquired Pneumonia (CAP) is one of the leading causes of morbidity and mortality in the world. Atypical bacteria (Chlamydia pneumoniae, Legionella pneumophila, Mycoplasma pneumaniae) are the important causes of CAP. In daily clinical practice, detection of atypical bacteria are sometimes neglected due to the limited standard test available. The real time multiplex PCR methode can be used as an alternative test for the detection of atypical bacteria.
Objective: Optimization of the multiplex real time PCR test to simultaneously detect C.pneumoniae, L.pneumophila and M.pneumoniae in CAP patients.
Methods: This study is experimental laboratory test that conducted in three phases. The first is optimization of annealing temperature, primers dan probe concentration, final elution of DNA extraction and volume of PCR templete. The second is determination of minimal detection of DNA and cross reaction of optimized real time PCR multiplex. The third is application of real time PCR multiplex in sputum clinical specimen patient with CAP.
Results: The multiplex real time PCR test was successfully optimized for annealing temperature, concentration of primer both forward and reverse, probes concentration and inhibitor. Limit detection of the DNA Chlamydia pneumoniae, Legionella pneumophila and Mycoplasma pneumaniae were 1855 copies, 3185 copies and 130 copies DNA. This test also showed no cross reaction to microorganisms that have potential to cause false positives. A total of 134 sputum clinical specimens have been tested with this method and only one sample (0,74%) was positive M.pneumoniae.
Conclusion: The multiplex real time PCR assay can detect C. pneumoniae, M. pneumoniae, and L. pneumophila simultanously in sputum of patients with Community Acquired Pneumonia (CAP)"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Lina Herliyana
"Latar Belakang : Siprofloksasin adalah salah satu antibiotik yang paling banyak digunakan untuk mengobati ISK yang paling sering disebabkan oleh Escherichia coli. Nilai konsentrasi hambat minimum (KHM)/ minimal inhibitory concentration (MIC) digunakan sebagai uji kepekaan kuantitatif yang rutin dilakukan di laboratorium mikrobiologi. Sehubungan dengan meningkatnya resistensi siprofloksasin pada pasien ISK, perlu dilakukan evaluasi batas ambang uji KHM/MIC sebagai dasar penentuan dosis siprofloksasin sesuai farmakokinetik dan farmakodinamiknya. Dilihat juga riwayat ISK berulang dan penggunaan antibiotika 3 bulan terakhir sebagai faktor risiko yang mempengaruhi terjadinya peningkatan nilai KHM/MIC.
Metode : Studi potong lintang dengan eksperimental laboratorium dilakukan pada tahun 2019-2020. Isolasi uropatogen dilakukan pada 106 sampel urin pasien dengan diagnosis klinis ISK yang berobat ke Puskesmas dan RSUD di kota Tangerang Selatan, serta beberapa RS di Jakarta. Uji kepekaan dilakukan dengan melihat nilai KHM/MIC beberapa antibiotik untuk ISK. Selanjutnya dilakukan uji Mutant Prevention Concentration (MPC) siprofloksasin terhadap E. coli, dengan cara menilai konsentrasi siprofloksasin terendah yang mampu membunuh 1010 koloni E. coli yang ditumbuhkan pada agar Mueller-Hinton, yang diinkubasi pada suhu 370C sampai dengan 96 jam. Nilai MPC dibandingkan dengan peningkatan nilai KHM/MIC dan faktor risiko yang mempengaruhinya.
Hasil : Hasil kultur urin ≥100.000 CFU/ml ditemukan pada 95 (89,6%) dari 106 pasien dewasa dengan diagnosis klinis ISK, yang terdiri dari 67,4% perempuan dan 32,6% laki-laki. E. coli merupakan penyebab terbanyak ISK yaitu 58,6%, dengan 36,2% isolat terdeteksi sebagai ESBL. Pola kepekaan siprofloksasin pada E. coli kurang dari 50%, dan lebih rendah lagi pada bakteri ESBL. Mutan E. coli ditemukan di semua isolat yang sensitif, terutama pada nilai KHM/MIC yang berada di batas ambang yang sensitif. Riwayat penggunaan antibiotik 3 bulan terakhir lebih tinggi risikonya dibandingkan riwayat ISK berulang untuk peningkatan nilai KHM/MIC pada mutan E. coli resisten siprofloksasin.
Kesimpulan : Penggunaan siprofloksasin untuk pengobatan ISK harus digunakan secara bijak. Nilai batas ambang sensitif KHM/MIC perlu diturunkan untuk mencegah kegagalan terapi disebabkan keberadaan mutan E. coli resisten siprofloksasin. Riwayat penggunaan antibiotik 3 bulan terakhir dan ISK berulang berisiko untuk peningkatan nilai KHM/MIC pada mutan E. coli resisten siprofloksasin

Background : Ciprofloxacin is one of the most widely used antibiotics to treat the UTIs commonly caused by Escherichia coli. Minimum inhibitory concentration (MIC) value is used as a quantitative susceptibility test, routinely carried out in the microbiology laboratory. Due to the increasing resistance of ciprofloxacin in UTI patients, it is necessary to evaluate the MIC threshold as a basis for determining the dose of ciprofloxacin accordingly to pharmacokinetics and pharmacodynamics. Assessment of recurrent UTI and antibiotic used in the last 3 months is also conducted as risk factors affecting the increase of MIC value.
Methods : A cross-sectional study and laboratory experiments were conducted in 2019-2020. Isolation of uropathogen was conducted on 106 urine samples from patients with a clinical diagnosis of UTI who went to the community health centre and regional hospital in South Tangerang, as well as several hospitals in Jakarta. Susceptibility testing was performed to detect the MIC value of several antibiotics for UTIs. After that, the Mutant Prevention Concentration (MPC) test of ciprofloxacin was carried out against E. coli, by assessing the lowest ciprofloxacin concentration which was able to kill 1010 E. coli colonies grown on Mueller-Hinton agar, incubated at 370C for up to 96 hours. The MPC value is compared with the increasing MIC value and the risk factors that influence it.
Results : Urine culture results of ≥100,000 CFU/ ml were found in 95 (89.6%) of 106 adult patients with a clinical diagnosis of UTI, consisting of 67.4% female and 32.6% male. E. coli was the most common cause of UTI, i.e. 58.6%, including 36.2% of the isolates detected as ESBL. The sensitivity pattern of ciprofloxacin against E. coli was less than 50%, and lower in ESBL bacteria. E. coli mutants were found in all sensitive isolates, especially in isolates with MIC value on the sensitivity threshold. Antibiotics used in the last 3 months had a higher risk than recurrent UTIs for increasing MIC values in E. coli mutants resistant to ciprofloxacin.
Conclusion : The use of ciprofloxacin for the treatment of UTIs must be used wisely. The sensitivity threshold of MIC value should be reduced to prevent treatment failure due to the presence of E. coli mutants resistant to ciprofloxacin. Antibiotics used for the last 3 months and recurrent UTIs are at risk for increasing of MIC values in E. coli mutants resistant to ciprofloxacin.
"
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Rony Satrio Utomo
"[ABSTRAK
Pendahuluan
Hipertensi merupakan masalah kesehatan dunia karena jumlah penderita yang
banyak serta komplikasi yang diakibatkannya. Pengendalian tekanan darah pada
pada pasien hipertensi masih belum adekuat. Penyebab utama kegagalan
pengendalian tekanan darah pada pasien hipertensi adalah ketidak-patuhan berobat,
adanya therapeutic inertia dan penyakit yang resisten.
Tujuan
Mengetahui proporsi therapeutic inertia pada pasien dengan tekanan darah tidak
terkontrol, tingkat medication adherence dan proporsi pengendalian tekanan darah
pada pasien hipertensi yang telah berobat lebih dari enam bulan dengan melakukan
pengisian kuesioner mengenai kepatuhan berobat dan evaluasi dari rekam medis
mengenai tatalaksana hipertensi.
Metode
Telah dilakukan penelitian potong lintang pada bulan April 2015 sampai Mei 2015
terhadap 126 pasien dengan hipertensi dan telah berobat lebih dari enam bulan di
poliklinik Ginjal-Hipertensi RSCM Jakarta-Indonesia. Subjek dilakukan
wawancara terstruktur dan pengukuran tekanan darah dan diminta untuk mengisi
kuesioner 8-item Morisky Medication Adherence Score (MMAS-8) untuk menilai
kepatuhan berobat serta evaluasi rekam medis pasien untuk menilai tatalaksana
hipertensi yang diterima, serta tekanan darah selama berobat.
Hasil
Didapatkan 113 subjek yang sesuai dengan kriteria penelitian. Dari hasil penelitian
didapatkan pengendalian tekanan darah adalah sebesar 69,3% dari seluruh
kunjungan pada pasien dengan tekanan darah tinggi, dari 30,7% pasien dengan
tekanan darah tidak terkontrol, tingkat therapeutic inertia mencapai 84,1%.
Kepatuhan berobat yang baik didapatkan pada 85,8% pasien dengan hipertensi
Simpulan
Tingkat pengendalian tekanan darah pada pasien hipertensi sudah cukup baik.
Kepatuhan berobat pasien dengan hipertensi sudah baik. Tingkat therapeutic
inertia pada pasien hipertensi dengan tekanan darah tidak terkontrol masih tinggi.

ABSTRACT
Background
Hypertension is a worldwide medical problem because of huge amount of
hypertensive patient and complication tha follows. The blood pressure control of
hypertensive patients is inadequate. The main reason failure in controlling blood
pressure of hypertensive patient are medication inadherent, therapeutic inertia and
resistant disease.
Objectives
To determine the proportion of therapeutic inertia in hypertensive patient with
uncontrolled blood pressure, medication adherence level and blood pressure
control rate in hypertensive patient who has been on medication for over than six
month by filling questionnaire on medication adherence and evaluation of medical
record on hypertension therapy.
Method
A cross-sectional study was conducted in April 2015 through May 2015 on 126
hypertensive patient and has been on hypertension medication for over than six
month at Nephrology-Hypertension clinic Cipto Mangunkusumo Hospital, Jakarta-
Indonesia. We conducted structured interview and blood pressure measurement to
the subject, and requested to fill 8-item Morisky Medication Adherence Score
(MMAS-8) to evaluate medication adherence and reveiw of medical record to
evaluate hypertension therapy and blood pressure during ambulatory visit.
Results
There were 113 subject that meet the study criteria. The blood pressure control rate
were 69.3% from all visit of hypertensive patient. From 30.7% visit with
uncontrolled blood pressure, therapeutic inertia were 84,1%. Good medication
adherence were found in 85.8% hypertensive patient.
Conclusion
Blood pressure control rate in hypertensive patient is good. Medication adherence
in hypertensive patient were also found good. We found that the theraputic inertia
level among hypertensive patient with uncontrolled blood pressure is high., Background
Hypertension is a worldwide medical problem because of huge amount of
hypertensive patient and complication tha follows. The blood pressure control of
hypertensive patients is inadequate. The main reason failure in controlling blood
pressure of hypertensive patient are medication inadherent, therapeutic inertia and
resistant disease.
Objectives
To determine the proportion of therapeutic inertia in hypertensive patient with
uncontrolled blood pressure, medication adherence level and blood pressure
control rate in hypertensive patient who has been on medication for over than six
month by filling questionnaire on medication adherence and evaluation of medical
record on hypertension therapy.
Method
A cross-sectional study was conducted in April 2015 through May 2015 on 126
hypertensive patient and has been on hypertension medication for over than six
month at Nephrology-Hypertension clinic Cipto Mangunkusumo Hospital, Jakarta-
Indonesia. We conducted structured interview and blood pressure measurement to
the subject, and requested to fill 8-item Morisky Medication Adherence Score
(MMAS-8) to evaluate medication adherence and reveiw of medical record to
evaluate hypertension therapy and blood pressure during ambulatory visit.
Results
There were 113 subject that meet the study criteria. The blood pressure control rate
were 69.3% from all visit of hypertensive patient. From 30.7% visit with
uncontrolled blood pressure, therapeutic inertia were 84,1%. Good medication
adherence were found in 85.8% hypertensive patient.
Conclusion
Blood pressure control rate in hypertensive patient is good. Medication adherence
in hypertensive patient were also found good. We found that the theraputic inertia
level among hypertensive patient with uncontrolled blood pressure is high.]"
2015
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Isa Bella
"Pendahuluan: Pasien yang dirawat di ICU berisiko tinggi terserang kandidiasis invasif. Pemberian antijamur empirik dini dapat memperbaiki kondisi klinis pasien dan menurunkan angka kematian. Candida Score dari Leon mempunyai sensitifitas dan spesifisitas yang baik untuk menggolongkan pasien ICU yang memang benar membutuhkan terapi empirik antijamur. Penelitian ini menganalisis kesesuaian kriteria Candida Score dan hasil kultur darah dengan pemberian antijamur pada pasien sepsis di ICU RSCM.
Metodologi: Studi potong lintang dilakukan pada pasien sepsis di ICU RSCM pada Maret 2015-Oktober 2015. Dilakukan kultur pada spesimen darah, urin, dan sekret saluran nafas, selanjutnya dibiakkan. Karakteristik pasien dan riwayat klinisnya dicatat. Candida Score dihitung pada setiap pasien kemudian diuji asosiasinya dengan terapi yang didapatkan.
Hasil: Dari 100 pasien 57 pasien mendapatkan antijamur. Proporsi pasien yang mendapat antijamur yaitu 50 , 17 , 57 , 83 , dan 100 pada kelompok pasien dengan Candida score 0-4 berturut-turut. Dalam penelitian ini tidak kami dapatkan pasien dengan Candida score=5. Hasil kultur darah positif Candida didapatkan pada 4 orang pasien dengan angka kematian sebesar 100 . Tiga pasien kandidemia dengan Candida score >3 mendapatkan antijamur setelah hasil kultur darah positif Candida.
Kesimpulan: Terdapat asosiasi bermakna antara kriteria Candida score dengan pemberian antijamur pada pasien sepsis di ICU RSCM p3 tidak mendapatkan terapi empirik.

Introduction Prompt empirical antifungal therapy is essential for controling invasive candidiasis and has been shown to reduce mortality. Candida Score, established by Leon, has a good sensitivity and specivicity to distinguish critically ill patients whose invasive candidiasis is highly probable. This study analyzed the conformity between candida score criteria and blood culture results with the antifungal administration in patients with sepsis at the ICU of Dr. Cipto Mangunkusumo General Hospital RSCM
Methods A cross sectional study was conducted from March October 2015 at the ICU of RSCM. Critically ill patients who exhibited sepsis were included in this study. The urine, blood, and respiratory secrete were collected and were cultured in the microbiology laboratory. Each patient rsquo s characteristics and medical history were also recorded. The candida score was calculated and then tested for their association with treatment obtained.
Results Of the 100 patients, 57 patients received antifungal therapy, with the proportion of 50 , 17 , 57 , 83 , and 100 in the patients group broken by the Candida Score of 0 to 4 respectively. There rsquo s no patient with Candida Score of 5. Candida positive blood culture results candidaemia were observed in 4 patients, with a mortality rate of 100 . Three of which had the score of 3 but received antifungal therapy after the positive blood culture results were obtained.
Conclusion There is a significant association between Candida Score criteria with antifungal administration in septic patients in the ICU of RSCM p 3 did not get empiric antifungal therapy. "
Depok: Universitas Indonesia, 2016
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Ignatius Bima Prasetya
"Latar Belakang: Risiko Non-Alcoholic Fatty Liver Disease NAFLD meningkat pada pasien dengan diabetes melitus DM tipe 2. Prevalensi dan faktor-faktor yang berhubungan dengan peningkatan risiko NAFLD pada populasi DM di Indonesia belum pernah diteliti. Profil derajat fibrosis pada populasi ini juga masih belum diketahui.
Tujuan: Mengetahui perbedaan profil pasien DM dengan atau tanpa NAFLD serta derajat fibrosisnya.
Metode: Penelitian dikerjakan secara potong lintang terhadap pasien DM tipe 2 dewasa yang berobat di poliklinik endokrin metabolik RSCM. Pengambilan sampel dilakukan secara konsekutif. Data yang dikumpulkan mencakup usia, lama diabetes, indeks masa tubuh IMT , lingkar pinggang, kadar HDL, trigliserida, dan HbA1C. Ultrasonografi abdomen dikerjakan pada semua pasien untuk menentukan adanya NAFLD. Pasien dengan NAFLD lalu menjalani pemeriksaan elastografi transien untuk menilai derajat fibrosis. Uji Chi Square atau Fischer's-Exact digunakan untuk analisis bivariat dan regresi logistik digunakan untuk analisis multivariat.
Hasil Penelitian: Sebanyak 186 pasien dianalisis dalam studi ini, dengan 84 pasien 45,2 terbukti mengalami NAFLD. Elastografi transien berhasil dikerjakan pada 68 pasien NAFLD, dengan 17 pasien 25,0 terbukti mengalami fibrosis berat. Analisis univariat menunjukan perbedaan signifikan IMT PR=1,878; 95 CI= 1,296-2,721.

Background: Risk of Non Alcoholic Fatty Liver Disease NAFLD is increased in patients with type 2 diabetes. Prevalence and factors related to the increased risk of NAFLD in diabetic patients in Indonesia are currently unknown. Data regarding fibrosis profile in this population is also unknown.
Aim: To understand the prevalence and fibrosis profile of Non Alcoholic Fatty Liver Disease in diabetes mellitus and factors associated with it.
Methods: This study was a cross sectional study on diabetic patients treated in the endocrinology and metabolic clinic of Cipto Mangunkusumo Hospital. Sampling was done consecutively. Data collected comprised of age, duration of diabetes, body mass index BMI, waist circumference, HDL, triglyceride, and HbA1C. Abdominal ultrasonography was conducted to every patient to determine the presence of NAFLD. Patients with NAFLD underwent transient elastography to assess their degree of liver fibrosis. Collected data were analyzed in univariate and multivariate manner.
Study Results: We analyzed 186 patients with diabetic. NAFLD were diagnosed in 84 patients 45,2. Transient elastography were carried out in 68 patients, with advanced fibrosis were found in 17 patients 25,0. Univariate analysis showed significant differences between BMI PR 1,878 95 CI 1,296 2,721 p
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
T55667
UI - Tugas Akhir  Universitas Indonesia Library
cover
Malikul Chair
"Artritis reumatoid (AR) dapat menyebabkan penurunan massa tulang sistemik akibat adanya peningkatan osteoklastogenesis dan penghambatan osteoblastogenesis melalui peningkatan sklerostin yang menyebabkan penghambatan jalur Wingless(Wnt)-bcatenin canonicaldan bone morphogenetic proteins(BMP). Sampai saat ini masih belum ada penelitian tentang korelasi TNF-adan sklerostin terhadap penanda turnovertulang (CTX dan P1NP) pada pasien AR perempuan premenopause.Penelitian ini bertujuan untuk menjelaskan patogenesis hilangnya massa tulang pada pasien artritis rheumatoid perempuan premenopause dengan menilai hubungan antara kadar sitokin proinflamasi TNF-α, penghambat Wnt signalingsklerostin, dan penanda resorpsi tulang P1NP dan CTX.Studi potong lintang ini melibatkan 38 perempuan AR premenopause. Pengambilan sampel dilakukan secara konsekutif. Pemeriksaan dilakukan dengan ELISA.
Penelitian ini didapatkan kadar CTX (rerata 2,74 ng/ml) yang lebih tinggi dan P1NP (median 34,04 pg/ml) yang lebih rendahdibandingkan dengan sampel sehat pada penelitian sebelumnya. Terdapat korelasi negatif (r = -0,388) antara kadar TNF-α dengan kadar sklerostin yang bermakna secara statistik (p = 0,016). Terdapat pula korelasi positif (r = 0,362) antara kadar TNF-α dengan kadar P1NP yang bermakna secara statistik (p = 0,026). didapatkan adanya peningkatan CTX dan penurunan P1NP, adanya korelasi negatif bermakna antara kadar TNF-α dan sklerostin serta adanya korelasi positif bermakna antara kadar TNF-α dan P1NP.

Rheumatoid arthritis is associated with systemic bone mass loss due tostimulation of osteoclastogenesis and inhibition of osteoblastogenesis through inhibition of Wingless(Wnt) -bcatenin canonical and bone morphogenetic proteins(BMP) pathway by sclerostin. There are currently no studies that assess the correlation of TNF-α and sclerostin with bone resorption markers CTX and P1NPin premenopause rheumatoid arthritis patients. This study aims to explainthe pathogenesis of bone mass decrease by assessing the correlation between TNF-α, sclerostin, P1NP and CTX. This cross-sectional study involves 38 premenopausal women with AR. Sampling is done consecutively. Examination is done by ELISA.
This study found higher level of serum CTX (mean 2,74ng/mL) and lower level of P1NP (median 34,04 pg/mL) than normal population in previous studies. There was a negative correlation (r = -0,388) between TNF-α levels and sclerostin levels which was significant (p = 0,016). There wasalso a positive correlation (r = 0,362) between TNF-α levels and P1NP levels which was also significant (p = 0,026). This study found an increase in CTX and decrease in P1NP. There was a significant negative correlation between TNF-α and sclerostin levels and also a significant positive correlation between TNF-α and P1NP levels.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T55523
UI - Tesis Membership  Universitas Indonesia Library
cover
Surya Ulhaq
"Latar belakang: Pemanfaatan modalitas diagnostik terbaru dalam diagnosis dan penatalaksanaan pasien dengan kolangitis akut telah berkontribusi pada penurunan mortalitas yang signifikan. Salah satu modalitas diagnosis kolangitis akut yang dewasa ini banyak digunakan secara luas adalah menggunakan kriteria diagnosis Tokyo. Walaupun demikian, kriteria TG18 masih memiliki spesifisitas yang relatif kurang, sehingga menyebabkan masih cukup tingginya temuan diagnosis positif palsu. Oleh karena itu, diperlukan penanda inflamasi yang lebih spesifik terhadap infeksi, misalnya procalcitonin (PCT), yang diharapkan dapat meningkatkan spesifisitas diagnosis kriteria TG18. Tujuan penelitian ini adalah menentukan akurasi diagnostik dan nilai tambah pemeriksaan kadar prokalsitonin dalam diagnosis kolangitis akut. Metode: Penelitian observasional prospektif dengan desain potong lintang ini dilakukan di Unit Gawat Darurat, rawat jalan, dan Pusat Endoskopi Saluran Cerna (PESC) RSUPN Cipto Mangunkusumo pada bulan April sampai Desember 2022. Penelitian ini melibatkan 84 pasien ikterus obstruktif yang direncanakan untuk tindakan drainase bilier di RSUPN Cipto Mangunkusumo. Kriteria yang digunakan adalah kriteria TG18. Pemeriksaan baku emas dikatakan positif apabila ditemukan salah satu bukti dari pemeriksaan baku emas, yaitu drainase bilier purulen secara makroskopik pada drainase yang pertama dan kultur bilier positif. Hasil: Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif dan rasio kemungkinan positif dari kriteria diagnostik Tokyo 2018 dalam diagnosis kolangitis akut berturut-turut sebesar 97,10%; 0,0%; 81,71%; 0,0%; dan 0,97.Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif dan rasio kemungkinan positif, dan rasio kemungkinan negatif dari kriteria diagnostik prokalsitonin dalam diagnosis kolangitis akut berturut-turut sebesar 69,6%; 80,0%; 94,12%; 36,36%; 3,48; dan 0,38. Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif dan rasio kemungkinan positif, dan rasio kemungkinan negatif dari kombinasi prokalsitonin dan kriteria TG18 dalam diagnosis kolangitis akut berturut-turut sebesar 69,6%; 80,0%; 94,12%; 36,36%; 3,48; dan 0,38 Kesimpulan: Kriteria TG18 dengan parameter prokalsitonin tidak terbukti dapat meningkatkan nilai diagnostik dari parameter prokalsitonin secara tunggal dalam mendeteksi kolangitis akut.

Background: Utilization of the latest diagnostic modalities in the diagnosis and management of patients with acute cholangitis has contributed to a significant reduction in mortality. One of the modalities for the diagnosis of acute cholangitis which is widely used today is the Tokyo diagnostic criteria. Even so, the TG18 criteria still have relatively low specificity, resulting in a relatively high number of false positive diagnosis findings. Therefore, a marker of inflammation that is more specific to infection is needed, for example procalcitonin (PCT), which is expected to increase the specificity of the diagnosis of the TG18 criteria. The purpose of this study was to determine the diagnostic accuracy and added value of testing procalcitonin levels in the diagnosis of acute cholangitis. Methods: This prospective observational study with a cross-sectional design was conducted at the Emergency Unit, outpatient care, and PESC of Cipto Mangunkusumo General Hospital from April to December 2022. This study involved 84 patients with obstructive jaundice who were planned for biliary drainage at Cipto Mangunkusumo General Hospital. The criteria used are the TG18 criteria. The gold standard examination is proven positive if one of the following criteria was noted: namely macroscopic purulent biliary drainage in the first drainage and positive biliary culture.
Results: Sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio of TG18 criteria in detecting acute cholangitis were 97,10%; 0,0%; 81,71%; 0,0%; and 0,97, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of procalcitonin in detecting acute cholangitis were 69,6%; 80,0%; 94,12%; 36,36%; 3,48; and 0,38, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of combined procalcitonin and TG18 criteria in the diagnosis of acute cholangitis were 69,6%; 80,0%; 94,12%; 36,36%; 3,48; and 0,38, respectively. Conclusion: TG18 criteria combined with procalcitonin was not found to be superior to procalcitonin only in the diagnosis of acute cholangitis.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
<<   1 2   >>