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Sutandhio, Silvia
FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

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Distribusi dan Antibiogram MRSA dari Spesimen Darah selama Empat Semester di RSUD Dr. Soetomo Surabaya Sutandhio, Silvia; Widodo, Agung Dwi Wahyu; Wasito, Eddy Bagus
JURNAL WIDYA MEDIKA Vol 4, No 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.33508/jwm.v4i2.1812

Abstract

MRSA bloodstream infection is hospital-acquired problem that is difficult to treat. Bacteria spread to body organs, create multiple loci of infection, and survive in the presence of beta-lactam antibiotics. Study of distribution and antibiogram of MRSA from blood specimens was done in four semesters; i.e. July–December 2014, January–June 2015, July–December 2015, and January–June 2016. Blood of patients suspected for bloodstream infection was drawn aseptically, transferred into liquid medium, and sent to Clinical Microbiology Laboratory of Dr. Soetomo General Hospital. Medium with microbial growth was subcultured on solid medium, and incubated for 18-24 hours in aerobic condition. Identification and susceptibility test were done with BD Phoenix, and interpreted based on Clinical and Laboratory Standards Institute 2015. Of total 107 MRSA isolates; 23 isolates (22%) were collected on July–December 2014, 12 isolates (11%) on January–June 2015, 25 isolates (23%) on July–December 2015, and 47 isolates (44%) on January–June 2016. MRSA mostly isolated from internal disease wards (45%). Isolates are sensitive to linezolid (91%), quinupristin-dalfopristin (83%), fosfomycin (82%), and vancomycin (80%). Trend of MRSA bloodstream infection is increasing. Although antibacterial agents against MRSA are available, it is best to prevent MRSA transmissions and infections.
Distribusi Dan Pola Kepekaan enterobacteriaceae Dari Spesimen Urin Di RSUD DR. Soetomo Surabaya Periode Januari – Juni 2015 Sutandhio, Silvia; Alimsardjono, Lindawati; Lusida, Maria Inge
JURNAL WIDYA MEDIKA Vol 3, No 1 (2015)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (135.018 KB) | DOI: 10.33508/jwm.v3i1.775

Abstract

Latar Belakang: Bakteri penyebab infeksi saluran kemih (ISK) didominasi oleh Enterobacteriaceae. Idealnya, setiap rumah sakit memiliki peta kuman dan pola kepekaan sendiri untuk digunakan sebagai panduan terapi empirik dan monitor penyebaran bakteri multiresisten. Hasil kultur urin, yang merupakan pemeriksaan penunjang untuk diagnosis dan pemilihan terapi antimikroba definitif, dapat dimanfaatkan untuk tujuan tersebut. Metode: Spesimen urin dikultur pada media isolasi primer, lalu diidentifikasi secara manual dan sistem semi-otomatis, yaitu BD Phoenix dan Vitek 2, yang telah dikonfirmasi dengan Clinical and Laboratory Standards Institute 2015. Hasil: Sebanyak 57.2% dari 1983 isolat hasil kultur teridentifikasi sebagai Enterobacteriaceae, dengan spesifikasi: 59.6%, 18.1%, 0.1%, 10.0%, dan 3.8%, berturut-turut untuk Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter spp., dan Proteus spp. Lebih dari 50% isolat Escherichia coli, Klebsiella pneumoniae, dan Klebsiella oxytoca merupakan penghasil Extended-Spectrum Beta Lactamase (ESBL). Kesimpulan: Enterobacteriaceae yang diisolasi umumnya resisten terhadap Ampisilin dan Sefalosporin generasi I, tetapi masih sensitif terhadap antimikroba golongan Karbapenem dan Aminoglikosida. Antimikroba golongan Karbapenem, yang merupakan pilihan terakhir pada kasus infeksi oleh Enterobacteriaceae multiresisten, hanya boleh diresepkan bila sesuai dengan indikasi, untuk mencegah timbulnya organisme resisten Karbapenem.
Antimikroba: Magic Bullet Versus Superbugs Sutandhio, Silvia; Alimsardjono, Lindawati; Wasito, Eddy Bagus
JURNAL WIDYA MEDIKA Vol 4, No 1 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (318.458 KB) | DOI: 10.33508/jwm.v4i1.1807

Abstract

Magic bullet is a terminology used by Paul Ehrlich to refer to substance that selectively attacks microbes that cause infection without affecting human tissues. The concept of magic bullet is adopted in attempts to find antimicrobial drugs that is safe to human. Improper and excessive use of antimicrobial drugs has caused the emergence ofmicrobes that are resistant to various antimicrobial drugs (superbugs). Superbugs are recent healthcare and public health issues. This condition is exacerbated bythe discovery void of effective antimicrobial drug against superbugs. Health practitioners must perform prudent use of antibiotics in order to prevent transmission of and infection by superbugs.
Perbandingan Distribusi Dan Pola Kepekaan Acinetobacter baumannii Terhadap Antimikroba Di RSUD Dr. Soetomo Surabaya Periode Januari–Maret 2015, April–Juni 2015, dan Januari–Maret 2016 Sutandhio, Silvia; Widodo, Agung Dwi Wahyu; Alimsardjono, Lindawati; Wasito, Eddy Bagus
JURNAL WIDYA MEDIKA Vol 4, No 1 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (415.157 KB) | DOI: 10.33508/jwm.v4i1.1782

Abstract

Acinetobacter baumannii is an environmental bacteria that can cause opportunistic infections such as ventilator-associated pneumonia, burn wound infection, urinary tract infection, and sepsis in immunocompromised patients. A. baumannii infections are troublesome because the bacteria resistance to many antimicrobial agents. Surveillance of distribution and sensitivity pattern of A. baumannii is best to be done frequently in hospitals.Venous blood as much as 10 milliliters was drawn aseptically and transferred into liquid medium Bactec® to be sent to Clinical Microbiology Laboratory of Dr. Soetomo General and Teaching Hospital. Medium that showed bacterial growth was subcultured on Blood Agar Plate and MacConkey Agar, and incubated for 18-24 hours in aerobic condition. Identification and susceptibility test were done with semi-automated system BD Phoenix, and interpreted based onClinical and Laboratory Standards Institute 2015.A. baumannii collected on trimester January-March 2015 were 30 isolates, with 19 isolates being Multidrug Resistant(MDR) A. baumannii (63%) and 6 isolatesPandrug Resistant(PDR)A. baumannii (20%). Isolates from trimester April-June 2015 were 32 isolates, with 21 isolates being MDR A. baumannii (66%) and 2 isolates PDR A. baumannii (6%). Isolates from trimester January-March 2016 were 40 isolates, with 22 isolates being MDR A. baumannii (55%) and 2 isolates PDR A. baumannii (5%).A. baumannii mostly isolated from Intensive Care Unit, followed by Internal medicine ward, Pediatric ward, Surgery ward and Emergency Department. High sensitivity of A. baumanniion trimester January-March 2016 was to imipenem (50%), meropenem (50%), amikacin (53%), cotrimoxazole (53%), dan cefoperazone-sulbactam (55%).. MDRA. baumannii mostly isolated from ICU, which reflects high burden of antimicrobial use. At this moment, antimicrobial agents that can be used as empirical therapy for A. baumannii infection are imipenem, meropenem, amikacin, cotrimoxazole, and cefoperazone-sulbactam. The entire hospital member must implement the Infection Control and Prevention and Antimicrobial Stewardship Program to preventnosocomial infections byA. baumanniiand the emergence of MDRA. baumannii.