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Epithelial Cells Count and the Ratio of Leukocytes and Epithelial Cells as the Criteria to Determine Qualified Specimen for Community-Acquired Pneumonia (CAP)-causing Pathogens Identification Ade Dharmawan; Anis Karuniawati; Pratiwi Pudjilestari Sudarmono; Delly Chipta Lestari; Cleopas Martin Rumende
The Indonesian Biomedical Journal Vol 12, No 1 (2020)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v12i1.873

BACKGROUND: Community-acquired pneumonia (CAP) is the most common infectious with serious rate of morbidity and mortality. Recent conventional method only described 30-50% of CAP etiology. Sputum specimen quality assessment is important to obtain an accessible CAP-causing pathogens identification.METHODS: This was a prospective descriptive study involving 100 specimens from CAP-diagnosed subjects in Budhi Asih Regional General Hospital inpatien tcare. We assessed three gram-staining criteria for specimen quality determination, and continued by bacterial identification.RESULTS: All specimens were qualified according to criteria II, while only 94 and 96 specimens were qualified according to criteria I and III, respectively. Sixty-five specimens could be identified by culture and pneumoCLART polymerase chain reaction (PCR) examination, and the 35 specimens remained unknown. Ten out of those 35 specimens were positive after analyzed by Acid-fast Bacilli (AFB) test. The pathogens we identified including Klebsiella pneumoniae (29.6%), Acinetobacter baumanii (10.2%), Enterobacter cloacae (4.6%), Pseudomonas aeruginosa (4.6%), Staphyloccocus aureus (4.6%), Moraxella catarrhalis (3.7%), Enterobacter aerogenes (2.8%), Escherichia coli (2.8%), Streptococcus pneumoniae (1.9%), Mycoplasma pneumoniae (1.9%) and Citrobacter koseri (0.9%).CONCLUSION: There were no significant differences among the three criteria for sputum specimen quality assessment, based on culture and pneumoCLART examination. We suggest that criteria II could be used to avoid many specimen rejections while good quality specimens still attained for accessible bacteria identification.KEYWORDS: community-acquired pneumonia, sputum, gram stain, pathogens, bacteria

Gene Families of AmpC-producing Enterobacteriaceae Present in the Intensive Care Unit of Cipto Mangunkusumo Hospital Jakarta Lucky Hartati Moehario; Thomas Robertus; Anis Karuniawati; Rudyanto Sedono; Delly Chipta Lestari; Andi Yasmon
The Indonesian Biomedical Journal Vol 11, No 1 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i1.552

BACKGROUND: Antibiotic resistance has become a worldwide problem. Among Asia countries, Indonesia has high prevalence of multi-drug resistant organisms mainly due to Gram-negative bacilli Enterobacteriaceae. This study aimed to find out whether gene family of AmpC and AmpC/ESBL-producing Enterobacteriaceae were present in the Intensive Care Unit (ICU) of Cipto Mangunkusumo Hospital, Jakarta, Indonesia.METHODS: Specimens were obtained from several body sites of adult patients with infection hospitalised in ICU of Cipto Mangunkusumo Hospital. VITEK®2 was used to identify the microorganisms. Antibiotic susceptibility tests were conducted using VITEK®2 and disc diffusion technique according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Double disc synergy (DDS) test method was employed to detect AmpC activity. Gene families of ampC were identified using multiplex polymerase chain reaction (PCR).RESULTS: Forty five isolates were identified as putative AmpC, extended-Spectrum β-lactamases (ESBL) and AmpC/ESBL-producing Enterobacteriaceae. Klebsiella pneumoniae (n=32) were predominant, followed by Escherichia coli (n=6), Enterobacter cloacae (n=5) and Enterobacter aerogenes (n=2). AmpC activity was detected in 9 isolates, in which 4 isolates were AmpC producing and 5 isolates were AmpC/ESBL. In vitro, AmpC-producing Enterobacteriaceae showed good susceptibility to many antibiotic tested, while those of AmpC/ESBL-producing only to Amikacin. The gene families of ampC were DHA, EBC and CIT identified from 6 isolates.CONCLUSION: DHA, EBC and CIT gene families were identified from AmpC and AmpC/ESBL-producing Enterobacteriaceae in the ICU of Cipto Mangunkusumo Hospital. While the AmpC-producing was still susceptible to almost all antibiotics tested, the AmpC/ESBL-producing showed resistant except for Amikacin.KEYWORDS: Enterobacteriaceae, β-lactamases, AmpC, ESBL

PREVALENSI ISOLAT MRSA PENGHASIL PANTON-VALENTINE LEUKOCIDIN PADA PASIEN ICU RUMAH SAKIT TERSIER Linosefa Linosefa; Delly Chipta Lestari; Ardiana Kusumaningrum; Anis Karuniawati; Andi Yasmon
Majalah Kedokteran Andalas Vol 39, No 1 (2016): Published in April 2016
Publisher : Faculty of Medicine, Universitas Andalas

Penilitian ini bertujuan untuk mengetahui prevalensi MRSA penghasil Panton-Valentine leukocidin (PVL) dan pola kepekaannya. Sampel penelitian adalah isolat MRSA dari 315 pasien Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM) selama tahun 2011 dan 2014, dengan melakukan identifikasi, uji kepekaan dan uji molekuler terhadap isolat tersebut. Penelitian ini menunjukkan sebanyak 59% dari koloni MRSA yang ditemukan masih sensitif terhadap antibiotik golongan selain β-laktam, sehingga masih dapat diduga sebagai community-associated MRSA (CA-MRSA). CA-MRSA sepertinya mulai ditransmisikan di fasilitas kesehatan. Uji molekuler terhadap isolat MRSA memberikan hasil 8,3% isolat MRSA menghasilkan PVL. Berdasarkan tipe pola kepekaannya isolat MRSA penghasil PVL tersebut masih dapat digolongkan sebagai CA-MRSA. MRSA penghasil PVL ditemukan di RSUPNCM sebagai kolonisasi. Surveilan perlu dilakukan untuk memahami interaksi antara MRSA di komunitas dan rumah sakit, terutama untuk mengurangi transmisi di fasilitas kesehatan.

Antimicrobial activity of homemade WHO ethanol-based hand rub solution in pediatric department, Dr. Cipto Mangunkusumo National Referral Hospital Nina Dwi Putri; Hindra Irawan Satari; Mulya Rahma Karyanti; Ari Prayitno; Pratama Wicaksana; Anis Karuniawati; Delly Chipta Lestari; Nabila Maudy Salma; Shindy Claudya Aprianti; Amalia Almira; Andi Annisa Rusyda Khafiyani
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.232-6

Background Hand hygiene is essential in reducing healthcare-associated infections. Alcohol-based hand rub solutions have been reported to have superior antimicrobial efficacy on both bacteria and lipophilic viruses compared to washing with hand soap. In low- and middle-income countries, the cost of infection control poses a challenge. Our hospital produced an ethanol-based hand rub based on a WHO formulation to reduce the infection prevention costs. Objectives To identify the antimicrobial activity of a WHO ethanol-based hand rub solution against bacterial contamination on the hands of healthcare workers at the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital. Methods This cross-sectional study was performed on the hands of healthcare workers (physicians and nurses) working in the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta. A total of 225 specimens from 75 subjects were obtained by collecting swabs on both hands before and after participants worked in the Department of Child Health, Dr. Cipto Mangunkusumo General Hospital. Bacterial culture tests were performed to identify gram-positive and gram-negative bacteria. Bacteria were grouped into no-growth/Bacillus sp, Enterobacteriaceae, cocci, and non-fermenter groups. Results The use of our WHO ethanol-based hand rub solution, generally resulted in a statistically significant decrease in bacterial growth from 84 to 54.6%, before compared to after the hand rub was performed. In more detail, there was a 72.7% decrease in Enterobacteriaceae, a 71.4% decrease in non-fermenters, an 8.6% decrease in cocci and a 44.1% increase in the number of specimens showing no growth bacteria/Bacillus sp. Conclusion Our WHO ethanol-based hand rub has significant antimicrobial activity for common nosocomial pathogens (e.g., Staphylococcus aureus, P. aeruginosa, and K. pneumoniae).

Combining Bacteriophage Lysin LYSGH15 and Celery (Apium graveolens L.) Apigenin for Treating Staphylococcus aureus Pneumonia in Children Muhammad Habiburrahman; Stefanus Sutopo; Delly Chipta Lestari
Cermin Dunia Kedokteran Vol 50 No 4 (2023): Anak
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i4.862

Pneumonia is one of the devastating diseases that affect children under five and can result in high incidence and significant mortality rates. A substantial subset of these cases is caused by Staphylococcus aureus (S. aureus), a Gram-positive bacteria that can cause severe complications and even death. Additionally, antibiotic resistance complicates this problem further. In order to combat this issue, combining flavonoids and bacteriophage products may be a critical solution in decreasing morbidity and mortality rates of pneumonia. Apigenin, extracted from celery (Apium graveolens L.), which has anti-inflammatory and antioxidant effects. Combined with bacteriophage lysin, it can work synergistically against infections and inflammation without being easily resisted by bacteria. This literature review focuses on the use of apigenin and phage lysin, LysGH15, as a treatment for children’s pneumonia, sourced from Google Scholar and PubMed, using several combined keywords such as “new treatment”, “children pneumonia”, “Staphylococcus aureus”, “MRSA”, “new antibacterial”, and “therapy”. Combination therapy shows potential as a new treatment candidate for children’s pneumonia. Pneumonia dikenal sebagai salah satu penyakit paling mematikan pada anak di bawah 5 tahun, dengan insiden 156.000.000 kasus per tahun, dan angka kematian yang signifikan. Salah satu penyebab penting penyakit ini adalah bakteri Gram-positif Staphylococcus aureus (S. aureus), yang sering menyebabkan komplikasi dan kematian. Peningkatan resistensi S. aureus terhadap antibiotik juga memperumit kondisi ini. Kombinasi perawatan yang berasal dari produk flavonoid dan bakteriofag mungkin dapat menjadi kunci untuk menurunkan morbiditas dan mortalitas. Apigenin adalah salah satu jenis flavonoid yang dapat diekstrak dari seledri (Apium graveolans L.). Bersama dengan lisin dari bakteriofag, kedua komponen ini bekerja secara sinergis dalam kasus infeksi dan peradangan, dengan keunggulan berupa tidak mudah mengalami resistensi oleh bakteri. Tinjauan literatur berasal dari Google Scholar dan PubMed menggunakan beberapa kata kunci: “pengobatan baru”, “pneumonia anak”, “Staphylococcus aureus”, “MRSA”, “antibakteri baru”, dan “terapi” berfokus pada penggunaan apigenin dan lisin bakteriofag, LysGH15, sebagai pengobatan untuk pneumonia anak. Terapi kombinasi ini diharapkan berpotensi untuk dikembangkan sebagai pengobatan pneumonia anak.

Combining Bacteriophage Lysin LYSGH15 and Celery (Apium graveolens L.) Apigenin for Treating Staphylococcus aureus Pneumonia in Children Muhammad Habiburrahman; Stefanus Sutopo; Delly Chipta Lestari
Cermin Dunia Kedokteran Vol 50 No 4 (2023): Anak
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i4.862

Pneumonia is one of the devastating diseases that affect children under five and can result in high incidence and significant mortality rates. A substantial subset of these cases is caused by Staphylococcus aureus (S. aureus), a Gram-positive bacteria that can cause severe complications and even death. Additionally, antibiotic resistance complicates this problem further. In order to combat this issue, combining flavonoids and bacteriophage products may be a critical solution in decreasing morbidity and mortality rates of pneumonia. Apigenin, extracted from celery (Apium graveolens L.), which has anti-inflammatory and antioxidant effects. Combined with bacteriophage lysin, it can work synergistically against infections and inflammation without being easily resisted by bacteria. This literature review focuses on the use of apigenin and phage lysin, LysGH15, as a treatment for children’s pneumonia, sourced from Google Scholar and PubMed, using several combined keywords such as “new treatment”, “children pneumonia”, “Staphylococcus aureus”, “MRSA”, “new antibacterial”, and “therapy”. Combination therapy shows potential as a new treatment candidate for children’s pneumonia. Pneumonia dikenal sebagai salah satu penyakit paling mematikan pada anak di bawah 5 tahun, dengan insiden 156.000.000 kasus per tahun, dan angka kematian yang signifikan. Salah satu penyebab penting penyakit ini adalah bakteri Gram-positif Staphylococcus aureus (S. aureus), yang sering menyebabkan komplikasi dan kematian. Peningkatan resistensi S. aureus terhadap antibiotik juga memperumit kondisi ini. Kombinasi perawatan yang berasal dari produk flavonoid dan bakteriofag mungkin dapat menjadi kunci untuk menurunkan morbiditas dan mortalitas. Apigenin adalah salah satu jenis flavonoid yang dapat diekstrak dari seledri (Apium graveolans L.). Bersama dengan lisin dari bakteriofag, kedua komponen ini bekerja secara sinergis dalam kasus infeksi dan peradangan, dengan keunggulan berupa tidak mudah mengalami resistensi oleh bakteri. Tinjauan literatur berasal dari Google Scholar dan PubMed menggunakan beberapa kata kunci: “pengobatan baru”, “pneumonia anak”, “Staphylococcus aureus”, “MRSA”, “antibakteri baru”, dan “terapi” berfokus pada penggunaan apigenin dan lisin bakteriofag, LysGH15, sebagai pengobatan untuk pneumonia anak. Terapi kombinasi ini diharapkan berpotensi untuk dikembangkan sebagai pengobatan pneumonia anak.

EVALUATION OF THE MICRODILUTION METHOD FOR DETERMINATION OF THE MINIMUM INHIBITORY CONCENTRATION (MIC) OF TERBINAFINE AGAINST TRICHOPHYTON RUBRUM Thalia Anggrea Noor; Delly Chipta Lestari; Conny Riana Tjampakasari
Multidiciplinary Output Research For Actual and International Issue (MORFAI) Vol. 6 No. 4 (2026): Multidiciplinary Output Research For Actual and International Issue
Publisher : RADJA PUBLIKA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.5281/zenodo.21912182

Trichophyton rubrum is the leading cause of dermatophytosis with a global prevalence of 50–90%. Terbinafine is a first-line therapy that works by inhibiting the squalene epoxidase enzyme in ergosterol biosynthesis. Accurate determination of the minimum inhibitory concentration (MIC) using a standardized susceptibility test method is necessary to ensure the effectiveness of therapy. This study aims to standardize the concentration of terbinafine using the microdilution method based on CLSI M38-A2 guidelines against Trichophyton rubrum ATCC MYA-4438. The test was carried out using an inoculum concentration of 1×10³–3×10³ CFU/mL with varying terbinafine concentrations , then incubated at 28–30°C for 3–4 days. The results showed MIC values of 0.125 µg/mL; 0.25 µg/mL; and 0.125 µg/mL, respectively. An essential agreement (EA) value of 100% indicates high method precision. Morphological analysis revealed changes in hyphal structure in the form of fragmentation, a decrease in the number of conidia, cytoplasmic clumping, and uneven cell walls due to squalene accumulation. Thus, the microdilution method proved valid and reproducible for determining the MIC of terbinafine against T. rubrum .

Microbiological Characterization of KPC-Producing Klebsiella Pneumoniae: A Systematic Review Aiman Idrus Alatas; Delly Chipta Lestari
Journal of Community Health Provision Vol. 6 No. 1 (2026): Journal of Community Health Provision
Publisher : PSPP JOURNALS

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55885/jchp.v6i1.914

Klebsiella pneumoniae (K. pneumoniae) is an opportunistic bacterium that causes nosocomial infections and usually affects people with malfunctioning immune systems. These bacteria can also cause potentially fatal community-acquired diseases. A high fatality rate has been documented in carbapenem-resistant K. pneumoniae, particularly carbapenemase-producing cases. This is due to few antibiotic therapy choices. This study aims to assess the microbiological characteristics of KPC-K. pneumoniae in terms of their genotypic features. This article reported a systematic review that used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines to identify articles related to carbapenem-resistant K. pneumoniae. Pubmed and SagePub, two online databases, were searched using pre-established inclusion and exclusion criteria. The search turned up six studies that showed K. pneumoniae contains numerous gene mutations that cause carbapenem resistance, including blaKPC, blaKPC-2, blaKPC-3, and blaKPC-23. The mutations in porins OmpK35, OmpK36, and OmpK37 also significantly contribute to this resistance. These findings indicated that the optimal combination of antibiotics should be tailored to the specific strain of K. pneumoniae with a carbapenem-resistant genotype, especially for KPC-Kp strains with a mutation in OmpK36. The findings of this systematic review offer vital information for creating successful strategies to fight carbapenem-resistant K. pneumoniae infections.

Kingella denitrificans as a Mimicker of Neisseria meningitidis in Carriage Surveillance Delly Chipta Lestari; Puspa Andhia Kemalasari; Rifka Kamila; Chesya Ejoli; Wisnu Tafroji; Ibnu Agus Ariyanto; Selvi Nafisa Shahab; Bebby Shelby; Alana Arumsari
Jurnal Kesehatan Komunitas Indonesia Vol 6 No 2: August 2026
Publisher : Al-Hijrah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58545/jkki.v6i2.871

Background: Meningitis caused by Neisseria meningitidis remains a significant public health concern. A carriage study is crucial for understanding the distribution of Neisseria meningitidis serogroups in the community. The presence of Kingella denitrificans may lead to misidentification as N. meningitidis due to phenotypic similarity on blood agar. However, the prevalence of K. denitrificans in nasopharynx and oropharynx remains unclear. Objective: This study aimed to determine the prevalence of K. denitrificans as a mimicker of N. meningitidis in a carriage surveillance setting and to evaluate the role of MALDI-TOF MS in ensuring accurate bacterial identification. Methods: A cross-sectional study was conducted from September to December 2025 among unvaccinated adults in Jakarta with meningococcal disease. Oropharyngeal and nasopharyngeal swabs were collected and cultured on VCNT-supplemented blood agar. Preliminary identification was performed using colony morphology, Gram staining, and oxidase and catalase tests. Definitive identification was carried out using MALDI-TOF MS. Results: Among 228 participants, 11 (4.8%) carried Kingella spp. in the nasopharynx and/or oropharynx. All carriers were females aged 19–33 years (median age: 25 years). The isolates exhibited colony morphology similar to N. meningitidis, potentially leading to misidentification. However, they could be differentiated by their Gram staining morphology and catalase test results. MALDI-TOF MS identified 5 of 11 isolates (45.5%) as K. denitrificans with high-confidence log scores. Conclusion: K. denitrificans phenotypically might mimicked N. meningitidis in carriage surveillance but can be distinguished with Gram staining. The integration of MALDI-TOF MS is essential to improve diagnostic accuracy and prevent false-positive results. Further studies are needed to assess the feasibility of implementing this technology in resource-limited settings.

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