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DETEKSI KEBERADAAN GEN hla SEBAGAI GEN PENYANDI ?-TOXIN HEMOLYSIN PADA ISOLAT METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) TERISOLASI DI LABORATORIUM MIKROBIOLOGI KLINIK RSUP PROF. DR. I.G.N.G. NGOERAH Saraswati, I Gusti Ayu Agung Putri Indria; Fatmawati, Ni Nengah Dwi; Darwinata, Agus Eka; Pinatih, Komang Januartha Putra
E-Jurnal Medika Udayana Vol 12 No 9 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i09.P18

Abstract

Latar Belakang : MDROs adalah mikrooganisme yang resisten terhadap beberapa antibiotic. Methicillin-resistant Staphylococcus aureus (MRSA) termasuk ke dalam MDROs, dimana dapat menyebabkan beberapa penyakit pada manusia seperti misalnya keracunan makanan dan infeksi kulit. Alfa-hemolysin merupakan salah satu faktor virulensi yang dimiliki oleh bakteri S. aureus termasuk MRSA. Faktor virulensi ini banyak berkontribusi dalam patogenesis beberapa penyakit dan infeksi pada tubuh manusia, beberapa diantaranya adalah pneumonia, abses otak, sepsis, infeksi kornea, sepsis artritis, bakteremia, trombositopenia. Oleh karena itu, sangat penting untuk dilakukan deteksi secara genotif terhadap keberadaan faktor virulensi ini dengan mendeteksi gen hla sebagai penyandi protein ?-hemolysin. Tujuan : Penelitian ini bertujuan untuk mengetahui keberadaan gen hla sebagai gen penyandi ?-hemolysin pada isolat MRSA di Laboratorium Mikrobiologi Klinik RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali. Metode : Penelitian ini merupakan penelitian potong lintang (cross-sectional) deskriptif. Sampel penelitian ini berjumlah 29 buah dan diambil dari stok gliserol MRSA di Laboratorium Mikrobiologi Klinik RSUP Prof. dr. I.G.N.G. Ngoerah, kemudian MRSA ditumbuhkan pada media agar darah. Selanjutnya, dilakukan isolasi DNA dengan menggunakan metode boiling. PCR dan elektroforesis dilakukan di Unit Laboratorium Biomedik Terpadu FK Unud divisi Bakteriologi dan Virologi. Setelah didapatkan hasil secara genotif, dilakukan inokulasi 2 sampel yang positif gen hla dan 2 sampel yang negative gen hla untuk konfirmasi secara fenotif keberadaan faktor virulensi ?-hemolysin. Hasil : Sebanyak 29 sampel yang diteliti, ditemukan sejumlah 7 sampel (24.14%) yang memiliki gen hla. Sejumlah 2 sampel (6.90%) berasal dari isolat darah, dan 5 sampel (14.24%) berasal dari isolat jaringan luka. Hasil inokulasi menunjukkan dari 4 sampel, sejumlah 3 sampel menunjukkan hasil positif ?-hemolysis dan 1 sampel tidak terdapat zona hemolysis. Simpulan : Berdasarkan penelitian yang dilakukan pada isolat MRSA yang terisolasi dari spesimen klinis di RSUP Prof. dr. I.G.N.G. Ngoerah pada tahun 2021, terdeteksi gen penyandi ?-toxin hemolysin (hla) dengan persentase sebesar 24.14%. Namun demikian terdapat perbedaan hasil antara deteksi genotif dan fenotif, mengindikasikan bahwa terdapat faktor virulensi lain yang dimiliki oleh MRSA untuk menimbulkan hemolisis.
Effect of Hypervirulent Strains, Antibiotic Resistance, and Host Characteristics on Mortality of Klebsiella pneumoniae Bacteremia Patients at a Tertiary Referral Hospital in Denpasar, Indonesia Adhy Candra, I Kadek Bayu; Suranadi, I Wayan; Darwinata, Agus Eka; Tarini, Ni Made Adi; Dharmika, Ida Ayu Gde Wahyudevi; Fatmawati, Ni Nengah Dwi
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3297

Abstract

Klebsiella pneumoniae bacteremia is one of the leading causes of sepsis that has a high mortality rate. The effect of multidrug resistance and different virulence of Klebsiella pneumoniae on mortality is still controversial. This study aimed to determine the impact of hypervirulent K. pneumoniae (hvKp), MDR, and clinical characteristics on mortality of K. pneumoniae bacteremia patients. A retrospective cross-sectional study was conducted on  K.  pneumoniae bacteremia cases of patients hospitalized at Professor dr. I.G.N.G Ngoerah General Hospital from December 1, 2020, to May 31, 2021. A positive PCR of rmpA, iucA genes, and/or a positive string test was identified as hvKp. The mortality rate of 51 K. pneumoniae bacteremia patients samples (aged 0-74 years) was 72.5%, in which 9.8% (5/51) of them were hvKp and 51% of the isolates (26/51) produced the Extended Spectrum Beta Lactamase (ESBL). Furthermore, 9.8% (5/51) of the cases were carbapenem-resistant. Thus, hvKp, MDR, gender characteristics, and comorbidities do not significantly affect the mortality of K. pneumoniae bacteremia patients. Multivariate logistic regression analysis showed that sepsis (odds ratio (OR) 4.29; p=0.038) and adult age group (mean 50 years) (OR 3.75; p=0.039) are independent predictors with a significant effect on mortality of  K. pneumoniae bacteremia patients. Careful and integrated management of K. pneumoniae bacteremia patients is essential for better outcomes, especially in sepsis and elderly patients. Although hvKp prevalence is low, emerging MDR-hvKp in health facilities is a severe concern for further actions and research.
External Validation of AI-powered GeNose C19 to Diagnose Volatile Organic Compounds in COVID-19 Patients Tested at Udayana University Academic Hospital Purnamasidhi, Cokorda Agung Wahyu; Darwinata, Agus Eka; Utama, I Made Susila; Merati, Ketut Tuti Parwati; Harkitasari, Saktivi; Junior, Darren; Diksha, I Gusti Ngurah Ariestha Satya; Suteja, Richard Christian
Biomedika Vol 16, No 2 (2024): Biomedika Agustus 2024
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v16i2.3940

Abstract

In search for potential alternatives to RT-PCR, Gadjah Mada University developed GeNose C19 which was deemed to have high sensitivity, specificity, PPV, and NPV. The objective of this study is to contribute to the development of GeNose C19 by means of external validation conducted in Udayana University Academic Hospital, Bali. This was a cross-sectional study conducted on adults above 17 years old. Demographic variables, symptoms, vaccination status, GeNose C19 results, and RT-PCR results were measured. We analyzed the sensitivity, specificity, PPV, and NPV using respective appropriate formulas and the impact of other variables gathered towards accuracy by means of Chi-squared test, Mann-Whitney U test and independent-samples T test. The results showed that the subjects included in this study were 50.8% female and had a mean (IQR) age of 23.0 (21.0-27.5) years old. Only three subjects (2.5%) showed COVID-19-related symptoms such as cough (1.7%), flu (0.8%), fever (0.8%), and headache (0.8%). GeNose C19 yields a sensitivity of 83.1%, a specificity of 73.6%, PPV of 79.4%, and NPV of 78.0%. There were no variables that significantly affect the accuracy of GeNose C19. Further study is still required to validate GeNose C19’s performance in different environmental conditions and multiple different races.
KARAKTERISTIK KLINIS DAN CAIRAN SEREBROSPINAL PASIEN MENINGITIS Streptococcus suis DI RSUP PROF. Dr. I.G.N.G. NGOERAH DENPASAR BALI Kusumajaya, I Gusti Bagus Ari Adi; Iswari, Ida Sri; Darwinata, Agus Eka; Hendrayana, Made Agus
Majalah Kesehatan Vol. 12 No. 2 (2025): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2025.012.02.3

Abstract

Meningitis selalu menjadi perhatian khusus dalam dunia kesehatan. Meningitis Streptococcus suis (S. suis) yang termasuk meningitis bakteri mengalami peningkatan yang cukup signifikan di Bali dalam 5 tahun terakhir, yang dikaitkan dengan tingkat konsumsi produk babi yang berisiko tinggi, terutama yang diolah mentah atau setengah matang. Desain penelitian ini adalah observasional deskriptif yang bertujuan untuk mengetahui karakteristik klinis dan cairan serebrospinal pada pasien meningitis dengan S. suis di RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar pada tahun 2020-2022 dengan menggunakan data sekunder dari rekam medis. Pada penelitian ini didapatkan 53 pasien meningitis S. suis pada usia dewasa dan lansia dengan dominan laki-laki (83,0%), pekerjaan karyawan swasta (35,8%), dan domisili di Kota Denpasar (47,2%). Manifestasi klinis yang ditemukan pada pasien meningitis S. suis adalah demam (100%), penurunan kesadaran (92,5%), nyeri kepala (90,6%), kaku kuduk (84,9%), tuli (35,8%), dan kejang (5,7%). Pada analisis cairan serebrospinal ditemukan peningkatan leukosit dengan dominan polimorfonuklear (PMN) (79,2%), kadar glukosa rendah (77,3%), dan kadar protein tinggi (98,1%). Penggunaan antibiotik untuk tatalaksana meningitis S. suis dengan ceftriaxon intravena masih memiliki sensitivitas 100%.
Pengaturan Kecepatan Motor Induksi Tiga Fasa Berbasis Teknik Modulasi Carrier Based Pulse Width Modulation (CBPWM) dengan Kendali Kontroller Fuzzy Logic Darwinata, Lalu Ishadi; Wiryajati, I Ketut; Citarsa, Ida Bagus Fery
TIN: Terapan Informatika Nusantara Vol 4 No 12 (2024): May 2024
Publisher : Forum Kerjasama Pendidikan Tinggi (FKPT)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47065/tin.v4i12.5169

Abstract

Along with increasing progress in the industrial world in Indonesia, the need for equipment used in the production of goods has also increased. One of the important equipment in an industry is a driving tool. The electric motor is a driving tool that has a big influence on the goods production system. Therefore, this paper discusses speed regulation of electric motors, especially 3-phase induction motors using Carrier Based Pulse Width Modulation (CBPWM) with Fuzzy Logic control which was carried out in Mataram. The speed response of the system will be improved with Fuzzy Logic Control (FLC). The results of the observations are compared with a system controlled by a PID controller. Simulation results with Simulink show that the Fuzzy Logic controller based on Carrier Based Pulse Width Modulation Control provides a better response than the PID controller. This is shown when there is an overshoot of 0%, a rise time of 0.5 seconds and a setting time of 1.5 seconds, whereas on the PID controller when there is an overshoot of 0.4%, a rise time of 0.7 seconds, and a setting time of 2.5 seconds, for a motor reference speed of 2 rad/second and load torque 0, 25, 50, 75, 100, 125, 150, 200 Nm. From the simulation results, it is proven that using a Fuzzy Logic controller based on Carrier Based Pulse Width Modulation Control, the speed response of a three-phase induction motor is better than using a PID controller.
Co-Authors Adhy Candra, I Kadek Bayu Agung Wiwiek Indrayani Agus Indra Yudhistira Diva Putra Anak Agung Gde Putra Wiraguna Ananda Eka Raharja Cokorda Agung Wahyu Purnamasidhi Dharmika, Ida Ayu Gde Wahyudevi Dhyana Ratmaja, I Gusti Agung Ngurah Diksha, I Gusti Ngurah Ariestha Satya F. S. Wignall Hearty Indah Oktavian I Gde Haryo Ganesha I Gede Agus Darsana Palgunadi I Gede Bayu Adi Pratama I Gede Gita Sastrawan I Gede Krisna Arim Sadeva I Gede Raka Adhyatma I Gede Sathya Agastya I Gede Wikania Wira Wiguna I Gusti Agung Istri Gladys Elsyaningrat I Gusti Ayu Dewi Ratnayanti I Gusti Kamasan Nyoman Arijana I Gusti Ngurah Kade Mahardika I Gusti Nyoman Sri Wiryawan I Ketut Wiryajati I Putu Bintang Pradita Kirana I Wayan Juli Sumadi I Wayan Sugiritama I Wayan Suranadi I Wayan Weta I. B. P. Dwija Ida Ayu Ika Wahyuniari Ida Bagus Fery Citarsa Ida Bagus Gede Adiguna Wibawa Ida Sri Iswari J. A. Pangkahila Junior, Darren K. Subrata K. Wirasandhi Ketut Tuti Parwati Merati Komang Januartha Putra Pinatih Kusumajaya, I Gusti Bagus Ari Adi Ledwin Meikel Wibisono Made Agus Hendrayana Made Indira Dianti Sanjiwani Maharani, Ida Ayu Komang Ananta Milhanah Milhanah N. K. Susilarini Ni Luh Gede Yoni Komalasari, Ni Luh Gede Yoni Ni Made Adi Tarini Ni Made Linawati Ni Made Susilawathi Ni Nengah Dwi Fatmawati Ni Nyoman Sri Budayanti Nyoman Budhi Wirananda Setiawan Paramyta, I Gusti Ayu Cintya Putu Agung Satvika Pradnyadevi Putu Nindya Krisnadewi Rahadi Raka-Sudewi A. A. Saktivi Harkitasari, Saktivi Saraswati, I Gusti Ayu Agung Putri Indria Surya Putra, I Gusti Agung Utama Suteja, Richard Christian Utama, I Made Susila Wimpie I Pangkahila Winnie Chandra Yoselyn Gunawan