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All Journal Disease Prevention and Public Health Journal Journal of Clinical Microbiology and Infectious Diseases
Saputra, I Wayan Agus Gede Manik
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Immunology & microbiology Medicine & Pharmacology Public Health

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Severe case of Streptococcus suis meningitis in Bali Mandara Hospital: a case report Saputra, I Wayan Agus Gede Manik; Triatmoko, Indira Chadijah; Widarmawan, I Gede Eka; Hermawan, I Gede; Adi, Putu Dwi
Journal of Clinical Microbiology and Infectious Diseases Vol. 3 No. 1 (2023): Available online : June 2023
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v3i1.45

Abstract

Background: Streptococcus suis meningitis (SSM) is one of the zoonotic disease that can cause serious illness in humans.  The major risk factor in many cases of SSM is associated with pig husbandry and consuming undercooked pork products. In Indonesia, especially in Bali, the cases of this acute bacterial meningitis has been strongly correlated with consuming Balinese traditional food called “red lawar”, a mixture of raw pork, fresh pork blood and traditional Balinese herbs. This study aims to report a case of SSM in Bali Mandara Hospital. Case description: A 63-year-old man admitted to the Emergency Department because of a decrease in consciousness (Glasgow coma scale 3/15).  This patient was transferred from a private hospital with septic shock and suspicious to acute bacterial meningitis.  He  had other related  symptoms like fever, headache, and cough since two days prior to admission. He also had a history of consuming “red lawar” 2 days before the symptoms appeared.  Laboratory findings from cerebrospinal fluid analysis and septic marker indicate the patient had bacterial meningitis. The patient was initially started by Meropenem due to his septic shock.  The broad spectrum antibiotics were then de-escalate to Ceftriaxone once the culture and sensitivity test completed and yielded Streptococcus suis.  The course of Ceftriaxone as definitive therapy has been administered for 14 days and showed clinical improvement without specific sequelae related to SSM infection like hearing loss. Conclusion: Severe meningitis e.c Streptococcus suis leading to septic shock is a life threatening health condition. Adequate antibiotic therapy and multidisciplinary approach can reduce mortality and morbidity of this case.
Congenital neurosyphilis in neonatal sepsis by Leclercia adecarboxylata: a case report Tanaya, Putu Wahyu Dyatmika; Manuaba, Ida Ayu Sri Kusuma Dewi; Saputra, I Wayan Agus Gede Manik
Journal of Clinical Microbiology and Infectious Diseases Vol. 3 No. 2 (2023): Available online: December 2023
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v3i2.54

Abstract

Introduction: Sepsis remains a leading cause of morbidity and mortality in neonates. In accordance with the development of diagnostic testing, various pathogens have been found to cause neonatal sepsis, ranging from common to even rarer pathogens. Leclercia adecarboxylata is a Gram-negative bacillus rarely found in neonatal sepsis and was previously found predominantly in environmental settings and the human gastrointestinal tract as commensal bacteria. We describe a rare case of Leclercia adecarboxylata in neonatal sepsis with congenital neurosyphilis. Case Description: We present a male neonate born from a positive syphilis serological test mother, presented with sepsis manifestation. Blood culture reveals growth of Leclercia adecarboxylata. The patient received both therapeutic regimens of antibiotics for sepsis and congenital syphilis. The cerebrospinal fluid analysis also performed revealed suggestive of congenital neurosyphilis. The patient passed away due to multiple organ failure. Conclusion: Neonatal sepsis and congenital neurosyphilis present with identical manifestations; therefore, appropriate recognition and comprehensive management should be done
Evaluation of Antibiotic Use in Children's Respiratory Tract Infections at Primary Health Center in Tabanan Bali Putri, Kadek Sephia Adiana; Widowati, I Gusti Ayu Rai; Sutema, Ida Ayu Manik Partha; Reganata, Gde Palguna; Saputra, I Wayan Agus Gede Manik
Disease Prevention and Public Health Journal Vol. 19 No. 1 (2025): Disease Prevention and Public Health Journal
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/dpphj.v19i1.11673

Abstract

Background: Respiratory Tract Infections are among the most common health problems affecting children globally, with a particularly high prevalence in Southeast Asia, including Indonesia. Inappropriate antibiotic use in treating respiratory tract infections can lead to antibiotic resistance. This study evaluates the rationality of antibiotic use in pediatric respiratory tract infections cases and assesses prescribing patterns based on established guidelines. Method: A descriptive observational study with a cross-sectional approach was conducted using purposive sampling. Data collected from 130 medical records of pediatric patients with respiratory tract infections (from January to March 2024) at a primary health care center in Tabanan, Bali were analyzed. The Gyssens method evaluated antibiotic rationality based on dosage, duration, and clinical indications. Data were analyzed descriptively to determine antibiotic prescribing patterns and compared with national antibiotic use guidelines. Results: The results showed that 46.1% of antibiotic use was included in the rational category (Category 0), while 43.1% were included in the use without clear indications (Category V). Amoxicillin is the most widely prescribed antibiotic (90.8%). These findings indicate a tendency to use antibiotics not by clinical guidelines. Conclusion: The use of antibiotics in pediatric patients with respiratory tract infections is mostly suboptimal. Interventions are needed to improve compliance with rational antibiotic use guidelines, including education for healthcare workers and ongoing monitoring of antibiotic prescribing patterns
Appropriateness of antibiotic use and mortality risk factors in moderate to severe COVID-19 patients admitted to the intensive care unit of Bali Mandara Hospital in 2021 Saputra, I Wayan Agus Gede Manik; Laksana, Ngurah Putu Werda; Idayanti, Luh Gede Dewi; Shantivani, Made Intan; Yuliastini, Ni Luh Putu; Pratama, I Putu Agus Bayu; Laksana, Ida Ayu Candrika Widyasari
Journal of Clinical Microbiology and Infectious Diseases Vol. 5 No. 1 (2025): Available online : 1 June 2025
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v5i1.69

Abstract

Introduction: The COVID-19 pandemic has been closely linked to the overuse of antibiotics, particularly in hospitalized patients. Early clinical uncertainty and lack of definitive treatments led to widespread empiric use. This study assessed the appropriateness of antibiotic use and identified mortality risk factors among moderate to severe COVID-19 patients in Bali Mandara Hospital's ICU. Methods: A retrospective cross-sectional study of 72 moderate to severe COVID-19 patients was conducted from 200 ICU admissions in 2021. Simple random sampling was used. Antibiotic appropriateness was assessed using the Gyssens method. Variables such as age, sex, severity, comorbidities (hypertension, diabetes), and culture results were analyzed using Chi-square tests. Result:  Among 322 antimicrobials, 226 were antibiotics. Gyssens' classification showed 40% appropriate use and 60% inappropriate use, mainly due to lack of indication (Category V). Age over 60, sex, and disease severity were significantly associated with mortality (p<0.05). Bacterial co-infection was confirmed in 30.6%, predominantly Enterobacteriaceae. Conclusion: Antibiotic appropriateness remains low, with substantial overuse. Mortality correlated significantly with age, sex, and disease severity. These findings underscore the need for enhanced antimicrobial stewardship and targeted clinical management in cases of severe COVID-19.
Co-Authors Adi, Putu Dwi I Gede Hermawan Idayanti, Luh Gede Dewi Laksana, Ida Ayu Candrika Widyasari Laksana, Ngurah Putu Werda Manuaba, Ida Ayu Sri Kusuma Dewi Pratama, I Putu Agus Bayu Putri, Kadek Sephia Adiana Reganata, Gde Palguna Shantivani, Made Intan Sutema, Ida Ayu Manik Partha Tanaya, Putu Wahyu Dyatmika Triatmoko, Indira Chadijah Widarmawan, I Gede Eka Widowati, I Gusti Ayu Rai - Yuliastini, Ni Luh Putu