Abu Tholib Aman
Department Of Microbiology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

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Journal : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Extended spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae clinical isolates and its susceptibility pattern to antibiotics at Dr. Soeradji Tirtonegoro General Hospital Klaten, Central Java Kian Sinanjung; Hera Nirwati; Abu Tholib Aman
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 1 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (26.624 KB) | DOI: 10.19106/JMedSci005201202003

Abstract

Globally, the prevalence of Klebsiella pneumoniae (K. pneumonia) producing extended spectrum beta lactamase (ESBL) has been increasing steadily. The susceptibility patterns of ESBL-producing K. pneumonia varies considerably among countries. Therefore, the investigation of ESBL-producing K. pneumoniae in clinical isolates and their susceptibility are warranted. This research aimed to determine the proportion of ESBL-producing K. pneumoniae and the antibiotic susceptibility patterns of clinical isolates from Dr. Soeradji Tirtonegoro General Hospital, Klaten, Central Java. Identification of K. pneumoniae was performed by analyzing colony morphology, microscopic examination, and biochemical testing using Microbact. Both antibiotic susceptibility testing and ESBL screening (using ceftazidime, cefotaxime, and ceftriaxone discs) were conducted using disc diffusion method according to CLSI. The positive results were confirmed with modified double disk synergy (MDDST) using amoxicillin-clavulanate, ceftazidime, cefotaxime, and cefepime discs. From 962 clinical bacterial isolates, 168 (17.46%) isolates were identified as K. pneumoniae, during June 2017-May 2018. K. pneumoniae was mainly isolated from the Intensive Care Units (ICU) (29.17%) and with sputum being the most common specimen (45.24%). Overall ESBL producers were 52.98%, with the majority from ICU (41.57%) and isolated from sputum specimens (40.45%). ESBL-producing K. pneumoniae showed high resistance to many antibiotics. The sensitivity of ESBL-producing K. pneumoniae isolated from respiratory tract samples against piperacillin-tazobactam, amikacin, and meropenem was more than 80%. In conclusion, among all K. pneumoniae isolates, ESBL K. pneumoniae was 52.98%. ESBL K. pneumoniae from respiratory tract specimens had a sensitivity of more than 80% against piperacillin-tazobactam, amikacin, and meropenem.
A fatal acute appendicitis with sepsis and pneumonia was caused by melioidosis: a case report Abu Tholib Aman; Yuli Mawarti; Agus Barmawi; Faisal Heryono; Rizka Humardewayanti Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2922.603 KB) | DOI: 10.19106/JMedSci0052022020010

Abstract

We report anunderdiagnosed fatal case of melioidosis that involved dygestion system which complicated with pneumonia, and sepsis. The case was initially diagnosed as acute appendicitis, and subsequently the patient underwent an exploratory laparatomy and appendectomy. He was discharged afer 3 days of hospitalization. Thirty days afterward, he was admitted to another private hospital to experience another exploratory laparatomy with indication of pancreatitis, intra-abdominal organs adhesions, and postoperative enterocutaneous fistula (ECF), and hospitalized there for 25 days. He eventually suffered from sepsis, pneumonia, unclosed ECF, anemia, hypoalbuminemia, and electrolyte imbalance. He then referred to a tertiary teaching hospital and hospitalized there for a total 134 days until he passed away. His clinical condition was declining, despite a long course of broad spectrum antibiotics. Treatment delay, prolong hospitalization, and complications were the inevitable, although Burkholderia pseudomallei was finally identified 2 weeks prior to his death. This case highlight that melioidosis canassociate with acute appendicitis, and that the delay on its diagnosis and treatment may trigger complications and death.
The rotavirus causing acute gastroenteritis in children of under 5-year of age in Indonesia 1972-2018: a review Abu Tholib Aman
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 1 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (38.498 KB) | DOI: 10.19106/JMedSci005301202105

Abstract

The reason of this review is the absence of thorough information of rotavirusinfection that had been the major cause of severe diarrhea in children of under5-years of age in Indonesia, despite numerous publications elaborating rotavirusinfection in some geographic areas of Indonesia. A review was conductedtowards 52 published articles covering rotavirus research in Indonesia duringperiod of 1972-2018.A thirty three selected articles were match with reviewcriteria which comprises rotavirus positive rate, clinical features, and severityof rotavirus infection, as well as genotypes of the rotavirus. Rotavirus has beenknown as the major cause of severe diarrhea among children under 5 years ofage world wide including in Indonesia. The rotavirus positive rates were rangefrom 31.1 to 90.9%, which variably to different subject’s population, studycriteria and methods, and time. Rotavirus can cause severe diarrhea withmajority of infected children suffered from dehydration, vomiting, and fever.The first genotyping conducted in Indonesia in the early 1980s revealed thepredominant genotypes were G3 and G4, followed by G2, and small proportionof G1 and mixed genotypes. However the following decades G1 and G2 were onthe raise with G3 predominantly re-appeared on 2015. G9 was first identified in2004, and occasionally detected until 2015. The P genotyping revealed P[4], P[6],and P[8] were the common genotypes detected. Mixed and untyped genotypeswere also detected in various proportion. Rotavirus diarrhea is a vaccinationpreventable disease, after natural infection, the immune system will produceprotective antibodies that will protect from infection of both homotypic andheterotypic, however homotypic infection will protect stronger. Therefore thisreview recommends continuous rotavirus genotypes surveillance in Indonesia.