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All Journal BALI MEDICAL JOURNAL (BMJ) International Journal of Biosciences and Biotechnology E-Jurnal Medika Udayana Majalah Kedokteran Bandung Medical Journal of Indonesia Journal of Biomedicine and Translational Research Indonesian Journal of Tropical and Infectious Disease Sari Pediatri Majalah Kesehatan FKUB Bali Journal of Anesthesiology ISM (Intisari Sains Medis) : Jurnal Kedokteran Majalah Kedokteran Neurosains Indonesian Archives of Biomedical Research (InABR) Journal of Clinical Microbiology and Infectious Diseases Neurona Jurnal Widya Medika
Ni Made Adi Tarini
Department Of Clinical Microbiology, Faculty Of Medicine, Udayana University, Sanglah General Academic Hospital, Denpasar
Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Antimicrobial susceptibility patterns of Acinetobacter baumanii isolates from ICU and non-ICU wards Budayanti, Ni Nyoman Sri; Suranadi, I Wayan; Tarini, Made Adi; Violentina, Gusti Ayu Dianti; Sathya Deva, I Dewa Gde
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (320.369 KB) | DOI: 10.15562/bjoa.v3i1.147

Abstract

ABSTRACTIntroduction: Acinetobacter baumanii is the most common agent of hospital-acquired infection with the increasing fatality rate due to multidrug-resistant (MDR) strain infection. The magnitude of the problem in Indonesia is unknown. Here, we provide data regarding susceptibility pattern of A. baumanii isolated from a tertiary referral hospital in Bali, Indonesia between 2012 and 2014.Methods: Data were collected retrospectively from culture-based records in the Clinical Microbiology department, Sanglah General Hospital during 2012-2014. A. baumanii was isolated from clinical specimens. Identification and antimicrobial susceptibility test were conducted using micro-dilution method (Vitek-2 Compact system). Isolates that resistant to ≥ 3 antibiotic classes were categorized as multi-drug resistant (MDR) A. baumanii.Results: A. baumanii collected from sputum in intensive care unit (ICU) wards were 7.9%, 11.1%, and 7.0%, while the isolates from sputum in non-ICU wards were 13.1%, 15.6%, and 19.9% in 2012, 2013, and 2014, respectively.  There was a reduced susceptibility of A. baumanii to ciprofloxacin, levofloxacin, ceftazidime, aztreonam, imipenem, ampicillin-sulbactam, and piperacillin-tazobactam in ICU ward. Meanwhile, the susceptibility of A. baumanii to Cotrimoxazole remained high in both ICU and non-ICU ward. MDR A. baumanii is found to be resistant to fluoroquinolones, cephalosporins, aztreonam, aminoglycosides, beta-lactamase inhibitors, and carbapenem. Data were analyzed and presented in a descriptive manner.Conclusion: Three years surveillance showed that the susceptibility of A. baumanii to most common antibiotics was decreasing. MDR A. baumanii was found to be resistant to all classes of common antibiotics mostly from ICU ward isolates. 
MENINGITIS BAKTERIAL STREPTOCOCCUS SUIS DENGAN TULI SENSORINEURAL BILATERAL Ni Made Susilawathi,* Ni Made Adi Tarini,** Anak Agung Raka Sudewi *
NEURONA Vol 34 No. 1 Desember 2016
Publisher : Neurona Majalah Kedokteran Neuro Sains

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Abstract

MENINGITIS CAUSED BY STREPTOCOCCUS SUIS S SUIS A ZOONOSIS DISEASE THAT CAN BE TRANSMITTED BY PIGS RARELY REPORTED IN INDONESIA THE COMPLICATION OF SENSORINEURAL HEARING LOSS DEVELOPS DURING THE ACUTE STAGE OF MENINGITIS WE REPORT A CASE OF S SUIS MENINGITIS WITH HEARING LOSS
Application Anti Microbial Activity Test and Direct Inoculation of Urinary Specimen Test to Increase the Quality of Results and Decrease the Production Cost in Clinical Microbiology Laboratory, Sanglah General Hospital Hospital, Bali-Indonesia Sri-Budayanti, N.; Sukrama, I. D. M.; Aditarini, M.; Sukardika, I. K.; Suata, I.K.
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Urinary tract infection (UTI) is the most common bacterial infection in general practice and in hospitals. Fast and accurate urine culture and sensitivity test are needed for adequate therapy. Anti Microbial Activity test (AMA test) that is used to detect the presence of antibiotics in urine specimens is not commonly used in clinical microbiology laboratories. Some laboratories are still using indirect inoculation technique using enriched media before inoculating onto the agar media. The aim of this research is to compare results of urinary examination of direct inoculation technique with AMA test with indirect inoculation technique without AMA test. Methods: A number of 210 urine specimens were collected in Clinical Microbiology Laboratory at Sanglah General Hospital within a time period between 16 June until 16 July 2009. Results: Antibiotics were detected in 40% of the urinary specimens; whereas 48.1% showed no evidence of UTI, that is negative AMA test and sterile urinary culture or colony growth < 105 CFU/ml. Only 11.9% of the specimens indicates urinary tract infections. The examination can be completed within 2-3 days which is shorter than indirect inoculation test which require 5-7 days. Direct inoculation technique can reduce the cost of production three-fold the costs require for an indirect inoculation test. Conclusions: Application of AMA test and direct inoculation technique can give results more rapidly, reliable and useful for clinicians. This also decrease the laboratory’s cost of production.
DETECTION METALLO-BETA-LACTAMASE GENE IMP-1 AND IMP-2 OF Pseudomonas aeruginosa CLINICAL ISOLATES IN SANGLAH HOSPITAL BALI Ni Made Adi Tarini; Ni Nengah Dwi Fatmawati; I Putu Bayu Mayura
International Journal of Biosciences and Biotechnology Vol 3 No 1 (2015)
Publisher : Central Laboratory for Genetic Resource and Molecular Biology, Faculty of Agriculture, Udayana University in cooperation with Asia-Oceania Bioscience and Biotechnology Consortium (AOBBC)

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Pseudomonas aeruginosa is a pathogen frequently found as an agent of Hospital Acquired infections. This bacterium is very easy to be resistant to several types of antibiotics through various mechanisms. Carbapenem such as Imipenem and Meropenem is a potential option for the therapy of this bacterium, but unfortunately P. aeruginosa has ability in hydrolyzing these antibiotics through enzyme metallo-?-lactamases (MBLs). Recently, IMP and VIM, MBLs enzyme group are reported common from various countries, but no data is reported for these enzymes in Indonesia especially in Bali. In fact, the resistant data of P. aeruginosa against carbapenem group antibiotics such as meropenem and imipenem is quite high in Sanglah General Hospital in 2014 was 35% and 45% respectively. Therefore, the aim of this study was to detect IMP-1 and IMP-2 genes of MDR P. aeruginosa, which are phenotypically resistant to the antibiotic Imipenem and Meropenem disks based on CLSI standards in Clinical Microbiology Laboratory, Sanglah General Hospital, Denpasar, Bali. Eighty-six isolates were isolated from sputum (25 / 29.1%), wound (25 / 29.1%), urine (15 / 17.4%),endotracheal Tube (11 / 12.8), pus (6/7% ), blood (3 / 3.5%) and tissue (1 / 1.1%). In this study, all isolates were subjected to PCR for detection of IMP-1 and IMP-2. The result showed that 9 isolates were positive IMP-1 gene (10.5%), but there was no isolate positive for IMP-2 gene. The result was similar with that of the other countries, especially for the gene IMP-1. Detection and molecular characterization of MBL-producing P. aeruginosa strains are very important for infection control purposes. Currently, this study is still continued for detection of another MBL genes.
MULTIPLEX PCR FOR DETECTION OF CAPSULAR POLYSACCHARIDES TYPES OF Streptococcus pneumoniae CLINICAL ISOLATES IN BALI Ni Nengah Dwi Fatmawati; Ni Made Adi Tarini; I Putu Bayu Mayura
International Journal of Biosciences and Biotechnology Vol 2 No 2 (2015)
Publisher : Central Laboratory for Genetic Resource and Molecular Biology, Faculty of Agriculture, Udayana University in cooperation with Asia-Oceania Bioscience and Biotechnology Consortium (AOBBC)

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Abstract

Streptococcus pneumoniae is causative agent of non-invasive and Invasive Pneumococcal Diseases(IPD). One of the major virulence factors is capsular polysaccharides (CPS). The CPS is known as thepneumococcal vaccine component. Several types of S. pneumoniae CPS are dominant in Indonesiasuch as types 6, 23, 15, 33 and 12 in West Nusa Tenggara, type 7F in Jakarta, and types 6A/B dan15B/C in Central Java. No data is reported from Bali related to S.pneumoniae CPS typing. Therefore,the aim of this study was to determine CPS types of S. pneumoniae isolates in Clinical MicrobiologyLaboratory, Sanglah General Hospital, Denpasar, Bali by using Multiplex PCR. Twenty-one isolatesthat were isolated from blood (11/52.4%), sputum (5/23.8%), and other clinical specimens (5/23.8%)were included in this study. Identification of S. pneumoniae was based on optochin test and presenceof pneumolysin gene (ply). Uniplex PCR was conducted to determine capsular type of each isolates,and then continued with Multiplex PCR 1 and 2, which used in-house positive controls. All isolateswere positive for the presence of ply, confirming the isolates were S. pneumoniae. Moreover, thisstudy showed that type 19F was the predominant type (7 isolates (66.7%)); 2 isolates (9.5%) werepositive for each type 23F and also for type 6A/B; and, there was only 1 isolate (4.8%) for each type7F and 15B/C. Total of 8 isolates (38.1%) were found to be nontypeable isolates. Multiplex PCR wassuccessfully identified different types of CPS. Development of Multiplex PCR could help indiagnosing and identifying capsular type of S. pneumoniae simultaneously.
IDENTIFIKASI JENIS BAKTERI DALAM AIR LIMBAH DI RUMAH SAKIT SANGLAH Ida Bagus Budhi Astawa; Ni Made Adi Tarini
E-Jurnal Medika Udayana Vol 6 No 6 (2017): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Rumah sakit adalah tempat perawatan berbagai macam penyakit. Namun rumah sakit juga merupakan tempat masyarakat mendapatkan berbagai macam penyakit, contohnya adalah infeksi. Penyebab dari infeksi terkait pelayanan kesehatan bisa berupa bakteri, virus, atau jamur. Banyak dari bakteri ini yang hidup dalam air limbah. Sampai sekarang belum ada penelitian yang benar-benar meneliti bakteri apa saja yang terkandung dalam air limbah, khususnya di rumah sakit yang ada di Bali. Berdasarkan hal tersebut diatas maka peneliti merasa perlu dilakukan penelitian untuk mengetahui jenis-jenis bakteri yang ada pada air limbah di Rumah Sakit Sanglah. Penelitian ini bertujuan untuk mengetahui jenis-jenis bakteri yang mungkin menyebabkan infeksi terkait dengan pelayanan kesehatan di air limbah rumah sakit sanglah. Sampel yang diambil pada penelitian ini berjumlah empat sampel, yang diambil di Instalasi Penanggulangan Air Limbah (IPAL) Mahotama dan IGD. Dari hasil penelitian didapatkan bakteri penyebab infeksi terkait dengan pelayanan kesehatan yang terdapat pada air limbah rumah sakit sanglah adalah Aeromonas hydrophila, Bacillus sp., Enterobacter cloacae, Enterobacter sakazaki, Escherichia Coli, Klebsiella oxytoca, Kluyvera sp., Serratia liquefaciens, Serratia odorifera, Serratia plymuthica, Serratia rubidea, Raoultella ornithinolytica. Dari hasil uji kepekaan menunjukan adanya variasi tingkat reristensi. Semua bakteri yang di uji sudah resisten terhadap Ampicilin, namun msih sensitif terhadap imipenem. Spesies Serratia liquefaciens dan Kluyvera sp. merupakan baketri yang paling resisten pada penelitian ini. Bakteri – bakteri tersebut juga berasal dari sampel air yang telah dilakukan penangan, ini mengindiasikan penanganan yang dilakukan pada air tersebut masih kurang dan perlu menjadi perhatian di Rumah Sakit.
Studi Molekuler Gen Penyandi Enzim Extended Spectrum ?-Lactamase (ESBL), ?-Lactamase AmpC, dan Karbapenemase pada Isolat Klinis Multi-drug Resistant (MDR) Klebsiella pneumoniae di RSUP Sanglah, Denpasar GNR Suwardana; NMA Tarini; NND Fatmawati
E-Jurnal Medika Udayana Vol 8 No 2 (2019): Vol 8 No 2 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Klebsiella pneumoniae adalah salah satu bakteri penyebab hospital acquired infections (HAIs) dengan angka morbiditas dan mortalitas yang tinggi. Tingginya beban kesehatan akibat infeksi K. pneumoniae utamanya diakibatkan oleh sifat resistensi terhadap banyak golongan antibiotik (multi-resisten), termasuk resistensi terhadap antibiotik golongan mutakhir seperti sefalosporin generasi ketiga dan karbapenem. Tujuan penelitian ini adalah untuk mengonfirmasi keberadaan gen penyandi enzim Extended Spectrum ?-Lactamase (ESBL), ?-Lactamase AmpC, dan karbapenamase pada isolat klinis multi-resisten K. pneumoniae. Lima isolat klinis multi-resisten K. pneumoniae terdeteksi secara fenotip menggunakan uji Vitek Compact 2 (Biomereux®), kemudian teknik polymerase chain reaction (PCR) digunakan untuk mendeteksi adanya gen blaSHV, blaTEM, blaCTX-M sebagai gen penyandi ESBL, blaFOX sebagai gen penyandi AmpC, dan blaKPC serta blaNDM-1 sebagai gen penyandi karbapenamase. Penelitian ini menemukan bahwa 4 dari 5 sampel positif memiliki gen penyandi ESBL, yakni 2 sampel dengan blaCTX-M, sedangkan 2 sampel lainnya didapatkan dual gen blaSHV dan blaTEM. Tidak ditemukan adanya gen penyandi AmpC maupun karbapenemase pada semua sampel. Sifat multi-resistensi pada isolat klinis K. pneumoniae kemungkinan diakibatkan karena adanya gen penyandi ?-lactamase, sedangkan resistensi terhadap karbapenem kemungkinan besar terjadi bukan karena adanya gen penyandi karbapenemase, namun dimungkinkan adanya mekanisme resistensi yang lain. Kata kunci : K. pneumoniae, multi-resistensi, ESBL, AmpC, karbapenemase
POTENSI ANTIMIKROBA EKSTRAK SAMBILOTO (ANDROGRAPHIS PANICULATA NESS.) DAN KUNYIT (CURCUMA LONGA LINN.) SERTA KOMBINASINYA TERHADAP BAKTERI ESCHERICHIA COLI IN VITRO Luh Putu Happy Sandha; Agung Wiwiek Indrayani; Ni Made Adi Tarini
E-Jurnal Medika Udayana vol 3 no 10(2014):e-jurnal medika udayana
Publisher : Universitas Udayana

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Abstract

Penggunaan tanaman tradisional sebagai obat telah banyak dikembangkan sebagai solusi pada kasus resistensi antibiotik. Penelitian ini bertujuan untuk menentukan aktivitas antimikroba dari ekstrak sambiloto, kunyit serta kombinasinya terhadap pertumbuhan bakteri gram negatif Esherichia coli. Penelitian ini adalah penelitian eksperimental murni yang dilakukan secara in-vitro. Ekstrak sampel kunyit dan sambiloto diperoleh dari proses ekstraksi menggunakan methanol 95%. Aktivitas antimikroba dinilai dari diameter zona hambat yang terbentuk pada bakteri E. coli dengan metode difusi cakram. Hasil penelitian ini ditemukan bahwa kombinasi ekstrak sambiloto dan kunyit memiliki potensi antimikroba yang bermakna terhadap bakteri E. coli dengan zona hambat sebesar 27,33 mm (p=0,002) pada konsentrasi 15 µg/ml. Ekstrak kunyit tunggal memiliki potensi antimikroba terhadap E. coli pada konsentrasi 15 µg/ml dengan zona hambat 28,67 mm (p=0,004). Ekstrak sambiloto tunggal tidak memiliki potensi antimikroba untuk E. coli. Simpulan penelitian ini yaitu penggunaan kunyit sebagai antimikroba tunggal memiliki potensi yang lebih baik dibandingkan kombinasi ekstrak, sehingga tidak perlu dikombinasi dengan sambiloto.    
DETEKSI MOLEKULER GEN ampC PADA ISOLAT KLINIS Klebsiella pneumoniae PENGHASIL ESBL DI RSUP SANGLAH DENPASAR I Gusti Ngurah Krishna Priyaka; Ni Made Adi Tarini; Ni Nengah Dwi Fatmawati
E-Jurnal Medika Udayana Vol 8 No 11 (2019): Vol 8 No 11 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

Sifat resistensi yang dimiliki oleh bakteri merupakan salah satu masalah pada kasus - kasus Healthcare Associated Infections (HAIs). Klebsiella pneumoniae dapat bersifat resistenterhadap antibiotik jenis cephalosporin akibat diproduksinya enzim AmpC yang dikode oleh genampC. Penelitian ini bertujuan untuk mengetahui prevalensi gen ampC dari isolat klinis K.pneumoniae penghasil ESBL di RSUP Sanglah tahun 2013. Penelitian ini menggunakan metodedeskriptif cross-sectional. K. pneumoniae diisolasi dari spesimen klinis di Instalasi MikrobiologiRumah Sakit Umum Pusat (RSUP) Sanglah selama tahun 2013. Uji fenotif DDST dilakukan padasampel untuk mendeteksi enzim ESBL. Selanjutnya uji genotif PCR dan sequencing dilakukanuntuk mendeteksi gen ampC. Dalam penelitian ini ditemukan hasil PCR 4 sampel positif denganpanjang pita yang tidak sesuai. Salah satu sampel lalu di-sequencing untuk mengidentifikasi genyang terdeteksi tersebut. Uji sequencing menemukan gen yang terdeteksi adalah fragmen genyang mengkode enzim alpha—amylase pada K. pneumoniae. Penelitian ini menunjukan genampC pada K. pneumoniae belum berhasil teramplifikasi melalui uji genotif PCR. Empat sampelterdeteksi memiliki fragmen gen yang mengkode enzim alpha-amylase dari hasil sequencing dananalisis. Perlu dilakukan penelitian lanjutan dengan menggunakan primer dengan target genpengkode AmpC lainnya. Kata Kunci: Klebsiella pneumoniae, HAIs, AmpC, ESBL, PCR
DETEKSI GEN fimH PADA ISOLAT KLINIS Klebsiella pneumoniae DI RSUP SANGLAH DENPASAR NMRP Dewi; NMA Tarini; NND Fatmawati
E-Jurnal Medika Udayana Vol 8 No 4 (2019): Vol 8 No 4 (2019): Vol 8 No 4 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Klebsiella pneumoniae merupakan salah satu bakteri gram negatif oportunistik penyebab Healthcare Associated Infection (HAIs) seperti infeksi saluran kemih, pneumonia dan sepsis. Kemampuan bakteri ini dalam proses adesi pada permukaan hospes merupakan langkah esensial dalam perkembangan infeksi K. pneumoniae. Salah satu faktor virulensi yang berperan penting dalam proses tersebut adalah gen fimH. Tujuan penelitian ini adalah untuk mengetahui prevalensi K. pneumoniae yang memiliki gen fimH di RSUP Sanglah Denpasar yang dideteksi dengan teknik Polymerase Chain Reaction (PCR). Desain penelitian ini adalah cross sectional dengan menggunakan 53 sampel yang diambil dari spesimen urin (30,19%), darah (54,72%), dan sputum (15%). Sebanyak 51 (96, 23%) dari 53 isolat klinis K. pneumoniae membawa gen fimH. Penelitian ini menunjukkan bahwa gen fimH merupakan salah satu faktor virulensi mayor pada infeksi K. pneumoniae. Kata kunci: Klebsiella pneumoniae, adhesin, fimH, PCR
Co-Authors Adhy Candra, I Kadek Bayu Agung Wiwiek Indrayani Agus Eka Darwinata Anak Agung Indah Jayanthi Andi Yasmon Bagus Ngurah Putu Arhana Bahagia, Dwi Dave Gerald Oenarta Dharmika, Ida Ayu Gde Wahyudevi Ema Alasiry, Ema Fadhilah Fera Ibrahim GNR Suwardana Gusti Ayu Putu Sri Satya Mahayani I Dewa Made Sukrama I Gusti Ayu Agung Praharsini I Gusti Kamasan Nyoman Arijana I Gusti Ngurah Kade Mahardika I Gusti Ngurah Krishna Priyaka I Komang Kari I Made Arimbawa I Putu Bayu Mayura I Putu Bayu Mayura I Wayan Gustawan I Wayan Suranadi I. K. Sukardika I.K. Suata Ida Bagus Budhi Astawa Ida Bagus Gede Suparyatha Ida Bagus Putu Putrawan Ida Bagus Subanada Ida Sri Iswari Ika Nurvidha Mahayanthi Mantra Komang Januartha Putra Pinatih Komang Reno Sutama Luh Putu Happy Sandha Made Gede Dwi Lingga Utama Maharani, Ida Ayu Komang Ananta Mardiastuti H Wahid MAYURA, I PUTU BAYU - Mochammad Hatta Nara Dhany, Henri Ni Nengah Dwi Fatmawati Ni Nyoman Sri Budayanti Ni Putu Siadi Purniti Ni Putu Sriwidyani Ni Putu Wirantari NMRP Dewi Pramitasuri, Tjokorda Istri Pusaka, Semerdanta Raka-Sudewi A. A. Riza Linda Samsuridjal Djauzi Sathya Deva, I Dewa Gde Susilawathi, Ni Made Tjokorda Istri Pramitasuri Violentina, Gusti Ayu Dianti YULIANDARI, PUTU