Ni Made Adi Tarini
Department Of Clinical Microbiology, Faculty Of Medicine, Udayana University, Sanglah General Academic Hospital, Denpasar

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EFIKASI PENGGUNAAN SABUN BERBAHAN TRICLOCARBAN DALAM MENCUCI TANGAN Komang Reno Sutama; Ni Made Adi Tarini
E-Jurnal Medika Udayana Vol 6 No 9 (2017): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (163.716 KB)

Abstract

Hand hygiene had been done by using either formulated soap or handrub. This formula used to decrease the duration of hand washing compared to WHO’s duration. The aim of this study was to determine the efficacy of the Triclocarban-based soap (TCC), based on hand hygiene duration. The efficacy shown by the difference between the number of bacterial colonization after soap contact time for 10 seconds and 30 seconds as control group. Samples were taken from 24 medical students of FK UNUD, divided into 2 groups. Everyone will press both of their hands on the surface of Muller Hinton Media before and after washing hands. Total of 48 pairs of Petri dish were collected. Total of 8 pairs of the Petri dish were issued, for allegedly contaminated. Mean and SD before washing hands from group A (10 second) was 127 ± 79.416 CFU and group B (30 second) was 92.40 ± 40.735 CFU. The mean and SD after washing the hands of group A was 44.80 ± 28.268 CFU and group B was 63.80 ± 55.994 CFU. There was significant difference in colonies number in group A with Triclocarban-based soap (p = 0.012, paired t-test), as well as in group B (p = 0.025, paired t-test). Whereas compared between the two groups, there is no significant difference in number of bacterial colonies (p = 0.351, Independent T-test). In conclusion the efficacy of TCC-based soap between 10 seconds and 30 seconds hand washing had no significant different.Keywords: Hand Hygiene, Contact Time, Number of Colonies of Bacteria
Surveilan Pneumokokus dan Dampak Pneumonia pada Anak Balita Putu Siadi Purniti; Ida Bagus Subanada; I Komang Kari; BNP Arhana; Ida Sri Iswari; Ni Made Adi Tarini
Sari Pediatri Vol 12, No 5 (2011)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp12.5.2011.359-64

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Latar belakang. Streptococcus pneumonia (SP) adalah penyebab utama meningitis, pneumonia, danbakteremia pada bayi dan anak. Mikroorganisme tersebut adalah penyebab utama kematian yang dapatdicegah dengan imunisasi pada anak usia di bawah lima tahun. Data tentang insiden invasive pneumococcaldisease (IPD) di Indonesia masih terbatas.Tujuan. Mengetahui dampak pneumonia dan IPD pada populasi target di Rumah Sakit Umum PusatSanglah Denpasar, Bali, Indonesia.Metode. Surveilan aktif berbasis rumah sakit, prospektif selama satu tahun pada anak usia 28 hari sampai 60bulan. Seluruh anak yang tinggal dalam area cakupan penelitian, usia 28 hari sampai 􀁤36 bulan mengalamidemam 􀁴39°C atau menderita pneumonia, menunjukkan gejala IPDHasil. Subjek 736 anak dengan median usia 10 bulan (79,2% usia 28 hari sampai <24 bulan). S. pneumoniatidak terdeteksi dari seluruh subjek. Biakan darah dilakukan pada 736 subjek, 125 di antaranya (17,19%)menunjukkan pertumbuhan bakteri. Bakteri yang diisolasi dari biakan darah antara lain Staphylococcus sp 58(46,4%), S. aureus 45 (36,0%), Pseudomonas sp 9 (7,2%), E. coli 3 (2,4%). Diagnosis awal terbanyak adalahpneumonia, 439 (59,7%). Insiden pneumonia 534,2/100000, usia 28 hari - <6 bulan 167,1/100000, danusia 28 hari - <24 bulan 839/100000. Angka insiden tertinggi pneumonia dengan foto dada usia 28 hari - <6bulan yaitu 10,9/100000, dan kelompok usia 28 hari - <24 bulan 19,4/100000. Angka insiden pneumoniadan foto dada dengan CRP 􀁴40 mg/L tertinggi pada kelompok usia 12 bulan - <24 bulan, 82,9/100000.Dilakukan pemeriksaan PCR S. pneumoniae terhadap 106 sampel, terdiri dari kasus meninggal, meningitis,sepsis dan pneumonia berat tidak terdeteksi S. pneumoniaeKesimpulan. Pneumonia mempunyai dampak yang cukup berarti bagi daerah cakupan RSUP Sanglah yangdisebabkan oleh pneumokokus, dan saat ini masih merupakan tantangan.
Biofilm forming potential of Streptococcus suis: focusing on luxs/ai-2-mediated quorum sensing system Tjokorda Istri Pramitasuri; Ni Made Adi Tarini; Ni Made Susilawathi; Anak Agung Raka Sudewi
Indonesian Archives and Biomedical Sciences Vol 1 No 1 (2021): Indonesian Archives and Biomedical Sciences Vol 1(1): 2021
Publisher : Konsorsium Ilmu Biomedik Indonesia (KIBI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (319.222 KB) | DOI: 10.55392/indarcbiores.v1i1.6

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Because of its virulence and ability to survive, the incidence of infection caused by Streptococcus suis (S. suis), an emerging zoonotic pathogen, is expected to increase significantly. A biofilm-forming process, which is a cornerstone of chronic infection, influences the survival rate of S. suis. The mechanism helps bacteria to live longer in host tissues, form colonies, escape immune clearance, and share genetic information. At this moment, the most studied regulatory mechanism of S. suis biofilm formation is Quorum Sensing (QS), mainly on LuxS/AI-2-mediated QS system, in which AI-2 is the most closely related molecule to biofilm formation. In this system, LuxS acts as the key player in the process. The understanding of biofilm formation in S. suis, especially the LuxS/AI-2-mediated QS system, is a valuable contribution to future therapeutic research frameworks.
Mean platelet volume count as a risk factor for bloodstream infection in Pediatric Ward Sanglah General Hospital Denpasar, Bali-Indonesia Ni Putu Wirantari; I Wayan Gustawan; Made Gede Dwilingga Utama; Bagus Ngurah Putu Arhana; Ni Nengah Dwi Fatmawati; Ni Made Adi Tarini
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (425.308 KB) | DOI: 10.15562/ism.v11i1.553

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Background: Mean platelet volume (MPV) is a potentially interesting parameter in predicting bacteremia in patients admitted with suspected community-acquired  infections. The incidence of bacteremia, defined as the presence of viable bacteria in the bloodstream, in patients who were being admitted to hospital. Multiple recent studies have confirmed that low-level bacteremia is more common than previously thought, occurring in 38% to 68% of all pediatric patients with a positive blood culture. The mortality rate is 25%–30%, increases to 50% when associated with severe sepsis. The objective of this study is to investigate whether MPV as a risk factor for bloodstream infection.Methods: This was a hospital-based case-control study, review of the medical record from January 2016 until December 2018. We collect age, gender, MPV, platelet and blood culture. We analyze the association between MPV to bloodstream infection.Result: Between January 1st 2016 and December 31st 2018, there were 86 patients with positive blood cultures and 89 negative blood cultures. In the case group, there were 48 (53.9%) male and 41 (46.1%) female subjects, while in the control group there were 63 (73.3%) male and 23 (26.1%) female subjects. The median age for case group was 14 months while the median age for control group was 23 months. From the ROC curve, the optimal cutoff value for MPV was determined as 5.59. The odd ratio determined the relationship between MPV to blood stream infection was 2,26 with 95% CI 1.13-4.52. The adjusted odds ratio was 2.24 95% CI (1.10-4.57). The majority diagnosis was pneumonia (46.1%) in case group then early onset neonatal sepsis (28.1%) and meningitis (7.9%).Conclusion: The MPV ≥5.59 is a risk factor for developed bloodstream infection. This result can be used as a cutoff point to initially administered antibiotic to prevent the worse prognosis (sepsis, multiple organ failure, and death).
Karakteristik infeksi Acinetobacter baumannii pada anak yang dirawat di RSUP Sanglah, Bali, Indonesia periode Januari 2017-Desember 2018 Gusti Ayu Putu Sri Satya Mahayani; I Wayan Gustawan; I Made Gede Dwi Lingga Utama; Ida Bagus Gede Suparyatha; I Made Arimbawa; Ni Made Adi Tarini
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.529 KB) | DOI: 10.15562/ism.v11i3.756

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Background: Acinetobacter baumannii is a gram-negative bacterium that can cause nosocomial infections in humans. An increased incidence of A. baumannii infection is accompanied by increased antibiotic resistance and mortality from this bacterial infection. This study aims to determine the characteristic Acinetobacter baumannii infection and the pattern of germ sensitivity of antibiotics in children treated at Sanglah Hospital.Methods: A cross sectional study was conducted in the Pediatric Ward Sanglah Hospital. We performed a retrospective review of medical records from pediatric patients who were proven to have Acinetobacter baumannii infection through microbiological examination from blood culture samples while undergoing treatment in Pediatric Ward Sanglah Hospital from January 2017 to December 2018. Data were analyzed using SPSS version 20 for Windows.Results: A total of 33 pediatric patients were proven to have Acinetobacter baumannii bloodstream infection through microbiological examination. Most of them are males (72.7%) and 57.57% are neonates. Laboratory results obtained mean leukocyte levels 16.2±8.6 x 103/?L, median platelets 113.8 (3.7-464) x 103/?L, and mean procalcitonin 20.0±3.11 ng/ml. The average length of stay before Acinetobacter baumannii infection was 7 days, with the average total length of stay was 29.7 days. Patients who died during treatment were relatively high (45.5%) and 84.8% of them were treated in the intensive care unit, with 30 out of 33 patients infected with A. baumannii multidrug-resistant (MDR). Most patients use medical devices with an average usage time of more than 7 days.Conclusion: Most patients infected by Acinetobacter baumannii are treated in the intensive care unit with a high mortality rate. The A.baumannii bacteria identified were mostly MDR with a history of long-term use of antibiotics and medical devices. Latar Belakang: Acinetobacter baumannii adalah bakteri gram negatif yang dapat menyebabkan infeksi nosokomial pada manusia. Terdapat peningkatan insiden infeksi A. baumannii yang disertai peningkatan kejadian resistensi terhadap antibiotik, serta mortalitas akibat infeksi bakteri ini. Penelitian ini bertujuan untuk mengetahui bagaimana gambaran infeksi Acinetobacter baumannii serta pola sensitifitas kuman terhadap antibiotik pada anak yang dirawat di RSUP Sanglah yang merupakan rumah sakit rujukan di wilayah Indonesia bagian timur.Metode: Studi ini merupakan studi deskriptif dengan pendekatan potong lintang. Studi ini menggunakan data sekunder dari rekam medis pasien anak yang terbukti terinfeksi Acinetobacter baumannii melalui pemeriksaan kultur darah selama dirawat di RSUP Sanglah periode Januari 2017-Desember 2018. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Terdapat 33 pasien dengan kultur darah positif Acinetobacter baumannii. Sebagian besar berjenis kelamin lelaki (72,7%) dan 57,57% merupakan neonatus kurang bulan. Hasil laboratorium didapatkan rerata kadar leukosit 16,2±8,6 x 103/?L, median trombosit 113,8 (3,7- 464) x 103/?L, dan rerata procalcitonin 20,0±3,11 ng/ml. Median lama perawatan sebelum terjadinya infeksi adalah 7 hari dengan rerata lama perawatan 29,7 hari. Pasien yang meninggal selama perawatan cukup tinggi (45,5%) dan 84,8% dari pasien dirawat di ruang intensif dengan 30 dari 33 pasien terinfeksi multidrug resistant (MDR) A. baumannii. Sebagian besar pasien menggunakan alat medis dengan rerata lama pemakaian lebih dari 7 hari.Simpulan: Sebagian besar pasien yang terinfeksi Acinetobacter baumannii dirawat di ruang intensif dengan angka kematian yang cukup tinggi. Kuman A.baumannii yang teridentifikasi sebagian besar bersifat MDR dengan riwayat penggunaan antibiotika serta alat medis dalam jangka waktu lama. 
Staphylococcus aureus sebagai agen penyebab infeksi pada kasus erisipelas kruris dekstra dengan liken simpleks kronikus Anak Agung Indah Jayanthi; Ni Made Adi Tarini; I Gusti Ayu Agung Praharsini
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1114.512 KB) | DOI: 10.15562/ism.v11i3.839

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Background: Erysipelas is a skin and soft tissue infection that affects the epidermis and superficial dermis as well as superficial lymphatic vessels. Erysipelas can occur due to the entry of bacteria through the skin barrier that is not intact and can occur in other medical conditions such as in patients with lichen simplex chronicus.Case presentation: A man, aged 62, Javanese, came to the Sanglah Hospital Emergency Room because of swelling, redness, and pain in the right calf since 2 days ago and complained of itching in the right lower leg since 1 week ago. The patient has a 1-year history of lichen simplex chronicus and has received medication. Physical examination found the presence of erythema patch efflorescence, warm palpation of the touch, non-pitting edema, pain on pressure, and diascopy test of blanching on pressure. The results of the wound bed culture examination showed the isolation of S. aureus. Intravenous fluids, open compresses, antibiotics, pain relievers, and anti-inflammatory creams were given to patients who experienced improvement on day 8.Discussion: The diagnosis of erysipelas is determined from the patient's complaints and the clinical picture from the results of the physical examination. In erysipelas, microbial pathogens enter through skin damage, then spread locally and systemically. Antibiotics have become the standard in the management of erysipelas by bacterial infections. The administration of ceftriaxone antibiotics was carried out based on the results of the sensitivity test also obtained on the results of the isolation of sensitive S. aureus bacteria.Conclusion: Diagnosis of erysipelas is based on history, physical examination, and investigation. Management of patients includes open compresses, administration of fluids, antibiotics, pain relief, and use of anti-inflammatory creams.
IDENTIFICATION OF VIBRIO CHOLERAE, VIBRIO PARAHAEMOLYTICUS, AND VIBRIO VULNIFICUS BACTERIA IN BATIK SHELLS (PAPHIA UNDULATA) CAUGHT AT PENGAMBENGAN BEACH, JEMBRANA REGENCY Maharani, Ida Ayu Komang Ananta; Pinatih, Komang Januartha Putra; Darwinata, Agus Eka; Tarini, Ni Made Adi
E-Jurnal Medika Udayana Vol 13 No 9 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i09.P12

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Indonesia is a maritime country with vast seas and beaches equipped with natural riches stored in them. Global warming causes several changes in the ocean, including the increase in bacteria commonly found in the ocean, such as Vibrio sp. bacteria which can infect various animals in the ocean. Several species of bacteria Vibrio sp. that can infect humans are Vibrio cholerae, Vibrio parahaemolyticus and Vibrio vulnificus which can cause significant complaints in the human digestive tract, wound infections, and even sepsis. This research aims to determine the bacterial contamination of Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus in batik shell (Paphia undulata) caught at Pengambengan Beach, Jembrana Regency. This research is a quantitative observational study with a cross sectional research approach and uses convenience sampling as a sampling technique. Based on several research stages starting from cultivating bacteria in APW liquid media to conducting tests on TSIA media, the results showed that from 70 samples, 16 samples were found to be positive for Vibrio sp. consisting of 11 positive samples for Vibrio vulnificus and five positive samples for Vibrio parahaemolyticus. The results of this study showed that 16 positive samples of Vibrio sp. bacteria were found from batik shell (Paphia undulata) caught at Pengambengan Beach, Jembrana Regency. Keywords: Vibrio cholerae, Vibrio parahaemolyticus, Vibrio vulnificus
Antibiotic-Resistant Phenotype and Genotype of S. suis serotype 2 (SS2) Isolated from Humans in Bali, Indonesia MAYURA, I PUTU BAYU -; TARINI, NI MADE ADI; Susilawathi, Ni Made; YULIANDARI, PUTU
Journal of Biomedicine and Translational Research Vol 10, No 2 (2024): August 2024
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v10i2.21985

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Background: In recent times, meningitis, an infection primarily attributed to the zoonotic bacteria Streptococcus suis, has emerged as a significant public health concern in Bali, Indonesia. Their resistance to a multitude of antibiotics has emerged as a contemporary threat, as opposed to their virulence. There is a current lack of reported information regarding the genetic or phenotypic susceptibility pattern of S. suis to antibiotics in Bali.Objective: The objective of this research endeavor was to ascertain the antibiotic susceptibility pattern of S. suis isolates in Bali, either through phenotypic or genetic means.Methods: The Clinical Microbiology Laboratory of Prof. I.G.N.G. Ngoerah Hospital was consulted for the acquisition of clinical specimens. Since April 2016 until April 2022, the antibiotic sensitivity of isolates was identified and assessed using the VITEK 2 Compact (Biomeriuex®). Determining the serotype and antibiotic resistance genes genetically required PCR employing multiple primers.Results: Successful isolation of sixty-six S. suis isolates occurred primarily from cerebrospinal fluid. The results demonstrated that all isolates exhibited phenotypic resistance to tetracycline, with one isolate demonstrating co-resistance to tetracycline and erythromycin/clindamycin. It is additionally corroborated genetically through the amplification of the tetM gene in every isolate, including those that exhibited concurrent resistance to erythromycin and tetracycline. The intTn gene, which is a member of the conjugate transposon Tn916 family, was amplified and utilized for horizontal media gene transfer on S. suis plasmids carrying the resistance genes ermB and tetM.Conclusion: This research represents the initial investigation into the antibiotic resistance phenotype and genotype of S. suis serotype 2 (SS2) isolated from human subjects in Bali, Indonesia. The findings suggest that the pathogenicity and widespread dissemination of SS2 in the community may have been influenced by the extensive use of tetracycline and the horizontal acquisition of the genetic element Tn916 with tetM.
Polysaccharide Capsule Serotype and Antibiotic Susceptibility Pattern of Streptococcus pneumoniae Clinical Isolates in Bali Tarini, Ni Made Adi; I Putu Bayu Mayura; Ika Nurvidha Mahayanthi Mantra
Indonesian Journal of Tropical and Infectious Disease Vol. 11 No. 3 (2023)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v11i3.45516

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Streptococcus pneumoniae (S. pneumoniae) is a causative agent of pneumonia that can spread progressively, cause invasive disease, and increase mortality in humans. Pneumococcal or polysaccharide conjugate vaccination reduces pneumonia rates by vaccine-covered serotypes, but increases infection by non-vaccine serotypes. To determine the polysaccharide capsule serotype of S. pneumoniae isolates that cause infection at Prof. Dr. I.G.N.G. Ngoerah General Hospital and patterns of S. pneumoniae susceptibility to antibiotics from April 2017 to March 2022. All S. pneumoniae isolates from April 2017 and April 2022 were stored in STGG media in a freezer at -80 ℃ then subcultured on sheep blood agar. Polymerase Chain Reaction (PCR) was performed to determine pneumolysin and capsular polysaccharide serotypes of S. pneumoniae. Of the 22 isolates studied, the order of the number of serotypes from the highest was serotype 19F, 3, 6A/B, 33F, 15B/C, 4, and 6V. Seven isolates were untypeable. Antibiotic sensitivity pattern S. pneumoniae was found to be sensitive to linezolid 91%, vancomycin 86%, levofloxacin and benzylpenicillin 82%, ceftriaxone and clindamycin 73%, erythromycin 55%, and chloramphenicol 45%. Serotype 19F was identified as the most dominant capsular serotype; however, serotypes 33F and 15B/C were also found. Interestingly, the 33F serotype is not covered in the 13-valent pneumococcal conjugate vaccine (PCV13) but is covered in pneumococcal polysaccharide vaccine 23 (PPSV23), and the 15B/C serotype is not included in either PCV13 or PPSV23. The antimicrobial susceptibility patterns revealed that S. pneumoniae was susceptible to linezolid, vancomycin, benzylpenicillin, and levofloxacin.
NF-κB, neutrophil extracellular traps, and microglial in mice with Streptococcus suis serotype 2 meningitis infection Susilawathi, Ni Made; Adi Tarini, Ni Made; Arijana, I Gusti Kamasan Nyoman; Sriwidyani, Ni Putu; Pramitasuri, Tjokorda Istri; Sudewi, Anak Agung Raka; Mahardika, I Gusti Ngurah Kade
Medical Journal of Indonesia Vol. 33 No. 3 (2024): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247394

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BACKGROUND Streptococcus suis is the most frequent etiology of zoonotic bacterial meningitis, potentially initiating an outbreak. Acute bacterial meningitis caused by S. suis has various manifestations, often accompanied by sepsis with multiple organ involvement. This study aimed to evaluate the pattern of S. suis outgrowth in the brain, which is associated with nuclear factor-κappaB (NF-κB) activation, neutrophil extracellular traps (NETs) release (NETosis), and microglial activation as three crucial pathological mechanisms of bacterial meningitis. METHODS This study used 64 female BALB/c mice aged 6 weeks and weighed 18−20 g, grouped into infected and non-infected as the control group. Both groups were administered 1 ml of S. suis serotype 2 suspension (1 × 107 colony forming-unit/ml) and normal saline intraperitoneally. The bacterial colony count of S. suis was evaluated, along with NF-κB and NET levels in blood and brain, as well as meningeal inflammation and microglial activation in the brain at Days 1, 3, 5, and 7 post-infection. RESULTS The invasion of S. suis into the brain slightly induced NF-κB activation, leading to a burst of inflammatory responses, neutrophil infiltration with NET releases, and microglia activation that co-occurred, showing their peaks on Days 3 and 5 after onset. CONCLUSIONS The S. suis invasion into the mice’s brain increased NF-κB activation, NETosis, and microglia activation during S. suis meningitis infection.