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All Journal International Journal of Public Health Science (IJPHS) BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana Jurnal Veteriner Jurnal Pendidikan Biologi Undiksha Medical Journal of Indonesia Indonesian Journal of Tropical and Infectious Disease Bali Journal of Anesthesiology ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Kedokteran: Media Informasi Ilmu Kedokteran dan Kesehatan Journal of Health Sciences and Medicine Bali Dental Journal Journal of Clinical Microbiology and Infectious Diseases Jurnal Widya Medika
Ni Nyoman Sri Budayanti
Departemen Mikrobiologi Klinik Fakultas Kedokteran Universitas Udayana
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Veterinary Other

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Risk Factors Associated with Suspected Clostridium difficile Infection (CDI) in Elderly Diarrhea Patients at Prof. Dr. I.G.N.G. Ngoerah Hospital Aryana, I Gusti Putu Suka; Budayanti, Ni Nyoman Sri; Wedari, Ni Luh Putu Harta
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.v11i3.47664

Abstract

Clostridium difficile infection (CDI) is a typical healthcare-associated infection that contributes to a significant proportion of morbidity and mortality among hospitalized patients. Anaerobe microbiological laboratory examinations cannot be performed at Prof. Dr. I.G.N.G. Ngoerah Hospital, leading to many undetected cases; therefore, it is crucial to determine the risk factors. Identification  of cases may help to prevent, recognize, and  appropriately treat CDI, reducing morbidity and mortality. This study aimed to determine the risk factors associated with suspected CDI in elderly patients with diarrhea due to their vulnerability to immunosenescence. This research used medical records as secondary data to determine the risk factors associated with suspected CDI in elderly diarrhea patients at Prof. Dr. I.G.N.G. Ngoerah Hospital during the year period of 2017 to 2021 with total of 70 samples who met inclusion criteria by purposive sampling technique. One hundred percent of all samples had a history of hospitalization for ³ 48 h. There were 53 patients (77.1%) had a history of antibiotic use, 26 (37.1%) proton pump inhibitors (PPIs), 66 (94.3%) chemotherapy, 66 (94.3%) urinary tract infections, 6 (8.6%) kidney disease, and 7 (10%) myocardial infarction. Seven (10%) patients had vascular disease, and 11 (15.7%) had diabetes mellitus. Risk factors associated with suspected CDI in elderly patients with diarrhea at Prof. Dr. I.G.N.G. Ngoerah Hospital include hospitalization ³ for 48 hours, use of antibiotics in the last few months, proton pump inhibitors, decreased immune system, urinary tract infection, kidney disease, myocardial infarction, vascular disease, and diabetes mellitus.
Prevalence of uropathogen producing extended spectrum beta lactamase (ESBL) at urinary tract infection in chronic kidney disease patients Wijaya, Carolin; Eriata, Anselmus Helbert; Rustawan, I Nengah Tony; Candra, I Kadek Bayu Adhi; Budayanti, Ni Nyoman Sri
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.v3i1.29

Abstract

Background: Urinary tract infection (UTI) is one of the most common bacterial infections encountered by clinicians in developing countries. UTI in patients with Chronic Kidney Disease (CKD) caused by ESBL-producing gram-negative bacteria has been increased in different countries. The common uropathogenic Gram negative bacteria are Escherichia coli and Klebsiella pneumoniae. The aim of this study was to identify prevalence of the common uropathogen producing ESBL E. coli and K. pneumonia among the patients with urinary tract infection (UTI) in chronic kidney disease as well as the susceptibility of antibiotic therapy. Methods: This was a cross-sectional retrospective study to evaluate clinical urine isolates collected from Prof. Dr. I.G.N.G. Ngoerah Hospital within July 2019 until July 2020. Identification and susceptibility tests in urine isolate were performed by Vitex-2 System (Biomerieux) and interpreted with CLSI 2020 standard. Results: From 1291 urine specimens,  210 urine specimens were collected (29.43%) from patients with UTI in CKD  during 12 months. Prevalence of uropathogen in chronic kidney disease from urine specimens were E.coli (41.57%), K.pneumoniae (13.15%), and Pseudomonas aeruginosa  (7.36%). It was found that ESBL produced E. coli (56.32%) and also K. pneumoniae (54%). Susceptibility antibiotic E. coli and K. pneumonia of UTI patient with CKD with ESBL producers were meropenem (99,10%), amikacin (98,07%), tigecycline (92,30%), gentamicin (80%), and fosfomycin (79,47%). Conclusion: ESBL producers in patient UTI in CKD patients were E. coli 56,32%, K. pneumoniae 54% that were sensitive to meropenem, amikacin, tigecycline gentamicin, fosfomycin.
Detection of antibacterial activity in chicken meat, eggs, drinking water, animal feed and sewage waste in Tabanan, Bali Setiabudy, Marta; Indraningrat, Anak Agung Gede; Suryanditha, Putu Arya; Budayanti, Ni Nyoman Sri; Yanti, Ni Komang Semara; Adhiputra, I Ketut Agus Indra; Widowati, I Gusti Ayu Rai; Agustina, Kadek Karang
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.v3i1.51

Abstract

Background: The use of antibiotics that are not in accordance with the indications, doses, and duration can trigger resistance and there is concern that it might leave antibiotic residues in the processed product. Aim of this study was to detect the antibacterial activity of livestock products, namely chicken meat and eggs and the surrounding environment such as drinking water, animal feed and waste disposal. This study was a preliminary study before the establishment of antibiotic wise village, One Health approach for antimicrobial stewardship program. Methods: This study was a descriptive study with a cross sectional design to determine antibacterial activity, particularly tetracycline in livestock products and the environment. The research samples were taken from 5 groups of farmers in one of the villages in Tabanan, Bali. Bioassay method based on the Kirby Bauer method was used in this study. Results: From a total of 44 samples, 6 samples showed weak antibiotic tetracycline activity (13.6%), namely in waste disposal (20%) and animal feed (40%). Antibiotic contamination was likely to occur because the animal feed used in this group contains antibiotics with or without the knowledge of the farmers themselves. Disposal waste came from livestock manure that ate the feed or from animal feed that was scattered around the cage. Conclusion: Samples of livestock meat and eggs did not show antibacterial activity. There were samples that have antibiotic activity but weak and inconsistent, namely in samples of waste disposal and animal feed. This condition cannot necessarily be concluded as antibiotic abuse in livestock however it can be the basis for the importance of providing education regarding antimicrobial resistance. Unless there was indication, antibiotics should not be given to livestock on a daily basis.
Various types of extended spectrum β-lactamases: a literature review Rastuti, Made Rina; Budayanti, Ni Nyoman Sri; Dwija, Ida Bagus Nyoman Putra
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.v3i2.52

Abstract

The inappropriate use of antibacterials causes the spread of resistance in bacteria and increases the health burden of infection due to the nature of resistance to many classes of antibiotics which are referred to as multi-resistant (multidrug resistant). Extended spectrum β-lactamase (ESBL) is one of the enzymes that cause multi-resistance, where bacteria with this enzyme become resistant to third-generation cephalosporin antibiotics which are often used to treat gram-positive and gram-negative bacterial infections in humans with minimal side effects. β -lactamase is an enzyme capable of hydrolyzing the β-lactam ring in β -lactam class antibiotics so that antibiotics become inactive. Mutations in the gene that encodes this enzyme produce a β-lactamase enzyme which can break down the β-lactam ring in all penicillin and cephalosporin antibiotics. The classification of β-lactamases is complex due to genetic, biochemical properties, and substrate affinity for β-lactamase inhibitors. There are also various types of ESBL enzyme-coding genes including TEM, SHV, CTX-M, VEB, PER, OXA, SFO-1, BEL-1, BES-1, TLA-1, and GES. This study aims to review various types of extended-spectrum β-lactamases.
A systematic review of multi-level intervention to enhance the quality of life patient with human immunodeficiency virus Yuntari, Gusti Ayu Krisma; Ady Wirawan, I Made; Sri Budayanti, Ni Nyoman; Arimbawa, Putu Eka
International Journal of Public Health Science (IJPHS) Vol 13, No 4: December 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i4.23936

Abstract

Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are still challenges worldwide. Improvement in quality of life (QoL) is crucial for HIV-infected people. The QoL of HIV-infected patients has been improved by the use of multilevel interventions in various circumstances. This study evaluates the evidence for interventions that target the quality of life of persons with HIV. A systematic review was performed according to the PRISMA guidelines. Science Direct, the Cochrane Library database, and Pubmed were also searched. Three independent reviewers extracted the data. Searches were conducted for articles published from 2013 to 2023. Searching procedures and data abstraction techniques were standardized. The 27 research examined the effects of interventions on HIVinfected people's quality of life. China is the most frequently mentioned country in the 27 studies, appearing as the setting in 8 (29.6%). Following South Africa (14.8%), New York (11.11%) and Kenya (7.4%) were the next most often mentioned countries. For analysis purposes, the interventions used in the 27 reviewed studies were classified into three main categories: individual intervention, family-community intervention, and health service intervention. Significant intervention innovations in quality-of-life research combining several interventions, including individual, family, community, and health system intervention, show the most promising results
Penerapan Teknik Polymerase Chain Reaction (PCR) dalam Mendeteksi Bakteri Patogen pada Sektor Peternakan dan Kesehatan Masyarakat Putra, Made Dwi Ambara; Budayanti, Ni Nyoman Sri; Mayura, I Putu Bayu
Jurnal Pendidikan Biologi Undiksha Vol. 11 No. 3 (2024)
Publisher : Undiksha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/jjpb.v11i3.91463

Abstract

Polymerase Chain Reaction (PCR) technology has emerged as a significant breakthrough in the detection and management of diseases in the livestock sector and public health. This study aims to evaluate the effectiveness and applications of PCR in detecting pathogens in livestock and zoonotic diseases that can transfer from animals to humans. The research adopts a literature review approach, analyzing various scientific findings related to the application of PCR in different contexts. The results demonstrate that PCR offers advantages in sensitivity, specificity, and detection speed compared to conventional methods, enabling effective early intervention to prevent disease spread. Furthermore, innovations such as digital PCR, Point-of-Care PCR systems, and real-time data integration broaden its applicability, particularly in resource-limited settings. These findings underscore the importance of continuous research and development in PCR technology to enhance disease surveillance and global health management.
Staphylococcus Aureus Colonization On An Erythrodermic Psoriasis Patient Dave Gerald Oenarta; NN Sri Budayanti; NN Dwi Fatmawati; NM Adi Tarini
JURNAL WIDYA MEDIKA Vol. 5 No. 2 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v5i2.2204

Abstract

Skin plays an important role as the physical barrier and first-line immunological defense against dangerous stimuli, including bacteria. Erythroderma is a condition of excessive skin irritation causing extensive erythema and desquamation. Erythroderma itself is caused by various underlying conditions, one of them is psoriasis vulgaris. In erythroderma, there is an extensive disruption of physical barrier leading to the exposure of various bacteria, including Staphylococcus aureus. In human, this bacteria can either colonize or infect the host if exposed to open wound. It is essential to determine this as it will affect the necessity of administering antibiotics. Laboratory examinations such as complete blood count, Gram staining, and culture can help to determine the status of this bacteria. A correlation between clinical features and laboratory examinations is paramount in deciding patient management.
Identification of Methicillin-Resistant Staphylococcus aureus (MRSA) carriers in the nasal passages of healthcare workers at Universitas Udayana Hospital Winaya, Made Illene; Made Agus Hendrayana; Ni Nyoman Sri Budayanti; Ni Nengah Dwi Fatmawati
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.v5i1.82

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen responsible for healthcare-associated infections (HAIs), with growing global concern due to its resistance to multiple antibiotics, including beta-lactams. Healthcare workers (HCWs), particularly those in critical care settings, are at risk of being asymptomatic carriers, facilitating MRSA transmission. This study aimed to determine the prevalence and distribution of MRSA carriers among healthcare workers (HCWs) at Universitas Udayana Hospital, Bali, Indonesia. Methods: A descriptive cross-sectional study was conducted from October to November 2024. A total of 44 nasal swab samples were collected from nurses across various hospital wards. Samples were cultured on Mannitol Salt Agar and underwent Gram staining, catalase, and coagulase testing. MRSA identification was confirmed using the cefoxitin disk diffusion method, with inhibition zones of ≤21 mm indicating methicillin resistance, as per CLSI guidelines. Data were analyzed descriptively. Results: MRSA colonization was identified in 4 out of 44 samples (9.1%), with cases distributed in the NICU (2 cases), ICU (1 case), and Surgical Ward (1 case). In addition, 12 samples (27.3%) were positive for methicillin-sensitive Staphylococcus aureus (MSSA), while 28 samples (63.6%) contained coagulase-negative staphylococci (CNS), predominantly in the outpatient and emergency departments. Conclusion: The presence of MRSA among HCWs, especially in critical units like NICU and ICU, emphasizes the importance of enhanced infection control measures. Routine screening, strict adherence to hand hygiene, appropriate use of personal protective equipment, and implementation of decolonization protocols, such as mupirocin application and chlorhexidine bathing, should be optimized to reduce MRSA transmission risks within healthcare facilities.
Trends in antimicrobial resistance of extended-spectrum beta-lactamase-producing Escherichia coli in urinary tract infections in ICU and non-ICU settings at Ngoerah Hospital, 2020-2022 Bryan Setiawan; Ni Nyoman Sri Budayanti; Fatmawati, Ni Nengah Dwi; I Putu Bayu Mayura
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.v5i1.83

Abstract

Background: Urinary Tract Infection (UTI) is one of the most common nosocomial infections, with Escherichia coli (E. coli) as the primary pathogen. The misuse and overuse of antibiotics has led to the emergence of antibiotic resistance, particularly in Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli. This resistance presents a significant challenge in managing UTIs, especially among ICU and non-ICU ward patients. This study aims to analyze trends in antibiotic resistance of ESBL-producing E. coli in UTI patients in ICU and non-ICU settings at Ngoerah Hospital during 2020–2022. Methods: A descriptive study with a cross-sectional approach was conducted. The inclusion criteria of this study were samples with identification results of E. coli bacteria with VITEK 2 Compact (bioMérieux, France), which showed E. coli with a probability greater than or equal to 90% and accompanied by sensitivity of E. coli bacteria to antibiotics. Result: Among 789 samples meeting inclusion criteria, 90% (714) were from non-ICU wards, while 10% (75) were from ICU wards. ESBL-producing E. coli accounted for 53% (416), while non-ESBL strains constituted 47% (373). The prevalence of ESBL-producing E. coli in non-ICU wards increased from 43% (96 isolates) in 2020 to 47% (129 isolates) in 2021 and 51% (149 isolates) in 2022. In ICU wards, prevalence rose from 3% (6 isolates) in 2020 to 4% (12 isolates) in 2021 and 8% (24 isolates) in 2022. Tigecycline, meropenem, and ertapenem demonstrated high sensitivity (≥96%), while beta-lactam antibiotics like ampicillin, cefixime, and cefazolin showed 100% resistance. Conclusion: The increasing resistance of ESBL-producing E. coli, particularly in non-ICU settings, highlights the need for strict antibiotic policies and monitoring to prevent further resistance.
Prevalence and antibiotic sensitivity patterns of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in pneumonia patients at Ngoerah Hospital from 2020 to 2022 Arikandini, Dewa Ayu Putu Aisaka Rajeshi; Ni Nyoman Sri Budayanti; Ni Nengah Dwi Fatmawati; I Putu Bayu Mayura
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.v5i1.86

Abstract

Background: Pneumonia remains a major global cause of mortality, with Klebsiella pneumoniae recognized as a significant pathogen. The emergence of antibiotic resistance, particularly due to Extended-Spectrum Beta-Lactamase (ESBL) production by K. pneumoniae, complicates treatment efforts. This study aimed to determine the prevalence of ESBL-producing K. pneumoniae in pneumonia patients and assess its antibiotic sensitivity profile. Methods: A descriptive cross-sectional study was conducted retrospectively using secondary data from VITEK 2 Compact (bioMérieux) laboratory results on sputum samples collected from pneumonia patients at Ngoerah Hospital from 2020 to 2022. A total of 515 samples met the inclusion criteria out of 1,350 tested. Results: ESBL-producing K. pneumoniae was identified in 305 isolates (59.2%), with yearly prevalence rates of 63% in 2020, 52% in 2021, and 61% in 2022. Most patients were male (66.6%), aged 60 years or older (40%), and treated in non-ICU settings (69.2%), with expectorated sputum as the most common specimen type (63%). Antibiotic sensitivity testing revealed high susceptibility of ESBL-producing isolates to ertapenem (100%), meropenem (100%), amikacin (93%), and tigecycline (81%). Conclusion: ESBL-producing K. pneumoniae accounted for over half of pneumonia cases, with fluctuating prevalence across the study period. The infection predominantly affected older male patients treated in non-ICU wards. Despite resistance to many beta-lactam antibiotics, high sensitivity to carbapenems and other specific agents highlights their continued relevance in treatment. Surveillance of antibiotic resistance patterns remains essential for effective clinical management.
Co-Authors A. Soebandrio A. Widayati Adhiputra, I Ketut Agus Indra Adinda Putra Pradhana Agus Eka Darwinata Agus Roy Rusly Hariantana Hamid Agus Simahendra Agustinus I Wayan Harimawan Ajeng Diantini Amin, Yusuf Sidang Anggita Dewi Arikandini, Dewa Ayu Putu Aisaka Rajeshi Aryana, I Gusti Putu Suka Bryan Setiawan Candra, I Kadek Bayu Adhi Chandra, Katherine Silvania Christopher Ryalino D A Indah Gitaswari Dave Gerald Oenarta Dea Antariksa Dewa Ayu Agung Anggita Ningrat Dwija, Ida Bagus Nyoman Putra Dyah Pradnyaparmita Duarsa Eriata, Anselmus Helbert Erly Sintya Erly Sintya F. S. Wignall Fedik Abdul Ratam Gusti Ayu Dianti Violentina Hearty Indah Oktavian Hendrawan, Gresya I Dewa Agung Gede Meisha Dhanam I Dewa Ayu Made Dian Lestari I Dewa Made Sukrama I Gede Gita Sastrawan I Gede Pradnya Wisnu Murthi I Gusti Agung Indah Pradnyani R.S I Gusti Ayu Dewi Ratnayanti I Gusti Kamasan Arijana I Gusti Ngurah Kade Mahardika I Gusti Ngurah Mayun I Gusti Nyoman Sri Wiryawan I Made Ady Wirawan I Made Sutha Saskara I Nyoman Hariyasa Sanjaya I Nyoman Wande I Putu Bayu Mayura I Putu Bayu Mayura, I Putu Bayu I Wayan Adi Pranata I Wayan Rivandi Pradiyadnya Mardana I Wayan Sugiritama I Wayan Suranadi I. B. P. Dwija I. K. Sukardika I.K. Suata Ida Ayu Andhira Dewi Suarisavitra Ida Ayu Putu Putri Andari Ida Bagus Gede Adiguna Wibawa Ida Sri Iswari Indramawan Setyojatmiko Indraningrat, Anak Agung Gede K. Subrata K. Wirasandhi Kadek Anggie Wigundwipayana Kadek Dede Frisky Wiyanjana Kadek Karang Agustina Komang Januartha Putra Pinatih Krishna Murprayana Lameng, Imaculata Sonia Vidaryo M. A.C.M. Nusatya Made Agus Hendrayana Made Widianantara Made Wiryana Marco Reeiner N. K. Niti Susila, N. K. N. K. Susilarini Ni Kadek Seri Mahayanti Ni Luh Made Mirah Rahayu Ni Luh Putu Harta Wedari Ni Luh Putu Harta Wedari Ni Luh Putu Harta Wedari, Ni Luh Putu Harta Ni Luh Ranthi Kurniawathi Ni Made Adi Tarini Ni Made Linawati Ni Made Mertaniasih Ni Made Susilawathi Ni Nengah Dwi Fatmawati Ni Nengah Dwi Fatmawati Nyoman Indra Karunia Putri Nyoman Yenny K, Nyoman Pande Putu Januraga Prilandari, Luh Inta Prisela Zharaswati Prisillia Brigitta Putra, I Dw. Gd. Bayu Artha Pratama Putra, Made Dwi Ambara Putu Arya Suryanditha Putu Dian Pratita Lestari Putu Eka Arimbawa Raka-Sudewi A. A. Rastuti, Made Rina Rustawan, I Nengah Tony Saranova, Hilda Sari Kusumadewi Sathya Deva, I Dewa Gde Setiabudy, Marta Shita Diwyani Sudarsa Tjokorda Gde Agung Senapathi V. Wiwing Violentina, Gusti Ayu Dianti Wahyu Hidayati Wibisana, I Dewa Nyoman Adi Ningrat Widowati, I Gusti Ayu Rai - Wijaya, Carolin Winatha, I Gde Pangestu Putrama Winaya, Made Illene Wira Guna, I Gede Bhima Yanti, Ni Komang Semara Yuntari, Gusti Ayu Krisma