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All Journal BALI MEDICAL JOURNAL (BMJ) International Journal of Biosciences and Biotechnology Buletin Udayana Mengabdi Journal of Agricultural Science and Biotechnology E-Jurnal Medika Udayana Indonesia Medicus Veterinus Majalah Kedokteran Bandung Bali Journal of Anesthesiology Oceana Biomedicina Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Journal of Health Sciences and Medicine OISAA Journal of Indonesia Emas Bali Dental Journal Journal of Clinical Microbiology and Infectious Diseases Jurnal Widya Medika Folia Medica Indonesiana
Ni Nengah Dwi Fatmawati
Dapertemen Mikrobiologi Klinik, FK UNUD Universitas Udayana, Denpasar
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Engineering Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Microbial Diversity and Antimicrobial Susceptibility from Wound Dehiscence Isolates in an Indonesian Tertiary Referral Hospital Aviana, Felicia; Fatmawati, Ni Nengah Dwi
Majalah Kedokteran Bandung Vol 56, No 3 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3422

Abstract

Healthcare-associated infections (HAIs) remain a critical issue for public health in Indonesia, with wound dehiscence associated with surgical site infections (SSIs) being one of them. Globally, SSIs are known as the most common postoperative complications with a heightened prevalence, particularly in low to middle-income countries. With its retrospective and descriptive design, this study aimed to illustrate the microbial patterns identified in Prof. Dr. I.G.N.G. Ngoerah General Hospital from 12 January 2020 to 12 December 2022. The study includes all patients who underwent surgery and were subsequently diagnosed with wound dehiscence and SSIs. Specimens were collected from patients and submitted to the Microbiology Laboratory at the hospital above. Bacterial identification and susceptibility testing to antimicrobials were performed using the Vitek 2 Compact System (bioMerieux, Marcy l'Etoile, France). Patient information was sourced from medical records. Out of 172 samples, 151 (87.8%) yielded positive cultures. Among these, 151 (87.8%) were found to be positive. Gram-negative bacteria were found to be most prevalent, with Escherichia coli (20.2%) and Pseudomonas aeruginosa (19.6%) being the most frequently isolated bacteria. The bacteria isolated were mostly susceptible to amikacin (72.1%), followed closely by meropenem (71.4%). This information could contribute to the development of an empirical antibiotic therapy protocol for wound dehiscence or SSI cases in this local context.
Effect of Hypervirulent Strains, Antibiotic Resistance, and Host Characteristics on Mortality of Klebsiella pneumoniae Bacteremia Patients at a Tertiary Referral Hospital in Denpasar, Indonesia Adhy Candra, I Kadek Bayu; Suranadi, I Wayan; Darwinata, Agus Eka; Tarini, Ni Made Adi; Dharmika, Ida Ayu Gde Wahyudevi; Fatmawati, Ni Nengah Dwi
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.3297

Abstract

Klebsiella pneumoniae bacteremia is one of the leading causes of sepsis that has a high mortality rate. The effect of multidrug resistance and different virulence of Klebsiella pneumoniae on mortality is still controversial. This study aimed to determine the impact of hypervirulent K. pneumoniae (hvKp), MDR, and clinical characteristics on mortality of K. pneumoniae bacteremia patients. A retrospective cross-sectional study was conducted on  K.  pneumoniae bacteremia cases of patients hospitalized at Professor dr. I.G.N.G Ngoerah General Hospital from December 1, 2020, to May 31, 2021. A positive PCR of rmpA, iucA genes, and/or a positive string test was identified as hvKp. The mortality rate of 51 K. pneumoniae bacteremia patients samples (aged 0-74 years) was 72.5%, in which 9.8% (5/51) of them were hvKp and 51% of the isolates (26/51) produced the Extended Spectrum Beta Lactamase (ESBL). Furthermore, 9.8% (5/51) of the cases were carbapenem-resistant. Thus, hvKp, MDR, gender characteristics, and comorbidities do not significantly affect the mortality of K. pneumoniae bacteremia patients. Multivariate logistic regression analysis showed that sepsis (odds ratio (OR) 4.29; p=0.038) and adult age group (mean 50 years) (OR 3.75; p=0.039) are independent predictors with a significant effect on mortality of  K. pneumoniae bacteremia patients. Careful and integrated management of K. pneumoniae bacteremia patients is essential for better outcomes, especially in sepsis and elderly patients. Although hvKp prevalence is low, emerging MDR-hvKp in health facilities is a severe concern for further actions and research.
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.
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.
Positivity of ExoU Gene of Type III Secretion System and Fluoroquinolone Resistance of Psedomonas aeruginosa from Sputum of Nosocomial Pneumonia Patients in Sanglah Hospital, Bali Saputra, I Wayan Agus Gede Manik; Mertaniasih, Ni Made; Fatmawati, Ni Nengah Dwi
Folia Medica Indonesiana Vol. 54, No. 2
Publisher : Folia Medica Indonesiana

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Pseudomonas aeruginosa is one of the Gram-negative rods bacteria that frequently cause nosocomial pneumonia. One of the main virulent effector proteins on Type III secretion system (TTSS) of P. aeruginosa is Exoenzyme U ( ExoU). ExoU works as a phospholipase A2 activity and exhibits lung tissue injury effect in pneumonia. As an antibiotic that has activity against P. aeruginosa, fluoroquinolone resistance has increased as many as three fold since the last decade. Infections caused by P. aeruginosa that are fluoroquinolone resistant and positive for ExoU gene show worse clinical outcome. The aim of this study was to determine the positivity of ExoU gene TTSS and fluoroquinolone resistance of P. aeruginosa that isolated from sputum of nosocomial pneumonia patients in Sanglah Hospital, Bali. P. aeruginosa isolated from sputum of patient that diagnosed as nosocomial pneumonia, isolates had been identified phenotypically by Vitek2 Compact system (bioMérieux, Inc., Marcy-l'Etoile - France), and then continued by genotypic detection by PCR. The susceptibility testing of P. aeruginosa isolates to Ciprofloxacin were conducted by Vitek2 Compact, whereas ExoU genes were detected by PCR. Fifty-three P. aeruginosa isolates were identified in this study, in which 35 isolates (66.1%) had ExoU gene and 22 isolates (41.5%) were resistant to Ciprofloxacin. Based on nosocomial pneumonia type, the highest proportion of isolates genotipically ExoU+ and phenotypically Ciprofloxacin were on VAP group accounted for 57.1% and 54.5%, respectively. Chi-square analysis showed significant correlation between Ciprofloxacin resistance and ExoU gene (p=0.001). As a conclusion, the positivity of ExoU+ isolates were more likely found in Ciprofloxacin resistant group.
Co-Authors Adhy Candra, I Kadek Bayu Agus Eka Darwinata Andi Yasmon Anggita Ratri Pusporini Aviana, Felicia Bagus Ngurah Putu Arhana Bryan Setiawan Budiman Bela Cynthia Dewi Sinardja Dave Gerald Oenarta Dea Antariksa Dharmika, Ida Ayu Gde Wahyudevi Dhyana Ratmaja, I Gusti Agung Ngurah Dwijastuti, Ni Made Sri F. S. Wignall Fera Ibrahim Gema Zakharian GNR Suwardana I Dewa Agung Gede Meisha Dhanam I Dewa Ayu Made Dian Lestari I Dewa Made Sukrama I G. A. Ngurah Aswin Panji Sanjaya I G. R. M. TEMAJA I Gede Agus Darsana Palgunadi I Gede Gita Sastrawan I Gede Pradnya Wisnu Murthi I Gede Raka Adhyatma I Gede Sathya Agastya I Gede Wikania Wira Wiguna I Gusti Agung Dyah Ambarawati I Gusti Agung Istri Gladys Elsyaningrat I Gusti Ayu Agung Praharsini I Gusti Ayu Janadewi I Gusti Ngurah Kade Mahardika I Gusti Ngurah Krishna Priyaka I Kadek Jaya Santika I Made Sathya Vijayananda I Made Sutha Saskara I Nengah Sujaya I Putu Bayu Mayura I Putu Bayu Mayura I Wayan Agus Gede Manik Saputra I Wayan Aryabiantara, I Wayan I Wayan Gustawan I Wayan Muda Suta Arta I Wayan Suranadi I. B. P. Dwija I.D.P.K. Pratiwi Ichlazul Ma’ruf Ida Ayu Andhira Dewi Suarisavitra Ida Bagus Gede Adiguna Wibawa Ida Sri Iswari Indramawan Setyojatmiko K. Subrata K. Wirasandhi Kadek Anggie Wigundwipayana Kadek Tresna Yuwana Ketut Tuti Parwati Komang Aditya Arya Prayoga KOMANG AYU NOCIANITRI Komang Januartha Putra Pinatih Luh Gede Melia Puspita Sari Made Agus Hendrayana Made Gede Dwi Lingga Utama Made Widianantara Marvin Giantoro N. K. Susilarini N.W.A. Utami Ni Kadek Seri Mahayanti Ni Luh Made Rasmawati Ni Made Adi Tarini Ni Made Mertaniasih Ni Made Susilawathi Ni Nyoman Sri Budayanti Ni Putu Wirantari Ni Wayan Eka Putri Gayatri Kastawa NMRP Dewi Prisela Zharaswati Prisillia Brigitta Putu Agung Satvika Pradnyadevi Putu Ayu Utami Prajawaty Putu Yoska Arya Harindana Rachmy Hamdiyati Raka-Sudewi A. A. Reny Rosalina Rian Ka Praja Saputra, Darmawan Jaya Saputra, I Wayan Agus Gede Manik Saraswati, I Gusti Ayu Agung Putri Indria Sonia Elvira Salim Surya Putra, I Gusti Agung Utama Wahyu Hidayati Wahyu Hidayati Wahyu Hidayati Yan Ramona