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Medical Audit of the Management of Patients with Sepsis in the Intermediate Care Unit of Department Internal Medicine School of Medicine Airlangga University/Dr. Soetomo Hospital Hadi, Usman; Triyono, Erwin Astha
Indonesian Journal of Tropical and Infectious Disease Vol 1, No 1 (2010)
Publisher : Institute of Topical Disease

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Abstract

Sepsis and septic shock is one of the highest causes of death in patients treated in hospitals. Research Objectives: to evaluate the quality of the management of sepsis patients in Intermediate Care Unit, Department of Internal Medicine Dr. Soetomo Hospital Surabaya, Indonesia. This study was a retrospective study to re-evaluate the patient medical record. The number of patients treated: 275 patients, sepsis patients: 80 patients, the number of patients who entered the study 50 patients, 30 (60%) female and 20 (40%) men, most age groups aged 60 -70 years (32%), Mean 54 Median 56. Diagnostic accuracy according to the criteria of sepsis 45 (90%) patients, compliance with taking blood culture 2 (4%) patients, appropriate antibiotic selection 49 (98%) patients, the number of patients who should not be given antibiotics (4 patients), but given the antibiotic is 3 (75%) patients, the number of patients who should be given antibiotics (46 patients) but were not given antibiotics 1 (2%) patient. The reason of patients discharged: 27 had died (54%), 13 cured (26%), not yet recovered 10 (20%). The reason of patients discharged forcibly: to feel recovered 2 (20%), the condition gets worse 3 (30%), no cost 2 (20%), not clear 3 (30%). Patients with sepsis remain a big problem, and it still needs to improve the management of sepsis on existing guidelines.
PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS? Hadi, Usman; Kuntaman, Kuntaman; Qiptiyah, Mariyatul; Paraton, Hari
Indonesian Journal of Tropical and Infectious Disease Vol 4, No 4 (2013)
Publisher : Institute of Topical Disease

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Abstract

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.
Typhoid fever in Indonesia clinical picture, treatment and status after therapy Soewandojo, Eddy; Suharto, Suharto; Hadi, Usman
Medical Journal of Indonesia Vol 7 (1998): Supplement 1
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1221.383 KB) | DOI: 10.13181/mji.v7iSupp1.1049

Abstract

[no abstract available]
Comparative results between bone marrow culture and blood culture in the diagnosis of Typhoid fever Soewandojo, Eddy; Suharto, Suharto; Hadi, Usman; Fans, P.; Prihartini, Prihartini
Medical Journal of Indonesia Vol 7 (1998): Supplement 1
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.838 KB) | DOI: 10.13181/mji.v7iSupp1.1111

Abstract

[no abstract available]
Empirical Antibiotic Therapy Assessment of Patients diagnosed with Sepsis in Intermediate Care Ward of Internal Medicine Department of Dr. Soetomo General Hospital according to Gyssens Method Adiwinoto, Ronald Pratama; Sustini, Florentina; Hardiono, Hardiono; Widodo, Agung Dwi Wahyu; Hidajat, Boerhan; Hadi, Usman
Oceana Biomedicina Journal Vol 1, No 2 (2018): Oceana Biomedicina Journal
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (546.601 KB) | DOI: 10.30649/obj.v1i2.17

Abstract

Rational empirical antimicrobial therapy is an important component of sepsis patient management. This study aimed to assess the rationality of empirical antimicrobial therapy in patients diagnosed with sepsis admitted in intermediate care ward of internal medicine department (RPI) of Dr. Soetomo General Hospital from January 2016 to July 2017. Medical records of 91 patients diagnosed with sepsis were collected and studied retrospectively in period from July 2017 to November 2017. 91 (85.05%) medical records from 107 sepsis patients were evaluated. Cultures and antimicrobial sensitivity tests were carried out in 21 (23.07%) patients. 14 patients yielded positive culture results, 9 of which were MDRO positive with ESBL as resistant marker. Empirical antibiotic therapies for these patients were reviewed according to Gyssens method.73 (80.2%) of 91 patients were deemed receiving appropriate empirical antibiotic therapies. Ceftriaxone IV injection as monotherapy or combination therapy were the most common empirical antibiotic therapies (82 in 91 patients, 90.1%), despite local microbiologic flora and antibiogram show most pathogens were resistant to ceftriaxone. Mortality rate in this study was high, 92.3% (84 patients died) despite rational empirical antibiotic therapies were high. This study concluded that empirical antibiotic therapies in sepsis patients according to guidelines adopted in Soetomo General Hospital, albeit deemed rational, was no longer appropriate according to local antibiogram issued by microbiological department of Soetomo General Hospital. Keywords: Empirical Antibiotics Therapy, Gyssens criteria, Intermediate Care Ward, Sepsis, Septic Shock
Post Traumatic Tuberculous Tenosynovitis in a Patient that Manifests as Soft Tissue Tumor: A Case Report Haryo N. Yahya; Hadi, Usman
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17554

Abstract

Mycobacterium tuberculosis infection is one of the oldest diseases of the human race. This bacteriacan attack any organ in the human body. Extra Pulmonary Tuberculosis (EPTB) infection diagnosis arerarely straightforward, and in many cases, delayed due to various reasons. Tuberculous tenosynovitis(inflammation of the tendon and its capsule because of Mycobacterium tuberculosis complex infection)is a rare form of EPTB. Tuberculosis infection at sites of previous trauma have been reported consistentlythough rarely. We present the case of a 48 years old male with complains of lumps on his lower left arm(with prior history of blunt trauma on the location) and progressive inability to flex the fingers of his lefthand. Early examinations suggest the diagnosis to be a soft tissue tumour. However, tissue biopsy latershowed that the patient was actually suffering from tuberculosis infection. The patient later showedsatisfying response to tuberculosis medication on subsequent follow ups.
Molecular Genotyping of Tsst-1 Gene Staphylococcus Aureus from Clinical Specimen Marinda Dwi Puspitarini; Wahyu Setyarini; Usman Hadi; Kuntaman Kuntaman
Folia Medica Indonesiana Vol. 57 No. 2 (2021): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (254.093 KB) | DOI: 10.20473/fmi.v57i2.17559

Abstract

Staphylococcus aureus (S. aureus) is the most common pathogen in humans that causes various infections. Variations in infections due to S. aureus are related to the presence of virulence factors, one of which is Toxic Shock Syndrome Toxin-1 (TSST-1) which is the main cause of Toxic Shock Syndrome (TSS). This study aimed to explore the genetic pattern of the tsst-1 genes among MSSA and MRSA from clinical isolates of patients at Dr. Soetomo Academic Hospital, Surabaya-Indonesia. PCR examination was performed on 106 clinical samples of S. aureus isolates to determine the presence of the tsst-1 genes; subsequently, phylogenetic analysis was performed. The positive tsst-1 genes were found in 3 (5.7%) MSSA isolates and 2 (3.8%) MRSA isolates from 106 samples, of which were divided into 53 MSSA isolates and 53 MRSA isolates. No significant difference was noticed between the tsst-1 genes on both the MSSA and MRSA bacteria (p = 0.648). The positive tsst-1 genes were found in 1 (4.5%) of pus specimens and 2 (16.7%) of blood specimens from MSSA isolates. However, the positive tsst-1 genes were found in neither sputum nor urine specimens. The genes were found in 2 (16.7%) of blood specimens from MRSA isolates. Based on the phylogenetic tree, Indonesian tsst-1 isolates belonged to the same clade as Japan, Iran, Iraq, India, Egypt and the United Kingdom isolates. The prevalence of tsst-1 genes of both MSSA and MRSA from clinical isolates in Dr. Soetomo Academic Hospital Surabaya are 5.7% and 3.8%, respectively. The tsst-1 genes of Surabaya-Indonesia, Japan, Iran, Iraq, India, Egypt and the United Kingdom belonged to the same clade.
Analysis of Quality of Antibiotic Usage on Patient with Internal and Surgical Service Nurul Ma'rifah; Didik Hasmono; Usman Hadi; Kuntaman Kuntaman
Folia Medica Indonesiana Vol. 57 No. 1 (2021): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (360.279 KB) | DOI: 10.20473/fmi.v57i1.26327

Abstract

It is well-known that hospitals are health facility with the widely use of antibiotics. It is about 13-37% from the total hospitalized patients in developed countries use antibiotic, even in developing countries can reach 30-80%. There is identified correlation between antibiotic use and the development of bacterial resistance. Even though the resistance cannot be eliminated, but its development can be suppressed  by the increasing of prudent use of antibiotics. The aim of this study was to determine the quality of antibiotic use on internal medicine and surgical patients in Aisiyah Hospital Bojonegoro. The study was a prospective cross sectional observational analytical study of among patients of internal and surgical who received antibiotic therapy in the period of August - September 2017. The total 50 samples were collected in this study which consists of 33 internal medicine  and 17 surgical patients. From 50 samples, there were 16 types of antibiotics with the total use of 81 of antibiotic use. As the result, in internal medicine patients there were 22 (40%) of appropriate use of antibiotics, 4 (7.27%) of inappropriate use and 29 (52.73%) use of antibiotics without indication. In surgical patients, there were 12 (46.15%) of appropriate use of antibiotics, 2 (7.69%) of inappropriate use and 12 (46.15%) use of antibiotics without indication. This study showed that more than 50% of antibiotic use were inappropriate, and mainly antibiotic with no indication, among patients hospitalized in Aisyiyah Hospital Bojonegoro.
Ventilator-Associated Pneumonia in Dr. Soetomo General Hospital Surabaya Ismi Masyithah; Usman Hadi; Eko Budi Koendhori
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 12 No. 2 (2021): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V12I22021.57-60

Abstract

Introduction: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in the intensive care unit (ICU). Mechanically, ventilated patients have a higher risk of VAP. VAP can increase morbidity, mortality, and treatment costs. However, Indonesia lacks data about VAP. The objective of this study was to find out the characteristics of VAP in Dr. Soetomo General Hospital, Surabaya, in the period of August 2017 until August 2018.Methods: This was a cross-sectional study by assessing medical records of the patients in ICU. The variables observed in this study were age, gender, outcome, length of stay in the ICU (LOSICU), and primary diagnosis. The inclusion criteria were the patients who have been using mechanical ventilation at least 2 x 24 hours in the ICU and confirmed VAP. The data were analyzed descriptively by using Microsoft Excel 2016.Results: A total of 18 VAP patients were diagnosed. VAP patients were dominated male (55.6%). The mean of LOSICU was 22.83 ± 11.24 days, and the mortality rate of VAP patients was high (55.6%). 30% of VAP patients had Guillain-Barre Syndrome (GBS) as the primary diagnosis, and 16.65% had Congenital Heart Disease (CHD).Conclusion: Most VAP patients were male and had prolonged stays. The mortality rate of VAP patients was still high. GBS was the most frequent of primary diagnoses in patients with VAP and also CHD.
CORRELATION OF DENGUE VIRUS SEROTYPE AND DVI SEVERITY IN ADULT PATIENTS Suci Andriani; Aryati Aryati; Usman Hadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1322

Abstract

The clinical manifestation of dengue virus infection is often not clear, varies widely from mild to severe. Exposure of dengue virus which serotype is different from a previous infection is a risk factor for the severe manifestation of dengue virus infection. Dengue hemorrhagic fever is classified into four degrees of severity based on clinical manifestations and laboratory results. Real-time RT-PCR Dengue can detect dengue virus serotype in early dengue virus infection. The aimed of this study was to prove the correlation between dengue virus serotype and degree of severity in adult patients. This study was a cross-sectional observational design done in February until July 2016. Subjects consisted of 100 dengue virus infection patients. Serum of the patients was examined using Real-time RT-PCR Dengue (Simplexa™ Dengue). It was shown that from 46 patients with DENV-3 serotype was 63%, DENV-2 serotype 17.4%, DENV-1 serotypes 17.4% and mixed infection of DENV-1 and DENV-3 serotype 2.2%. There was not any DENV-4 serotype. Dengue Hemorrhagic Fever (DHF) stage I was 47.8%, DHF stage II was 30.4%, DHF stage III was 10.9% and Dengue Fever was 10.9%. There was not any DHF stage IV. There was not enough evidence that DENV-3 correlated with the degree of severity (p= 0.510). Based on this research, DENV-3 serotype was the dominant serotype prevalent at the Dr. Soetomo Hospital. There was no correlation between viral dengue serotype and severity in dengue adult patients in this study.