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All Journal PAUD Teratai Microbiology Indonesia Medical Journal of Indonesia The Indonesian Biomedical Journal Paediatrica Indonesiana Eksakta : Berkala Ilmiah Bidang MIPA Majalah Kedokteran Andalas Jurnal Kesehatan Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia PREPOTIF : Jurnal Kesehatan Masyarakat The New Ropanasuri Journal of Surgery Jurnal Kesehatan Tambusai Respiratory Science eJournal Kedokteran Indonesia Makara Journal of Science MEDICINUS The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Kedokteran Hewan Jurnal Penyakit Dalam Indonesia Journal of Clinical Microbiology and Infectious Diseases Jurnal Kesehatan dan Kedokteran
Anis Karuniawati
Departemen Mikrobiologi Klinik, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia – RSUPN Dr. Cipto Mangunkusumo, Jakarta
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Third-Generation cephalosporins (3GC) and Fluoroquinolones (FQ) Co-Resistance in Extended-Spectrum Beta-Lactamase-Producing Escherichia coli (ESBL-Ec) from Clinical and Community Isolates Febrianti, Tati; Puspandari, Nelly; Karuniawati, Anis
EKSAKTA: Berkala Ilmiah Bidang MIPA Vol. 24 No. 04 (2023): Eksakta : Berkala Ilmiah Bidang MIPA (E-ISSN : 2549-7464)
Publisher : Faculty of Mathematics and Natural Sciences (FMIPA), Universitas Negeri Padang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24036/eksakta/vol23-iss04/462

Abstract

The growing AMR issue affects the current antimicrobial therapy recommendations, particularly for broad-spectrum antibiotics, like third-generation cephalosporins (3GC) and fluoroquinolones (FQ). Actually, the inappropriate use of both antibiotics in clinical and community settings increase the resistance of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-Ec). Although ESBL-Ec is used as a surveillance indicator of bacterial resistance, but currently studies related to 3GC-FQ co-resistance among clinical and community (including human and wastewater samples) based ESBL-Ec isolation, have not been widely carried out. The objective of this study was to analyze the possibility and mechanism of 3GC-FQ co-resistance among ESBL-Ec, in human clinical and communal isolates from previous published research. Out of 257 articles screened, four studies in accordance with our study are included in the analysis. The result indicated that ESBL-Ec derived from all sample sources had 3GC-FQ co-resistance. According to two studies reviewed, blaCTX-M was the most predominant ESBL gene, while the FQ-associated resistant gene dominated by qnr family genes. Resistant genes and co-resistant ESBL-Ec can be spread rapidly through plasmids.
Genotypic pattern of fluoroquinolone resistance among extended-spectrum beta-lactamase-producing Escherichia coli Febrianti, Tati; Puspandasari, Nelly; Febriyana, Dwi; Weaver, Tom; Karuniawati, Anis
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247544

Abstract

BACKGROUND Fluoroquinolone (FQ) is one of the therapeutic options for treating extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (ESBL-Ec) infection, but its use could increase the resistance level of ESBL-Ec. This study aimed to analyze the resistant genes responsible for ESBL production and FQ resistance among the ESBL-Ec isolated from healthy humans and communal wastewater. METHODS This was an observational study using stored isolates and laboratory data. Genome sequencing was done on 43 E. coli DNA isolates before resistance genes, mutations, and high-risk clones were examined through bioinformatic data analysis. RESULTS The analysis of 39 ESBL-Ec isolates showed ESBL genes, including blaCTX-M-55 (56%), blaCTX-M-15 (31%), and blaCTX-M-27 (8%). ESBL-Ec isolates exhibited mutations in gyrA (54%), gyrB (0%), parC (28%), and parE (10%). Plasmid-mediated quinolone resistance genes detected included qnrS1 (54%), qnrS13 (13%), qnrB2 (3%), aac(6’)-Ib-cr5 (3%), qepA (0%), and oqxAB (0%). ESBL and FQ resistance genes were simultaneously detected in 33 ESBL-Ec isolates, with high-risk clones identified as ST155, ST10, ST23, ST38, ST131, and ST69 Cplx. CONCLUSIONS ESBL and FQ resistance genes were simultaneously detected in ESBL-Ec isolated from healthy humans and communal wastewater.
Respiratory Syncytial Virus (RSV): Virologi, Patogenesis, Respon Imun, dan Vaksin Pada Dewasa Resti H. Lestari; Fariz Nurwidya; Anis Karuniawati
MEDICINUS Vol. 38 No. 7 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/n0vpzd50

Abstract

Respiratory syncytial virus (RSV) is classified within the Pneumoviridae family, genus Orthopneumovirus. RSV is a single-stranded, negative-sense RNA virus and has two genotypes, A and B. It is primarily associated with lower respiratory tract infections, including bronchiolitis and bronchopneumonia, and is a common cause of hospitalization in infants, elderly individuals, and immunocompromised patients. RSV also has the potential to become systemic infection. Symptoms of RSV infection, such as fever, cough, sore throat, and runny nose, are usually mild in adults. However, in some cases, especially for specific high-risk individuals, the infection can become severe enough to require hospitalization, and complications may lead to death. Understanding the pathogenesis and immune response to RSV are crucial for recognizing the virus’s effects and potential risks. This literature review covers the virology, pathogenesis, immune response, and recent advancements in RSV vaccine development in adult populations. Comprehensive knowledge of RSV is essential for developing effective prevention and treatment strategies.
PERBANDINGAN ANTARA MESIN SEMI-OTOMATIS UNTUK UJI KEPEKAAN ANTIBIOTIK KOLISTIN DENGAN BROTH MICRODILUTION SEBAGAI BAKU EMAS Fitriah, Laela; Hasanah, Lili; Maretti, Nadia; Karuniawati, Anis
Jurnal Kesehatan Tambusai Vol. 6 No. 4 (2025): DESEMBER 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v6i4.34532

Abstract

Kolistin merupakan salah satu antibiotik pilihan terakhir yang efektif melawan infeksi bakteri Gram-negatif yang resisten terhadap semua antibiotik. Uji kepekaan antibiotik kolistin saat ini masih menjadi tantangan, karena tidak ada metode pengujian yang terstandar. Tujuan studi ini adalah  membandingkan mesin semi otomatis penguji kepekaan antibiotik kolistin (yang diwakili oleh mesin Vitek®2) dengan broth microdilution (BMD) sebagai baku emas. Metode Penelusuran artikel dilakukan di tiga pangkalan data yaitu Pubmed, Wiley dan Scopus sesuai dengan pertanyaan klinis. Skrining artikel menggunakan kriteria inklusi, mengecek kelengkapan artikel, serta membaca artikel keseluruhan untuk mendapatkan artikel yang sesuai. Artikel dinilai kualitasnya berdasarkan validitas, kepentingan dan aplikabilitas.  Hasil dari penelusuran didapatkan lima artikel dari database dan artikel dari google scholar tidak didapatkan artikel yang memenuhi kriteria eligibilitas. Sehingga telaah kritis dilakukan pada kelima artikel tersebut. Hasil telaah pada 3 artikel tersebut adalah Essential agreement (EA) < 90% dan Categorical agreement (CA) > 90%. Artikel lainnya menyebutkan ketidak-konsistenan hasil uji pada isolat E. coli dan K. pneumoniae. Nilai VME didapatkan pada kelima studi dianggap kurang baik pada uji kepekaan menggunakan mesin semi otomatis. Kesimpulan dari penelitian ini ialah pemeriksaan uji kepekaan kolistin dengan metode semi otomatis tidak dapat dijadikan pemeriksaan alternatif uji kepekaan kolistin karena  kurang sesuai dengan hasil yang didapatkan dengan metode BMD.
PEMERIKSAAN MIKROBIOLOGI PADA ASPERGILOSIS PULMONAL Sari, Rifta; Arfan, Ahmad; Karuniawati, Anis; Haryanto, Budi
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 10 No. 1 (2026): APRIL 2026
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v10i1.54309

Abstract

Aspergilosis pulmonal merupakan infeksi jamur oportunistik yang disebabkan oleh Aspergillus spp. dan memiliki spektrum klinis luas, mulai dari bentuk alergi, kronik, hingga invasif yang mengancam jiwa. Peningkatan jumlah pasien imunokompromais, penyakit paru kronis, serta penggunaan kortikosteroid jangka panjang berkontribusi terhadap meningkatnya insidensi aspergilosis paru. Diagnosis penyakit ini masih menjadi tantangan karena gejala klinis dan temuan radiologis sering tidak spesifik serta menyerupai penyakit paru lain, seperti tuberkulosis dan keganasan paru. Artikel ini bertujuan untuk mengkaji secara komprehensif pemeriksaan mikrobiologi pada aspergilosis pulmonal, meliputi pemeriksaan mikroskopis langsung, kultur jamur, identifikasi spesies, uji kepekaan antijamur, pemeriksaan serologi, serta deteksi molekuler. Metode yang digunakan adalah studi kepustakaan dengan pendekatan deskriptif naratif terhadap literatur ilmiah nasional dan internasional sepuluh tahun terakhir. Hasil kajian menunjukkan bahwa pemeriksaan mikrobiologi memegang peranan penting dalam menunjang diagnosis aspergilosis pulmonal, namun harus diinterpretasikan bersama data klinis dan radiologis untuk membedakan kolonisasi, kontaminasi, dan infeksi aktif. Cairan bronchoalveolar lavage (BAL) merupakan spesimen terbaik untuk berbagai metode diagnostik. Kombinasi pemeriksaan kultur, serologi, dan biomarker jamur seperti galaktomanan dapat meningkatkan akurasi diagnosis dan membantu penatalaksanaan yang tepat.
Diagnostic Stewardship dalam Penanganan Penyakit Infeksi Anis Karuniawati
Majalah Kedokteran Indonesia Vol 73 No 5 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.5-2023-1195

Abstract

Stewardship atau dalam Bahasa Indonesia diterjemahkan sebagai penatalayanan. Kata tersebut seringkali digunakan dalam rangkaian kata antimicrobial stewardship atau dengan terjemahan yang disesuaikan, yaitu penatagunaan antimikroba. World Health Organization (WHO) telah menerbitkan pedoman diagnostic stewardship pada tahun 2016 sebagai pelengkap pedoman antimicrobial stewardship. Diagnostic stewardship diartikan sebagai suatu panduan untuk mengoptimalkan atau meningkatkan kesesuaian penggunaan pemeriksaan mikrobiologi sebagai acuan penentuan terapi. Peningkatan kesesuaian dalam diagnostic stewardship meliputi semua tahap proses diagnosis mikrobiologi klinis dan tata kelola laboratorium, yaitu tahap pra-analisis, analisis, dan pasca-analisis. Tahap pra-analisis meliputi pemilihan, penanganan, dan pengiriman spesimen ke laboratorium disertai data pasien yang penting untuk menentukan jenis pemeriksaan mikrobiologi dan interpretasi hasilnya. Tahap analisis meliputi penentuan kualitas spesimen dan proses pengujian, sedangkan tahap pasca-analisis meliputi pelaporan hasil, interpretasi sesuai kondisi pasien, dan kemudian hasil digunakan oleh klinisi untuk tata laksana pasien. Keberhasilan setiap tahap tersebut juga sangat tergantung pada kualitas serta efektivitas pemanfaatan sumber daya yang tersedia.1
Risk and Prevention of Infections in the Bronchoscopy Room Wahju Aniwidyaningsih; Indah Puspita Sari; Anis Karuniawati; Fathiyah Isbaniah; Mia Elhidsi; Ni Putu Laksmi Ananda Martini
Respiratory Science Vol. 6 No. 3 (2026): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i3.217

Abstract

Bronchoscopy is a widely used diagnostic and therapeutic procedure in pulmonary medicine, with increasing utilization as technology advances. However, it is also associated with a risk of infection, which may negatively impact patient outcomes, particularly in individuals with underlying lung disease or immunocompromised conditions. The Centers for Disease Control and Prevention (CDC) has reported that endoscopic procedures, including bronchoscopy, are among the most frequently implicated medical devices in healthcare-associated outbreaks. Post-bronchoscopy infections, although relatively uncommon (0.2–5.2%), may lead to serious complications such as pneumonia, lung abscess, and empyema. These infections can originate from endogenous respiratory flora or from exogenous contamination related to inadequate bronchoscope reprocessing. This narrative review aims to summarize current evidence on infection risks, sources of transmission, and preventive strategies in the bronchoscopy setting, including occupational risks to healthcare workers. Strengthening infection control practices is essential to improve patient safety and reduce the risk of transmission in bronchoscopy units.
Multiplex PCR Respiratory Panel in Indonesia: A Narrative Review Johan Nathan; Fariz Nurwidya; Anis Karuniawati
Respiratory Science Vol. 6 No. 3 (2026): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i3.237

Abstract

Acute Respiratory infections (ARIs) remain a major cause of illness and death worldwide. Conventional diagnostic methods are often slow or have limited sensitivity. Multiplex (Polymerase Chain Reaction) PCR respiratory panels allow rapid detection of multiple respiratory pathogens from a single specimen and are increasingly available in Indonesia. This review summarizes the respiratory panels available in Indonesia and discusses their potential clinical use. A narrative review was conducted using literature from PubMed, manufacturer technical documents, and the Indonesian Ministry of Health medical device registry. Information on pathogen coverage, diagnostic performance, specimen requirements, and clinical applications was reviewed. There are six respiratory panel platforms currently available in Indonesia: VITRO Respiratory Flow Chip Kit, BioFire FilmArray Respiratory Panel 2.1 Plus, BioFire FilmArray Pneumonia Panel Plus, QIAstat-Dx Respiratory SARS-CoV-2 Panel, ALLPLEX Respiratory Panel, and COBAS Respiratory Flex. Most platforms focus on respiratory viruses and atypical bacteria using nasopharyngeal/oropharyngeal specimens, whereas BioFire FilmArray Pneumonia Panel Plus is designed for lower respiratory tract infections and additionally detects common bacterial pathogens, antimicrobial resistance genes, and provides semi-quantitative results. BioFire, QIAstat-Dx, and COBAS offer highly automated sample-to-answer workflows with minimal hands-on time, whereas VITRO and ALLPLEX require more manual processing but provide greater flexibility through open systems. Despite these advantages, implementation remains challenged by high costs and limited access in Indonesia. Six multiplex PCR respiratory panel platforms are available in Indonesia, each with different diagnostic characteristics and potential clinical applications. No single platform is optimal for all situations. Therefore, test selection should be tailored to the clinical setting, laboratory capacity, and available resources. Appropriate implementation may improve respiratory pathogen diagnosis and antimicrobial stewardship, although local evidence regarding clinical impact and cost-effectiveness is still needed.
Demographic, Clinical, and Antibiotic Exposure Factors Associated with Carbapenem-Resistant Acinetobacter baumannii: An Eight-Year Retrospective Study Angky Budianti; Dzaki Fadlurrahman Ayyasy; Mubarokah Mubarokah; Victor Sitorus; Yulia Rosa Saharman; Budiman Bela; Anis Karuniawati
Jurnal Kesehatan dan Kedokteran Vol. 5 No. 3 (2026): Oktober: Jurnal Kesehatan dan Kedokteran
Publisher : Asosiasi Dosen Muda Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56127/jukeke.v5i3.3072

Abstract

Antimicrobial resistance is a major global health challenge, and carbapenem-resistant Acinetobacter baumannii (CRAB) is of particular concern because of its high level of resistance, limited therapeutic options, and substantial burden in healthcare-associated infections. Identifying patient characteristics and antibiotic exposure associated with CRAB is essential to support effective antimicrobial stewardship and infection prevention strategies. Objective: This study aimed to analyze the association of demographic factors, including age and comorbidities, clinical diagnosis or manifestations, and a history of carbapenem use within the previous month with CRAB among clinical isolates examined at the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia, during 2017–2024. Methodology: This quantitative study employed a retrospective cross-sectional design using secondary laboratory and clinical data. Samples were selected through total sampling from patients with clinical specimens yielding A. baumannii. Descriptive analysis was used to characterize the study population, while Chi-square tests were applied to assess associations between the investigated factors and carbapenem resistance. Findings: A total of 172 A. baumannii clinical cultures were identified, of which 118 (68.6%) were CRAB. Age was significantly associated with CRAB (p=0.004), with patients aged >59 years representing the largest CRAB group. Clinical diagnosis or manifestation was also significantly associated with CRAB (p=0.005), with respiratory tract infection being the most frequent manifestation. Previous carbapenem use within one month was significantly associated with CRAB (p=0.009), with an odds ratio of 8.33 (95% CI: 1.48–46.94). In contrast, comorbidity was not significantly associated with CRAB (p=0.665). Implications: These findings support strengthening antimicrobial stewardship, particularly the appropriate use and continuous evaluation of carbapenem therapy, alongside enhanced surveillance and infection prevention measures among high-risk patients. Originality: This study provides local epidemiological evidence from an eight-year clinical dataset and integrates demographic, clinical, and previous carbapenem-exposure factors to characterize CRAB at a clinical microbiology laboratory in Jakarta, thereby contributing institution-specific evidence for CRAB surveillance and prevention strategies.
Co-Authors . Andriansjah Ade Dharmawan Amalia Almira Amarila Malik Amin Soebandrio Andi Annisa Rusyda Khafiyani Andi Yasmon Andra Aswar Andra Aswar, Andra Angky Budianti Aniwidyaningsih, Wahju Anwar S. Ibrahim Aprilia Rakhmawati Ardiana Kusumaningrum Arfan, Ahmad Ari Fahrial Syam Ari Prayitno Aria Kekalih Aryo Tedjo Asmarani Kusumawati Augustine Natasha Aulia Rizki Bachti Alisyahbana Badriul Hegar Badriul Hegar Bambang Madiyono Budi Haryanto Budiman Bela Burhanuddin Iskandar Ceva W. Pitoyo Chairunissa T. Rizal Cleopas Martin Rumende Delly Chipta Lestari Dimas Seto Prasetyo Dwiana Ocviyanti Dzaki Fadlurrahman Ayyasy E. Risdiyani Elhidsi, Mia Em Yunir Em Yunir, Em Erwin Christian Susanto Esthika Dewiasty Esthika Dewiasty, Esthika Falasiva, Rezyta Fariz, Nurwidya Febrianti, Tati Febriyana, Dwi Fitriah, Laela Futihati Ruhama Zulfa Gestina Aliska Gortap Sihotang Hana Paraswati Putri Handaya, Adeodatus Y. Hasanah, Lili Hindra I. Satari Ida Parwati Ika Ningsih Indah Puspita Sari Indah S. Widyahening Isbaniah, Fathiyah Iswanto, J. Johan Nathan Joyce Bratanata Joyce Bratanata, Joyce Kambang Sariadji Khie Chen Kuntjoro Harimurti Linosefa Linosefa Lucky Hartati Moehario Manuel Lamberto Willem Mboeik Martin Hartiningsih Mboeik, Manuel Lamberto Willem Mubarokah Mubarokah Muhammad K Azwar, Muhammad K Mulya Rahma Karyanti, Mulya Rahma Mulyadi M. Djer Muziasari, Windi Nabila Maudy Salma Nadia Maretti Nasution, Safruddin Nelly Puspandari Ni Putu Laksmi Ananda Martini Nie Nie Nina Dwi Putri Nuraini I Susanti Permatasari, Tri Wijayanti Pratama Wicaksana Pratiwi Pujilestari Sudarmono Pratiwi Sudharmono Prawoto Prawoto Prawoto Prawoto Pujilestari, Ratih Purwantyastuti Purwantyastuti Puspandasari, Nelly Rakhmawati, Aprilia Resti H. Lestari Reynaldo Reynaldo Reynaldo Reynaldo, Reynaldo Rezyta Falasiva Riamin Sitorus Rianto Setiabudi, Rianto Rida Tiffarent Rosdiana Irawati Rudyanto Sedono S. Nilawati Santya Fatma Dewi Sari Wiraswasty Sari, Rifta Saunar, Rofy S. Shindy Claudya Aprianti Simanjuntak, Glory Gelarich Sitorus, Truly Panca SJATHA, FITHRIYAH Subari A. Riyanto Sudigdo Sastroasmoro Sukman T. Putra Sunarno Sunarno Susan M. Noor Susan Maphilindawati Noor Susanti, Nuraini I Susanti, Nuraini I Susanto, Erwin Christian Sweety Pribadi SYADZA RHIZKY PUTRI AKHMAD T. M. Sudiro Teguh Harjono Karjadi Teguh Harjono Karjadi, Teguh Harjono TETSUHIRO MATSUZAWA Thomas Robertus Tjampakasari, Conny Riana Toar J.M. Lalisang TOHRU GONOI Tony Loho Trisni U Dewi, Trisni U Truely Panca Sitorus Usman, Nurhayat Victor Sitorus Weaver, Tom Wia Melia Windi Muziasari Yefta Moenadjat Yeva Rosana Yulia R. Saharman Yulia Rosa Saharman