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Murad Lesmana
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Comparative analysis of transport media for isolating Shigella Lesmana, Murad; Salim, Oktavianus Ch.; Herwana, Elly; Bukitwetan, Paul; Surjawidjaja, Julius E
Universa Medicina Vol 27, No 2 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.51-56

Abstract

Transport media for Shigella include buffered glycerol saline (BGS), and Cary-Blair (CB). However being a liquid medium BGS may leak or spill during transport and thus may cause contamination. The other concern is the 30% concentration of glycerol in the BGS which may be inhibitory to some susceptible Shigella species. This study was conducted to determine the best and safe transport media for Shigella. Rectal swab samples were obtained from 289 dysenteric patients and transported to the laboratory in Cary-Blair (CB) transport medium, standard buffered glycerol saline (BGS), BGS with the addition of 0.5% agar (BGS-A), and BGS with the addition of 0.5% agar and reduced glycerol to 15% (BGS-M). Recovery rates between CB, BGS, BGS-A and BGS-M and their combinations were compared. The overall prevalence of Shigella recovered from any of the four tubes was 24.9% (72/289). CB and BGS-M recovered Shigella in 54 out of 289 patients (18.7%), CB and BGS-A in 50 (17.3%), and CB and BGS in 49 (17.0%), while CB, BGS, BGS-A, and BGS-M alone gave positive Shigella in 30 (10,4%), 29 (10.0%), 34 (11.8%) and 46 (15.9%), respectively. This study suggests that a minor modification to the BGS raised the recovery rate of Shigella.
Perbandingan agar MacConkey, Salmonella-Shigella, dan xylose lysine deoxycholate untuk isolasi Shigella dari usap dubur penderita diare Surjawidjaja, Julius E; Salim, Oktavianus Ch.; Bukitwetan, Paul; Lesmana, Murad
Universa Medicina Vol 26, No 2 (2007)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2007.v26.57-63

Abstract

LATAR BELAKANGUmumnya media untuk isolasi Shigella dari tinja terdiri dari media diferensial seperti MacConkey (MAC) dan media selektif seperti agar Salmonella-Shigella (SS), xylose-lysine-deoxycholate (XLD), dan Hektoen enteric (HEA). Untuk isolasi kuman enterik digunakan kombinasi media dengan selektivitas sedang dan sangat selektif, tetapi belum ada keseragaman mengenai media atau kombinasi media yang baik. Penelitian ini bertujuan untuk membandingkan media MAC, SS, dan XLD serta mengetahui media mana yang paling sensitif untuk isolasi Shigella.METODEUsap dubur dari penderita diare ditanamkan pada agar MAC, SS dan XLD. Lempeng- agar diinkubasi pada suhu 370C selama 24 jam. Koloni tersangka (non-lactose fermenting) diambil dan ditanamkan ke media biokimia untuk identifikasi Shigella. Uji serologi dilakukan untuk konfirmasi dengan menggunakan serum anti spesifik (Difco laboratories, Detroit, MI). Program Epi Info versi 6 (Center for Disease Control and Prevention) digunakan untuk analisis statistik.HASILSebanyak 1.027 usap dubur dari penderita diare dibiakkan pada agar MAC, SS, dan XLD. Hasil isolasi untuk Shigella secara keseluruhan adalah 8,4%, terdiri dari S. flexneri 6,2%, S. sonnei 1,9%, S. boydii 0,2% dan S. dysenteriae 0,2%. Derajat isolasi Shigella pada agar MAC adalah sebesar 5,1%, pada SS 4,8%, dan pada XLD 7,1%. Kombinasi dari media biakan menunjukkan bahwa 6,5% dari isolat Shigella diperoleh dari MAC+SS, 8,1% dari MAC+XLD, dan 7,9% dari SS+XLD. Dari 86 usap dubur yang positif untuk Shigella, 20 (22,7%) isolat berasal ari lempeng agar XLD saja, 5 (5,8%) dari SS saja, dan 6 (7,0%) dari MAC saja.KESIMPULANUntuk isolasi S. flexneri dan S. sonnei, XLD adalah media yang paling sensitif. MAC+XLD merupakan kombinasi media diferensial dan selektif yang paling sensitif untuk isolasi kuman Shigella.
Prevalence of extended spectrum beta-lactamase in Klebsiella pneumoniae Herwana, Elly; Yenny, Yenny; Pudjiadi, Laurentia; Surjawidjaja, Juius E; Lesmana, Murad
Universa Medicina Vol 27, No 3 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.98-105

Abstract

Increased irrational use of antibiotics promotes bacterial resistance to these drugs. Among the resistance mechanisms developed by bacteria is the production of â-lactamase which can destroy the â-lactam ring and cause resistance to the other â-lactam antibiotics, such as amoxycillin. Extended spectrum â-lactamase (ESBL), an enzyme found in bacterial plasmids, is capable of hydrolyzing third-generation cephalosporins, namely cefotaxime, ceftazidime, ceftriaxone, and the monobactams. ESBL is predominantly found in Klebsiellas spp., Escherichia coli and other bacteria of the Enterobacteriaceae family. This study was conducted to determine the prevalence of Klebsiella resistant to cephalosporins and the prevalence of those producing ESBL. A total of 65 clinical isolates of Klebsiella were tested by the disk diffusion method according to Kirby-Bauer to determine their antibiotic susceptiblity and by the double-disk synergy method to detect the presence of ESBL. The results show that 18.5% of Klebsiella isolates tested were resistant to ceftazidime and cefixime, 13.9% to ceftriaxone, and 23.1% to aztreonam. Testing for ESBL revealed that the prevalence of ESBL producers in clinical Klebsiella isolates ranged from 10.8% to 12.3%. The presence of ESBL, plus the potential for plasmid-mediated quinolone and carbapenem resistance, undoubtedly will create significant therapeutic problems in the future.
Alkaline peptone water plus 0.5% agar suitable for transport of Vibrio cholerae Meiyanti, Meiyanti; Salim, Oktavianus Ch.; Surjawidjaja, Julius E.; Lesmana, Murad
Universa Medicina Vol 30, No 2 (2011)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2011.v30.95-101

Abstract

Microbiological procedures for V. cholerae isolation from clinical specimens are important factors in clinical and epidemiological management of cholera. The standard preservation medium for enteric pathogenic bacteria, including V. cholerae, is Cary-Blair medium (CB), a semisolid medium for preservation and transport of specimens containing intestinal bacteria. A special medium for Vibrio organisms is alkaline peptone water (APW), which is both a transport and an enrichment medium. The purpose of this study was to ascertain the suitability of APW supplemented with 0.5% agar (APW-0.5) as a sensititive preservation-transport medium for rectal swab specimens for isolation of V. cholerae. A total of 144 paired rectal swab specimens were collected from children and adults with acute diarrhea. Of each specimen pair, one was placed in CB and the other in APW-0.5, from which they were plated out to thiosulfate citrate bile sucrose (TCBS) agar. Altogether, from both CB and APW-0.5 transported specimens, V. cholerae non-O1 was present in 29 (20.1%) specimens, while only 2 (1.4%) specimens were positive in CB and 9 (6.3%) positive in APW-0.5 transported specimens. The number of V. cholerae non-O1 isolates from APW-0.5 transported specimens was significantly higher (p=0.000) as compared to that from Cary-Blair transported specimens. It may be concluded that for isolation of V. cholerae, specimen transport in APW-0.5 medium was more effective than transport in Cary-Blair medium.
Helicobacter pylori and gastro-esophageal reflux disease (GERD) Lesmana, Murad
Universa Medicina Vol 29, No 1 (2010)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2010.v29.46-55

Abstract

Helicobacter pylori is the major cause of gastritis and duodenitis, and is responsible for the majority of gastric and duodenal ulcers. It is thought that H.pylori may have a benign influence in the prevention of reflux esophagitis and gastro-esophageal reflux disease (GERD). GERD is due to failure of the gastro-esophageal anti-reflux mechanism, thus allowing gastric acid to damage the esophageal mucosa, but the main abnormalities may also be found in the stomach and duodenum. The recently decreased prevalence of H.pylori has led to a lower incidence of duodenal ulcer and gastric carcinoma, but increasing acid secretion resulted in an increase in GERD. Eradication of H.pylori does not aggravate the symptoms of GERD and also does not induce the development of GERD in the normal population or in patients with duodenal ulcer. Pharmacological suppression of acid secretion is more effective in patients infected with H.pylori in comparison to non-infected individuals. The evidence on the efficacy of acid suppression therapy and its association with H.pylori infection is still contradictory. The sharply differing opinions regarding the role or association of H.pylori infection with GERD have not been reconciled and contradictory study results are still widespread.
Isolation and antibiotic sensitivity of Aeromonas from children with diarrhea Meiyanti, Meiyanti; Salim, Oktavianus Ch.; Surjawidjaja, Julius E.; Lesmana, Murad
Universa Medicina Vol 29, No 1 (2010)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2010.v29.14-20

Abstract

Aeromonas species are gram-negative, motile, facultative anaerobic, rod shaped, oxidase positive bacteria of the recently assigned family Aeromonadaceae. The significance of Aeromonas species as causative agent of human diarrhoea has recently been established. The aim of the present study was to investigate the distribution, and antibiotic sensitivity of Aeromonas in nonhospitalized children with diarrhea.One hundred and seventeen rectal swabs from children with diarhhea were cultured for isolation of Aeromonas organisms as the etiological agents. In addition to Aeromonas, other enteric pathogens were also isolated. Overall, the isolates of enteric pathogens amounted to 36.8%, consisting of Salmonella, Shigella, Aeromonas, and Vibrio. Aeromonas was only found in 5.1% of cultures, with a ratio of A. caviae and A. hydrophila of 2:1, while Salmonella made up the majority of causative organisms with an isolation frequency of 18.8%, followed by Shigella with 11.1%. In this study no isolates of Vibrio cholerae O1 were found as etiological agents of diarrhea; however, V. cholerae non-O1 and V. parahaemolyticus were found in small numbers (<1%). All isolates of Aeromonas were resistant to ampicillin and tetracycline, but sensitive to ciprofloxacin and ceftriaxone, as were the other enteric pathogens. Although the frequency of isolation of these enteric pathogens was higher than for Vibrio spp., their role in infective diarrhea was less clearcut in comparison with Salmonella and Shigella.
Multimicronutrient supplementation and asymptomatic urinary tract infections in the elderly Boekitwetan, Paul; Surjawidjaja, Julius E.; Aidilfit, Mahyunis; Lesmana, Murad
Universa Medicina Vol 28, No 1 (2009)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2009.v28.25-33

Abstract

As human life expectancy continues to increase, developing countries are reporting higher percentages of elderly in their respective populations. The defense mechanisms of the elderly are reduced due to several factors, such as increased susceptibility to infection, specifically urinary tract infection (UTI). A randomised, placebo-controlled, double-blind trial was conducted to assess whether multimicronutrient supplementation is effective in reducing UTIs in older people in the community. A total of 261 elderly who lived in Mampang Prapatan district, South Jakarta, were randomised to daily multimicronutrient supplementation or control groups. The primary outcomes were the incidence of asymptomatic UTI, the organisms responsible for UTIs and the results of sensitivity tests on UTI microorganisms. UTI was defined as culture-positive urine yielding a single species of organisms in numbers greater than 104 cfu/mL urine specimen. At base-line 19.5% of the elderly had UTI, namely 23.7% patients in the MMN group and 16.7% in the control group, but the difference was not statistically significant (p=0.158). Escherichia coli was the most common microorganism, isolated in 20.7% of the MMN group and 17.5% of the control group. After six months of supplementation, UTI in the MMN group decreased by 40.6% compared with only 14.4% in the control group. The numbers of E. coli also declined by 64.3% in the MMN group compared to 37.8% in the control group. This study has confirmed the beneficial effect of multimicronutrient supplementation on UTI in the elderly.
Co-Authors Elly Herwana, Elly Juius E Surjawidjaja, Juius E Julius E Surjawidjaja, Julius E Julius E. Surjawidjaja, Julius E. Laurentia Pudjiadi, Laurentia Mahyunis Aidilfit, Mahyunis Meiyanti Meiyanti, Meiyanti Oktavianus Ch. Salim, Oktavianus Ch. Paul Boekitwetan, Paul Paul Bukitwetan, Paul YENNY YENNY