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All Journal Paediatrica Indonesiana The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Nuraini I Susanti
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Health Professions Medicine & Pharmacology

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A study on the antibiotic resistance of Shigella Pramita G Dwipoerwantoro; Sri P Pulungsih; Nuraini I Susanti; Hartaniah Sadikin; Agus Firmansyah
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (429.806 KB) | DOI: 10.14238/pi45.2.2005.49-54

Abstract

Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causesa persistent diarrhea and may lead to drug resistance.Objectives With various kinds of antibiotics available in Indone-sia at the moment, this study aimed to anticipate the kinds of anti-biotics appropriate for shigellosis and to evaluate the clinical spec-trum of dysentery in children in Indonesia.Method The study involved 50 children diagnosed with dysenteryor dysentery-like syndrome, aged 1 to 12 years, who came to fourdifferent hospitals in Jakarta, from November 2001 to April 2002.Parents were asked for their consent. Interviewers recorded de-tails of the children’s history of illness and the physical examina-tions. Stool culture and resistance tests were done.Results Fifty dysentery cases, comprising 30 males and 20 fe-males, 98% aged from 1 to 5 years, came to the four hospitalsduring the study period. Only 24 cases had positive Shigella cul-tures, of which 87% were Shigella flexneri and 17% were Shigellasonnei. The clinical manifestations of shigellosis were bloody stools(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-ver and tenesmus were absent in 67% and 92% of subjects, re-spectively. Almost 87% of shigellosis cases were resistant tocotrimoxazole; all were sensitive to colistin and most were sensi-tive to nalidixic acid.Conclusion This data suggests that colistin and nalidixic acid aredrugs of choice for dysentery syndrome. The clinical manifesta-tion of dysentery is not always accompanied by bloody stools butmostly incorporates watery diarrhea and mucus in the stool
Microscopic Examination of Fecal Leukocytes as a Simple Method to Detect Infective Colitis in Children Nuraini I Susanti; Reynaldo Reynaldo; Aria Kekalih; Anis Karuniawati; Badriul Hegar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 2 (2017): VOLUME 18, NUMBER 2, AUGUST 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (495.275 KB) | DOI: 10.24871/182201773-79

Abstract

Background: Various pathogenic bacteria are reported as the cause of infectious colitis in children. Infectious colitis does not have a specific sign, therefore an accurate examination is required. The implementation of fecal cultures accompanied with drug resistance tests often have constraints, beside the relatively expensive costs, longer times are needed, and not all health care facilities have required instruments. On the other hand, this condition requires an immediate antibiotic therapy, so that the infection should not be continued. In daily practice, it is not uncommon to find diarrhea with the amount of fecal leukocyte 10/hpf with pathogenic bacteria on the examination of the fecal culture.Method: Cross-sectional study was conducted to observe the pattern of bacterial distribution in children’s fecal who have acute diarrhea and  the correlation between the existence of pathogenic bacteria and the number of leukocytes in the fecal, as well as antibiotic resistance patterns. The population of this study is children with age of 6 months old - 18 years old who were suffering from acute diarrhea with the  amount of  fecal leucocyte  ≥ 5/hpf, who recruited from polyclinic or patient admitted at Cipto Mangunkusumo Hospital and Fatmawati  General Hospital, Jakarta.Results: Based on examinations of fecal cultures and PCR, Salmonella sp and C. dificille were found subsequently in 2 children (33.3%), Enterophatogenic E. Coli(EPEC) and Shigella were found subsequently in 1 child (16.7%). Based on the ROC curve, it was found that there was no intersection of maximum and  minimal leukocyte value with the midline, whereas the best sensitivity and specificity value was found at the cut-off point of 8.5, hence the cut-off  point  of leukocytes was determined at 8 and 8. The sensitivity value was 83.3% and the specificity value was 45.1%.Conclusion: The antibiotic sensitivity test showed that one child infected  by EPEC was sensitive to ciprofloxacin. Two children infected  by Salmonella, were still sensitive to chloramphenicol, cotrimoxazole, cefixime, and ceftriaxone. Two children infected by C. Difficile were sensitive to ceftriaxone, and 1 child infected by Shigella was sensitive to cefixime, ceftriaxone and ciprofloksazine.
Co-Authors Agus Firmansyah Anis Karuniawati Aria Kekalih Badriul Hegar Hartaniah Sadikin Pramita G Dwipoerwantoro Reynaldo Reynaldo Sri P Pulungsih