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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN The Indonesian Biomedical Journal Jurnal Kesehatan Komunitas Jurnal Ilmu Kedokteran dan Kesehatan Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) The Journal of Hospital Accreditation (JHA) Jurnal Farmasi Indonesia Indonesian Journal of Biomedicine and Clinical Sciences
Andaru Dahesihdewi
Departemen Patologi Klinik Dan Kedokteran Laboratorium, Fakultas Kedokteran Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Assessing the impact of antimicrobial stewardship programs in tertiary hospitals for UTI: does it work alone? Yuri, Prahara; Shigemura, Katsumi; Dahesihdewi, Andaru; Zulfiqqar, Andy; Kitagawa, Koichi; Fujisawa, Masato
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 2 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i2.12939

Abstract

Antibiotic resistance is currently an emergent global challenge. Urinary tract infection (UTI), one of the most commonly reported infections, are is becoming a difficult case to treat considering the increasing prevalence of antimicrobial resistance (AMR). The objective of this study was to assess the impact of a hospital antibiotic stewardship program on AMR in managing UTI at a tertiary referral hospital in Yogyakarta, Indonesia, while considering the absence of the program in lower-tier referral hospitals. A retrospective cross-sectional study was conducted from January 2017 to December 2020, classified into pediatric and adult samples. Urine samples were collected and cultured from all patients with UTI hospitalized in the Dr. Sardjito General Hospital, Yogyakarta. The UTI causative bacteria and antibiotic susceptibilities were investigated in the comparison of the first 2 years (2017-2018, prior to the hospital antibiotic stewardship program) and the last 2 years (2019-2020, following the implementation of the hospital antibiotic stewardship program). The isolates from 717 adult urine samples were cultured. Escherichia coli (39.1%), Acitenobacter baumanii (9.3%), and Pseudomonas aeruginosa (8.5%) were identified as the most common bacteria prior to the hospital antibiotic stewardship program. Extended-spectrum β-lactamase-producing E. coli and Burkholderia cepacia were still increasing in the following the implementation of the hospital antibiotic stewardship program. Our study indicated that the stewardship program does not exhibit a significant change during the first two years considering the absence of the program in lower-tier referral hospitals.
Perbandingan Tingkat Deteksi Bakteri Gram Negatif Penghasil Karbapenemase Pada Uji Carba Nordmann Poirel (Carba NP) Dan Modified Hodge Test (MHT) Muliasih, Mulat; Dahesihdewi, Andaru; Intansari, Umi Solekhah
Jurnal Ilmu Kedokteran dan Kesehatan Vol 11, No 12 (2024): Volume 11 Nomor 12
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v11i12.17485

Abstract

Penggunaan karbapenem yang tinggi pada infeksi bakteri Gram negatif menimbulkan resistansi dengan mekanisme terbanyak berupa produksi enzim karbapenemase yang menyebabkan kematian lebih tinggi daripada mekanisme lain. Diperlukan suatu uji fenotip pendeteksi penghasil karbapenemase yang bisa menentukan terapi dengan cepat dan mengontrol penyebaran infeksi. Penelitian ini merupakan penelitian observasional analitik dengan rancangan potong lintang. Sampel berupa isolat klinis pasien bangsal dengan hasil tes kultur berupa patogen Gram negatif resistan karbapenem. Kriteria eksklusi yaitu sampel klinis berasal dari alat, hasil kultur polimikrobia, dan data rekam medis tidak lengkap. Isolat klinis diperiksa uji Carba NP dan MHT untuk dideteksi sebagai penghasil karbapenemase. Kemampuan kedua uji dibandingkan dan dihitung nilai Kappa. Hasil penelitian Carba NP mendeteksi karbapenemase 56 isolat (74,66%), tidak berbeda bermakna dengan uji MHT yang mendeteksi 53 isolat (70,66%), p 0,549. Nilai Kappa kedua metode 0,6.
Antibiotic Susceptibility among Infective Endocarditis Population: Syndromic Antibiogram Evaluation at Indonesian National Cardiovascular Center Indrawati, Lilik; Sugianli, Adhi Kristianto; Prakoso, Baskoro Justicia; Gunawan, Adrian; Soerarso, Rarsari; Soesanto, Amiliana M.; Dewi, Andaru Dahesih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2223

Abstract

Infective Endocarditis (IE) is a life-threatening disease with a high mortality rate (25%). Laboratory approaches to support the diagnosis of IE especially blood and/or cardiac vegetation culture, are crucial for providing definitive therapy. However, negative culture is frequently observed, therefore empirical use of antibiotics seems unavoidable and may lead to increasing antimicrobial resistance. This study aims to observe the prevalence of antibiotic susceptibility among the IE population using the WISCA approach. This retrospective study observed medical record data of all inpatients diagnosed with IE according to ICD-10 at Cardiovascular Center Harapan Kita Hospital (NCCHK) between January 2018 and December 2022. Patient data were combined with bacterial identification and antibiotic susceptibility test data from the laboratory information system, and evaluated based on period (year). A total of 67,858 inpatients and 1.1% (n=772) were diagnosed with IE. Successful culture growth (blood and/or cardiac vegetation specimen) was between 36.8% and 70% annually. Streptococcus viridans group (82/237, 34.6%) and Coagulase-negative Staphylococci (57/237, 24.1%) were dominantly observed among the IE population. Low susceptibility among Penicillin (34.3%) towards Gram-positive bacteria, as first-line treatment option in IE. Meanwhile, high susceptibility range was observed in Ceftriaxone (95.7%), Gentamicin (80.4%), Rifampicin (84.4%), and Vancomycin (98.7%) as second-line treatment in IE. Despite the low prevalence, the occurrence of antimicrobial resistance in IE has become a priority concern. Continuing the syndromic antibiogram is mandatory to assist the trend of empirical antibiotic usage and refine the established local treatment guidelines.
Amikasin: Profil Penggunaan pada Pasien Dewasa Rawat Inap di RSUP Dr.Sardjito Yogyakarta berdasarkan Fungsi Ginjal Utami, Esti Dyah; Puspitasari, Ika; Asdie, Rizka Humardewayanti; Lukitaningsih, Endang; Dahesihdewi, Andaru
JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X Vol. 13 No. 1 (2021): Jurnal Farmasi Indonesia
Publisher : Pengurus Pusat Ikatan Apoteker Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.829 KB) | DOI: 10.35617/jfionline.v13i1.9

Abstract

Amikacin is used for serious infection treatment, with a nephrotoxicity incidence of 3-13%. More than 90% of amikacin is excreted through the renal in unchanged form, thus accumulation may occur in renal dysfunction. This research is aimed to determine the amikacin usage profiles based on the patient’s renal function and evaluate the association between a renal function with hospital discharge conditions and length of stay (LOS). This research was conducted by collecting the medical record data of adult inpatients at Dr. Sardjito Hospital treated with amikacin in 2020. A Chi-Square test was used to determine the proportion differences between 2 groups of patients with different renal functions, and the relationship of renal function with discharge condition and LOS. The majority of 78 subjects had normal renal function, with a diagnosis of mixed infection. Amikacin was used as definitive therapy, as an antibiotic combination, with a median dosage of 14.3mg/kgBW/day, 12 hours interval, and 5 days duration. Results showed that the CrCl, infection type, comorbid, amikacin intervals and duration had significantly different proportions (p<0.05) between patients with normal renal function and those with renal dysfunction. Renal function was positively associated with the patient’s discharge condition, but not with LOS.
Co-Authors Adhi Kristianto Sugianli Adrian Gunawan, Adrian Ahmad Syauqi ahmad syauqi, ahmad Ali Djamhuri Amiliana M. Soesanto Budi Mulyono Budi Mulyono Emy Noerwidayati Endang Lukitaningsih Esti Dyah Utami Fujisawa, Masato Hetty Ismainar Ika Puspitasari Iwan Dwiprahasto Iwan Dwiprahasto Iwan Dwiprahasto Kitagawa, Koichi Lilik Indrawati, Lilik Lutfan Lazuardi Muliasih, Mulat Nunung Dartini Wahyuningtyas Osman Sianipar Prahara Yuri Prakoso, Baskoro Justicia Rarsari Soerarso Rizka Humardewayanti Asdie Rochady Setianto Samsirun Halim Samsirun Halim Shigemura, Katsumi Sotianingsih Sotianingsih Sotianingsih, Sotianingsih Sri Kartika Sari Supra Wimbarti Umi S. Intansari Ida Savitri Laksanawati Zulfiqqar, Andy