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Isolation of environmental microorganisms from clinical specimens: A report of the occurrence of Acinetobacter anitratus in blood of hospitalized patients in Jakarta in a 7 year period Moehario, Lucky H.; Tjoa, Enty
Medical Journal of Indonesia Vol 18, No 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Aim:Â to report the presence of environmental microorganisms, A. anitratus, in blood of hospitalized patients in Jakarta from 2002 to 2008 and their susceptibility to antibiotics.Methods: A Retrospective study w as performed on all blood specimens that were received in Clinical Microbiology Laboratory (CML) Faculty of Medicine University of Indonesia during 2002-2008. Culture and antimicrobialsusceptibility examination were carried out according to up to date standard practice in CML and Clinical Laboratory Standard Institute, recpectively. Data was collected by WHONET 5.4 program. All Gram-negative microorganisms that were isolated from blood specimens were tabulated, and so the antibiotics susceptibility of A. anitratus. The origin of the specimens in term of institutions where the specimens came from was also analyzed.Results: In a 7 year period up to 2008, A. anitratus was found in blood specimens, and these invironmental bacteria were in fact the most predominant isolated Gram negative microorganisms. Together with another environmental microorganism, Pseudomonas aeruginosa, it composed nearly 50%. Antimicrobial susceptibility test of this microorganism showed some degree of resistance to all tested antibiotics. The origin of those blood specimens which yielded A. anitratus were mainly from government-owned hospitals, that was 88 specimens (74%), followed by private hospitals (18 specimens, 15%), individuals (3 specimens, 3%), and unknown source (10 specimens, 8%).Conclusion: Persistent occurrence of A. anitratus in blood specimens of hospitalized patients in hospitals in Jakarta was observed. In the near future, a study to fi nd risk factors for the acquisition of A. anitratus bacteremia is needed to reduce potential hospital associated infection. Moreover, genotyping is advised in order to determine the relationship of hospital and patient derived strains. (Med J Indones 2009; 18:227-32)Keywords: gram-negative microorganisms, antimicrobial susceptibility

Microbes profile from blood stream infection cases and their relationship to those of environment in Neonatal unit Moehario, Lucky H.; Tjoa, Enty; Rohsiswatmo, Rinawati; Nursyirwan, Sarah R.
Medical Journal of Indonesia Vol 21, No 1 (2012): February
Publisher : Faculty of Medicine Universitas Indonesia

Background: Hospital Acquired Infection (HAI)-Blood Stream infection (BSI) cause considerable morbidity, mortality and health care costs. This study aimed to assess the HAI-BSI in neonates with birth weight 1000-2000 g in Neonatal Unit Cipto Mangunkusumo National Hospital (RSUPNCM), Jakarta, during 4 months period (Oct 2010-Jan 2011), and to review the possibility of sources and transmission of environment microbes to the presence of HAI-BSI in the unit.Methods: Subjects of this study were neonates (birth weight 1000-2000 g) with clinically sepsis and within 48 hours or more being hospitalized, no clearly focal infection detected, with catheter lines. Two blood specimens from two separate venipunctures, drawn simultaneously, were cultivated. Identification and antimicrobial susceptibility tests were performed for each isolates. Cultures from environment in the unit and other suspected clinical specimens were also examined.Results: From 29 neonates with 39 episodes of sepsis, 5 positive isolates from blood cultures were obtained i.e. Enterobacter asburiae (2), Enterobacter cloacae (1), Pseudomonas aeruginosa (1) and Klebsiella oxytoca (1). The laboratory confirmed HAI-BSI was 12.8%, and HAI-BSI rate was 1.46 per 1000 catheter line days during 4 months period (Oct 2010-Jan 2011). Cultures performed for environment specimens gave yield some species which were as those from clinical specimens. Antibiogram analysis showed those of environment isolates i.e E. asburiae and P. aeruginosa shared similarity to those of neonatesâ blood isolates.Conclusion: Gram-negative bacteria were responsible to the occurrence of HAI-BSI in the Neonatal Unit RSUPNCM. Despite of low HAI-BSI rate found in this study, analysis of antibiogram profiles of the isolates originated from neonatesâ blood and environment strongly suggested that cross infection was present in the unit. (Med J Indones 2012;21:32-7)Keywords: Antibiogram, blood stream infection, hospital acquired infection, neonates

Infeksi Luka Operasi (ILO) di Bangsal Kebidanan dan Kandungan RSUPN Ciptomangunkusumo (RSCM): Laporan Serial Kasus Bulan Agustus-Oktober 2011 Wardoyo, Eustachius Hagni; Tjoa, Enty; Ocvyanty, Dwiana; H Moehario, Lucky
Cermin Dunia Kedokteran Vol 41, No 5 (2014): Muskuloskeletal
Publisher : PT. Kalbe Farma Tbk.

Tujuan: Mendeskripsikan kejadian Infeksi Luka Operasi (ILO) di bangsal Kebidanan dan Kandungan RSCM selama bulan Agustus- September 2011. Metode: Deskripsi analitik terhadap data rekam medik di bagian Kebidanan dan Kandungan RSCM dengan cara purposive sampling. Kejadian ILO yang dilaporkan oleh tim pengendalian infeksi rumah sakit (PPIRS) dimasukkan sebagai kriteria inklusi. Hasil: Infeksi Luka Operasi (ILO) di Bangsal Kebidanan dan Kandungan RSCM selama Agustus-Oktober 2011 memiliki insidensi 25/566 (4,4%). Mikroorganisme penyebab ILO: E. coli (7), Acinetobacter spp. (2), Staphylococcus epidermidis (2), Pseudomonas spp., Enterobacter aerogenes, Klebsiella oxytoca, Klebsiella pneumonia, Staphylococcus aureus, Streptococcus non hemolitikus, grup D masing-masing 1, Staphylococcus sp. & Bacillus sp. (1), Klebsiella pneumonia & Pseudomonas sp. (1) dan E.coli & Acinetobacter sp (1). Simpulan: Insidensi ILO bangsal Kebidanan dan Kandungan pada Agustus â€“ Oktober 2011 dilaporkan 4,4%. E. coli merupakan organisme penyebab ILO terbanyak.Objective: To describe the incidence of surgical site infection (SSI) in Obstetric and Gynaecologic Ward Cipto Mangunkusumo National Referral Hospital (RSCM) during August to September 2011. Method: Analytic description on medical record from Obstetric and Gynaecologic Ward obtained by purposive sampling methods. The incident of SSI reported by RSCM infection control team was included. Result: The incidence of SSI during August to September 2011 was 25/566 (4,4%). The organism detected were: E. coli (7), Acinetobacter spp. (2), Staphylococcus epidermidis (2), Pseudomonas spp., Enterobacter aerogenes, Klebsiella oxytoca, Klebsiella pneumonia, Staphylococcus aureus, Streptococcus non hemolitikus, grup D one case each, Staphylococcus sp. & Bacillus sp. (1), Klebsiella pneumonia & Pseudomonas sp. (1) dan E.coli & Acinetobacter sp (1). Conclusion: The incidence of SSI in Obstetric and Gynaecologic ward during August to September 2011 was 4.4%. E. coli was the organism most frequently isolated.

Screening of Legionella pneumophila from water sources in the hospitals in Jakarta Lucky Moehario; T. Robertus; Yuliana Grace; Enty Tjoa
Health Science Journal of Indonesia Vol 10 No 1 (2019)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v10i1.1852

Latar belakang: Pneumonia akibat bakteri Legionella masih menjadi masalah di berbagai tempat di dunia; menjadi penyebab 2-15 % dari pneumonia yang perlu di rawat di Rumah Sakit. Kasus legionellosis di Indonesia dilaporkan terjadi di Bali pada tahun 1996 dan di Tangerang tahun 1999. Keberadaan Legionella di fasilitas Pelayanan Kesehatan berpotensi sebagai penyebab infeksi nosokomial. Bakteri Legionella hidup di lingkungan perairan hangat dan lembab, juga ditemukan diberbagai sumber air seperti, sumber air sistem pendingin ruangan, kolam renang, tempat penampungan air di rumah sakit, perkantoran, hotel, dan perumahan sehingga turut berkontribusi dalam terjadinya community acquired dan pneumonia nosokomial. Metode: Penelitian ini merupakan penelitian deskriptif yang bertujuan untuk penapisan keberadaan Legionella pneumophila diberbagai sumber dan penampungan air di Rumah Sakit (RS) di Jakarta dengan menggunakan medium Legionella Charcoal Yeast Extract (CYE) dan dengan berbagai suplemen. Tujuh belas sampel air yang berasal dari berbagai sumber air di dua RS yang berlokasi diJakarta Utara dan Barat telah diteliti. Hasil: Dua puluh satu koloni yang ditemukan memiliki karakterisitik L. pneumophila dari semua varian medium, namun pada tes agglutinasi latex tidak memberikan reaksi positif. Kesimpulan: L. pneumophila tidak ditemukan diberbagai sumber air dari dua RS ini. Penggunaan metode yang lebih sensitif dan spesifik perlu dilakukan untuk memastikan ditemukannya L. pneumophila. Kata kunci: Legionellosis, Legionella pneumophila, medium BCYE Abstract Background: Pneumonia due to Legionella bacteria is still a problem in various places in the world, causes 2 15% of pneumonia that need hospitalization. In Indonesia, legionellosis cases have been reported in Bali in 1996 and Tangerang in 1999. The existence of Legionella in healthcare facilities is potential to cause nosocomial infections. Legionella bacteria live in warm and humid waters, and are also commonly found in various water sources, such as water cooling systems, swimming pools, water reservoirs in hospitals, offices, hotels and housing. These bacteria contribute to the occurrence of community-acquired and nosocomial pneumonia. Methods: This study was a descriptive research, and aimed to screen water sources and reservoirs in the hospitals in Jakarta for the existence of Legionella pneumophilla using Legionella Charcoal Yeast Extract (CYE) medium with various supplements. A total of 17 water samples from 2 hospitals located in West and North Jakarta have been examined. Results: The results showed a total of 21 colonies with characteristics as of L. pneumophila were obtained from those water samples, however, none showed positive results in the latex agglutination test. Conclusion: L. pneumophila was not found thus far in the water sources in these two hospitals. A more sensitive and specific approaches might be used to enable the findings of L. pneumophila. Keywords: Legionellosis, Legionella pneumophila, BCYE medium

Comparison of BCYE and BMPA media on recovery rate of Legionella pneumophila Lucky Moehario; Enty Tjoa; Mutiara J. Taslim; Yohanna Angelina
Health Science Journal of Indonesia Vol 11 No 1 (2020)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v11i1.3127

Latar belakang: Legionella pneumophila (L. pneumophila) telah banyak diketahui sebagai penyebab legionellosis; habitat nya di berbagai sumber air, lingkungan lembab dan hangat. Metode kultur menggunakan media spesifik masih menjadi baku emas untuk identifikasi L. pneumophila. Penelitian ini bertujuan membandingkan recovery rate L. pneumophila ATCC®33823 pada medium spesifik BCYE, dan medium selektif BMPA. Metode: Dilakukan dilusi serial pada suspensi 0,5 McFarland L. pneumophila ATCC®33823; 100 ul dari tiap tingkat dilusi diinokulasi pada medium Buffered Charcoal Yeast Extract (BCYE) dan medium BMPA (medium BCYE yang ditambahkan suplemen BMPA-α), secara duplo. Konsentrasi suspensi dihitung menggunakan metode Angka Lempeng Total (ALT) dari Standar Nasional Indonesia No. 01-2332.3-2006. Persentase recovery rate dihitung dan dianalisis secara statistik menggunakan SPSS versi 23,0. Hasil: Jumlah koloni L. pneumophila yang tumbuh pada medium BMPA jauh lebih tinggi daripada yang tumbuh di medium BCYE; konsentrasi tertinggi yang diperoleh adalah pada medium BMPA sebesar 1,45 x 107 CFU/ml. Persentase recovery rate pada medium BMPA adalah 96,67%, dan 60,67% pada medium BCYE. Kesimpulan: Recovery rate medium BMPA untuk pertumbuhan koloni L. pneumophila ATCC®33823 jauh lebih tinggi daripada media BCYE, karena itu medium BMPA dapat direkomendasikan untuk kultivasi L. pneumophila, khususnya pada program surveilans berbagai sumber air dengan biaya lebih terjangkau. Kata kunci: Legionella pneumophila, medium spesifik, BCYE , BMPA, recovery rate Abstract Background: Legionella pneumophila (L. pneumophila) has been known as the etiology of legionellosis; they live in aquatic environment, warm and moist. Culture method using specific medium remains as the gold standard in the identification of L. pneumophila. This study aimed to compare the recovery rate of L. pneumophila ATCC® 33823 on the specific medium BCYE for the cultivation of Legionella, and BMPA, the selective medium. Methods: Suspension of L. pneumophila ATCC® 33823 of 0.5 McFarland was diluted to 10 fold serial dilution; 100 ul of each dilution was inoculated on Buffered Charcoal Yeast Extract (BCYE) medium, and BMPA (BCYE supplemented with BMPA-α) in duplicate manner. The concentration was calculated using Total Plate Count standard as of Indonesian Nasional Standard number 01-2332.3-2006. The percentage of recovery rate was calculated, and the statistical analysis was performed using SPSS version 23.0. Results: Numbers of colonies of L. pneumophila grew on BMPA was much higher than on BCYE medium; the highest concentration was yielded on BMPA medium i.e. 1.45x107 CFU/ml. The recovery rates were 96.67% and 60.67% on BMPA medium and BCYE subsequently. Conclusion: The recovery rate of the BMPA medium on the colony growth of L. pneumophila ATCC®33823 was markedly higher than the BCYE, therefore BMPA medium can be suggested to be used in the cultivation of L. pneumophila especially in the routine surveillance program for water sources with less cost. Keywords: Legionella pneumophila, specific medium, BCYE , BMPA, recovery rate

Prevalence of Cutibacterium acnes and Staph spp. in the lesions of acne vulgaris in Jakarta Hermawan, Melyawati; Tjoa, Enty; Hidajat, Inneke J.; Teressa, Maria; Layadi, Eka B.; Wolter, Alegra
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 5, No. 2
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Background: Acne vulgaris (AV) is a chronic skin disorder that is commonly seen in young adults. Recent studies have shown that bacteria other than Cuticubacterium acnes found in the skin microbiota also play vital roles in the pathogenesis of AV. Understanding the skin microbiota and its disruption in patients with AV is paramount in treating patients with AV. Methods: Samples were obtained from 36 subjects to evaluate the proportion of Cutibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus in lesions of AV by means of bacterial culture. Results: There were 69 specimens collected from the 36 subjects with AV. The most abundant type of bacteria that was successfully isolated in the cultured AV lesions was Staphylococcus epidermidis(46.4%), followed by Cutibacterium acnes(14.5%), and Staphylococcus aureus(2.9%). Conclusion: Staphylococcus epidermidis,the major species of human skin flora, is the most abundant microorganism found in AV. The development of AV is not necessarily associated with the high proportion of Cutibacterium acnes. More pathogenic bacteria, such as Staphylococcus aureusis also not always found in the AV lesions. These findings may provide the basis for the clinicians to determine which types of antibiotics to prescribe for the treatment of AV.

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