Devi Artami Susetiati
Departemen Dermatologi Dan Venereologi, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia

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Ceftriaxone-and-cefixime-resistant Neisseria gonorrhoeae in a 26-year-old-male with gonococcal urethritis: a case report Prameshwara, Almarissa Ajeng; Prawarni, Vidyadhari Puspa; Susetiati, Devi Artami; Nuryastuti, Titik
Journal of Clinical Microbiology and Infectious Diseases Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v4i2.68

Abstract

Introduction: Gonorrhoea is the most prevalent sexually transmitted infection (STI) in Indonesia. The increasing resistance of Neisseria gonorrhoeae to antibiotics has prompted the World Health Organization (WHO) to classify gonorrhoea as an urgent public health threat. Reports of resistance to third generation extended-spectrum cephalosporins (ESCs), such as cefixime and ceftriaxone, against N. gonorrhoeae are rare in Indonesia. This study aims to present a case of cefixime and ceftriaxone resistance in a 26-year-old man with gonococcal urethritis. Case Description: A 26-year-old man presented to an STI clinic with a two-week history of increased urethral discharge. He reported a history of sexual activity with multiple partners. Physical examination revealed mucopurulent exudate and thick greenish-white pus from the external genitalia. Microscopic examination of a urethral smear identified numerous polymorphonuclear cells (>10 PMN/high-power field) and Gram-negative intracellular diplococci. Bacterial culture confirmed the presence of Gram-negative diplococci consistent with N. gonorrhoeae. Polymerase chain reaction (PCR) testing further confirmed N. gonorrhoeae. Susceptibility testing revealed resistance to both cefixime and ceftriaxone. The patient was treated with dual therapy, consisting of a single oral dose of azithromycin (1 g) and cefixime (400 mg). Complete symptom resolution was achieved within one week. Conclusion: Third-generation ESCs, including injectable ceftriaxone and orally administered cefixime, are the most commonly used antibiotics for gonorrhoea treatment. Resistance to these drugs represents a significant global health threat. Discrepancies between antibiotic susceptibility test results and clinical outcomes highlight the need for further investigation into underlying factors contributing to treatment efficacy.
Segmental Stiff Skin Syndrome: A Rare Case Report from Indonesia Nurmastuti, Hafidzah; Danarti, Retno; Anggraheni, Radijanti; Arvianty, Intan; Susetiati, Devi Artami; Trisnowati, Niken
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 37 No. 1 (2025): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V37.1.2025.68-72

Abstract

Background: This paper reports a segmental Stiff Skin Syndrome (SSS) case in a four-year-old girl.  SSS is a rare disease characterized by skin hardening and joint stiffness due to a mutation of the fibrillin-1 (FBN-1) gene encoding the fibrillin protein. The effective therapies for this disease are limited. Case Report: The patient presented with hardened skin and a limping gait.  Clinically, there were hard, hyperpigmented patches with hypertrichosis on the skin of the left femur and left gluteal. The left coxae and left genu joint were in fixed flexion, causing a limping gait. The SSS histology revealed thickened collagen fibers, trapping adipocytes between them, but no inflammatory cells.  The UV-A phototherapy and physiotherapy session resulted in a modest improvement. Discussion: This case's segmental SSS diagnosis was based on clinical and histological findings. Establishing a diagnosis of SSS is a challenge for clinicians because it can resemble other skin disorders, particularly sclerosing diseases. The recommended management for SSS remains limited. In this case, after the UV-A phototherapy and physiotherapy, complaints of hardened skin were said to soften.
Gram stain evaluation in dermatovenereology clinic and microbiology laboratories: case series Kusumadewi, Yolanda Pitra; Kholidah, Siti Nurhayati; Susetiati, Devi Artami; Nuryastuti, Titik
Journal of Clinical Microbiology and Infectious Diseases Vol. 5 No. 1 (2025): Available online : 1 June 2025
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v5i1.59

Abstract

Introduction: The normal vaginal flora consists of aerobic and anaerobic bacteria; Lactobacillus sp. is the main microorganism in the vagina. In bacterial vaginosis, there is a decrease in Lactobacillus sp. and an increase in pathogenic bacteria. Direct gram staining of vaginal fluid is the standard microbiological method for diagnosing bacterial vaginosis. Gram staining allows us to distinguish between gram-positive and gram-negative bacteria based on differential staining with crystal violet iodine complex and safranin. This study aimed to evaluate and compare the gram stain results between the dermatovenereology clinic and microbiology laboratories. Case description: Direct gram staining of vaginal or cervical swabs was carried out on women aged 19 years, women aged 29 years, and women aged 40 years. The gram staining was carried out at the dermatovenereology clinic and microbiology laboratory with different results between the two locations. Conclusion: It is important to evaluate the process of taking vaginal fluid samples, making smears/slides, and gram staining so that the quality of the examination results is maintained
Perilaku Seksual Lesbian, Gay, Biseksual,Transgender, dan Risikonya terhadap Infeksi Menular Seksual Puspitasari, Monika; Susetiati, Devi Artami; Siswati, Agnes Sri
Cermin Dunia Kedokteran Vol 50 No 12 (2023): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i12.968

Abstract

Lesbian, gay, bisexual, transgender (LGBT) face many gaps in sexual health aspects, including an increased risk of human immunodeficiency virus (HIV infection), sexually transmitted infections (STIs), and pregnancy. LGBT often experience social stigmatization, isolation, and rejection, even from their respective parents. Risk of STIs is related to sexual orientation, sexual anatomy, and sexual behaviour. LGBTs sexual activity may vary and with multiple partners, who are vulnerable to transmission of STIs and HIV infection. Health care providers are responsible for an open discussion regarding sexual health issues; including sexual orientation, sexual behavior, and gender identity.