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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
Ambroxol Therapy as an Antibiofilm Candidate in Diabetic Ulcer Patients Wahyuddin, Munifah; Sari, Ika Puspita; Asdie, Rizka Humardewayanti; Nuryastuti, Titik
Jurnal Mandala Pharmacon Indonesia Vol. 11 No. 1 (2025): Jurnal Mandala Pharmacon Indonesia
Publisher : Program Studi Farmasi Universitas Mandala Waluya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35311/jmpi.v11i1.791

Abstract

Patients with diabetic ulcers are susceptible to infection because the tissue in their extremities is constantly exposed to various pathogenic bacteria, so biofilm formation plays an important role in developing the disease. Based on previous studies, ambroxol can inhibit the formation of biofilm bacteria. The purpose of this study was to identify biofilm-forming bacteria, prove that ambroxol has the potential to inhibit and eradicate biofilms formed by bacteria in diabetic ulcers and analyse the potential of ambroxol in eradicating biofilms formed by bacteria in diabetic ulcer patients based on PEDIS and SEM scores. The method used was a 96-well microtiter plate assay (MtPA) with crystal violet and MTT staining techniques, a test using human samples with a quasi-experimental method with sampling carried out by nonprobability sampling. The samples used were diabetic ulcer patients with culture results forming biofilms. The results obtained identified 3 clinical isolates that formed biofilms with 100% Gram-negative bacteria, including two isolates of Pseudomonas aeruginosa and one isolate of Escherichia coli with the ability to form biofilms are moderate. Ambroxol effectively inhibits and eradicates 50% of biofilms formed by diabetic ulcer bacteria at a minimum concentration of 1 mg/ml. Based on the PEDIS score and SEM images of diabetic ulcer patients, there was a decrease in the PEDIS score in each patient, with an average score of 2. Several studies have demonstrated that combining Ambroxol with antimicrobials can synergistically enhance the antibiotic's efficacy against biofilms. The co-administration of Ambroxol with other antimicrobial agents represents a promising approach to improving antibiotic effectiveness. Nevertheless, careful consideration must be given to the concentration of Ambroxol used.
Treatment of the cytokine storm in COVID-19: review of clinical pharmacology Sapriati, Aisyah Nur; Rahmawati, Fita; Nuryastuti, Titik
JSFK (Jurnal Sains Farmasi & Klinis) Vol 10 No 2 (2023): J Sains Farm Klin 10(2), Agustus 2023
Publisher : Fakultas Farmasi Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jsfk.10.2.162-183.2023

Abstract

The cause of the COVID-19 pandemic can be attributed to the Acute Respiratory Syndrome Virus-2 (SARS-CoV-2). COVID-19 manifests with severe symptoms in the upper respiratory tract and can progress to a critical condition due to an acute hyperinflammatory response that triggers a cytokine storm. The cytokine storm refers to an excessive or impaired production of proinflammatory cytokines, resulting in immune dysregulation and uncontrolled inflammatory activity. To effectively address the hyperinflammatory state induced by SARS-CoV-2 infection, it is imperative to explore promising strategies aimed at overcoming the cytokine storm, such as the prompt initiation of anti-inflammatory therapy. Several classes of drugs can potentially prevent the deterioration of COVID-19 patients by mitigating immune system dysregulation and suppressing uncontrolled inflammatory responses. These drug classes encompass corticosteroids, chloroquine and hydroxychloroquine, inhibitors of interleukin-1 (IL-1), inhibitors of interleukin-6 (IL-6), inhibitors of tumor necrosis factor (TNF), and anti-inflammatory drugs. Additionally, tumor necrosis factor alpha (TNF-α) inhibitors, as well as inhibitors targeting the Janus kinase signaling pathway and activator of transcription (JAK/STAT), have exhibited efficacy in treating COVID-19. This efficacy is evident when considering the drug's mechanism of action and pharmacokinetics, while also taking into account the tolerable side effects associated with their usage
Badai Sitokin pada Covid-19: Ulasan Naratif: Cytokine Storm in Covid-19: Narative Review Sapriati, Aisyah Nur; Rahmawati, Fita; Nuryastuti, Titik
Jurnal Surya Medika (JSM) Vol. 10 No. 1 (2024): Jurnal Surya Medika (JSM)
Publisher : Institute for Research and Community Services Universitas Muhammadiyah Palangkaraya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33084/jsm.v10i1.7243

Abstract

SARS-Cov-2 adalah virus yang dapat menyebabkan terjadinya penyakit COVID-19 yang parah yang terkait dengan peningkatan produksi sitokin/kemokin proinflamasi. Badai sitokin adalah pelepasan sitokin proinflamasi yang berlebihan atau tidak terkendali yang menyebabkan kekacauan pada sistem kekebalan tubuh dan respon inflamasi yang tidak terkendali. Artikel ini dibuat dengan tujuan untuk memberikan pemahaman terkait badai sitokin, patofisiologi yang menyertainya, manifestasi klinis, pengukuran laboratorium, dan faktor-faktor yang memicu terjadinya badai sitokin. Badai sitokin pada COVID-19 ini menyebabkan terjadinya kegagalan multi-organ bahkan kematian. Faktor-faktor yang menyebabkan terjadinya badai sitokin pada pasien COVID-19 ini bukan saja disebabkan oleh adanya SARS-CoV-2 tetapi adanya factor pendukung lain seperti usia yang lebih tua, jenis kelamin laki-laki, golongan darah A serta adanya gangguan metabolisme pada pasien seperti peningkatan tekanan darah, obesitas maupun diabetes.
Effectiveness evaluation of antibiotic use in patients with Methicillin-resistant Staphylococcus aureus (MRSA) infection: a review As, Musdalifa; Ika Puspitasari; Nuryastuti, Titik
Indonesian Journal of Pharmacology and Therapy Vol 5 No 1 (2024)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.10771

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that become a public health problem due to its ability to be resistant to more than three classes of antibiotics. Evaluation of the effectiveness of antibiotic use in patients with MRSA is important to optimize antibiotic use and to control antibiotic resistance. This article review attempted to evaluate the effectiveness of antibiotics in patients with MRSA. This review explored the results of previous research from PubMed as a literature source and the PRISMA flow diagram as a protocol for the article selection process. Eight studies reviewed the evaluation of the effectiveness of antibiotic use in MRSA patients with various clinical conditions, such as uncomplicated wound infections, cellulitis and no wound, purulent drainage or abscess, cSSSI infections caused by MRSA, infections caused by MRSA bacteremia and nosocomial infections caused by MRSA. In conclusion, the effectiveness of antibiotics in patients with MRSA infection depends on the clinical condition of each patient. Therefore, the use of antibiotics is adjusted based on the type of infection and the efficacy of the antibiotics. Combination therapy is recommended for MRSA patients considering its life-threatening ability.
The hospital environment as an ecological driver of multidrug-resistant organisms: evidence from intensive isolation and operating rooms Widyasari, Domas Fitria; Daniwijaya, Edwin Widyanto; Purnomo, Galih Santo; Rahayu, Ayu; Nuryastuti, Titik
Berita Kedokteran Masyarakat Vol 42 No 01 (2026)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v42i01.24745

Abstract

Purpose: Multidrug-resistant organisms (MDROs) present a significant challenge for hospital infection control, with environmental surfaces acting as key reservoirs. This study sought to identify MDRO species, evaluate their biofilm-forming capacity, and quantify microbial bioburden in intensive care isolation and operating rooms. Methods: Environmental sampling was conducted in 16 rooms. Air and surface samples, including floors, walls, and bedside monitors, were collected using a microbiological air sampler and sterile swabs. Samples were cultured to determine total bioburden and detect MDROs, with bacterial identification performed using VITEK 2. Antimicrobial resistance was assessed using the Kirby-Bauer disc diffusion test, and bioburden levels were compared to national standards. Results: Forty-nine MDRO isolates were identified: 3 methicillin-resistant Staphylococcus aureus (MRSA, 6.12%), 19 methicillin-resistant coagulase-negative staphylococci (MRCONS, 38.78%), 24 carbapenem-resistant Acinetobacter spp. (CRA, 48.98%), and 3 extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (6.12%). Mean microbial bioburden remained within acceptable limits for air (57.44 CFU/m³), walls (70.63 CFU/100 cm²), and bedside monitors (22.63 CFU/100 cm²), but exceeded thresholds on floors (753.75 CFU/100 cm²). Biofilm-forming capacity varied: MRCONS (26.32% strong biofilm), CRA (8.33% strong biofilm), and ESBL-producing Enterobacterales (66.67% weak biofilm). Conclusion: MDROs were detected in all sampled rooms, with CRA as the predominant species. Floors exhibited microbial loads above acceptable standards, highlighting the necessity for improved cleaning protocols. Enhanced environmental infection control strategies are essential to reduce MDRO transmission in healthcare settings.
The hospital environment as an ecological driver of multidrug-resistant organisms: evidence from intensive isolation and operating rooms Widyasari, Domas Fitria; Daniwijaya, Edwin Widyanto; Purnomo, Galih Santo; Rahayu, Ayu; Nuryastuti, Titik
Berita Kedokteran Masyarakat Vol 42 No 01 (2026)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v42i01.24745

Abstract

Purpose: Multidrug-resistant organisms (MDROs) present a significant challenge for hospital infection control, with environmental surfaces acting as key reservoirs. This study sought to identify MDRO species, evaluate their biofilm-forming capacity, and quantify microbial bioburden in intensive care isolation and operating rooms. Methods: Environmental sampling was conducted in 16 rooms. Air and surface samples, including floors, walls, and bedside monitors, were collected using a microbiological air sampler and sterile swabs. Samples were cultured to determine total bioburden and detect MDROs, with bacterial identification performed using VITEK 2. Antimicrobial resistance was assessed using the Kirby-Bauer disc diffusion test, and bioburden levels were compared to national standards. Results: Forty-nine MDRO isolates were identified: 3 methicillin-resistant Staphylococcus aureus (MRSA, 6.12%), 19 methicillin-resistant coagulase-negative staphylococci (MRCONS, 38.78%), 24 carbapenem-resistant Acinetobacter spp. (CRA, 48.98%), and 3 extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (6.12%). Mean microbial bioburden remained within acceptable limits for air (57.44 CFU/m³), walls (70.63 CFU/100 cm²), and bedside monitors (22.63 CFU/100 cm²), but exceeded thresholds on floors (753.75 CFU/100 cm²). Biofilm-forming capacity varied: MRCONS (26.32% strong biofilm), CRA (8.33% strong biofilm), and ESBL-producing Enterobacterales (66.67% weak biofilm). Conclusion: MDROs were detected in all sampled rooms, with CRA as the predominant species. Floors exhibited microbial loads above acceptable standards, highlighting the necessity for improved cleaning protocols. Enhanced environmental infection control strategies are essential to reduce MDRO transmission in healthcare settings.
Addressing Disparities in Clean and Healthy Living Behaviors through Targeted Health Education in a Rural Community Widodo, Irianiwati; Rinonce, Hanggoro Tri; Asysyifa, Azzahra; Syarifa, Cut Alima; Sabila, Aflifia Birruni; Nurrahma, Bira Arumndari; Farmawati, Arta; Sari, Dwi Cahyani Ratna; Nugrahaningsih, Dwi Aris Agung; Jaya, Sudi Indra; Sholikhah, Eti Nurwening; Rizal, Dicky Moch; Susilowati, Rina; Nuryastuti, Titik; Murhandarwati, E. Elsa Herdiana; Triyono, Teguh; Ratnaningsih, Tri
Engagement: Jurnal Pengabdian Kepada Masyarakat Vol. 10 No. 1 (2026): February 2026
Publisher : Asosiasi Dosen Pengembang Masyarajat (ADPEMAS) Forum Komunikasi Dosen Peneliti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29062/engagement.v10i1.2043

Abstract

Background: This study addresses the public health issue of community hygiene and wellness by focusing on the Clean and Healthy Lifestyle Behavior (CHLB) as a key parameter. The subject of the assessment is the community of Sompok Hamlet, Bantul, with the purpose of evaluating the implementation of CHLB within households to understand areas of strength and needed improvement. Purpose of the Study: The purpose is to assess the level of CHLB implementation in Sompok Hamlet. The objective is to measure household compliance across various CHLB indicators and identify specific behavioral gaps that require targeted intervention. Methods: The study employed a cross-sectional survey design conducted in 2023. Data were collected from 202 households across seven neighborhood units (RT) using a structured questionnaire to evaluate compliance with standard CHLB indicators. Results: The results showed that 68.3% of households met the criteria for independent healthy communities. High compliance was observed in indicators like access to clean water, sanitation, exclusive breastfeeding, and toddler weighing. However, significant gaps were identified in physical activity (71.3% low compliance) and indoor smoking practices (64% low compliance). Practices related to fruit/vegetable consumption, handwashing, and larva elimination showed varied results. The findings highlight the need for focused educational programs to address these specific behavioral deficiencies to promote sustainable community health.
Evaluasi Penggunaan Antibiotik Definitif pada Pasien dengan Infeksi Bakteri Resisten Carbapenem di RSUP Dr. Sardjito, Yogyakarta Primasari, Firdhani Satia; Sari, Ika Puspita; Nuryastuti, Titik
PHARMACY: Jurnal Farmasi Indonesia (Pharmaceutical Journal of Indonesia) Jurnal Pharmacy, Vol. 22 No. 02 Desember 2025
Publisher : Pharmacy Faculty, Universitas Muhammadiyah Purwokerto

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

Abstract

Currently, many countries have reported infections caused by carbapenem-resistant bacteria, and Indonesia is no exception. This condition makes the scope of therapeutic options becomes quite limited. This study aims to evaluate the definitive antibiotics used in patients with carbapenem-resistant bacterial infections along with the calculation of the predictive value of pharmacokinetic parameters which are then linked to the patient's clinical outcome. This research is a retrospective descriptive-analytic study. The subjects of this study were all inpatients with carbapenem-resistant bacterial infections in the period January-March 2020. Antibiotic suitability evaluation was analyzed descriptively, the estimated values ​​of pharmacokinetic parameters were calculated using the pharmacokinetic calculation formula, and the correlation between the estimated pharmacokinetic values ​​and clinical outcomes of the patients was analyzed statistically using Fisher test. The results of the evaluation of definitive antibiotic administration in patients with carbapenem-resistant bacterial infections found that 11 antibiotics met the suitability of the type, dose, frequency, and duration of the 27 antibiotics analyzed. The predicted value of the pharmacokinetic parameters of the 11 definitive antibiotics in the form of minimal levels in the blood at steady state compared to the MIC value showed that 1 (9.1%) antibiotic had a Cssmin value ≥ MIC and 10 (90.9%) other antibiotics had a Cssmin value < MIC. There is no relationship between the predictive value of the pharmacokinetic parameters of definitive antibiotics that meet regimen suitability and clinical outcomes in patients with carbapenem-resistant bacterial infections. In general, although the dosage regimen of definitive antibiotics meet the suitability criteria, drug concentration in blood can be inadequate to eradicate the bacteria due to many factors and can influence the clinical outcomes.
Multidrug Resistance and Invasive Medical Device Use with Staphylococcus aureus Biofilm Formation in Riau Mansyar, Putri Purnama Sari; Nuryastuti, Titik; Anggraini, Dewi
Jurnal Ilmiah Kesehatan (JIKA) Vol. 7 No. 3 (2025): Volume 7 Nomor 3 Desember 2025
Publisher : Sarana Ilmu Indonesia (Salnesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36590/jika.v7i3.1608

Abstract

Staphylococcus aureus (S. aureus) infection is a major cause of healthcare-associated infections, particularly among patients using invasive medical devices. These devices provide surfaces for bacterial adhesion and biofilm formation, a key mechanism that enhances antibiotic resistance, especially in multidrug-resistant (MDR) strains. This study aimed to analyze the association between MDR status and invasive medical device use with biofilm formation in clinical isolates of S. aureus at Arifin Achmad General Hospital, Riau Province. This was an analytic-observational study with a cross-sectional design involving 44 clinical isolates of S. aureus collected from patients between January and April 2025. Biofilm formation was assessed using the Microtiter Plate Assay (MtPA), and antibiotic susceptibility testing was conducted using the Vitek 2 System. Demographic and clinical data of the subjects, such as gender, age, and use of invasive medical devices, were obtained from medical records. The relationship was analyzed using the Chi-square test. The results showed that out of 44 clinical isolates of S. aureus, 29 isolates (65,91%) were capable of forming biofilm. There was a significant association between MDR status (p-value = 0,026) and the use of invasive medical devices (p-value = 0,019) with biofilm formation (p-value < 0,05). These findings indicate that MDR status and the use of invasive medical devices may contribute to the increased ability of S. aureus clinical isolates to form biofilms. Therefore, strengthening infection control measures and rationalizing the use of invasive medical devices are essential to prevent persistent infections that are difficult to treat due to biofilm formation.
Co-Authors . Mursiti Abu Tholib Aman Ade Christanti Putri Sidabutar Afdina Melya Ganes Febiyanti Aflifia Birruni Sabila Aisyah Nur Sapriati Altaufik Ngani Amaia, Devika N. Amalia Setyati Aman, Alia Hanifa Aminy, Sayyidah A. Andi Ameilia Sari Riandika Anggraeni, Nuniek Annisa Aulia Savitri Annisa Somaningtyas Anton Pratama Apriyanto, Muchammad Arief Nurrochmad Arta Farmawati As, Musdalifa Asysyifa, Azzahra Atikana, Akhirta Atthobari Avanilla Fany Septyasari Ayu Rahayu Bastiaan P. Krom, Bastiaan Bastian P. Krom Cicilia Widhi Astuti Cindy Elvionita Daniwijaya, Edwin Widyanto Daru Estiningsih Dessy Kurnia Sari Devi Artami Susetiati Dewi Anggraini Dewi Purbaningsih Dhannia Fitratiara Diah Susanti Dicky Moch Rizal Dicky Moch Rizal Diyan Ajeng Rossetyowati Diyan Ajeng Rossetyowati Djoko Wahyono Djoko Wahyono Domas Fitria Widyasari Dwi Aris Agung Nugrahaningsih Dwi Cahyani Ratna Sari Dwi Utami Anjarwati Dwikisworo Setyowireni E. Elsa Herdiana Murhandarwati Edwin W. Daniwijaya Eggi Arguni Elya Antariksana Bachmida Emi Rusdiyati Endang Estriningsih Ervina Damayanti Estiningsih, Daru Estriningsih, Endang Eti Nurwening Sholikhah Firdhani Satia Primasari Fita Rahmawati Fita Rahmawati Galang Ridha Allatief Hakim, Mohamad Saifudin Hamzah, Hasyrul Hananun Zharfa Hanifah Handi Virawan Hanggoro Tri Rinonce Hardyanto Soebono Henk J. Busscher Henk J. Busscher, Henk J. Henny C. van der Mei Henny C. van der Mei, Henny C. Hera Nirwati Ika Puspita Sari IKA PUSPITA SARI Ika Puspita Sari Ika Puspita Sari Ika Puspita Sari Ika Puspita Sari Ika Puspita Sari Ika Puspitasari Ika Puspitasari Ika Puspitasari Ika Puspitasari Ilma Tazkiya Iman Iman Ishak SKM., MPH IWAN DWIPRAHASTO Jaya, Sudi Indra Kholidah, Siti Nurhayati Kris Kurniawan Kuwat Triyana LINDA SUKMARINI Linda, Vitia Ajeng Nur Lucky Herawati Luthvia Annisa Mansyar, Putri Purnama Sari Marselinus Edwin Widyanto Daniwijaya Maulidia, Faiqoh Nur Maulidiah, Rizka Mawarti, Yuli Meilia Nhadia Amalia Mubasysyir Hasanbasri Mujahidah, Mujahidah Mukhriani, Mukhriani Munifah Wahyuddin Mursiti, Mustofa, Handry Darussalam, Titik Nuryastuti, Mursiti, Mustofa Mustofa Nanang Munif Yasin Ni Luh Putu Vidya Paramita Niken Puspitasari Ning Rintiswati Nunung Yuniarti Nunung Yuniarti Nurkhalika, Rachmi Nurpagino, Bombong Nurrahma, Bira Arumndari Prameshwara, Almarissa Ajeng Praseno Praseno Pratama, Anton Prawarni, Vidyadhari Puspa Prayoga, Muhammad Bagas Primasari, Firdhani Satia Pujilestari, Dwi Purnomo, Galih Santo PUSPITA LISDIYANTI Qonita Imma Irfani Rachma Dewi Isnaini Putri Rahmawati, Fita Rakhmat Ari Wibowo Rebriarina Hapsari Retno Wahyuningrum Rina Susilowati Rina Triasih Ritmaleni, Ritmaleni Rizal Fauzi Rizka Humardewayanti Asdie Rizka Humardewayanti Asdie Rizqi Nurul Khasanah Roel Kuijer Roel Kuijer, Roel SAMUEL BUDI Sapriati, Aisyah Nur Setiawati, Setiawati SHANTI RATNAKOMALA Subagus Wahyuono Supriyati Susi Iravati Syarifa, Cut Alima Sylvia Utami Tunjung Pratiwi Takushi Kaneko Tatang Irianti Teguh Triyono Tina Amnah Ningsih Titi Ira Pangestuti Tri Murti Andayani Tri Murti Andayani Tri Ratnaningsih Tri Wibawa Triana Hertiani Tristina Devi Azzahra Untari, Febriana Vera Olfiana Wahyuddin, Munifah Widodo, Irianiwati Wihda Yanuar Wihda Yanuar Yanuar, Wihda Yeli Trimayanti Yolanda Pitra Kusumadewi Yusrizal Djam’an Saleh ZULLIES IKAWATI