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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Folia Medica Indonesiana Global Medical and Health Communication Journal of Health Sciences and Medical Development Jurnal Penyakit Dalam Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Uun Sumardi, Uun
Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Padjadjaran, Bandung
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary Other

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Incidence of Dengue Hemorrhagic Fever Related to Annual Rainfall, Population Density, Larval Free Index and Prevention Program in Bandung 2008 to 2011 Karina, Anggia; Sari, Sri Yusnita Irda; Sumardi, Uun; Setiawati, Elsa Pudji
Althea Medical Journal Vol 2, No 2 (2015)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (649.403 KB)

Abstract

Background: Dengue Hemorrhagic Fever (DHF) remains one of health problems in all provinces in Indonesia including West Java. Bandung as the capital of West Java province has dengue prevalence that is above the average prevalence of all provinces. This study aimed to describe the pattern of dengue incidence rate, annual rainfall, population density, and larval free index as well as the implementation of prevention program in sub-districts with the highest incidence rate in Bandung between 2008 and 2011.Methods: A descriptive retrospective study was conducted in September 2012 using secondary data during the period of January 2008 to December 2011. The incidence rate was calculated based on DHF patients who live in Bandung. Data were analyzed using computer and Arc View 3.3. Pattern of incidence rate was characterized with red, yellow, and green region respectively. Results: The highest incidence rate of DHF occurred in 2009. Incidence increased in January to February and declined in the end of the year. Subdistricts with highest incidence had no highest annual rainfall and the population density below the average of population density in Bandung. The highest implementation of fogging program was not only performed in high incidence subdistricts but also in area with larval free index less than 95%. Larval free index in subdistricts with highest incidence were not all below 95%.Conclusions: Incidence of DHF increases after months of highly rainfall. The pattern of incidence rate in all subdistrict is dynamic and suspected do not related to annual rainfall, population density, high larva free index, and frequency of fogging. [AMJ.2015;2(1):262–7]
Pathogen Profile of Patients with Sepsis in Internal Medicine, Dr. Hasan Sadikin General Hospital, Bandung 2013 Fauzi, Afiq Syazwan; Sumardi, Uun; Tristina, Nina
Althea Medical Journal Vol 3, No 2 (2016)
Publisher : Althea Medical Journal

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Abstract

Background: Sepsis is a continuous disease which begins with systemic inflammatory response syndrome (SIRS), seen in association with a large number of clinical conditions. These include infectious insults that produce SIRS, such as pancreatitis, ischemia, multiple traumas and tissue injury, hemorrhagic shock, immunemediated organ injury, and the exogenous administration of such putative mediators of the inflammatory process as tumor necrosis factor and other cytokines. A frequent complication of SIRS is the development of organ system dysfunction, including such well-defined clinical conditions as acute lung injury, shock, renal failure, and multiple organ dysfunction syndrome (MODS). Hence, this study was conducted to identify the pathogen profile that often causes sepsis.Methods: A retrospective study was performed to 152 medical records of patients diagnosed as sepsis from Internal Medicine Department Dr. Hasan Sadikin General Hospital from January 2013 to December 2013. The variables observed from the medical records were age, sex, comorbidity, main infection, culture sample, type of gram bacteria, resistant bacteria, and antibiotic susceptibility test. After data collection was completed, the data were analyzed using computer. The data were presented in percentage.Results: Sepsis in male was higher than female. Highest comorbid was chronic kidney disease (CKD). The main infection was health care acquired pneumonia (HCAP). Highest pathogen that caused sepsis was Escherichia coli and highest multidrug-resistant organism (MDRO) was extended spectrum beta-lactamase(ESBL) Escherichia coli.Conclusions: The most common pathogen that causes sepsis is Escherichia coli. [AMJ.2016;3(2):200–5]DOI: 10.15850/amj.v3n2.785
KESESUAIAN TERHADAP PROSEDUR STANDAR RESUSCITATION BUNDLE 6 JAM PADA PELAKSANAAN PENDERITA SEPSIS BERAT DAN SYOK SEPSIS Wirawan, Chevie; Alisjahbana, Bachti; Sumardi, Uun
Majalah Kedokteran Bandung Vol 50, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (15.169 KB) | DOI: 10.15395/mkb.v50n1.1157

Abstract

Sepsis berat dan syok sepsis memiliki angka kematian tinggi. Resuscitation bundle 6 jam adalah panduan tata laksana sepsis berat dan syok sepsis yang terbukti menurunkan mortalitas. Kesesuaian penatalaksanaan sepsis berat dan syok sepsis dalam 6 jam pertama dengan prosedur standar resuscitation bundle diteliti. Penelitian observasional deskriptif ini dilaksanakan selama September?Desember 2015 terhadap penderita sepsis berat dan syok sepsis di SMF Ilmu Penyakit Dalam RSUP Dr. Hasan Sadikin Bandung. Data dikumpulkan adalah data umum penderita dan pelaksanaan prosedur 6 jam pertama sesuai standar: pemeriksaan laktat, kultur darah, pemberian antibiotik, resusitasi cairan, pemberian vasopresor, pengukuran CVP, dan pemeriksaan Scvo2/Svo2. Dari 80 subjek penelitian, 59 (74%) sepsis berat dan 21 (26%) syok sepsis. Pada sepsis berat dan syok sepsis, dalam 3 jam pertama pemeriksaan laktat dilakukan pada 2%  dan 14%, kultur darah sebelum antibiotik 17% dan 10%, pemberian antibiotik spektrum luas 32% dan 43%, serta  resusitasi cairan 30 mL/kgBB 2% dan 14%. Pada syok sepsis dalam 6 jam pertama pemberian vasopresor 62% dan pengukuran CVP 5%. Pemeriksaan Scvo2/Svo2 tidak dilakukan pada syok sepsis. Angka kematian sepsis berat 7% dan syok sepsis 19,1% dalam 6 jam pertama. Simpulan, kesesuaian penatalaksanaan 6 jam pertama penderita sepsis berat dan syok sepsis dengan prosedur standar masih kurang.Kata kunci: Resuscitation bundle 6 jam, sepsis berat, syok sepsis  Compliance to 6-Hour Resuscitation Bundle Standard in Severe Sepsis and Septic Shock ManagementSevere sepsis and septic shock have a high mortality rate. Six-hour resuscitation bundle is a management standard for severe sepsis and septic shock that has been proven to reduce mortality rate. Compliance to the 6-hour resuscitation bundle standard was studied. This was a descriptive observational study on severe sepsis and septic shock patients in the Internal Medicine Department of Hasan Sadikin General Hospital Bandung in the period of September?December 2015. Data collected were patient?s general data and the implementation of the 6-hour management standard procedures that include lactate measurement, blood culture, broad spectrum antibiotics, fluid resuscitation, vasopressor use, CVP measurement, and Scvo2/Svo2 measurement. Of 80 subjects, 59 (74%) had severe sepsis and 21 (26%) had septic shock. In the first 3 hours, for severe sepsis and septic shock patients, lactate was examined in 2% and 14% respectively. For blood culture before antibiotics, broad spectrum antibiotic provision, and 30 mL/kgWt fluid resuscitation, the values were 17% and 10%, 32% and 43%; and 2% and 14%, respectively. In septic shock, in the 6 hours, vasopressor was given to 62% and CVP was measured in CVP 5%. Scvo2/Svo2 was not measured. The mortality rates in the first 6 hours for severe sepsis and septic shock were 7% and 19%. Compliance to first 6-hour standard procedure for severe sepsis and septic shock is still inadequate. Key words: Septic shock, severe sepsis, six hours resuscitation bundle
Defined Daily Dose and Cost of Therapy of Empirical Ceftriaxone Pre- and Post-Antimicrobial Stewardship Program Model Implementation in Sepsis Patients in A Tertiary Hospital in Indonesia Uun Sumardi; Anggra Filani; Evan Susandi; Ida Parwati
International Journal of Integrated Health Sciences Vol 7, No 2 (2019)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v7n2.1693

Abstract

Objective: Antibiotic resistance requires substantial responses through two mechanisms: new antibiotic development and smart antibiotic use. Antibiotic Stewardship Program (ASP) is one of the responses that reduce the overall antibiotics use and prevent the overuse of antibiotics to avoid antibiotic resistance. The purpose of this study was to assess the difference in defined daily dose (DDD) and the cost of therapy (COT) for empirical ceftriaxone therapy in sepsis patients pre- and post-ASP model implementation in Dr. Hasan Sadikin General Hospital, Bandung.Methods: A pre- and post-intervention quasi-experimental study on ASP model implementation in empirical ceftriaxone therapy provided to sepsis patients treated in the intensive or semi-intensive care units was performed from December 2015 to July 2016 using the Mann Whitney test and t-test. The DDD was calculated as DDD/100 patient-days, while the COT was calculated as the COT/patient-day. The ASP model intervention implemented in these units applied 2 main strategies: ceftriaxone use restriction and ceftriaxone therapy duration audit.Results: Participants of this study consisted of 112 sepsis subjects (n=112) with 55 subjects in the pre-ASP group and 57 subjects in the post-ASP group. The mean DDD/100 patient-days in the post-ASP subject was lower than that of the pre-ASP (16.3±4.3 and 45.8±16.8; p=0.018). The median COT/patient-days in post-ASP subject was IDR 42,000 (IDR 14.000–42.000), which was lower than that of the pre-ASP group of IDR 84.000 (IDR 28.000–420.000, p=0.001).Conclusion: The differences in the DDD/100 patient-day and COT/patient-day values between the pre-ASP and post-ASP are significant. The ASP model applied in Dr. Hasan Sadikin General Hospital, Bandung leads to a smart use of ceftriaxone and reduces costs for the empiric ceftriaxone therapy in sepsis patients.
Erythropoiesis Differences in Various Clinical Phases of Dengue Fever using Immature Reticulocyte Fraction Parameter Amaylia Oehadian; Putri Vidyaniati; Jeffery Malachi Candra; Uun Sumardi; Evan Susandi; Bachti Alisjahbana
International Journal of Integrated Health Sciences Vol 9, No 1 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v9n1.1805

Abstract

Objective: To determine the mechanism of erythropoiesis that led to anemia using the Immature Reticulocyte Fraction (IRF) parameter in various clinical phases of dengue fever.Methods: This study was a comparative analytical research using secondary data derived from the Dengue-associated Endothelial Cell Dysfunction and Thrombocyte Activation (DECENT) research. The study was performed at Dr. Hasan Sadikin Hospital Bandung, Indonesia from March 2011 to March 2012. Patients were grouped into fever, critical, recovery, and convalescent phases and a healthy control was established. Data collected were analyzed using the Kolmogorov-Smirnov normality test, followed by Friedman test and Mann-Whitney post hoc test.Results: There were 244 subjects participating in this study. The median IRF for all subjects was 4.8% with an IQR of 2.4-8.1%. The values of Immature Reticulocyte Fraction in fever-phase, critical-phase, recovery-phase, convalescent-phase and healthy-control were 1.8% (IQR of 0.5-2.85%), 3.6% (IQR of 1.8-5.0%), 7.05% (IQR of 4.08-11.85%, 7.3 % (IQR of 3.95-9.3%) and 4.1% (IQR of 2.2-6.6%), respectively. There was a significant difference in IRF between groups (p<0.05).  The immature Reticulocyte Fraction in fever phase was significantly different from the IRF in other phases and healthy controls (p<0.05).Conclusions:There are changes in erythropoiesis activities detected through the IRF in various clinical phases of dengue infection. Erythropoiesis suppression occurs mainly during the fever phase and starts to be restored in the critical phase. In the recovery and convalescent phases, the erythropoiesis activities increase.  This is the first study describing IRF in multiple phases of dengue disease. 
Upaya Pengendalian Aedes aegypti di Desa Cibeusi dan Cikeruh Kecamatan Jatinangor berdasar atas Populasi Nyamuk Lia Faridah; Cica Lavemita; Uun Sumardi; Nisa Fauziah; Dwi Agustian
Global Medical & Health Communication (GMHC) Vol 6, No 1 (2018)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (348.325 KB) | DOI: 10.29313/gmhc.v6i1.2586

Abstract

Masalah kesehatan masyarakat di Indonesia yang umum terjadi dalam beberapa tahun terakhir adalah penyakit demam berdarah dengue (DBD) yang ditularkan melalui gigitan nyamuk Aedes spp. Salah satu daerah endemis DBD adalah Kecamatan Jatinangor, kasus DBD tertinggi terjadi di Desa Cibeusi dan kasus terendah di Desa Cikeruh pada tahun 2014. Penelitian ini menggunakan rancangan potong lintang (cross sectional) dilaksanakan dari bulan September hingga November 2016. Teknik pengambilan sampel diambil secara sengaja (purposive sampling) dari dalam rumah di Desa Cibeusi dan Cikeruh. Setiap desa dipasang 10 perangkap nyamuk untuk 10 rumah meliputi luas wilayah 100×100 m2. Evaluasi hasil tangkapan dilakukan setiap 3 hari untuk setiap minggu selama 3 bulan. Data yang dicari adalah perbedaan jumlah nyamuk rata-rata dan upaya pengendalian Aedes aegypti di kedua desa. Data yang diperoleh dianalisis dengan uji t tidak berpasangan. Pada equal variance assumed, Sig. (2-tailed) sebesar 0,711 (p<0,05), hal tersebut menunjukkan bahwa jumlah nyamuk rata-rata di kedua desa tidak berbeda bermakna secara statistik pada probabilitas 0,05. Upaya pengendalian Aedes aegypti yang telah dilaksanakan di Desa Cibeusi pada tahun 2016 adalah larvasidasi, sementara Desa Cikeruh melaksanakan fogging. Simpulan, upaya pengendalian vektor yang dilaksanakan Puskesmas Jatinangor dalam menurunkan angka kejadian DBD masih kurang. ASSESSMENT OF AEDES AEGYPTI CONTROL EFFORT IN CIBEUSI AND CIKERUH VILLAGES JATINANGOR SUB-DISTRICT BASED ON THE POPULATION OF MOSQUITOThe dengue hemorrhagic fever (DHF) is a common public health problem in Indonesia over the past few years which is transmitted by the bite of Aedes spp. One of the DHF endemic area is the Jatinangor sub-district, in 2014 Cibeusi village that had the highest number of DHF cases whereas the lowest number was recorded in Cikeruh village. This study used cross sectional design and it was conducted from September until November 2016. The sampling technique was purposive sampling from the residencies in Cibeusi and Cikeruh village. Each village was set up 10 mosquito traps for 10 houses covering an area 100×100 m2. Evaluation of the catches was done every 3 days per week for 3 months. Data to be found is the difference in mean number of mosquitoes and Aedes aegypti control efforts in both villages. The data collected was analyzed with unpaired t-test. Sig. (2-tailed) value at equal variance assumed was 0.711 (p<0.05), this showed that there was no statistically significant difference in the mean number of Aedes aegypti or it is not significant at 0.05 probability in both villages. Aedes aegypti control efforts on 2016 which have been held in Cibeusi village was larvaciding, while fogging activities in Cikeruh village as a control efforts. In conclusion, there is still lacking of vector control efforts undertaken by Jatinangor Public Health Center in reducing DHF incidence.
The Combination of NLCR and Enhances the Sepsis-3 Strategy Emmy Hermiyanti Pranggono; Endah Nurul Aini; Uun Sumardi; Yovita Hartranti; Adhi Kristianto Sugianli
Folia Medica Indonesiana Vol. 58 No. 2 (2022): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (751.686 KB) | DOI: 10.20473/fmi.v58i2.31051

Abstract

Highlights: The combination of NLCR and PLR will improve the ability to distinguish infection rather than noninfection in the emergency setting for early antibiotic prescribing as well as the sepsis-3 strategy. The diagnostic value of PLR in adult bacterial sepsis patients has never been studied.   Abstract: According to Sepsis-3, antibiotics should be administered in the first hour of diagnosis of sepsis. Still, there is difficulty in differentiating between bacterial and nonbacterial infections and a lack of a rapid diagnostic tool to distinguish them. This study evaluated the diagnostic value of NLCR and PLR in suspected bacterial sepsis. The diagnostic value of PLR in adult bacterial sepsis patients has never been studied. This study was a retrospective study from the medical record of Dr. Hasan Sadikin Hospital Bandung. All patients at age ≥ 18 years diagnosed with sepsis based on ICD-10 code and qSOFA ≥ 2 were included. We calculated sensitivity, specificity, NPV, PPV, positive LR, and AUC of NLCR and PLR. There were 177 patients included in this study. The sensitivity of NLCR was 69.5%, specificity was 34.7%, NPV was 56.9%, PPV was 47.9%, and LR+ was 1.06, while the sensitivity of PLR was 62.2%, specificity was 38.9%, NPV was 54.4%, PPV was 46.8%, and LR+ was 1.02. We obtained cut-off values for NLCR 11.06, AUC 0.500, PLR 222.41, and AUC 0.497. The low value of AUC NLCR and PLR was due to prior antibiotic use. The combination of NLCR and PLR had higher positive LR (1.16) and specificity (54.7%), and also, according to NLCR, we had the highest sensitivity (69.5%). The combination of NLCR and PLR enhances the sepsis-3 strategy because it can be used as screening tools for bacterial sepsis, and antibiotics can also be administered in the first hour of managing sepsis, particularly in the emergency ward.
Invasive Candidiasis Prevalence Among Patients in IntensiveCare Unit, Hasan Sadikin Hospital Maulana, Hafizh Ridwan; Sumardi, Uun; Koesoemadinata, Raspati C.
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Intensive care unit (ICU) patients have a high risk of invasive candidiasis (IC), which increase mortality and prolong length of stay in hospitals, resulting greater costs. This study aimed to determine the prevalence of IC and associated risk factors in ICU patients. Methods. A cross-sectional study was conducted including medical records of patients treated in ICU Hasan Sadikin Hospital Bandung admitted in June 2016-June 2017 whose blood sample were sent for culture. The prevalence of IC and corresponding 95% confidence interval (95% CI) was determined. A case-control study was done comparing the characteristics of patients with positive culture for Candida (cases) with those who have a negative culture admitted to ICU in the same week as the cases (control), with ratio 1 to 4. Multivariate analysis was performed to determine the adjusted odds ratio (AOR), 95% CI, and p value. Results. Blood cultures were performed on 313 ICU patients. The prevalence of IC was 3.5% (95%CI: 1.8-6.2), and 9 patients died. There were 8 cases and 33 controls with complete data to be compared. Characteristics associated with invasive candidiasis were: use of ventilator more than 6 days (AOR=15.52; 95%CI: 1.51-159.15; p=0.021); use of urine catheter more than 8 days (AOR=10.77; 95%CI: 1.05-110.86; p=0.046); and positive sputum culture for Candida (AOR=9.54; 95%CI: 1.44- 63.44; p=0.020). Conclusions. Invasive candidiasis has a high mortality rate. Long-term use of ventilator and urine cathether, and positive sputum culture result were important risk factors for IC among adult patients in ICU.
An Overview of Antibiotic Solubility Based on Reconstitution Time Roosmeilany, R. Meitha; Sumardi, Uun; Supiani, Epa; Syabariyah, Sitti; Rahmawati, Endah Yuliany
Journal of Health Sciences and Medical Development Vol. 4 No. 01 (2025): Journal of Health Sciences and Medical Development
Publisher : The Indonesian Institute of Science and Technology Research

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56741/hesmed.v4i01.739

Abstract

The reconstitution of parenteral antibiotics is the process of mixing antibiotic drugs with sterile solutions for intravenous use. According to Indonesian Nursing Law No. 38 of 2014, Article 33, nurses are authorized to provide limited pharmaceutical services, including assisting in drug reconstitution. Errors in the mixing process can lead to incorrect drug dosages or reduced efficacy. This study aims to describe the solubility of antibiotics based on the reconstitution time of antibiotics in the Medical Intermediate Care (MIC) unit at Dr. Hasan Sadikin General Hospital in Bandung. The research method used is quantitative descriptive correlational, utilizing frequency distribution to assess respondent characteristics, the antibiotics used, and their solubility. Central tendency measures are used to determine the mean solubility of antibiotics based on reconstitution time. A total of 66 samples were collected using accidental sampling techniques. The reconstitution procedure used aquabidest (distilled water) and NaCl. The duration of the reconstitution process affected the solubility of the antibiotics. It was concluded that the reconstitution and mixing procedures for parenteral preparations in the MIC unit did not fully meet Good Preparation standards. Antibiotics such as Cefepime, Vancomycin, Cefotaxime, and Meropenem had relatively longer reconstitution times compared to other antibiotics. Nurses should have the knowledge and skills to perform drug reconstitution according to standards. Hospitals should establish drug reconstitution standards to ensure the quality of medications administered to patients, thus preventing an increase in antibiotic resistance.
Effect of Health Education on Community Participation to Eradicate Aedes aegypti-Breeding Sites in Buahbatu and Cinambo Districts, Bandung Elsa, Zahratul; Sumardi, Uun; Faridah, Lia
Kesmas Vol. 12, No. 2
Publisher : UI Scholars Hub

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Abstract

Dengue hemorrhagic fever (DHF) is still a major public health problem in many regions in Indonesia including Bandung City. Community participation in implementing Eradication of Mosquito-Breeding Sites is still needed as it is considered the most effective method in controlling the dengue fever. This study aimed to determine the influence of health education towards community participation to eradicate mosquito-breeding sites, which was measured by knowledge level and larva index conducted in Bandung, specifically in two different locations with the highest and the lowest incidence rates of DHF. This study used quasi-experimental method. Samples were 100 people living in Cijawura and Cisaranten Wetan Subdistricts taken by using purposive sampling technique. Pre-test results showed that knowledge level of respondents in both subdistricts was significantly increasing (p value = 0.000) after health education was given. Container index (CI) and House index (HI) values in Cijawura Subdistrict were 13.2% and 26.7% respectively, then 9.6% and 28.4% respectively in Cisaranten Wetan Subdistrict. After the health education, CI value in Cijawura and Cisaranten Wetan Subdistricts significantly decreased (p value < 0.05), but HI value did not (p value > 0.05).
Co-Authors Adhi Kristianto Sugianli Amaylia Oehadian Anggia Karina, Anggia Anggra Filani Bachti Alisjahbana Cica Lavemita Dwi Agustian Elsa Pudji Setiawati Elsa, Zahratul Emmy Hermiyanti Pranggono Endah Nurul Aini Evan Susandi Fauzi, Afiq Syazwan Fauziah, Nisa Hafizh Ridwan Maulana Ida Parwati Jeffery Malachi Candra Koesoemadinata, Raspati C. Lia Faridah Maulana, Hafizh Ridwan Nina Tristina Putri Vidyaniati Rahmawati, Endah Yuliany Raspati C. Koesoemadinata Roosmeilany, R. Meitha Sri Yusnita Irda Sari, Sri Yusnita Irda Supiani, Epa Syabariyah, Sitti Wirawan, Chevie Yovita Hartranti