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The Outcome of Patients with Sepsis at Tarakan Hospital Central Jakarta in 2018 Dharmawan, Ade; Istia, Mieke Joseba; Tan, Henny Tannady; Suparto, Suparto; Anastasia, Monica Cherlady; Layanto, Nicolas
Muhammadiyah Medical Journal Vol 2, No 2 (2021): Muhammadiyah Medical Journal (MMJ)
Publisher : Faculty of Medicine and Health Universitas Muhammadiyah Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (468.53 KB) | DOI: 10.24853/mmj.2.2.49-54

Abstract

Background: Sepsis is a common, life-threatening organ dysfunction caused by a dysregulated host response to infection. In 2017, estimated cases for sepsis reached 48.9 million worldwide, with 11 million deaths. Adequate antibiotic therapy is crucial for the treatment of sepsis. Purposes: The objective of this study is to find factors related to sepsis patient outcomes. Methods: We conducted a 1-year retrospective descriptive study with the inclusion criteria of all adult sepsis patients in Tarakan District Hospital in 2018. We compiled 39 samples that fit the inclusion criteria. Results: The distribution gender of this study were 51.2% female and 48.8% male patients; with most patients in the age of 65 years old (53.8%), 7 days in the length of stay (72%), and the most common source of infection was gastrointestinal (33.3%) followed by lungs (28.2%). Conclusion: We found a mortality rate of 59%, with the most common source of infection leading to death was the lungs (81.2%) and treated with single ceftriaxone antibiotic therapy (78.3%). Another factor associated with mortality is inadequate single antibiotic therapy.
Profil Bakteri Patogen dan Kepekaannya pada Pasien Ventilator Associated Pneumonia dengan Infeksi COVID- 19 di Rumah Sakit UKRIDA¬ Christopher, Jeremy; Dharmawan, Ade; Pasaribu, Donna Mesina; Layanto, Nicolas
Jurnal Kesehatan Andalas Vol. 11 No. 3 (2022): Online November 2022
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v11i3.1998

Abstract

The use of ventilators during the COVID-19 pandemic has increased the incidence of Ventilator-Associated Pneumonia (VAP). This is accompanied by a trend of antibiotic resistance resulting from irrational use. The emergence of multi-drug resistant (MDR) bacteria during the pandemic presents a challenge due to limited antibiotic options. Objective: To determined the pathogenic bacterial profile and antibiotic susceptibility in Ventilator Associated Pneumonia (VAP) patients with COVID-19 infection. Methods: This is a descriptive cross-sectional study with a retrospective approach using secondary data from the medical records of UKRIDA Hospital patients from January 2021 to August 2021. Results: Most of the study sample had characteristics of being male (71.9%), aged 25-64 years (78.1%), overweight (40.6%), and hypertension (40.6%) as the comorbid. Gram-negative bacteria is the pre-dominated bacteria in this study, with Acinetobacter baumannii, Klebsiella pneumoniae, and Stenotrophomonas maltophilia being the most isolated bacteria. Antibiotics such as colistin still showed good susceptibility to Acinetobacter baumannii and Klebsiella pneumoniae, with 75% and 90% sensitivities, respectively. Antibiotics such as linezolid, tigecycline, and gentamicin-synergy still showed (100%) sensitivity to all Gram-positive bacteria. Conclusion: The discovery of MDR bacteria in patients with VAP and the limited availability of susceptible antibiotics highlights the importance of conducting antibiotic resistance surveillance and infection control, especially in the era of COVID-19.Keywords:  antibiotic susceptibility, bacteria profile, COVID-19, VAP
Unusual Polymicrobial Wound Infections In Healthy Patient After Cesarean Sectio Tan, Henny Tannady; Elena, Irene Maria; Dharmawan, Ade; Layanto, Nicolas
Jurnal Midpro Vol. 12 No. 1 (2020): JURNAL MIDPRO
Publisher : Universitas Islam Lamongan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30736/md.v12i1.151

Abstract

Cesarean delivery often complicated by surgical site infection, wound infection and endometritis. No study mention Multidrug Resistant Klebsiella pneumonia and Acinetobacter lwofii were isolated.Here we report a rare case of polymicrobial wound infections in healthy patient after Cesarean Sectio caused by Pseudomonas aeruginosa, Multidrug Resistant Klebsiella pneumonia and Acinetobacter iwofii. A 30-year-old woman at 37 weeks gestation (G1P0A0) presented to our hospital for cesarean sectio due to oligohydroamnios and malpresentation. She came to us on the eleventh post-delivery day with discharge from her surgical wound. Intraoperative cultures revealed Pseudomonas aeruginosa, Multidrug Resistant Klebsiella pneumonia and Acinetobacter lwofii.The greatest contribution to risk for surgical site infection was associated with maternal obesity and hypertensive disorder, but she has no risk factor.The polymicrobial combination of our patient’s is unique from previously described studies, in this case all were Gram negative bacteria (Pseudomonas aeruginosa, Multidrug Resistant Klebsiella pneumonia and Acinetobacter lwofii).
Sensitivitas Fosfomycin pada ISK Akibat Infeksi Enterobacteriaceae Penghasil ESBL pada Pasien di RS X Tahun 2023 William Dharma Wijaya; Layanto, Nicolas; Dharmawan, Ade
Jurnal MedScientiae Vol. 4 No. 2 (2025): Agustus
Publisher : Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jmedscientiae.v4i2.3575

Abstract

Urinary tract infection (UTI) is one of the most common infections in humans. However, intensive and extensive use and misuse of antibiotics over the past 50 years such as in the use of carbapenems, resistance to antibiotics increased dramatically in recent years, especially in Enterobacteriaceae. This study aims to determine the sensitivity of fosfomycin as an drug option in treating UTI due to Extended-spectrum-β-Lactamase (ESBL)-producing Enterobacteriaceae in the era of increasing antibiotic resistance. This study is an analytical descriptive study with a cross-sectional observational design, by looking at the sensitivity pattern of ESBL-producing Enterobacteriaceae causing UTI at a certain point in time. This study used secondary data in the form of microbiology laboratory results at Hospital X in 2023. The results showed that ESBL-producing Enterobacteriaceae causing urinary tract infections were dominantly found Escherichia coli (79.41%). The level of fosfomycin sensitivity to non-ESBL-producing and ESBL-producing Enterobacteriaceae is very good and there are no significant differences in the results of the use of fosfomycin in urinary tract infections due to non-ESBL-producing and ESBL-producing Enterobacteriaceae, with the percentage being (91.31%) and (91.17%). Thus fosfomycin can be a drug option in treating UTI due to ESBL-producing Enterobacteriaceae infection.
Extensive Subcutaneous Abscess in a Patient with Diabetes Mellitus: A Case Report Tan, Henny Tannady; Wijaya, Jefri; Dharmawan, Ade; Layanto, Nicolas
Journal of Current Research In Multidisciplinary Vol. 3 No. 1 (2025): JCRIM (Journal of Current Research In Multidisciplinary)
Publisher : Yayasan Gema Bina Nusantara

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

Abstract

Abscess is a collection of pus in a tissue, usually caused by bacterial infection. The main symptoms of abscess are local pain, warmth and oedema (if the abscess is located close to the skin layer) or can be accompanied by constitutional symptoms (if the abscess is far from the skin layer or deep). In this case report, we report a case of extensive subcutaneous abscess in a woman with diabetes mellitus complicated by sepsis. The patient came with complaints of enlarged boils in the abdominal area for 2 weeks ago, this complaint was accompanied by other signs and symptoms of infection. The Infectious Diseases Society of America (IDSA) in 2014 classified SSTI into purulent (furuncles, carbuncles, and abscesses) and non-purulent (cellulitis, erysipelas, and necrotizing infections). There are several predisposing factors for skin abscesses, namely skin trauma, oedema caused by impaired lymphatic flow and venous insufficiency, obesity, immunosuppressive conditions (diabetes, HIV), previous infections (tinea, impetigo, varicella) and previous venous actions. Patients with sepsis syndrome or life-threatening infections need immediate surgical intervention and given combination antibiotics.
Prevalensi dan Pola Kepekaan Acinetobacter baumannii di Ruang Rawat Intensif RS Swasta di Jakarta Dharmawan, Ade; Devita, Arleen; Gunardi, Wani Devita; Layanto, Nicolas
Jurnal Biomedika dan Kesehatan Vol 6 No 2 (2023)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2023.v6.178-185

Abstract

Background Acinetobacter baumannii is one of the bacteria that cause nosocomial infections, especially in the intensive care unit. These bacteria can cause infections, including bacteremia, pneumonia, urinary tract infections, surgical site infections, and meningitis. Most of these bacteria are multi-resistant to various antibiotics, impacting cure rates and length of stay. This study aimed to determine these bacteria's prevalence and antibiotic susceptibility patterns in the intensive care unit. Methods This research is descriptive research with a retrospective approach. The data was taken from the antibiotic susceptibility report in the intensive care unit of a private hospital in Jakarta in the period January 2020 – December 2021. The antibiotic susceptibility report was processed using the WHONET 2018 software. Results From 681 specimens examined in the intensive care unit, the prevalence of Acinetobacter baumannii was 28.7%, 80% of which came from respiratory specimens. In the sensitivity test results, only the antibiotic Colistin has the best sensitivity to this bacteria, which is 100% sensitive, while other antibiotics have poor sensitivity. Conclusions Acinetobacter baumannii is the bacteria that causes infection in the intensive care unit, with almost all of them being multi-drug resistant bacteria.
Pemeriksaan Penunjang Mikrobiologi untuk Diagnosis Infeksi Mycobacterium Other Than Tuberculosis (MOTT) Devita, Arleen; Dharmawan, Ade
Jurnal Biomedika dan Kesehatan Vol 7 No 2 (2024)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2024.v7.251-261

Abstract

Mycobacterium other than tuberculosis (MOTT) is an environmental bacterium that can be an opportunistic pathogen. These bacteria are resistant to various types of disinfectants and antibiotics because they have the characteristics of thick cell wall peptidoglycan that are rich in lipids and mycolic acid. There are now over a hundred MOTT species, some of which are known to infect people with immune system disorders such as chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), people with a history of tuberculosis (TB), HIV infection, or diabetes mellitus, but can also infect individuals with good immune systems. This type of mycobacterium can also cause nosocomial infections because it can contaminate hospital water as well as medical devices such as bronchoscopes, endoscopes, and dialysis fluids. Infections in humans originate from environmental exposure and spread through ingestion or inhalation. The clinical manifestations of MOTT infection can be pulmonary and extrapulmonary infections, including skin, soft tissue, the gastrointestinal system, bones, and joints, and disseminated with symptoms that are difficult to distinguish from a Mycobacterium tuberculosis infection. Therefore, it is necessary to conduct supporting examinations, in particular microbiological examinations, to detect and identify the species of MOTT and then determine the appropriate therapeutic management. The types of microbiological examination that can be performed are microscopic examination with acid-fast staining, culture, identification with biochemical tests, molecular tests, and immunodiagnostic tests.
Chest X-Ray Photo and Pathogenic Bacteria Distribution in Pneumonia Patients: A Literature Review Cherlady Anastasia, Monica; Dharmawan, Ade
Eduvest - Journal of Universal Studies Vol. 4 No. 7 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i7.1242

Abstract

Pneumonia is an acute infectious or inflammatory disease affecting the lung parenchyma that can be caused by microorganisms such as bacteria, viruses, and fungi. This study aims to determine the image of thorax photos and the distribution of pathogenic bacteria in pneumonia patients, as well as to see the image of thorax photos in certain pathogens. The method in this study was to search for articles through Google Scholar and Pubmed. The results showed that the distribution of pathogenic bacteria in pneumonia cases varied, but the most common bacteria causing pneumonia were Streptococcus pneumoniae, Klebsiella pneumoniae, and Mycoplasma pneumonia. The thorax photographs were also quite diverse, and the most common results were consolidation, infiltrates, and pleural effusion. In patients with pneumonia caused by Mycoplasma pneumoniae, the most common thorax images are lobar pneumonia or lobar consolidation.
Mikrobiota Usus dan Diabetes Mellitus Tipe 2: Sebuah Tinjauan Komprehensif Marcel Antoni; Ade Dharmawan
Jurnal Ners Vol. 9 No. 1 (2025): JANUARI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i1.38278

Abstract

Diabetes melitus tipe 2 (DMT2) adalah penyakit metabolik yang sangat umum di seluruh dunia. Menurut studi terbaru, patofisiologi DMT2 berkaitan dengan keseimbangan mikrobiota usus. Tinjauan pustaka ini bertujuan untuk mengkaji hubungan antara mikrobiota usus dan DMT2, mengevaluasi jalur biologis yang mendasari, dan menyelidiki terapi berbasis mikrobiota. Melalui proses yang meliputi sintesis metabolit mikroba, peradangan sistemik, dan permeabilitas usus, mikrobiota usus memainkan peran penting dalam DMT2. Sensitivitas insulin dan kontrol glikemik dapat ditingkatkan dengan pendekatan terapi seperti transplantasi mikrobiota fekal (FMT), penggunaan probiotik, dan prebiotik. Meskipun temuan ini dapat memberikan informasi untuk strategi pencegahan dan pengobatan DMT2, penelitian lanjutan diperlukan untuk memahami mekanisme spesifik dan mengembangkan intervensi yang lebih efektif.
Profil Klinis dan Evaluasi Penggunaan Antibiotik Penderita Demam Tifoid di RSUD Tarakan Ade Dharmawan; Widya Widya; Diana Wijaya; Wani Devita Gunardi; Marcel Antoni
Jurnal Ners Vol. 9 No. 2 (2025): APRIL 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i2.43471

Abstract

Demam tifoid merupakan penyakit endemik yang sering terabaikan dan tidak diobati sehingga dapat terjadi resistensi antibiotik. Prevalensi demam tifoid di Jakarta dan provinsi lain di Indonesia tersebar merata tetapi bergantung dengan faktor yang mempengaruhi yaitu sanitasi lingkungan dan kebersihan diri. Demam tifoid dapat diderita oleh semua orang terutama perempuan dan berusia 18 – 60 tahun. Untuk menegakkan diagnosis, pemeriksaan penunjang harus dilakukan yaitu dengan pemeriksaan immunoserologi seperti widal atau tubex. Profil klinis penyakit ini tidak spesifik dan sering disangka penyakit ringan dengan ciri khas demam tinggi pada malam hari. Desain penelitian dilakukan yaitu cross sectional yang bersifat deskriptif dengan pendekatan retrospektif dan diambil melalui data sekunder yaitu rekam medis pasien. Penelitian ini juga melakukan evaluasi antibiotik yang diberikan kepada penderita. Hasil dari penelitian menunjukan profil klinis paling banyak diderita adalah demam. Untuk pemeriksaan penunjang yang dilakukan yaitu tubex (72 %) dan widal (28 %). Antibiotik yang paling banyak digunakan adalah seftriakson (86 %), antibiotik lini kedua ini efektif untuk pasien rawat inap demam tifoid. Ketepatan antibiotik yang diberikan, dosis, frekuensi dan lama pemberian terdapat perbedaan dengan Konsensus Demam Tifoid karena pasien demam tifoid di RSUD Tarakan menderita penyakit penyerta yaitu COVID – 19 sehingga antibiotik yang diberikan harus disesuaikan untuk penyembuhan optimal.