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All Journal Medicinus : Jurnal Kedokteran Jurnal Pengabdian Masyarakat dalam Kesehatan
Cucunawangsih Cucunawangsih, Cucunawangsih
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Health Professions Medicine & Pharmacology Nursing Public Health

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DIAGNOSIS KLINIS DINI PENYAKIT DENGUE PADA PASIEN DEWASA Cucunawangsih, Cucunawangsih
Medicinus Vol. 4 No. 8 (2015): February 2015 - May 2015
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v4i8.1185

Abstract

Menyebarnya penyakit dengue di dunia, khususnya Indonesia adalah sebagai akibat dari pengaruh meningkatnya proporsi kasus dewasa. Infeksi virus dengue seringkali memberikan gejala klinis non-spesifik dan singkatnya waktu infeksi, karena itu uji diagnostik laboratorium cepat, dan identifikasi penanda dengue yang dapat segera dilakukan dan mudah diperoleh tetap menjadi prioritas. Deteksi dini pada pasien infeksi virus dengue secara substansial ditujukan untuk mengkonfirmasi dan mengendalikan manajemen klinis. WHO (Organisasi Kesehatan Dunia) dan beberapa penelitian menunjukkan bahwa deteksi antidengue NS-1 dengan/atau tanpa IgM sebagai faktor indicator untuk menyingkirkan infeksi virus lainnya. Risiko kejadian penyakit dengue yang parah dan dirawat di rumah sakit sering tidak  nampak pada pasien dewasa yang lebih tua, hal ini menunjukkan bahwa kelompok pasien ini harus mendapatkan manfaat dari deteksi dini. Pada pasien dewasa yang mempunyai gejala demam dan leukopenia harus dilakukan pemeriksaan terhadap virus dengue. Namun demikian, gejala klinis demam, trombositopenia, leukopenia, dan monositosis lebih konsisten ditemukan pada pasien terinfeksi virus dengue daripada kasus negatif. 
ANTIBIOTIC SUSCEPTIBILITY IN UROPATHOGEN FROM INTENSIVE CARE PATIENTS WITH URINE CATHETER Wibowo, Angeline Nifiani M; Cucunawangsih, Cucunawangsih
Medicinus Vol. 4 No. 9 (2015): June 2015 - September 2015
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v4i9.1187

Abstract

Background: Multi-Drug Resistance Organisms (MDROs) are defined as organisms that acquired non-susceptibility to more than one antimicrobial agent. Intensive care patients are immune-compromised patients, using catheter and are given broad-spectrum antibiotics. Hence, the chance to develop microbial resistance is high. The aim of this study is to see the etiology and the microbial susceptibility pattern of catheter-associated urinary tract infection patients treated in intensive care.Materials and Methods: The urine samples were taken from catheterized patients admitted to intensive care in Siloam Lippo Village, Tangerang, Indonesia in a one year period from July 2013 until June 2014. We confirmed species identification with Vitex-2 Compact® from Biomérieux, France. The susceptibility of antibiotics is according to Clinical and Laboratory Standard Institute (CLSI). Results: We managed to get 113 urine culture results with mean of age 57.03 ± 18.505 (years). There were 67 males (59.3%) and 46 females (40.70%) that were acquired in the sample. The result of species identification showed that Escherichia coli was the dominant isolate from the urine culture (40.63%), followed by Klebsiella pneumoniae (12.5%). The percentage of MDRO was found to be 71.9%. The antibiotics susceptibility of Escherichia coli for Amoxicilin, Ampicillin/Sulbactam, Ciprofloxacin and Levofloxacin are 50%, 58%, 76% and 75% respectively. Meanwhile the susceptibility against Amikacin and Meropenem are 100% for Escherichia coli and Klebsiella pneumoniae. Conclusion: The proportion of Escherichia coli was the highest among with susceptibility of Meropenem was still high susceptibility for both gram negative and gram positive bacteria.  
DEKONTAMINASI DAN PEMBERSIHAN AKHIR (TERMINAL CLEANING) DI LINGKUNGAN ICU (Intensive Care Unit) Cucunawangsih, Cucunawangsih
Medicinus Vol. 4 No. 9 (2015): June 2015 - September 2015
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v4i9.1189

Abstract

Patogen MDRO, seperti vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), Acinetobacter spp., extended spectrum beta-lactamase (ESBL)-producing bacteria, dan Clostridium defficile seringkali menyebabkan kolonisasi/healthcare-associated infection (HAI) di lingkungan ICU. Sejumlah penelitian membuktikan bahwa petugas kesehatan menularkan pathogen ini melalui kontak langsung dengan tangan atau sarung tangan setelah menyentuh permukaan yang terkontaminasi atau pasien. Lingkungan berperan penting pada penyebaran hospital-acquired pathogens (HAP) dan terjadinya HAI. Metode pembersihan dan dekontaminasi rutin yang telah diterapkan dan dilakukan di lingkungan rumah sakit seringkali gagal ataupun tidak efektif dalam menggurangi penyebaran patogen MDRO. Kegagalan ini disebabkan tidak seluruh permukaan medis dan rumahtangga yang seringkali tersentuh tidak terdekontaminasi dengan sempurna. Untuk itu diperlukan tindakan lanjutan berupa pembersihan terminal menggunakan metode baru, seperti (1) hydrogen peroxide vapor (HPV) dan (2) sinar UV yang telah terbukti efektif secara mikrobiologi, aman dan mudah digunakan.
In Vitro Susceptibility Of Tigecycline Among Acinetobacter Baumanii Clinical Isolates From a Hospital in Indonesia Wiwing, Veronica; Cucunawangsih, Cucunawangsih
Medicinus Vol. 7 No. 1 (2017): October 2017 - January 2018
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i1.1436

Abstract

Acinetobacter baumanii (A. baumanii) has arisen as the most important cause of nosocomial infection, typically in severely ill patients with many comorbidities and medical supportive devices. Tigecycline is a therapeutic option for treating this infection because of its potential ability against wide spectrum of bacterias, including multi-drug resistance A. baumannii (MDRAB). Our study determine the in vitro susceptibility of tigecycline against A. baumanii isolates and the emergence of MDRAB. The frequency of isolates that were not inhibited at MIC ‰¤ 0.5 µg/ml was 50.46%, at MIC = 1µg/ml was 2.38%, and at MIC = 2 µg/ml was 19.07%. The susceptibility rate of tigecycline against A. baumanii was 68.27% in 2015, 79.58% in 2016, and 67.87% in 2017. In vitro result demonstrated that tigecycline had good value of MIC against A. baumanii at the range of 0.5 to 2 µg/ml.
Risk Factors of Non-Typhoidal Salmonella Bacteremia Versus Typhoidal Salmonella Bacteremia in Patients from a General Hospital in Karawaci, Tangerang, Indonesia: A Five-Year Review Lugito, Nata; Cucunawangsih, Cucunawangsih; Kurniawan, Andree; Purnamasari, Dewi
Medicinus Vol. 9 No. 1 (2019): October:2019
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i6.2593

Abstract

Salmonella infections including Non-typhoidal Salmonella (NTS) and enteric fever are important global public health problem, causing approximately 94 million human cases of gastroenteritis with 150,000 deaths annually around the globe. The aim of this study was to determine risk factors for NTS bacteremia patients compared to Typhoidal patients in Indonesia, area with high incidence of enteric fever. This retrospective descriptive study was conducted in Siloam Hospital in Karawaci, Indonesia, from January 2011 to December 2015. Logistic regression model was used to determine independent predictors of NTS bacteremia including demographic and epidemiologic characteristics, clinical presentations, and laboratory results. Out of 129 positive isolates for Salmonella with complete medical records, 18 (13.9%) were positive for NTS. Patients with NTS bacteremia were more likely to belong in the age group below 5 or above 60 year-old, more frequent to have anemia and abnormal leucocyte count. The susceptibility patterns against antimicrobial of NTS bacteremia and Typhoidal bacteremia were similar. In logistic regression analysis, age below 5 or above 60 year-old, hemoglobin level below 12 g/dL and leucocyte count below 4,000/µL or above 12,000/µL were independent risk factors for NTS bacteremia.
Co-Authors Andree Kurniawan Angeline Nifiani M Wibowo Dewi Purnamasari Diannita, Catharina Guinda Feliana Feliana Feliana, Feliana Gunawan, Pricilla Yani Margaret Merlyn Tjiang, Margaret Merlyn NATA LUGITO, NATA Nata Pratama Hardjo Lugito Patrisia, Ineke Sampepadang, Mega Sihombing, Riama Marlyn Siregar, Deborah VERONICA WIWING Wibowo, Angeline Nifiani M