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Angka Kejadian dan Karakteristik Klinis Pasien Infeksi Jamur Invasif di RSUP Dr. Hasan Sadikin Tahun 2020 – 2022 Alessandro, Ariella; Fauziah, Nisa; Megantara, Imam; Wisaksana, Rudi; Dewi, Intan Mauli Warma
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 4
Publisher : UI Scholars Hub

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Introduction. Invasive fungal infection (IFI) is increasingly common in patients at risk, especially those with impaired immune response. In Indonesia, there is currently a low prevalence of IFI which may be influenced by challenges in diagnosis. This study aimed to determine the prevalence and clinical characteristics of IFI patients in Dr. Hasan Sadikin Hospital in Bandung, Indonesia. Methods. This cross-sectional study was conducted at Dr. Hasan Sadikin Hospital. Data were collected using medical records of IFI patients diagnosed between 2020 and 2022 which were selected using total sampling method. Demographic data, clinical symptoms, radiological appearance, and laboratory results were recorded. Results. The prevalence of IFI in Dr. Hasan Sadikin Hospital between 2020 and 2022 was 0,04% (40 per 100,000 patients). The most common cause of invasive fungal infection was Cryptococcus spp. and Candida spp. Fever and loss of consciousness were the two most common signs and symptoms found in this study. HIV/AIDS was present in 51,4% of cases. The diagnostic test was mostly done with cryptococcal antigen (CrAg) examination. Lung involvement was common, appearing as consolidation, infiltration, and ground glass opacity in the lungs. The mortality rate of IFI patients was 51,4%. Conclusions. The prevalence of IFI in Dr. Hasan Sadikin Hospital was quite low, with HIV/AIDS as the most common risk factor. However, there was a high mortality rate found this study is high. Thus, timely diagnosis and antifungal treatment induction should be considered to improve the outcome of invasive fungal infection patients.
Gambaran Klinis Pasien Terduga Tuberkulosis Paru Resisten Obat (TB-RO) dengan Kolonisasi Candida sp. di Rumah Sakit Hasan Sadikin Bandung Zalfa, Hasna Rafifah Zahira; Kulsum, Iceu Dimas; Suryadinata, Hendarsyah; Chrysanti, Chrysanti; Dewi, Intan Mauli Warma
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

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Introduction. Candida sp. is a fungus that lives as a commensal in human body, but may cause infection upon immune suppression. The decrease in immunity due to TB infection and long-term use of antibiotics in TB patients may increase the risk of the Candida sp. colonization in patient. Data regarding the prevalence of Candida sp. colonization in TB patients and its impact has not been widely reported. This study was conducted to determine the prevalence and clinical characteristics of presumptive drug-resistance TB patients with Candida sp. colonization. Methods. A cross-sectional study was conducted using secondary data from a previous study in 2018 at the DR-TB clinic in Hasan Sadikin General Hospital Bandung, Indonesia. Patients who were included in the study were aged 18 years or above, presented with pulmonary TB symptoms, and had minimum 5 months of TB treatment history. Candida sp. growth on sputum was examined by culture on CHROMagar® media. Results. One hundred and twenty-two patients met the inclusion and exclusion criteria. The prevalence of Candida sp. colonization in presumptive drug-resistance TB patients was 54.9%. The species found were mostly Candida albicans (71.6%), Candida glabrata and Candida parapsilosis (14.9%), and Candida tropicalis (5.9%). The predominant symptoms of pulmonary tuberculosis included a persistent cough lasting two weeks or longer and productive cough (100%), while the most frequently observed abnormalities on radiological scans were nodules and patchy lesions (98.5%). There were no significant differences between patients with positive and negative Candida sp. colonization. Conclusions. More than 50% of presumptive drug-resistant TB patients at the MDR-TB clinic in Hasan Sadikin General Hospital had positive results of Candida sp. culture on their sputum. The most common clinical manifestations were coughing for 2 weeks or more, productive cough, hemoptysis, fever, chest pain, shortness of breath, night sweats, weight loss, and reduced appetite. Future studies should be conducted to determine the long-term outcome of fungal colonization in these patients.
Prevalensi dan Karakteristik Pasien Tuberkulosis Paru Resisten Obat (TB-RO) dengan Diabetes Melitus Tipe 2 di Klinik TB-RO Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Bandung Maulida, Diva Harnum; Dewi, Intan Mauli Warma; Santoso, Prayudi; Cahyadi, Adi Imam; Kusumawati, Maya; Kulsum, Iceu Dimas
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Introduction. Diabetes mellitus (DM) patients have a higher risk of tuberculosis (TB) infection, including the risk of drug- resistant (DR)-TB infection, compared to those without DM. Data on the characteristics of pulmonary DR-TB with DM in Indonesia are still very limited. The management of pulmonary DR-TB with DM should consider multiple factors, such as drug interactions between DM medication and anti-TB drugs, as well as potential exacerbation of DM complications by anti-TB drugs side effects. Effective management of pulmonary DR-TB patients with DM will improve treatment outcomes. This study aimed to determine the prevalence and characteristics of pulmonary DR-TB patients with type 2 DM at the DR-TB clinic of Dr. Hasan Sadikin Central General Hospital, Bandung. Methods. This cross-sectional study was conducted at the Drug Resistant Tuberculosis (DR-TB) Clinic of Dr. Hasan Sadikin Central General Hospital, Bandung, during the period of January 2020 to May 2023. Data were obtained from the medical records of patients with drug resistant pulmonary tuberculosis and type 2 DM. The study included patients diagnosed with drug resistant pulmonary tuberculosis and type 2 DM who were aged 18 years or older. Data analysis was performed using descriptive statistical methods, and normality test was conducted using the Kolmogorov-Smirnov test. Results. The prevalence of pulmonary DR-TB cases with Type 2 DM was 11.17%. Out of a total of 82 samples, more than half had normal BMI (61.04%), diagnosed with MDR-TB (74.39%). The duration of Type 2 DM were in average between 1-5 years (53.16%), with an HbA1c value ≥7% in 94.20% of the patients. Infiltrates were found in 46.27% of radiological findings. Anemia was present in 54,88% of participants, with an average and standar deviation hemoglobin level of 12.15 (± 1.75) g/dL. Conclusions. The prevalence of pulmonary drug-resistant tuberculosis with type 2 DM at Dr. Hasan Sadikin Central General Hospital, Bandung, is 11,17%. The majority of patients had uncontrolled type 2 DM (HbA1c ≥7%), normal BMI, positive sputum mycobacteriology, and the primary chest X-ray finding is infiltrate. Future studies are necessary to determine the clinical and treatment outcome of these patients.
Incidence and Characteristics of Dermatophytosis Lesions in Cats (Felis catus) at Go Pet Care Animal Clinic (2020-2022) Fauziyyah, Salma Aqilla; Dewi, Intan Mauli Warma; Khairani, Shafia
Journal of Parasite Science Vol. 8 No. 2 (2024): Journal of Parasite Science
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jops.v8i2.61621

Abstract

Dermatophytosis, a dermatological condition caused by dermatophyte fungi, affects the superficial keratinized structures of the skin. The primary etiological agents include the genera Microsporum, Trichophyton, and Epidermophyton. This study examines the incidence and characteristics of dermatophytosis lesions in domestic cats (Felis catus) at Go Pet Care Animal Clinic from 2020 to 2022. The research utilized secondary data from the clinic's medical records, which is a significant reference institution in Kabupaten Bandung Barat, to assess the prevalence and features of dermatophytosis within this population. The findings revealed a prevalence of 7.5% in 2020, 11.3% in 2021, and 3.7% in 2022. The incidence was highest in cats under 1 year of age, with a notable frequency in Persian breed cats and males. Common lesions identified included localized alopecia primarily in the ear region, alopecia in the back region, and crust formation also in the back area. This study provides critical insights into the epidemiology and clinical presentation of dermatophytosis in domestic cats, offering guidance for improved diagnosis and management of the condition.
Chronic Respiratory Symptoms among TB Survivors in a High-TB Burden Setting in Indonesia: A Preliminary Study Dewi, Intan Mauli Warma; Fauziyyah, Raden Nabilah Putri; Wanda, Dananfi; Kulsum, Iceu Dimas; Lestari, Bony Wiem; Soeroto, Arto Yuwono
Jurnal Respirologi Indonesia Vol 45 No 3 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i3.844

Abstract

Background: Tuberculosis (TB) affects over 10 million people worldwide and causes more than 1.4 million deaths in 2019. Despite improvements in TB treatment, many TB survivors experience ongoing health problems. Post-TB lung disease (PTLD) affects 30-60% of treated patients, leading to chronic respiratory impairments and reduced quality of life. Data on PTLD in Indonesia, a country with a high TB burden, are still scarce. We conducted a preliminary study in Bandung to estimate the burden of respiratory health problems among those who completed TB treatment. Methods: Adults aged 18 years or older with a history of TB treatment and a minimum of 6 months since treatment completion were screened at two primary healthcare centres in Bandung municipality. Data on demographics, previous TB history, and clinical symptoms were collected. Results: From 133 identified TB survivors, 61 eligible patients were interviewed. Persistent respiratory symptoms, such as cough or shortness of breath, were observed in 6 (9.8%) patients. Among these patients, some had abnormal chest x-ray and/or negative Gene Xpert MTB/RIF results. Conclusion: Even after completing treatment, nearly 1 in 10 TB survivors experienced chronic respiratory symptoms. Greater efforts and awareness are needed to improve post-TB wellbeing, especially in high-burden settings like Indonesia.
Prevalence and Pathological Lesions of Dermatophytosis in Cats (Felis catus) at the Animal Health Center in Cimahi: August-September 2023 Fauziyah, Sri Nur Farah; Dewi, Intan Mauli Warma; Khairani, Shafia
Journal of Parasite Science Vol. 9 No. 2 (2025): Journal of Parasite Science
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jops.v9i2.61623

Abstract

Dermatophytosis is a zoonotic fungal infection affecting the superficial skin layer. characterized by circular lesions commonly referred to as "ringworm." This condition has been recorded as the most frequently occurring ailment at the Animal Health Center in Cimahi. This study aims to determine the prevalence and characteristics of dermatophytosis lesions in cats at the Animal Health Center in Cimahi during the period of August-September 2023. Samples were collected based on physical examinations and supporting diagnostics. such as Wood's lamp inspection. on animals suspected of having dermatophytosis. The results revealed that the prevalence of dermatophytosis in cats during the specified period was 10.5%. with 91 cases out of 864 patients. The most common lesions observed included epidermal collars with scales. crusts. erythema. hyperpigmentation. and alopecia. totaling 613 lesions from 91 patients. The highest number of lesions was found in the dorsal body region. with a total of 115 lesions. Predisposing factors such as age. sex. and breed indicated that dermatophytosis was most prevalent in cats aged less than 6 months (38 cats. 41.7%). female cats (46 cats. 50.5%). and domestic breed cats (40 cats. 43.9%). This study contributes valuable epidemiological data on dermatophytosis in animals in Indonesia.
Antifungal Drug Resistance Profile in Candida sp. as a Cause of Oral Candidiasis: A Scoping Review Anastasia, Mutiara; Mauli Warma Dewi, Intan; Yunivita, Vycke
Jurnal Kedokteran Brawijaya Vol. 33 No. 4 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.04.7

Abstract

Candida sp. is renowned for causing oral candidiasis. The prevalence of this disease is around 20-25% and the prevalence can increase in patients with systemic factors (40.2,%). Meanwhile, resistance to antifungal drugs can worsen the prognosis, especially in patients who have systemic risk factors. Therefore, this study aimed to analyze the resistance profile of Candida sp. as a cause of oral candidiasis. The scoping review method was used based on Preferred Reporting Items for Systematic Reviews and Meta-Analyse Extensions for Scoping Reviews. Data were collected through the Pubmed, Springer Open, and Google Scholar databases. Based on the inclusion and exclusion criteria, a total of 18 articles were analyzed. The results showed that antifungal drug resistance test profile depended on the species of Candida and the status of comorbid disease. Based on species, antifungal drug resistance was higher in non-Candida albicans than in Candida albicans. In the comorbid group, Candida sp. resistance to antifungal drugs was higher in the azole group. Meanwhile, in the group without comorbidities, antifungal drug resistance in groups with comorbidities is higher in flucytosine, econazole, and ketoconazole groups than in nystatin, caspofungin, and miconazole. This suggest that the use of nystatin is still effective for treating oral candidiasis. Healthcare provider may need consider prescribing nystatin, especially for patients with systemic risk factors.
The Correlation between Plasma IL-17 Levels, Lymphocyte Counts, and Neutrophil Counts with the Colonisation of Candida sp. in Tuberculosis Patients with a Treatment History Yunivita, Vycke; Anastasia, Mutiara; Warma Dewi, Intan Mauli; Murad, Chrysanti
Nusantara Medical Science Journal Vol. 10 No. 2 (2025): Volume 10 Issue 2, July - December 2025
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.v10i2.46139

Abstract

Introduction:  Tuberculosis (TB) patients with a history of ATT therapy are associated with changes in IL-17 levels, lymphocyte counts, and neutrophil counts. Increased IL-17 levels, lymphocyte counts and neutrophil counts indicate colonisation of Candida sp. fungus. Changes in the immune response in TB patients with Candida sp. colonisation may cause complications of TB that affect the treatment success rate. Methods:  This research was designed for observational analytical study with a cross-sectional design. 59 subjects are divided into 3 groups, consisting of 21 TB-positive people with Candida sp. colonisation, 21 TB-positive people without Candida sp. colonisation, and 17 TB-negative people with Candida sp. colonisation. Plasma IL-17 levels are examined using the ELISA test, while the lymphocyte and neutrophil counts are seen from previous study examinations (AFFECT). Results:   The plasma IL-17 levels in the TB-positive group with Candida sp. colonisation were 24.05 pg/ml (IQR 21.77-30.50). The plasma IL-17 levels in the TB-positive group without Candida sp colonisation were 23.08 pg/ml (IQR 19.11-32.46). The plasma IL-17 levels in the TB-negative group with Candida sp. colonisation is 20.72 pg/ml (IQR 18.51-22.84) pg/ml, (p=0.046). However, there are no statistically significant difference was observed in lymphocyte and neutrophil counts (p=0.078). Conclusions:  The differences in IL-17 levels that occur in the TB group with Candida sp colonisation may serve as an immunological signal suggesting the need for fungal assessment if the TB patients do not improve their treatment outcome after undergoing ATT for over 6 months.