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ICU dan Non-ICU MRSA: Kejadian dan Faktor Risiko di Rumah Sakit Tersier Tarigan, Junita; Putri, Maulinda; Suhartomi, Suhartomi; Sitompul, Owen
Nommensen Journal of Medicine Vol 11 No 1 (2025): Nommensen Journal of Medicine Edisi: Agustus 2025
Publisher : Universitas HKBP Nommensen

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36655/njm.v11i1.1939

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that is resistant to penicillin-class antibiotics and poses a serious threat to healthcare facilities. Its global prevalence reached 30% in 2020, while in Indonesia it ranges from 0.3% to 52%, with the highest rate reported in Jakarta. Objective: To compare the incidence and risk factors of MRSA among patients in the Intensive Care Unit (ICU) and general wards (non-ICU) at RSUP Haji Adam Malik Medan, during 2022–202. Methods: A cross-sectional study was performed on 569 patients in ICU and non-ICU wards with culture examinations performed from January 2022 to December 2023. Bivariate analysis was conducted for nine independent variables, followed by multivariate logistic regression for variables with p-values < 0.25. Results: From 18,121 culture examinations, 569 isolates of Staphylococcus aureus were identified. MRSA incidence was higher in non-ICU wards (246 of 441 isolates; 55.7%) than in the ICU (63 of 128 isolates; 49.2%). Statistically significant risk factors differed between the two groups: in ICU patients, only diabetes mellitus (OR 2.50; p = 0.017) was significant; while in non-ICU patients, chronic kidney disease (OR 0.644; p = 0.037) and a history of prior antibiotic use (OR 3.037; p = 0.011) were significant factors. Additionally, 4.21% of all isolates were confirmed as VRSA. Conclusion: MRSA incidence was higher among patients in non-ICU wards. The main risk factors differed between units: diabetes mellitus was prominent among ICU patients, whereas chronic kidney disease and previous antibiotic use played a role among non-ICU patients. These differences highlight the need for infection prevention and control strategies tailored to the specific risk profiles of each care unit.
Human Monkeypox Virus infection br tarigan, junita; Putri, Maulinda; Br. Purba, Sri Ulina; Ginting, Franciscus
Medistra Medical Journal (MMJ) Vol 3 No 1 (2025): Medistra Medical Journal (MMJ)
Publisher : Institut Kesehatan Medistra Lubuk Pakam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35451/3jp6vr60

Abstract

Monkeypox is a zoonotic disease. First, this infection was found in animals but has been widespread in humans and become a pandemic all over the world including Indonesia with different case fatality rates caused by monkeypox infection among the countries. Some clinical features caused by monkeypox infection are similar to other infections caused by chicken pox and other viruses. Treating and preventing monkeypox infection need holistic management among medical personnel.
Case Report: Aspiration Pneumonitis as a Rare Complication Following Hydrogen Peroxide Intoxication Putri, Maulinda; Suhartomi; OK Yulizal; Syarifah, Siti
Jurnal Kedokteran Meditek Vol 31 No 4 (2025): JULI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i4.3404

Abstract

Introduction: Suicide rates continue to rise globally, with self-poisoning being a common method in some developing countries. This report reported a case of hydrogen peroxide ingestion leading to aspiration pneumonitis, a less-discussed complication compared to gastrointestinal toxicity. Case Illustration: A 41-year-old woman presented to the emergency unit 8 hours post-ingestion of a hydrogen peroxide-based toilet cleaner. Symptoms included vomiting, hoarseness, faintness, and frothing at the mouth. The physical examination revealed dyspnea, irritability, a cleaning solution odor in the oral cavity, rhonchi in the middle and lower lung fields, epigastric tenderness, and increased bowel sounds. Gastric lavage with 200 mL of saline was performed, and activated charcoal and sucralfate syrup were administered via a nasogastric tube. The patient had previously received ranitidine at another facility and was also treated with omeprazole and ondansetron. Laboratory results showed leukocytosis, and a chest x-ray indicated bilateral lung infiltration and increased broncho-vascular pattern. Discussion: Early and proper intervention by trained healthcare professionals, combined with preventive measures such as positioning the patient in a semi-upright position and avoiding emetogenic liquids, is essential. Conclusion: This case showed the importance of prompt management involving gastric lavage, mucosal protection, acid suppression, and absorption inhibition. Nonetheless, respiratory complications, such as aspiration pneumonitis, remain challenging to prevent.