Konfirmasi laboratorium kasus difteri dilakukan dengan isolasi dan tes toksigenisitas bakteri penyebab difteri menggunakan metode konvensional berbasis kultur. Metode konvensional memiliki keterbatasan dalam hal sensitivitas pemeriksaan. Penelitian ini bertujuan untuk menguji penggunaan darah domba + telurit sebagai enrichment-selective medium untuk meningkatkan sensitivitas pemeriksaan laboratorium difteri dengan metode konvensional. Sebanyak 18 spesimen klinis (swab tenggorok) penderita difteri digunakan sebagai sampel penelitian. Swab tenggorok tersebut sebelumnya telah digunakan untuk pemeriksaan Polymerase Chain Reaction (PCR) sehingga proses ekstraksi DNA menyebabkan jumlah sel bakteri yang tertinggal menjadi sangat terbatas. Sel bakteri tersebut ditumbuhkan menggunakan 2 cara yang berbeda, yaitu inokulasi langsung dan inokulasi yang didahului dengan penggunaan enrichment-selective medium. Hasil identifikasi bakteri penyebab difteri dibandingkan antara keduanya. Hasil penelitian menunjukkan bahwa inokulasi secara langsung hanya berhasil mengisolasi dan mengidentifikasi bakteri penyebab difteri (Corynebacterium diphtheriae) pada 3 dari 18 sampel yang diperiksa. Sebaliknya dengan penggunaan enrichment-selective medium, bakteri penyebab difteri berhasil diisolasi dan diidentifikasi pada 9 dari 18 sampel yang diperiksa. Oleh karena itu, disimpulkan bahwa enrichment-selective medium (darah domba + telurit) dapat digunakan untuk meningkatkan sensitivitas pemeriksaan laboratorium difteri. Laboratory confirmation for diphtheria cases are performed by using conventional culture-based method for isolation/identification and toxigenicity of the bacteria causing diphtheria. This method has limitation in its sensitivity. This study aimed to examine the sensitivity of sheep blood + tellurite as the enrichment selective medium to improve the sensitivity of the conventional method. The samples were 18 clinical specimens (throat swabs) obtained from diphtheria patient, which had been used for Polymerase Chain Reaction (PCR) assay, therefore the DNA extraction process caused the number of bacteria cells to be very limited. The samples were cultured by two different methods, directly on the agar medium and indirectly through enrichment selective medium previously. The result showed that the directly inoculation could isolate C. diphtheriae as many as 3 out of 18 samples, whereas indirectly method by using enrichment selective medium could isolate and identify 9 out of 18 samples. In conclusion, enrichment selective medium (sheep blood + tellurite) may improve the examination sensitivity of bacteria causing diphtheria identification in the laboratory.
Diarrheal diseases are the second cause of the high morbidity and mortality in children under five years old. According to the Basic Health Survey 2018 conducted by the Ministry of Health, the prevalence of diarrheal diseases among children under five years old that were diagnosed by healthcare workers was 11.0%. The aim of this study was to describe the enteric pathogen isolated from children with diarrhea. The study was conducted in five cities in Indonesia: Jakarta, Serang, Denpasar, Makassar, and Mataram. The Inclusion criteria were children aged one month to five years old, with diarrhea that was diagnosed by a healthcare worker. The rectal swabs were sent to the Centre for Research and Development for Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health in Jakarta. Virus and Enterotoxigenic Escherichia coli (ETEC) identification by using multiplex PCR from Seegene, meanwhile bacteria identified by conventional method. As many as 2626 children under five years old participated in this study. The highest viral pathogen that causes diarrhea is viral 1.807 (68,81%) and 486 (18,56%). The virus etiology was Rotavirus 982 (54,34%) cases, followed by Adenovirus 916 (50.69) cases, Norovirus II 444 (24,57%) cases, meanwhile the bacteria pathogen were Enterotoxigenic Escherichia coli detected in 262 (9,98%) followed by Campylobacter jejuni and Shigella spp. This study described Rotavirus is the prevalence etiology of diarrhea among children under five years old followed by Adenovirus and Norovirus, some other cases reported the cause of diarrhea were bacteria ETEC E. coli followed Campylobacter jejuni, Shigella spp, etc.
Pertussis cases have been reported most frequently in developed countries, but they are predicted to be the most prevalent in developing countries. Indonesia, a developing country, routinely conducts case-based surveillance for pertussis. We reviewed the data on pertussis cases and close contacts based on clinical sample documents examined in the National Reference Laboratory for pertussis, Indonesia (2016–2020). Our objective was to analyze the laboratory and epidemiological aspects of pertussis cases and close contacts, particularly to evaluate the implementation of a 5-year case-based surveillance of pertussis in Indonesia. Data were collected from sample documents and annual laboratory reports between January 2016 and December 2020. We analyzed the proportion of pertussis cases and close contacts by geographic region, year, age, and sex. We used the χ2 test to correlate the laboratory and epidemiological data. In total, 274 clinical cases of pertussis and 491 close contacts were recorded in 15 provinces. The peak number of cases occurred in 2019, with a positivity rate (percentage of laboratory-confirmed cases) of 41.23% (47/114). Clinical cases were dominated by infants aged <1 year (55.5%), and 52.9% of them were aged <6 months. Similarly, 72.3% (68/94) of the laboratory-confirmed cases were infants. Both clinical cases and positivity rates tended to be higher in females (155 cases, 38.1%) than in males (119 cases, 29.4%). No confirmed cases were found in children aged ≥10 years, although positive results still occurred in close contact. Age-group and laboratory-confirmed cases were correlated (p = 0.00). Clinical and confirmed cases of pertussis occurred mostly in the early age group and may be lower in those aged ≥10 years, especially in confirmed cases. New policies are needed for pertussis prevention at an early age, as well as the application of serology tests to increase laboratory-confirmed cases in children aged ≥10 years.
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