Melioidosis is known to be highly endemic in parts of southeast Asia and northern Australia; however, cases are rarely reported in Indonesia. Here we report three cases of melioidosis in Makassar, South Sulawesi, Indonesia occurring between 2013 and 2014. Two patients died and the other was lost to follow-up. Burkholderia pseudomallei isolates from all three cases were identified by the VITEK2 Compact installed in the hospital in 2012. None of the three patients reported received antimicrobials recommended for melioidosis because of the delayed recognition of the organism. We reviewed the literature and found only seven reports of melioidosis in Indonesia. Five were reported before 1960. We suggest that melioidosis is endemic throughout Indonesia but currently under-recognized. Training on how to identify B. pseudomallei accurately and safely in all available microbiological facilities should be provided, and consideration should be given to making melioidosis a notifiable disease in Indonesia.
BackgroundChikungunya virus (CHIKV) is often overlooked as an etiology of fever in tropical and subtropical regions. Lack of diagnostic testing capacity in these areas combined with co-circulation of clinically similar pathogens such as dengue virus (DENV), hinders CHIKV diagnosis. To better address CHIKV in Indonesia, an improved understanding of epidemiology, clinical presentation, and diagnostic approaches is needed. Methodology/Principal findingsAcutely hospitalized febrile patients �1-year-old were enrolled in a multi-site observational cohort study conducted in Indonesia from 2013 to 2016. Demographic and clinical data were collected at enrollment; blood specimens were collected at enrollment, once during days 14 to 28, and three months after enrollment. Plasma samples negative for DENV by serology and/or molecular assays were screened for evidence of acute CHIKV infection (ACI) by serology and molecular assays. To address the co-infection of DENV and CHIKV, DENV cases were selected randomly to be screened for evidence of ACI. ACI was confirmed in 40/1,089 (3.7%) screened subjects, all of whom were DENV negative. All 40 cases initially received other diagnoses, most commonly dengue fever, typhoid fever, and leptospirosis. ACI was found at five of the seven study cities, though evidence of prior CHIKV exposure was observed in 25.2% to 45.9% of subjects across sites. All subjects were assessed during hospitalization as mildly or moderately ill, consistent with the Asian genotype of PLOS NEGLECTED TROPICAL DISEASES
Infeksi virus dengue adalah salah satu masalah kesehatan masyarakat yang menimbulkan dampak sosial dan ekonomi. Pemeriksaanrasio netrofil/limfosit sangat mudah dan cepat dilakukan. Rasio netrofil/limfosit dihubungkan dengan perembesan plasma di pasienDBD. Untuk mengetahui rasio netrofil/limfosit pasien DBD berdasarkan derajat DBD. Penelitian ini merupakan penelitian retrospektifdengan mengambil data rekam medis RSUP Dr. Wahidin Sudirohusodo Makassar masa waktu Juni 2013–Juni 2015. Uji statistikdilakukan dengan uji Mann-Whitney, uji t dan uji kenasaban Spearman. Didapatkan 96 subjek penelitian yang memenuhi patokankesertaan. Rerata umur subjek penelitian 53,5 tahun (18–89), sebagian besar laki-laki 56,25% dan perempuan 43,75%. Uji Mann-Whitney menunjukkan median leukosit grade I 4,45 (1,10–28,80), grade II 3,25 (1,60–9,20) dengan p=0,03. Median netrofil gradeI 2,41 (0,47–24,65), grade II 1,16 (0,29–6,50) dengan p=<0,01. Median trombosit grade I 113,50 (5,00–342,000), grade II 76,50(3,00–274,00) dengan p=0,009. Rasio netrofil/limfosit grade I 2,19 (0,61–17,25), grade II 0,80 (0,18–5,91) dengan p=<0,01. Ujikenasaban Spearman didapatkan nilai p<0,001 menunjukkan kenasaban antara rasio netrofil/limfosit dan derajat DBD bermakna.Nilai kenasaban Spearman sebesar -0,68 menunjukkan hubungan terbalik, semakin rendah rasio netrofil/limfosit, semakin berat derajatDBD. Uji t menunjukkan tidak ada perbedaan bermakna nilai limfosit dan hematokrit pasien DBD grade I dan II. Rasio netrofil/limfositpada DBD grade I lebih tinggi daripada grade II, semakin rendah rasio netrofil/limfosit semakin berat derajat DBD.
Vancomycin Resistant Staphylococcus aureus (VRSA) refers to bacteria that have complete resistance to Vancomycin. The increasing prevalence of VRSA can be a significant clinical problem with the limited therapeutic options. Therefore, the identification of VRSA is necessary to improve the management of antibiotic therapy, infection control and to prevent the occurrence of wider resistance. This retrospective descriptive study used secondary data of antibiotic susceptibility test on Staphylococcus aureus identified using VITEK 2 and patient medical records from January 2015 to December 2016. The data is processed using SPSS. Of 387 Staphylococcus aureus isolates obtained, 45 (11%) were VRSA. The most common VRSA isolates were male patients (57.8%) with the mean age being 41-60 years old (35.6%). The treatment ward with the most VRSA isolates were from surgical ward (20%), and internal medicine ward (15.6%) whereas the VRSA isolates from outpatient record were from surgical department (8.9%), dermatology department and ENT department (2.2%). The most common specimens were blood (28.9%), pus (26.7%), and sputum (20.0%). The highest prevalence of VRSA was found in the use of ≥ 3 invasive medical devices and from clinical outcome was found 11 (24.4%) of the patients died. Linezolid, Quinupristin / Dalfopristin, Tigecycline, and Nitrofurantoin as a therapeutic option have > 90% sensitivity. Identification of VRSA in Dr. Wahidin Sudirohusodo Hospital Makassar emphasized the need for immediate action by infection control division, especially in related units to prevent the transmission.
About 70% of all nosocomial infections occur in surgical patients. In open fracture, there is contact with the environment or unsterilebody compartment, so that bacterial contamination may occur and cause infection. Besides debridement, prophylactic antibiotics havebeen used as a standard procedure in the open fracture management. This procedure may cause antibiotics resistance leading to increasethe number of infections. The aim of this retrospective study was to know the characteristics, microbial pattern, and sensitivity of 35cultures and sensitivity test of open fracture patients in Orthopaedics Department of Wahidin Sudirohusodo Hospital during the period ofJune 2009–June 2010. The most common bacteria found were Proteus mirabilis (26%), Klebsiella pneumonia (14. 8%), and Providenciaalcalifaciens (14%). The sensitivity test for antimicrobials showed that most of the 19 antimicrobials, were resistant. The sensitiveantimicrobial is Meropenem.
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