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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.

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.

Meningitis kriptokokus adalah infeksi sistem saraf pusat dengan onset subakut atau kronis, disebabkan oleh sel ragi berkapsul Cryptococcus neoformans. Pasien dengan MK biasanya adalah pasien imunodefisiensi/imunokompromais. Di negara-negara Asia Tenggara, penyakit infeksi oportunistik yang sering dijumpai pada pasien Human Immnunodeficiency Virus (HIV) stadium lanjut adalah MK. Meningitis kriptokokus juga ditemukan pada riwayat penggunaan steroid sistemik, terapi immunosuppresive, transplantasi organ, gagal ginjal, keganasan, penyakit reumatik, diabetes melitus, dan systemic lupus erythematosus atau bahkan pada pasien yang imunokompeten sekalipun. Penelitian ini merupakan studi deskriptif retrospektif potong lintang yakni pengambilan data rekam medis hasil pemeriksaan neurologis dan analisa carian serebrospinal (CSS) penderita MK yang dirawat di Siloam Hospitals Lippo Village dari bulan Januari 2009 hingga September 2014. Teknik pengumupulan data pada penelitian ini dengan mengumpulkan data dari rekam medis. Dari 8 subyek penelitian yang memenuhi kriteria inklusi diperoleh hasil: pasien meningitis kriptokokus dengan HIV (+) sebanyak 6 orang (75%) dan dengan HIV (-) sebanyak 2 orang (25%). Proporsi pria dan wanita sebesar 3:1. Rentang usia subyek dari 4 hingga 55 tahun dimana sebagian besar subyek penelitian berusia sekitar 20-40 tahun dengan hasil pemeriksaan HIV (+). Saat masuk rumah sakit, secara keseluruhan gejala yang paling sering ditemukan pada subyek berupa nyeri kepala (87.5%). Meskipun memiliki sejumlah kelemahan data hasil penelitian ini diharapkan dapat bermanfaat bagi perkembangan neurologi khususnya neuroinfeksi di Banten. Di masa yang akan datang diharapkan dapat dilakukan penelitian dengan skala yang lebih besar dan komprehensif.

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.

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.

The World Health Organization (WHO) 1997 / WHO (Regional Office of South-East Asia) SEARO 2011 and WHO 2009 dengue guideline emphasized different aspects. Indonesia as a limited resources hyperendemic area will a large number of patients hopitalized using the WHO 2009. This study compared the adult non severe dengue cases in out-patient settings using both classification. This retrospective cohort study on 85 patients found 48 dengue cases confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) on the period of August 2011 – January 2012, in 5 out-patient settings health facilities. The sensitivity and spesificity of WHO 1997 / WHO SEARO 2011 were 48.93% and 23.68%, while the WHO 2009 were 78.72% and 68.42%. Out of 8 secondary infection patients, 25% in WHO 1997 / WHO SEARO 2011 and 0% in WHO 2009 were classified as the more severe form. The WHO 2009 shown higher sensitivity and specificity, but the WHO 1997 / WHO SEARO 2011 could diagnose more patient that would have suffered severe forms of dengue and also more secondary infection who have the probability of severe forms compared to WHO 2009.Keywords: dengue, out-patient setting, world health organization

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.