Anis Karuniawati

Progress towards antimicrobial resistance containment and control in Indonesia

A pilot programme to evaluate Indonesia’s antimicrobial resistance containment plan shows that progress is on the right track, but substantial strengthening is needed, say Harry Parathon and colleagues

Presentation, etiology, and outcome of brain infections in an Indonesian hospital: A cohort study

Background Little detailed knowledge is available regarding the etiology and outcome of CNS infection, particularly in HIV-infected individuals, in low-resource settings. Methods From January 2015 to April 2016, we prospectively included all adults with suspected CNS infection in a referral hospital in Jakarta, Indonesia. Systematic screening included HIV testing, CSF examination, and neuroimaging. Results A total of 274 patients with suspected CNS infection (median age 26 years) presented after a median of 14 days with headache (77%), fever (78%), seizures (27%), or loss of consciousness (71%). HIV coinfection was common (54%), mostly newly diagnosed (30%) and advanced (median CD4 cell count 30/µL). Diagnosis was established in 167 participants (65%), including definite tuberculous meningitis (TBM) (n = 44), probable TBM (n = 48), cerebral toxoplasmosis (n = 48), cryptococcal meningitis (n = 14), herpes simplex virus/varicella-zoster virus/cytomegalovirus encephalitis (n = 10), cerebral lymphoma (n = 1), neurosyphilis (n = 1), and mucormycosis (n = 1). In-hospital mortality was 32%; 6-month mortality was 57%. The remaining survivors had either moderate or severe disability (36%) according to Glasgow Outcome Scale. Conclusion In this setting, patients with CNS infections present late with severe disease and often associated with advanced HIV infection. Tuberculosis, toxoplasmosis, and cryptococcosis are common. High mortality and long-term morbidity underline the need for service improvements and further study.

The Evaluations of Bleach as Decontaminant Solution to Promote The Positivity Rate of Mycobacterium Tuberculosis Culture for Sputum Specimen

Background: Tuberculosis (TB) is still worldwide health problems. Sputum is contaminated by normal flora, that make its should be decontaminated prior to culture. Bleach known as a potent disinfectant, easy to access because it is commercially available, could be the alternative solution as decontaminant in TB culture. Aims Assessing the capability of bleach to promote the positivity rate in TB culture compared by others decontaminant solution. Method We use 35 sputum samples with volume 3-5 ml. The research was conducted at TB laboratory of Faculty of Medicine University of Indonesia, by using 35 samples sputum with positive AFB, 3-5 ml. Each sample was divided into 4 groups that were decontaminated by different methods. The methods are 4%NaOH, 2%NALC-NaOH, 5% oxalic acid and 1% bleach. 1% bleach was prepared from commercially bleach. The positive culture was validated using MPT 64. The culture positivity rate was compared based on its AFB score. Result Bleach had the same 100% positivity rate as the 4% NaOH and NALC for (+2) and (+3) AFB. However, its became smaller rate for the (+1) AFB group, which was 88% for bleach and 96% for NALC and 100% for NaOH. Oxalic acid had the smallest positivity rate in all AFB score compared to the others. Conclusion The positivity rate of the bleach as same as 4% NaOH and NALC for AFB score higher than (+2)

DETEKSI BRUCELOSIS PADA SUSU SAPI DENGAN UJI POLYMERASE CHAIN REACTION (PCR)

Penelitian ini bertujuan mendeteksi brucelosis pada sampel susu sapi dengan uji polymerase chain reaction (PCR) dan membandingkan tingkat sensitivitas dan spesifisitasnya dengan metode milk ring test (MRT). Sebanyak 24 sampel susu sapi yang dikoleksi secara aseptik dari lapang diuji PCR dan MRT. Hasil pengujian menunjukkan bahwa 79,17% (19/24) sampel susu positif brucelosis dengan uji PCR dan 83,33% (20/24) dengan uji MRT. Sensitivitas dan spesifisitas PCR mendeteksi brucelosis masing-masing sebesar 75 dan 100% dibandingkan dengan uji MRT .