Mulya Rahma Karyanti

Dengue seroprevalence and force of primary infection in a representative population of urban dwelling Indonesian children

Background Indonesia reports the second highest dengue disease burden in the world; these data are from passive surveillance reports and are likely to be significant underestimates. Age-stratified seroprevalence data are relatively unbiased indicators of past exposure and allow understanding of transmission dynamics. Methodology/Principal Findings To better understand dengue infection history and associated risk factors in Indonesia, a representative population-based cross-sectional dengue seroprevalence study was conducted in 1–18-year-old urban children. From October to November 2014, 3,210 children were enrolled from 30 geographically dispersed clusters. Serum samples were tested for anti-dengue IgG antibodies by indirect ELISA. A questionnaire investigated associations between dengue serologic status and household socio-demographic and behavioural factors. Overall, 3,194 samples were tested, giving an adjusted national seroprevalence in this urban population of 69.4% [95% CI: 64.4–74.3] (33.8% [95% CI: 26.4–41.2] in the 1–4-year-olds, 65.4% [95% CI: 69.1–71.7] in the 5–9-year-olds, 83.1% [95% CI: 77.1–89.0] in the 10–14-year-olds, and 89.0% [95% CI: 83.9–94.1] in the 15–18-year–olds). The median age of seroconversion estimated through a linear model was 4.8 years. Using a catalytic model and considering a constant force of infection we estimated 13.1% of children experience a primary infection per year. Through a hierarchical logistic multivariate model, the subject’s age group (1–4 vs 5–9 OR = 4.25; 1–4 vs. 10–14 OR = 12.60; and 1–4 vs 15–18 OR = 21.87; p<0.0001) and the number of cases diagnosed in the household since the subject was born (p = 0.0004) remained associated with dengue serological status. Conclusions/Significance This is the first dengue seroprevalence study in Indonesia that is targeting a representative sample of the urban paediatric population. This study revealed that more than 80% of children aged 10 years or over have experienced dengue infection at least once. Prospective incidence studies would likely reveal dengue burdens far in excess of reported incidence rates.

Isolation and complete genome analysis of neurotropic dengue virus serotype 3 from the cerebrospinal fluid of an encephalitis patient

Although neurological manifestations associated with dengue viruses (DENV) infection have been reported, there is very limited information on the genetic characteristics of neurotropic DENV. Here we describe the isolation and complete genome analysis of DENV serotype 3 (DENV-3) from cerebrospinal fluid of an encephalitis paediatric patient in Jakarta, Indonesia. Next-generation sequencing was employed to deduce the complete genome of the neurotropic DENV-3 isolate. Based on complete genome analysis, two unique and nine uncommon amino acid changes in the protein coding region were observed in the virus. A phylogenetic tree and molecular clock analysis revealed that the neurotropic virus was a member of Sumatran-Javan clade of DENV-3 genotype I and shared a common ancestor with other isolates from Jakarta around 1998. This is the first report of neurotropic DENV-3 complete genome analysis, providing detailed information on the genetic characteristics of this virus.

Pola Sensitifitas Bakteri dan Penggunaan Antibiotik

Latar belakang .Penggunaan antibiotik yang tidak tepat bisa mengakibatkan resistensi obat, meningkatkan morbiditas, mortalitas dan biaya pengobatan. Faktor utama menentukan tepatnya penggunaan antibiotik adalah pemilihan antibiotik yang tepat, berdasarkan bakteri penyebab dan sensitifitasnya terhadap antibiotik. Sampai saat ini penelitian penggunaan antibiotik dan pola sensitifitas bakteri pada pasien anak di RS Penyakit Infeksi Sulianti Saroso belum pernah dilakukan. Tujuan. Mengetahui pola bakteri dan sensitifitasnya terhadap antibiotik pada pasien anak yang dirawat di RSPI SS. Metode. Penelitian dilakukan secara deskriptif, retrospektif dari rekam medis pasien rawat inap anak nonbedah, umur 1 bulan-15 tahun, dan hasil kultur tumbuh bakteri, periode tahun 2010 dan 2011. Pasien PICU dan pasien yang dalam perawatannya didiagnosis sebagai pasien bedah dikeluarkan dari penelitian. Hasil. Kultur dilakukan pada 286/1256 (22,8%) sampel, tumbuh bakteri pada 96/286(33,6%). Kelompok bayi 1bulan-<1tahun 14 (26,9%) paling banyak dilakukan kultur. Hasil kultur terbanyak S. typhi11/54 (20,4%), E. coli9/54 (16,7%) dan S epidermidis 7 (13%). S. typhisensitif 100% terhadap sefotaksim, seftriakson, kloramfenikol, dan kotrimoksazol. SensitifitasE. coli62,5% terhadap kloramfenikol, tetapi kurang sensitif terhadap antibiotik lainnya. Kesimpulan. Bakteri terbanyak ditemukan S typhi (20.4%)danE coli (16.7%). Sensitifitas S typhi 100% terhadap semua antibiotik yang digunakan (kotrimoksazol, tiamfenikol, kloramfenikol, sefotaksim dan seftriakson). Penggunaan antibiotik untuk S typhimasih bisa dengan lini pertama antibiotik sejauh tidak ada kontra indikasinya.