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Abstrak :
Penelitian ditujukan untuk mengetahui prevalensi tinea kruris dan kandidosis kutis intertriginosa pada pekerja wanita di bagian Weaving dan Finishing yang bekerja di lingkungan kerja yang panas dan lembab di pabrik tekstil PT S. Metode penelitian menggunakan desain kros-seksional dengan uji statistik Chi-kuadrat dan Fisher dan analisis multivariat Logistik - regresi. Pengukuran tingkat pajanan panas dengan "Indeks Suhu Basah Bola" (ISBB). Penelitian dilakukan pada 200 responden, bekerja pada lingkungan kerja yang berbeda, terdiri dari 100 responden terpajan panas dan 100 responden terpajan panas yang lebih rendah. Pengumpulan data dilakukan dengan kuesioner, pengamatan, pemeriksaan fisik dan laboratorium serta pengukuran lingkungan kerja. Hasil penelitian menunjukkan tekanan panas di Weaving sebesar 32.9° C ISBB (NAB 26,5) dan kelembaban relatif 56.4%. Pemeriksaan dari semua responden menunjukkan 25,5% responden mengalami tinea kruris dan atau kandidosis kutis intertriginosa. Dari analisis bivariat, variabel lingkungan kerja, masa kerja, status gizi dan kebersihan pribadi memiliki hubungan kemaknaan dengan kejadian tinea kruris dan atau kandidosis kutis intertriginosa (p< 0,035). Faktor paling berpengaruh terhadap prevalensi tinea kruris dan atau kandidosis kutis intertriginosa adalah kebersihan pribadi (OR>10,348).

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Prevalence Of Tinea Cruris And Candidosis Cutis Intertriginosa With Relation Of Heat And Humidity In Women Workers Of Textile Factory PT "S" In Tangerang The study is to reveal the prevalence of tinea cruris and candidosis cutis intertriginosa among women workers at weaving and finishing departement exposured to heat stress and humidity in a textile factory (PT. S) in Tangerang. Cross sectional method was applied in the study. Chi-square and Fisher, and Logistic regression were used for statistical analysis. Heat exposure level in the working environment measured by the Wet Bulb Globe Temperature Index. This study examined 200 workers in different working environment, 100 workers exposed to heat, and 100 workers exposed to a relatively lower heat stress. To see the impact of heat stress and humidity to the workers, observation was done, utilizing questionnaire, physical, and laboratory examination and working environment measurement. This study reveals the heat stress in weaving reached 32.9°C WBGT and 56.4% relative humidity. The examination showed that 25.5% of respondents have tinea cruris and candidosis cutis intertriginosa. From bivariate analysis, it is revealed that working environment, working period, nutrition status, personal hygiene showed significant relationship with the prevalence of tinea cruris and candidosis cutis intertriginosa (p < 0.035). The dominant factor is personal hygiene (OR > 10,348).

Abstrak :
Kandidiasis orofaring yang disebabkan oleh C. albicans merupakan infeksi oportunistik yang paling sering terjadi pada pasien HIV/AIDS. Flukonazol telah digunakan secara luas untuk terapi kandidiasis. Beberapa penelitian saat ini telah melaporkan terjadinya resistensi spesies Candida terhadap flukonazol terutama pada pasien HIV/AIDS. Tujuan penelitian ini untuk melihat besarnya resistensi spesies Candida yang diisolasi dari pasien HIV/AIDS juga ingin diketahui categorical agreement antara metode otomatik Vitek2 dengan metode manual difusi cakram dalam menguji kepekaan spesies Candida terhadap antijamur. Penelitian potong lintang ini terdiri dari 137 isolat Candida yang didapatkan dari 86 subyek HIV/AIDS dengan Kandidiasis Orofaring di RSCM. Data karakteristik subyek dicatat dan dilakukan pengambilan swab orofaring. Identifikasi spesies dilakukan menggunakan media CHROMagar dan YST Vitek2. Uji kepekaan dilakukan memakai metode otomatik Vitek2 dan manual difusi cakram, kemudian dicari interpretasi error dan categorical agreement antara kedua metode. Didapatkan 8 spesies Candida yaitu C.albicans sebesar 77 (55,3%), C.glabrata 21(15,3%), C.tropicalis 19 (13,9%), C.krusei 9 (6,7%), C.parapsilosis 5 (3,6%), C.dubliniensis 4 (2,9%), C.famata 1 (0,76%), C.magnoliae 1 (0,76%). Angka resistensi C.albicans dengan Vitek2 terhadap FCA,VOR,AMB, dan FCT berturut turut adalah 0; 1,3%; dan 2,6%; dan 0, C.glabrata 9,5%; 9,5%; 5%; dan 0, C.krusei 100%; 0; 11,1%; dan 0, C.dubliniensis 0; 0; 25%; dan 0. Angka resistensi C.albicans dengan difusi cakram terhadap FCA,VOR,AMB berturut turut adalah 2,6%; 2,6%; 0, C.glabrata 52,4%; 23,8%; 23,8%, C.tropicalis 5,3%; 5,3%; 0, C.krusei 100%; 0; 11,1%, C.parapsilosis 0; 0; 2%. Categorical agreement uji resistensi antara metode otomatik Vitek2 dengan manual difusi cakram terhadap FCA, VOR, dan AMB berturut turut untuk C.albicans yaitu 90,9%; 92,2%; dan 98,7%, C.glabrata 19,05%; 71,4%; dan 80,95%, C.tropicalis 89,5%; 89,5%; dan 89,5%, C.krusei 100%; 88,9%; dan 55,6%, C.parapsilosis 100%; 100%; dan 80%, serta C.dubliniensis 75%; 100%; dan100%. Kami menyimpulkan C.albicans masih merupakan penyebab kandidiasis tersering, dan angka resistensi isolat Candida yang didapatkan dari subyek HIV/AIDS dengan kandidiasis orofaring di RSCM cukup rendah, kecuali C.krusei dan C.glabrata. Total categorical agreement untuk seluruh spesies Candida antara Vitek2 dengan difusi cakram cukup baik, kecuali untuk C.glabrata. ...... Oropharyngeal candidiasis caused by C. albicans is the most common opportunistic infection in patients with HIV / AIDS. Fluconazole has been used widely for the treatment of candidiasis. Recent studies have reported the occurrence of fluconazole resistance to Candida species, especially in HIV / AIDS patients. The purpose of this study is to determine frequency of resistance of Candida species isolated from patients with HIV / AIDS to antifungal drugs. Further, to explore the categorical agreement between Vitek2 automatic with manual disc diffusion method to determine the sensitivity of Candida species. This cross-sectional study conducted between October 2012 and March 2013 yield on 137 Candida isolates from 86 oropharyngeal candidiasis HIV/AIDS patients at RSCM. Data on baseline characteristic were recorded and isolation of Candidia species was obtained by performing oropharyngeal swab. Species identification using CHROMagar media and YST Vitek2 and sensitivity test by automatic Vitek2 methods and manual disc diffusion was performed. The error interpretation and categorical agreement between the two methods was then calculated We identified total of eight Candida species, 77 (55.3%) C.albicans and non albicans included C.glabrata 21 (15.3%) ; C.tropicalis 19 (13.9%) ; 9 (6.7%) C.krusei; 5 (3.6%) C.parapsilosis; 4 (2.9%) C.dubliniensis and 1 (0.76%) for each C.famata and C.magnoliae. Vitek2 resistance rates against C.albicans with fluconazole (FCA), voriconazole (VOR), amphoterisin B (AMB), and flucytosin (FCT) were 0; 1.3%; 2.6% and 0 respectively, C.glabrata 9.5%; 9.5%; 5% and 0, respectively. C.krusei 100%; 0; 11.1%, and 0 respectively. C.dubliniensis 0; 0; 25%, and 0. Using disc diffusion the resistance of FCA, VOR, AMB was 2.6%, 2.6%, 0 for C.albicans, C.glabrata 52.4%, 23.8%, 23.8%, C. tropicalis 5.3%, 5.3%, 0, C.krusei 100%; 0; 11.1%, C.parapsilosis 0; 0; 2%. Total categorical agreement for all Candida species against FCA, VOR and AMB, Vitek2 and disc diffusion method Vitek2 was C.albicans 90,9%; 92,2%; and 98,7%, C.glabrata 19,05%, 71,4%, and 80,95%, C.tropicalis 89,5%, 89,5%, and 89,5%, C.krusei 100%, 88,9%, and 55,6%, C.parapsilosis 100%, 100%, and 80% C.dubliniensis 75%, 100%, and 100% respectively. C.albicans still found as the most common caused of oropharyngeal candidiasis and remained sensitive to antifungal treatment. Among the non albicans species, susceptibilities of C.krusei and C.glabrata to antifungal treatment was poor. Sensitivity test using Vitek2 and disc diffusion methods resulted in excellent to

Abstrak :
Kandidemia merupakan salah satu bentuk kandidosis sistemik. Prevalensinya meningkat dalam dasawarsa terakhir karena mcningkatnya populasi pasien imunokompromis akibat berbagai sebab seperti prosedur kedokteran modern. Penelitian ini mcncliti tentang spesies Candida penyebab kandidemia, pola kepekaan Candida terhadap flukonazol dan vorikonazol dengan metode difusi cakram serta sumber infeksi eksogcn di lingkungan perawatan Perinatologi RSUPN-CM. Dari 187 sampel darah diperiksa dan dibiak, 95 positif (prevalensi 50,8%) dan berhasil diisolasi sebanyak 109 spesies Candida. Spesies yang dominan adalah C. zropicalis. Pola kepekaan Candida spp terhadap ilukonazol lebih beragam dibanding vorikonazol. Belum ditemukan sumbcr inf¢ksi eksogen dilingkungan rumah sakit. ......Candidemia is one of the clinical feature of systemic candidosis. Its prevalence increasing rapidly in the last decade due to increased number of immune compromised population. Thus study is aimed to determine the species of Candida that caused candidemia, its susceptibility patten against lluconazol and voriconazol using disk diffusion method and with evaluation to determine exogenous sources of infection on perinatology ward RSUPN-CM. 95 out of 187 blood samples were positive (prevalence 50,8%) with number of Candida spp. Isolated were lO9, C. Tropicalis was the predominant species. Susceptibility pattem against iluconazol is more variable comparing to voriconazol. No exogenous sources of infection found.

Abstrak :
Pendahuluan: Kandidiasis merupakan penyakit infeksi yang disebabkan oleh jamur jenis Candida sp. Beberapa jenisnya adalah Candida albicans, spesies Candida sp. yang menjadi etiologi terbanyak kasus kandidiasis dan Candida krusei, spesies Candida sp. yang memiliki resistensi tertinggi terhadap flukonazol. Dewasa ini, kejadian kandidiasis semakin meningkat disebabkan tingginya insidens HIV dan semakin maraknya penggunaan antibiotika spektrum luas. Tujuan dari penelitian ini adalah untuk mengetahui pola kepekaan Candida albicans dan Candida krusei terhadap antifungal flukonazol secara in vitro di Indonesia. Metode: Penelitian ini merupakan penelitian observasional in vitro menggunakan data sekunder hasil uji kepekaan difusi cakram kultur Candida albicans dan Candida krusei yang didapat dari spesimen klinik yang masuk ke Laboratorium Departemen Parasitologi Fakultas Kedokteran Universitas Indonesia periode 2013-2018. Setiap spesimen dimasukkan cakram antifungal flukonazol dan dilakukan interpretasi hasil kepekaan sesuai panduan dari CLSI yang terdiri atas sensitif, peka tergantung dosis, dan resisten. Hasil: Uji kepekaan Candida albicans terhadap flukonazol menunjukkan dari 1554 isolat Candida albicans didapatkan 1545 isolat (99,421%) sensitif, 4 isolat (0,257%) peka tergantung dosis, dan 5 isolat (0,322%) resisten. Sementara itu, uji kepekaan Candida krusei terhadap flukonazol menunjukkan dari 191 isolat Candida krusei, didapatkan 96 isolat (50,262%) sensitif, 4 isolat (2,094%) peka tergantung dosis, dan 91 isolat (4,31%) resisten. Hasil uji statistik menunjukkan terdapat perbedaan yang signifikan antara pola kepekaan Candida albicans dan Candida krusei terhadap antijamur flukonazol secara in vitro (p <0,001). Kesimpulan: Candida krusei memiliki presentase resistensi terhadap flukonazol yang lebih tinggi dibandingkan Candida albicans. ......Introduction: Candidiasis is an infectious disease caused by a fungus type Candida sp. Several types of them are Candida albicans, species of Candida sp. which became the most etiological cases of candidiasis and Candida krusei, species of Candida sp. which has the highest resistance to fluconazole. Nowadays, the incidence of candidiasis is increasing due to the high incidence of HIV and the increasingly widespread use of broad-spectrum antibiotics. The purpose of this study was to determine the pattern of sensitivity of Candida albicans and Candida krusei to antifungal fluconazole in vitro in Indonesia. Method: This study was an in vitro observational study using secondary data from the diffusion sensitivity test of Candida albicans and Candida krusei culture discs obtained from clinical specimens that entered the Laboratory of the Department of Parasitology, Faculty of Medicine, University of Indonesia, 2013-2018. Each specimen was inserted fluconazole antifungal discs and interpreted the sensitivity results according to the guidelines of CLSI which consisted of sensitive, dose-dependent, and resistant. Result: Candida albicans sensitivity to fluconazole showed that from 1554 Candida albicans isolates of which 1545 isolates (99.421%) were sensitive, 4 isolates (0.257%) were susceptible dose dependent (SDD), and 5 isolates (0.322%) were resistant. Meanwhile, Candida krusei sensitivity to fluconazole showed that from 191 Candida krusei isolates of which 96 isolates (50.262%) were sensitive, 4 isolates (2.094%) were susceptible dose dependent (SDD), and 91 isolates (4.31%) were resistant. Statistical test results showed that there were significant differences between the sensitivity patterns of Candida albicans and Candida krusei to fluconazole antifungals in vitro (p <0.001). Conclusion: Candida krusei has a higher percentage of resistance to fluconazole than Candida albicans.

Abstrak :
Latar belakang: Kandidiasis merupakan infeksi yang disebabkan oleh anggota genus jamur Candida, dikaitkan dengan morbiditas serta mortalitas tinggi. Telah terjadi peningkatan jumlah isolat spesies non-albicans (NAC), salah satunya C. krusei. Jamur ini memiliki resistensi alami terhadap flukonazol, dan merespon buruk terhadap terapi antijamur, dengan mortalitas 40–58%. Salah satu mekanisme molekuler terjadinya resistensi adalah penurunan akumulasi obat intraseluler akibat pompa efluks (protein ATP-binding cassette; ABC). Analisis bioinformatika sekuens protein ABC2 C. krusei dapat memberikan pemahaman komprehensif terkait mekanisme molekuler yang terlibat. Metode: Penelitian ini merupakan studi eksperimental observasional untuk mengkarakterisasi sekuens gen dan protein ABC2 Candida krusei. Sekuens didapatkan dari UniProtKB dan GenBank, lalu dianalisis menggunakan BLAST pada genom 18 sampel C. krusei dan spesies Candida lainnya. Analisis filogeni dilakukan menggunakan program MEGA11. Pemodelan struktur 3D didapatkan dari I-TASSER, AlphaFold, dan SWISS-MODEL. Prediksi mutasi berefek dicari menggunakan SNAP2. Hasil: Sekuens ABC2 didapatkan pada seluruh spesimen, utamanya pada kromosom 2, dengan panjang 358 bp. ABC2 memiliki homolog pada C. albicans, C. tropicalis, C. glabrata, dan C. parapsilosis dengan kemiripan konsisten. Analisis filogenetik menunjukkan kekerabatan terdekat dengan protein pada C. glabrata, meski kurang didukung secara statistik. Pemodelan 3D menghasilkan struktur yang tersusun mayoritas oleh alfa-heliks, area pengikatan ligan ADP, dan kemiripan terhadap transporter Saccharomyces cerevisiae. Prediksi varian efek oleh SNAP2 mengidentifikasi residu G16 sebagai area berpotensi berpengaruh signifikan pada fungsi protein. Kesimpulan: Sekuens protein ABC2 C. krusei menunjukkan divergensi genetik dari homolog-homolognya di spesies Candida lain, meski kurang didukung secara statistik; belum dapat ditentukan hubungan kausal antara divergensi dengan peran ABC2 dalam resistensi intrinsik flukonazol C. krusei. Profil mutasi yang diprediksi menunjukkan residu G16 sebagai asam amino dengan potensi efek tertinggi terhadap fungsi protein ABC2; hubungannya dengan resistensi flukonazol belum dapat dijelaskan, sebab residu tidak terletak pada area pengikatan ligan. Dari pemodelan 3D, ditemukan variasi struktur alfa heliks ABC2 jika dibandingkan dengan CDR4 C. albicans. ......Background: Candidiasis is an infection caused by members of the genus Candida, associated with high morbidity and mortality. There has been an increase in the number of non-albicans species (NAC) isolates, among them C. krusei. Having a natural fluconazole resistance, C. krusei responds poorly to antifungal therapy, with 40–58% mortality. One molecular mechanisms of resistance is intracellular drug accumulation reduction due to efflux pumps (ATP-binding cassette protein; ABC). Bioinformatics analysis of C. krusei ABC2 protein sequences could elucidate the mechanisms involved. Methods: This was an observational-experimental study characterizing the gene and protein sequences of C. kruseiABC2. Sequences obtained from UniProtKB and GenBank were BLAST-searched in the genomes of 18 C. kruseisamples and other Candida. Phylogeny analysis was done using MEGA11. 3D models were obtained from I-TASSER, AlphaFold, and SWISS-MODEL. Prediction of effected mutation was searched using SNAP2. Results: ABC2 sequences were obtained in all specimens, especially on chromosome 2, spanning 358 bp. ABC2 has homologs in C. albicans, C. tropicalis, C. glabrata, and C. parapsilosis with consistent similarities. Phylogenetic analysis showed closest relationship to a C. glabrata protein, although statistically unsupported. 3D-modelling resulted in a structure composed mostly of alpha-helices, ADP-binding areas, and similarity to a Saccharomyces cerevisiae transporter. Prediction of effect variance by SNAP2 identified G16 residue as a potentially significant area of ​​effect on protein function.Conclusions: ABC2 protein shows genetic divergence from its homologs in other Candida, although not statistically supported; the causal relationship between the divergence and its role of ABC2 in C. krusei resistance to fluconazole is undetermined. Predicted mutation profile showed G16 as the residue with the highest potential effect on protein function; its relationship with fluconazole resistance is inconclusive, as it is not located in the ligand binding site. 3D-modelling shows variations in the alpha-helix of ABC2 when compared to C. albicans CDR4.

Abstrak :
Penelitian ini dilakukan dengan tujuan untuk mendapatkan data langka mengenai berapa banyak penderita diabetes yang terkena kandidiasis mulut, karena sampai saat ini di Indonesia belum ada angka/ data tersebut. Diharapkan hasil penelitian ini dapat memberikan data kelainan mulut pada penderita diabetes. Pengambilan usap mulut dilakukan pada penderita diabetes yang datang ke Subg Met.Endokrinologi (Penyakit.Dalam) RSCM, yang kemudian dikirim kebagian Parasitologi FKUI untuk dilakukan pemeriksaan laboratorium. Diagnosa kandidiasis mulut ditegakkan dengan pemeriksaan klinis yang didukung dengan pemeriksaan laboratorium. Hasil Penelitian: Dari 95 penderita diabetes tanpa gigi tiruan yang diteliti didapatkan 42 pria diabetes {44,2%) dan 53 wanita diabetes (55,8%), yang berumur antara 25-80 th. 14 penderita diabetes (14,7%), berumur antara 20-40th. Sedangkan 81 penderita diabetes (85,37.) berumur diatas 40 th. Dan dari 95 usap mulut penderita diabetes setelah dilakukan pemeriksaan langsung terdapat 60% Candida positif, sedangkan pada biakan usap mulut ditemukan 62 penderita diabetes {65,2%) Candida positif. Ternyata dari 62 Candida positif pada biakan usap mulut, 33,9% positif 1, 50% positif 2, dan 16,1% positif 3. Kandidiasis mulut terdapat pada 12 penderita diabetes (12,6%), yang terdiri dari 7 pria dibetes dan 5 wanita diabetes. Dan kandidiasis mulut terdapat pada 70% dari Candida positif 3, 16,1% dari Candida positif 2, sedangkan pada positif 1 tidak terjadi kandidiasis mulut.

Abstrak :
[Latar Belakang: Saat ini insidens infeksi jamur invasif yang disebabkan oleh Candida semakin meningkat. Candida merupakan genus jamur yang paling sering menyebabkan infeksi jamur invasif. Kandidiasis invasif berdampak pada meningkatnya angka mortalitas dan meningkatnya masa rawat dan biaya perawatan. Sampai saat ini di Indonesia belum ada studi yang meneliti tentang prevalensi, karakteristik klinis pasien dan pola sebaran spesies jamur pada pasien kandidiasis invasif dewasa. Tujuan: Mengetahui prevalensi dan karakteristik klinis pasien kandidiasis invasif dewasa di RSCM serta mengetahui pola penyebabnya. Metodologi: Penelitian ini bersifat retrospektif, menggunakan desain potong lintang, berdasarkan data sekunder (rekam medis) pasien sepsis yang dirawat di RSCM sejak bulan Januari 2012 sampai bulan Juni 2014. Dari rekam medik, dicari pasien kandidiasis invasif (KI) berdasarkan kriteria EORTC/MSG tahun 2008. Pada pasien kandidiasis invasif, selanjutnya dilakukan pencatatan data demografis, data klinis dan penunjang, diagnosis, spesies penyebab, jenis obat antifungal dan antibiotik yang diberikan, luaran klinik serta masa rawat. Hasil: Prevalensi pasien kandidiasis invasif di RSCM adalah 12,3%, yakni 91 pasien KI dari 738 pasien sepsis yang rekam mediknya dapat diteliti. Dari 91 pasien KI yang memenuhi kriteria diagnosis EORTC/MSG tahun 2008, didapatkan 35 pasien dengan kategori proven, 31 pasien probable dan 25 pasien possible. Manifestasi klinik KI yang paling sering ditemukan adalah kandidemia dengan penyebab utama Candida albicans. Rerata usia pasien adalah 47,9 tahun yang didominasi oleh pasien medis, dirawat di ruang rawat biasa, non-neutropenia dan menderita syok sepsis. Kebanyakan pasien menderita keganasan, yang seringkali disertai infeksi paru, sedangkan piranti medik yang paling sering digunakan adalah kateter urin. Umumnya pasien mendapat antibiotik cefalosporin generasi tiga, sementara antifungal yang paling sering digunakan adalah flukonazol. Sebagian pasien KI (44%) tidak mendapatkan pengobatan antifungal sistemik. Mortalitasnya sebesar 68,4% dan median masa rawat total adalah 27 hari. Kesimpulan: Prevalensi kandidiasis invasif sebesar 12,3%. Mortalitas akibat kandidiasis invasif cukup tinggi dan C. albicans merupakan spesies yang paling sering ditemukan. ...... Background: Recently, incidence of invasive fungal infection is rising. Candida is the most common cause of invasive fungal infection. Invasive candidiasis contribute to high mortality, prolonged hospitalization and high cost. Until now in Indonesia, there is no study about the prevalence, clinical characteristic and etiologic pathogen of invasive candidiasis in adults. Objective: To study the prevalence, clinical characteristic and etiologic pathogen in adult patients with invasive candidiasis at RSCM. Methods: Retrospective, cross sectional, based on the medical record sepsis patients which hospitalized in January 2012 until June 2014. We traced candidiasis invasive (IC) patients which fulfill EORTC/MSG 2008 diagnostic criteria for IC. We recorded demographic data, clinical and supporting data, diagnosis, etiologic pathogen, antibiotic, antifungal, outcome and length of stay. Results: IC prevalence at RSCM was 12,3%. We have found 91 IC patients from 738 sepsis patients which has complete medical record. The proportion is 35 proven patients, 31 probable patients and 25 possible patients. Candidemia was the most common form of IC and C. albicans was the most common etiologic pathogen. Mean age were 47,9 years, dominated with medical patient, non-neutropenic and septic shock. Most patients had malignancy with lung infection. The most common medical intervention was application of urinary catheter. Most patient was given cephalosporin 3rd generation and the most common antifungal used was fluconazole. Most patient (44%) didn?t get systemic antifungal treatment. Mortality was 68,4% and median length of stay were 27 days. Conclusions: IC prevalence was 12,3%. Mortality because of IC is high and C. albicans is most common etiologic pathogen;Background: Recently, incidence of invasive fungal infection is rising. Candida is the most common cause of invasive fungal infection. Invasive candidiasis contribute to high mortality, prolonged hospitalization and high cost. Until now in Indonesia, there is no study about the prevalence, clinical characteristic and etiologic pathogen of invasive candidiasis in adults. Objective: To study the prevalence, clinical characteristic and etiologic pathogen in adult patients with invasive candidiasis at RSCM. Methods: Retrospective, cross sectional, based on the medical record sepsis patients which hospitalized in January 2012 until June 2014. We traced candidiasis invasive (IC) patients which fulfill EORTC/MSG 2008 diagnostic criteria for IC. We recorded demographic data, clinical and supporting data, diagnosis, etiologic pathogen, antibiotic, antifungal, outcome and length of stay. Results: IC prevalence at RSCM was 12,3%. We have found 91 IC patients from 738 sepsis patients which has complete medical record. The proportion is 35 proven patients, 31 probable patients and 25 possible patients. Candidemia was the most common form of IC and C. albicans was the most common etiologic pathogen. Mean age were 47,9 years, dominated with medical patient, non-neutropenic and septic shock. Most patients had malignancy with lung infection. The most common medical intervention was application of urinary catheter. Most patient was given cephalosporin 3rd generation and the most common antifungal used was fluconazole. Most patient (44%) didn’t get systemic antifungal treatment. Mortality was 68,4% and median length of stay were 27 days. Conclusions: IC prevalence was 12,3%. Mortality because of IC is high and C. albicans is most common etiologic pathogen., Background: Recently, incidence of invasive fungal infection is rising. Candida is the most common cause of invasive fungal infection. Invasive candidiasis contribute to high mortality, prolonged hospitalization and high cost. Until now in Indonesia, there is no study about the prevalence, clinical characteristic and etiologic pathogen of invasive candidiasis in adults. Objective: To study the prevalence, clinical characteristic and etiologic pathogen in adult patients with invasive candidiasis at RSCM. Methods: Retrospective, cross sectional, based on the medical record sepsis patients which hospitalized in January 2012 until June 2014. We traced candidiasis invasive (IC) patients which fulfill EORTC/MSG 2008 diagnostic criteria for IC. We recorded demographic data, clinical and supporting data, diagnosis, etiologic pathogen, antibiotic, antifungal, outcome and length of stay. Results: IC prevalence at RSCM was 12,3%. We have found 91 IC patients from 738 sepsis patients which has complete medical record. The proportion is 35 proven patients, 31 probable patients and 25 possible patients. Candidemia was the most common form of IC and C. albicans was the most common etiologic pathogen. Mean age were 47,9 years, dominated with medical patient, non-neutropenic and septic shock. Most patients had malignancy with lung infection. The most common medical intervention was application of urinary catheter. Most patient was given cephalosporin 3rd generation and the most common antifungal used was fluconazole. Most patient (44%) didn’t get systemic antifungal treatment. Mortality was 68,4% and median length of stay were 27 days. Conclusions: IC prevalence was 12,3%. Mortality because of IC is high and C. albicans is most common etiologic pathogen]

Abstrak :
Latar belakang: Candida glabrata merupakan salah satu penyebab kandidiasis non-albicans dengan prevalensi yang terus meningkat, utamanya pada pasien imunosupresi. Peningkatan resistensi C. glabrata terhadap golongan azol dan nistatin mendorong pencarian pengobatan alternatif. Daun mangkokan (Polyscias scutellaria Fosberg) mengandung zat dengan aktivitas antifungal. Tujuan: Mengetahui aktivitas antifungal ekstrak n-heksana daun mangkokan terhadap pertumbuhan Candida glabrata. Metode: Pada metode difusi cakram dan dilusi terdapat lima kelompok uji dengan konsentrasi ekstrak n-heksana mangkokan 800, 1600, 3200, 6400, 12800 ppm dan kelompok kontrol yang diukur diameter zona hambat pada metode difusi cakram dan nilai Optical Density (OD) pada metode dilusi. Hasil: Pada metode difusi cakram, semua kelompok termasuk kategori resisten (< 20 mm) dengan nilai tertinggi pada konsentrasi 1600 ppm (4,33 ± 0,58 mm). Pada metode dilusi, nilai terendah OD kelompok uji pada konsentrasi 12800 ppm (0,334933±0,00340 AU). Terdapat tren peningkatan aktivitas antifungal yang sejalan dengan peningkatan konsentrasi namun sebaran data tidak normal. Terdapat signifikansi antarkelompok pada metode dilusi (p = 0,025) sedangkan tidak signifikan pada metode difusi cakram (p = 0.553). Simpulan: Ekstrak n-heksana daun mangkokan memiliki KHM 12800 ppm untuk menghambat pertumbuhan C.glabrata dengan KHM metode difusi cakram 1600 ppm dan metode dilusi 12800 ppm. ......Introduction: C.glabrata is non-albicans candidiasis with increasing prevalence and its resistance towards azoles and nistatin, commonly seen in immunocompromised patients. Polyscias scutellaria Fosberg leaves contain substances with antifungal properties. Aim: To evaluate the antinfungal activity of P. scutellaria leaves n-hexana extract against C. glabrata. Methods: In-vitro tests (disc diffusion and dilution test) use five treatment group with P. scutellaria concentration of 800, 1600, 3200, 6400, 12800 ppm and control groups, done in triplo. Disc diffution test is measured with inhibition zone diameter and dilution test with optical density (OD). Result: Disc diffusion test results on all groups shown to be resistance (inhibition zone <20 mm) and the highest inhibition zone in 1600 ppm group (4,33 ± 0,58 mm). Dilution test with the lowest OD value is 12800 ppm group (0,334933±0,00340 AU). A trend of increased antifungal activity with increased concentration is seen, although both tests do not have normal distribution (p<0.05). Disc diffusion test (p = 0.553) showed no significance between groups, while dilution test (p = 0.553) showed otherwise. Conclusion: Leaf n-hexana extract of P. scutellaria can effectively inhibit C.glabrata (MIC 12800 ppm) with MIC value of disc diffusion test and dilution test 1600 ppm and 12800 ppm, respectively.

Abstrak :
Bakterial Vaginosis (BV) merupakan keputihan yang paling banyak dialami oleh wanita usia reproduksi. Menurut SIHA DKI Jakarta tahun 2017, kasus BV dan Kandidiasis menempati posisi terbanyak yaitu 11267. Puskesmas Kecamatan Matraman, memiliki jumlah penduduk perempuan usia reproduksi 15-49 tahun lebih banyak (54%), di bandingkan dengan kelompok umur lainnya. Penelitian ini bertujuan untuk mengetahui gambaran kejadian Bakterial Vaginosis di Puskesmas Kecamatan Matraman. Penelitian dilakukan dengan pendekatan deskriptif, menggunakan desain studi Case Series Report. Hasil penelitian berdasarkan karakteristik pasien, sebagian besar kejadian BV berusia 20-29 tahun (54,8%), sudah menikah (93,1%), berpendidikan menengah (60,7%) dan sedang hamil (68,8%). Berdasarkan perilaku pasien, sebagian besar responden tidak menggunakan kondom (99,2%), memiliki 1 pasangan seksual (67,6%) dan tidak melalukan cuci vagina selama seminggu terakhir (84,2%). Terkait faktor lingkungan pasien, sebagian besar bekerja sebagai ibu rumah tangga (77,3%) dan bertempat tinggal di Kelurahan Pisangan Baru (26,7%). Upaya penguatan kegiatan preventif dan promotif perlu dilakukan oleh Puskesmas Kecamatan Matraman. Adapun kegiatan yang dapat dilakukan dengan memberikan informasi tentang pencegahan infeksi Bakterial Vaginosis pada kelas ibu hamil, pada program Unit Kesehatan Sekolah (UKS) dan pada ibu rumah tangga pada setiap pertemuan di Balai pertemuan warga wilayah kerja Puskesmas Kecamatan Matraman, terutama di lokalisasi prostitusi serta diperlukan upaya screening pada wanita pekerja seks dan pasangan seksualnya bila terdiagnosa BV. ......Bacterial vaginosis (BV) is the most common vaginal infection found in women at the reproductive age. According to SIHA DKI Jakarta in 2017, BV and Candidiasis Infection are the highest case (11,267). Public Health Center of Matraman, East Jakarta, has the biggest women population in the age of 15-49 years (54%). This study aims to describe the occurance of Bacterial Vaginosis at Public Health Center of Matraman. The research is conducted with a descriptive approach, using a case series report study design. The study results found that most of the infected women are aged 20-29 years old (54.8%), married (93.1%), with middle-grade education (60.7%) and pregnant (68.8%). Based on their behaviors, most respondents did not use condoms (99.2%), had onesex partner (67%) and did not clean their vagina during the past week (84.2%). Most of them are housewives (77.3%) and lives in Pisangan Baru Village (26,7%). Prevention and promotion activities regarding the disease needs to be implemented at Matraman Public Health Center. One of the activities is to provide the disease information in pregnancy class, in school health program, and at monthly meeting of the community particularly at the prostitute localization area. A screening program for sex workers and their partners also needs to be implemented.