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Abstrak :
The aim of this research is to select and analyse lovastatin from isolated molds of Aspergillus spp. from University of Indonesia Culture Collection (UICC). Lovastatin is an inhibitor 3 hydroxy-3-methylglutaryl-coenzyme-A reductase (HMG-CoA reductase) enzyme and a competitive inhibitor of the biosynthesis of cholestrol. The result revealed that out of 40 cultures, 18 cultures (45%) produced lovastatin and 22 cultures (55%) were negative. Aspergillus flavus UICC 360 showed the biggest lovastatin production compared to a number of selected cultures. Thin Layer Chromatography (TLC) analysis showed an amount of Aspergillus with same similarities of Rf value compared to the standard High Performance Chromatography (HPLC) analysis which confirmed that lovastatin Aspergillus flavus UICC 360 has the same retention time with the standard (13.2) minutes.

Abstrak :
Kasus chronic pulmonary aspergillosis (CPA) di Indonesia memiliki prevalensi ±83.000 penderita dengan penambahan kasus baru sebanyak 17.561 pasien dengan riwayat tuberkulosis paru-paru setiap tahunnya, disebabkan oleh kapang Aspergillus spp. Gen calmodulin (CaM) merupakan markah genetik Aspergillus yang memiliki spesifikasi sekuens tinggi untuk membedakan tiap spesies Aspergillus, namun studi mengenai profil sekuensnya pada isolat penderita CPA pasca tuberkulosis di Indonesia belum ditemukan laporannya. Penelitian ini menggunakan gen CaM untuk dianalisis sekuens DNA-nya sekaligus mengidentifikasi dan memantau spesies Aspergillus dari 31 isolat spesimen klinis pasien CPA beriwayat tuberkulosis paru-paru dari 6 rumah sakit umum di Jakarta. Ekstraksi DNA dilakukan menggunakan metode PCI lalu gen CaM diamplifikasi dengan primer Cmd5 dan Cmd6, selanjutnya dilakukan sekuensing DNA. Hasil menunjukkan sekuens gen CaM Aspergillus spp. memiliki wilayah lestari dan polimorfik khas antar spesies intraseksi maupun interseksi (Nigri, Fumigati, dan Flavi). Hasil identifikasi molekuler menunjukkan spesies terdiri dari A. niger (n = 3), A. fumigatus (n = 17), A. flavus (n = 4), A. tubingensis (n = 2), A. welwitschiae (n = 2), A. tamarii (n = 2), dan A. brunneoviolaceus (n = 1). Spesies A. welwitschiae dan A. tamarii dikonfirmasi menjadi salah satu spesies kriptik penyebab CPA pada pasien beriwayat tuberkulosis paru-paru di Jakarta, Indonesia. ......The number of chronic pulmonary aspergillosis (CPA) cases in Indonesia reached a prevalence number ±83.000 patients with increasing rate of 17.561 patients with lung tuberculosis medical history each year, caused by Aspergillus fungi. Calmodulin (CaM) gene is a biomarker for Aspergillus which has high sequence specifity to distinguish among species within the group, however a report to characterize its sequence profile on post-tuberculosis CPA isolates in Indonesia has not yet been found. The aims of this research are to conduct sequence analysis on Aspergillus CaM genes, also to identify and monitor the species from 31 isolates of post-tuberculosis CPA patient’s clinical specimens obtained from 6 public hospital in Jakarta. The results showed that CaM gene from Aspergillus spp. have unique conserved and polymorphic regions both intra/intersectionally (among Nigri, Fumigati, and Flavi) within the genus. The molecular identification results revealed a species consisiting A. niger (n = 3), A. fumigatus (n = 17), A. flavus (n = 4), A. tubingensis (n = 2), A. welwitschiae (n = 2), A. tamarii (n = 2), and A. brunneoviolaceus (n = 1). A. welwitschiae and A. tamarii are confirmed to be one of cryptic species responsible for causing human post-tuberculosis CPA in Jakarta, Indonesia.

Abstrak :
Latar belakang: Infeksi Aspergillus spp. dan aspergillosis menunjukkan prevalensi yang tinggi pada pasien tuberkulosis dan imunokompromais. Antijamur golongan azol, yaitu itrakonazol dan vorikonazol digunakan sebagai tata laksana untuk infeksi Aspergillus spp. Namun, belum ada penelitian di Indonesia yang membahas pola kepekaan kedua jamur tersebut dengan metode difusi cakram. Penelitian ini bertujuan untuk mengetahui profil kepekaan Aspergillus spp. dengan itrakonazol dan vorikonazol serta perbandingan keduanya. Metode: Sampel didapat dari rekam medis dari Laboratorium Mikologi Departermen Parasitologi FKUI periode 2013-2020. Kriteria inklusi yaitu rekam medis dengan kultur positif Aspergillus spp. yang mendapatkan uji kepekaan itrakonazol dan vorikonazol. Pola kepekaan Aspergillus spp. terhadap antijamur itrakonazol dan vorikonazol didapat dari hasil metode difusi cakram yang mana kelompok kepekaan dibagi menjadi sensitif, intermediet, resisten. Hasil: Berdasarkan 94 rekam medis yang dianalisis, didapatkan profil kepekaan antijamur vorikonazol yaitu 91,5% sensitif, 4,3% intermediet, 4,3% resisten, sedangkan itrakonazol yaitu 73,4% sensitif, 4% intermediet, 21% resisten. Pola kepekaan Aspergillus spp. terhadap antijamur vorikonazol dibandingkan dengan itrakonazol menunjukkan hasil yang sangat berbeda bermakna secara statistik (p = 0,000). Kesimpulan: Perbanding pola kepekaan Aspergillus spp. terhadap itrakonazol dengan vorikonazol berbeda bermakna secara statistik. Vorikonazol menunjukkan hasil yang lebih baik pada uji kepekaan tersebut. ......Introduction: Aspergillus spp. infection and Aspergillosis show high prevalence in tuberculosis patients also in immunocompromised individuals. Antifungal drug class azole, namely itraconazole and voriconazole has been used as a treatment for Aspergillus spp. infection. However, no research in Indonesia discusses itraconazole and voriconazole susceptibilities of Aspergillus spp. using disk diffusion method. Our research aims to discover and compare itraconazole and voriconazole susceptibility profile on Aspergillus spp. Method: Samples were obtained from medical records at Mycology Laboratory in Department of Parasitology FMUI from 2013-2020. Inclusion criteria were medical records with a positive culture of Aspergillus spp. that went for itraconazole and voriconazole susceptibility test. Susceptibility test was done by using disk diffusion method. Result: Total of 94 samples were analyzed, voriconazole susceptibility profile was 91,5% sensitive, 4,3% intermediate, 4,3% resistant, while itraconazole susceptibility profile was 73,4% sensitive, 4% intermediate, 21% resistant. Voriconazole susceptibility test compared to itraconazole in Aspergillus spp. shows significant result according to statistical analysis (p= 0,000). Conclusion: Voriconazole susceptibility test compared to itraconazole in Aspergillus spp. shows significant result in statistical analysis. Voriconazole indicates superior result in susceptibility test.

Abstrak :
Pendahuluan: Pasien kanker paru di seluruh dunia meningkat, demikian pula dengan infeksi oportunistiknya, mikosis paru. Meskipun mikosis paru sudah lama dikenal, namunpenelitian yang tepat tentang prevalensi dan insidensinya masih terbatas di Indonesia.Informasi tentang kerentanan itrakonazol sebagai obat oral yang dapat digunakan untuk mengobati mikosis paru juga diperlukan. Tujuan penelitian ini adalah untuk mengetahui profil jamur dan kerentanannya terhadap itrakonazol pada penderita kanker paru. Metode: Desain penelitian deskriptif cross-sectional. Subyek dalam penelitian ini adalah pasien kanker paru yang dirawat di RS Persahabatan dari Januari sampai Mei 2020, dan sputumnya dilakukan pemeriksaan di Laboratorium Mikologi Departemen Parasitologi Universitas Indonesia. Pasien berusia sama atau lebih dari 18 tahun, belum menjalani kemoterapi, dan diperiksa dengan bronkoskopi. Uji kepekaan jamur dilakukan dengan difusi cakram pada agar Müeller Hinton. Itraconazole (8 μg) digunakan dan Amphotericin B (20 μg) dan Fluconazole (25 μg) sebagai kontrol positif. Hasil: Tujuh puluh tujuh pasien didapatkan. Kanker yang paling banyak dijumpai adalah adenokarsinoma pada 58 penderita, sisanya adalah karsinoma sel skuamos. Jenis jamur yang ditemukan adalah Aspergillus niger (22,1%), Aspergillus flavus (15%), Aspergillus fumigatus (14,3%), Candida albicans (40%), Candida glabrata (5%), Candida parapsilosis (2,1%), Candida krusei ( 0,7%), dan Candida tropicalis (0,7%). Sebagian besar spesies masih sensitif terhadap itrakonazol dan amfoterisin B. Kesimpulan: Jenis jamur yang paling banyak ditemukan adalah Candida albicans. Aspergillus spp dan Candida spp dan mayoritas sensitif terhadap Itraconazole. Kata kunci: Kanker paru-paru, Mikosis Paru, Kolonisasi jamur, Candida spp, Aspergillus spp, sputum

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Introduction: Lung cancer patients around the globe are increasing along with its opportunistic infection, pulmonary mycosis. Despite pulmonary mycosis being wellknown, a proper research about the prevalence and incidence are limited in Indonesia. An update about the susceptibility of itraconazole as the most common drug used to treat pulmonary mycosis is also needed. The aim of this study was to determine the fungal profile and its susceptibility to itraconazole in lung cancer patients. Methods: This is a descriptive cross-sectional study using both secondary and primary data. Lung cancer patients who had been admitted to Persahabatan Hospital from January to May 2020 were tested for mycological examinations by Mycology Laboratory of the Department of Parasitology, University of Indonesia. Patients aged equal or more than 18 years old, had not undergone chemotherapy, and examined with bronchoscopy were included. The fungi susceptibility test were conducted using disk diffusion on Müeller Hinton agar. Itraconazole (8 μg) were used and Amphotericin B (20 μg) and Fluconazole (25 μg) were also measured as a positive control. Results: Seventy-seven patients were involved. The most common cancer was adenocarcinoma in 58 subjects, the rest were squamos cell carcinoma. The fungal species found were Aspergillus niger (22.1%), Aspergillus flavus (15%), Aspergillus fumigatus (14.3%), Candida albicans (40%), Candida glabrata (5%), Candida parapsilosis (2.1%), Candida krusei (0.7%), and Candida tropicalis (0.7%). Most of the species were still sensitive to itraconazole and amphotericin B. Conclusion: The most common fungal species was Candida albicans. Aspergillus spp and Candida spp were sensitive to Itraconazole. Key words: Lung cancer, Lung Mycosis, Fungal Colonization, Candida spp, Aspergillus spp, sputum