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Abstrak :
Candida albicans adalah fungus oportunistik yang paling banyak menyebabkan infeksi pada manusia. Dalam lingkungan oral, fungi ini biasanya berasosiasi dengan bakteri Streptococcus mutans membentuk biofilm, yang menjadikan banyak obat oral tidak efektif menangani permasalahan kesehatan seperti karies atau lainnya. Biofilm adalah bentuk alami pertumbuhan mikroorganisme yang umum terjadi dalam niche lingkungan. Hasil pembentukan biofilm menyebabkan peningkatan resistensi terhadap pengaruh lingkungan yang negatif termasuk resistensi terhadap antibiotik dan agen antimikroba lainnya. Karena sifat penting dari biofilm mempengaruhi penyakit infeksi dan penyebaran resistensi obat, maka dinilai sangat penting untuk menemukan agen antibiofilm mikroba baru yang dapat mencegah pembentukan dan perkembangan biofilm. Berbagai penelitian awal menunjukkan bahwa produk alami dari tanaman memiliki sifat antimikroba dan berpotensi menanggulangi permasalahan biofilm. Ruta angustifolia (L.) Pers. adalah salah satu tanaman obat yang secara tradisional sering digunakan untuk mengobati banyak penyakit. Penelitian ini bertujuan untuk mengekplorasi ekstrak kasar dan senyawa bioaktif yang diisolasi dari R. angustifolia (L.) Pers. sebagai kandidat obat yang dapat digunakan untuk mengatasi permasalah biofilm dari C. albicans dan S. mutans baik dalam kultur tunggal maupun campuran. Dalam penelitian ini, dilakukan ekstraksi (dengan metode maserasi mengunakan pelarut metanol 96%), skrining fitokimia dan isolasi serta identifikasi senyawa bioaktif (metode Kromatografi Lapis Tipis (KLT) , Kromatografi Cair dengan spektrometri massa tandem (LC-MS/MS) dan Nuclear Magnetic Resonance (NMR)) dari tanaman Ruta angustifolia (L.) Pers. asal Kabupaten Lembang, Jawa Barat, Indonesia. Hasil ekstrak kasar maupun senyawa bioaktif yang didapat lalu dilihat efektifitasnya terhadap biofilm C. albicans dan S. mutans secara fisiologi (metode Cristal Violet (CV) dan 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) / Coloni Forming Unit (CFU)) serta secara morfologi terhadap morfogenesis C. albicans (menggunakan Light Microscope dan Scanning Electron Microscopy). Hasil penelitian memperoleh ekstrak kasar dengan nilai rendemen sebesar 31,69 %. Hasil skrining fitokimia menunjukkan bahwa ekstrak metanol R. angustifolia (L.) Pers. terbukti mengandung senyawa steroid, flavonoid, alkaloid, tanin dan kuinon. Hasil isolasi dan identifikasi mendapatkan tiga senyawa bioaktif murni yang terkonfirmasi sebagai kokusaginine, chalepin dan lindelofine. Pengujian terhadap efektivitasnya sebagai antibiofilm secara fisiologi maupun morfologi menunjukkan bahwa baik ekstrak kasar maupun senyawa bioaktif yang diisolasi dari tanaman R. angustifolia (L.) Pers. (kokusaginine, chalepin dan lindelofine) secara umum berpotensi digunakan sebagai antibiofilm C. albicans dan S. mutans dalam kultur tunggal maupun campuran. ......Candida albicans is the most common opportunistic fungus causing infections in humans. In oral environment, this fungus usually associates with Streptococcus mutans form a biofilm, which makes many oral drugs ineffective in treating health problems such as caries or others. Biofilms are natural forms of microorganism growth that are common in environmental niches. The resulting biofilm formation leads to increased resistance to negative environmental influences including resistance to antibiotics and other antimicrobial agents. Due to the important nature of biofilms influencing infectious diseases and the spread of drug resistance, it is considered important to find new microbial antibiofilm agents that can prevent the formation and development of biofilms. Various preliminary studies have shown that natural products from plants have antimicrobial properties and have the potential to overcome biofilm problems. Ruta angustifolia (L.) Pers. is a medicinal plant traditionally used to treat many diseases. This study aims to explore crude extracts and bioactive compounds isolated from R. angustifolia (L.) Pers. as drug candidates that can be used to overcome the biofilm problem of C. albicans and S. mutans in both single and mixed cultures. In this study, extraction was carried out (by maceration method using methanol 96%), phytochemical screening and isolation as well as identification of bioactive compounds (Thin Layer Chromatography (TLC), Liquid Chromatography with tandem mass spectrometry (LC-MS/MS) and Nuclear Magnetic Resonance (NMR). The results of crude extracts and bioactive compounds obtained were then seen for their effectiveness on the biofilms of C. albicans and S. mutans physiologically and morphologically (using Light Microscope and Scanning Electron Microscopy). The results obtained crude extract with a yield value of 31.69%. The results of phytochemical screening showed that the methanol extract of R. angustifolia (L.) Pers. proven to contain steroid compounds, flavonoids, alkaloids, tannins and quinones. The results of the isolation and identification obtained three pure bioactive compounds that were confirmed as kokusaginine, chalepin and lindelofine. Tests on its effectiveness as an antibiofilm physiologically and morphologically showed that both crude extracts and bioactive compounds isolated from the R. angustifolia (L.) Pers. (kokusaginine, chalepin and lindelofine) in general have the potential to be used as antibiofilms for C. albicans and S. mutans in single or mixed cultures.

Abstrak :
Penyebab utama kandidiasis yang merupakan infeksi jamur tersering pada manusia, adalah Candida albicans. Asupan glukosa yang tinggi merupakan salah satu faktor predisposisi kandidiasis oral. Substitusi asupan glukosa dengan xylitol dilaporkan mampu mengontrol pertumbuhan C. albicans. Berbagai penelitian in vitro terdahulu tentang konsentrasi efektif xylitol dalam menghambat pertumbuhan C. albicans bervariasi, yaitu xylitol 1%, 5%, atau 10%. Tujuan: Mengetahui pengaruh konsentrasi dan durasi pemaparan xylitol dalam menurunkan jumlah koloni C. albicans in vitro. Metode: Sampel C. albicans diambil dari usapan lesi mukosa mulut seorang pasien laki-laki penderita kandidiasis oral. Identifikasi spesies menggunakan CHROMagar dan uji serum. Setelah teridentifikasi positif, dibuat suspensi C. albicans pengenceran 108 kali. Pemaparan xylitol konsentrasi 1%, 5%, 10% (kelompok uji) serta tanpa xylitol (kelompok kontrol) dilakukan dalam Sabouraud Dextrose Broth (SDB) selama 3 hari dan 7 hari. Selanjutnya, C. albicans diinkubasi pada suhu 37oC selama 48 jam dalam Sabouraud Dextrose Agar (SDA) untuk mendapatkan jumlah CFU/ml. Sebagai pembanding, prosedur yang sama dilakukan terhadap C. albicans strain ATCC 10231. Hasil: Pada kultur C. albicans yang diberi xylitol selama 3 hari, peningkatan konsentrasi xylitol menyebabkan penurunan jumlah koloni C. albicans secara bermakna (p = 0,044). Konsentrasi xylitol 10% menyebabkan penurunan jumlah koloni C. albicans yang sangat bermakna dibandingkan kontrol (p = 0,024). Pada kultur C. albicans yang diberi xylitol selama 7 hari, konsentrasi xylitol tidak mempengaruhi jumlah koloni C. albicans secara bermakna (p = 0,396). Kesimpulan: Konsentrasi dan durasi pemaparan xylitol mempengaruhi efek xylitol dalam menurunkan jumlah koloni C. albicans in vitro. Pemaparan xylitol 10% selama 3 hari sangat berpengaruh dalam menurunkan jumlah koloni C. albicans in vitro.

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Candidiasis which is the most common fungal infection of human, primarily caused by Candida albicans. The growth of C. albicans is influenced by glucose intake. Substitution of glucose intake with xylitol is reported to inhibit the growth of C. albicans. Several previous studies reported various concentrations of xylitol, 1%, 5%, or 10%, as an effective concentration in inhibiting C. albicans in vitro. Objectives: Investigating the effect of different concentration and duration of xylitol exposure in inhibiting C. albicans growth in vitro. Methods: C. albicans sample was taken from oral swab of a male oral candidiasis patient. Identification of C. albicans was conducted using CHROMagar, confirmed by germ tube test. The cultures were serially diluted and inoculated in Sabouraud Dextrose Broth (SDB) contained 1%, 5%, 10% xylitol, and without xylitol (as control), for 3 and 7 days. These inoculations were then incubated in 37oC on Sabouraud Dextrose Agar (SDA). The Colony Forming Unit (CFU) were counted after 48 hours. As a comparison, the same procedure was conducted for the C. albicans ATCC 10231 strain. Results: After 3 days, increased concentration of xylitol added to C. albicans media lead to decreased growth of C. albicans significantly (p = 0,044). Ten percent xylitol resulted in significant lower growth of C. albicans compared to control (p = 0,024). After 7 days, there?s no significant effect of the three concentrations of xylitol in decreasing the growth of C. albicans (p = 0,396). Conclusion: Concentration and duration of xylitol exposure influent the inhibitory effect of xylitol on the growth of C. albicans. Three days exposure of 10% xylitol could significantly inhibit the growth of C. albicans in vitro.

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: Temulawak yang mengandung xanthorrhizol diketahui memiliki efek antijamur. Xanthorrhizol dilaporkan mampu mengeradikasi biofilm Candida albicans. Tujuan: Menganalisis korelasi antara efek hambat ekstrak etanol temulawak EET dengan perkembangan biofilm C. albicans isolat klinis pada berbagai fase, serta mengamati gambaran mikroskopis biofilm C. albicans. Metode: Uji MTT digunakan untuk menguji viabilitas C. albicans pada biofilm dan dikonversikan persen hambat ekstrak etanol temulawak KHBM50 . Efek EET terhadap gambaran mikroskopis setiap fase perkembangan biofilm C. albicans diamati dengan Scanning Electron Microscopy. Hasil: Nilai Konsentrasi Hambat Biofilm Minimal KHBM50 EET terhadap biofilm C. albicans isolat klinis pada fase awal, menengah, dan maturasi secara berturut-turut adalah 20 , 30 , dan 35 . Gambaran mikroskopis pada setiap fase perkembangan biofilm C. albicans terlihat penurunan jumlah sel dan densitas C. albicans, serta terhambatnya pembentukan filamen dibandingkan dengan kelompok tanpa perlakuan. Kesimpulan: EET mampu menghambat perkembangan fase awal, menengah, dan maturasi biofilm C. albicans isolat klinis. Semakin matur fase perkembangan biofilm, C. albicans akan semakin resisten terhadap ekstrak temulawak. Paparan ekstrak temulawak memengaruhi kemampuan C. albicans isolat klinis dalam membentuk filamen serta menurunkan jumlah sel dan densitas biofilm. ...... Background: Javanese turmeric which contains xanthorrhizol is known to have antifungal effect. Xanthorrhizol is reported to be able to eradicate Candida albicans' biofilm formation. Objective: Analyze the correlation between inhibition concentration of Javanese turmeric ethanol extract JTEE and each development phase of C. albicans' biofilm, and observing microscopic appearance of each phase of C. albicans biofilm. Method: MTT assay was used to test the viability of C. albicans towards biofilm and converted to Minimum Biofilm Inhibitory Concentration MBIC50 . JTEE' s effect on each phase of microscopic appearance of C. albicans' biofilm is observed by Scanning Electron Microscopy. Result: MBIC50 of JTEE towards development of clinical isolate of C. albicans' biofilm in the early adhesion and proliferation , intermediate, and maturation phase as follows 20, 30, and 35 respectively. The microscopic appearance on each phase of C. albicans' biofilm development shows decrease in cell number and density, as well as inhibiton of filament formation compared with control group. Conclusion: JTEE can inhibit the development phases of C. albicans' biofilm. The potency of JTEE to inhibit development of C. albicans' biofilm was decreased along with the maturation of biofilm. The JTEE' s exposure leads to changes of microscopic appearance of C. albicans' biofilm development.

Abstrak :
ABSTRAK Ruang Lingkup dan Cara Penelitian: Amiloid merupakan suatu substansi protein patologis. Amiloidosis pada manusia merupakan penyakit dengan kelainan klinik yang sangat bervariasi, maka penyelidikan amiloidosis pada hewan percobaan mempunyai arti yang penting. Dinding sel C. albicans mengandung mannan, yang diduga berperan dalam terjadinya amiloidosis; demikian pula kasein dikenal dapat menimbulkan amiloidosis pada hewan percobaan. Perjajanan penyakit atau proses terjadinya amiloidosis pada kedua cara induksi tersebut belum jelas. Tujuan penelitian ini adalah mempelajari proses terjadinya amiloidosis dengan membandingkan cara induksi antara C. albicans dan kasein, dengan menilai terjadinya amiloidosis pada lokalisasi tertentu yang merupakan tempat predisposisi pada hati dan Limpa mencit murni C3H. Digunakan 112 mencit betina dan jantan umur 10-12 minggu, dibagi dalam kelompok yang mendapat 1) C. albicans 100.000 sel/0,5 ml; 2) Larutan kasein 50 mg/0,5 ml; 3) larutan 0,85% NaCL/0,5 ml; 4) larutan 0,15 M NaHC0310,5 ml; 5) kelola tanpa perlakuan. Mencit dibunuh 2, 4, 6 dan 8 minggu setelah perlakuan; jaringan hati dan Limpa diambil untuk membuat sediaan mikroskopik dan dipu;as dengan hematoksilin eosin dan merah kongo. Deposit amiloid ditetapkan berdasarkan reaksi spesifik dengan cahaya polarisasi. Hasil dan Kesimpulan: C. aLbicans dosis 100.000 sel/0,5 ml mempunyai daya induksi amiloidosis pada mencit C3H Lebih tinggi daripada yang disebabkan kasein dosis 50 mg/0,5 ml. Pada amiloidosis limpa terdapat perbedaan sebesar 5,3% pada 2 minggu setelah perlakuan, 14,6% pada 4 minggu, dan 5,6% pada 6 dan 8 minggu setelah perlakuan. Pada amiLoidosis hati terdapat perbedaan 39% pada 4 minggu, dan 33% pada 6 dan 8 minggu setelah perlakuan. Hasil ini menunjukkan perbedaan bermakna (p<0,0005) Gambaran mikroskopik amiloidosis limpa dan hati yang disebabkan C. albicans berbeda bermakna (p<0,0005) dibanding dengan yang disebabkan kasein, bila dihubungkan dengan waktu perkembangannya.

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ABSTRACT Amyloid is a pathologic proteinaceous substance. amyloidosis could cause illness to human beings, with varied clinical signs; the study of amyloidosis on experimental animals was very useful. The cell wall of C. albicans contains mannan which was suspected of causing amyloidosis, and casein was also known to cause amyloidosis in experimental animals. The aim of this research is to study the process of amyloidosis and to compare the induction by C. albicans and casein by examining amyloidosis at the pre-disposing localization in the liver and spleen of C3H mice. The experiment used 112 mice (male and female) 10-12 weeks old; they were divided into groups given: 1) C. albicans 100,000 cells/0.5 ml, 2) casein 50 mg/ 0.5 ml, 3) 0.85% NaCL10.5 ml, 4) 0.15 M NaHC03/0.5 ml, 5) control without treatment. The mice were killed at the 2nd, 4th, 6th and 8th week after treatment finished, and the liver and spleen were taken out to make microscopic preparation and stained with hematoxylin eosin and Congored. Amyloid deposit was examined by specific reaction to polarized Light. Findings and Conclusions: C. albicans 100,000 cells/0.5 ml showed higher effect in inducing amyloidosis in C3H mice compared to casein 50 mg/0.5 ml. There were 5.3% difference on the 2nd week of treatment in the spleen, 14.6% on the 4th week, and 5.6% on the 6th and 8th week. In the Liver amyloidosis process, there were 39% difference on the 4th week after treatment and. 33% on the 6th and 8th week. These differences were statistically significant (p<0.0005).

Abstrak :
ABSTRAK
Latar belakang: Infeksi HIV masih banyak ditemukan di Indonesia saat ini. Terapi antiretroviral telah merubah morbiditas dan mortalitas pasien terinfeksi HIV, dan juga merubah manifestasi oral HIV/AIDS, termasuk kandidiasis orofaring KOF . Dalam penelitian ini dieksplorasi peran faktor genetik dan respons imun pasien terinfeksi HIV dengan dan tanpa KOF, sebelum dan sesudah terapi ARV.Metode: Subyek penelitian sebesar 82 pasien terinfeksi HIV, ARV-na ve dengan jumlah sel T CD4

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ABSTRACT
Background HIV infection remains common in Indonesia nowadays. Antiretroviral therapy ART has altered morbidity and mortality of HIV infected people, and also altered oral manifestation of HIV AIDS, including oropharyngeal candidiasis OPC . Here we explore the role of host genetic factors and immune responses in HIV infected patients beginning ART.Methods This study included 82 ARV na ve HIV infected patients with

Abstrak :
Latar Belakang: Kandidiasis Oral adalah infeksi pada rongga mulut yang terutama disebabkan oleh jamur C. albicans. C. albicans dalam bentuk biofilm bersifat virulen. Pembentukan biofilm C. albicans diawali dengan proses adhesi sel diikuti dengan proliferasi dan pembentukan biofilm. Temulawak Curcuma Xanthorrhiza Roxb. merupakan tanaman obat asli Indonesia yang mengandung zat aktif xanthorrhizol yang memiliki efek antijamur. Tujuan: Menganalisis efek hambat ekstrak etanol temulawak terhadap biofilm C. albicans pada fase awal. Metode: Paparan ekstrak etanol temulawak diberikan pada kultur C. albicans isolate klinis dan ATCC 10231 usia 1.5 jam selama 6 jam untuk mencapai fase awal. Viabilitas C. albicans diuji dengan MTT assay. Hasil: KHM Ekstrak etanol temulawak terhadap C. albicans isolat klinis dan ATCC 10231 secara berturut-turut adalah 15 dan 20 . KHBM50 ekstrak etanol temulawak terhadap biofilm C. albicans isolat klinis dan ATCC 10231 pada fase awal secara berturut-turut adalah 20 dan 25. Kesimpulan: Hasil penelitian ini menunjukkan bahwa Ekstrak Etanol Temulawak dapat menghambat biofilm C. albicans pada fase awal. ...... Background: Oral Candidiasis is an oral cavity infection caused by C. albicans. C. albicans in the form of biofilm is virulent. C. albicans biofilm formation initially starts with the fungal cell adhesion followed by the proliferation and the formation of biofilm. Javanese Turmeric Curcuma Xanthorrhiza Roxb. is an Indonesian medicinal plant that contains xanthorrhizol as the active substance which has antifungal effects. Objective: To investigate the inhibitory effect of Javanese turmeric ethanol extract on C. albicans biofilm in the initial phase. Methods: exposing Javanese Turmeric ethanol extract was given to C. albicans culture aged 1.5 hours for 6 hours to achieve initial phase of biofilm. The viability of C. albicans was assesed by MTT assay. Result: The MIC Minimum Inhibitory Concentration of Javanese turmeric ethanol extract against C. albicans clinical isolated and ATCC 10231 were 15 and 30 , respectively. The concentration of temulawak ethanol extract which had MBIC50 value on C. albicans clinical isolated and ATCC 10231 in the adhesion phase were 20 and 25, respectively. Conclusion: The results showed Javanese turmeric ethanol extract could inhibit C. albicans biofilm in initial phase.

Abstrak :
Latar Belakang: Temulawak (Curcuma xanthorrhiza Roxb.) merupakan tanaman obat asli Indonesia yang telah dilaporkan memiliki efek eradikasi terhadap biofilm Candida albicans. Faktor virulensi C. albicans di antaranya adalah aktivitas enzim fosfolipase dan pembentukan biofilm. Tujuan: Menganalisis aktivitas enzim fosfolipase ketiga fase biofilm C. albicans yang tereradikasi ekstrak etanol temulawak. Metode: Pada penelitian ini, kelompok perlakuan dipaparkan ekstrak etanol temulawak (EET), kelompok kontrol positif dipaparkan nystatin, dan kelompok kontrol negatif tidak dipaparkan apapun. Biofilm C. albicans diinkubasi selama 6, 24, dan 48 jam untuk mencapai fase awal, menengah, dan maturasi. Setelah inkubasi, biofilm C. albicans dipaparkan EET dengan konsentrasi sesuai kadar eradikasi biofilm minimal. Media egg yolk agar digunakan untuk mengobservasi aktivitas enzim fosfolipase C. albicans. Hasil: Nilai aktivitas enzim fosfolipase (nilai Pz) kelompok perlakuan secara berturut-turut pada fase awal, menengah, dan maturasi adalah 0,67, 0,66, 0,70. Nilai Pz kelompok kontrol negatif secara berturut-turut pada fase awal, menengah, dan maturasi adalah 0,51, 0,50, 0,47. Kontrol positif pada ketiga fase memiliki nilai Pz 1. Kesimpulan: Cenderung terjadi penurunan aktivitas enzim fosfolipase pada biofilm C. albicans yang tereradikasi ekstrak etanol temulawak dibandingkan pada kelompok kontrol negatif.

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Background: Javanese turmeric (Curcuma xanthorrhiza Roxb.) is an original Indonesian medicinal plant that has been reported for having eradication effect to Candida albicans biofilm. Virulence factors of C. albicans are including biofilm formation and phospholipase enzyme activity. Objective: Analyzing phospholipase enzyme activity on three biofilm phases of C. albicans that has been eradicated by Javanese turmeric ethanol extract. Method: The treatment group was exposed to Javanese turmeric ethanol extract, the positive control group was exposed to nystatin, and negative control group wasnt exposed to anything. C. albicans biofilm was incubated for 6, 24, and 48 hours to achieve initial, intermediate, and maturation phase. After incubation, the biofilm was exposed to minimum biofilm eradication concentration of Javanese turmeric ethanol extract. Egg yolk agar medium was used to observe phospholipase enzyme activity of C. albicans. Result: Phospholipase enzyme activity value (Pz value) of the treatment group on initial, intermediate, and maturation phase respectively are 0,67, 0,66, and 0,70. Pz value of the negative control group on initial, intermediate, and maturation phase respectively are 0,51, 0,50, and 0,47. Positive control of every phase has Pz value = 1. Conclusion: There is tendency of lowering phospholipase enzyme activity of C. albicans biofilm that has been eradicated by Javanese turmeric ethanol extract compared to the negative control group.

Abstrak :
Latar Belakang: Temulawak (Curcuma xanthorrhiza Roxb.) merupakan tanaman berkhasiat obat asli Indonesia yang telah dilaporkan mampu menginhibisi dan mengeradikasi setiap fase biofilm Candida albicans. Faktor virulensi dari Candida albicans adalah pembentukan biofilm dan sekresi enzim proteinase. Tujuan: Mengetahui efek inhibisi dan eradikasi ekstrak etanol temulawak terhadap setiap fase biofilm Candida albicans berdasarkan aktivitas enzim proteinase. Metode: Membuat biofilm yang akan diinhibisi dengan menginkubasi Candida albicans selama 90 menit kemudian dipaparkan ekstrak etanol temulawak dan diinkubasi sesuai dengan fase pembentukan biofilm (6 jam, 24 jam, dan 48 jam). Membuat biofilm yang akan dieradikasi dengan menginkubasi Candida albicans sesuai dengan fase pembentukan biofilm (6 jam, 24 jam, dan 48 jam) kemudian dipaparkan ekstrak etanol temulawak selama 24 jam. Setelah dipaparkan oleh ekstrak etanol temulawak Candida albicans dipindahkan pada media uji aktivitas enzim proteinase berupa BSAA. Menganalisis aktivitas enzim proteinase dengan cara mengukur zona proteolysis yang terbentuk disekitar koloni. Hasil: Pada setiap fase biofilm Candida albicans yang terinhibisi maupun tereradikasi oleh EET memiliki nilai Prz yang lebih tinggi dibandingkan dengan kontrol negatif dan terdapat perbedaan yang bermakna secara statistik. Kesimpulan: Adanya penurunan aktivitas enzim pada setiap fase biofilm yang terinhibisi maupun tereradikasi oleh EET dan teruji secara statistik. ......Background: Java Tumeric (Curcuma xanthorrhiza Roxb) is an medicinal plant from Indonesia that has been reported having inhibition and eradication effect to every phase biofilm formation of Candida albicans. Virulence factor of Candida albicans are biofilm formation and proteinase enzyme secretion. Objective: Knowing inhibition and eradication effect by Java Tumeric Ethanol Extract to every phase biofilm formation of Candida albicans based on proteinase enzyme activity. Method: Biofilm that will be inhibited, incubating Candida albicans for 90 minutes then expose with Java Tumeric Ethanol Extract and further incubation to reach phase of biofilm formation (6 hours, 24 hours, and 48 hours). Biofilm that will be eradicated, incubation Candida albicans according to phase of biofilm formation (6 hours, 24 hours, and 48 hours) then exposed with Java Tumeric Ethanol Extract and further incubation for 24 hours. After that, biofilm of Candida albicans moved to BSAA medium for proteinase enzyme activity assay. Analysing proteinase enzyme activity by measuring proteolysis zone seen around the colony of Candida albicans. Result: Every phase biofilm of Candida albicans that had been inhibited and eradicated by Java Tumeric Ethanol Extract has higher Prz score than negative control and statistically meaningful. Conclusion: There are reduction of proteinase enzyme activity on every phase biofilm of Candida albicans that had been inhibited and eradicated by Java Tumeric Ethanol Extract and statistically tested.

Abstrak :
Latar Belakang: Candida albicans merupakan flora komensal yang dapat berubah menjadi virulen pada keadaan tertentu yang dipengaruhi oleh faktor predisposisi dan virulensi. Salah satu faktor virulensi C. albicans  adalah kemampuan membentuk biofilm dengan gambaran morfologi yang berubah pada setiap fasenya. Pembentukan biofilm dapat meningkatkan resistensi terhadap agen antijamur. Temulawak merupakan tanaman obat unggulan Indonesia yang diketahui memiliki khasiat antijamur. Tujuan: Mengetahui perkembangan berbagai fase biofilm C. albicans ATCC 10231 setelah paparan ekstrak etanol temulawak (Curcuma xanthorrhiza Roxb.) Metode: Uji MTT-assay digunakan untuk mengetahui konsentrasi minimum ekstrak etanol temulawak dalam menghambat pembentukan biofilm C. albicans (KHBM₅₀). Gambaran mikroskopis perkembangan biofilm C. albicans diobservasi dengan menggunakan  Scanning Electron Microscope (SEM). Hasil: Nilai Konsentrasi Inhibisi Biofim Minimal (KHBM₅₀) ekstrak etanol temulawak terhadap biofilm C. albicans ATCC 10231 pada fase awal (adhesi dan proliferasi), fase menengah, dan fase maturasi berturut turut adalah 25%, 35%, dan 40%. Kemampuan ekstrak etanol temulawak dalam menghambat perkembangan biofilm C. albicans  menurun seiring dengan peningkatan fase biofilm.  Pada fase adhesi, morfologi C. albicans ATCC 10231 yang dipaparkan ekstrak etanol temulawak dan nystatin masih berbentuk blastospora, berbeda dengan kontrol negatif yang sudah menunjukkan germinasi. Pada fase proliferasi, menengah, dan maturasi C. albicans ATCC 10231 yang dipaparkan temulawak maupun nystatin menunjukkan adanya pertumbuhan hifa yang lebih pendek namun dengan jumlah dan densitas yang jauh lebih sedikit jika dibanding dengan kontrol negatif. Kesimpulan: Ekstrak etanol temulawak mempengaruhi viabilitas C. albicans ATCC 10231 dan menghambat perkembangan biofilm C. albicans ATCC 10231 dengan cara menghambat pertumbuhan hypha serta menurunkan densitas biofilm. Semakin meningkat fase perkembangan biofilm, dibutuhkan konsentrasi ekstrak etanol temulawak yang lebih tinggi. ...... Background: Candida albicans is a commensal flora that can turn into virulent in certain circumstances that are influenced by predisposing and virulence factors. One of the virulence factors of C. albicans is the ability to form biofilm with morphologic changes in every phase. Biofilm formation can increase resistance towards antifungal agents. Javanese turmeric is an Indonesian medical plant that is reported to have antifungal effect which can inhibit the development of C. albicans biofilm. Objective: To observe the development of Candida albicans ATCC 10231 biofilm formation after exposed to Javanese turmeric ethanol extract (Curcuma xanthorrhiza Roxb.) Method: MTT-assay was used to measure the minimum inhibitory concentration of Javanese turmeric ethanol extract in inhibiting C. albicans ATCC 10231 biofilm formation (MBIC₅₀). The morphological changes of the various stages of C. albicans biofilm were observed using Scanning Electron Microscope (SEM). Results: The Minimum Biofilm Inhibitory Concentration (MBIC₅₀) of Javanese turmeric ethanol extract towards formation of C. albicans biofilm ATCC 10231 in the early phase (adhesion and proliferation), intermediate phase, and maturation phase as follows; were 25%,  35%, and 40% respectively. In the adhesion phase, the morphology of C. albicans ATCC 10231 exposed javanese turmeric ethanol extract and nystatin is still in the form of blastospores, unlike negative controls that have shown germination. In the proliferation, intermediate, and maturation phase C. albicans ATCC 10231 exposed to Javanese turmeric ethanol extract and nystatin showed the growth of shorther hyphae and slightly lesser amounts and densities compared negative controls. The ability of javanese turmeric ethanol extract in inhibiting the development of C. albicans biofilm decreased along with the increased of biofilm phase. Conclusion:  Javanese turmeric ethanol extract affected the viability of C. albicans cells and inhibit the development of C. albicans biofilm by inhibiting the hyphal formation and decreasing the biofilm density.