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Abstrak :
Pendahuluan: Pasien yang dirawat di ICU berisiko tinggi terserang kandidiasis invasif. Pemberian antijamur empirik dini dapat memperbaiki kondisi klinis pasien dan menurunkan angka kematian. Candida Score dari Leon mempunyai sensitifitas dan spesifisitas yang baik untuk menggolongkan pasien ICU yang memang benar membutuhkan terapi empirik antijamur. Penelitian ini menganalisis kesesuaian kriteria Candida Score dan hasil kultur darah dengan pemberian antijamur pada pasien sepsis di ICU RSCM. Metodologi: Studi potong lintang dilakukan pada pasien sepsis di ICU RSCM pada Maret 2015-Oktober 2015. Dilakukan kultur pada spesimen darah, urin, dan sekret saluran nafas, selanjutnya dibiakkan. Karakteristik pasien dan riwayat klinisnya dicatat. Candida Score dihitung pada setiap pasien kemudian diuji asosiasinya dengan terapi yang didapatkan. Hasil: Dari 100 pasien 57 pasien mendapatkan antijamur. Proporsi pasien yang mendapat antijamur yaitu 50 , 17 , 57 , 83 , dan 100 pada kelompok pasien dengan Candida score 0-4 berturut-turut. Dalam penelitian ini tidak kami dapatkan pasien dengan Candida score=5. Hasil kultur darah positif Candida didapatkan pada 4 orang pasien dengan angka kematian sebesar 100 . Tiga pasien kandidemia dengan Candida score >3 mendapatkan antijamur setelah hasil kultur darah positif Candida. Kesimpulan: Terdapat asosiasi bermakna antara kriteria Candida score dengan pemberian antijamur pada pasien sepsis di ICU RSCM p3 tidak mendapatkan terapi empirik.

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Introduction Prompt empirical antifungal therapy is essential for controling invasive candidiasis and has been shown to reduce mortality. Candida Score, established by Leon, has a good sensitivity and specivicity to distinguish critically ill patients whose invasive candidiasis is highly probable. This study analyzed the conformity between candida score criteria and blood culture results with the antifungal administration in patients with sepsis at the ICU of Dr. Cipto Mangunkusumo General Hospital RSCM Methods A cross sectional study was conducted from March October 2015 at the ICU of RSCM. Critically ill patients who exhibited sepsis were included in this study. The urine, blood, and respiratory secrete were collected and were cultured in the microbiology laboratory. Each patient rsquo s characteristics and medical history were also recorded. The candida score was calculated and then tested for their association with treatment obtained. Results Of the 100 patients, 57 patients received antifungal therapy, with the proportion of 50 , 17 , 57 , 83 , and 100 in the patients group broken by the Candida Score of 0 to 4 respectively. There rsquo s no patient with Candida Score of 5. Candida positive blood culture results candidaemia were observed in 4 patients, with a mortality rate of 100 . Three of which had the score of 3 but received antifungal therapy after the positive blood culture results were obtained. Conclusion There is a significant association between Candida Score criteria with antifungal administration in septic patients in the ICU of RSCM p 3 did not get empiric antifungal therapy.

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 albicans merupakan penyebab utama infeksi mikroba oportunistik pada pasien kanker. Pasien Leukemia Limfositik Akut (LLA) yang menjalani kemoterapi memiliki risiko tinggi terkena kandidiasis karena imunosupresi dan melemahnya barier epitel. Penggunaan obat antifungal sistemik dibatasi oleh risiko efek samping yang lebih besar dan berkembangnya strain yang resisten, namun obat antifungal topikal yang tersedia saat ini masih dianggap kurang efektif untuk pasien imunosupresi termasuk pasien kemoterapi. Beberapa penelitian memberikan bukti kelayakan probiotik Lactobacillus casei untuk bertindak sebagai antifungal alternatif di berbagai sistem organ manusia. Tujuan: Menganalisis pengaruh probiotik terhadap jumlah C. albicans di rongga mulut anak penderita LLA selama kemoterapi. Metode: Sampel saliva diambil dari 11 anak penderita LLA selama kemoterapi. Subyek diinstruksikan untuk berkumur dengan probiotik yang mengandung L. casei selama 60 detik, dua kali sehari, selama 14 hari. Sampel saliva tidak terstimulasi dikumpulkan secara berurutan pada 3 titik waktu (awal, 7 hari, dan 14 hari). Jumlah C. albicans dihitung dengan qPCR. Hasil: Perbedaan signifikan secara statistik ditemukan antara jumlah C. albicans pada awal (494.363+180.737 CFU/ml), setelah 7 hari (276.654+69.903 CFU/ml), dan setelah 14 hari (229.286+50.883 CFU/ml) berkumur dengan probiotik. Jumlah yang lebih rendah secara signifikan ditemukan setelah 7 dan 14 hari berkumur dengan probiotik (p<0.05). Kesimpulan: Probiotik L. casei memiliki efek menurunkan jumlah C. albicans di rongga mulut anak leukemia selama kemoterapi. ......Background: Candida albicans is the leading cause of opportunistic microbial infections in patients with cancer. Acute Lymphocytic Leukemia (ALL) patients undergoing chemotherapy have high risk of candidiasis due to immunosuppression and weakened epithelial barriers. Systemic antifungal drugs’ usage is limited by the greater risk of side effects and developing resistant strains, yet currently available topical antifungal drugs are still considered ineffective for immunosuppressed patients including chemotherapy patients. Several studies provide evidence for the feasibility of probiotic Lactobacillus casei to act as alternative antifungal in various human organ systems. Objectives: To analyze the effects of probiotic L. casei on the number of C. albicans in oral cavity of children with ALL during chemotherapy.Methods: Saliva samples were taken from 11 children with ALL during chemotherapy. Subjects were instructed to do mouth rinse with probiotics contained Lactobacillus casei for 60s, twice daily, over the course of 14 days. Unstimulated saliva samples were collected sequentially at 3 time points (baseline, 7 days, and 14 days). The number of C. albicans was quantified by qPCR. Results: Statistically significant differences were found between the number of C. albicans at baseline (494.363+180.737 CFU/ml), after 7 days (276.653+69.903 CFU/ml), and after 14 days (229.286+50.883 CFU/ml) mouth rinsing with probiotic L. casei. Significant lower number was found both after 7 and 14 days rinsing with probiotics (p<0.05). Conclusion: Probiotic L.casei has reducing effects on the number of C. albicans in oral cavity of children with ALL during chemotherapy.

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 :
Candida sp. Berbagai spesies Candida seperti; C.albicans, C.glabrata, C,parapsilosis, C.tropicalis, C.keyfr, C.lusitaniae dan C.krusei. Saat ini, kandidiasis meningkat akibat tingginya individu dengan defisiensi imun, penyakit kronik, transplantasi dan faktor lainnya. Beberapa obat dilaporkan mengalami resistensi. Fluconazole merupakan salah satu lini pertama pada kandidiasis. Beberapa studi melaporkan fluconazole mengalami resistensi terhadap C. krusei. Voriconazole merupakan golongan azole terbaru yang mempunyai sensitifitas lebih tinggi terhadap C.krusei. Tujuan: Penelitian ini bertujuan untuk mengetahui sensitifitas fluconazole dan voriconazole terhadap C.krusei Metode: Penelitian ini menggunakan data sekunder dari rekam medik pasien kandidiasis di RSCM tahun 2013-2018 yang sudah diuji difusi cakram untuk pengujian sensitifitas dengan total sampel adalah 249. Hasil: Uji sensitifitas menunjukkan perbedaan yang bermakna antara fluconazole dengan voriconazole dengan rincian 191 isolat diuji dengan fluconazole 50.26% sensitif, 2.09% Susceptible Dose Dependent (SDD), dan 47.64% resisten sementara dengan voriconazole menunjukkan 100% sensitif dari 58 sampel (p< 0.05). Hasil dari penelitian, voriconazole lebih sensitif dari fluconazole terhadap Candida krusei. Kesimpulan: C.krusei lebih sensitif terhadap voriconazole karena memiliki kemampuan resistensi secara intrinsik terhadap fluconazole.
Candida sp. Various species of Candida such as; C. albicans, C. glabrata, C. parapsilosis, C. tropicalalis, C. keyfr, C. lusitaniae and C. krusei. Currently, candidiasis is increasing due to the high number of individuals with immunodeficiency, chronic disease, transplantation and other factors. Several drugs have been reported to be resistant. Fluconazole is one of the the first line of treatment for candidiasis. Several studies reported that fluconazole was resistant to C. krusei. Voriconazole is the newest azole group that has a higher sensitivity to C. krusei. Objective: This study aims to determine the sensitivity of fluconazole and voriconazole to C.krusei Methods: This study used secondary data from the medical records of candidiasis patients at the RSCM in 2013-2018 which had been tested for disc diffusion for sensitivity testing with a total sample of 249. Results: Test sensitivity showed a significant difference between fluconazole and voriconazole with details of 191 isolates tested with fluconazole 50.26% sensitive, 2.09% Susceptible Dose Dependent (SDD), and 47.64% resistant while with voriconazole showed 100% sensitivity from 58 samples (p < 0.05). The results of the study, voriconazole more sensitive than fluconazole to Candida krusei. Conclusion: C. krusei is more sensitive to voriconazole because it has the ability to intrinsic resistance to fluconazole.

Abstrak :
Pelaksanaan praktek residensi keperawatan medical bedah peminatan imunologi ditujukan supaya perawat residen mampu memberikan asuhan keperawatan spesialis dalam menerapkan evidence-based nursing (EBN) yang berperan sebagai inovator dan edukator di pelayanan keperawatan. Peran perawat residen sebagai pemberi asuhan keperawatan dilakukan dengan menerapkan teori adaptasi Roy pada pasien dengan HIV dan AIDS dengan TB Paru dan 30 pasien HIV dan AIDS dengan infeksi oportunistik lainnya. Masalah keperawatan yang paling banyak didapatkan yaitu risiko ketidakseimbangan elektrolit, intervensi keperawatan yang dilakukan adalah pemantauan elektrolit dengan tujuan keseimbangan elektrolit meningkat. Penerapan EBN pemberian probiotik yogurt pada pasien dengan HIV, AIDS dan keganasan yang menunjukkan kandidiasis oral berupa plak putih pada lidah. Probiotik yogurt diberikan 2 kali sehari selama 5 hari dengan penilaian evaluasi skor tongue coating Miyazaki, hasil menunjukkan 45,6% terjadi penurunan skor dari grade 3 menjadi grade 0. Proyek inovasi pemberian edukasi dengan materi infeksi oportunistik yang menunjukkan pengetahuan dan sikap ODHA meningkat setelah pemberian edukasi. ...... The implementation of medical surgical residency practice with specialization in immunology is intended for resident nurses to provide specialist nursing care in implementing evidence-based nursing (EBN) which acts as an innovator and educator in services that are capable of being involved. The role of the resident nurse as a care giver is carried out by applying Roy's adaptation theory to patients with HIV and AIDS with pulmonary TB and 30 HIV and AIDS patients with other opportunistic infections. The most commonly encountered problem is the risk of going to electrolyte court, the engagement intervention for the risk of electrolyte stress is electrolyte monitoring with the aim of increasing electrolyte balance. Application of EBN giving probiotic yogurt to patients with HIV, AIDS and malignancy showing oral candidiasis in the form of white plaque on the tongue. Probiotic yogurt was given 2 times a day for 5 days with an evaluation of the Miyazaki tongue coating score, the results showed a 45.6% decrease in score from grade 3 to grade 0. An innovation project providing education with material on opportunistic infections which shows that the knowledge and attitudes of PLWHA have increased after providing education.

Abstrak :
Kasus kekerasan seksual dalam bentuk persetubuhan dapat terjadi pada perempuan usia reproduksi yang sedang mengalami keputihan. Sekitar 75-80% dari semua perempuan setidaknya sekali menderita infeksi kandidiasis vulvovaginal dan infeksi tersebut menyumbang lebih dari 25% vaginitis menular. Kondisi keputihan akibat kandidiasis disebabkan oleh perubahan mikrobioma vagina dapat menimbulkan perubahan pH dan jumlah neutrofil vagina yang memengaruhi motilitas dan persistensi spermatozoa dalam vagina. Lama motilitas dan persistensi spermatozoa dalam vagina baik pada kondisi fisiologis maupun patologis merupakan dasar pertimbangan bagi praktisi forensik dalam penentuan waktu terjadinya persetubuhan. Penelitian ini bertujuan untuk menganalisis pH, jumlah neutrofil, dan profil mikrobioma vagina terhadap motilitas dan persistensi spermatozoa dalam vagina tikus kandidiasis. Penelitian eksperimental ini menggunakan tikus putih (Rattus norvegicus) galur wistar dengan tikus jantan sebanyak 6 ekor untuk sampel spermatozoa dan tikus betina sebanyak 32 ekor untuk perlakuan. Tikus betina dibagi dua kelompok yaitu tikus normal dan tikus kandidiasis. Pada kedua kelompok tikus betina diberikan perlakuan berupa inseminasi semen dalam vagina. Variabel yang diukur adalah pH, jumlah neutrofil, profil mikrobioma, motilitas dan persistensi spermatozoa dalam vagina. Analisis statistik perbedaan pH, jumlah neutrofil vagina, diversitas alfa mikrobioma, motilitas dan persistensi spermatozoa antara tikus kondisi normal dan model kandidiasis dengan uji Mann-Whitney, sedangkan perbedaan diversitas beta mikrobioma dilakukan uji permutational multivariate analysis of variance (Permanova). Estimasi survival motilitas dan persistensi spermatozoa dalam vagina menggunakan kurva kesintasan Kaplan-Meier dengan uji log-rank untuk penilaian signifikansi. Hubungan antara pH, jumlah neutrofil dan profil mikrobioma vagina dengan motilitas dan persistensi spermatozoa, dengan uji korelasi Spearman dilanjutkan uji regresi linear berganda. Hipotesis terbukti apabila pada uji perbedaan, uji log-rank,dan uji korelasi didapatkan nilai signifikansi p<0,05. Hasil penelitian menunjukkan terdapat perbedaan pH, jumlah neutrofil, motilitas dan persistensi spermatozoa antara kelompok tikus normal dengan tikus kandidiasis, namun tidak terdapat perbedaan profil mikrobioma tikus normal dan tikus kandidiasis. Kesintasan motilitas dan persistensi spermatozoa dalam vagina lebih lama pada tikus normal dibandingkan tikus kandidiasis. Terdapat korelasi antara pH dan jumlah neutrofil dengan motilitas dan persistensi spermatozoa dalam vagina tikus, namun tidak terdapat korelasi profil mikrobioma dengan motilitas dan persistensi spermatozoa dalam vagina tikus normal dan tikus kandidiasis. Semakin tinggi pH dan jumlah neutrofil dalam vagina, maka motilitas dan persistensi spermatozoa dalam vagina akan semakin menurun. Prosedur tambahan baru pada pemeriksaan kasus kekerasan seksual yang disarankan untuk dilakukan adalah pemeriksaan pH dan jumlah neutrofil vagina. ......Cases of sexual violence in the form of sexual intercourse can occur in women of reproductive age who are experiencing vaginal discharge. Approximate 75-80% of all women suffer from vulvovaginal candidiasis infection at least once and the infection accounts for more than 25% of infectious vaginitis. The condition of vaginal discharge due to candidiasis is caused by changes in the vaginal microbiome which can cause changes in vaginal pH and neutrophil count which affects the motility and persistence of spermatozoa in the vagina. Duration of motility and persistence of spermatozoa in the vagina, both physiological and pathological conditions is a basic consideration for forensic practitioners in determining time since intercourse. This study aimed to analyze pH, neutrophil count, and vaginal microbiome profile on the motility and persistence of spermatozoa in the vagina of candidiasis rat as a principles for determining the time since intercourse. An experimental study was conducted using white rats (Rattus norvegicus) Wistar strain with 6 male rats for spermatozoa samples and 32 female rats for treatment. Female rat were divided into two groups, namely normal and candidiasis rat. In both groups, female rat were given treatment in the form of vaginal insemination of semen. The variables measured included pH, neutrophil count, microbiome profile, motility and persistence of spermatozoa in the vagina. Statistical analysis of differences in pH, vaginal neutrophil count, microbiome alpha diversity, motility and persistence of spermatozoa between rat in normal conditions and candidiasis models was carried out using the Mann-Whitney test, while differences in microbiome beta diversity were carried out by the permutational multivariate analysis of variance (Permanova) test. Estimation of survival motility and persistence of spermatozoa in the vagina used the Kaplan-Meier survival curve with the log-rank test for significance assessment. The correlation between pH, neutrophil count and vaginal microbiome profile with spermatozoa motility and persistence, with the Spearman correlation test followed by multiple linear regression tests. The hypothesis is proven if the difference test, log-rank test and correlation test show a significance value of p<0.05.The results showed that there were differences in pH, neutrophil count, motility and persistence of spermatozoa between groups of normal and candidiasis rat, but there were no differences in the microbiome profiles of normal and candidiasis rat. The survival of motility and persistence of spermatozoa in the vagina is longer in normal rat than in candidiasis rat. There was a correlation between pH and the neutrophil count with the motility and persistence of spermatozoa in the vagina of rat, but there was no correlation between the microbiome profile and the motility and persistence of spermatozoa in the vagina of normal and candidiasis rat. The higher the pH and neutrophil count in the vagina, the motility and persistence of spermatozoa in the vagina will decrease. A new additional procedure in examining cases of sexual violence that is recommended to be carried out is checking the pH and vaginal neutrophil count.

Abstrak :
ABSTRACT
Infeksi jamur adalah salah satu penyakit yang masih menjadi masalah kesehatan di Indonesia. Infeksi jamur yang banyak terjadi berupa kandidiasis dan kriptokokosis yang disebabkan oleh jamur Candida sp dan Cryptococcus sp. Kedua tipe infeksi jamur seringkali menyerang orang dengan sistem imun rendah, seperti penderita AIDS. Penyakit infeksi ini dapat diobati dengan senyawa antijamur. Propolis mengandung senyawa dengan sifat antijamur terhadap Candida sp. dan Cryptococcus sp. Namun, kandungan propolis berbeda tergantung pada sumber propolis, jenis lebah penghasilnya, dan lingkungannya. Propolis yang digunakan dalam penelitian merupakan propolis Indonesia dari lebah Tetragonula biroi dalam dua tipe yaitu propolis karang dan propolis padatan. Potensi antijamur propolis Indonesia dapat diketahui dengan melihat aktivitas antijamur propolis pada beberapa spesies jamur Candida dan Cryptococcus. Propolis Indonesia dalam bentuk ekstrak etanol propolis EEP diujikan pada jamur Candida albicans, C. krusei, C. glabrata, C. parapsilosis, C. tropicalis, dan Cryptococcus neoformans dengan metode difusi cakram. Hasil antijamur menunjukkan bahwa propolis Indonesia dalam bentuk EEP memiliki potensi sebagai antijamur untuk seluruh tipe jamur dan bahkan memiliki diameter hambat lebih tinggi dibandingkan flukonazol untuk jamur Candida krusei, Candida glabrata, dan Cryptococcus neoformans, serta propolis karang memiliki potensi lebih besar untuk mayoritas tipe jamur yang diujikan. Kandungan flavonoid dan polifenol dari propolis Indonesia diperoleh dengan penggunaan quercetin sebagai standar flavonoid dan asam galat sebagai standar polifenol. Didapatkan propolis padatan memiliki keunggulan dalam kedua kategori yakni pada 17,45 flavonoid dan 18,32 polifenol dibandingkan dengan 7,83 flavonoid dan 14,72 polifenol pada propolis karang. Kandungan senyawa aktif propolis Indonesia sendiri dapat diketahui dengan metode spektroskopi massa kromatografi cair LC-MS dimana didapatkan senyawa antijamur yang terkandung dalam propolis Indonesia berupa dehydroabetic acid, ziyuglycoside II, muscanone, 6,7-dihydroxycoumarin, coronalolide, montecristin, plakevulin A, dan asam shikimate.

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ABSTRACT
Fungal infection is one of the existing diseases in Indonesia. Most common fungal infections are the candidiasis and cryptococcosis disease which is caused by Candida sp and Cryptococcus sp fungi respectively. Both type of fungal infection often attacks people with low immune system, such as AIDS patients. This disease can be treated with antifungal compounds. Propolis contains compounds that has antifungal properties to Candida sp. and Cryptococcus sp. However, the compounds contained in propolis differs accoding to its source the bee that produces it, and its environment. The propolis used in the study is Indonesian propolis produced by Tetragonula biroi bee with two types of propolis, rough propolis and smooth propolis. The antifungal potential of Indonesian propolis can be discovered by observing its antifungal activity to a few species of Candida and Cryptococcus. Indonesia propolis in the form of etanol extract propolis EEP is tested on Candida albicans, C. krusei, C. glabrata, C. parapsilosis, C. tropicalis, dan Cryptococcus neoformans with the disc diffusion method. Indonesian propolis is discovered to have antifungal properties for all the fungi types tested with even higher diameter of inhibition compared to flukonazol on Candida krusei, Candida glabrata, and Cryptococcus neoformans, and on most fungal type, rough propolis shows a higher potential to inhibit the growth of fungi. The flavonoid and polyphenol content of Indonesian propolis which is categorized into smooth and rough propolis was discovered by using quercetin as the flavonoid standard and gallic acid as the polyphenol standard. The result shows that smooth propolis excels more in the two contents with 17,45 flavonoid dan 18,32 polyphenol compared to the 7,83 flavonoid dan 14,72 polyphenol on rough propolis. The active compounds of Indonesian propolis itself is done with the liquid chromatography mass spectroscopy LC MS method where it is discovered that Indonesian propolis has dehydroabetic acid, ziyuglycoside II, muscanone, 6,7 dihydroxycoumarin, coronalolide, montecristin, plakevulin A, and shikimic acid as its antifungal compounds.