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All Journal The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia
Usman, Nurhayat
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology

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Epidemiology of Microorganisms in intraabdominal infection/complicated intraabdominal infections in six centers of surgical care in Indonesia: A preliminary study Moenadjat, Yefta; Lalisang, Toar JM.; Saunar, Rofy S.; Usman, Nurhayat; Handaya, Adeodatus Y.; Iswanto, J.; Nasution, Safruddin; Karuniawati, Anis; Loho, Tony; Widyahening, Indah S.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Data of complicated intraabdominal infections (cIAI) and the epidemiology of causative microorganisms which is Indonesian characteristics is required to develop a guideline. Thus, a preliminary study run to find out such characteristics. Method. Data of subjects with cIAI managed in six centers of teaching hospital in Indonesia in period of 2015–2016 were collected. Those data of source of infection, the epidemiology of microorganism and susceptibility of antibiotics were descriptively provided. Results. Source of infection were perforated appendicitis (26.64%), perforated gastric and duodenal ulcer (22.70%), small bowel perforation (11.84%), large bowel perforation (13.16%), postoperative (9.54%), and others (16.2%). Escherichia coli and Klebsiella pneumonia were the most microorganisms found in the pus specimen. The sensitivity of Escherichia coli and Klebsiella pneumonia to cephalosporins were in range of 14.1– 42% and 28.7–35.6%, respectively. Conclusion. Perforated appendicitis, perforated gastric and duodenal ulcer, small bowel perforation, large bowel perforation, and postoperative in sequent are the main causal of cIAIin Indonesia. The epidemiology predominated by Gram negative, particularly Escherichia coli and Klebsiella pneumonia.
Pengaruh Pemberian Kanamisin Oral Sebelum Operasi pada Persiapan Kolon Mekanik Terhadap Konsentrasi Bakteri Kolon dan Rektum Herizal, Hendra; Usman, Nurhayat; Purnama, Andriana
Jurnal llmu Bedah Indonesia Vol 46 No 1 (2018): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v46i1.31

Abstract

Background. For decades, ​​colorectal surgical procedures have been associated with high postoperative infections complication. This is expected because of the large number of bacteria in the colon and rectum content. The aim of this study was to investigate wether preoperative oral kanamycin can reduce colonic bacterial concentration, furthermore reduce postoperative infection complication in colorectal malignancy patients who will be performed elective surgical tumor removal. Method. This was an experimental, pre-post test with control group desiagn study, ie groups of patient that prepared with mechanical bowel preparation and administration of oral Kanamycin 3 x 2000 mg a day before the operation day and group of patient that prepared with mechanical bowel preparation only. This study was comparing the concentration of bacteria in the colon and postoperative infection incidence between the two groups. Result. Thirty two patients were randomly assigned to one of two groups, the treatment group and the control group. Obtained equitable distribution of age, sex, tumor location and type of surgery. There was significant bacterial concentration reduction difference between two groups (p = 0.01). There was significant surgical site infection (SSI) incidence difference between two groups, 5 patients (31,3 %) developed an SSI in treatment group and 11 patients (68,8 %) in control group (p=0,03), with OR 0,21 ( CI 95%; 0,046-0,92). Conclusion. Preoperative oral kanamycin could reduce colonic bacteria concentration and SSI incidence in patients with colorectal malignancy who would be performed elective surgical tumor removal. Thus, these methods can be considered its use as a colorectal surgery preparation procedures.
The Relationship Between Initial Hematocrit and Base Excess For Signs Of Hemorrhagic Shock In Patients With Blunt Abdominal Trauma Akhsan, Alfie Barkah; Usman, Nurhayat; Rudiman, Reno
Jurnal llmu Bedah Indonesia Vol 45 No 1 (2017): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v45i1.38

Abstract

Introduction: Trauma abdominal and pelvic part of the largest causes of death and, if diagnosed early, the deaths could have been prevented. By increasing the capacity for early detection and prompt and appropriate action, will produce a satisfactory outcome. In patients with bleeding, hemodilution appear within a few minutes to obtain a decrease in hematocrit. BE decline is the result of pyruvic acid metabolism occurring anaerobic tissue hypoperfusion due to bleeding unresolved. There is a strong correlation between the decrease in hematocrit and BE with shock because of intra-abdominal haemorrhage. To analyze the relationship between decreased hematocrit and BE in bleeding patients we investigated the relationship between the initial value of hematocrit and BE against any signs of shock because of intra-abdominal hemorrhage in patients with blunt abdominal trauma. Methods: cross-sectional of the 34 subjects. The research data obtained from history taking, physical examination, investigation, and medical records. Conducted a comparative analysis of Kruskal-Wallis. Test for normality by Kolmogorov-Smirnov test. A p value <0.05 indicates a significant relationship between variables. Data were analyzed using SPSS version 19. Result: It was found an average increase in the pulse (P) frequency with decreasing hematocrit (Ht) is 92.67 ± 6.43x / min for group Ht> 40%, 95.5 ± 16.52x / min for group Ht 37-40%, and 112.89 ± 19.23x / min for group Ht <37%. Obtained an average increase of P frequency with decreasing Base Excess (BE) is 88.0 ± 0x / min for groups BE> 2, 92.33 ± 7.84x / min for BE Group 2 - (- 2), and 112.81 ± 19.22x / min for groups BE < -2. This means that there is a significant relationship between hematocrit decrease with increased of P frequency as one of the signs of hemorrhagic shock with p value = 0.046 and significant correlation between the decrease in BE with increased P frequency as one of the signs of hemorrhagic shock with p value = 0.028. Conclusion: There is a significant correlation between the value of the initial hematocrit and BE with signs of hemorrhagic shock due to intra-abdominal hemorrhage in patients with blunt abdominal trauma.
Hubungan antara Nilai Fibrinogen Inisial dengan Kejadian Koagulopati dan Mortalitas pada Pasien Trauma Multipel di Rumah Sakit Hasan Sadikin Bandung Sulistyanti, Raden Lyana; Rudiman, Reno; Usman, Nurhayat
Jurnal llmu Bedah Indonesia Vol 45 No 1 (2017): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v45i1.43

Abstract

Latar Belakang: Dari data suatu penelitian dikatakan 1 dari 7 kematian disebabkan oleh trauma dan 30% dari trauma tersebut datang dalam kondisi koagulopati. Koagulopati pada trauma disebut sebagai Trauma Induced Coagulopathy (TIC). Pada TIC, nilai fibrinogen yang rendah sering ditemui dan nilai fibrinogen plasma mencapai nilai terendah lebih awal dibandingkan parameter factor koagulasi lainnya. Nilai fibrinogen inisial berhubungan kuat dengan nilai Injury Severity Score (ISS) dan menjadi nilai prediktor independen untuk mortalitas. Penelitian ini bertujuan melihat hubungan antara fibrinogen inisial dengan kejadian koagulopati dan mortalitas. Metode: Penelitian ini merupakan studi prospektif. Seluruh pemeriksaan didapatkan dari 25 pasien trauma multipel. Kadar fibrinogen inisial diambil dari pemeriksaan laboratorium darah bersamaan dengan pemeriksaan rutin lainnya ketika pasien datang ke Instalasi Gawat Darurat Rumah Sakit Hasan Sadikin (IGD RSHS). Koagulopati ditentukan berdasarkan nilai laboratorium Prothrombin Time (PT) atau Partial Thromboplastin Time (aPTT) yang abnormal. Trauma multipel ditentukan dengan nilai ISS ≥ 15 dan dihitung berdasarkan diagnosis pasti setelah tegak berdasarkan pemeriksaan klinis dan penunjang sesuai dengan prosedur tetap di IGD RSHS. Analisis menggunakan SPSS 19.0 dengan metoea analisis chi square untuk melihat kemaknaan hubungan. Hasil: Dari 25 pasien trauma multipel didapatkan mayoritas 80% adalah pasien laki – laki dengan mekanisme kejadian terbanyak adalah trauma kepala sebanyak 16 orang (64%). Terdapat 8 pasien (32%) terjadi koagulopati dan mortalitas terjadi pada 7 pasien (28%). Dari metode analisis chi square didapatkan hubungan yang bermakna antara fibrinogen dengan kejadian koagulopati (p=0,043) sedangkan hubungan antara fibrinogen inisial dengan terjadinya mortalitas didapatkan tidak bermakna (p=0.341). Kesimpulan: Terdapat hubungan bermakna antara fibrinogen inisial dengan kejadian koagulopati tetapi tidak didapatkan hubungan bermakna antara fibrinogen inisial dengan terjadinya mortalitas pada pasien dengan trauma multipel di RSHS.
Co-Authors Akhsan, Alfie Barkah Andriana Purnama, Andriana Anis Karuniawati Handaya, Adeodatus Y. Herizal, Hendra Indah S. Widyahening Iswanto, J. Lalisang, Toar JM. Nasution, Safruddin Reno Rudiman Saunar, Rofy S. Sulistyanti, Raden Lyana Tony Loho Yefta Moenadjat