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All Journal International Journal of Public Health Science (IJPHS) BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana Jurnal Veteriner JURNAL WIDYA MEDIKA Medical Journal of Indonesia Indonesian Journal of Tropical and Infectious Disease Bali Journal of Anesthesiology ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Kedokteran: Media Informasi Ilmu Kedokteran dan Kesehatan Journal of Health Sciences and Medicine Bali Dental Journal Journal of Clinical Microbiology and Infectious Diseases
Ni Nyoman Sri Budayanti
Departemen Mikrobiologi Klinik Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Veterinary Other

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Role of β−lactamase in the susceptibility of clinical isolates to β−lactam antibiotics Soebandrio, A.; Sri-Budayanti, N. N.; Widayati, A.; Wiwing, V.; Nusatya, M. A.C.M.
Medical Journal of Indonesia Vol 13, No 3 (2004): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.679 KB) | DOI: 10.13181/mji.v13i3.147

Abstract

Combination of β−lactam antibiotic with β−lactamase inhibitor has been proven to overcome resistance caused by β−lactamase production. An evaluation to the MIC of some β−lactam antibiotics to β−lactamase producing isolates will be reported. A. anitratus, E. coli, K. pneumoniae, Proteus sp, Pseudomonas sp, S. aureus, S. epidermidis, S. pneumoniae, S. viridans, and β−hemolytic Streptococcus, were challenged to Ampicillin/Sulbactam (AMS), Amoxicillin/Clavulanic acid (AMC), Cefoperazone (CFP), Cefoperazone/Sulbactam (CSL), Ceftriaxone (CRO), dan Cefotaxime (CTX) using ETest techniques. β−lactamase production was identified using Cefinase disk. Sixtyfour percent of isolates were capable of producing β−lactamase. All E. coli and K. pneumoniae tested were β−lactamase producer, none of Proteus sp, Pseudomonas sp, and S. epidermidis tested produced β−lactamase. In β−lactamase producing group, Sulbactam was able to reduce resistance to CFP from 25% to 5%. About 20% of β−lactamase producing isolates which were resistant to CFP, were susceptible to CSL. Susceptibility of S.viridans to AMS, AMC, CFP, and CSL was higher than 80%, but less than 50% to CRO and CTX. S. pneumoniae was less susceptible to tested antibiotics, 50 to 60% susceptibility was shown to AMC, CFP, and CSL. S.aureus was 60 to 70% susceptible, while β−haemolytic Streptococcus showed good response to the tested antibiotics. Only 30% or less of K. pneumoniae and E. coli was susceptible to AMS and AMC. A. anitratus showed good susceptibility only to AMS (78%) and CSL (89%). Sixtyfour percent of isolate studied produced β−lactamase. β−lactamase inhibitor could reduce resistance of β−lactamase producing organism to β−lactam antibiotic from 25 to 5 percent. (Med J Indones 2004; 13: 140-5)Keywords: Antibiotic Susceptibility, MIC, β−lactam antibiotic, β−lactamase inhibitor
SURGEONS BEHAVIOR TOWARD PROPHYLAXIS ANTIBIOTICS IN SANGLAH HOSPITAL Suranadi, I Wayan; Sukrama, Dewa Made; Budayanti, Ni Nyoman Sri; Pradhana, Adinda Putra; Amin, Yusuf Sidang
Bali Journal of Anesthesiology Vol 2, No 3 (2018)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.011 KB) | DOI: 10.15562/bjoa.v2i3.102

Abstract

 Background: The emergence of antibiotic resistance is a complicated problem due to many factors, especially its use and abuse. Inappropriate use of antibiotics is very common in both developed and developing countries. The goal of this study was to see the knowledge of the surgeons toward prophylaxis antibiotic at Sanglah Hospital.Methods: This is a descriptive study of 55 surgeons who performed elective surgery at Sanglah Hospital. A questionnaire was filled by the surgeons randomly without prior notice about the study. The information about their behavior toward prophylaxis antibiotics was gathered from medical record of the day.Result: Out of the 55 surgeons participated in this study, 85.5% have followed a training on rational antibiotic use. The level of knowledge about factors that can increase surgical wound infections is quite good (94.4%), while the knowledge regarding factors that can reduce surgical wound infections very low (16.4%). Almost all (92.7%) clean-surgery patients were given prophylactic antibiotics. The most given antibiotic was ceftriaxone (72.7%), the third generation of cephalosporins.Conclusion: The mean knowledge of the surgeons toward antibiotic prophylaxis was 59.8%. The most used antibiotic as pre-surgical prophylaxis was ceftriaxone. And the time of administration for prophylaxis antibiotic was 16-60 minutes prior to surgical incision.
Antimicrobial susceptibility patterns of Acinetobacter baumanii isolates from ICU and non-ICU wards Budayanti, Ni Nyoman Sri; Suranadi, I Wayan; Tarini, Made Adi; Violentina, Gusti Ayu Dianti; Sathya Deva, I Dewa Gde
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (320.369 KB) | DOI: 10.15562/bjoa.v3i1.147

Abstract

ABSTRACTIntroduction: Acinetobacter baumanii is the most common agent of hospital-acquired infection with the increasing fatality rate due to multidrug-resistant (MDR) strain infection. The magnitude of the problem in Indonesia is unknown. Here, we provide data regarding susceptibility pattern of A. baumanii isolated from a tertiary referral hospital in Bali, Indonesia between 2012 and 2014.Methods: Data were collected retrospectively from culture-based records in the Clinical Microbiology department, Sanglah General Hospital during 2012-2014. A. baumanii was isolated from clinical specimens. Identification and antimicrobial susceptibility test were conducted using micro-dilution method (Vitek-2 Compact system). Isolates that resistant to ≥ 3 antibiotic classes were categorized as multi-drug resistant (MDR) A. baumanii.Results: A. baumanii collected from sputum in intensive care unit (ICU) wards were 7.9%, 11.1%, and 7.0%, while the isolates from sputum in non-ICU wards were 13.1%, 15.6%, and 19.9% in 2012, 2013, and 2014, respectively.  There was a reduced susceptibility of A. baumanii to ciprofloxacin, levofloxacin, ceftazidime, aztreonam, imipenem, ampicillin-sulbactam, and piperacillin-tazobactam in ICU ward. Meanwhile, the susceptibility of A. baumanii to Cotrimoxazole remained high in both ICU and non-ICU ward. MDR A. baumanii is found to be resistant to fluoroquinolones, cephalosporins, aztreonam, aminoglycosides, beta-lactamase inhibitors, and carbapenem. Data were analyzed and presented in a descriptive manner.Conclusion: Three years surveillance showed that the susceptibility of A. baumanii to most common antibiotics was decreasing. MDR A. baumanii was found to be resistant to all classes of common antibiotics mostly from ICU ward isolates. 
Udayana One Health Collaborating Center (OHCC) initiated Bali’s first mass, integrated basic life support training Sudewi, Anak Agung Raka; Budayanti, Nyoman Sri; Wiryana, Made; Senapathi, Tjokorda Gde Agung; Ryalino, Christopher; Pradhana, Adinda Putra
Bali Journal of Anesthesiology Vol 3, No 1 (2019)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (174.494 KB) | DOI: 10.15562/bjoa.v3i1.136

Abstract

ABSTRACTBasic Life Support (BLS) is a first-aid training that can be utilized in case of emergency until the victims are retained by medical professionals. Mastering BLS skills can be the difference between life and death. A cardiopulmonary resuscitation (CPR) performed by a passer-by is important to ensure a successful resuscitation in out-of-hospital cardiac arrest. Yet, improving the survival rate for out-of-hospital cardiac arrest is still a major problem. Starting in 2019, Udayana One Health Collaborating Center (Udayana OHCC) will implement the first mass and integrated BLS training in Bali. The goals are to introduce BLS to more people and to produce BLS-friendly environment in Bali.
IMMUNE RESPONSE AND COST ANALYSIS OF INTRADERMAL RABIES VACCINATION FOR POST-EXPOSURE PROPHYLAXIS REGIMEN IN HUMAN Budayanti, N. S.; Susilawathi, N. M.; Darwinata, A. E.; Dwija, I. B. P.; Fatmawati, N. D.; Wirasandhi, K.; Subrata, K.; Susilarini, N. K.; Wignall, F. S.; Sudewi, A. A. R.; Mahardika, and G. N. K.
BALI MEDICAL JOURNAL Vol 3 No 1 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background The outbreak of rabies in human in Bali-Indonesia is causing an extraordinary pressure for the government in providing adequate doses of anti-rabies vaccine for post-exposure prophylaxis (PEP). Here, we directly compare the immune response and benefit of the intradermal (ID) protocol for rabies vaccine delivery with the intramuscular (IM) route. Methods: Sixty health workers who were willing to participate in this study have been randomly selected and grouped into ID, IM, and control groups, each with 20 volunteers. The Thai Red Cross ID- and Zangreb IM-protocols have been applied to the respective group. The sera of the volunteers were collected at day 0, week 1, week 3, week 4, month 3, month 6, month 9, and month 12 after the first vaccination. Anti-rabies virus IgG was detected using PlateliaTM Rabies II Kit (Bio-Rad). Results: Anti-rabies IgG could be detected in the ID-group at one week. The ID-vaccine delivery induced a slightly higher maximum antibody titer compared to IM, though not statistically significant (p>0.05). ID vaccination caused less adverse reactions and produces longer lasting protective immune response. Cost minimization analysis (CMA) on the provincial and national PEP data in 2009-2011 shows that the ID-delivery will reduce the total cost for a completed regimen by USD 28.5, and would have saved the Indonesian government budget approximately USD 3.6 and 4.3 million for complete regimens in Bali and Indonesia, respectively. Conclusion: The ID administration of anti-rabies vaccine induces a similar immune response compared to that of intramuscular injection. It also produces longer lasting protective immune response. It offers additional advantages of potential net cost savings as well as decreasing the pressure on vaccine availability due to the high number of dog bite cases.
GROUP-B STREPTOCOCCUS IN PREGNANT WOMEN: Prevalence of Colonization and Sensitivity Pattern in Denpasar during June 2007?May 2008 Sri-Budayanti,, N; Hariyasa-Sanjaya, and, N
BALI MEDICAL JOURNAL Volume 2 Number 1, January-April 2013
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Group-B Streptococci (GBS) are Gram-positive cocci that are the most common cause of early onset neonatal sepsis. The mortality rate of early onset neonatal sepsis has been reported up to 50%. One of the major risks of early onset neonatal sepsis is GBS colonization in birth canal of pregnant women that can infect the baby during process of vaginal delivery. Antibiotic chemoprophylaxis for pregnant women that is colonized by GBS can reduce the risk of early onset neonatal sepsis. The detection of GBS colonization needs Todd Hewitt (TH) enrichment medium to reduce false negative result. Until now, there is no report about either prevalence of colonization or sensitivity pattern of Group B Streptococcus among pregnant women in Denpasar. The aims of this research were to determine the prevalence of GBS colonization and sensitivity pattern of GBS among pregnant women with Todd Hewitt enrichment medium. Method: This research was a descriptive cross-sectional study. Vaginal swab specimens from 35-37 weeks gestation pregnant women were collected and 32 samples that met the inclusion criteria were cultured on Blood agar (BA) plates, Chromagar (CA) plates, and Todd Hewitt (TH) broth. The GBS colonization that grew in culture medium was followed by antibiotic sensitivity test. Results: In the present study, we found that the prevalence of GBS colonization in pregnant women detected with culture method using BA and CA without TH broth was 9.4%, whereas the prevalence with culture method using BA and CA enriched by TH broth was 31.3%. Moreover, GBS showed resistance to penicillin, erythromycin, and cefazolin. It is indicated that TH enrichment medium seems to be promising as a screening method for GBS colonization in pregnant women in Bali. Conclusion: There was an enrichment detection of GBS prevalence colonization in pregnant women detected the swab with culture method using BA and CA enriched by TH compare to BA and CA without TH broth. Moreover, GBS showed resistance to penicillin, erythromycin, and cefazolin. It is indicated that TH enrichment medium seems to be promising as a screening method for GBS colonization in pregnant women in Bali.
Application Anti Microbial Activity Test and Direct Inoculation of Urinary Specimen Test to Increase the Quality of Results and Decrease the Production Cost in Clinical Microbiology Laboratory, Sanglah General Hospital Hospital, Bali-Indonesia Sri-Budayanti, N.; Sukrama, I. D. M.; Aditarini, M.; Sukardika, I. K.; Suata, I.K.
BALI MEDICAL JOURNAL Volume 1, Number 2, May-August 2012
Publisher : BALI MEDICAL JOURNAL

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Abstract

Objective: Urinary tract infection (UTI) is the most common bacterial infection in general practice and in hospitals. Fast and accurate urine culture and sensitivity test are needed for adequate therapy. Anti Microbial Activity test (AMA test) that is used to detect the presence of antibiotics in urine specimens is not commonly used in clinical microbiology laboratories. Some laboratories are still using indirect inoculation technique using enriched media before inoculating onto the agar media. The aim of this research is to compare results of urinary examination of direct inoculation technique with AMA test with indirect inoculation technique without AMA test. Methods: A number of 210 urine specimens were collected in Clinical Microbiology Laboratory at Sanglah General Hospital within a time period between 16 June until 16 July 2009. Results: Antibiotics were detected in 40% of the urinary specimens; whereas 48.1% showed no evidence of UTI, that is negative AMA test and sterile urinary culture or colony growth < 105 CFU/ml. Only 11.9% of the specimens indicates urinary tract infections. The examination can be completed within 2-3 days which is shorter than indirect inoculation test which require 5-7 days. Direct inoculation technique can reduce the cost of production three-fold the costs require for an indirect inoculation test. Conclusions: Application of AMA test and direct inoculation technique can give results more rapidly, reliable and useful for clinicians. This also decrease the laboratory’s cost of production.
CRYOTHERAPY PADA DESCEMETOCELE REKUREN POST-PERIOSTEAL GRAFT : LAPORAN KASUS PADA KERATOKONJUNGTIVITIS GONOKOKUS Yenny K, Nyoman; Susila, NK Niti; Budayanti, Nyoman Sri
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Abstract

Keratokonjungtivitis gonokokus disebabkan oleh Neisseria gonorrhoeae, kokus gram negatif yangmenginvasi epitel kornea intak menyebabkan keratolisis stroma kornea hingga perforasi. Membrandescemet merupakan barrier terhadap mikroorganisme, namun ketika ditembus oleh mikroorganisme,akan  menonjol ke depan membentuk descemetocele. Dilaporkan satu kasus descemetocele padakeratokonjungtivitis gonokokus pada wanita usia 45 tahun di Rumah Sakit Umum Pusat SanglahDenpasar. Penderita mengeluh pandangan buram, kotoran mata kekuningan, kental sejak 6 hari,kelopak mata bengkak dan bintik hitam di mata kanan. Tajam penglihatan mata kanan 5/60.Pemeriksaan oftalmologi pada mata kanan didapat udem palpebra , konjungtiva sekret mukopurulenmasif, conjunctival vascular injection dan pericorneal vascular injection, udemkornea dan descemetoceledi jam 1, ukuran  3x2 mm, bilik mata depan dangkal dan fibrin, iris retraksi, pupil ireguler dan reflekpupil negatif, lensa tertutup fibrin, vitreus sulit dievaluasi, reflek fundus positif. Pada penderita telahdilakukan periosteal graft namun flap bergeser sehingga dilakukan tindakan ulangan cryotherapy yangmemberikan hasil baik. [MEDICINA 2015;46:184-8]Gonococcus keratoconjunctivitis caused by Neisseria gonorrhoeae, a gram-negative coccus thatinvading intact corneal epithel causing keratolysis until perforation. Descemet membrane is a barrierfor microorganism, but when penetrated by microorganism, it will bulging forming descemetocele.Wereported a case descemetoceleon gonococcus keratoconjunctivitis of a 45 years old woman in SanglahHospital-Denpasar.Patient complained blurry vision, white-yellowish secrete, purulent since 6 days,palpebra edema, and black dot on right eye. Right eye visual acuity was 5/60. Ophthalmologyexamination of palpebra was edema, massive conjunctival mucopurulene secrete, conjunctival vascularinjection, pericorneal vascular injection, corneal edema, and descemetocele at 1o’clock hour, size 3x2mm, shallow anterior chamber and fibrin, iris retracted, irregular pupil, negative pupil reflex, fibrincovered by lens, can not evaluated vitreous, funduscopy reflex positive.Patient had been treated withgraft periosteal but then the flap was sliding, so we treated patient with cryotherapy and gave goodresult. [MEDICINA 2015;46:184-8].
Staphylococcus Aureus Colonization On An Erythrodermic Psoriasis Patient Dave Gerald Oenarta; NN Sri Budayanti; NN Dwi Fatmawati; NM Adi Tarini
JURNAL WIDYA MEDIKA Vol 5, No 2 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (533.597 KB) | DOI: 10.33508/jwm.v5i2.2204

Abstract

Skin plays an important role as the physical barrier and first-line immunological defense against dangerous stimuli, including bacteria. Erythroderma is a condition of excessive skin irritation causing extensive erythema and desquamation. Erythroderma itself is caused by various underlying conditions, one of them is psoriasis vulgaris. In erythroderma, there is an extensive disruption of physical barrier leading to the exposure of various bacteria, including Staphylococcus aureus. In human, this bacteria can either colonize or infect the host if exposed to open wound. It is essential to determine this as it will affect the necessity of administering antibiotics. Laboratory examinations such as complete blood count, Gram staining, and culture can help to determine the status of this bacteria. A correlation between clinical features and laboratory examinations is paramount in deciding patient management.
KARAKTERISTIK ANTIBIOGRAM ISOLAT Escherichia coli DAN Klebsiella pneumoniae DARI RUANG INTENSIVE CARE UNIT DAN NON-INTENSIVE CARE UNIT DI RSUP SANGLAH SELAMA TAHUN 2018-2020 Ni Luh Ranthi Kurniawathi; Indramawan Setyojatmiko; Ni Nyoman Sri Budayanti
JURNAL KEDOKTERAN Vol 7 No 1 (2021): Desember 2021
Publisher : Fakultas Kedokteran Universitas Islam Al-Azhar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36679/kedokteran.v7i1.421

Abstract

Resistesi antibiotik meningkat secara global dalam beberapa tahun ini, terutama kejadian Escherichia coli (E.coli) dan Klebsiella pneumoniae (K.pneumoniae) penghasil Extended Spektrum Beta Lactamases (ESBL). Tujuan dari penelitian ini adalah untuk memberikan gambaran prevalensi keberadaan dan antibiogram isolat E.coli dan K. pneumoniae penghasil ESBL di rumah sakit tersier di Bali. Penelitian retrospektif potong lintang ini dlikaukan pada Januari 2018- Desember 2020 di Rumah Sakit Umum Pusat Sanglah, Bali. Identifikasi bakteri dan uji sensitivitas antibiotik dilakukan dengan alat otomatis Vitek®2 Compact. Hasil penelitian menunjukkan dari 2972 isolat, 1067 (63,82%) isolat adalah E. coli penghasil ESBL dan 902 isolat (69,39%) adalah K. pneumoniae penghasil ESBL. Isolat penghasil ESBL ditemukan terbanyak pada non-ICU (89,39%). Bakteri E.coli penghasil ESBL menunjukkan sensitivitas > 80% terhadap Amikacin, Ertapenem, Meropenem, Nitrofurantoin, Piperacillin-tazobactam, dan Tigecycline. Sedangkan, K. pneumoniae penghasil ESBL menunjukkan sensitivitas > 80% terhadap Amikacin, Ertapenem, Meropenem, dan Tigecycline. Penelitian ini menyoroti tingginya prevalensi E.coli dan K.pneumoniae penghasil ESBL di rumah sakit rujukan tersier di Bali. Analisis yang seksama dari antibiogram kedua spesies penghasil ESBL tersebut akan membantu menyusun kebijakan penggunaan antibiotik dan pencegahan, pengendalian penyebaran bakteri penghasil ESBL.Kata Kunci: Escherichia coli; Klebsiella pneumoniae; Extended Spectrum Beta Lactamases; ICU dan Non-ICU
Co-Authors A. Soebandrio A. Widayati Adinda Putra Pradhana Agus Eka Darwinata Agus Roy Rusly Hariantana Hamid Agus Simahendra Agustinus I Wayan Harimawan Ajeng Diantini Amin, Yusuf Sidang Anak Agung Gede Indraningrat Anggita Dewi Anselmus Helbert Eriata Carolin Wijaya Christopher Ryalino D A Indah Gitaswari Dave Gerald Oenarta Dea Antariksa Dewa Ayu Agung Anggita Ningrat Dyah Pradnyaparmita Duarsa Erly Sintya Erly Sintya F. S. Wignall Fedik Abdul Ratam Gresya Hendrawan Gusti Ayu Dianti Violentina Hearty Indah Oktavian I Dewa Agung Gede Meisha Dhanam I Dewa Ayu Made Dian Lestari I Dewa Made Sukrama I Dw. Gd. Bayu Artha Pratama Putra I Gde Pangestu Putrama Winatha I Gede Gita Sastrawan I Gede Pradnya Wisnu Murthi I Gusti Agung Indah Pradnyani R.S I Gusti Ayu Dewi Ratnayanti I Gusti Ayu Rai Widowati I Gusti Ayu Rai Widowati I Gusti Kamasan Arijana I Gusti Ngurah Kade Mahardika I Gusti Ngurah Mayun I Gusti Nyoman Sri Wiryawan I Gusti Putu Suka Aryana I Kadek Bayu Adhi Candra I Ketut Agus Indra Adhiputra I Ketut Agus Indra Adhiputra I Made Sutha Saskara I Nengah Tony Rustawan I Nyoman Hariyasa Sanjaya I Nyoman Wande I Wayan Adi Pranata I Wayan Rivandi Pradiyadnya Mardana I Wayan Sugiritama I Wayan Suranadi I. B. P. Dwija I. K. Sukardika I.K. Suata Ida Ayu Andhira Dewi Suarisavitra Ida Ayu Putu Putri Andari Ida Bagus Gede Adiguna Wibawa Ida Sri Iswari Imaculata Sonia Vidaryo Lameng Indramawan Setyojatmiko K. Subrata K. Wirasandhi Kadek Anggie Wigundwipayana Kadek Dede Frisky Wiyanjana Kadek Karang Agustina Komang Januartha Putra Pinatih Krishna Murprayana Luh Inta Prilandari M. A.C.M. Nusatya Made Agus Hendrayana Made Widianantara Made Wiryana Marco Reeiner Marta Setiabudy N. K. Niti Susila, N. K. N. K. Susilarini Ni Kadek Seri Mahayanti Ni Komang Semara Yanti Ni Luh Made Mirah Rahayu Ni Luh Putu Harta Wedari Ni Luh Putu Harta Wedari Ni Luh Putu Harta Wedari Ni Luh Ranthi Kurniawathi Ni Made Adi Tarini Ni Made Linawati Ni Made Mertaniasih Ni Made Susilawathi Ni Nengah Dwi Fatmawati Nyoman Indra Karunia Putri Nyoman Yenny K, Nyoman Pande Putu Januraga Prisela Zharaswati Prisillia Brigitta Putu Arya Suryanditha Putu Dian Pratita Lestari Raka-Sudewi A. A. Sari Kusumadewi Sathya Deva, I Dewa Gde Shita Diwyani Sudarsa Tjokorda Gde Agung Senapathi V. Wiwing Violentina, Gusti Ayu Dianti Wahyu Hidayati