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SUSCEPTIBILITY OF RIFAMPICIN-ISONIAZID RESISTANT MYCOBACTERIUM TUBERCULOSIS ISOLATES AGAINST LEVOFLOXACIN Kurniawan, Alvin Hartanto; Mertaniasih, Ni Made; Soedarsono, S.
BALI MEDICAL JOURNAL Vol 5 No 1 (2016)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (453.946 KB)

Abstract

Background: Tuberculosis (TB) is a high burden disease in Indonesia with multidrug-resistant (MDR) TB incidence started to increase. Treatment success of MDR-TB globally was low in number than it was targeted which was especially caused by fluoroquinolone resistance. One of the fluoroquinolone is levofloxacin, an antibiotic that has been widely used irrationally as antimicrobial treatment. Therefore, this study investigated the sensitivity and MBC of MDR Mycobacterium tuberculosis isolates against Levofloxacin. Method: The susceptibility test for MDR -Mycobacterium tuberculosis on levofloxacin by standard method with levofloxacin were on concentrations 0,5 ?g/ml, 1 ?g/ml, and 2 ?g/ml. Sample of 8 strains MDR-Mycobacterium tuberculosis were cultured with each concentrations on Middlebrook 7H9 for 1 week incubation. Next, each of the incubated concentration was subcultured on solid media Middlebrook 7H10 for 3 weeks incubation. Colonized agar plates after 3 weeks incubation were confirmed with acid-fast stain. Results: On MB 7H10 with levofloxacin concentration 2 ?g/ml showed bactericidal effect 100% by no MDR Mycobacterium tuberculosis colony grew (0/8) while the MB 7H10 with levofloxacin concentration 1 ?g/ml and 0,5 ?g/ml showed the bactericidal effect 37,5% and 25% respectively. The colonized agar plate implied that the MDR Mycobacterium tuberculosis with levofloxacin concentration 1 ?g/ml (5/8) and 0,5 ?g/ml (6/8) grew well. Conclusion: Levofloxacin concentration 2 ?g/ml was susceptible on MDR Mycobacterium tuberculosis. The concentration 2 ?g/ml of levofloxacin could be considered as MBC.
SPECIFIC GYRB SEQUENCE OF MYCOBACTERIUM TUBERCULOSIS CLINICAL ISOLATED FROM SPUTUM OF PULMONARY TUBERCULOSIS PATIENTS IN INDONESIA Mertaniasih, Ni Made; Wiqoyah, Nurul; Kusumaningrum, Deby; Soedarsono, S.; Perwitasari, Agnes Dwi Sis; Artama, Wayan Tunas
BALI MEDICAL JOURNAL Vol 3 No 3 (2014)
Publisher : BALI MEDICAL JOURNAL

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Abstract

Background: Indonesia have many different geographic areas which could be various on the variant strains of Mycobacterium tuberculosis. The gyrB gene codes GyrB protein as sub unit compound of Gyrase enzyme that functioning in multiplication of bacteria. Detection of gyrB gene could be a marker of active multiplication of viable bacteria in the specimen from patients; and some of the DNA sequence regions were conserved and specific in the strain of Mycobacterium tuberculosis that would be a marker for identification. This research aims to analyze the sequence of gyrB gene of Mycobacterium tuberculosis clinical isolates from sputum of pulmonary TB patients in Indonesia, and determine the specific region. Method: Mycobacterium tuberculosis clinical isolates have been collected from sputum of the patients with pulmonary TB that live in some area in Indonesia. Isolation and identification of Mycobacterium tuberculosis clinical isolates using standard culture method; sequence analysis using PCR-direct sequencing of the part bases region of gyrB. Results: this study revealed that nucleotide sequence on a fragment 764 bases of gyrB gene Mycobacterium tuberculosis strains among clinical isolates almost identically to a wild type strain Mycobacterium tuberculosis H37Rv and subspecies member of Mycobacterium tuberculosis complex (MTBC), with a little difference of SNPs; there are many difference nucleotide sequence with MOTT and Gram positive or negative bacteria, except Corynebacterium diphtheria identically with MTBC. Conclusion: the gyrB sequence in Mycobacterium tuberculosis strains among these clinical isolates from sputum of pulmonary TB patients in Indonesia have the conserved specific DNA region that almost identically with wild type strain H37Rv and MTBC.
THE EFFECT OF DENSITY AND FLOOR TYPES ON PERFORMANCE, PHYSIOLOGICAL STATE AND IMMUNE RESPONSE OF BROILERS Sunarti, D.; Haryono, H.; Soedarsono, S.
Journal of the Indonesian Tropical Animal Agriculture Vol 35, No 4 (2010): (December)
Publisher : Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jitaa.35.4.275-281

Abstract

The purpose of this research was to study the effect of density and floor types on performance,physiological state and immune response of broilers. The research involved 368 male broilers of theNew Lohman strain aged 8 days which were raised up to 35 days at different densities and floor types.Floor types consisted of rice hull litter and bamboo slat were used as the main plot; while densities of 7,10, 13 and 16 birds/m2 applied as the sub-plot. The results showed that the final body weight gain of the35-day Lohmann broilers at densities of 7, 10 and 13 birds/m2 were 28.22, 24.43 and 19.27 kgrespectively, compared to 16 birds/m2 at 13.53 kg (P>0.05). Broilers in the bamboo slats floor hadlymph weight at 3.73 g compared to the litter floor at 2.55 g (P<0.05). Also, broilers in the bambooslats had average RHL (0.65) lower than broilers in the litter floor (0.79). It could be concluded thatbamboo slats best being used for broilers up to a density of 13 broilers/m2.
THE CORRELATION BETWEEN SEX, AGE, NUTRITIONAL STATUS AND DIABETES MELLITUS WITH CLINICAL SYMPTOMS MDR PULMONARY TB AT RSUD DR SOETOMO Ni Putu Anggita Medyantari; Soedarsono Soedarsono; Manik Retno Wahyunitisari
Jurnal Kedokteran Syiah Kuala Vol 19, No 2 (2019): Volume 19 Nomor 2 Agustus 2019
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v19i2.18063

Abstract

Abstract. Multi-drug resistance is a condition where drugs rifampicin and isoniazid is not effective in killing bacteria Mycobacterium tuberculosis. Some of the causes of resistance to OAT are the use of a single drug in the treatment of tuberculosis, the use of drugs is inadequate and the irregular drug administration. In RSUD Dr. Soetomo, 25% of MDR Pulmonary TB patients do not want to be treated because symptoms are mild, no pain and feel the treatment is not comparable with the symptoms. This research is to determine the correlation between sex, age, nutritional status and diabetes mellitus with the clinical description of MDR pulmonary TB patients in RSUD Dr. Soetomo. Hence, it is expected  people can make the earliest possible prevention against this disease. In addition, clinicians are more aware of the symptoms of MDR Pulmonary TB. Method in this research is  descriptive observational study research. There were  103 patients taken as the sample of the study. Research variables consist of sex, age, nutritional status, and diabetes mellitus. The obtained data were analyzed by administering Chi- square analysis. The results of this study showed that each  variable tested in this study (sex, age, nutritional status and diabetes mellitus) associated with the symptoms of MDR Pulmonary TB  has  p 0.05 which means no significant relationship. There are no relation between sex, age, nutrition status and comorbidities with symptom of MDR pulmonary TB.  Keywords: multidrug resistance, sex, age, nutritional status, diabetes mellitus Multi-drug resistance adalah suatu kondisi dimana obat rifampisin dan isoniazid tidak efektif dalam membunuh bakteri Mycobacterium tuberculosis. Beberapa penyebab resistensi terhadap OAT adalah penggunaan obat tunggal dalam pengobatan tuberkulosis, penggunaan obat tidak memadai dan pemberian obat tidak teratur. Di RSUD Dr. Soetomo, 25% pasien TB paru MDR tidak mau diobati karena gejalanya ringan, tidak terasa sakit dan rasakan pengobatannya tidak sebanding dengan gejalanya. Penelitian ini bertujuan untuk mengetahui hubungan antara jenis kelamin, umur, status gizi dan diabetes mellitus dengan gambaran klinis pasien TB paru MDR di RSUD Dr. Soetomo. Sehingga diharapkan masyarakat bisa melakukan pencegahan paling dini terhadap penyakit ini. Selain itu, dokter lebih sadar akan gejala TB paru MDR. Metode yang digunakan dalam penelitian ini adalah penelitian observasional deskriptif. Terdapat 103 pasien yang diambil sebagai sampel penelitian. Variabel penelitian terdiri dari jenis kelamin, umur, status gizi, dan diabetes mellitus. Data yang diperoleh dianalisis dengan analisis Chi-square. Hasil penelitian ini menunjukkan bahwa setiap variabel yang diuji (jenis kelamin, usia, status gizi dan diabetes mellitus) yang dihubungkan dengan gejala TB paru MDR memiliki p 0,05 yang berarti tidak ada hubungan yang signifikan. Kesimpulannya, tidak ada hubungan antara jenis kelamin, usia, status gizi dan komorbiditas dengan gejala TB paru MDR.
HUBUNGAN JENIS KELAMIN, USIA DAN PEKERJAAN DENGAN KEJADIAN ASFIKSIA GANTUNG DIRI DI RSUD DR SOETOMO TAHUN 2013-2016 Siti Ermawati; Bendrong Moediarso; Soedarsono Soedarsono
Indonesian Journal of Legal and Forensic Sciences (IJLFS) Vol 8 No 1 (2018): Indonesian Journal of Legal and Forensic Sciences
Publisher : Penerbit, sejak 2012 : Asosiasi Ilmu Forensik Indonesia dan UPT Lab. Forensik Sain dan Kriminilogi - Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/IJLFS.2018.v08.i01.p04

Abstract

Latar Belakang: Bunuh diri merupakan fenomena yang terus meningkat dan hingga kini belum dapat dipahami secara pasti penyebab munculnya tindakan bunuh diri oleh seseorang. Bunuh diri merupakan penyebab kedua tertinggi kematian individu dengan rentang usia 15-29 tahun di dunia. Salah satu cara bunuh diri adalah mati gantung diri (hanging). Hanging adalah bentuk kematian akibat pencekikan dengan alat jerat, gaya yang bekerja pada leher berasal dari hambatan gravitasi berat tubuh atau bagian tubuh sehingga menimbulkan asfiksia lalu kematian. Tujuan: Mengetahui hubungan antara jenis kelamin, usia dan pekerjaan dengan kejadian asfiksia gantung diri di RSUD Dr Soetomo tahun 2013-2016. Metode: Merupakan jenis penelitian analitik desain cross sectional dengan sampel korban meninggal asfiksia di Instalasi Kedokteran Forensik & Medikolegal RSUD Dr Soetomo tahun 2013-2016. Hasil: dari 108 data meliputi 45 data korban meninggal karena asfiksia gantung diri dan 63 data korban meninggal karena asfiksia tidak gantung diri menunjukkan ada hubungan usia dengan kejadian asfiksia gantung diri (p=0,036) dan nilai contingency coefficient 0.221 yang artinya terdapat hubungan berkekuatan lemah. Namun, tidak ada hubungan antara jenis kelamin dengan terjadinya asfiksia gantung diri (p=1). Tidak ada hubungan antara pekerjaan dengan terjadinya asfiksia gantung diri (p=0,264). Kesimpulan: ada hubungan antara usia dengan kejadian asfiksia gantung diri. Namun, tidak ada hubungan antara jenis kelamin dan pekerjaan dengan terjadinya asfiksia gantung diri. Diperlukan sosialisasi kepada masyarakat tentang faktor risiko terjadinya asfiksia gantung diri agar kewaspadaan masyarakat meningkat dan asfiksia gantung diri dapat dicegah. Diperlukan penelitian lebih lanjut dengan variabel lain agar faktor risiko asfiksia gantung diri dapat diketahui secara pasti.
Analysis of IFN-gamma and IL-10 Levels as Markers of Inflammation and Response Therapy of Anti-Tuberculosis in MDR Lung TB Patients Herni Setyawati; Soedarsono Soedarsono; Yulistiani Yulistiani; Umi Fatmawati
Folia Medica Indonesiana Vol. 55 No. 4 (2019): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (317.191 KB) | DOI: 10.20473/fmi.v55i4.24394

Abstract

Multidrug-Resistant Tuberculosis (MDR TB) is caused by an organism that is resistant to at least isoniazid and rifampisin, the two most potent TB drug. Immune response to against Mycobacterum tuberculosis infection is related to the function of immunity. The function of interferon-γ (pro-inflammatory) is to activate macrophages, to stimulate antimicrobial molecules (to reactive oxygen species and nitric oxide), and to inhibits interleukin-10. Interleukin-10 function is to triggers humoral immunity, to inhibit IFN- γ. This study aimed to analyze level changes and the correlation with clinical data, also months of MDR TB patients who received standard OAT therapy. This was an observational study using cross sectional design. There were 29 patients who received standard MDR TB OAT therapy from 1-24 months, who met the inclusion criteria. Then, the patients were divided based on duration of the therapy, which are the initial/intensive and advanced phase. The initial phase divided into 2: first one is for 1-4 months therapy’s time (5 patients) and the second one is for more than 4-8 months (6 patients). Then, the advanced group divided into two groups again, which are third group with more than 8-16 months (13 patients) and fouth group with more than 16-24 months (5 patients). Then, measured serum concentration IFN-γ, IL-10 at the start of the study and 4 weeks later with the ELISA method. This research during the period July-December (6 months). IFN-γ post concentrations were decreased by 39.14 ± 139.12 pg/mL (p > 0.05). The concentration of IL-10 was decreased by 33.93 ± 109.20pg/mL (p>0.05). Based on the TB score bandim method during pre and posts results were 1 patient experienced severity change from severity class 1 to 2, 1 patient from severity class 2 to 1, 1 patient remained in severity 2 and 26 patient remained in severity 1. The results showed that serum IFN-γ and IL-10 levels in initial/intensive and advanced phase patients who received MDR TB regiment after four weeks did not changed,
THE RISK FACTORS FOR DRUG INDUCED HEPATITIS IN PULMONARY TUBERCULOSIS PATIENTS IN DR. SOETOMO HOSPITAL Soedarsono Soedarsono; Sari Mandayani; Kinasih Prayuni; Rika Yuliwulandari
Indonesian Journal of Tropical and Infectious Disease Vol. 7 No. 3 (2018)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (457.097 KB) | DOI: 10.20473/ijtid.v7i3.8689

Abstract

Tuberculosis (TB) is still a major public health problem in Indonesia. Anti-tuberculosis drug-induced hepatotoxicity (DIH) is common side effect leading to changes in treatment regimens, and the less effective second-line treatments. Several risk factors such as age, sex, body mass index (BMI) and acetylization status for hepatotoxicity were suggested in previous studies but in the fact, those are often not related to DIH incidence after receiving standard TB treatment regimen. The aim of this study was to asses the role of risk factors in the DIH incidence in pulmonary TB patients receiving standard TB treatment regimen in Dr. Soetomo Hospital, Surabaya. Study design was analytic observational with case control. The subjects were 30 TB DIH patients and 31 TB non-DIH patients receiving standard national TB program therapy. DIH severity was divided based on International DIH Expert Working Group. Demographic data and BMI status were taken from medical records. The age classification are ≥35 years old and <35 years old as one of the risk factors studied. DNA sequencing was used to assess single-nucleotide polymorphisms in NAT2 coding region to evaluate acetylator status from blood samples. The risk factors were evaluated using chi-square test and Mantel-Haenszel test. Significant association between low BMI and DIH in general was identified (OR=3.017; 95% CI=1.029-8.845) and more significant association between low BMI and moderate DIH (OR=15.833; 95% CI=1.792-139.922). Age, sex, and acetylization status has no significant correlation with DIH incidence in general. Significant association between slow acetylator phenotype and incidence of moderate DIH was identified (OR=7.125; 95% CI= 1.309-38.711). In conclusion, some risk factors were correlated to DIH incidence in pulmonary TB patientsreceiving standart TB treatment regimen.
FIRST LINE ANTI-TUBERCULOSIS DRUG RESISTANCE PATTERN IN MULTIDRUG-RESISTANT PULMONARY TUBERCULOSIS PATIENTS CORRELATE WITH ACID FAST BACILLI MICROSCOPY GRADING Soedarsono Soedarsono; Ni Made Mertaniasih; Titiek Sulistyowati
Indonesian Journal of Tropical and Infectious Disease Vol. 8 No. 2 (2020)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v8i2.14294

Abstract

Multidrug-resistant tuberculosis (MDR-TB) is a global public health crisis. Acid-fast bacilli (AFB) gradation in sputum examination is an important component in Pulmonary Tuberculosis (PTB) diagnosis and treatment outcome monitoring. Previously treated pulmonary TB patients with a higher AFB smear gradation may have higher rates of acquired resistance. Patients with a higher AFB grade indicate a higher bacillary load and had higher rates of acquired resistance. This study aims to evaluate the correlation between AFB gradation and first-line anti-TB drug resistance patterns in MDR pulmonary TB patients. This was a retrospective study conducted from August 2009 to April 2018 in Dr. Soetomo Hospital. Sputum samples were taken from MDR PTB patients. Sputum smear examination was done using Ziehl–Neelsen staining and gradation was measured according to IUATLD criteria. Samples with positive smear were evaluated for resistance patterns based on culture and resistance tests using the MGIT 960 BACTEC System. There were 433 sputum samples with AFB positive collected from MDR PTB patients. Resistance to RHES was found in 22 (14%) AFB +1, 19 (15%) AFB +2, and 29 (20%) AFB +3. Resistance to RHS was found in 22 (14%) AFB +1, 12 (9%) AFB +2, and 13 (9%) AFB +3. Resistance to RHE was found in 39 (25%) AFB +1, 38 (29%) AFB +2, and 35 (24%) AFB +3. Resistance to RH was found in 74 (47%) AFB +1, 61 (47%) AFB +2, and 69 (47%) AFB +3. Statistic analysis by Spearman test showed that there was no significant correlation between AFB gradation and first-line anti-TB drug resistance patterns. Acquired resistance to RHES can also found in lower bacillary load AFB +1.
Validity of Method for MTBC and NTM Detection in FNAB Specimens from Tuberculous Lymphadenitis Using Microscopy, XPERT MTB / RIF and Culture Method Herisa Nataliana Junus; Ni Made Mertaniasih; Soedarsono Soedarsono
Indonesian Journal of Tropical and Infectious Disease Vol. 9 No. 1 (2021)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v9i1.16043

Abstract

Mycobacterium tuberculosis and Nontuberculous Mycobacteria usually cause infection in tuberculous lymphadenitis. To improve accuracy of the detection MTB and NTM bacteria it is necessary to select valid methods. This study aims to compare validity of diagnostic methods from FNAB specimens for determining tuberculous lymphadenitis patients. a descriptive observational laboratory study involved 35 samples were obtained from tuberculous lymphadenitis patients in Dr. Soetomo Hospital Surabaya East Java. All specimens examined Ziehl-Neelsen staining microscopy, Xpert MTB/RIF , culture method Middlebrook7H10 solid media and  MGIT as Gold standard. Identification of MTB dan NTM with SD Bioline TB Ag MPT64 and niacin paper strip BD . Used diagnostic test 2x2 to analyze sensitivity, specificity, negative predictive value and positive predictive value. Ziehl-Neelsen staining microscopy Sensitivity 83,33 %  and Specificity 95,65% of  , PPV  90,91%and NPV 91,67%, Diagnostic Accuracy 91,43 % . Xpert MTB/RIF Sensitivity 75% and Specificity 95,65% , PPV  90 % and NPV 88 %, Diagnostic Accuracy 88,57 % with 95% CI (Confidence Interval ) . Characteristics female dominated 23/35 (65.7%) while Male numbered 12/35 (34.3%), age range distribution of TB lymphadenitis patients is highest in young adults 17 years to 25 years as many as 15/35 (42.9%) the second highest is the age group of 36 years to 45 years by 8/35 (22.9%), Clinicial presentation are mostly lymph node enlargement in cervical  37% patients other locations supraclavicular ,mamae. Clinical symptoms mostly lymphadenopathy 31,5% and other lymphadenopathy with fever. Microscopy method still have the good validity shoul be conjunction with the  molecular rapid tests and culture as gold standard in determining the diagnosis of TB lymphadenitis.
Diagnosis Based on Detection of CXCL10 in Urine as Biomarker for The Determining Diagnosis of Active Lung Tuberculosis Ni Made Mertaniasih; I Gede Yogi Prema Ananda; Soedarsono Soedarsono; Deby Kusumaningrum
Indonesian Journal of Tropical and Infectious Disease Vol. 9 No. 1 (2021)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v9i1.22160

Abstract

Tuberculosis diagnosis is an important component in decreasing TB incidence and prevalence. Because of the difficulty to collect sputum in some cases, urine specimens are used as it is easier to garner. One of the biomarkers in urine that can be used to diagnose pulmonary TB is IP-10, which can be represented by the CXCL10 gene. The study aims to determine the accuracy of diagnosis based on detection of the CXCL10 gene in urine as a biomarker for the patients with suspected pulmonary TB in Dr. Soetomo Hospital in Surabaya from November 2019 until March 2020. Thus, this is an observative laboratory research with a cross-sectional study. CXCL10 gene was examined using PCR for 36 urine samples, and then, the data, together with the medical records of clinical manifestations of pulmonary TB, GeneXpert MTB /RIF, blood count, and thorax radiograph, were processed using IBM SPSS Statistics 26. The results of the GeneXpert MTB/RIF and thorax radiograph criteria show positive results of pulmonary TB, which were 44.4% and 69.4% respectively. CXCL10 gene was not found in all urine of healthy people (negative), while 2.8% (1/36 samples) positive CXCL10 gene was found in a patient with positive GeneXpert, also with negative clinical manifestations and urine culture. In this study, the accuracy of diagnosis based on detection of the CXCL10 gene in urine for diagnosis of active pulmonary TB was 2.8%. Future research is needed to improve the methods, among them are bigger size of urine samples and clearer medical history of patients.