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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN

Ridha Wahyutomo

Microbiology Departement of Medical Faculty of Sultan Agung Islamic University

Author-ID : 411569

Health Professions Medicine & Pharmacology

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Difference on Cefoxitin and Oxacillin Disk Test on In Vitro MRSA Detection (Meticillin Resistant Staphylococcus aureus) Experimental Study on Microbiology Laboratorium of Medicine Faculty of UNISSULLA Mustikawati, Hana Tiyas; Wahyutomo, Ridha; Djaman, Qathrunnada
Sains Medika : Jurnal Kedokteran dan Kesehatan Vol 6, No 1 (2015): January-June 2015
Publisher : Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)

Background: MRSA phenotypic detection has been a problem since it was found in 1962. Some studies explain that the diffusion method of cefoxitinand oxacilin disk test can be used to detect MRSA. Objective: knowing if there is difference between cefoxitin disk test and oxacilin disk test to detectMRSA.Method: laboratory experimental research with diagnostic test design. Research was done at the laboratory of medicine faculty of UNISSULA using 24 watch glasses, 12 with MRSA bacteria (Meticillin Resisten Staphylococcus aureus), and the other 12 with MSSA bacteria (Meticillin sensitive Staphylococcus aureus). specimentsThe results were classified into sensitive and resistant category based on CLSI standard (Clinical Laboratory Standards Institute).Hypothesis test using fisher test, with significance level <0,05Results: speciments MRSA detection using cefoxitin disk resulted 12 resistant speciments and no sensitive speciments. The oxacilin disk resulted 9 resistant speciments and 3 sensitive speciments. MSSA detection using cefoxitin disk resulted no resistant speciments and 12 sensitive speciments, oxacilin disk resulted no resistant speciments and 12 sensitive speciments. Diagnostic test was done by CEBM statistic calculator. The sensitivity and specificity value of MRSA sampels using cefoxitin disk were 96,2% & 96,2%, PPV (positive predictive value) 96,2%, NPV (negative predictive value) with was 96,2%. While the oxacilin disk, the sensitivity was 73,1%, specificity 96,2%, PPV 95,0%, NPV 73,8%. The result of fisher test for cefoxitin disk and oxacilin disk was p=0.000 meant there was difference between cefoxitin disk test and oxacilin disk test to detect MRSA.Conclusion: diffusion method in cefoxitin disk is better than oxacillin disk in MRSA detection.

Cytomegalovirus Congenital Cataract Wahyutomo, Ridha
Sains Medika : Jurnal Kedokteran dan Kesehatan Vol 3, No 1 (2011): Januari-Juni 2011
Publisher : Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)

Cytomegalovirus congenital infection is an infection caused by the the subfamily Ã¢ Herpesviridae, during pregnancy. The incidence of infections among newborn infants is 1 %. One of the effects of congenitally acquired infection is the congenital cataract. A 6-year-old child complained to have a blurred vision diagnosed with cytomegalovirus congenital cataract. The diagnosis was confirmed by a positive serology testing for Ig M and Ig G CMV. The laboratory test using Giemsa staining to find inclusion bodies and a faster PCR could not be carried out (Sains Medika, 3(1):84-88).

Infective Endocarditis in 60 Years Old Man at Dr. Kariadi Hospital Wahyutomo, Ridha
Sains Medika : Jurnal Kedokteran dan Kesehatan Vol 5, No 1 (2013): January-June 2013
Publisher : Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)

Infective endocarditis is an infection of the lining of the heart, particularly the cusps of valves characterized by fever and heart murmur, with or without malaise and fatigue. Clinical features can be divided into early manifestations of infection, embolic events, and late complications of sepsis and inflammation. It was reported that 60 years old man was brought to Kariadi hospital with prolong febris as his chief complaint. Patient has history of high grade fever and accompanied by weight loss, 3 kilograms for about 2 months. From physical examination result, in internal ward, we found he looked moderate ill. Heart systolic bruit at triscupidal valve and lungs were within normal limit. The result of blood culture from 3 different sites and throat swab culture were possitive, lead to the performance Streptococcus b haemolyticusâ€™s colonies. From the result of the ASTO, Echocardiography and physical examination show infective endocarditisâ€™s sign. The theraphy was Ceftriaxone 2 gram daily. Having obtained the results of negative cultures, and show an improvement of symptoms, finally the patient was getting improvement clinically and then treat as an outpatient. Patient was programmed to get Ceftriaxone 2 gram daily for 4 weeks. The decision of treatment not only from clinical manifestation but also from microbiology examination on the first admission in emergency unit. Blood culture with 3 bottles, interval 30 minutes is important for infective endocarditis. Furthermore, swab of throat area were taken to confirm for endocarditis cultures too. Finally there is no growth in culture until eighth day hospitalizasition. Spesific method on blood culture sampling is important to confirm the diagnostic of infective endocarditis and very useful for the clinicians to do the right clinical management for it. Subsequently, the role of clinical microbiologist in this case not only to support the clinical diagnostic but also the treatment in term of selecting of right antibiotic.

Errors in Interpretation of Gram Stain in The First Notification from Positive BACTEC Blood Cultures in Clinical Microbiology Laboratory of Dr. Kariadi Hospital Maryani, Maryani; Sari, Desvita; Wahyutomo, Ridha; Masfiyah, Masfiyah
Sains Medika : Jurnal Kedokteran dan Kesehatan Vol 4, No 1 (2012): Januari-Juni 2012
Publisher : Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)

Background: Blood cultures in conjunction with the initial Gram stain of positive cultures have often been considered the â€œgold standardâ€ for the diagnosis of bacteremia. When blood cultures turn positive, the attending physicians are usually notified immediately about Gram stain findings. However, information on the accuracy of Gram staining is very limited. We examined the error of preliminary blood culture reports provided by a local laboratory in an observational study.Design and Method: This was an observational study with a cross sectional approach. In this study, 369 blood cultures were examined. The positive blood cultures (135 samples) were then examined by Gram stain. Blood cultures handled on Bactec 9050, while the Gram stain was done in standard procedure Gram. Interpretation errors of Gram stain were confirmed by cultures result.Result: During one month (April 2011) we examined 369 blood cultures which 135 are positive (36.5%). Positive blood cultures were misread for 6 (4.4%) of 135 patients, they were two read as gram positive cocci had gram negative organisms by culture which were Acinetobacter baumannii, one read as gram positive bacilli had gram negative bacilli by culture which was Klebsiella pneumoniae. One isolate read as gram negative bacilli had gram positive bacilli which was Bacillus species, while two sample read as gram negative bacilli only had polymicrobial by culture, of these one isolate grew to be Enterobacter aerogenes and Staphylococcus aureus and the other were Escherichia coli and Acinetobacter spp.Conclusion: The overall 4.4% error rate of misinterpreted Gram stains from positive blood culture bottles is relatively high, so laboratory professionals and clinical microbiologist must be aware of the potential types of error that occur (Sains Medika, 4(1):23-29).

Prevalence of Influenza Viruses (Influenza Like Illness) In Regional Laboratory Avian Influenza Semarang Wahyutomo, Ridha; Ciptaningtyas, V. Rizke; Hadi, Purnomo
Sains Medika : Jurnal Kedokteran dan Kesehatan Vol 3, No 2 (2011): Juli-Desember 2011
Publisher : Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)

Background: Influenza is the major health threat worldwide causing illness and death every year. However, data on the epidemiology of influenza in tropical countries, including Indonesia, are still limited. Up dated data for its prevalence is needed to monitor its spreading and to evaluate its outbreak. Therefore a working regional laboratory in surveillance of ILI (Influenza Like Illness) was formed. This research was conducted to provide updated data on prevalence of ILI in regional laboratorium avian influenza Semarang.Design and Method: Data from patients examined in the regional laboratory of avian influenza Semarang from April 2009 until December 2010 was collected. Samples were obtained from Malang sentinel, Yogyakarta sentinel and Semarang sentinel. Samples were examined using PCR to detect influenza A, influenza B, and swine flu.Result: out 1367 patients tested, 279 patients (20.41%) were from Yogyakarta sentinel, 619 patients (45.28%) were from Malang sentinel, and 467 patients (34.16%) were from Semarang sentinel. Flu A virus was detected in 117 patients (8.5%). Influenza B virus was found in 39 patients (2.8%). H1 virus was detected in 5 patients (0.36%). H3 virus was detected in 45 patients (3.29%). Swine flu virus was detected in 3 patients in Malang.Conclusion: The highest prevalence of flu A and flu B examined in avian influenza regional laboratory Semarang was from Semarang sentinel, followed by Yogyakarta sentinel and Malang (Sains Medika, 3(2):157-161).

Co-Authors Desvita Sari, Desvita Djaman, Qathrunnada Hana Tiyas Mustikawati, Hana Tiyas Maryani Maryani Masfiyah Masfiyah, Masfiyah Purnomo Hadi V. Rizke Ciptaningtyas

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