Infectious Disease Reports

Staphylococcus pasteuri is a gram-positive organism found in food products as well as naturally occurring in air and on surfaces. We present the first known case of Staphylococcus pasteuri osteomyelitis caused by machine injection injury. The patient was treated with emergent surgical debridement as well as doxycycline for a soft tissue infection. Despite targeted therapy, the infection progressed to osteomyelitis and was treated successfully with additional surgical debridement and trimethoprim-sulfamethoxazole. There is sparse information on both infections and treatment of Staphylococcus pasteuri. We present our case report as well as a review of the literature on the epidemiology, susceptibility and treatment recommendations for Staphylococcus pasteuri infections. Full article

There is a lack of consensus regarding management of infections with carbapenem- resistant Gram-negative (CR-GN) pathogens. This study comprised a medical chart review to assess patient management in a high CR prevalence setting. Data was collated retrospectively from medical records of patients hospitalized between November 1^st, 2015 and October 31^st, 2016. Of 29 patients, 66% had respiratory tract infections. Median duration of hospitalization was 28 days and ~50% of patients were admitted to the intensive care unit, with 77% remaining for >2 weeks. Median time to obtain respiratory culture results was 5 days. Isolation of patients with diagnosed CR-GN infection took ≥5 days in >50% of patients. A majority (76%) of patients received ≥1 antibiotic before providing a specimen for culture; a total of 17 antibiotic treatments were used. Overall, 72% of patients, and 68% of those with respiratory infections, were discharged alive; 38% were discharged without further antibiotics. The difficulties in achieving effective management in patients with CR-GN infections are largely due to complex co-morbidities, a history of prior antibiotic treatment, and multiple referrals across health care facilities. Full article

Background: East Java has become one of the provinces that have higher prevalence of leprosy, especially in the coastal region. Environment has also influenced for leprosy transmission and early detection could reduce the incidence rate of new leprosy cases. Epidemiological studies of leprosy in children can give an illustration of the important aspects of the environment. Presence of Mycobacterium leprae (M. leprae) DNA in nasal swabs and seropositivity level among them can describe M. leprae exposure in that area. Objective: Analyzing PCR from nasal swab and seropositivity level among elementary school children between northern coast and southern coast of East Java province. Methods: Five hundred and thirty children in Pacitan and Lamongan were involved. Both areas are representation of northern and southern coastal region in East Java Province. After clinical examination, nasal swab and blood samples were obtained. ELISA test was performed to measure the titer of IgM anti Phenolic Glicolipid-1 (PGL-1) antibody then continued by PCR to detect M. leprae DNA. Results: From 301 students in Pacitan, 25 students (8.3%) are sero-positives and 9 students (2.9%) are PCR positives. from 229 students in Lamongan, 110 (48.3%) students are sero-positives and 49 students (21.4%) are PCR positives. Both are analyzed by Chi-Square, and from the PCR and ELISA, it concluded that there are statistically significant differences between the two regions. Conclusion: From study above shows that in the northern coast of East Java, incidence of subclinical leprosy is still high, it means that in this area still has a high risk of new cases of leprosy in the future and early detection tools need to performed as a preventative measure. Full article

Relationship between humans and cats has negative impact associates with zoonotic diseases. It is the reason why studies on the prevalence of gastrointestinal (GI) parasites in cats are important. Some of zoonotic GI parasites in cats are Toxocara spp., Ancylostoma sp., and Toxoplasma gondii. The current study was conducted to investigate the prevalence of GI parasites in owned and stray cats in Lumajang East Java Indonesia. One hundred and twenty fecal samples were collected from owned and stray cats on November 2018 to January 2019. The samples were examined by direct smears, sedimentation and flotation techniques. Identification of parasites was determined based on the morphology of worm eggs and protozoan cysts. The results showed that gastrointestinal parasites were found in 68.33% (82/120) examined samples, respectively, 48.33% (29/60) and 88.33% (53/60) from owned cats and stray cats. We found 7 genera of parasites, 4 genera of worm eggs and 2 genera protozoan oocyst. The egg worm were Toxocara cati (40%), Toxocara leonina (10.33%), Ancylostoma sp. (18.33%), Diphylobothrium sp. (3.33%) and Dipylidium caninum (1.67%). The protozoan oocyst were Isospora felis (27.5%), Isospora rivolta (13.33%) and Eimeria spp. (8.33%). Toxocara cati, Ancylostoma sp. (hookworm), Diphylobothrium sp. and Dipylidium caninum were zoonotic parasites. Rate infection in younger and older cat were no significant difference. One cat can be infected one or more parasite. To conclude, the prevalence of zoonotic GI parasites both in owned and stray cats were high. It is necessary to plan a program to control this zoonotic parasites. Full article

Background: Human herpesvirus 8 (HHV-8) infection is etiologically related to Kaposi’s sarcoma. Antibodies directed against HHV-8 can be detected in 80%–95% of HIV-seropositive patients with KS. HHV-8 serological tests have been done in several countries in Southeast Asia such as Malaysia, and Thailand however no serological data is available in Indonesia. This study was to examine the presence of HHV-8 antibodies in HIV-positive patients in Surabaya, Indonesia. Material and methods: Ninety-one serum samples were collected from HIV-positive patients in Surabaya, Indonesia. Human immunodeficiency virus-positive serum samples were collected from 10 homosexual men, 25 intravenous drug users (IVDUs) and 56 heterosexuals. Serums were then tested for the presence of HHV-8 antibody by using sandwich ELISA (Abbexa Ltd, Cambridge, UK). Results: The total of 91 HIV-infected were testing with antibodies to HHV-8 using enzyme-linked immunosorbent assay. Antibodies of HHV-8 were detected in 7/91 (7.7%) of the samples. According to a gender, six men (85.7%) and a women (14.3%) were positive of HHV-8 antibodies. No correlation regarding the gender and age from this study. The antibodies of HHV-8 was detected among intravenous drug users (IVDUs) men 5/7 (42.8%) and 2/7 (28.6%) from homosexual and heterosexual, respectively. Conclusion: This study found the presence of HHV-8 antibodies in 7.7% of patients in Surabaya, Indonesia. This finding was higher more than Southeast Asian countries. The patients with a positive result could suggest measures to prevent HHV-8 infection. Full article

Enteroaggregative haemorrhagic Escherichia coli (E. Coli, EAHEC) has been identified as the agent responsible for one of the largest outbreaks of gastroenteritis and Haemolytic-uremic syndrome (HUS) that is transmitted through food in Germany in 2011. The hypervirulent pathotype has a unique combination of two pathogens namely enterohemorrhagic E.coli strain (EHEC) which produces shiga/verotoxin and enteroaggregative E.coli toxins (EAEC) which produces toxins similar to ST and hemolysin. The toxin produced by the EAHEC strain is a hybrid pathotype that combines the virulence potential of the EAEC and EHEC strains that will damage the microcirculation, cause vasculitis and other toxic effects. The purpose of this study was to determine the percentage of samples infected with enteroaggregative hemorrhagic E. coli bacteria (EAHEC) in pediatric diarrhea patients at DR. Soetomo Hospital, Surabaya, Indonesia, 2015. This study used PCR (Polymerase Chain Reaction) method to detect enteroaggregative E. coli strains (CVD432 and aaic genes) and enterohemorrhagic E.coli (eae gene).The results showed that 33 out of 40 (82.5%) stool samples examined were detected enteroaggregative E. coli (EAEC), 4 out of 40 (10%) enterohemorrhagic E. coli (EHEC) and 3 out of 40 (7.5%) enteroaggregative haemorrhagic E. coli bacteria (EAHEC) , which caused diarrhea in pediatric diarrhea patients at Dr. Soetomo General Hospital. The unique combination of genomic features of the Surabaya outbreak strain, containing characteristics from pathotypes EAEC and EHEC, suggested that it represents a new pathotype enteroaggregative haemorrhagic E. coli (EAHEC). It is expected that development of specific primer design and sequencing are needed to continue in this research. Full article

Dengue fever and dengue hemorrhagic fever are transmitted to humans by the Aedes aegypti and Aedes albopictus mosquitoes, with an observed 30-fold increase in global incidence the last 50 years. Despite the tremendous efforts invested anti-dengue virus research, no clinically approved vaccine or antiviral chemotherapeutics are available for humans, and disease treatment is limited to supportive care. Over the years there has been a continuous interest in the chemistry of metal complexes with biological activity, including platinum complexes with antitumor activity and silver complexes with antimicrobial action. Aim of the project was to investigate [Cu(2,4,5-triphenyl-1H- imidazole)₂ (H₂O)₂].Cl₂ as antiviral compound that was further tested for inhibitory effect on the replication of dengue virus type 2 (DENV-2) in Vero cell. DENV-2 were infected in Vero cells and replication of virus was measured by Viral ToxGlo with selectivity index value (SI) and determined as the ratio of cytotoxic concentration 50 (CC₅₀) to inhibitory concentration 50 (IC₅₀) for com- pound. The standard curve between concentration of compound (μg/mL) and %viability of cells was analyzed by logarithmic cor- relation regression with regression equation. For infection rates, t-test was used to exam- ine the statistical significances among the concentrations of compound. P < 0.05 was considered to be significant. The maximum inhibitory concentration (IC₅₀) of [Cu(2,4,5- triphenyl-1H-imidazole)₂ (H₂O)₂].Cl₂ against DENV-2 was 98.62 μg/mL. The cytotoxic concentration (CC₅₀) of compound against Vero cells was 300.36 μg/mL. The SI values for [Cu(2,4,5-triphenyl-1H-imidazole)₂ (H₂O)₂].Cl₂ 1.86. Based on selectivity index values, [Cu(2,4,5-triphenyl-1H-imidazole)₂ (H₂O)₂].Cl₂ can inhibit the growth of DENV- 2 and has low toxicity values for Vero cells. Full article

Cellular immune has an important role in response HIV infection, which is attack the infected cells to activate signaling molecule. Hyperbaric Oxygen (HBO) worked as complementary treatment for HIV infection. The production of ROS and RNS molecules during hyperbaric exposure can affect gene expression which contributes to cellular adaptative response. This study was conducted to explore the mechanisms of cellular adaptive response to HIV infection during hyperbaric exposure. This study was carried on in vitro using healthy volunteers’ PBMCs (Peripheral Blood Mononuclear Cells) cultures infected with HIV-1. The study was conducted as a post- test only group design. The experimental unit was PBMC from venous blood of healthy volunteers which were cultured in vitro and infected by co-culturing with HIV-1 in MT4 cell line. The experimental unit consist of treatment and control group. Each group examined the expression of transcription factor NFκB, Interferon α, reverse transcriptase inhibitors (p21), and the amount of HIV-1 p24 antigen. There were increasingly significant differences in the expression of the trancription factor of NFκB, p21, and HIV-1 p24 antigen,as well as mRNA transcription of interferon α2 between treatment and controlgroup. By decreasing p24 antigen showed that HBO exposure was able to suppress HIV-1 replication. The exposure to hyperbaric oxygen at the pressure of 2.4 ATAand 98% oxygen wasable to produce ROS and RNS molecules, which play a role in cellular adaptive responses through increasing the expression of nfĸb, p21 and mRNA of interferon α2 plays a role in inhibition mechanism of HIV-1 replication in cells. Full article

The presence of transmitted drug resist- ance (TDR) in human immunodeficiency virus type 1 (HIV-1) infected individuals naive to antiretroviral therapy, may affect the effectiveness of treatment. Jakarta, the capital city of Indonesia, recorded the high- est number of cumulative HIV infection cases in the country. This study aimed to identify on the appearance of TDR, as well as to identify HIV-1 subtypes circulating among treatment-naive individuals in Jakarta. Whole blood samples collected from 43 HIV-1 infected, treatment-naive individuals. Viral subtyping and drug resist- ance testing were performed on HIV-1 pol genes amplified using nested polymerase chain reaction. CRF01_AE was detected most frequently in Jakarta (73.08%). Drug resistance-related major mutation was not detected in protease fragments of pol gene, but two major mutations, K103N (6.67%) and Y181C (6.67%), were detected in reverse transcriptase fragments of pol gene. Our results suggest that TDR was emerged in Jakarta at a certain extent, thus further surveillance study to monitor the TDR prevalence and circulating HIV-1 subtypes in this region is considered to be necessary. Full article

Staphylococcus aureus (S. aureus) is a round-shaped Gram-positive bacteria that caused infection in the human body. S. aureus infection can be inhibited by the use of antibiotics. However, these bacteria displayed resistance to some antibiotics. The purpose of this study is to determine the effects of Tembelekan (Lantana camara L.) and Kopasanda (Chromolaena odorata L.) leaf extracts against S. aureus. The method used in this study is the disc method to determine the inhibition zone. The test results showed there was no significant difference in the sensitivity of Tembelekan leaf extract (L. camara L.) and Kopasanda leaf extract (C. odorata L.) against S. aureus (P0.8>α0.05). However, based on the average value of the inhibition zone, Kopasanda leaf extract was showed higher inhibition zone compared to Tembelekan leaf extract. In conclusion, Tembelekan leaf and Kopasanda leaf at a concentration of 100% were produced inhibition zones of 0.6 cm and 0.8 cm respectively against S. aureus. Full article

Background: Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. Problem of Latent Tuberculosis Infection (LTBI) is increasing in number especially in countries with high TB incidence rate, such as Indonesia. Although not every LTBI will become active TB, if untreated and not handled appropriately it can still be a source of transmission and may increase the rate of resistance to the first-line TB drugs. Mycobacterium tuberculosis as a cause of tuberculosis disease is an intracellular pathogens that survives within the phagosome of host macrophages. Several host factors are involved in this process, including the Tryptophan Aspartate-containing Coat Protein (TACO). TACO is a protein recruited and retained by viable Mycobacterium tuberculosis on the surface of the phagosome membrane to maintain its survival in phagosome, because the presence of TACO plays an important role in inhibiting the fusion of phagosomes and lysosomes. Objective: the aim of this studyis to assess the difference of gene expression TACO protein in Latent Tuberculosis Infection (LTBI) and healthy people. Method: A preliminary studyof mRNA examination of TACO protein using Immunocytochemistry (ICC) and Real Time-Polimerase Chain Reaction (RT-PCR) method by a PCR Light Cycler 2.0 machine (Roche) in LTBI and healthy groups. Results: 18 samples of peripheral blood monocyte cells (PBMCs) were collected and divided into 2 groups. We found that there was a significantly difference between the 2 groups of samples. Conclusion: Further research is required to consider that the measurement of TACO expression using RT-PCRcan used as one of the other method to determine LTBI. Full article

Anti retroviral drugs for HIV has problems with uncomfortable side effects and that endanger the lives of HIV sufferers. Several herbs have been empirically proven to have an effect on HIV eradication through inhibition of reverse transcriptase. One of such antiviral herbs is Justicia gendarussa (J. gendarussa). The aim of research is to evaluate anti-HIV activity of 70% fractionated-ethanol extract (with releasing alkaloids) and 70% ethanol extract (without releasing alkaloids) of J. gendarussa leaves on in vitro HIV-infected of MOLT-4 cells. The effect of the extracts in inhibiting viral replication and fusion process on acute HIV infection was identi- fied through syncytia formation assay. Effect of the extracts on HIV p24 antigen was evaluated using HIV-1 p24 ELISA kit. It was found that 70% fractionated-ethanol extract and 70% ethanol extract of J. gendarussa leaves significantly inhibited of HIV replication by inhibition of syncytia formation, where the 50% effective concen- tration (EC50) values of the 70% fractionated-ethanol extract and 70% ethanol extract are 70.5 μg/mL and 228.7 μg/mL, respec- tively. Both of the extracts were also significantly inhibited HIV replication by decreasing HIV p24 antigen level where the EC 50 values of the 70% fractionated-ethanol extract and 70% ethanol extract are 88.8 μg/mL and 540.7 μg/mL, respectively. Moreover, it was found that 70% fractionated-ethanol extract of J. gendarussa leaves has anti-HIV activity since its EC50 values less than 100 μg/mL. It was concluded that J. gendarussa could be potentially developed into a phytopharmaceutical product due to its anti-HIV activity. Full article

Stunting is caused by chronic malnutrition and recurrent infectious diseases. Stunting in Pasongsongan Village affects less than 20% of the children under two, leading to problems in growth in early childhood. Ocean fish is the main animal products in this village on the coast, but it turned out that it is not served to the children, even if they should have begun to be introduced to animal products by the age of 9 months. The purpose of this study was to observe the practices of complementary feeding among stunted children under the age of two in Pasongsongan Village. This research was carried out by qualitative method. The informants were twelve mothers of children under the age of two. Data was collected from interviews, observations and documentation. The stunted children only consumed rice porridge until the age of one, which means that the food intake contains mostly carbohydrates. The mothers who have stunted children have argued that the children’s intestines is not strong enough to digest food with coarser texture like eggs, fish, beef and chicken. Sea fish are given when the children can walk because there has long been a belief that fish contain worms. No feeding fishes and other animal products that are good source of protein can affect their growth in a nega- tive way. The feeding practice of stunted children under the age of two in Pasongsongan Village was strongly influenced by culture. The mindsets of mothers of the stunted children regarding feeding practices must be changed. Full article

Antigen and collagen-induced arthritis (ACIA) is animal model of rheumatoid arthritis. The aim of this study was to identify the effect of different doses of hyperbaric oxygen (HBO) exposure in reducing inflammation on ACIA through analysis hypoxia inducible factor-1α (HIF-1α), anticyclic citrullinated peptide antibody (ACPA) and interleukine 17a (IL-17a). 24 male Balb/C mice were divided into 3 groups, 8 mice did not receive HBO exposure as a control group (G1) and 16 mice received HBO exposure as treatment group (G2 and G3). G2 was ACIA which was exposed to HBO 2.4 ATA O₂ 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days. G3 was ACIA which was exposed to HBO 2.4 ATA O₂ 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 5 consecutive days, break 5 days, 5 consecutive days. ACPA and IL-17a were measured by enzyme-linked immunosorbent assay (ELISA) technique. The expression of HIF-1α was measured by immunohistochemistry technique. There was significant decrease of ACPA levels, IL-17a levels and HIF-1α expression (P < 0.05) in G2 and G3 compared to G1. There was not significant decrease of ACPA levels (P > 0.05), there was significant decrease of IL-17a levels and HIF-1α expression (P < 0.05) in G2 compared to G3. G2 was a group with a higher oxygen partial pressure than G3. HBO 2.4 ATA O₂ 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days more effective in reducing inflammation than exposure 5 consecutive days, break 5 days, 5 consecutive days in ACIA. HBO has therapeutic potential for the treatment of RA. Full article

Kendari city had serious issues related to emerging a hundred of fast food sellers in 2017, including in Mokoau Health Centre area. However, there were only two health environmental staffs in that health care centre. Therefore, involving cadres in the fast food control become necessary. This study aimed to analyse the relationship between cadre’s capacity and Assessing to the food seller’s performance in food hygiene and sanitation management in Mokoau Health Centre in Kendari City since March 2019. There were 15 active cadres who controlled 35 fast food sellers. This study used the One-Group Pretest- Posttest Design. Data analysis used Paired T-test, Mann-Whitney test and Chi-Square test. This study found that 93.3% cadres had a senior high school diploma and only 6.7% of them had a Bachelor degree. There were 60.6% active cadres who had been in social health work for more than 5 years. The majority of cadres have got training about less than 15 times (86.7%). Involving cadres in the fast food control affected to seller’s performance change in fast food hygiene and sanitation management (P=0.006). Cadre with bachelor degree (P=0.006), were active in the social health work for less than 5 years (P=0.003), and got training less than 15 times (Pvalue= 0.026) influenced significantly to cadre’s assessing for the seller’s performance in food hygiene and sanitation management. This study suggested that improving cadre’s or community volunteer’s knowledge and skill related to fast food control technique becomes necessarily in fast food control. Full article

Transformation of infectious diseases is a dynamic movement of the spread of disease that is largerly determined by the ability to understand geomedical maps, disease transmission and impacts on national security. Disease transformation is an order of infection that can be life threatening in a clinical perspective an outbreak at the community level. The involvement of the Indonesian National Military (Tentara Nasional Indonesia, TNI) in the transformation of infected diseases is a network that needs to be strengthened, considering that its role is very important to maintain health security as a gate for national security. Strength in dealing with the extraordinary event of infection requires on going collaboration, competence, networking and integration. Full article

Congenital Rubella Syndrome (CRS) consists of hearing impairment, ophthalmology abnormalities, and congenital heart disease in children, resulting from rubella infection during pregnancy. Rubella vaccine has been implemented as national immunization program in Indonesia since 2017, and needed to be evaluated. This study aimed to report the CRS patients’ profile of Audiology Outpatient Clinic in Surabaya. A descriptive study from patient’s medical record was conducted in Dr. Soetomo Hospital Surabaya from January 2016 to December 2017. CRS was categorized using World Health Organization classification. Suspected infants with CRS burden were assessed by Otoacoustic Emission and rubella antibody test. Ninety five infants suspected with CRS classified as laboratory- confirmed CRS (58.95%), clinically confirmed CRS (15.79%), and discarded CRS (25.26%). Clinical manifestations included combination of congenital heart disease and hearing impairment (17.89%), congenital heart disease, ophthalmology abnormalities, and hearing impairment (16.84%), and hearing impairment and ophthalmology abnormalities (13.68%). The data show a high burden of CRS in Surabaya. These implies the urgent need for national rubella immunization program. Full article

Identification of solid state to investigate the possibility of physical interaction between Antimalarial Artemisinin Combination Treatment base Artesunate (AS) and Amodiaquine (AQ) by hot contact method Kofler, cold contact method (crystallization reaction) and binary phase diagram confirmation had been carried out. The results of hot contact method Kofler shown the formation a new crystalline habit as a long and thin needle on the contact zone (mixing zone) between AS and AQ. A different melting point was seen in its single component. Cold contact methods between two of supersaturated solution of component AS and AQ in methanol solvent also indicated the growth of crystal habit as similar as hot contact method Kofler. Confirmation by biner phase diagram shown the specific diagram for cocrystalline phase. Solid state interaction between AS and AQ was analysed by powder X-ray diffraction, FTIR (Fourier Transformed Infra Red) spectrophotometric, microscopic SEM (Scanning Electron Microscopic) and thermal DTA (Differential Thermal Analysis), TG-DSC (Thermal Gravimetry- Differential Scanning Calorimetry). Microscopic analysis by SEM showed significantly the change of habit and morphology of crystal to long and thin needle shaped. The difference of powder X-ray diffraction (PXRD) interferences peaks were observed in addition to PXRD interference peaks of each component and its physical mixtures that proved formation of cocrystalline phase. DSC Thermogram indicated a new endothermic peak corresponding to melting point of a new cocrystalline phase at temperature 160,4 °C. Full article