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"Latar belakang: Kondiloma akuminatum (KA) merupakan infeksi menular seksual tersering. Meskipun dinyatakan 90% lesi KA terkait HPV risiko rendah, tipe 6 dan 11, namun belum ada publikasi yang memaparkan tentang tipe HPV pada berbagai bentuk klinis KA di Indonesia. Tujuan: Mengidentifikasi tipe HPV pada berbagai bentuk klinis KA. Metode: Dilakukan penelitian potong lintang di Poliklinik Kulit dan Kelamin Rumah Sakit dr. Cipto Mangunkusumo, Indonesia, pada bulan April-Juli 2013, melibatkan 25 lelaki dan 12 perempuan berusia 20-57 tahun. Didapatkan 40 sampel DNA berasal dari 40 lesi KA pada 37 subyek penelitian (SP) dengan berbagai bentuk klinis. Identifikasi tipe HPV dilakukan dengan menggunakan HPV express matrix® yang mampu mendeteksi 21 tipe HPV baik risiko rendah maupun tinggi. Pemeriksaan ini mampu mengidentifikasi infeksi HPV multipel pada spesimen. Hasil: Pada 37 SP didapatkan berbagai bentuk klinis, 3 (8%) di antaranya ditemukan bentuk klinis multipel, sehingga keseluruhan lesi KA berjumlah 40. Tipe HPV teridentifikasi pada 34 lesi (85%). Terdapat 4 gambaran klinis KA dan tipe HPV terkait: (1) bentuk klasik 26 dari 40 lesi (65%): temuan terbanyak adalah HPV tipe risiko rendah pada 18 sampel, yaitu tipe 6, 11, 43, sementara pada 7 sampel terdapat ko-infeksi dengan tipe risiko rendah, dan pada 1 sampel tipe HPV tidak teridentifikasi, (2) bentuk keratotik 2 lesi (5%): pada 1sampel hanya ditemukan HPV tipe risiko tinggi yaitu tipe 35 dan pada 1 sampel tipe HPV tidak teridentifikasi, (3) papul dengan permukaan halus 9 lesi (22,5%): HPV tipe risiko rendah teridentifikasi pada 4 sampel, yaitu tipe 6, 11, 42, 43, sementara pada 3 sampel terdapat ko-infeksi dengan HPV tipe risiko rendah, dan pada 2 sampel tipe HPV tidak teridentifikasi, dan (4) papul datar-plak 3 lesi (7,5%): pada 2 sampel hanya ditemukan HPV tipe risiko tinggi, yaitu tipe 52 dan pada 1 sampel tipe HPV tidak teridentifikasi. Tipe HPV 6 dan atau 11 teridentifikasi pada 28 sampel (70%). Tipe HPV risiko rendah yang teridentifikasi adalah 6, 11, 42, dan 43, sedangkan tipe risiko tinggi yang teridentifikasi adalah 16, 31, 35, 39, 45, 52, 56, 66, dan 68. Kesimpulan: Penelitian ini adalah penelitian pertama di Indonesia yang mengidentifikasi tipe HPV pada berbagai bentuk klinis KA. Tipe yang paling banyak ditemukan pada KA tipe klasik adalah HPV risiko rendah tipe 6 dan 11. Beberapa tipe HPV risiko tinggi juga ditemukan pada beberapa lesi KA.

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Background: Condyloma acuminatum (CA) is the most common sexually transmitted infection. Although, it is stated that low-risk HPV types 6 and 11 are associated with 90% of genital warts, but there is no publication in Indonesia about identification of HPV types in various CA clinical manifestations.

Purpose: To identify HPV type among various clinical pictures of anogenital warts.

Method: A cross-sectional study is conducted in Dermato-Venereology Clinic Dr. Cipto Mangunkusumo National Hospital, Jakarta. Twenty five men and 12 women (20-57year-old) from April to July 2013 were eligible in this study. Fourty DNA samples from 40 lesions of 37 subjects with various clinical pictures of CA were collected. The HPV typing was based on PCR and dot blot hybridization using the HPV express matrix® which detects 21 HPV types of high- and low-risk, able to identify multiple types from a single specimen.

Result: Multiple clinical manifestations were found on 3 of 37 subjects (8%). HPV types were identified among 34lesions (85%). Four clinical manifestations of CA and HPV typing were documented: (1) classic 26 of 40 lesions (65%): low-risk HPV types (6, 11, 43), predominated in 18 samples, while 7 samples were co-infected with the high risk types and another sample had unidentified HPV types. (2) keratotic 2 lesions (5%): 1 sample only harbour the high risk HPV type 52, while the other was unidentified. (3) smooth papule 9 lesions (22.5%): Low-risk HPV types (6, 11, 42, 43) were found in 4 samples, while 3 samples were co-infected with the high risk types, while 2 others were unidentified, and (4) flat top papule to plaque 3 lesion (7.5%): 2 samples were unidentified and the other was high risk HPV type 52. HPV 6 and 11 can be identified in 28 samples (70%). The low risk HPV type had been identified were 6, 11, 42, and 43, while the high risk type were 16, 31, 35, 39, 45, 52, 56, 66, and 68.

Conclusion: This is the first study in Indonesia which identified HPV types in various CA clinical manifestations. The HPV low risk types 6 and 11 were the most prevalent in classic CA. Several high risk HPV types were also found in some CA lesions."

"Latar belakang. Kulit kering merupakan keluhan yang sering dihadapi pasien kusta, akibat kerusakan saraf otonom atau terapi yang didapat.Tujuan. Membandingkan efikasi vaselin album dengan urea 10% sebagai terapi kulit kering pasien kusta.Metode. Uji klinis acak tersamar ganda. Subjek penelitian dibagi dua kelompok, yaitu kelompok urea 10% dan kelompok vaselin album. Evaluasi dilakukan dalam 2 dan 4 minggu terapi dengan mengukur transepidermal waterloss (TEWL) dan skor kulit kering (SRRC) pada tungkai bawah.Hasil. Sebanyak 48 subjek penelitian (SP) mengikuti penelitian, 24 SP mendapat vaselin album dan 24 SP mendapat krim urea 10%. Nilai TEWL pada kedua kelompok menurun secara bermakna sebelum dan sesudah terapi. Penurunan tidak berbeda bermakna antara kedua kelompok, (6,53 kelompok vaselin album versus 6,45 kelompok urea 10%). Skor SRRC menurun secara bermakna pada kedua kelompok sebelum dan sesudah terapi 2 dan 4 minggu. Penurunan skor SRRC tidak berbeda bermakna antara kedua kelompok, (2,5 dan 3,5 pada kelompok vaselin album versus 3 dan 3 pada kelompok urea).Kesimpulan. Kedua pelembab mampu menurunkan TEWL dan SRRC pasien kusta secara bermakna. Tetapi perubahan nilai tersebut tidak berbeda bermakna antara kelompok pengguna salap vaselin album ataupun krim urea 10%.

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Background. Dry skin is a common problem in leprosy patient, due to destruction of autonom nerve or side effect of therapy.

Aim. Compare the efficacy of urea 10% cream versus petrolatum ointment on leprosy patient with dry skin.

Method. Double blinded randomnized controlled study participant were divided into two group, either received petrolatum ointment or urea 10% cream. Evaluation was done after 2 and 4 weeks treatment by measuring transepidermal waterloss (TEWL) and dry skin score (SRRC).

Result. 48 participant enrolled in the study, 24 received urea 10% cream while 24 received petrolatum.TEWL value in both groups were reduced significantly before and after medication. The difference was not significant in both groups (6.53 in vaselin group and 6.45 in urea group). SRRC score in both groups were reduced significantly before and after 2 and 4 weeks medication. The difference was also not significant in both groups (2,5 and 3,5 in vaselin group versus 3 and 3 in urea group).

Conclusion. Both moisturizers significantly reduce TEWL and dry skin score. There was no significantly difference in reduction between vaselin album ointment and urea 10% cream."

"Penelitian ini bertujuan untuk mengetahui proporsi kepositivan infeksi Mycoplasma hominis dan Ureaplasma urealyticum serta hubungannya dengan cuci vagina sebagai faktor risiko terkait pada populasi wanita penjaja seks di Jakarta Timur. Di Indonesia, data dasar mengenai hal ini belum ada, sedangkan data dasar ini sangat penting untuk menyusun standar tatalaksana dan pencegahan infeksi Ureaplasma urealyticum dan Mycoplasma hominis yang optimal. Penelitian ini merupakan penelitian analitik dengan rancangan studi potong lintang. Hasil penelitian menunjukkan bahwa proporsi kepositivan infeksi Mycoplasma hominis dan Ureaplasma urealyticum di Jakarta Timur tergolong tinggi (130 dari 180 subyek penelitian; 72%). Tidak ada perbedaan antara subyek penelitian yang melakukan cuci vagina atau tidak dengan kejadian infeksi Mycoplasma hominis dan Ureaplasma urealyticum.

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This study aim to determine the proportion of Mycoplasma Hominis and Ureaplasma Urealyticum’ infection and its correlation with vaginal douching in female sex workers in East Jakarta. In Indonesia these data are not yet available, meanwhile these data are needed to set standards management and prevention of Mycoplasma hominis and Ureaplasma urealyticum’ infection. The study design is analytical cross-sectional study.

Result shows that the proportion of Mycoplasma Hominis and Ureaplasma Urealyticum’ infection in East Jakarta is high (130 out of 180 subjects; 72%). There is no correlation between vaginal douching and proportion of Mycoplasma Hominis and Ureaplasma Urealyticum infection."

"Latar belakang: Virus papilloma humanus (VPH) merupakan penyebab infeksi menular seksual yang sering ditemukan. VPH tipe mukosa terutama menyerang genitalia dan oral. Infeksi VPH oral saat ini dihubungkan dengan keganasan orofaring yang insidensnya makin meningkat. Prevalensi VPH oral pada populasi sehat berkisar 2-7%, sedangkan pada populasi pasien kondiloma akuminatum (KA) anogenaital sebesar 10,4%. Faktor risiko penularan ke rongga mulut terutama melalui hubungan seksual, frekuensi seks oral lebih bermakna dibandingkan dengan jumlah pasangan seks oral. Tujuan: Mencari proporsi VPH oral pada pasien KA anogenital dan hubungannya dengan frekuensi seks oral. Metode : Penelitian potong lintang, subyek penelitian (SP) adalah laki-laki atau perempuan dengan KA anogenital, berusia 18-60 tahun. Tempat penelitian di poliklinik RSUPN Dr. Cipto Mangunkusumo dan Klinik PKBI Jakarta. Bahan pemeriksaan VPH oral berasal dari bilas mulut, lalu diolah menggunakan express matrix VPH di Laboratorium Kalgen. Hasil: Hasil VPH oral positif ditemukan pada 7 dari 75 SP. Uji statistik untuk melihat perbedaan VPH oral positif di antara kelompok frekuensi seks oral menggunakan Uji Kolmogorov-Smirnov dengan hasil P>0.05. Kesimpulan: Proporsi VPH oral pada pasien KA anogenital sebesar 9,3%, dan tidak terdapat perbedaan proporsi VPH oral di antara kelompok SP berdasarkan frekuensi seks oral.

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Mucosal types of HPV mainly infect anogenital and oral mucosa. Nowdays, oral cancer is strongly related to HPV infection and the incidence is increasing. Oral HPV prevalence in healthy population is 2-7%, meanwhile the prevalence in anogenital condyloma acuminata (CA) patients is 10,4%. The risk factors of oral HPV infection are mostly related to sexual behaviour, oral sex frequency is more related than total sex partner.

Objective : To know the oral HPV proportion in anogenital CA patients and it?s relation to oral sex frequency.

Methods: This is a cross sectional study. The subjects are anogenital CA patients, age 18-60 y.o, from outpatients clinic RSUPN Dr. Cipto Mangunkusumo and PKBI clinic, Jakarta. The sample was taken from mouth rinse, the HPV detection was done by using HPV express matrix at Kalgen laboratory.

Results : Oral HPV positif was found in 7 out of 75 subjects. We use Kolmogorof-Smirnov as statistical calculation to know the difference of oral HPV positive between oral sex frequency groups, the result is p>0,05.

Conclusions : Oral HPV proportion in anogenital CA patients is 9,3%, and there is no statistically difference beetwen oral sex frequency groups."

"[ABSTRAKLatar belakang. Rekomendasi Global Alliance dalam penanganan AVS meliput antibiotik, asam retinoat, dengan atau tanpa BPO. Resistensi obat menjadi perhatian utama pada penggunaan antibiotik jangka panjang dalam terapi akne vulgaris sedang. Kombinasi antibiotik dan BPO direkomendasikan untuk mengatasi masalah tersebut. Pada tipe kulit IV-V hiperpigmentasi pasca akne merupakan masalah yang sering dikeluhkan. Tujuan. Membandingkan efektivitas, efek samping dan kejadian hiperpigmentasi pasca inflamasi penggunaan BPO sebagai paduan terapi lini pertama AVS pada tipe kulit IV-V Fitzpatrick. Metode. Penelitian analitik dengan desaain uji klinis acak tersamar ganda membandingkan dua sisi wajah. Subyek diberikan paduan terapi lini pertama. Sisi wajah perlakuan diberikan gel BPO 2,5% sedangkan kelompok kontrol gel plasebo. Hasil. Pada minggu ke-2,4,6,8 didapatkan penurunan persentase total lesi sebesar 51,47%, 71%, 75%, 82,84% pada kelompok BPO dan 30%, 53,75%, 62,28, 71% pada kelompok plasebo (p<0,001 .) Efek samping dan kejadian HPI pada minggu ke 2,4,6 dan 8 tidak berbeda bermakna. Kesimpulan. Penggunaan BPO sebagai bagian dari paduan terapi lini pertama AVS lebih efektif, tidak meningkatkan efek samping ataupun kejadian HPI.Kata kunci. akne vulgaris, gel BPO 2,5%,

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ABSTRACTBackground. Global alliance recommendation for moderate acne treatment are antibiotic, retinoic acid with or without benzoyl peroxide. Drug resistance become the most common problem due to longterm use of antibiotic in acne treatment. Combination of antibiotic and BPO is recommeded to overcome this problem. In patient with skin type IV-V post acne hyperpigmentation is one of the most significant complaint. Aim. To compare efectivity, side effect and post inflammatory hyperpigmentation of BPO 2,5% gel as a part of first line therapy regiment in patient with skin type IV-V. Method. This is an analytic study with randomized control trial design comparing both half-face (split-face). Subjects were given first line therapy regiment. Half-face was given BPO 2,5% gel twice daily while other half face with placebo. Result. Total lesions reduction in BPO group on week 2,4,6,8 were 51,47%, 71%, 75%, 82,84% respectively and 30%, 53,75%, 62,28, 71% in placebo group respectively. Conclusion. BPO as a part of first line therapy regiment for moderate acne is more effective, with no increase of side effect nor post inflammatory hyperpigmentation compared to placebo., Background. Global alliance recommendation for moderate acne treatment are antibiotic, retinoic acid with or without benzoyl peroxide. Drug resistance become the most common problem due to longterm use of antibiotic in acne treatment. Combination of antibiotic and BPO is recommeded to overcome this problem. In patient with skin type IV-V post acne hyperpigmentation is one of the most significant complaint. Aim. To compare efectivity, side effect and post inflammatory hyperpigmentation of BPO 2,5% gel as a part of first line therapy regiment in patient with skin type IV-V. Method. This is an analytic study with randomized control trial design comparing both half-face (split-face). Subjects were given first line therapy regiment. Half-face was given BPO 2,5% gel twice daily while other half face with placebo. Result. Total lesions reduction in BPO group on week 2,4,6,8 were 51,47%, 71%, 75%, 82,84% respectively and 30%, 53,75%, 62,28, 71% in placebo group respectively. Conclusion. BPO as a part of first line therapy regiment for moderate acne is more effective, with no increase of side effect nor post inflammatory hyperpigmentation compared to placebo.]"

"[ABSTRAKHuman Papilloma Virus (HPV) merupakan penyebab infeksi menular seksual yang paling sering di dunia. HPV genital berdasarkan potensi onkogeniknya terdiri dari low risk HPV (lr-HPV) dan high risk HPV (hr-HPV). Kondiloma akuminata merupakan penyakit menular seksual yang disebabkan oleh HPV dan memiliki angka morbiditas paling tinggi di seluruh dunia termasuk di RS Cipto Mangunkusumo. Sebagian besar kondiloma akuminata disebabkan oleh lr- HPV, tetapi dewasa ini diketahui terdapat proporsi infeksi hr-HPV yang cukup besar pada kondiloma akuminata. Infeksi hr-HPV pada kondiloma akuminata merupakan salah satu faktor risiko terjadinya keganasan anogenital. Penelitian ini bertujuan untuk mendapatkan proporsi hr- HPV serta HPV 16 dan 18 pada lesi kondiloma akuminata atipikal regio anogenital di RS dr. Cipto Mangunkusumo dengan metoda Real Time Polymerase Chain Reaction (PCR). Dilakukan pemeriksaan PCR terhadap 21 lesi kondiloma akuminata atipikal dari 20 subyek penelitian. Hasil pemeriksaan mendapatkan proporsi hr-HPV sebesar 42,9% (9 dari 21 lesi) serta proporsi HPV 16 dan 18 sebesar 23,8% (5 dari 21 lesi).

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ABSTRACTHuman papillomavirus (HPV) is the most common cause of sexually transmitted disease in the world. In accordance to its oncogenic property, genital HPV is known to be low risk HPV (lr-HPV) and high risk HPV (hr-HPV). Condyloma acuminata is a sexually transmitted disease caused by HPV and has a high morbidity worldwide including in Cipto Mangunkusumo National Hospital. Most of condyloma acuminata caused by lr-HPV, although recently findings revealed a high proportion of hr-HPV in condyloma acuminata. Infection of hr-HPV in condyloma acuminata is one of risk factor for anogenital malignancy. This study aimed to obtain the proportion of hr-HPV in atypical lesion of condyloma acuminata in anogenital region at Cipto Mangunkusumo National Hospital with Real Time Polymerase Chain Reaction (PCR). Real Time PCR was conducted on 21 atypical lesion from 20 subject. The proportion of hr-HPV from those lesions was 42,9% and HPV 16/18 was 23,8%. ;Human papillomavirus (HPV) is the most common cause of sexually transmitted disease in the world. In accordance to its oncogenic property, genital HPV is known to be low risk HPV (lr-HPV) and high risk HPV (hr-HPV). Condyloma acuminata is a sexually transmitted disease caused by HPV and has a high morbidity worldwide including in Cipto Mangunkusumo National Hospital. Most of condyloma acuminata caused by lr-HPV, although recently findings revealed a high proportion of hr-HPV in condyloma acuminata. Infection of hr-HPV in condyloma acuminata is one of risk factor for anogenital malignancy. This study aimed to obtain the proportion of hr-HPV in atypical lesion of condyloma acuminata in anogenital region at Cipto Mangunkusumo National Hospital with Real Time Polymerase Chain Reaction (PCR). Real Time PCR was conducted on 21 atypical lesion from 20 subject. The proportion of hr-HPV from those lesions was 42,9% and HPV 16/18 was 23,8%. , Human papillomavirus (HPV) is the most common cause of sexually transmitted disease in the world. In accordance to its oncogenic property, genital HPV is known to be low risk HPV (lr-HPV) and high risk HPV (hr-HPV). Condyloma acuminata is a sexually transmitted disease caused by HPV and has a high morbidity worldwide including in Cipto Mangunkusumo National Hospital. Most of condyloma acuminata caused by lr-HPV, although recently findings revealed a high proportion of hr-HPV in condyloma acuminata. Infection of hr-HPV in condyloma acuminata is one of risk factor for anogenital malignancy. This study aimed to obtain the proportion of hr-HPV in atypical lesion of condyloma acuminata in anogenital region at Cipto Mangunkusumo National Hospital with Real Time Polymerase Chain Reaction (PCR). Real Time PCR was conducted on 21 atypical lesion from 20 subject. The proportion of hr-HPV from those lesions was 42,9% and HPV 16/18 was 23,8%. ]"

"Penelitian ini bertujuan untuk mengevaluasi penggunaan metode difusi cakram standar CLSI dan CDS dalam menentukan pola kepekaan Neisseria gonorrhoeae terhadap antibiotik. Pada metode difusi cakram standar CLSI dapat terjadi double zone inhibition yang dapat mempersulit dalam interpretasi zona hambat yang sesungguhnya. Dengan metode difusi cakram standar CDS diharapkan hal tersebut tidak terjadi. Penelitian ini merupakan uji kesetaraan antara hasil uji kepekaan antibiotik metode difusi cakram menurut standar CDS dan standar CLSI yang dibandingkan dengan Etest sebagai baku emas. Dari penelitian ini didapatkan hasil metode difusi cakram standar CDS lebih sesuai dengan Etest daripada standar CLSI pada tiga antibiotik yaitu azitromisin (total agreement 96,7%), seftriakson (total agreement 80,0%) dan penisilin (total agreement 73,3%) sedangkan metode difusi cakram standar CLSI lebih sesuai dengan Etest daripada standar CDS pada dua antibiotik yaitu siprofloksasin (total agreement 73,3%) dan spektinomisin (total agreement 73,3%). Pola kepekaan Neisseria gonorrhoeae terhadap antibiotik di RSCM dan pelayanan kesehatan jejaring menurut metode difusi cakram yang paling sesuai dengan Etest yaitu: dengan standar CDS didapatkan azitromisin 86,7%, seftriakson 76,7%, penisilin 16,7% dan dengan standar CLSI didapatkan siprofloksasin 0% dan spektinomisin 70%. Pola kepekaan Neisseria gonorrhoeae terhadap sefiksim yaitu 46,7% yang hanya diujikan dengan standar CLSI. Pemberian sefiksim dan seftriakson yang merupakan terapi pilihan untuk gonore harus diberikan secara bijak, untuk menghindari kejadian resistensi yang lebih luas.

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This study aimed to evaluate the use of CLSI and CDS standard disc diffusion method in determining the sensitivity patterns of Neisseria gonorrhoeae to antibiotics. In the CLSI standard disc diffusion method can occur double inhibition zone that can complicate the interpretation of the actual inhibition zone. With the CDS standard disc diffusion method expected it does not happen. This study was a test of equivalence between the results of antibiotic susceptibility test disc diffusion method according to CLSI standards and standardized CDS compared with the Etest as gold standard.

From this study, compared with Etest, the results of the standard disc diffusion method in accordance with CDS over the CLSI standard than three antibiotics, namely azithromycin (total agreement 96.7%), ceftriaxone (total agreement 80.0%) and penicillin (total agreement 73.3%) whereas the standard disc diffusion method according to CLSI more than CDS standard on the two antibiotics are ciprofloxacin (total agreement 73.3%) and spectinomycin (total agreement 73.3%). Neisseria gonorrhoeae patterns of sensitivity to antibiotics in RSCM and health care networks by disc diffusion method that best suits the Etest are with the standard CDS obtained azithromycin 86,7%, ceftriaxone 76.7%, penicillin 16,7% and with the CLSI standards obtained ciprofloxacin 0% and spektinomisin 70%. Neisseria gonorrhoeae pattern of sensitivity to cefixime is 46.7 % which is only tested with the CLSI standard. Cefixime and ceftriaxone as the drug of choice for gonorrhea should be given prudently to prevent the occurrence of resistance more extensive."

"ABSTRAKLatar belakang dan tujuan: Pioderma superfisialis (PS) masih menjadi masalahkesehatan di Indonesia dengan jumlah kunjungan yang masih tinggi di PoliklinikKulit dan Kelamin Rumah Sakit Cipto Mangunkusumo (PKK-RSCM). Saat inipengobatan topikal lini pertama adalah asam fusidat 2% sedangkan penggunaanmupirosin 2% dibatasi. Beberapa penelitian terdahulu memperlihatkan resistensiterhadap asam fusidat 2% dan mupirosin 2%. Penelitian ini bertujuan untukmembandingkan efektivitas mupirosin 2% dengan asam fusidat 2% terhadapkesembuhan klinis PS di PKK-RSCM.Metode: Uji klinis acak buta ganda dilakukan terhadap 42 pasien PS usia 12-59tahun di PKK-RSCM. Setelah pemeriksaan bakteriologis, setiap subjekmendapatkan satu jenis krim antibiotik untuk dioleskan selama tujuh hari. Evaluasiklinis didasarkan pada pengurangan luas lesi dan skala nyeri. Pemeriksaan biakandan resistensi dilakukan di Laboratorium Mikrobiologi Klinik UniversitasIndonesia.Hasil: Efektivitas krim mupirosin (kelompok M) adalah 83,3% dan krim asamfusidat (kelompok AF) 40% (p=0,048), sedangkan persentase penurunan luas lesikelompok M sebesar 83,5% dan kelompok AF 60,7% (p=0,041). Tidak ditemukanefek samping subjektif maupun objektif pada kedua kelompok. Pada biakan kuman,54,8% sampel ditemukan 2 jenis kuman, jenis terbanyak adalah S.aureus danS.pyogenes. Sebagian besar S.aureus (78,8%, 75,8%) dan S.pyogenes (50%,94,4%)memiliki kepekaan intermediet terhadap mupirosin 2% dan asam fusidat 2%.Kesimpulan: Krim mupirosin 2% lebih efektif daripada krim asam fusidat 2%terhadap PS.Kata kunci: mupirosin 2%, asam fusidat 2%, kesembuhan klinis, luas lesi, skalanyeri

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ABSTRACTBackground and objectives: Superficial pyodermas (SP) are common healthproblem in Indonesia with high incidence in the Dermatovenereology OutpatientClinic Dr. Cipto Mangunkusumo Hospital (DV-CMH). Current guidelines endorses2% fusidic acid as the first line topical therapy, while 2% mupirocin is reserved forcertain condition. Past studies demonstrated increasing resistance to 2% fusidic acidand 2% mupirocin. This study aims to compare the effectiveness of 2% mupirocinand 2% fusidic acid in SP treatment in our institution.Methods: A double-blind randomized controlled trial was conducted on 42 SPpatients aged 12-59 years old in DV-CMH. Following bacteriologic examination,each subject received a random antibiotic cream for seven days. Clinical evaluationwas determined by reduction of lesion size and pain scale. Bacteriologic culture andsusceptibility test were performed in Clinical Microbiology Laboratory Universityof Indonesia.Results: The effectiveness in 2% mupirocin group (M) was 83,3% and in 2%fusidic acid group (FA) 40% (p=0,048). Lesion size decrease was 83.5% in M groupand 60.7% in FA group (p=0,041). No side effects were observed in both treatmentgroups. At the bacteria culture , 54.8 % of the samples found two types of bacteria,most types are S.aureus and S.pyogenes. Most of S.aureus (78,8%, 75,8%) andS.pyogenes (50%,94,4%) have an intermediate susceptibility to 2 % mupirocin and2% fusidic acid.Conclusion: The 2% mupirocin cream was more effective than 2% fusidic acidcream in SP treatment.Keywords: 2% mupirocin, 2% fusidic acid, clinical cure, lesion size, pain scale"

"Latar belakang: Neisseria gonorrhoeae (NG) telah mengalami resistensi terhadap berbagai antibiotik. Setidaknya sepuluh negara telah melaporkan kegagalan pengobatan gonore dengan extended-spectrum cephalosporins (ESCs). Pengawasan berkelanjutan penting untuk menentukan pedoman pengobatan lokal.Tujuan: Mengetahui prevalensi NG yang resisten terhadap penisilin, tetrasiklin, levofloksasin, sefiksim, dan seftriakson pada kelompok risiko tinggi di Jakarta serta mengidentifikasi berbagai faktor yang berhubungan.Metode: Sebuah penelitian dengan desain potong lintang dilakukan di Jakarta pada September hingga November 2018. Terdapat 98 laki-laki dan perempuan berisiko tinggi yang memenuhi kriteria penelitian. Sediaan duh tubuh diambil dari uretra atau serviks, disimpan di media transport, kemudian diantarkan ke Laboratorium Mikrobiologi Klinik FKUI untuk biakan dan identifikasi. Uji resistensi dilakukan dengan metode difusi cakram sesuai rekomendasi Clinical and Laboratory Standard Institute (CLSI).Hasil: Dari seluruh spesimen yang dibiakkan, 35 di antaranya menunjukkan pertumbuhan isolat NG. Prevalensi NG yang resisten terhadap penisilin, tetrasiklin, levofloksasin, sefiksim, dan seftriakson pada kelompok risiko tinggi di Jakarta adalah 97,1%; 97,1%; 34,3%; 0%; 0%. Usia, orientasi seksual, riwayat konsumsi antibiotik, berhubungan seksual secara komersial, dan berhubungan dengan pasangan seksual dari luar kota tidak berhubungan dengan NG yang resisten terhadap levofloksasin.Kesimpulan: Tidak ditemukan isolat NG yang resisten terhadap sefiksim dan seftriakson. Hasil tersebut menunjukkan bahwa sefiksim dan seftriakson efektif mengobati gonore di Jakarta. Tidak ada faktor yang berhubungan dengan resistensi pada penelitian ini.

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Background: Neisseria gonorrhoeae (NG) has developed resistance to various antimicrobials. At least ten countries have reported treatment failures with extended-spectrum cephalosporins (ESCs). Continuous surveillance is important to determine local treatment guideline.

Objectives: To determine the resistance rates of NG to penicillin, tetracycline, levofloxacin, cefixime, ceftriaxone among the high-risk population in Jakarta, and identify the associated factors.

Methods: A cross-sectional study was conducted in Jakarta, Indonesia from September to November 2018. A total of 98 high-risk men and women fulfilled the studies’ criteria. The specimens were collected from urethral or endocervical swabs, put into Amies transport media, and then transported to the Laboratory of Clinical Microbiology Universitas Indonesia for culture and identification. Proven gonococcal isolates were examined for susceptibility to various antibiotics using the disk diffusion method according to Clinical and Laboratory Standard Institute (CLSI) recommendation.

Results: Among 98 specimens, 35 were confirmed to be NG. The NG resistance rates to penicillin, tetracycline, levofloxacin, cefixime, and ceftriaxone among high-risk population were 97,1%; 97,1%; 34,3%; 0%; 0%. Age, sexual orientation, history of antibiotic consumption, commercial sexual activities, and sexual activities with partners from other regions were not associated with the resistance to levofloxacin.

Conclusion: No resistance to cefixime and ceftriaxone was reported. This finding indicates that they are still effective to treat gonorrhea in Jakarta. There were no associated factors identified in this study."

"Servisitis klamidia masih menjadi masalah kesehatan yang cukup signifikan di Indonesia karena sulitnya diagnosis pasti klamidia. Pemeriksaan penunjang yang mudah dan murah dilakukan yaitu pewarnaan Gram namun memiliki sensitivitas dan spesifisitas yang rendah. Pemeriksaan baku emas adalah polymerase chain reaction (PCR) namun membutuhkan biaya mahal dan membutuhkan fasilitas laboratorium lengkap. Dibutuhkan sebuah tes cepat untuk mendiagnosis klamidiosis dengan sensitivitas dan spesifisitas yang lebih baik dari pewarnaan Gram. Penelitian ini bertujuan menentukan nilai diagnostik dari QuickStripe™ Chlamydia rapid test (CRT) dalam mendiagnosis servisitis klamidia pada perempuan risiko tinggi di Jakarta. Studi potong lintang ini melibatkan perempuan risiko tinggi, baik simtomatik maupun asimtomatik, yang berada di Balai Rehabilitasi Sosial Eks Watunas Mulya Jaya selama bulan Juni hingga Juli 2020. Apusan endoserviks diambil dari tiap subjek dengan urutan acak untuk pemeriksaan QuickStripe™ CRT, pewarnaan Gram, dan real time PCR. Sebanyak 41 subjek berpartisipasi dalam penelitian ini. Sensitivitas dan spesifisitas QuickStripe™ CRT pada penelitian ini adalah 73,6% (IK 95%: 48,80% sampai 90,85%) dan 81,82% (IK 95%: 59,72% sampai 94,81%), dengan nilai duga positif dan negatif sebesar 77,78% (IK 95%: 58,09% sampai 89,84%) dan 78,05% (IK 95%: 62,39% sampai 89,44%). Proporsi servisitis klamidia berdasarkan real-time PCR pada penelitian ini adalah 46,3%. Sebuah studi menyatakan bahwa penggunaan rapid test dengan sensitivitas suboptimal pada populasi risiko tinggi dapat meningkatkan angka pengobatan dibandingkan penggunaan baku emas yang membutuhkan kunjungan ulang agar pasien mendapatkan pengobatan. Penelitian ini menyimpulkan bahwa QuickStripe™ CRT dapat menjadi alternatif dalam mendiagnosis servisitis klamidia pada perempuan risiko tinggi di Jakarta......Chlamydial cervicitis is one of health problems in Indonesia due to difficulty of definitive diagnosis for Chlamydia trachomatis. Gram staining is quick and affordable and usually done to make presumptive diagnosis despite its low sensitivity and specificity. Polymerase chain reaction (PCR) is considered gold standard but costly, technically demanding and difficult to be performed in low-resource settings. Thus, a rapid test with higher sensitivity and specificity is needed to aid chlamydial cervicitis. This study aims to determine the diagnostic value of QuickStripe™ Chlamydia rapid tests (CRT) in diagnosing chlamydial cervicitis among high-risk women in Jakarta. This cross-sectional study included symptomatic and asymptomatic high risk women in Balai Rehabilitasi Sosial Eks Watunas Mulya Jaya during June to July 2020. Endocervical swabs from each participant were taken for QuickStripe™ CRT, Gram staining, and real time PCR. A total of 41 participants were enrolled. The sensitivity and specificity for QuickStripe™ CRT were 73.6% (95% CI: 48,80% to 90.85%) and 81.82% (95% CI: 59.72% to 94.81%). Positive and negative predictive value were 77.78% (95% CI: 58.09% to 89.84%) and 78.05% (95% CI: 62.39% to 89.44%). Chlamydial cervicitis proportion based on real-time PCR was 46.3% in this study. A modelling study stated that a rapid test with suboptimal sensitivity in a high risk setting can improve rates of treatment compared to a gold standard test that requires return visits for patients to receive results and treatment. We concluded that QuickStripe™ CRT may become alternative diagnostic test among high-risk women in Jakarta."