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"A study on habitat and food preference of Philemon buceroides in Moyo island, West Nusa Tenggara was conducted in April 1999 until July 1999. The aim of study is to explore the diversity and composition of plants and foods prefered by P. buceroides in its nature habitat. The results from this study will be very valuable in providing information and managing its conservation in both nature and or in man made habitat (in-situ and ex-situ)."

"Research on usable of Gunung Gede Pangrango National Park and Botanical Garden to develop the conservation education has been carried out, but the available information due to the package of conservation education using both of conservation areas is stilt lacking.The aim of this study is to measure and compare conservation education packages, which have conducted at Gunung Gede Pangrango and Bogor Botanical Garden. The compiling information from this study will be useful as a contribution to develop the program of conservation education as well as to increase the management of conservation area.The comparative study was conducted in two conservation area, the Gunung Gede Pangrango (representative for in situ conservation), and Bogor Botanical Garden (for ex situ conservation), using a questionnaire method, document analyzing, field observation, and measure the progress of the institutional development using matrix of the Institutional Development Framework ( IDF ). Correspondence is the key-person from institutions who responsible in organizing the conservation education program.The conclusion of this study was that the Gunung Gede Pangrango National Park is more diverse in having potential interpretation material compare to that of Bogor Botanical Garden, especially the available concepts of ecology and conservation in species and ecosystem level. In comparison, the Bogor. Botanical Garden has relatively more facilities on species interpretation. The conservation education program at both areas has limit goal, only covered the awareness and knowledge, and not completed with the education evaluation, which measured the impact of education on conservation for the participants. Covering the goal of the education, usable of flagship species and education evaluation might develop the quality of the program at both areas.Both of the institutions have limit facilities and skill to develop the package of the conservation education program, therefore they need cooperation with other institution as a partner. The study also identified that the Partners have a good contribution on developing the package of the Conservation education program as well as provide human resources. Some partners have provided the technical and facilities for educating, however none of the four NGO's which cooperate with the two institutions (Gunung Gede Pangrango National Park and Bogor Botanical Garden) in sustainability stage at institutional; development continuum. It seem that their institutional development progress will influence the existing packages for educating conservation program, which prepared at Gunung Gede Pangrango National Park and Bogor Botanical Garden."

"Karies gigi pada anak merupakan masalah kesehatan penting yang diderita lebih dari 89,16% anak Indonesia.Tingginya konsumsi makanan manis dan rendahnya kebiasaan menyikat gigi pada anak meningkatkan resiko terjadinya karies. Pada periode gigi campur (7-11 tahun) tetiadi peningkatan karies gigi. Karies daiam rongga mulut memberikan lingkungan yang baik bagi pertumbuhan mikroorganisme tennasuk Candida. Tujuan penelitian ini untuk mengetahui keragaman spesies dan jumlah koloni Candida da1am rongga mulut anak non karies dan karies pada usia 7-11 tahun. Untuk mengetahui hal tersebut telah dikumpulkan 112 sampel kumuran.Penentuan derajat karies dilakukan berdasarkan criteria WHO. Penentuan jumlah koloni dan keragaman spesies Candida dilakukan dengan menanam sampel pada agar sabouraud deslctrosa. agar kromogenik, agar staib, agar tajin dan uji asimilasi. Prevalensi karies penelitian ini sebesar 84,8 %, tetdiri atas karies ringan (41,1%), karles sedang (33,9%) dan karies berat (9 8%}, sisanya 15.2 % tanpa kartes. Selanjutnya, didapatkan prevalensi Candida dalam rongga mulut adalah 68,7%. Keragaman Candida pada anak non karies dan dengan karies didominasi oleh Candida albicans, diikuti Candida non C.albicans. Antara keragaman spesies dengan derajat karies tidak terdapat hubungan bennakaa (p?:0,05). Semakin tinggi derajat karies jumlah koloni Candida yang tllmbuh semakin banyak (p.::£0,05) namun jumlah koloni Candida menurun seiring dengan pertambahan usia (p:S0,05).

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Dental caries in children is a major public health problem. The prevalence of caries among children in Indonesia is around 89,16 %. The high preva1ence of caries is related to the high consumption of sugar and low prevalence of tooth brushing habit. The high prevalence of caries is also related with mixed dentistry period (7-11 years old). Dental caries accommodates the life of microorganisms including Candida. The aim of this study is to know the species variety of Candida in the oral cavity of children with caries and non caries in mixed dentistry period. Oral rinse from 112 children was collected and the type of caries was done based on WHO criteria. The species and its variety. colony forming unit, were detennined by plating the sampJes on Sabouraud dextrose agar and chromogenic media. The identification until species level was conducted by chromogenic media, and in continue with staib agar. rice cream-tween 80 and assimilation test {API AUX Bio Merieux: Prancis) if any doubtful result. The prevalence of caries in study is 84,8 o/o, consisted of light caries (41,1%), moderate caries (33,9%) and severe is 9,8%, while 15,2 % without caries. Moreover. the prevalence of Candida in the oral cavity is 68,7%.and the species identified mostly Candida albicans both in children with and without caries., followed by Candida non C. albicans. The relation between the variety of Candida species and the type of caries is not statistically significant (p?:0,05). The severe the caries the higher colony forming unit (p .05), but decreasing in older children of more than I0 years old (p,05)."

"Cryptococcus adalah jamur penyebab tersering pada pasien imunokompromi. Pada penelitian ini, 200 isolat yang berasal dari cairan otak 20 pasien terinfeksi HIV ditetapkan spesies dan serotipenya, serta kepekaannya terhadap obat antifungal (amfoterisin B, flukonazol, vorikonazol, ketokonazol, flusitosin). Spesies dan serotipe Cryptococcus ditetapkan menggunakan medium canavanine glycine bromthymol blue (CGB) dan medium creatinine dextrose bromthymol thymine (CDBT), sementara kepekaan terhadap antifungal diuji dengan metode difusi cakram, NCCLS M-44A, approved guidelines. Spesies C. neoformans ditemukan pada 170 isolat (85%), dengan seluruhnya adalah serotipe A dan 30 isolat adalah C. gattii. Infeksi tunggal C. neoformans ditemukan pada 10 pasien, infeksi tunggal C. gattii pada satu pasien, dan infeksi campuran pada 9 pasien. Cryptococcus spp sensitif terhadap amfoterisin B (93,5%), flukonazol (88,5%), vorikonazol (100%) dan ketokonazol (98%). Resistensi primer terhadap flusitosin ditemukan pada semua isolat C. neoformans dan C. gattii (100%) sebelum dan sesudah terapi. Secara keseluruhan, C. gattii kurang peka dibandingkan C. neoformans terhadap seluruh obat antifungal.

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Cryptococcus are common causes of mycoses in imunocompromised patient. In this study, 200 clinical cerebrospinal fluid from 20 HIV patient?s isolates of Cryptococcus were determine their species and serotypes, and their susceptibilities to antifungal (amphotericin B, fluconazole, voriconazole, ketoconazole, flucytosine) were analyzed. Cryptococcus species and serotypes were determined by canavanine glycine bromthymol blue (CGB) medium and creatinine dextrose bromthymol thymine (CDBT) medium, meanwhile antifungal susceptibilities were determined by disk diffusion method, NCCLS M-44A, approved guidelines. Species C. neoformans was found in 170 (85%) isolate with all of them was serotipe A dan 30 isolates (15%) were C. gattii. Single infection of C. neoformans was found in 10 patients, single infection of C. gattii in one patient and mixed infection in nine patients. Cryptococcus spp susceptible to amphotericin B (93,5%), fluconazole (88,5%), voriconazole (100%) and ketoconazole (98%). Primary resistance to flucytosine was found in all isolates C. neoformans and C. gattii (100%) before and after therapy. In general, C.gattii was less susceptible than C. neoformans to all drug tested. "

"Zat besi merupakan mikronutrien esensial yang diperlukan tubuh seperti pertumbuhan sel darah merah dan sel otak Kebutuhan besi meningkat pada masa kehamilan Komposisi mikrobiota dapat berubah selama tahap kehidupan yang dipengaruhi oleh berbagai faktor misalnya besi Penelitian ini merupakan penelitian dengan desain potong lintang yang bertujuan untuk mengetahui korelasi antara asupan besi dan kadar feritin serum dengan jumlah Bifidobacterium pada ibu hamil trimester ketiga Penelitian ini dilakukan di seluruh puskesmas kecamatan di Jakarta Timur dari bulan Maret sampai April 2015 Pengambilan subjek dilakukan dengan cara konsekutif dan didapatkan 52 ibu hamil yang memenuhi kriteria penelitian Data dikumpulkan dengan wawancara meliputi kuesioner data asupan besi heme dan non heme protein serta vitamin C dengan FFQ semikuantitatif Pengukuran antropometri untuk menilai status asupan gizi pemeriksaan laboratorium untuk mengetahui kadar feritin serum dan kadar CRP serta jumlah Bifdobacterium dalam tinja Didapatkan rerata usia 29 1 5 9 tahun nilai median asupan besi 66 7 3 3 144 1 mg hari kadar feritin serum 31 1 3 6 96 1 g L dan jumlah Bifidobacterium usus 7 45 5 1 9 5 log g tinja Tidak didapatkan korelasi yang bermakna asupan besi dengan jumlah Bifidobacterium usus r 0 202 p 0 152 juga tidak didapatkan korelasi bermakna antara kadar feritin serum dengan jumlah Bifidobacterium usus (r=0,116 p=0,411).

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Iron is an essensial micronutrient which body needed such as for blood growth cell and brain cell Iron rsquo s requirement increases in pregnancy Microbiota composition can change in cycle of life which be affected by many factors likely iron The aim of this cross sectional study was to find the correlation between iron intake and serum ferritin with Bifidobacterium third trimester of pregnancy Data collection was conducted from March 2015 until April 2015 in all of sub district of public health centre in east Jakarta Subjects were obtained using consecutive sampling method A total of 52 pregnancy subjects had met the study criteria Data were collected through interviews including questionnare iron intake heme and non heme protein and vitamin C used semiquantitative FFQ Anthropometry measurementsto assess the nutritional status and laboratory examination i e blood levels of serum ferritin and CRP and Bifidobacterium in feces Mean age 29 1 5 9 years Median of intake of iron was 66 7 3 3 144 1 mg day serum ferritin was 31 1 3 6 96 1 g L and gut Bifidobacterium 7 45 5 1 9 5 log g feces No significant correlation was found between iron intake and Bifidobacterium in feces r 0 202 p 0 152 and negative correlations and no significant between serum ferritin and Bifidobacterium in feces (r=0, 116, p=0,411)"

"ABSTRAKPneumocystis jirovecii adalah penyebab infeksi oportunistik di saluran pernapasanbawah pada individu dengan sistem kekebalan tubuh yang lemah, terutama padapasien HIV. Pemeriksaan infeksi P.jirovecii di Indonesia masih berdasarkanpemeriksaan klinis dan mikroskopis, yang memerlukan waktu yang cukup lama,kurang sensitif dan spesifik. Karena alasan tersebut dalam penelitian inidikembangkan uji molekuler real time PCR (rPCR) yang lebih sensitif danspesifik. Uji rPCR telah berhasil dioptimasi dengan kemampuan deteksi minimumDNA 6,55 copy/μl dan tidak bereaksi silang dengan mikroorganisme yang diujipada penelitian ini. Dibandingkan dengan uji mikroskopis, uji rPCR memberikanhasil positif 20% lebih tinggi daripada uji mikroskopis. Uji rPCR dapatmendeteksi P.jirovecii pada sampel klinis sputum dan sputum induksi dari pasienHIV dengan pneumonia dengan jumlah sel CD4+ > 200 maupun ≤ 200. Olehkarena itu, uji rPCR yang telah dioptimasi dalam studi ini dapat mendeteksiP.jirovecii pada sampel klinis sputum dan sputum induksi dari pasien HIV denganpneumonia dengan jumlah sel CD4+ > 200 maupun ≤ 200

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ABSTRACTPneumocystis jirovecii is the cause of opportunistic infections in the lowerrespiratory tract in individuals with weakened immune systems, especially inpatients with HIV. Examination P.jirovecii infection in Indonesia was based onclinical and microscopic examination, requiring considerable time, less sensitiveand specific. Because of these reasons in this study developed a molecular testreal time PCR (rPCR) is more sensitive and specific. rPCR test has beensuccessfully optimized with minimum DNA detection capabilities 6.55 copy/μLand do not cross-react with the microorganisms were tested in this study.Compared with microscopic test, test rPCR gives positive result 20% higher thanthe microscopic test. rPCR test can detect P.jirovecii on clinical samples ofsputum and sputum induction of HIV patients with pneumonia with CD4+ cellcounts > 200 or ≤ 200. Therefore, rPCR test which has been optimized in thisstudy can detect P.jirovecii in clinical sputum samples and sputum induction ofHIV patients with pneumonia with CD4+ cell counts > 200 or ≤ 200"

"ABSTRAKPneumonia komunitas Community Acquired Pneumonia, CAP merupakan penyakit infeksi yang sering terjadi dan merupakan masalah kesehatan, menempati peringkat ke lima sebagai penyebab kematian global. Etiologi CAP dapat ditemukan hanya pada 30 ndash; 50 kasus menggunakan metode konvensional. Pemberian tatalaksana awal antibiotika pada CAP menggunakan metode terapi empirik berdasarkan educated guess atau data antibiogram lokal. Pewarnaan Gram sputum merupakan metode yang sederhana dan murah untuk secara cepat memperkirakan etiologi mikroba pneumonia. Penelitian ini dilakukan secara prospektif untuk melakukan evaluasi hasil pemeriksaan mikroskopik sputum dengan pewarnaan Gram untuk menetapkan dugaan etiologi pneumonia komunitas pada pasien rawat inap di RSUD Budhi Asih. Dari 100 sampel sputum yang sudah diseleksi kelayakannya, dinilai lagi kelayakannya menurut kriteria ASM 94 sampel , Bartlett rsquo;s 100 sampel dan Musher dkk 96 sampel . Setelah dilakukan pemeriksaan kultur, PCR dari 100 sampel, 65 sampel diketahui penyebabnya, sedangkan 35 sampel tidak diketahui, namun 10 diantaranya BTA positif. Patogen yang ditemukan adalah Klebsiella pneumoniae 29,6 , Acinetobacter baumanii 10,2 , Enterobacter cloacae, Pseudomonas aeruginosa dan Staphyloccocus aureus 4,6 , Moraxella catarrhalis 3,7 , Enterobacter aerogenes dan Escherichia coli 2,8 , Streptococcus pneumoniae dan Mycoplasma pneumoniae 1,9 , Citrobacter koseri 0,9 . Penilaian kelayakan sputum dapat menggunakan kriteria Bartlett rsquo;s karena kriteria ini yang lebih longgar sehingga penolakan spesimen sputum lebih sedikit dan hasil yang didapat tidak berbeda secara signifikan

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ABSTRACTCommunity Acquired Pneumonia CAP is an infectious disease that often occurs and is a health problem, ranked fifth as the cause of global death. The etiology of CAP can be found in only 30 50 of cases using conventional methods. Administration of early antibiotic treatment in CAP using empirical therapy method, based on educated guess or local antibiogram data. Sputum Gram staining is a simple, rapid and cheap method to estimate the etiology of bacterial pneumonia. This study was conducted prospectively to evaluate the results of sputum microscopic examination with Gram staining to establish the alleged etiology of community acquired pneumonia in inpatients at RSUD Budhi Asih. From 100 selected sputum samples eligible, they were re assessed according to ASM criteria 94 samples , Bartlett 39 s 100 samples and Musher et al 96 samples . After culture examination and PCR detection from100 samples, 65 samples can be identified the etiology, while 35 samples cannot be identified, but 10 samples are positive AFB. Pathogens found were Klebsiella pneumoniae 29,6 , Acinetobacter baumanii 10,2 , Enterobacter cloacae, Pseudomonas aeruginosa and Staphyloccocus aureus 4,6 , Moraxella catarrhalis 3,7 , Enterobacter aerogenes and Escherichia coli 2,8 , Streptococcus pneumoniae and Mycoplasma pneumoniae 1,9 , Citrobacter koseri 0,9 . Assessment of sputum eligibility may use Bartlett 39 s criteria, since it more flexible criteria so that fewer sputum specimens will be rejected and the results obtained do not significantly differ"

"ABSTRAKInfeksi oleh bakteri Staphylococcus aureus terutama Methicillin Resistant Staphylococcus aureus MRSA menjadi masalah kesehatan utama di seluruh dunia. Antibiotik pilihan untuk pengobatan MRSA sangat terbatas, salah satunya adalah vankomisin yang hanya tersedia dalam bentuk sediaan injeksi. Pengunaan yang terbatas hanya untuk infeksi sistemik dengan berbagai efek samping yang ditimbulkannya, menyebabkan perlu dipikirkan mencari antibiotik baru yang dapat digunakan sebagai alternatif pilihan. Produk antibiotik dari tanaman seperti belimbing wuluh merupakan salah satu pilihan yang menjanjikan. Tujuan penelitian ini untuk mendapatkan fraksi jamur endofit yang paling berpotensi untuk dikembangkan sebagai antibiotik untuk infeksi yang disebabkan oleh Staphylococcus aureus, termasuk MRSA. Jamur endofit diisolasi dari ranting belimbing wuluh yang diambil dari enam lokasi di Jabodetabek, menggunakan medium agar Sabouraud dengan kloramfenikol. Hasil uji dengan metode agar difusi didapatkan bahwa Aspergillus brunneoviolaceus merupakan isolat jamur endofit belimbing wuluh, yang paling berpotensi dikembangkan sebagai anti-stafilokokus Analisis selanjutnya dilakukan dengan metode ekstraksi dan fraksinasi. Crude ekstrak dan tiga fraksi dianalisis dengan Thin Layer Chromatography dan diuji kembali aktivitas anti-stafilokokus dengan metode agar difusi. Kandungan senyawa kimia dari crude extract dianalisis menggunakan uji Gas Chromatography Mass Spectrometry GC-MS . Hasil uji agar difusi memperlihatkan bahwa ketiga fraksi fraksi metanol, n-heksan dan etil asetat mempunyai daya hambat yang lebih baik dari crude extractnya terhadap Staphylococcus aureus, termasuk MRSA. Dibandingkan dengan vankomisin sebagai antibiotik pilihan MRSA, konsentrasi 5000 ppm ketiga fraksi memiliki aktivitas yang lebih baik, terutama fraksi n-heksan mempunyai daya hambat yang terbaik. Analisis senyawa kimia yang terkandung di dalam crude extract jamur Aspergillus brunneoviolaceus adalah asam lemak, yang beberapa dari senyawanya sudah pernah dilaporkan terbukti memiliki aktivitas antimikroba.

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ABSTRACTInfection caused by Staphylococcus aureus bacteria especially Methicillin Resistant Staphylococcus aureus MRSA become primary health concern around the world. Antibiotics option for MRSA treatment is very limited, one of it is Vancomycin which only available in injection form. Limited usage of systemic infection with a variety of side effects, causing a need to find a new alternative option of antibiotics. Antibiotic product extracted from plants such as star fruit become a promising choice. The purpose of this research is to obtain a fraction of endophytic fungi which has the best potential for antibiotics development to treat infection caused by Staphylococcus aureus, including MRSA. Endophytic fungi isolated from star fruit branch which was taken from six locations at Jabodetabek, using Sabouraud agar with chloramphenicol as a medium. Test result from agar diffusion method shown that Aspergillus brunneoviolaceus, endophytic fungi isolated from star fruit has the best potential to be developed as anti staphylococcus. Further analysis was done using extraction and fractionation method. Crude extract and three fractions were analyzed using Thin Layer Chromatography and then tested again for anti staphylococcus activities using agar diffusion method. Chemical compound content from crude extract was analyzed using Gas Chromatography Mass Spectrometry GC MS test. Agar diffusion test result shown that all three fractions methanol fraction, n hexane, and ethyl acetate have better resistance against Staphylococcus aureus, including MRSA, compared to its crude extract. Compared to Vancomycin as antibiotic for MRSA, 5000 ppm concentration of all three fractions have better activity, especially n hexane fraction has the best activity. Analysis of chemical compound from a crude extract of Aspergillus brunneoviolaceus fungi shown contains of fatty acid, which several of its compounds had reportedly proven to have antimicrobe activity."

"

Kriptokokosis merupakan infeksi jamur Cryptococcus sp. yang sering ditemukan pada individu imunokompromi. Infeksi tersebut dapat menyerang berbagai organ, termasuk otak, susunan saraf pusat dan paru.. Pemeriksaan langsung dan biakan dari bahan klinis memiliki sensitivitas rendah. Deteksi antigen glucuronoxylomannan (GXM) merupakan alternatif pemeriksaan untuk diagnosis kriptokokosis, biasanya dilakukan pada cairan otak dan serum. Pemeriksaan antigen GXM dengan metode lateral flow assay (LFA) telah menjadi uji point-of-care dalam diagnosis kriptokokosis otak dan diseminata. Penggunaan LFA untuk diagnosis kriptokokosis paru belum pernah dilakukan sebelumnya. Penelitian ini bertujuan untuk mengetahui kegunaan uji LFA untuk diagnosis kriptokokosis paru. Penelitian berdisain potong lintang ini menyertakan pasien dengan gejala pneumonia pada beberapa rumah sakit di Jakarta dan sekitarnya sejak Maret-Oktober 2018. Pemeriksaan mikologi dilakukan di laboratorium Departemen Parasitologi FKUI menggunakan LFA IMMY dan LFA Dynamiker, serta pemeriksaan klasik. Dari 30 pasien yang diteliti, hasil pemeriksaan bahan sekreta paru (sputum/cairan pleura/BAL) menunjukkan semua hasilnya negatif dengan LFA IMMY. Adapun pemeriksaan LFA Dynamiker menunjukkan hasil positif pada empat pasien (13,3%). Profil klinis empat pasien dengan dugaan kriptokokosis paru pada penelitian ini menunjukkan batuk berdahak, nyeri dada, dan nodul paru. Hasil pemeriksaan pewarnaan tinta India menunjukkan hasil negatif, sedangkan biakan tidak ditemukan pertumbuhan Cryptococcus.

 

Kata kunci : pneumonia, Cryptococcus¸ lateral flow assay

 

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Cryptococcosis is a fungal infection caused by Cryptococcus sp. and often found in immune-compromised patients. Cryptococcus sp. can infect various organs such as brain, central nervous system and lung. Direct examination and culture of clinical samples are not sensitive in detecting pulmonary cryptococcosis. Detection of antigen glucuronoxylomannan (GXM) is an alternative to confirm the diagnosis of cryptococcosis, mostly examine from brain and sera.  The detection of GXM antigen using lateral flow assay (LFA) is recommended as point-of-care testing for the diagnosis of meningeal and disseminated cryptococcosis. However, diagnosis of pulmonary cryptococcosis using LFA has never been reported. Therefore, this research aimed to investigate the usefulness of the LFA test for the diagnosis of pulmonary cryptococcosis

This cross-sectional study involved patients with pneumonia in several hospitals in Jakarta and its surrounding, from March-October 2018. All mycology tests, including LFA IMMY and LFA Dynamiker, were performed in the laboratory of  Parasitology Department, Faculty of  Medicine, Universitas Indonesia. Thirty pulmonary secreta including sputum and bronchoalveolar lavage (BAL) were collected from 30 patients. None of the samples showed positive result on LFA IMMY testing, whereas using LFA Dynamiker four samples (13,3%) were shown to be Cryptococcus antigen positive. The clinical manifestations of four suspected cryptococcosis patients were cough, chest pain, and pulmonary nodule. The fungal cultures using bird seed agar (BSA) did not show any positive result.

 

Keywords: pneumonia, Cryptococcus, lateral flow assay

 

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"Latar belakang: Candida sp. merupakan flora normal di rongga mulut. Deteksi Candida sp. dari spesimen BAL dianggap sebagai kontaminasi atau kolonisasi yang tidak perlu diobati. Tetapi keberadaan Candida sp pada pasien yang berisiko dengan sistem kekebalannya yang rendah seperti pasien yang dirawat di ICU bisa meningkatkan morbiditas dan mortalitas. Petugas kesehatan yang lalai dalam menjalankan program PPI dapat menjadi sumber penularan infeksi jamur Candida sp. secara sistemik, seperti kurangnya kebersihan tangan (hand hygiene) yang berkontak dengan alat-alat invasif yang digunakan pasien, lingkungan yang tercemar, walaupun bisa juga melalui penularan autoinfeksi oleh pasien sendiri. Tujuan: Untuk mengetahui kemaknaan klinis Candida sp. yang diisolasi dari BAL pasien dengan faktor risiko untuk sebagai prediktor keluaran infeksi pasien rawat di ICU. Metode: Penelitian menggunakan desain potong lintang dengan pengambilan sampel secara konsekutif di ICU-IGD dan ICU Dewasa Kanigara Lt.8 RSCM pada juli – desember 2023. Sampel diambil dari bilasan bronkoalveolar pasien dengan diagnosis pneumonia dan dilakukan pemeriksaan mikroskopik Gram, KOH dan dikultur pada sabouraud dekstrosa agar. Jamur yang tumbuh diidentifikasi dan dilakukan uji kepekaan menggunakan mesin Vitekâ2. Sumber infeksi dicari dengan cara melakukan swab handrail tempat tidur dan meja status pasien. Audit kebersihan tangan dilakukan padapetugas kesehatan yang merawat pasien dengan positif kultur jamurnya, menggunakan panduan WHO Hasil: Candida albicans 26,3% diisolasi dari sampel BAL pasien ICU. Keberadan Candida sp. kemungkinan dapat mempengaruhi pola kepekaan antibiotik bakteri potensi MDR 31,6%. Penggunaan Candida score >2,5 dapat digunakan sebagai dimulainya pemberian antijamur. Pada Ko-infeksi jamur dengan Influenza A dan rhinovirus terdapat 22,2% pasien meninggal. Berdasarkan pelacakan sumber infeksi, tidak ditemukan sumber kontaminasi di permukaan lingkungan sekitar pasien, audit tingkat kepatuhan kebersihan tangan petugas kesehatan rata-rata 83,1% hal ini belum memenuhi target yang ditetapkan Permenkes.Kesimpulan: Identifikasi Candida sp. perlu dilakukan secara dini untuk mencegah terjadinya penyebaran di rumah sakit yang dapat tumbuh secara bersamaan dengan bakteri MDR. Selain itu Ko-infeksi Candida dengan influenza dan Rhinovirus mungkin dapat mempengaruhi keluaran klinis yang mengakibatkan kondisi klinis pasien menjadi lebih berat.

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Background: Candida sp. are normal flora in the oral cavity. Detection of Candida sp. from BAL specimens is considered to be contamination or colonization that does not need to be treated. However, the presence of Candida sp in at-risk patients with low immune systems, such as patients treated in the ICU, can increase morbidity and mortality. Health workers who are negligent in implementing infection prevention and control programs can become a source of transmission of Candida sp fungal infections. systemically, such as lack of hand hygiene in contact with invasive tools used by patients, a polluted environment, although it can also be through transmission of autoinfection by the patient himself.

Objective: This study aims to determine the clinical significance of Candida sp. Isolated from BAL patients with risk factors for ICU as predictors of outpatient infection output.

Method: The study used a cross-sectional design with consecutive sampling in the ICU-IGD and Adult ICU Kanigara Floor 8 RSCM in July – December 2023. Samples were taken from the bronchoalveolar lavage of patients with a diagnosis of pneumonia and were subjected to Gram, KOH microscopic examination and cultured on sabouraud dextrose agar. The fungus that grows is identified and a sensitivity test is carried out using a Vitekâ2machine. The source of infection is sought by swabbing the bed handrail and patient status table. Hand hygiene audits were carried out on health workers caring for patients with positive fungal cultures, using WHO guidelines

Result: Candida albicans 26.3% was isolated from BAL samples of ICU patients. The presence of Candida sp. possibly influencing the antibiotic sensitivity patterns of potential MDR bacteria 31,6%. The use of a Candida score >2.5 can be used to start antifungal theraphy. In fungal co-infection with influenza A and rhinovirus, 22.2% of patients died. Based on tracking the source of infection, no source of contamination was found on surfaces in the environment around the patient, the audit level of hand hygiene compliance for health workers was an average of 83.1%, this does not meet the target set by the Minister of Health."