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1.
Artículo en Inglés | MEDLINE | ID: mdl-20578526

RESUMEN

A surveillance of Shigella infections was conducted on 612 children aged 0-12 years-old presenting with diarrhea to Mampang and Tebet Community Health Centers in South Jakarta, Indonesia, during February 2005 through September 2007. Shigella was isolated from 9.3% of diarrhea patients in the health centers. S.flexneri which was found in 5.9% of patients, and was the most frequent species isolated, comprising 63.2% (36/57) of all Shigella species isolated. Shigella species were found significantly more often among children over 2 years old, and the rate of isolation increased with age. Stool with mucus and/or blood were the main characteristics of Shigella infection in these patients. Antibiotic multi-resistance was found in S. flexneri and S. boydii strains, in particular to ampicillin, chloramphenicol, tetracycline, and trimethoprim-sulfamethoxazole. None of the Shigella species showed resistance to nalidixic acid, norfloxacin, ciprofloxacin, or ceftriaxone


Asunto(s)
Disentería Bacilar/epidemiología , Disentería Bacilar/microbiología , Shigella/aislamiento & purificación , Niño , Preescolar , Farmacorresistencia Bacteriana , Disentería Bacilar/tratamiento farmacológico , Femenino , Humanos , Indonesia/epidemiología , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Vigilancia de la Población
2.
Southeast Asian J Trop Med Public Health ; 38(6): 1088-94, 2007 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18613551

RESUMEN

A study was conducted during January 2003 through August 2005, at two community health centers in south Jakarta, Indonesia, to detect nontyphoidal Salmonella infections in children with diarrhea. A total of 814 rectal swab samples were collected, of which 56 (6.9%) were positive for Salmonella. Among the serovars detected, Salmonella enterica serovar Typhimurium was found most frequently in 32.1% of all Salmonella isolates. Antimicrobial susceptibility testing using eight antibiotics showed 5.6% to 66.7% of Salmonella serovars resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, tetracycline, and nalidixic acid. However, all serovars were susceptible to norfloxacin, ciprofloxacin, and ceftriaxone.


Asunto(s)
Antibacterianos/uso terapéutico , Salmonella enterica/efectos de los fármacos , Adolescente , Niño , Preescolar , Diarrea/tratamiento farmacológico , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Humanos , Indonesia , Lactante , Recién Nacido , Infecciones por Salmonella/tratamiento farmacológico , Salmonella enterica/aislamiento & purificación
3.
J Health Popul Nutr ; 24(1): 107-12, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16796157

RESUMEN

The study compared the safety and efficacy of an oral rehydration salts (ORS) solution, containing 75 mmol/L of sodium and glucose each, with the standard World Health Organization (WHO)-ORS solution in the management of ongoing fluid losses, after initial intravenous rehydration to correct dehydration. The study was conducted among patients aged 12-60 years hospitalized with diarrhoea due to cholera. One hundred seventy-six patients who were hospitalized with acute diarrhoea and signs of severe dehydration were rehydrated intravenously and then randomly assigned to receive either standard ORS solution (311 mmol/L) or reduced-osmolarity ORS solution (245 mmol/L). Intakes and outputs were measured every six hours until the cessation of diarrhoea. During maintenance therapy, stool output, intake of ORS solution, duration of diarrhoea, and the need for unscheduled administration of intravenous fluids were similar in the two treatment groups. The type of ORS solution that the patients received did not affect the mean serum sodium concentration at 24 hours after randomization and the relative risk of development of hyponatraemia. However, patients treated with reduced-osmolarity ORS solution had a significantly lower volume of vomiting and significantly higher urine output than those treated with standard WHO-ORS solution. Reduced-osmolarity ORS solution was as efficacious as standard WHO-ORS solution in the management of cholera patients. The results indicate that reduced-osmolarity ORS solution is also as safe as standard WHO-ORS solution. However, because of the limited sample size in the study, the results will have to be confirmed in trials, involving a larger number of patients.


Asunto(s)
Diarrea/terapia , Fluidoterapia/métodos , Soluciones para Rehidratación/análisis , Adolescente , Adulto , Bicarbonatos/análisis , Niño , Cólera/complicaciones , Cólera/terapia , Femenino , Glucosa/análisis , Humanos , Masculino , Persona de Mediana Edad , Concentración Osmolar , Cloruro de Potasio/análisis , Cloruro de Sodio/análisis , Resultado del Tratamiento
4.
BMC Infect Dis ; 5: 89, 2005 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-16242013

RESUMEN

BACKGROUND: In preparation of vaccines trials to estimate protection against shigellosis and cholera we conducted a two-year community-based surveillance study in an impoverished area of North Jakarta which provided updated information on the disease burden in the area. METHODS: We conducted a two-year community-based surveillance study from August 2001 to July 2003 in an impoverished area of North Jakarta to assess the burden of diarrhoea, shigellosis, and cholera. At participating health care providers, a case report form was completed and stool sample collected from cases presenting with diarrhoea. RESULTS: Infants had the highest incidences of diarrhoea (759/1,000/year) and cholera (4/1,000/year). Diarrhea incidence was significantly higher in boys under 5 years (387/1,000/year) than girls under 5 years (309/1,000/year; p < 0.001). Children aged 1 to 2 years had the highest incidence of shigellosis (32/1,000/year). Shigella flexneri was the most common Shigella species isolated and 73% to 95% of these isolates were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol and tetracycline but remain susceptible to nalidixic acid, ciprofloxacin, and ceftriaxone. We found an overall incidence of cholera of 0.5/1,000/year. Cholera was most common in children, with the highest incidence at 4/1,000/year in those less than 1 year of age. Of the 154 V. cholerae O1 isolates, 89 (58%) were of the El Tor Ogawa serotype and 65 (42%) were El Tor Inaba. Thirty-four percent of patients with cholera were intravenously rehydrated and 22% required hospitalization. V. parahaemolyticus infections were detected sporadically but increased from July 2002 onwards. CONCLUSION: Diarrhoea causes a heavy public health burden in Jakarta particularly in young children. The impact of shigellosis is exacerbated by the threat of antimicrobial resistance, whereas that of cholera is aggravated by its severe manifestations.


Asunto(s)
Cólera/epidemiología , Diarrea/epidemiología , Disentería Bacilar/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Cólera/microbiología , Disentería Bacilar/microbiología , Femenino , Humanos , Incidencia , Indonesia/epidemiología , Lactante , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Estaciones del Año , Factores de Tiempo
5.
Am J Trop Med Hyg ; 68(6): 666-70, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12887025

RESUMEN

The antimicrobial susceptibility patterns for 2,812 bacterial pathogens isolated from diarrheal patients admitted to hospitals in several provinces in the cities of Jakarta, Padang, Medan, Denpasar, Pontianak, Makassar, and Batam, Indonesia were analyzed from 1995 to 2001 to determine their changing trends in response to eight antibiotics: ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, tetracycline, cephalothin, ceftriaxone, norfloxacin, and ciprofloxacin. Vibrio cholerae O1 (37.1%) was the pathogen most frequently detected, followed by Shigella spp. (27.3%), Salmonella spp. (17.7%), V. parahaemolyticus (7.3%), Salmonella typhi (3.9%), Campylobacter jejuni (3.6%), V. cholerae non-O1 (2.4%), and Salmonella paratyphi A (0.7%). Of the 767 Shigella spp. isolated, 82.8% were S. flexneri, 15.0% were S. sonnei, and 2.2% were S. dysenteriae (2.2%). The re-emergence of Shigella dysenteriae was noted in 1998, after an absence of 15 years. Shigella spp. were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline. Salmonella typhi and Salmonella paratyphi A were susceptible to all antibiotics tested, while Salmonella spp. showed various resistance patterns according to species grouping. A small number of V. cholerae O1 were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline; however, they were still sensitive to ceftriaxon, norfloxacin, and ciprofloxacin. Similar results were shown for V. cholerae non-O1. Campylobacter jejuni showed an increased frequency of resistance to ceftriaxone, norfloxacin, and ciprofloxacin, but was susceptible to erythromycin. This study shows that except for C. jejuni and V. parahaemolyticus, which appeared to be resistant to ciprofloxacin, the majority of the enteric pathogens tested were still susceptible to fluoroquinolones.


Asunto(s)
Antibacterianos/farmacología , Diarrea/epidemiología , Diarrea/microbiología , Farmacorresistencia Bacteriana , Bacterias Gramnegativas/efectos de los fármacos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Bacterias Gramnegativas/patogenicidad , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Indonesia/epidemiología , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad
6.
Diagn Microbiol Infect Dis ; 43(2): 91-7, 2002 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12088614

RESUMEN

Vibrio spp was isolated from 1024 (21.2%) of 4820 diarrhea patients admitted to a community hospital in North Jakarta from 1996 through 1998. Vibrio cholerae O1 (49.5%) and V. parahaemolyticus (30.1%) comprised the major species isolated, followed by V. cholerae non-O1 (16.9%), and V. fluvialis (9.4%). In 938 (19.4%) patients, Vibrio was found as single isolate. Multiple infections were detected in 86 (1.8%) patients. A small number of V. furnisii, V. metschnikovii, V. mimicus and V. hollisae were also isolated. No V. cholerae O139 was detected. The majority of patients with Vibrio spp. infections were adults between the ages of 20 to 45 years. No Vibrio spp. was isolated from infants <1 year old in this study. In vitro antibiotic susceptibility testing revealed no antibiotic resistance associated with the 507 V. cholerae O1 isolates tested, except for colistin (100%). These data implicate Vibrio spp. as a major cause of diarrhea in this region.


Asunto(s)
Diarrea/microbiología , Vibrio/clasificación , Vibrio/aislamiento & purificación , Enfermedad Aguda , Adolescente , Adulto , Técnicas de Tipificación Bacteriana , Niño , Preescolar , Farmacorresistencia Bacteriana , Femenino , Humanos , Indonesia , Lactante , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad
7.
Diagn Microbiol Infect Dis ; 44(3): 227-34, 2002 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-12493168

RESUMEN

Emerging or reemerging infections due to bacterial disease may be a local, regional or global problem. Bacterial acute gastroenteritis is a potential cause of substantial morbidity in travelers and deployed U.S. military personnel. A surveillance study was conducted over a two-year period in Indonesia among 6760 patients with debilitating diarrheal diseases. Of the 6,760 patients, 587 (9%) of the patient stools were positive for bacteria. The proportions of bacteria isolated from the 587 patients were: Shigella flexneri (39%), Salmonella spp. (26%), Vibrio spp. (17%), S. sonnei (7%), Campylobacter jejuni (4.4%), Salmonella typhi (3%) and S. dysenteriae (2.3%). Shigella flexneri was the most prevalent pathogen isolated, over Vibrio spp. No V. cholerae was isolated in the cities of Pontianak, Padang or Batam in Indonesia. Shigella dysenteriae reemergence was noted in Bali, Kalimantan, Batam and Jakarta after an absence of 15 years. Isolation of a high proportion of S. flexneri, and Vibrio spp. occurred during the rainy months. All bacterial isolates were susceptible to quinolones, with the exception of C. jejuni and Salmonella spp., which were resistant to ciprofloxacin, norfloxacin and nalidixic acid. Our findings highlight the decline of V. cholerae, the rise of S. flexneri and the reemergence of S. dysenteriae in Indonesia. The study also documents the emergence of quinolone-resistant Campylobacter spp. in the Indonesia archipelago.


Asunto(s)
Diarrea/epidemiología , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/epidemiología , Vigilancia de la Población , Adolescente , Campylobacter/aislamiento & purificación , Niño , Preescolar , Diarrea/microbiología , Femenino , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Indonesia/epidemiología , Lactante , Recién Nacido , Masculino , Salmonella/aislamiento & purificación , Estaciones del Año , Shigella/aislamiento & purificación , Vibrio/aislamiento & purificación
8.
FEMS Immunol Med Microbiol ; 34(2): 139-46, 2002 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-12381465

RESUMEN

The prevalence of bacteria, parasite and viral pathogens in 3875 patients with diarrhea in community and hospital settings from March 1997 through August 1999 in Jakarta, Indonesia was determined using routine bacteriology and molecular assay techniques. Bacterial pathogens isolated from hospital patients were, in decreasing frequency, Vibrio cholerae O1, Shigella flexneri, Salmonella spp. and Campylobacter jejuni, while S. flexneri, V. cholerae O1, Salmonella spp. and C. jejuni were isolated from the community patients. V. cholerae O1 was isolated more frequently (P<0.005) from the hospital patients than the community patients. Overall, bacterial pathogens were isolated from 538 of 3875 (14%) enrolled cases of diarrhea. Enterotoxigenic Escherichia coli were detected in 218 (18%) of 1244 rectal swabs. A small percentage of enterohemorrhagic E. coli (1%) and of Clostridium difficile (1.3%) was detected. Parasitic examination of 389 samples resulted in 43 (11%) positives comprising Ascaris lumbricoides (1.5%), Blastocystis hominis (5.7%), Giardia lamblia (0.8%), Trichuris trichiura (2.1%) and Endolimax nana (0.5%). Rotavirus (37.5%), adenovirus (3.3%) and Norwalk-like virus (17.6%) were also detected. Antimicrobial resistance was observed among some isolates. Bacterial isolates were susceptible to quinolones, with the exception of some isolates of C. jejuni which were resistant to ciprofloxacin, nalidixic acid and norfloxacin. Data obtained from this community- and hospital-based study will enable the Indonesian Ministry of Health to plan relevant studies on diarrheal diseases in the archipelago.


Asunto(s)
Diarrea/microbiología , Enfermedad Aguda , Adulto , Animales , Niño , Diarrea/epidemiología , Diarrea/parasitología , Sistema Digestivo/microbiología , Sistema Digestivo/parasitología , Sistema Digestivo/patología , Farmacorresistencia Bacteriana , Enfermedades Endémicas/clasificación , Enfermedades Endémicas/prevención & control , Enfermedades Endémicas/estadística & datos numéricos , Hospitalización , Humanos , Indonesia/epidemiología , Prevalencia , Estudios Prospectivos , Características de la Residencia
9.
J Infect Dev Ctries ; 7(11): 781-7, 2013 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-24240034

RESUMEN

INTRODUCTION: We undertook a prospective community-based study in North Jakarta, Indonesia, to determine the incidence, clinical characteristics, seasonality, etiologic agent, and antimicrobial susceptibility pattern of enteric fever. METHODOLOGY: Following a census, treatment centre-based surveillance for febrile illness was conducted for two-years. Clinical data and a blood culture were obtained from each patient. RESULTS: In a population of 160,261, we detected 296 laboratory-confirmed enteric fever cases during the surveillance period, of which 221 (75%) were typhoid fever and 75 (25%)  were paratyphoid fever.  The overall incidence of typhoid and paratyphoid cases was 1.4, and 0.5 per thousand populations per year, respectively. Although the incidence of febrile episodes evaluated was highest among children under 5 years of age at 92.6 per thousand persons per year, we found that the burden of typhoid fever was greatest among children between 5 and 20 years of age. Paratyphoid fever occurred most commonly in children and was infrequent in adults. CONCLUSION: Enteric fever is a public health problem in North Jakarta with a substantial proportion due to paratyphoid fever. The results highlight the need for control strategies against enteric fever.


Asunto(s)
Salmonella paratyphi A/aislamiento & purificación , Salmonella typhi/aislamiento & purificación , Fiebre Tifoidea/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Niño , Preescolar , Femenino , Humanos , Incidencia , Indonesia/epidemiología , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Prospectivos , Salmonella paratyphi A/efectos de los fármacos , Salmonella typhi/efectos de los fármacos , Estaciones del Año , Fiebre Tifoidea/microbiología , Fiebre Tifoidea/patología , Adulto Joven
10.
Am J Trop Med Hyg ; 86(1): 46-51, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22232450

RESUMEN

We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine non-malaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus, and spotted fever group rickettsia. During 1997-2000, 226 patients (127 males and 99 females) 1-80 years of age (median age = 25 years) were enrolled. Positive blood cultures (n = 34, 15%) were obtained for Salmonella Typhi (n = 13), Escherichia coli (n = 8), Streptococcus pneumoniae (n = 6), Staphylococcus aureus (n = 5), Streptococcus pyogenes (n = 1), and Klebsiella pneumoniae (n = 1). Twenty (8.8%) patients were positive for leptospirosis by polymerase chain reaction. Eighty (35.4%) of 226 patients had ≥ 1 positive serology, diagnostic for 15 rickettsial and 9 dengue cases. Acid-fast bacilli-positive sputum was obtained from three patients. Most common confirmed (81 of 226, 35.8%)/suspected diagnoses were typhoid fever (n = 41), pneumonia (n = 29), leptospirosis (n = 28), urinary tract infections (n = 20), rickettsioses (n = 19), dengue (n = 17), and meningitis/encephalitis (n = 15). There were 17 deaths, 7 (46.7%) were caused by meningitis/encephalitis. Multiple positive serologic results and few confirmed diagnoses indicate the need for improved diagnostics.


Asunto(s)
Infecciones Bacterianas/complicaciones , Fiebre/epidemiología , Fiebre/etiología , Virosis/complicaciones , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/complicaciones , Bacteriemia/epidemiología , Bacteriemia/microbiología , Bacteriemia/mortalidad , Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/mortalidad , Infecciones del Sistema Nervioso Central/complicaciones , Infecciones del Sistema Nervioso Central/epidemiología , Infecciones del Sistema Nervioso Central/etiología , Infecciones del Sistema Nervioso Central/mortalidad , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Papúa Nueva Guinea/epidemiología , Virosis/epidemiología , Virosis/mortalidad , Virosis/virología , Adulto Joven
11.
Med Princ Pract ; 13(5): 286-9, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15316263

RESUMEN

OBJECTIVE: To determine the inhibition effect of zinc sulfate on isolates of enteric bacteria. MATERIALS AND METHODS: Mueller-Hinton agar containing different concentrations of zinc sulfate was prepared. Isolates used in this study were obtained from local clinics. They were Salmonella typhi, Salmonella groups A, B, C, D and E, Escherichia coli, Enterobacter, Shigella and Vibrio cholerae. Overnight cultures of test organisms in brain-heart infusion broth were adjusted to 0.5 McFarland standard turbidity by adding normal saline with 1 microl of each adjusted broth culture inoculated onto zinc sulfate agar plates. The plates were incubated for 18-20 h at 37 degrees C. The inhibition concentration was recorded as the lowest concentration of zinc sulfate that completely inhibited growth. RESULTS: All enteric pathogens tested were inhibited by zinc sulfate. Of the isolates, S. typhi was most sensitive since 20% of the strains were inhibited by zinc sulfate of 0.8 mg/ml. Salmonella paratyphi A was inhibited at 1.2 mg/ml. Other Salmonella spp. were inhibited at concentrations between 1.4 and 2.0 mg/ml. V. cholerae O1 and Shigella flexneri demonstrated a similar pattern of inhibition as S. paratyphi A. A higher concentration of zinc sulfate (1.6 mg/ml) was required to completely inhibit Shigella sonnei. CONCLUSION: The findings indicate that zinc sulfate has an antimicrobial effect on enteric pathogens and may contribute to the treatment of diarrhea.


Asunto(s)
Antibacterianos/farmacología , Enterobacteriaceae/efectos de los fármacos , Enterobacteriaceae/crecimiento & desarrollo , Vibrio cholerae/efectos de los fármacos , Vibrio cholerae/crecimiento & desarrollo , Sulfato de Zinc/farmacología , Recuento de Colonia Microbiana , Humanos , Pruebas de Sensibilidad Microbiana
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