Indonesian Journal of Tropical and Infectious Disease

Synthesis and Characterization of Cu(II)-EDTA Complexes: Antibacterial Studies (Escherichia coli, Staphylococcus aureus) and Inhibition of Dengue Virus Serotype 2 in Vero Cell

Theresia Janice Kinetasari — 2025-08-31

The Cu(II)-EDTA complex is known to have antibacterial and antiviral potential, but its effectiveness against pathogenic bacteria and dengue virus serotype 2 (DENV-2) still needs to be studied. This study synthesized and characterized the Cu(II)-EDTA complex of CuSO₄ precursors, and then tested the antibacterial activity against Escherichia coli and Staphylococcus aureus, as well as the antiviral activity against DENV-2 in Vero cells. This study successfully synthesized and characterized the Cu(II)-EDTA complex using CuSO₄ as a precursor through the solvothermal method, producing blue crystals with a Cu ratio of 1:1. DSC analysis showed thermal stability up to 250°C with an endothermal peak at 270-300°C. The particles are 6.31 nm in size with a PDI of 0.076, indicating uniform distribution with nanoparticle size (<100 nm). FTIR confirms the formation of the complex through significant shifts in the O-H and C=O bands. SEM shows a layered morphology that can affect the solubility and release of substances. UV-Vis shows maximum absorbance peaks of EDTA at 244 nm and CuSO₄ at 740 nm. Antibacterial tests of Cu(II)-EDTA against E. coli and S. aureus showed that Cu(II)-EDTA had less activity than pure CuSO₄. For DENV-2, CuSO₄ was more effective with an EC₅₀ value of 77.86 μg/mL, lower than Cu(II)-EDTA 356.13 μg/mL, indicating that CuSO₄ was better at inhibiting viral replication.

Resistance Pattern of Anti-TB Drugs in Drug-Resistant TB of Pulmonary Tuberculosis Patients in Dr. Soetomo Academic Hospital, Surabaya, Indonesia

Olivia Marsha Maritsa — 2025-08-31

Pulmonary tuberculosis is an infectious disease that can be transmitted through the air due to infection with Mycobacterium tuberculosis bacteria. According to the WHO, TB is the second-highest cause of death in infectious diseases in the world. This study aims to determine patterns of anti-TB drug resistance in drugresistant TB patients in Dr. Soetomo Academic Hospital from January 2022 to December 2023. This was a descriptive retrospective using patient medical record data in Dr. Soetomo Academic Hospital for the period January 2022 - December 2023. This study included 261 drug resistant pulmonary TB patients, the majority of whom were new TB patients (61.3%). Anti-TB drug resistance
was most prevalent in RR-TB (43.7%), with the highest number of new cases (28.4%). Drug susceptibility test showed High-dose Isoniazid (INH^HD) had a high resistance rate (56%). Isoniazid (H) had a high resistance rate (66%). Pyrazinamide (Z) showed high sensitivity (66%). Levofloxacin (Lfx) showed high sensitivity (89%). High-dose Moxifloxacin (Mfx^HD) high sensitivity level (94%). Moxifloxacin (Mfx) high sensitivity level (92%). Bedaquiline (Bdq) high sensitivity level (98%). Linezolid (Lzd) high sensitivity level (99%). Clofazimine (Cfz) high sensitivity level (97%). Amikacin (Amk) high sensitivity level (100%). Drug-resistant pulmonary TB patients recently show a high drug sensitivity pattern to the second-line anti-TB drugs. MTB has become resistant to Isoniazid. However, it is still sensitive to Pyrazinamide by 66% and Levofloxacin by 89%. Moxifloxacin, Bedaquilin, Linezolid, Clofazimine, and Amikacin have high sensitivity >90%.

Role of Clinical Features and GeneXpert MTB/RIF Assay in Diagnosing Tuberculosis Among Toddler Patients in Surabaya

Siva Allysha Prasanti — 2025-04-30

Tuberculosis (TB) is a leading cause of global morbidity and mortality, mainly in the age of 0-5 years old (toddlers). Several risk factors make toddlers more prone to TB infection. Although it commonly depends on clinical evidence, diagnosis of toddler TB can be done using microbiological confirmation like GeneXpert MTB/RIF Assay. However, this is still challenging to perform due to the low bacterial loads and difficulties in obtaining specimens. While prior studies focused more on the clinical aspects, this study will determine both the clinical and microbiological profiles of toddler TB patients at Dr. Soetomo General Academic Hospital Surabaya. This study was conducted using a retrospective approach. Samples were obtained using a total sampling technique from electronic medical records from January 2018 to September 2023. Variables collected include age, gender, type of TB, BCG vaccination status, history of household contact, nutritional status, symptoms, and GeneXpert MTB/RIF examination specimens and results. Among 125 toddler TB patients, the majority being female (57%), between the ages of 1–2 (45%), had BCG vaccination (86%), and without a history of household contact (63%). Most of the samples were malnourished (56%) and had cough as the symptom (62%). In GeneXpert MTB/RIF examination, gastric aspirate was the most collected specimen (52%) and the most common result found was negative (70%). In addition, two toddler patients were found to have DR-TB. In conclusion, while GeneXpert MTB/RIF assay predominantly resulted in negative, clinical features become the essential evidence to establish a diagnosis of tuberculosis among toddler patients.

Fungemia in Tertiary Hospitals; An Overview Fungal Profile, Antifungal Resistance, and Antifungal Therapy

Syafira Putri Monita — 2025-04-30

Fungemia is a bloodstream infection caused by fungal pathogen and commonly occurs in hospitalized patients with certain risk factors. Indonesia itself is a tropical country with middle income that makes the incidence rate of fungemia tend to be higher, namely10/1 0,000 people. A recent study about candidemia conducted in Dr. Soetomo General Academic Hospital stated that the most common species that caused candidemia is Candida albicans (33.96%) and the blood sample mostly collected from patients from high care unit and patient with diabetes. We conducted this study to provide a new overview of data on the profile of the causes of fungal infections, patterns of fungal resistance to antifungals, and antifungal therapy in patients with fungemia in hospitalized patients at Dr. Soetomo General Academic Hospital, Surabaya, for the period of January December 2023. This research is a descriptive study using the patient’s medical records. Variables observed in this study include; gender, age, care unit, risk factor, species distribution, resistance pattern, type of antifungal therapy, and duration of antifungal therapy. Mostly the blood cultures are collected from female patients aged 0-9 years old. This study also found that most blood cultures are collected from patients in intensive care unit with use of CVC. Most of the patients did not receive antifungal therapy The most frequent found species is Candida parapsilosis with highest resistance rate found in Amphotericin-B. The most common antifungal that is used is Fluconazole which is mostly given within the range of 8-14 days .

Clinical Patterns and Demographic Characteristics of Dermatophytosis in Surabaya

Safira Azzahra — 2024-12-30

Dermatophytosis, the most common fungal infection in humans, significantly impacts quality of life due to its clinical and cosmetic effects. Its high prevalence underscores the need to evaluate patient profiles to improve management strategies. This study aim is to identify the most prevalent type of dermatophytosis, patient demographics, clinical characteristics, laboratory investigations, and therapy in dermatophytosis into the clinical and epidemiological characteristics of dermatophytosis in a tropical, high-burden region. This descriptive retrospective study used total sampling of medical records of dermatophytosis patients from January 2017 to December 2022. Tinea corporis and tinea cruris was the most common, while tinea manuum is the least common dermatophytosis. Female adults were the most affected group. Common clinical features for each type included alopecia for tinea capitis, erythematous macules for other types, and nail dystrophy for tinea unguium. Trichophyton mentagrophytes was the commonest pathogen in 2017. Most of the therapies followed Clinical Practice Guidelines with extensive use of griseofulvin and ketoconazole cream. Further research should explore therapeutic outcomes, preventive measures, and factors influencing recurrence and adherence to treatment.

In Vitro Analysis of SARS-CoV-2 Variants that Caused Severe COVID-19 in the Elderly

Silvia Sutandhio — 2025-04-30

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the global problem of respiratory disease from 2019 to 2024. One of the earliest variations in the SARS-CoV-2 S protein was the S D614G mutation. SARS-CoV-2 has several important variants, namely, Alpha, Beta, Gamma, Delta, and Omicron. Omicron is the variant that has caused severe health problems, some
resulting in death, in the elderly. Omicron has further differentiated to some wellknown variants, such as, BA.1, BA.2, BA.2.75, BA.5, BQ.1.1, and XBB.1. According to Japanese Government data, the number of citizens aged 65 years old and above reached 28.9% in 2021. From our previous experiment, antibodies of the elderly that have received four doses of mRNA vaccine still could not optimally neutralize Omicron BQ.1.1 and XBB.1. We aimed to analyze the plaque size of SARS-CoV-2 variants that caused severe COVID-19 in the elderly. SARS-CoV-2 variants were seeded in Vero E6-TMPRSS2 cell culture to create plaques. The resulting plaques were analyzed with ImageJ application to select solitary plaques and to determine plaque sizes. The size of BA.1 plaque was indifferent to BA.2 plaque. The plaque area comparison result was as follows, BA.1/BA.2<BA.5<BA.2.75<BQ.1.1<XBB.1. The plaque sizes of Omicron BQ.1.1 and XBB.1 were bigger that those of Omicron BA.1 and BA.2. The plaque sizes of all Omicron variants were smaller than those of the previous
variants, S D614G and Delta. The result of this in vitro experiment inferred that there is increase in fusogenicity of BQ.1.1 and XBB.1, when compared with BA.1 and BA.2.

Effect of Fetal Bovine Serum Concentration on Detection and Morphological Identification of Blastocystis hominis in vitro

Putu Sathiya Adi Janendra — 2025-08-31

Diarrhea significantly contributes to the high rates of illness and death among young children. Diarrhea can be caused by bacterial infections, viruses, or even parasites. Blastocystis hominis causes parasitic diarrhea, which can be identified by microscopy, culture, and molecular methods. Previous reports have modified the Jones’ culture medium using three different serums, such as human plasma, donkey serum, and horse serum (in Jones’ medium). This research replaces horse serum with fetal bovine serum for detection tests, morphological observation, and diagnosis of B. hominis. The research encompasses five experimental groups, each subjected to varying concentrations of fetal bovine serum: 2%, 10%, 20%, 30%, and 40%. Detection analysis is conducted using the Mc-Nemar test, while the Wilcoxon test is applied to evaluate ordinal data from morphological assessments. Diagnostic tests and metrics such as accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) are performed using MedCalc® software. The findings demonstrate that serum concentrations of 2%, 10%, 20%, and 30% produced effective results in detection tests, morphological identification, and diagnostic evaluations of B. hominis, exhibiting high sensitivity, specificity, PPV, NPV, and accuracy. Fetal bovine serum can be used at a concentration of 2% in a Jones’ medium that has been modified. This depends on the results of detection tests, morphology, and diagnosis.

Profile of Nontuberculous Mycobacteria and Mycobacterium tuberculosis Detected in the Sputum of Pulmonary Tuberculosis Re-treatment Patients at Dr. Soetomo General Hospital

Mochammad Afif Ziaulhaq — 2025-04-30

Tuberculosis (TB) remains one of the leading infectious diseases worldwide. Despite global efforts to control TB, it remains a major public health issue, affecting 10.6 million people annually in 2021, with significant morbidity and mortality, particularly in resource-limited settings. Effective treatment of TB requires strict adherence to long-term medication, but challenges such as treatment failure, relapse, and loss to follow-up complicate outcomes. This is especially concerning for patients with comorbidities such as diabetes, HIV, or hypertension, which not only increase the risk of TB but also hinder its treatment and elevate the likelihood of nontuberculous mycobacteria (NTM) infections. This study aimed to analyze 326 pulmonary TB retreatment cases at Dr. Soetomo General Academic Hospital from October 2023 to April 2024. The retrospective design identified that 323 cases involved MTB and 3 involved NTM. The findings show that loss to follow-up was the most common reason for retreatment, particularly among males and older adults. Comorbidities were found to exacerbate treatment challenges, with some retreatment cases lasting up to 24 months. The study concludes that loss to follow-up remains a major risk factor for TB retreatment, particularly in MTB cases, and highlights the importance of managing comorbidities to improve treatment outcomes.

Correlation Between Complete Blood Count Parameters with Procalcitonin in Immunogenomic Phases of COVID-19 Patients

Sarah Triwinar Sellynastiti — 2025-04-30

Coronavirus Disease 2019 (COVID-19), a global pandemic caused by SARSCoV-2, presents varying degrees of severity influenced by different immunogenomic phase. The immunogenomic phase that occurs in patients with COVID-19 is divided into three phases, namely the initial phase, propagating phase, and complicating phase. Severity disease progression can be monitored from the results of complete blood count (CBC) parameters and several inflammatory parameters such as procalcitonin. The purpose of this study was to investigate, during the immunogenomic phase of COVID-19 patients, the correlation between PCT levels and full blood count parameters. Patients treated at Dr. Soetomo General Hospital for COVID-19 were the subjects of this crosssectional study. Data analysis used in this study is Kolmogorov-Smirnov Test for normality, followed by Wilcoxon signed-rank test and bivariate Pearson correlation test to determine the correlation between complete blood count (CBC) parameters and PCT. Our findings reveal that most patients are male, predominantly aged between 50 and 60 years. Distinct variation of CBC parameters and PCT levels were observed in each phase. A significant relationship between these hematological markers, the immunogenomic phase and the progression of the disease. The PCT level of COVID-19 patients was associated with parameters of red blood cells, including hemoglobin, hematocrit, and the width-standard deviation of red blood cell distribution, leukocytes and their differential count, including lymphocytes and neutrophils, and platelets.. This analysis further understanding regarding the hematological dynamics in COVID-19 patients, providing important information about the pathophysiology of the disease and potential biomarkers for monitoring its progression.

Intervention Model for Pulmonary Tuberculosis (TB) with A Positive Acid-Fast Bacilli (AFB+) in Peukan Bada Sub-district, Aceh Besar Regency

Farrah Fahdhienie — 2025-08-31

Pulmonary tuberculosis (TB) with positive Acid-Fast Bacilli (AFB+) remains one of the most transmissible infectious diseases worldwide. This disease poses a significant public health challenge in many countries. This study aimed to develop a risk-factor-based intervention model to reduce the incidence of Pulmonary TB (AFB+). A case-control approach was employed, with the case group comprising people diagnosed with Pulmonary TB (AFB+), and the control group consisting of non-TB individuals from the same neighborhoods. Binary logistic regression was used for bivariate analysis, and multivariate analysis utilized logistic regression. This study found that the social determinants model accounted for 34.9% of the variance in the incidence of Pulmonary TB (AFB+) (R² = 0.349). The biological determinants model showed an R² of 0.127, indicating that this model explains 12.7% of the variance in the disease. The third model, which focused on behavioral determinants, had an R² of 0.312, meaning that behavioral factors accounted for 31.2% of the variance. The fourth model, examining the physical condition of housing, showed an R² of 0.425, indicating that 42.5% of the variance in Pulmonary TB (AFB+) is explained by variables related to housing conditions. In conclusion, the physical condition of housing emerged as the strongest predictor of Pulmonary TB (AFB+). These findings suggest that improving housing conditions should be a key component of public health strategies to reduce the incidence of Pulmonary TB (AFB+). Targeted interventions to improve the household environment are crucial for reducing the risk and transmission of Pulmonary TB (AFB+).