The prevalence of bacteremia caused by carbapenem-non-susceptible Acinetobacter baumannii (CNSAB) continues to increase, and it is associated with a high mortality rate. Early recognition of infection and mortality determinants risk factors is necessary for adequate antibiotic administration. We aimed to determine the risk factors and outcomes of CNSAB bacteremia in Indonesia. A multicenter case-control study was conducted in three referral hospitals in Indonesia. Data were collected retrospectively from January 2019 to December 2021. Cases were defined as patients with bacteremia where CNSAB was isolated from the blood, while the controls were patients with bacteremia caused by carbapenem-susceptible A. baumannii (CSAB). Risk factors for bacteremia and mortality associated with CNSAB bacteremia were determined using univariates analysis (chi-squared and Student’s t-test or Mann–Whitney test) and multivariate logistic regression analysis. A total of 144 bacteremia patients were included, of whom 72 patients were for each case and control group. The final model of multivariate regression analysis revealed that bacteremia source from the lower respiratory tract (adjusted odds ratio (aOR): 3.24; 95% CI: 1.58–6.63, p = 0.001) and the use of central venous catheter (aOR: 2.56; 95% CI: 1.27–5.18; p = 0.009) were independent risk factors for CNSAB bacteremia. Charlson Comorbidity Index ≥ 4 (aOR: 28.56; 95% CI: 3.06–265.90, p = 0.003) and Pitt Bacteremia Score ≥ 4 (aOR: 6.44; 95% CI: 1.17–35.38; p = 0.032) were independent risk factors for mortality due to CNSAB bacteremia. Only high Pitt Bacteremia Score was an independent risk factor for mortality of CSAB bacteremia. In conclusion, we identified the risk factors for CNSAB-associated bacteremia and the risk factors for death, which are relevant for empiric therapy and infection control prevention, as well as prognosis evaluation of patients with bloodstream infections.

Prehipertensi dan hipertensi merupakan penyakit yang disebabkan oleh berbagai faktor risiko dan saat ini cukup mengkhawatirkan karena prevalensinya yang tinggi serta cenderung meningkat. Prehipertesi dan hipertensi juga menjadi masalah karena mulai ditemukan pada dewasa muda (18-29 tahun) dan sering kali tidak terdiagnosis. Tujuan dari penelitian ini adalah mengetahui prevalensi dan faktor risiko prehipertensi dan hipertensi pada mahasiswa profesi Fakultas Kedokteran Universitas Riau tahun 2020. Penelitian ini menggunakan metode deskriptif observasional dan dilaksanakan pada Oktober 2020 – April 2021. Didapatkan 123 orang yang terdiri dari 33 orang (26,8%) laki-laki dan 90 orang (73,2%) perempuan, ditemukan prevalensi prehipertensi sebesar 23,6% dan hipertensi sebesar 9,8%. Faktor risiko yang didapatkan meliputi jenis kelamin laki-laki (26,8%), riwayat hipertensi keluarga (35,8%), indeks massa tubuh overweight (23,6%) dan obesitas (27,6%), aktifitas fisik ringan (0,8%), tingkat stres sangat parah (24,4%), kualitas tidur buruk (87%) dan perokok (0,8%). Saran bagi mahasiswa profesi Fakultas Kedokteran Universitas Riau dan masyarakat umum agar melakukan modifikasi gaya hidup dan menerapkan gaya hidup sehat untuk mencegah prehipertensi dan hipertensi pada usia muda.

Pendahuluan: Streptococcus mutans (S. mutans) merupakan bakteri yang mempunyai glukosiltransferase surface (GTFs) yang berperan pada proses perlekatan dan virulensi bakteri pada permukaan gigi. Enzim GTFs terdiri atas tiga jenis enzim GTFs yaitu GTFB, GTFC dan GTFD dan masing-masing enzim ini dikode oleh gen gtfB, gtfC dan gtfD yang juga berperan sebagai prekursor dalam adhesi seluler plak gigi yang dapat menyebabkan karies gigi. Tujuan penelitian adalah mengidentifikasi gen gtfC dan gtfD S. mutans pada pasien karies gigi. Metode: Penelitian dilakukan dengan consecutive sampling. Sampel penelitian diambil dari kerokan jaringan karies gigi, diisolasi, dikultur, dan diidentifikasi di laboratorium Mikrobiologi dan Sentral FK UNRI. Identifikasi S. mutans dan gen kariogenik gtfC dan gtfD menggunakan metode Polymerase Chain Reaction (PCR). Data ditampilkan dalam bentuk tabel distribusi frekuensi dan dinyatakan dalam persentase Hasil: Dari 60 kerokan jaringan karies didapatkan S. mutans sebanyak 10 isolat, sedangkan gen gtfC dan gen gtfD didapatkan masing-masing 4 (40%) isolat. Simpulan: Gen kariogenik teridentifikasi gen gtfC dan gtfD pada isolat S. mutans dari pasien karies gigi sebanyak 40%.Kata kunci: gtfC, gtfD, kariogenik glukosiltransferase Streptococcus mutans. ABSTRACTIntroduction: Streptococcus mutans (S. mutans) is a bacterium with a glucosyltransferase (Gtfs) surface, which plays a role in the attachment process and bacteria virulence on the tooth surface. The Gtfs enzyme consists of three types of Gtfs enzymes, namely GtfB, GtfC, and GtfD. These enzymes are encoded by the GtfB, GtfC, and GtfD genes, which also act as precursors in the cellular adhesion of dental plaque that can cause dental caries. This study was aimed to identify the GtfC and GtfD of S. mutans in dental caries patients. Methods: This study was conducted with consecutive sampling. Research samples were taken from dental caries tissue scrapings, isolated, cultured, and identified in the Microbiology and Central Laboratory of the Faculty of Medicine University of Riau. Identification of S. mutans and GtfC and GtfD cariogenic genes using the Polymerase Chain Reaction (PCR) method. The data was displayed in the form of a frequency distribution table and expressed as a percentage. Results: From 60 caries tissue scrapings, ten isolates were obtained, while the GtfC gene and GtfD gene were obtained 4 (40%) isolates each. Conclusion: Forty percents of S. mutans isolates from dental caries patients were identified as the GtfC and GtfD cariogenic genes.Keywords: GtfC, GtfD, cariogenic, Streptococcus mutans glucosyltransferase.

Indonesia has one of the highest HIV infection rates in Southeast Asia. The use of dolutegravir, an integrase strand transfer inhibitor (INSTI), as a first-line treatment underscores the need for detailed data on INSTI drug resistance mutations (DRMs). Currently, there is a lack of comprehensive data on DRMs INSTI and other HIV drug resistance in Indonesian patients, both pre- and post-treatment. The aim of this study was to identify the subtypes and drug resistance mutations of the protease, reverse transcriptase, and integrase genes in both treatment-naive and ARV-treated patients in Bandung, West Java, Indonesia. A cross-sectional study was conducted involving HIV-positive patients at Hasan Sadikin Hospital, Bandung, Indonesia, from September 2022 to January 2023. The patients were categorized into two groups: ARV-treated and pre-treatment patients. Peripheral blood mononuclear cells (PBMCs) were processed for DNA extraction, followed by amplification and sequencing of the pol gene to detect mutations and subtypes. The study found that the predominant subtype was CRF01_AE, accounting for 85.4% and 69% of pre-treatment and treated patients, respectively, followed by recombinant forms such as A1/CRF01_AE, CRF01_AE/CRF02_AG, subtype B, and other subtypes. Among ARV-treated/INSTI-naive patients, major INSTI DRMs R263K and Y143H were identified, while pre-treatment patients exhibited accessory integrase DRMs. The most common DRMs detected were non-nucleoside reverse transcriptase inhibitor (NNRTI) DRMs, with prevalences of 14.6% and 7% in pre-treatment and ARV-treated patients, respectively. In conclusion, CRF01_AE emerged as the predominant subtype in both pre-treatment and ARV-treated patients in Bandung, underscoring the necessity for ongoing surveillance of integrase DRMs, particularly given the presence of major INSTI DRMs in patients undergoing INSTI treatment.

Community-acquired pneumonia (CAP) poses a significant impact on the healthcare system due to rehospitalization and mortality. About one-third of hospitalized CAP patients died within one year. In addition to advanced age, vulnerable groups with comorbidities such as cancer, diabetes, and cerebrovascular disease (CVD) are more likely to suffer from severe CAP. The aim of this study was to investigate the factors linked to mortality in adult hospitalized CAP patients. The study extracted the medical records of patients aged ≥18 years, admitted to a referral hospital in Riau Province, who were diagnosed with CAP between January and December 2023. Multiple logistic regression step-wise analysis was employed to determine the factors associated with mortality in CAP patients. The study involved 334 patients with a median age of 58 years. Based on the confusion, urea, respiratory rate, blood pressure, and age ≥65 years (CURB-65) score, 11.9% of patients had severe CAP (CURB-65 scores 3 and 4). Age was a significant predictor of severe CAP (p≤0.001). The most prevalent comorbidities were malignancy (33.2%), CVD (30.2%), and diabetes (28.4%). Mortality incidence during hospitalization reached 35.9%. Significant factors associated with mortality in hospitalized CAP patients included renal dysfunction/elevated serum urea levels (p=0.031), CURB-65 score (p=0.023), vasopressor use (p≤0.001), mechanical ventilator use (p≤0.01) and steroid use (p=0.029). However, CVD was associated with a decreased risk of mortality (p=0.019). Gram-negative bacteria predominated, accounting for 50.6% of all positive isolates. Several significant factors were associated with mortality in adult patients hospitalized with CAP at referral Hospital in Riau, including renal dysfunction, CURB-65 score, vasopressor use, mechanical ventilator use, and steroid use. This finding underscored the importance of early identification factors in CAP patients.

Research on noncoding RNA, particularly microRNAs (miRNAs), is growing rapidly. Advances in genomic technologies have revealed the complex roles of miRNAs in pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD). It has been demonstrated that the progression of PAH associated with CHD is characterized by particular dysregulation of miRNAs and is related to cardiovascular remodeling, cell death, and right ventricle dysfunction. This review provides a comprehensive overview of the current state of knowledge regarding the involvement of miRNAs in the pathogenesis and progression of PAH associated with CHD. We commence by explaining the process of miRNA synthesis and its mode of action, as well as the role of miRNA in PAH associated with CHD. Moreover, the article delves into current breakthroughs in research, potential clinical implications, and prospects for future investigations. The review provides the insight into novel approaches for diagnosis, prognosis, and therapy of PAH associated with CHD.