Enteropathogens associated with acute diarrhea in community and hospital patients in Jakarta,Indonesia

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.     

Lecanicillium and Verticillium species from Indonesia and Japan including three new species

Forty-six Lecanicillium strains and one Verticillium strain were isolated from subterranean and epiphytic arthropods, soil, and other sources collected in Indonesia and Japan. These strains were identified as nine Lecanicillium and one Verticillium species including six undescribed species based on light microscopy and the sequences of the ITS-1 and ITS-2 regions including 5.8S ribosomal DNA. Four of the ten species (L. araneicola, L. kalimantanense, Lecanicillium sp. 4, and V. indonesiacum) were recovered from Indonesia, five of the ten (L. attenuatum, L. fusisporum, L. psalliotae, Lecanicillium sp. 1, and Lecanicillium sp. 3) were from Japan, and L. saksenae was from both countries. In this article, new species (L. araneicola, L. kalimantanense, and V. indonesiacum) and a new combination (L. saksenae) are proposed from the fungi isolated from epiphytic and subterranean arthropods collected in East Kalimantan.     

Indonesian Kickxellales: two species of <Emphasis Type="Italic">Coemansia</Emphasis> and <Emphasis Type="Italic">Linderina</Emphasis>

Four species belonging to Kickxellales (Kickxellomycotina) isolated from soil of Indonesia are described and illustrated. Two new species of Coemansia, C. asiatica and C. javaensis, were discovered in South Sulawesi and West Java, and two known species of Linderina, L. pennispora and L. macrospora, were discovered in East Kalimantan and South Sulawesi, respectively. These four species are newly added to the Indonesian mycobiota. A technique for inducing sporulation of C. javaensis and L. macrospora by adding substances derived from invertebrates such as aphids, nereids, or cladocerans to culture media is described.     

Genotypes and phenotypes of G6PD deficiency among Indonesian females across diagnostic thresholds of G6PD activity guiding safe primaquine therapy of latent malaria

BackgroundPlasmodium vivax occurs as a latent infection of liver and a patent infection of red blood cells. Radical cure requires both blood schizontocidal and hypnozoitocidal chemotherapies. The hypnozoitocidal therapies available are primaquine and tafenoquine, 8-aminoquinoline drugs that can provoke threatening acute hemolytic anemia in patients having an X-linked G6PD-deficiency. Heterozygous females may screen as G6PD-normal prior to radical cure and go on to experience hemolytic crisis.Methods & findingsThis study examined G6PD phenotypes in 1928 female subjects living in malarious Sumba Island in eastern Indonesia to ascertain the prevalence of females vulnerable to diagnostic misclassification as G6PD-normal. All 367 (19%) females having <80% G6PD normal activity were genotyped. Among those, 103 (28%) were G6PD wild type, 251 (68·4%) were heterozygous, three (0·8%) were compound heterozygotes, and ten (2·7%) were homozygous deficient. The variants Vanua Lava, Viangchan, Coimbra, Chatham, and Kaiping occurred among them. Below the 70% of normal G6PD activity threshold, just 18 (8%) were G6PD-normal and 214 (92%) were G6PD-deficient. Among the 31 females with <30% G6PD normal activity were all ten homozygotes, all three compound heterozygotes, and just 18 were heterozygotes (7% of those).ConclusionsIn this population, most G6PD heterozygosity in females occurred between 30% and 70% of normal (69·3%; 183/264). The prevalence of females at risk of G6PD misclassification as normal by qualitative screening was 9·5% (183/1928). Qualitative G6PD screening prior to 8-aminoquinoline therapies against P. vivax may leave one in ten females at risk of hemolytic crisis, which may be remedied by point-of-care quantitative tests.     

The baseline distribution of malaria in the initial phase of elimination in Sabang Municipality, Aceh Province, Indonesia

ABSTRACT: BACKGROUND: Sabang Municipality, in Aceh Province, Indonesia, plans to initiate a malaria elimination programme in 2013. A baseline survey of the distribution of malaria in the municipality was conducted to lay the foundations for an evidence-based programme and to assess the island's readiness to begin the elimination process. METHODS: The entire population of the municipality was screened for malaria infection and G6PD deficiency. Specimens collected included blood slides, blots and tubes for selected households. Results and Discussion Samples were collected from 16,229 residents. Microscopic examination of the blood smears revealed 12 malaria infections; 10 with Plasmodium falciparum and 2 with Plasmodium vivax. To confirm the parasite prevalence, polymerase chain reaction (PCR) diagnosis was performed on the entire positive cases by microscopy and randomized 10% of the microscopically negative blood samples. PCR revealed an additional 11 subjects with malaria; one P. falciparum infection from the village of Paya Keunekai, and nine P. vivax infections and one mixed P. falciparum/P. vivax infection from the village of Batee Shok. The overall slide positivity rate was 0.074% (CI 95%: 0.070 - 0.078) and PCR corrected prevalence 0,590% (CI 95%: 0.582 - 0.597). Analysis of 937 blood samples for G6PD deficiency revealed two subjects (0.2%) of deficient G6PD. Analysis of several genes of the parasite, such as Pfdhfr, Pfdhps, Pfmdr1, Pfcrt, Pfmsp1, Pfmsp2, Pvdhfr, Pvdhps, Pvmdr1 and host gene, such as G6PD gene revealed that both P. falciparum and P. vivax carried the mutation associated with chloroquine resistance. CONCLUSION: Malariometric and host genetic analysis indicated that there is a low prevalence of both malaria and G6PD deficiency in the population of Sabang Municipality. Nevertheless, malaria cases were clustered in three rural villages and efforts for malaria elimination in Sabang should be particularly focused on those three villages.     

Correlation between squamous suture and sylvian fissure: OSIRIX DICOM viewer study

Background

Sylvian fissure (SF) is an important corridor in neurosurgery, and the end of sylvian fissure (eSF) represents the optimal target area to expose suitable recipient artery in STA-MCA bypass. Unfortunately little have been addressed concerning its relationship with external cranial surface.

Objective

Correlation between Squamous Suture (SS) and SF was investigated.

Methods

50-adult 3D-CTA images were studied using OSIRIX DICOM viewer. The measurement points were determined from external auditory meatus 0, 1, 1.5, 2, 2.5, 3, 3.5 and 4-cm anteriorly, perpendicular from orbitomeatal (OM) line. The distance of SF was compared with the one of SS.

Results

SSs were all located below SF at 0 cm. At a distance of 0 to 1.5 cm, SSs were located above SF, then started to merge and went side by side from 2 cm anteriorly. Anterior sylvian point, the most anterior part of SF, was found at 4 cm from OM line. Inferior Rolandic point, which corresponds to the central sulcus inferior extent, was found to be at 2 cm from OM line. The eSF was identified at 0 cm anteriorly from OM, and perpendicularly 1.5 cm above SS. 50% patients had Chater''s point (CP) above eSF. Average value for CP was 0.01 below eSF, giving a significantly closer value compared to the one of SS (p<0.01). However, SS showed consistent value of 1.5 below SF. Furthermore, SS is a bony landmark, which has no shifting effect during surgery, therefore drawing a 1.5-cm line upward from SS could lead to exact location of eSF.

Conclusion

The course of SF and its correlation to SS have been identified, and this is also the first study to investigate the relationship of SS and eSF using OSIRIX DICOM viewer. SS is also comparable to CP, therefore it is usable for a simple landmark of eSF.     

The importance of ARG513 as a hydrogen bond anchor to discover COX-2 inhibitors in a virtual screening campaign

Structure-based virtual screening (SBVS) protocols were developed to find cyclooxygenase-2 (COX-2) inhibitors using the Protein-Ligand ANT System (PLANTS) docking software. The directory of useful decoys (DUD) dataset for COX-2 was used to retrospectively validate the protocols; the DUD consists of 426 known inhibitors in 13289 decoys. Based on criteria used in the article describing DUD datasets, the default protocol showed poor results. However, having ARG513 as a hydrogen bond anchor increased the quality of the SBVS protocol. The modified protocol showed results that could be well considered, with a maximum enrichment factor (EF(max)) value of 32.2.     

Entomopathogenic fungi isolated from suspended-soil-inhabiting arthropods in East Kalimantan,Indonesia

As a preliminary survey to develop suspendedsoil arthropods as a new isolation source of entomopathogenic fungi, we investigated the entomopathogenic fungi of these arthropods. Fifty-five suspended-soil arthropods were collected from lowland tropical rainforests in East Kalimantan, and ten fungal isolates belonging to seven entomopathogenic species, including two undescribed species, were isolated from nine of the arthropods. Only two of the seven entomopathogenic species were commonly found from the arthropods inhabiting the ground soil in the same forests. The percentage of entomopathogenic fungi-positive arthropods from suspended soil was similar to that from ground soil of the same and another forest of the region, and lower than that from ground soil of Japan. However, the number of entomopathogenic species isolated from the suspended-soil arthropods was larger than that from ground-soil arthropods. This result suggests that suspended-soil arthropods can be a new isolation source of entomopathogenic fungi.