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Background and Aim: There is an increasing rate of antibiotic resistance in Neisseria gonorrhoeae (N. gonorrhoeae). Several obstacles affect the culture and susceptibility testing of N. gonorrhoeae. This study was aimed to determine the antimicrobial susceptibility pattern and molecular characteristics in multidrug-resistant (MDR) N. gonorrhoeae in Jakarta, Indonesia. Materials and Methods: Forty-one endocervical specimens were streaked onto the chocolate agar and then gently rolled onto a glass object. The suspected colonies were identified by Gram staining, oxidase testing, and biochemical identification using VITEK® 2 NH cards. The antimicrobial susceptibility testing was performed using the disk diffusion or E-test method. Molecular detection of N. gonorrhoeae was carried out using the SYBR green real-time PCR targeting the opa gene. The multiplex real-time PCR with high-resolution melting (HRM) was also conducted to analyze the gene mutations in penA and 23S rRNA. DNA sequencing was used to confirm penA and 23S rRNA mutations. Results: SYBR green real-time PCR against the opa gene on direct specimens detected N. gonorrhoeae with higher positivity rate (49%) compared to the culture (34%). Susceptibility testing detected 11.1% N. gonorrhoeae resistant to cefixime, whereas resistance to azithromycin and ceftriaxone was 0%. The resistance of N. gonorrhoeae to levofloxacin and kanamycin was 33.3% and 88.9%, respectively. All isolates were resistant to penicillin, tetracycline and ciprofloxacin. There were no mutations in the penA genes Ala501, Gly545Ser, 23S rRNA A2059G and C2611T. Conclusion: Cefixime resistance was found in our samples. This resistence was not correlated with penA gene mutations. All isolates were still susceptiblle to azithromycin, which was in line with its molecular characteristics. The SYBR green real-time PCR targeting the opa gene successfully detected the DNA extracted from endocervical swabs as N. gonorrhoeae. [ABSTRACT FROM AUTHOR]

Background Great scientific interest has grown around the role of vitamin D in many chronic diseases, due to its reported immunomodulatory effects and its association with several autoimmune and allergic diseases, including chronic urticaria (CU). Previous studies have shown low serum 25-hydroxyvitamin D [25(OH)D] or calcidiol levels in CU patients, with clinical improvements after vitamin D supplementation. However, data on the correlation between levels of vitamin D in the serum and CU disease activity are still limited, especially in low-middle income tropical countries like Indonesia. Objective We proposed to investigate the correlation between serum calcidiol levels and clinical disease activity in patients with CU. Methods We performed an analytic-descriptive cross-sectional study. Disease activity in CU patients, measured using the Urticaria Activity Score 7 (UAS 7) questionnaire, and serum calcidiol levels were assessed in 30 patients aged 18-59 years with CU. Results Mean UAS7 score was 14.6, median duration of illness was 12 months, and the median serum calcidiol level was 12.1 ng/mL. Most subjects (80%) were vitamin D deficient. We found no statistically significant correlations between serum calcidiol and CU disease activity (r=0.151; p=0.425). However, in subjects with severe vitamin D deficiency, a significant negative correlation was found (r=-0.916; p=0.001). Significant moderate correlation was also found between CU disease activity and illness duration (r=0.391; p=0.033). Conclusion We found no correlations between serum calcidiol levels and CU activity, however there was a tendency of increased CU disease activity in vitamin D deficient patients. [ABSTRACT FROM AUTHOR]

Background Neisseria gonorrhoeae has developed resistance to various antimicrobials. At least 10 countries have reported treatment failures with extended-spectrum cephalosporins. Periodic surveillance is essential to determine local treatment guidelines. This study was conducted to determine the resistance of N. gonorrhoeae to penicillin, tetracycline, levofloxacin, cefixime and ceftriaxone among the high-risk population for acquiring STIs in Jakarta and to identify factors associated with resistance.Methods: A cross-sectional study was conducted in Jakarta, Indonesia, from September to November 2018. In all, 98 high-risk males and females who fulfilled the study criteria were included. Specimens were collected from urethral or endocervical swabs, put into Amies transport medium and then transported to the Laboratory of Clinical Microbiology, Universitas Indonesia for culture and identification. Proven gonococcal isolates were examined for susceptibility to various antimicrobials using the disk diffusion method according to Clinical and Laboratory Standard Institute guidelines.Results: Of the 98 specimens, 35 were confirmed to be N. gonorrhoeae. The proportion of N. gonorrhoeae specimens resistant to penicillin, tetracycline, levofloxacin, cefixime and ceftriaxone among the high-risk population was 97.1%, 97.1%, 34.3%, 0% and 0% respectively. The possible factors associated with resistance could only be analysed for levofloxacin. Age, sexual orientation and a history of orogenital sexual activity during the past month were not associated with N. gonorrhoeae resistance to levofloxacin.Conclusion: This study detected no resistance of N. gonorrhoeae to cefixime and ceftriaxone. Further studies with larger samples are needed to obtain more representative results of N. gonorrhoeae resistance and the possible factors associated with resistance. [ABSTRACT FROM AUTHOR]

Psoriatic lesions on the scalp, face, intertriginous, genitals, palms/soles, and nails are often delay diagnosed, hard-to-treat, and cause disability. Metabolic syndrome (MetS) is one of the most frequent and significant comorbidities in psoriasis. Many studies have discovered a link between psoriasis and MetS, but none have specifically assessed the hard-to-treat psoriasis in Indonesian population. This is a multicenter study involving four dermatology referral hospitals to investigate the association between psoriasis severity that has hard-to-treat lesions with the prevalence of MetS in Jakarta, Indonesia. Data was collected from April to October 2022. The severity of 84 hard-to-treat psoriasis patients was measured by Psoriasis Area Severity Index (PASI) scores. The participants divided into PASI score >10 (severe) and ≤ 10 (mild-moderate) groups. MetS was identified based on the modified National Cholesterol Education Program Adult Treatment Panel III. MetS was found in 64.3% of patients. Patients with a PASI score>10 had a significantly higher risk of metabolic syndrome compared to those with a score ≤ 10 (78.6% vs 50%, OR 3.667; 95% CI 1.413-9.514; p = 0.006). The prevalence of hypertension (p = 0.028), low levels of high-density lipoprotein (HDL) cholesterol (p = 0.01), mean fasting blood sugar (p = 0.018), and triglyceride levels (p = 0.044) between the two groups differed significantly. This study found most frequent components of MetS were abdominal obesity, decreased levels of HDL cholesterol, hypertension, hyperglycemia, and hypertriglyceridemia respectively. Individuals with severe hard-to-treat psoriasis had a 3.67 times more likely to have MetS rather than the mild-moderate group., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Evyana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Street children's level of knowledge, attitudes, and practice (KAP) regarding sexually transmitted infections (STIs) and HIV-related diseases remains a challenge since it is difficult to reach all key populations. This study aims to provide an overview of the findings of STI cases and their association with the KAP of street children in Jakarta and Banten., Methods: We conducted a cross-sectional study on 259 male street children (aged 10 -21 years old). We collected the data through questionnaire interviews, history taking, physical examination, and specimen collection for STI and HIV testing., Results: 5.8% ( n = 15) STI cases were discovered, consisting of Hepatitis B ( n = 6), Hepatitis C ( n = 1), HIV ( n = 2), Chlamydia ( n = 3), Syphilis ( n = 1), and Gonorrhea ( n = 1). Buskers (44.4%) and other occupations like helping parents sell their wares, parking lot attendants, shoe shiners, or gathering (44.8%) dominated the sociodemographic characteristics. Condomless sex predominated risky sexual behavior, despite some subjects already having good knowledge., Conclusion: Sociodemographic characteristics and the KAP of street children in Indonesia are varied. The association between the KAP level and STI cases in street children is challenging to describe. Further studies covering more areas in Indonesia are required., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence., Design: Prospective cohort study., Methods: MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence., Results: Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1-0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47-5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22-11.19) and Bali (aOR 3.39; 95% CI 1.07-10.75), being employed/freelance (aOR 3.99; 95% CI 1.48-10.77), and not being circumcised (aOR 2.29; 95% CI 1.07-4.88) were independently associated with anal HR-HPV persistence., Conclusion: HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.