Infectious diseases often attack tropical countries, including Indonesia. The problem of infection in tropical countries is unique because the vectors (infection-carrying organisms) are generally insects such as mosquitoes and flies as well as nematodes (microorganisms) such as roundworms and pinworms. Vector breeding grounds are also greatly influenced by the hot climate throughout the year and the greater volume of rain in certain months. Prof. Dr. dr. Yeva Rosana, MS, Sp.MK(K) conveyed this in her inauguration speech as Professor in the Field of Microbiology, Faculty of Medicine (FK) UI, Saturday (23/12) in the IMERI Hall, UI Salemba Campus.
In her speech entitled “Application of Clinical Microbiology as an Effort to Prevent Infection and the Spread of Antimicrobial Resistance Based on Evidence to Improve the Quality of Health in Indonesia”, she said that population density and lack of personal and environmental hygiene made transmission easier. “The application of Clinical Microbiology in understanding infectious diseases in tropical countries is an indispensable basis for diagnosis and management of patients. Indonesia also needs to strive for behavior change, prevention, and health promotion which requires a multisectoral approach. Local communities really need to be involved, such as through the Healthy Living Community Movement which can have a positive impact on populations in remote areas in Indonesia,” said Prof. Yeva.
Infection is a disease caused by microorganisms such as bacteria, viruses, fungi, or parasites. Each microorganism can enter the human body in various ways, for example, inhaling through the respiratory tract, through contaminated food, through the blood, or through sexual activity. Outbreaks of infectious diseases can claim a large number of victims, one of which is the SARS-CoV-2 case which has an impact on the severity of the COVID-19 pandemic globally.
However, in the treatment of infectious diseases, the problem of antimicrobial resistance is often encountered. Resistance can occur in all causative microorganisms, including bacteria and fungi. Suboptimal use of antimicrobials is often caused by inappropriate interpretation or use of microbiological test results. In addition, the lack of a microbiologically confirmed diagnosis, laboratory test errors, failure to submit suitable specimens for culture, misuse of microbiological resources, and over-reliance on empiric antimicrobial therapy.
One example of a case of antimicrobial resistance was proven through the research results of Prof. Yeva was carried out from 1995 to 2022 on Neisseria gonorrhoeae as a cause of sexually transmitted infections. From this research, it was concluded that ciprofloxacin was no longer recommended as a treatment because of the high rate of resistance found. Guidelines for treating gonorrhea infections in Indonesia can still follow the World Health Organization (WHO) guidelines, namely a combination of ceftriaxone and azithromycin or cefixime and azithromycin for empiric therapy of genital and anorectal gonorrhea.
The problem of resistance in high-risk populations related to other sexually transmitted infections in Indonesia was also found in Treponema pallidum to azithromycin. In addition, the problem of resistance was found in the fungus Candida albicans as one of the critical pathogenic fungi which is a WHO priority. These examples show that the resistance mechanism of each microorganism is largely determined by the way we use an antimicrobial. Antimicrobial use guidelines are largely determined by germ patterns and sensitivities. Therefore, surveillance must be carried out regularly to obtain appropriate guidance.
According to Prof. Yeva, the application of Clinical Microbiology in understanding the pathogenesis of infection and resistance mechanisms is very necessary to develop strategies for preventing infection and the spread of antimicrobial resistance. Some of the roles of Clinical Microbiology in infection prevention are to support diagnosis, surveillance, outbreak detection and management, guidance on antimicrobial use, infection prevention, collaboration in infection control committees, and education. Test selection should be tailored to the clinical diagnosis, to reduce the cost of treating a patient. Appropriate examination results will be a guide for choosing a rational antimicrobial, which is able to prevent the increase in the rate of resistance and at the same time inhibit the spread of antimicrobial resistance.
Before conducting a study on preventing infection and the spread of antimicrobial resistance, Prof. Yeva has done a lot of similar research. Some of them are Profile of multidrug-resistant bacteria causing urinary tract infections in inpatients and outpatients in Jakarta and Tangerang (2023); Resistance genes of Neisseria gonorrhoeae to cefixime and azithromycin (2023); and Detection of A2058G and A2059G on the 23S rRNA Gene by Multiplex Nested PCR to Identify Treponema pallidum Resistance to Azithromycin in Indonesia (2022).
Prof. Dr. dr. Yeva Rosana, MS, Sp.MK(K) completed her education in medicine (1994), Masters in Biomedical Sciences (2001), and Doctorate (2013) at FKUI. She also obtained the title Specialist 1 in Clinical Microbiology in 2001 and Specialist 2 in Consultant Clinical Microbiology in 2009 from the Collegium of the Indonesian Association of Clinical Microbiology Specialist Doctors (PAMKI). In 2020, Prof. Yeva received the Satyalancana Karya Satya XX Year Medal of Honor. Currently, she serves as Deputy Chair 1 of the Special Work Unit (UKK) of the Clinical Microbiology Laboratory (LMK) FKUI and Consultant Clinical Microbiology Specialist, FKUI Dr. Cipto Mangunkusumo Hospital (RSCM).
The inauguration procession of professor Prof. Yeva was also attended by the Professor of FK Hasanuddin University, Prof. Dr. Muh. Nasrum Massi, Ph.D., SpMK(K); Professor at the Faculty of Veterinary Medicine, Bogor Agricultural Institute, Prof. Dr. drh. Agustin Indrawati, M. Biomed.; Professor at the Faculty of Medicine and Health Sciences, Krida Wacana Christian University, Prof. Dr. dr. Tonny Loho, DMM, Sp.PK(K); Professor of FK Trisakti University, Prof. Dr. Widyasari Kumala, M.Biomed, Sp.MK(K); Rector of Sultan Ageng Tirtayasa University, Prof. Dr. Ir. H. Fatah Sulaiman, S.T., M.T.; Commissioner of PT. Prodia Widyahusada Tbk/ Main Director of Prodia Utama, Dra. Endang W. Hoyaranda; and Main Director of RSUI, Dr. dr. Astuti Giantini, SpPK(K), MPH.
