Sunarjati Sudigdoadi
Department of Microbiology and Parasitology, Faculty of Medicine Universitas Padjadjaran

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Methicillin-Resistant Staphylococcus aureus pada Penderita Dermatitis Atopik dan Sensitivitasnya terhadap Mupirosin Dibandingkan dengan Gentamisin Istasaputri M., Keni; Sutedja, Endang; Suwarsa, Oki; Sudigdoadi, Sunarjati
Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Methicillin-resistant Staphylococcus aureus (MRSA) mulai dijumpai pada penderita dermatitis atopik (DA) derajat sedang hingga berat dan bersifat multiresisten terhadap antibiotik topikal. Gentamisin telah digunakan secara luas, sedangkan mupirosin merupakan pilihan utama eradikasi MRSA. Penelitian ini bertujuan untuk mengetahui kolonisasi MRSA pada penderita DA dan sensitivitasnya terhadap mupirosin dibandingkan dengan gentamisin di Poliklinik Departemen Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Survei potong lintang analitik dilakukan selama 19 September–31 Oktober 2011 terhadap 22 penderita DA derajat sedang hingga berat sesuai dengan Scoring Atopic Dermatitis objektif dan 22 individu sehat. Seluruh subjek dilakukan pemeriksaan apusan kulit untuk deteksi MRSA dan uji sensitivitas terhadap mupirosin dan gentamisin. Pada kedua kelompok masing-masing didapatkan 10 laki-laki dan 12 perempuan. Pada kelompok penderita DA didapatkan DA derajat sedang (10/22) dan berat (12/22), dengan lesi akut (14/22) dan kronik (8/22). Pertumbuhan S. aureus didapatkan pada 17/22 penderita DA dengan sensitivitas terhadap mupirosin 14/17 dan gentamisin 11/17 penderita. Pada individu sehat tidak didapatkan pertumbuhan koloni S. aureus. Galur MRSA ditemukan pada 3/17 penderita DA dan dianggap berbeda secara bermakna bila dibandingkan dengan individu sehat (p<0,01), galur ini bersifat sensitif terhadap mupirosin pada 2/3 penderita dan seluruhnya resisten terhadap gentamisin. Simpulan, kolonisasi MRSA perlu dicurigai pada penderita DA derajat sedang hingga berat, sehingga perlu pengobatan tambahan antibiotik topikal mupirosin. [MKB. 2013;45(1):36–44]Kata kunci: Dermatitis atopik, gentamisin, MRSA, mupirosinMethicillin-Resistant Staphylococcus aureus in Atopic Dermatitis Patients and Its Sensitivity to Mupirocin Compared to GentamycinMethicillin-resistant Staphylococcus aureus (MRSA) is found in moderate to severe atopic dermatitis (AD) and is multiresistant against topical antibiotic. Gentamycin is widely used while mupirocin is the first line therapy to eliminate MRSA. This research is intended to observe the colonization of MSRA case in AD patients and its sensitivity to mupirocin compared to gentamycin in Dermato-venereology Clinic Dr. Hasan Sadikin General Hospital Bandung. An analytical cross sectional survey was intended from 19th September–31st October 2011 in 22 moderate to severe AD patients based on objective Scoring Atopic Dermatitis and 22 healthy persons. All subjects went through skin-scraping, MSRA was detected and sensitivity test was done for mupirocin and gentamycin. The subjects consisted of 10 boys and 12 girls in both group. Based on severity, 10/22 of AD subjects were in moderate AD and 12/22 were severe AD, 14/22 of AD subjects presented with acute lesions and 8/22 subjects had chronic lesions. In the group of AD patients, 17/22 growth of S. aureus were found with sensitivity against mupirocin 14/17 and gentamycin 11/17. In healthy individual group, no  S. aureus growth was found. Methicillin-resistant Staphylococcus aureus strain in AD patients was observed on 3/17 patients, and this was declared significantly different compared to healthy individuals (p <0.01). The isolates in 2/3 patients were sensitive to mupirocin and all patients were resistant to gentamycin. In conclusion, the patients of moderate to severe AD are prone to MRSA colonization and therefore requires mupirocin topical antibiotic treatment.  [MKB. 2013;45(1):35–43]Key words: Atopic dermatitis, gentamycin, MRSA, mupirocin DOI: http://dx.doi.org/10.15395/mkb.v45n1.203
Isolation and Identification of Pathogenic Fungi from Air Conditioners in Tutorial Rooms of the Faculty of Medicine, Universitas Padjadjaran Govindasamy, Gowre; Husin, Usep Abdullah; Syukriani, Yoni Fuadah; Sudigdoadi, Sunarjati; Mulyana, Yanti
Althea Medical Journa Vol 1, No 1 (2014)
Publisher : Althea Medical Journa

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Background: Awareness about health problems caused by air conditioner is very important. Thus, it is crucial to have knowledge about proper maintenance of air conditioner. At the Faculty of Medicine, Universitas Padjadjaran, air conditioners are used in every tutorial rooms. This study was performed to provide adequate information on the fungi, such as Aspergillus, Penicillium and Mucor, found in air conditioners.Methods: A descriptive laboratory study was used to identify the presence and the type of pathogenic fungi from air conditioners in tutorial rooms. Thirty-four samples were collected from the air outlet grille of the air conditioners and cultured on Sabouraud agar at 27°C for 2 weeks. Fungi presence were then identified microscopicallyResults: The results showed that the majority of air conditioners in tutorial rooms of the Faculty of Medicine, University Padjadjaran contained many types of fungus that grew in Sabouraud agar. From 34 samples, thirty two samples were positive and 2 samples were negative. Various fungus have been identified, those were Penicillium (37.5%), Aspergillus (25%), Mucor (2.5%) and unidentified (35%)Conclusions : The majority of air conditioners in tutorial rooms of the Faculty of Medicine, University Padjadjaran contained many types of opportunistic fungus. [AMJ.2014;1(1):21–4]Keywords : Air conditioner, Aspergillus, fungi, Mucor, Penicillium Isolasi dan Identifikasi Jamur Patogen dari Pendingin Udara di Kamar Tutorial dari Fakultas Kedokteran, Universitas PadjadjaranLatar Belakang: Kesadaran tentang masalah kesehatan yang disebabkan oleh pendingin udara sangat penting. Dengan demikian , sangat penting untuk memiliki pengetahuan tentang perawatan yang tepat dari pendingin udara. Di Fakultas Kedokteran, Universitas Padjadjaran, pendingin udara digunakan di setiap kamar tutorial . Penelitian ini dilakukan untuk memberikan informasi yang memadai tentang jamur, seperti Aspergillus, Penicillium dan Mucor, yang ditemukan di pendingin udara. Metode: Sebuah studi laboratorium deskriptif digunakan untuk mengevaluasi keberadaan dan jenis jamur patogen dari pendingin udara di kamar tutorial. Tiga puluh empat sampel dikumpulkan dari kisi-kisi pendingin udara dan dikultur pada Sabouraud agar pada 27 °C selama 2 minggu. Pertumbuhan jamur kemudian diidentifikasi secara mikroskopis.Hasil: Hasil penelitian menunjukkan bahwa pada sebagian besar pendingin udara di ruang tutorial Fakultas Kedokteran Universitas Padjajdjaran terdapat banyak jamur yang dapat tumbuh di Sabaroaud agar, 32 hasil positif dan 2 hasil negatif untuk pertumbuhan jamur . Jamur yang tumbuh adalah Penicillium (37,5%, Aspergillus (25%), Mucor (2,5%) dan tidak teridentifikasi (35%).Simpulan : Sebagian besar pendingin udara di ruang tutorial Fakultas Kedokteran Universitas Padjadjaran Jatinangor menunjukkan adanya pertumbuhan jamur oportunistikKata kunci : Aspergillus, jamur , Mucor , Penicillium, pendingin udara
Pengaruh Ekstrak Etanol Propolis Terhadap Aktivitas dan Kapasitas Fagositosis pada Kultur Makrofag yang Diinfeksi Enteropathogenic Escherichia coli (EPEC) Herawati, Iis; Husin, Usep A.; Sudigdoadi, Sunarjati
Majalah Kedokteran Bandung Vol 47, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Penanganan penyakit infeksi diperlukan suatu imunostimulator. Propolis adalah campuran resin yang dikumpulkan lebah dari tumbuh-tumbuhan, digunakan sebagai material isolasi sarang lebah, merupakan bahan yang berpotensi sebagai imunostimulator. Penelitian dilakukan di Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada, pada Januari–Maret 2013. Penelitian ini bertujuan menganalisis peningkatan aktivitas dan kapasitas fagositosis kultur makrofag yang diberi ekstrak etanol propolis terhadap Enteropathogenic Escherichia coli (EPEC). Desain penelitian eskperimen. Ke dalam kultur makrofag yang diperoleh dari tiga orang subjek, masing-masing diberi ekstrak etanol propolis 6,25, 12,5, 25, 50, dan 100 µg/mL serta kontrol tanpa ekstrak etanol propolis. Inkubasi dilakukan satu hari. Kultur diinfeksikan EPEC selama 30 menit, diwarnai dengan Giemsa dan diamati dengan mikroskop. Persentase aktivitas fagositosis diperoleh dengan menghitung jumlah makrofag yang aktif dalam 100 makrofag. Nilai kapasitas fagositosis diperoleh dengan menghitung jumlah bakteri yang difagosit oleh 50 makrofag. Uji analysis of variance (ANOVA) menunjukkan perbedaan signifikan aktivitas maupun kapasitas fagositosis kultur makrofag yang diberi ekstrak etanol propolis dibanding dengan kontrol (p=0,000). Uji Tukey HSD pada aktivitas fagositosis menunjukkan hasil signifikan antara kontrol dan konsentrasi 6,25 µg/mL (p=0,008), sedangkan pada kapasitas fagositosis terlihat antara kontrol dan konsentrasi 12,5 µg/mL (p=0,001). Simpulan, ekstrak etanol propolis meningkatkan aktivitas dan kapasitas fagositosis kultur makrofag terhadap EPEC dengan konsentrasi minimum 12,5 µg/mL. [MKB. 2015;47(2):102–8]Kata kunci: Aktivitas fagositosis, Enteropathogenic Escherichia coli (EPEC), kapasitas fagositosis, makrofag, propolis.    The Effect of Ethanolic Extract Propolis on Phagocytosis Activity and Capacity Macrophages Culture which Infected by Enteropathogenic Escherichia coli (EPEC)AbstractThe use of immunostimulant for treatment infectious diseases is needed. Propolis is mixture of resin collected from plants by bees, used as an insulating material in beehives, which has potential as immunostimulant. The research was performed at Laboratory of research and integrated testing Gadjah Mada University in January−March 2013. This experimental research is amied to analyze the increase of phagocytosis activity and capacity on macrophages culture which added by propolis ethanolic extract againts Enteropathogenic Escherichia coli (EPEC). The design research is experimental. Macrophage culture obtained from three subjects, individually culture supplemented with the propolis ethanolic extract 6.25, 12.5, 25, 50, and 100 µg/mL as well as control without the addition of propolis ethanolic extract. The cultures were incubated for one day. Macrophage cultures infected by EPEC for 30 minutes, stained by Giemsa and observed by microscope. Percentage of phagocytosis activity is determined by the number of active macrophages per 100 macrophages. Phagocytosis capacity value determined by counting the number of bacteria that phagocytized by 50 macrophages.  Analysis of variance (ANOVA) showed significantly different phagocytosis activity and capacity between macrophage cultures that added by propolis ethanolic extract and control (p=0.000). Tukey HSD analysis showed significantly different phagocytosis activity between control and subject with concentration 6.25 µg/mL (p=0.008) whereas on phagocytosis capacity appears between control and subject with concentration 12,5 µg/mL (p=0.001). In conclusion, propolis ethanolic extract is able to increase the phagocytosis activity and capacity of macrophages againts EPEC with minimum concentration 12.5µg/mL. [MKB. 2015;47(2):102–8] Key words: Enteropathogenic Escherichia coli (EPEC), macrophage, phagocytosis activity, phagocytosiscapacity, propolis DOI: 10.15395/mkb.v47n2.460
Enteropathogenic Bacteria from Padang Food in Jatinangor September–October 2012 Husain, Syed Anwar; Sudigdoadi, Sunarjati; Firmansyah W., Abdullah
Althea Medical Journal Vol 2, No 2 (2015)
Publisher : Althea Medical Journal

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Background: Diarrhea is a food borne disease and still a major health problem in Indonesia. Padang foodis a popular cuisine and is exposed on an opened display, sometimes for many hours in room temperature,catering favorable conditions for bacterial growth. This study is undertaken to identify enteropathogenicbacteria on food in Padang restaurants located in Jatinangor, SumedangMethods: A laboratory study was conducted in the microbiology laboratory of the Department ofMicrobiology in the Faculty of Medicine, Universitas Padjadjaran, during September–October 2012. Sampleswere collected from 5 Padang restaurants located in Jatinangor using systematic random sampling. Fromeach restaurant, 4 wet samples were collected approximately 2–4 hours after being left open on the display shelves from sambal hijau, sambal merah, gulai babat and gulai nangka, cultured in tryptic soy broth (TSB) and incubated for 24 hours at 37 ºC, then inoculated in Mac Conkey agar and incubated for 24 hours at 37 ºC. Gram-staining was performed to identify gram-negative rods. The bacteria were put through biochemical tests.Results: Four species bacteria from the Enterobacteriaceae family were identified. The most frequent bacteria which was identified in the samples was Shigella sp (4 from 20), followed by Klebsiella pneumonia(3 from 20), Escherichia coli and Pseudomonas sp were less identified.Conclusions: Various Padang foods have potential risks of bacterial contamination due to the preparation,handling, and serving. It should be considered that the prepared food should be covered and placed in foodwarmers, ensuring warm food for hours. [AMJ.2015;2(1):241–44]
Enteric Pathogen Bacteria in Non-Broiler Chicken Egg Shells from Traditional Market and Supermarket, Jatinangor Subdistrict, West Java Arumugam, Kavita; Sudigdoadi, Sunarjati; Nugraha, Gaga Irawan
Althea Medical Journal Vol 2, No 3 (2015)
Publisher : Althea Medical Journal

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Background: Around 1.5 million of children dying annually due to diarrhea. Contaminated food is one of the sources of the diarrhea incidence (food borne diseases). Eggs are one of the least expensive forms of protein which is affordable by the community and is easily to find in either traditional or modern market/supermarkets.The objective of this study was to identify enteropathogenic bacteria contamination on non-broiler (ayam kampung) egg shell and to compare the findings between eggs sold in traditional and modern markets.Methods: This was a descriptive study performed at the Microbiology Laboratory of the Faculty of Medicine, Universitas Padjadjaran. A total of 40 eggs were used, 20 from two traditional markets and 20 from two modern markets. The eggs were swabbed using saline, dipped in tryptic soy broth and streaked on Mac Conkey agar. The collected data were analyzed and presented in tables.Results: Out of 40 samples, there were 19 positive cultures found from the traditional market and 16 from the modern market. There were 30 pink colonies indicating that they were lactose fermented, 5 transparent colonies indicated non-lactose fermentation, 4 showed no colony growth, and 1 grew an unidentified colony. The most found bacteria were Klebsiella sp. and Enterobacter sp. in both market. Conclusions: Eggs shells from traditional and modern markets are contaminated with Enteropathogenic microbes. DOI: 10.15850/amj.v2n3.487
Antimicrobial Suspectibility of Bacterial Isolated from Burn Unit in Dr. Hasan Sadikin General Hospital Bandung, Indonesia from June to September 2013 Evila, Yodya; Sudigdoadi, Sunarjati; Soedjana, Hardisiswo
Althea Medical Journal Vol 2, No 3 (2015)
Publisher : Althea Medical Journal

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Background: Development of infection in burned patients is a crucial matter because it may increase morbidity and mortality. Factors contributing to high risk for infections are disrupted skin barrier, dysfunction of the immune system and prolonged hospitalization. Crowded hospital condition and transfer of patients from one unit to another can affect development of infection caused by environmental factors. The aim of the study was to identify the antimicrobial suspectibility of bacterial isolated from Burn Unit in Dr. Hasan Sadikin General Hospital, Bandung.Methods: A descriptive study was carried out in Burn Unit Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from June to September 2013.  A total of 30 environment samples were collected and cultured to identify the bacterias. Futhermore, the colonies  found, underwent antimicrobial susceptibility test.Results: Most common bacteria found from the environmental samples in Burn Unit was Staphylococcus saprophyticus (24%). Other bacterias found were Klebsiella pneumonia (17%), Acinetobacter baumanii (15%), Staphylococcus epidermidis (12%), Bacillus sp.(12%), Pseudomonas sp.(7%), Staphylococcus aureus (5%), Enterobacter aerogenes (5%) and Serratia sp. (2%). Some bacteria still had good sensitivity to antibiotics while the Enterobacteriaceae were almost completely resistant to antimicrobial used in the study.Conclusions: The most common bacteria found from the environment samples in Burn Unit is Staphylococcuss aprophyticus. Additionally, Klebsiella pneumoniae as one of the Enterobacteriaceae groups, appears as an emerging hospital associated infection pathogen with their resistant to many antimicrobials. DOI: 10.15850/amj.v2n3.592
Antimicrobial Sensitivity of Neonatal Bacterial Sepsis Iswandari, Nadya; Primadi, Aris; Sudigdoadi, Sunarjati
Althea Medical Journal Vol 4, No 2 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v4n2.1072

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Background: Appropriate treatment on neonatal bacterial sepsis is important based on the exact etiology to prevent bacterial resistance, but bacterial identification using blood cultures requires a considerable time. The newest data of various bacteria and their sensitivity can be used to assist empirical antibiotics usage. This study was conducted to identify bacterial profile that caused neonatal sepsis and their sensitivity to antibiotics at Dr. Hasan Sadikin General Hospital Bandung..Methods: A total of 275 neonatal sepsis cases and 288 blood cultures results were collected from a database provided by Dr. Hasan Sadikin General Hospital Bandung during the period of July 2011 toDecember 2012 (three semesters).  Etiology of the bacteria and antimicrobial sensitivity profile data were taken from positive bacteria results. Then, these variables were processed using the descriptive method and classified by semesterResult: The most common bacteria that caused neonatal sepsis in the second semester 2011 is Serratia marescens, the first semester 2012 was Enterobacter aerogenes and in the second semester 2012 was Burkholderia cepacia. The most sensitive antibiotics were piperacillin tazobactam, cefepime, meropenem and amikacin in all three semesters, gentamycin in the second semester 2011 and 2012, and amoxicillin clavulanic in the second semester 2012.Conclusions: Bacterial and antimicrobial sensitivity profile is varied in every semester.Keywords: Antimicrobial sensitivity profile, bacterial profile, neonatal sepsisDOI: 10.15850/amj.v4n2.1072
The immunogenicity and safety of the new, Indonesian DTwP-HB-Hib vaccine compared to the DTwP/HB vaccine given with the Hib vaccine Bachtiar, Novilia Sjafri; Rusmil, Kusnandi; Sudigdoadi, Sunarjati; Kartasasmita, Cissy B; Hadyana, Hadyana
Paediatrica Indonesiana Vol 57 No 3 (2017): May 2017
Publisher : Indonesian Pediatric Society

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Background Haemophilus influenzae type b (Hib) causes infection with predominant manifestations of pneumonia, meningitis, and other invasive diseases, occurring primarily in children aged under 2 years, particularly in infants.  The World Health Organization (WHO) and Indonesian Technical Advisory Group for Immunization recommend to include the Hib vaccine into the national immunization program. The newly developed DTwP-HB-Hib combination vaccine is anticipated to be the preferred choice for Hib vaccine introduction; it is efficient, simple, and has higher coverage.Objective To evaluate the immunogenicity and safety of a new, combined Bio Farma DTwP-HB-Hib vaccine, compared to the registered Hib monovalent vaccine given simultaneously with the local DTwP-HB vaccine, when used as the primary vaccination of Indonesian infants.Methods A prospective, randomized, open-label, phase II study was conducted on the DTwP-HB-Hib vaccine compared to the Hib (registered) vaccine given simultaneously with the DTwP-HB vaccine, in Bandung from July 2011 to January 2012. Infants were serially vaccinated at 6-11, 10-15, and 14-19 weeks. Serological assessments were done prior to the first vaccine dose and 28 days after the third dose. Safety was assessed from the time of first injection until 1 month after the last injection.Results Of 220 healthy infants enrolled, 211 completed the study, with 105 receiving the combined vaccine and 106 the two separate vaccines. All vaccines were well tolerated. No differences in rates of local and systemic reactions were seen between the two methods of administration. No serious adverse events were considered to be related to the vaccines. In the DTwP-HB-Hib primary-vaccination group, at least 98% of the infants reached protective levels of antibodies (seropositivity) against the antigens employed in the vaccines while 96% in the control group.Conclusion The DTwP-HB-Hib combined vaccine is immunogenic and safe, as well as comparable to the Hib vaccine given simultaneously with to the DTwP-HB vaccine.
Impact of Training on Improving Proper Handwashing Practices among Elementary School Students Huthamaputiran, Theruna; Sudigdoadi, Sunarjati; Purnama, Andriana
Althea Medical Journal Vol 4, No 2 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v4n2.1073

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Background: Hand washing is among the most effective ways to prevent diseases. In Indonesia, only a quarter of the entire population practice proper handwashing techniques. Of these, children are the most vulnerable group for contracting diseases. Nevertheless, they also are crucial agent for behavior transformation as they are keen and open to new ideas. Therefore, this study was conducted to determine if training would have an improvement on a proper hand washing practices among elementary school students.Methods:An observational descriptive study design using random sampling was conducted from September to November 2013 in Jatinangor Subdistrict, West Java, Indonesia using primary data of one hundred elementary school students from four elementary schools. Questionnaires were given after informed consent. A demonstration on hand washing techniques and education on proper hand washing practices was then given. Two weeks later, the same questionnaire was given to measure the influence of the training. The collected data were presented using frequency tabulation.Results: Before the training on proper hand washing practices was conducted, only 86.9% students were practicing it properly. After the training was given, 90.7% of the students were doing it properly. For the hand washing technique, only 66.8% of students knew the correct steps before the intervention was given and 78.7% students did them correctly after the intervention.Conclusions:The training shows an overall improvement on the students’ hand washing practices. DOI: 10.15850/amj.v4n2.1073
Isolated Bacteria from Hemodialysis Water Distribution Systems in Hemodialysis Centers in Bandung bin Mohd Rafee, Mohd Hafeez; Sudigdoadi, Sunarjati; Dewanto, Julius B
Althea Medical Journal Vol 3, No 2 (2016)
Publisher : Althea Medical Journal

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Background: Despite the advent of water treatment technology for the past few decades, bacterial contamination is still an everlasting issue that requires solid intervention. Many studies across the world have identified myriad of bacteria that colonize the hemodialysis water distribution system. This study was conducted to identify common bacteria that colonized the hemodialysis water distribution systems in Bandung.Methods: This was a descriptive laboratory study conducted at the Department of Microbiology Faculty of Medicine Universitas Padjadjaran in 2014. Sterile bottles were used to collect 16 samples of reverse osmosis water from 2 hemodialysis centers in Bandung. Approximately 15 ml of water volume was collected in each bottle from 7 standard points for water sampling in hemodialysis system. The samples were first inoculated into R2A agar by pour-plate method and colonies were sub–cultured onto MacConkey and blood agar and the identification was based on Gram stain morphology, colony characteristics, and biochemical tests.Results: Micrococcus luteus and Pseudomonas sp. were the two predominant organisms which colonized the hemodialysis water distribution system. In addition, some genus of the Enterobacteriaceae such as Enterobacter aerogenes, Klebsiella pneumoniae, and Yersinia pseudotuberculosis were also isolated from the system and seemed to colonize the entire system.Conclusions: Bacterial contamination in hemodialysis water distribution system in Bandung is still a major problem regardless the efforts taken to minimize it. [AMJ.2016;3(2):259–64] DOI: 10.15850/amj.v3n2.788