METODE ROLL-UP FORCE DOWN UNTUK ANALISIS PERAMALAN BEBAN KONSUMEN PADA TRANSFORMATOR GARDU INDUK

Kegiatan manusia dalam menggunakan listrik dari waktu ke waktu akan mengalami pertumbuhan. Pertumbuhan penduduk, pertumbuhan perumahan dan pertumbuhan ekonomi suatu wilayah diyakini sebagai salah satu faktor yang mempengaruhi meningkatnya konsumsi energi listrik. Salah satu komponen penyalur tersebut adalah gardu induk. PT. Perusahaan Listrik Negara (PLN) sebagai pemasok tegangan listrik perlu mengevalusi transformator yang ada pada gardu induk untuk melayani kebutuhan beban listrik konsumen. Tujuan penelitian mengevaluasi transformator pada gardu induk dengan memprediksi beban konsumen, dan berapa besar total bisnis (target) manajemen yang dapat ditanggung transformator dengan kapasitas terpasang sehingga diharapkan tidak terjadi pemadaman energi listrik dikarenakan kapasitas transformator gardu induk tidak mampu menanggung besarnya permintaan konsumen. Metode tahapan 1.) Analisa data awal 2.) trend moment 3.) Roll-up 4.) Force-down 5.) Analisa hasil. Hasil perhitungan menunjukan pada bulan-ke 12, nilai roll-up forecast sebesar Rp 780.787.158.836 disisi lain total bisnis manajemen ditetapkan  sebesar Rp1.000.000.000.000. Untuk total bisnis manajamen  yang telah ditetapkan diperkirakan pada bulan ke-40 target tersebut tercapai dengan hasil roll up sebesar Rp 1.006.802.944.52

Multihospital occurrence of pan-resistant Klebsiella pneumoniae sequence type 147 with an ISEcp1-directed blaOXA-181 insertion in the mgrB gene in the United Arab Emirates

The emergence of pan-resistant Klebsiella pneumoniae strains is an increasing concern. In the present study, we describe a cluster of 9 pan-resistant K. pneumoniae sequence type 147 (ST147) isolates encountered in 4 patients over nearly 1 year in 3 hospitals of the United Arab Emirates (UAE). The isolates exhibited highly similar genotypes. All produced chromosomally encoded OXA-181, and the majority also produced the NDM-5 carbapenemase. As with the previously described single isolate from the UAE, MS6671, the mgrB was disrupted by a functional, ISEcp1-driven blaOXA-181 insertion causing resistance to carbapenems. The mutation was successfully complemented with an intact mgrB gene, indicating that it was responsible for colistin resistance. blaNDM-5 was located within a resistance island of an approximately 100-kb IncFII plasmid carrying ermB, mph(A), blaTEM-1B, rmtB, blaNDM-5, sul1, aadA2, and dfrA12 resistance genes. Sequencing this plasmid (pABC143-NDM) revealed that its backbone was nearly identical to that of plasmid pMS6671E from which several resistance genes, including blaNDM-5, had been deleted. More extensive similarities of the backbone and the resistance island were found between pABC143C-NDM and the blaNDM-5-carrying IncFII plasmids of two K. pneumoniae ST147 isolates from South Korea, one of which was colistin resistant, and both also produced OXA-181. Notably, one of these strains was isolated from a patient transferred from the UAE. Our data show that this pan-resistant clone has an alarming capacity to maintain itself over an extended period of time and is even likely to be transmitted internationally

Real-time polymerase chain reaction for rapid detection of genes encoding SHV extended-spectrum β-lactamases

Purpose: This study aimed to develop an improved method for the detection of bacterial SHV-type extended-spectrum β-lactamases (ESBLs). Materials and Methods: Our method was based on real-time polymerase chain reaction (PCR) in which the amplification of the product was monitored with a fluorescent probe. This method enabled the detection of bla SHV genes with high degrees of sensitivity and specificity. Results: Based on ESBL phenotyping methods and bla gene DNA sequencing, we identified 240 bla genes from 662 Enterobacteriaceae isolated from clinical culture specimens. Of these 240 isolates, 26 had the bla SHV-28 genotype and three had the bla SHV-1 genotype. With our new real-time PCR assay, we detected 29 out of 29 bla SHV genes in ESBL-producing isolates. Conclusion: This method represents a powerful tool for epidemiological studies of SHV ESBLs. Furthermore, it has potential for use in diagnostic microbiology

Metode Roll-up Force Down Untuk Analisis Peramalan Beban Konsumen Pada Transformator Gardu Induk

Kegiatan manusia dalam menggunakan listrik dari waktu ke waktu akan mengalami pertumbuhan. Pertumbuhan penduduk, pertumbuhan Perumahan dan pertumbuhan ekonomi suatu wilayah diyakini sebagai salah satu faktor yang mempengaruhi meningkatnya konsumsi energi listrik. Salah satu komponen penyalur tersebut adalah gardu induk. PT. Perusahaan Listrik Negara (PLN) sebagai pemasok tegangan listrik perlu mengevalusi transformator yang ada pada gardu induk untuk melayani kebutuhan beban listrik konsumen. Tujuan penelitian mengevaluasi transformator pada gardu induk dengan memprediksi beban konsumen, dan berapa besar total bisnis (target) manajemen yang dapat ditanggung transformator dengan kapasitas terpasang sehingga diharapkan tidak terjadi pemadaman energi listrik dikarenakan kapasitas transformator gardu induk tidak mampu menanggung besarnya permintaan konsumen. Metode tahapan 1.) Analisa data awal 2.) trend moment 3.) Roll-up 4.) Force-down 5.) Analisa hasil. Hasil perhitungan menunjukan pada bulan-ke 12, nilai roll-up forecast sebesar Rp 780.787.158.836 disisi lain total bisnis manajemen ditetapkan sebesar Rp1.000.000.000.000. Untuk total bisnis manajamen yang telah ditetapkan diperkirakan pada bulan ke-40 target tersebut tercapai dengan hasil roll up sebesar Rp 1.006.802.944.52

Coinfections in Patients Hospitalized with COVID-19: A Descriptive Study from the United Arab Emirates

Abiola Senok,1,* Mubarak Alfaresi,2,* Hamda Khansaheb,3 Rania Nassar,1,4 Mahmood Hachim,1 Hanan Al Suwaidi,1 Majed Almansoori,2 Fatma Alqaydi,2 Zuhair Afaneh,2 Aalya Mohamed,2 Shahab Qureshi,2 Ayman Ali,2 Abdulmajeed Alkhajeh,3 Alawi Alsheikh-Ali1,3 1College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates; 2Sheikh Khalifa General Hospital, Umm Al Quwain, United Arab Emirates; 3Dubai Health Authority, Dubai, United Arab Emirates; 4Oral and Biomedical Sciences, School of Dentistry, Cardiff University, Cardiff, UK*These authors contributed equally to this workCorrespondence: Abiola SenokCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, PO Box 505055, Dubai, United Arab EmiratesTel +971-4-383-8717Email [email protected]: Microbial coinfections in COVID-19 patients carry a risk of poor outcomes. This study aimed to characterize the clinical and microbiological profiles of coinfections in patients with COVID-19.Methods: A retrospective review of the clinical and laboratory records of COVID-19 patients with laboratory-confirmed infections with bacteria, fungi, and viruses was conducted. Only adult COVID-19 patients hospitalized at participating health-care facilities between February 1 and July 31, 2020 were included. Data were collected from the centralized electronic system of Dubai Health Authority hospitals and Sheikh Khalifa General Hospital Umm Al Quwain.Results: Of 29,802 patients hospitalized with COVID-19, 392 (1.3%) had laboratory-confirmed coinfections. The mean age of patients with coinfections was 49.3± 12.5 years, and a majority were male (n=330 of 392, 84.2%). Mean interval to commencement of empirical antibiotics was 1.2± 3.6) days postadmission, with ceftriaxone, azithromycin, and piperacillin–tazobactam the most commonly used. Median interval between admission and first positive culture (mostly from blood, endotracheal aspirates, and urine specimens) was 15 (IQR 8– 25) days. Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli were predominant in first positive cultures, with increased occurrence of Stenotrophomonas maltophilia, methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, Candida auris, and Candida parapsilosis in subsequent cultures. The top three Gram-positive organisms were Staphylococcus epidermidis, Enterococcus faecalis, and Staphylococcus aureus. There was variability in levels of sensitivity to antibiotics and isolates harboring mecA, ESBL, AmpC, and carbapenemase-resistance genes were prevalent. A total of 130 (33.2%) patients died, predominantly those in the intensive-care unit undergoing mechanical ventilation or extracorporeal membrane oxygenation.Conclusion: Despite the low occurrence of coinfections among patients with COVID-19 in our setting, clinical outcomes remained poor. Predominance of Gram-negative pathogens, emergence of Candida species, and prevalence of isolates harboring drug-resistance genes are of concern.Keywords: SARS-CoV2, microbial coinfections, clinical outcomes, Pseudomonas, Candid