The Effectiveness of Audit Guideline Using Directive Discourse for Control and Prevention of Methicillin Resistant Staphylococcus Aureus Infection

Methicillin Resistant Staphylococcus aureus (MRSA) infection is one of the major problems in the hospital, due to its increasing of prevalence. The aim of this study was to analyze the effectiveness of the Audit Guideline for control and prevention of MRSA infection, using directive discourse on nurses in hospitals. The Audit Guideline was focused on its effectiveness in improving the situation awareness of the nurses. This study was a quasi-experimental study using a pretest-posttest control group design. The population was ward nurses in a hospital. The samples were taken from four medical wards, two wards as the treatment group (25 nurses) and two wards as the control group (28 nurses). The two groups get the training of MRSA infection control and prevention. The training of the guideline of MRSA infection control and prevention using directive discourse was only applied in the treatment group. The analysis of the results of the situation awareness action was conducted, and the result of situation awareness action was improved from 0.8 response to 1.8 response (p = 0.014). This result was significantly difference because of the training using Audit Guideline for MRSA infections control and prevention with directive discourse become a positive reinforcement, the positive driven to stimulate behavior change of the nurses

The Effectiveness of Audit Guideline Using Directive Discourse for Control and Prevention of Methicillin Resistant Staphylococcus aureus Infection

Methicillin Resistant Staphylococcus aureus (MRSA) infection is one of the major problems in the hospital, due to its increasing of prevalence. The aim of this study was to analyze the effectiveness of the Audit Guideline for control and prevention of MRSA infection, using directive discourse on nurses in hospitals. The Audit Guideline was focused on its effectiveness in improving the situation awareness of the nurses. This study was a quasi-experimental study using a pretest-posttest control group design. The population was ward nurses in a hospital. The samples were taken from four medical wards, two wards as the treatment group (25 nurses) and two wards as the control group (28 nurses). The two groups get the training of MRSA infection control and prevention. The training of the guideline of MRSA infection control and prevention using directive discourse was only applied in the treatment group. The analysis of the results of the situation awareness action was conducted, and the result of situation awareness action was improved from 0.8 response to 1.8 response (p = 0.014). This result was significantly difference because of the training using Audit Guideline for MRSA infections control and prevention with directive discourse become a positive reinforcement, the positive driven to stimulate behavior change of the nurses

The distribution of Streptococcus mutans and Streptococcus sobrinusin children with dental caries severity level

Background: The prevalence of dental caries is high worldwide and specifically in Indonesia, especially in children. Cariogenic bacteria are the major cause of dental caries. Streptococcus mutans (S. mutans) is one of the bacteria often associated with caries, due to its ability in producing acid and forming the biofilm for bacterial colonisation on the surface of oral cavities. In addition to S. mutans, Streptococcus sobrinus (S. sobrinus) bacteria are also thought to play an important role in the process of caries. Purpose: This study aims to analyse the distribution of S. mutans and S. sobrinus in children with seriously high dental caries levels. Methods: This study was an observational analytical study. Bacterial isolation was conducted in carious lesions of 50 paediatric patients 6-12 years old with superficial dental caries. Samples of caries lesions were put directly into a tube containing the Brain Heart Infusion Broth (BHI-B) and incubated at 37o C for 24 hours. The samples were sub-cultured on selective tryptone yeast cystine sucrose bacitracin (TYCSB-Himedia) agar, and then incubated for two days. Bacterial identification was then performed using the polymerase chain reaction (PCR) Multiplex method. Statistical analysis with Chi-square. Results: The total number of children with dental caries included in this study was 50. Among these, 94% showed positive for S. mutans and 30% positive for S. sobrinus. The analysis of the prevalence of bacterial colonisation (S. mutans and S. sobrinus) based on caries severity and the Simplified Oral Hygiene Index (OHI-S), showed there was no significant difference (p> 0.05). Conclusion: This study showed that among 50 caries noted in the children, 94% were colonised S. mutans and 30% S. sobrinus. There was no significant difference between the colonisation of S. mutans and S. sobrinus among children from the severe to mild decayed exfoliated filling teeth (DEFT) category, and between bad and good OHI-S

Antimicrobial resistance among commensal isolates of Escherichia coli and Staphylococcus aureus in the Indonesian population inside and outside hospitals

The prevalence of antimicrobial resistance among the commensal microflora was examined in the Indonesian population inside and outside hospitals. A total of 3,995 individuals were screened in two major urban centers. Among Escherichia coli from rectal samples (n= 3,284) the prevalence of resistance to ciprofloxacin and other classes of antibiotics was remarkably high, especially in individuals at the time of discharge from hospital. Staphylococcus aureus isolates (n=361) were often resistant to tetracycline (24.9%), but this was not associated with hospital stay. Two S. aureus isolates harbored the mecA gene. Regional differences in resistance rates exist, suggesting regional differences in selection pressure, i.e., antibiotic usage patterns. The results show that antimicrobial resistance among commensal E. coli and S. aureus has emerged in Indonesi

PREVALENCE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS FROM NOSE AND THROAT OF PATIENTS ON ADMISSION TO MEDICAL WARDS OF DR SOETOMO HOSPITAL, SURABAYA, INDONESIA

Epidemiological data of methicillin resistant Staphylococcus aureus (MRSA) carriage in Indonesian hospitals are still scarce. These data are required for health management of infectious diseases in order to control hospital MRSA. The carriage rate of MRSA in nose and throat of patients on admission to Dr Soetomo Hospital Surabaya, Indonesia was 8.1% of 643 patients, 5.4% from throat, 3.9% from nose and 1.2% from both sites. Prevalence of MRSA among patients admitted to surgical and non-surgical ward was not different (8.2% and 8.0%, respectively). Although MRSA prevalence in Indonesian hospitals is low compared to many other countries worldwide, appropriate health strategies will be needed to be implemented if this infection is to be controlled

Rapid typing of extended-spectrum β-lactamase- and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae isolates by use of spectracell RA

Enterobacteriaceae are important pathogens of both nosocomial and community-acquired infections. In particular, strains with broad-spectrum beta-lactamases increasingly cause problems in health care settings. Rapid and reliable typing systems are key tools to identify transmission, so that targeted infection control measures can be taken. In this study, we evaluated the performance of Raman spectroscopic analysis (RA) for the typing of multiresistant Escherichia coli and Klebsiella pneumoniae isolates using the SpectraCell RA bacterial strain analyzer (River Diagnostics). Analysis of 96 unrelated isolates revealed that RA generated highly reproducible spectra and exhibited a discriminatory power that is comparable to pulsed-field gel electrophoresis. Furthermore, adequate results were obtained for three collections of clinical isolates. RA was able to discriminate outbreak-related isolates from isolates that were not involved in an outbreak or transmission. Furthermore, it was found that the RA approach recognized clones, irrespec