Konsumsi Air di Kota Serang Tahun 2018

Kebutuhan air di Kota Serang diperoleh dari PDAM Tirta Albantani dan PDAB Tirta Madani, dimana pengembangan sistem penyediaan air minum adalah salah satu program prioritas. Penelitian ini bertujuan untuk memberikan gambaran konsumsi air minum perpipaan di Kota Serang berdasarkan analisa profil pelanggan yang dilayani dan konsumsi air yang terjual pada tahun 2018. Metode penelitian ini adalah pengumpulan data jumlah sambungan langganan dan volume konsumsi air selama 2018. Kemudian analisa golongan kelompok pelanggan domestik. Selain itu, hasil konsumsi air juga dibandingkan dengan peraturan terkait dan kota lain pada kategori berbeda. Saat ini, jumlah sambungan rumah PDAM Tirta Albantani sebanyak 2.880 SR sedangkan PDAB Tirta Madani sebanyak 1.636 SR. Total konsumsi air oleh PDAM Tirta Albantani pada tahun 2018 adalah 531.735 m3/tahun sedangkan PDAB Tirta Madani sebesar 397.278 m3/tahun. PDAM Tirta Albantani terbagi dalam III golongan pelanggan sedangkan PDAB Tirta Madani terbagi menjadi V kelompok pelanggan yang dibentuk berdasarkan kelompok tarif air minum pada penggunaan pelanggan tersebut. Konsumsi domestik terbesar adalah kelompok pelanggan rumah tangga A dan terkecil adalah kelompok pelanggan rumah tangga C. Rasio konsusmsi domestik PDAB Tirta Albantani adalah 95,12%, non domestik adalah 4,98% sedangkan rasio konsumsi domestik PDAB Tirta Madani 94,68%, non domestik 5,32%. Konsumsi air domestik PDAB Tirta Madani maupun PDAM Tirta Albantani sesuai dengan standar kebutuhan air menurut Peraturan Menteri Pekerja Umum No 1 Tahun 2014. Dan jika dibandingkan dengan Kota Sukabumi dan Kabupaten Bekasi, konsumsi air di Kota Serang jauh lebih kecil.Kata Kunci : PDAM, Konsumsi air, Sambungan rumah, Kelompok pelanggan, Uji keseragama

Cerebral perfusion in sepsis

This article is one of ten reviews selected from the Yearbook of Intensive Care and Emergency Medicine 2010 (Springer Verlag) and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/yearbook. Further information about the Yearbook of Intensive Care and Emergency Medicine is available from http://www.springer.com/series/2855

Imipenem resistance of Pseudomonas in pneumonia: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Pneumonia, and particularly nosocomial (NP) and ventilator-associated pneumonias (VAP), results in high morbidity and costs. NPs in particular are likely to be caused by <it>Pseudomonas aeruginosa </it>(PA), ~20% of which in observational studies are resistant to imipenem. We sought to identify the burden of PA imipenem resistance in pneumonia.</p> <p>Methods</p> <p>We conducted a systematic literature review of randomized controlled trials (RCT) of imipenem treatment for pneumonia published in English between 1993 and 2008. We extracted study, population and treatment characteristics, and proportions caused by PA. Endpoints of interest were: PA resistance to initial antimicrobial treatment, clinical success, microbiologic eradication and on-treatment emergence of resistance of PA.</p> <p>Results</p> <p>Of the 46 studies identified, 20 (N = 4,310) included patients with pneumonia (imipenem 1,667, PA 251; comparator 1,661, PA 270). Seven were double blind, and 7 included US data. Comparator arms included a β-lactam (17, [penicillin 6, carbapenem 4, cephalosporin 7, monobactam 1]), aminoglycoside 2, vancomycin 1, and a fluoroquinolone 5; 5 employed double coverage. Thirteen focused exclusively on pneumonia and 7 included pneumonia and other diagnoses. Initial resistance was present in 14.6% (range 4.2-24.0%) of PA isolates in imipenem and 2.5% (range 0.0-7.4%) in comparator groups. Pooled clinical success rates for PA were 45.2% (range 0.0-72.0%) for imipenem and 74.9% (range 0.0-100.0%) for comparator regimens. Microbiologic eradication was achieved in 47.6% (range 0.0%-100.0%) of isolates in the imipenem and 52.8% (range 0.0%-100.0%) in the comparator groups. Resistance emerged in 38.7% (range 5.6-77.8%) PA isolates in imipenem and 21.9% (range 4.8-56.5%) in comparator groups.</p> <p>Conclusions</p> <p>In the 15 years of RCTs of imipenem for pneumonia, PA imipenem resistance rates are high, and PA clinical success and microbiologic eradication rates are directionally lower for imipenem than for comparators. Conversely, initial and treatment-emergent resistance is more likely with the imipenem than the comparator regimens.</p

Impact of species and antibiotic therapy of enterococcal peritonitis on 30-day mortality in critical care - An analysis of the OUTCOMEREA database

Introduction: Enterococcus species are associated with an increased morbidity in intraabdominal infections (IAI). However, their impact on mortality remains uncertain. Moreover, the influence on outcome of the appropriate or inappropriate status of initial antimicrobial therapy (IAT) is subjected to debate, except in septic shock. The aim of our study was to evaluate whether an IAT that did not cover Enterococcus spp. was associated with 30-day mortality in ICU patients presenting with IAI growing with Enterococcus spp. Material and methods: Retrospective analysis of French database OutcomeRea from 1997 to 2016. We included all patients with IAI with a peritoneal sample growing with Enterococcus. Primary endpoint was 30-day mortality. Results: Of the 1017 patients with IAI, 76 (8%) patients were included. Thirty-day mortality in patients with inadequate IAT against Enterococcus was higher (7/18 (39%) vs 10/58 (17%), p = 0.05); however, the incidence of postoperative complications was similar. Presence of Enterococcus spp. other than E. faecalis alone was associated with a significantly higher mortality, even greater when IAT was inadequate. Main risk factors for having an Enterococcus other than E. faecalis alone were as follows: SAPS score on day 0, ICU-acquired IAI, and antimicrobial therapy within 3 months prior to IAI especially with third-generation cephalosporins. Univariate analysis found a higher hazard ratio of death with an Enterococcus other than E. faecalis alone that had an inadequate IAT (HR = 4.4 [1.3-15.3], p = 0.019) versus an adequate IAT (HR = 3.1 [1.0-10.0], p = 0.053). However, after adjusting for confounders (i.e., SAPS II and septic shock at IAI diagnosis, ICU-acquired peritonitis, and adequacy of IAT for other germs), the impact of the adequacy of IAT was no longer significant in multivariate analysis. Septic shock at diagnosis and ICU-acquired IAI were prognostic factors. Conclusion: An IAT which does not cover Enterococcus is associated with an increased 30-day mortality in ICU patients presenting with an IAI growing with Enterococcus, especially when it is not an E. faecalis alone. It seems reasonable to use an IAT active against Enterococcus in severe postoperative ICU-acquired IAI, especially when a third-generation cephalosporin has been used within 3 months. © 2019 The Author(s)