PETA DISTRIBUSI DAN RESISTENSI Acinetobacter baumannii DARI SPESIMEN KLINIK DI RSUD DR. ZAINOEL ABIDIN TAHUN 2018

Kemampuan hidup Acinetobacter baumannii pada berbagai keadaan dikombinasikan dengan resistensi berkaitan erat dengan Healthcare Associated Infections (HAIs). Kemunculan strain resisten telah banyak dilaporkan. Penelitian ini bersifat observasional deskriptif. Pemeriksaan spesimen klinik dilakukan di Laboratorium Mikrobiologi Klinik RSUD dr. Zainoel Abidin Banda Aceh. Isolat Acinetobacter baumannii dikumpulkan,  dilakukan uji kepekaan serta dinilai tingkat resistensinya. Angka insidensi Acinetobacter baumannii adalah 4,6% yang dominan terisolasi dari spesimen sputum. Strain resisten sangat umum dijumpai pada ruang rawat intensif, ruangan non intensif memiliki lebih banyak strain susceptible. Strain MDR menunjukkan kepekaan terhadap amikacin, trimethoprim-sulfamethoxazole, tobramycin, ampicillin-sulbactam, dan meropenem. Acinetobacter baumannii strain XDR hanya menunjukkan kepekaan yang masih baik terhadap amikacin. Data epidemiologi resistensi antibiotik adalah komponen utama Program Pengendalian Resistensi Antibiotik di rumah sakit

Validating Quantitative Polymerase Chain Reaction Assay for the Molecular Diagnosis of Chronic Suppurative Otitis Media

BACKGROUND: Pathogen identification is critical for antibiotic selection in suppurative otitis media. However, bacterial culture challenges from suppurative specimens often cause antibiotic misuse and ineffective treatment. A quantitative polymerase chain reaction (PCR) controlled by the human cells contained in the specimen (HIRA-TAN) has been established in differentiate between pathogens and colonization in the previous pneumonia study. AIM: The aim of this study was to investigate the utility of HIRA-TAN and determine the causative pathogen in chronic suppurative otitis media. METHODS: Thirty-nine patients were recruited to the study. The otorrhea was swab-collected and processed for both bacterial culture and a multiplex PCR-based test. The cutoff of cycle threshold to determinate the pathogens was defined by receiver operating characteristic curves. RESULTS: Thirty-nine patients ranging from 1.7 to 62 years old were enrolled. The hearing impairment was found different between adult and children (p < 0.005) with adults (24/29 patients) had a significantly higher rate. A total of 35.9% of samples were positive for bacterial culture; Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, and Morganella morganii, while Bacteroides fragilis, Acinetobacter baumannii, Moraxella catarrhalis, and Escherichia coli were not identified by culture, although high cycle-threshold values were obtained suggesting the inability of the culture system in detecting some pathogens. CONCLUSION: Our results indicate that HIRA-TAN is a potential diagnostic tool in suppurative otitis media and warrant a larger cohort study

IN VITRO ANTIBACTERIAL ACTIVITY OF EUCALYPTUS (Melaleuca leucadendra) OIL AGAINST METHICILLIN-RESISTANT Staphylococcus aureus (MRSA)

Highlights • The use of eucalyptus oil is natural and risk-free. It has a lengthy history of use as a traditional medicine in Asia, including Indonesia. • It has been demonstrated that eucalyptus oil possesses antibacterial activity against MRSA, and this activity was controlled by the oil's concentration. Abstract Background: Eucalyptus (Melaleuca leucadendra) oil is used by Indonesians as an herbal medicine. Eucalyptus containing 1,8-cineol at 72.30% is expected to be used as an antibacterial.  Objective: The study aimed to assess the antibacterial activity of eucalyptus oil against Methicillin-resistant Staphylococcus aureus (MRSA) bacteria in vitro. Material and Method: The materials used were eucalyptus oil (M. leucadendra) in various concentrations with ethyl acetate as solvent. The research method used was the agar-well diffusion assay. The MRSA was suspended to 0.5 McFarland turbidity. The MRSA suspension was thoroughly swabbed onto the surface of the Mueller-Hinton agar plate. The wells were made with a diameter of 0.6 mm on Muller-Hinton agar aseptically and 100 µl of eucalyptus oil was put into the well using a micropipette and incubated for 24 hours at 37°C. The diameter of the inhibition zone was measured with a caliper. Statistical analysis using the SPSS software edition 23. Result: Eucalyptus oil solution starting from a concentration of 10% to 100% had an antibacterial response, which could be seen by the formation of a bacterial inhibition zone around the eucalyptus oil (M. leucadendra) wells. The inhibition ability of eucalyptus oil against MRSA bacteria was greatest at a concentration of 90% with an inhibition zone of 31.26 mm. It was found that the concentration of eucalyptus oil affected the diameter of the bacterial inhibition area. Conclusion: Eucalyptus oil has been shown to have antibacterial activity against MRSA and was influenced by the concentration of the oil

Meningitis tuberkulosis

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RABIES

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Distribution and antibacterial susceptibility pattern of isolated bacteria from endotracheal aspirates among ventilator-assisted pneumonia patients in Indonesia

An accurate and timely identification of causative microorganisms as well as determination of their antibiotic susceptibility patterns will help in the selection of proper antibiotics and prevention of their misuse in pneumonia patients. The aim of this study was to determine the distribution and antibiotic susceptibility pattern of bacteria isolated from endotracheal aspirates of ventilator-assisted pneumonia patients in Indonesia. A retrospective cross-sectional study was conducted at Dr. Zainoel Abidin Hospital, a provincial reference hospital in Banda Aceh, Indonesia, from January to December 2021. Ventilator-assisted pneumonia patients aged ≥17 years treated in the hospital were considered eligible. Antibiotic susceptibility was valuated using Kirby-Bauer disc-diffusion followed with VITEK 2 Compact. We included 57 patients of which 73.7% males and 26.3% aged 56–65 years (represent the majority group of the patients). Each patient reported at least one comorbidity and the average duration of receiving mechanical ventilation was 8.68 days, and more than half (59.7%) of the patients had a poor clinical outcome (died). A total 57 bacteria isolates (consisting nine species) were recovered; 68.5% Gram-negative and 31.5% Gram-positive bacteria. Among 57 patients, Acinetobacter baumannii was the most frequent isolated Gram-negative bacteria (19.3%), followed by Klebsiella pneumoniae (17.5%), Pseudomonas aeruginosa (15.8%), and Achromobacter denitrificans (12.3%). A. baumannii exhibited <70% sensitivity to aminoglycoside and carbapenem antibiotics and 100% resistance to third-generation cephalosporins. The most abundant Gram-positive bacteria was Staphylococcus aureus (17.5%), followed by S. haemolyticus (10.5%) and S. epidermidis (3.5%). All S. aureus were sensitive to linezolid, tigecycline, vancomycin, and macrolide antibiotics (azithromycin, clarithromycin, clindamycin, and erythromycin), whereas 50% were sensitive to some beta-lactams. However, 50% of S. aureus were methicillin resistant S. aureus (MRSA). Given the magnitude of multi-drug resistance, an empiric antimicrobial therapy in particular to specific settings and implementation of antibiotic stewardship programs are crucial

Antiviral Activity of Ivermectin Against SARS-CoV-2: An Old-Fashioned Dog with a New Trick—A Literature Review

The coronavirus disease 2019 (COVID-19) pandemic is a major global threat. With no effective antiviral drugs, the repurposing of many currently available drugs has been considered. One such drug is ivermectin, an FDA-approved antiparasitic agent that has been shown to exhibit antiviral activity against a broad range of viruses. Recent studies have suggested that ivermectin inhibits the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), thus suggesting its potential for use against COVID-19. This review has summarized the evidence derived from docking and modeling analysis, in vitro and in vivo studies, and results from new investigational drug protocols, as well as clinical trials, if available, which will be effective in supporting the prospective use of ivermectin as an alternative treatment for COVID-19