Bacteria Fight Back, Also in Indonesia!

Get an infection, take an antibiotic. That simple, sensible, and often life-saving intervention, repeated myriad times, has triggered an ever-escalating war between humans and microbes—a war the microbes seem to be winning. Almost as soon as penicillin was introduced in 1942, bacteria started to develop resistance. Now, many common bacteria have acquired resistance to multiple antibiotics, making some infections extraordinarily difficult to treat. Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. In Indonesia, antibiotics can be purchased even without a doctor’s prescription. Now, as bacterial resistance to antibiotic are increasing, the potency of an antibiotic to eradicate pathogenic bacteria seems to be decreasing, not very long after a new antibiotic is available in the market. Generally, the development of resistant bacteria to antibiotics happen spontaneously or because of a pressure of inappropriate antibiotic use in clinical practice. In Indonesia, the absence of antibiotic regulation to be used in human as well as animal health is also believed to have contributed to the rapidly increasing incidence of multidrug resistant bacteria. The antibiotic resistant bacteria has become a serious problem especially for patients hospitalized in intensive care units. More than 40% of the budget for drugs is allocated for antibiotics, and once the causative bacteria develops resistance to antibiotics, the case fatality rate of the infections increases

Bacterionomics and vironomics in carcinogenesis

Virus and bacteria are microbes which are very common cause human infection. Most of the bacterial infection can be eradicated by antibiotics and infection symptoms disappear. But for virus infection, once infected, the virus will persistently stay in the host, even undergo not only a lytic cycle but also integrated into host genome. Nowadays, at least 6 virus type are consistently related to human cancer, such as EBV,HPV,HTLV,HBV,HCV,HKSV, and the new one Merkel Virus (MCV). Although not every infected people will get cancer, but around 20% of the whole cancer in human are caused by viral oncogene.Class one oncogenic bacterial is Helicobacter pylori. Infection with this bacteria can cause persistent gastro duodenal inflammation which cause some alteration in gastric cell growth into transformation. Expression of Cag gene and Vac gene and some expression of OMP protein usually link to gastric cancer.Molecular mechanisms of carcinogenesis for every virus which cause infection  is a very complex , which include several processes caused by cell transformation. Besides, other host and environmental factors are also play a significant role in cancer development. Some scientist put a Hallmark analysis as a model to quickly summarize what pathobiology process will happen and what gene or protein caused the process. The Hallmark analysis comprise of several process which may happen simultaneously because some of the Hallmark is caused by the same protein. The Hallmark consists of various virus strategies in oncogenesis such as promoting angiogenesis, avoiding immune destruction, genome instability and mutation, deregulating cellular energetic, resisting cell death, sustaining proliferative signaling, evading growth suppressors, enabling cellular immortality, promoting inflammation and activation metastasis. For example, infection by HPV, will cause low grade dysplasia which can continue to invasive cervical cancer. After host cell transformation, in the long control region genes, E6 and E7 protein will cause several strategies in oncogenesis including resisting cell death and evading growth suppressors.  HBV infection will end without any serious liver damage, but after cell transformation, almost all Hallmark strategies of viral oncogenesis are happening step by step in line with the severity of liver cell damage.As the onset of cancer development after infection can last years, there are an opportunity to design either vaccine or genetic therapy to minimalize further risk of cancer in human

Biosecurity dalam Kedokteran dan Kesehatan

Virus dan bakteri adalah mikroorganisme yang dapat menimbulkan wabah penyakit yang menyebardengan cepat dan mengakibatkan kematian.Selain itu, beberapa wabah dikaitkan denganaksi terorisme yang menimbulkan kepanikan masyarakat, pemerintah dan petugas kesehatan.Hal tersebut mendorong WHO dan beberapanegara bekerja sama untuk menanggulangi dan mencegah terulangnya kejadian tersebut, dalam suatu istilah yang disebut biosecurity.1,2 Biosecurity merupakan konsep baru yang sedang berkembang di dunia kesehatan dan kedokteran. Oleh karena itu, biosecurity harus dimengerti oleh semua tenaga kesehatan, salah satunya adalah dokter.Sebagai klinisi, seorang dokter harus memiliki kecurigaan terhadap pertambahan angka kejadian penyakit tertentu, juga karakteristik berbagaipenyakit yang relatif baru yang terkait dengan bahan biologi atau agen infeksi patogen yang dapat disalahgunakan dalam bioterorisme, juga manifestasi klinis yang meragukan dan tidak biasa.Dalam upaya menanggulangi berbagai ancaman/bahaya bioterorisme, seorang dokter juga harus mampu bekerja sama dengan pemerintah ataupun berbagai elemen masyarakat terkait agar USAha bioterorisme dapat ditanggulangi

Development of a SYBR Green real-time PCR-based assay system for detection of Neisseria gonorrhoeae

Diagnosis of Neisseria gonorrhoeae infection is needed for patient therapy and for reducing this bacterial transmission in the population. The culture method is a gold standard method for N. gonorrhoeae detection, however it has low sensitivity. Among molecular methods with high sensitivity and specificity, SYBR Green real-time PCR is the potential method for N. gonorrhoeae detection. In this study, we developed an SYBR Green real-time PCR-based system assay for N. gonorrhoeae detection. Several PCR conditions were optimized and analyzed including primer annealing temperature, DNA template volume, the limit of detection (LoD), cross-reaction with others (bacteria, viruses, fungus, protozoa), and quality assurance. The results showed that the annealing temperature and DNA template volume were 60oC and 5 µL, respectively. The LoD was 29 DNA copies corresponding to 3 bacterial cells per reaction. No cross-reaction was detected for other bacteria, viruses, fungus and protozoa. The external quality assurances enrolled in 2019 and 2021 showed 100% concordance. The preliminary testing for clinical samples was also 100% concordance. In conclusion, the SYBR Green real-time PCR-based system assay developed in this study is promising for application in clinical laboratories

A comparison study of GeneXpert and In-House N1N2 CDC Real-Time RT-PCR for detection of SARS-CoV-2 infection

COVID-19 is a disease caused by SARS-CoV-2, a new virus from genus β-coronaviruses. This disease has been declared a pandemic by WHO on 11 March 2020 until now. The nucleic acid tests are the most frequently used assays because of their high sensitivity and specificity. One of the tests is the GeneXpert, a real-time reverse transcription polymerase chain reaction (rRT-PCR)-based assay platform. The use of the GeneXpert shows great public health interest because of the rapid (50 min), the minimum number of trained staff, and less infrastructure and equipment. However, there are limited data on the application of the GeneXpert for the detection of SARS-CoV-2. Therefore, we conducted a comparative study between the GeneXpert and in-house N1N2 CDC rRT-PCR assay. Of 86 samples, 17 were rRT-PCR positive while 13 were GeneXpert positive. Of rRT-PCR positive 17 samples, 7 were GeneXpert negative [58.82% (10/17] sensitivity]. We also found that 3 GeneXpert positive samples showed rRT-PCR negative (95.65% [66/69] specificity). It is concluded that negative results by the GeneXpert can not rule out the possibility of SARS-CoV-2 infection, particularly in close-contact individuals and the interpretation of the positive result should be analyzed carefully, particularly amplification with Ct>40

EFFECTIVENESS OF WET COMBING COMPARED WITH 1% PERMETHRIN LOTION FOR THE TREATMENT OF PEDICULOSIS CAPITIS

Objective: Pediculus humanus capitis is an ectoparasite that sucks blood from the patient’s scalp. Gamma-hexachlorocyclohexane is an effective treatment but its use has been discontinued because of its neurotoxicity. Although the replacement pediculicide is permethrin, this is not affordable for everyone, and thus the recommended treatment is wet combing. The aim of this study is to evaluate the effectiveness of permethrin compared with wet combing for eliminating pediculosis. Methods: This study was a randomized controlled trial (RCT) conducted in a boarding school in Bogor District; the data were collected in July–August, 2018. Subjects were regarded as infested if lice were found during examination. Infested subjects were divided into two groups. In the permethrin group, the hair was wetted with permethrin lotion and left for 10 min. Afterwards, a fine-toothed comb was used to remove lice, and then the subjects were instructed to wash their hair with shampoo. On day 14, each subject’s head was reexamined to determine the cure rate. The wet-combing group was treated similarly but using conditioner instead of permethrin. Results: Of 121 subjects, 88.4% were infested with head lice. The cure rate after one week of treatment was 66% in the permethrin group and 63% in the wet-combing group. After a two-week course of treatment, the cure rate increased to 94% in permethrin group and 89% in the wet-combing group. There was no significant difference in cure rate between permethrin and wet combing after a one-(P = 0.740) or two-week (P = 0.507) course of treatment. Conclusion: The prevalence of pediculosis capitis in a boarding school in Bogor District was 88.4%. Wet combing treatment was as effective as permethrin for treating pediculosis capitis

Parasitic Diseases in a Boarding School Children in Bogor Regency

InductionThis study was aimed to determine the prevalence of parasitic diseases in boarding school children followed by eradication. Parasites consist of ecto and endo parasites. This study was conducted in Daarul Mustaqiem Boarding School, Pamijahan Village, Bogor Recency on May 2018 with the subject of all students. Diagnosis of intestinal parasite was done by microscopic stool examination with lugol staining while diagnosis of pediculosis and scabies by dermatological examination. The number of students attending the parasitic examination from PAUD to Aliyah was 501 students. Based on stool examination, the prevalence of intestinal parasitic infections was 57%. The most parasitic infections are B. hominis (128 students), followed by G. lamblia (13 students) and O. vermicularis (6 students). Students with positive worms were treated with albendazole 400 mg three days in a row and positive protozoa was treated with metronidazole. As many as 107 of the 121 (88.4%) students found live head lice. Students who are positive for pediculosis are treated with permethrin 1%. On examination of 159 male students, the prevalence of scabies was (7.5%). Students positive for scabies were treated with permethrin cream 5%. It was concluded that the prevalence of intestinal parasitic infections in santri was 59.4% with the highest infection in B. hominis; other intestinal parasites was relatively low. The prevalence of pediculosis capitis in female student was very high (88.4%) and the prevalence of scabies is low. All children treated according to the diagnosis and followed by health education on parasitic diseases and healthy hygiene behavior

20 Years of Progress in Typhoid Research

In 1981, the reported number of cases of typhoid fever in Indonesia was 19,596, increasing to 26,606 m 1986, most of the increase was due to improved detection and recognition of the pathogen. A more realistic estimate of incidence for this underreported and underdiagnosed disease would be from 540,000 to 1,210,000 cases per year. This was based on results of a household survey done by Budiarso R. et al. in 1980 and 1986, and on result of a community surveillance done by Ruwido and Simanjuntak et al. from 1983-1988. These studies were done in Plaju, South Sumatera, representing an urban area and Paseh, West Java, representing a semi-rural area. The results showed that the incidence rate of typhoid fever in the semi rural area was 358/100,000 population/year, and between 760-810/100,000 population/year in the urban area. These studies also indicated that the high risk group in the population was school age children between ages of 3-19 years. From other observations, it is also noted that the case fatality in urbanized and growing areas of Indonesia, may be higher than it is reported in other areas of the worl