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All Journal Indonesian Journal of Tropical and Infectious Disease Journal of Clinical Microbiology and Infectious Diseases Folia Medica Indonesiana
Adhiputra, I Ketut Agus Indra
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Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Antimicrobial Resistance Profile of MDR & Non-MDR Meropenem-Resistant Pseudomonas aeruginosa Isolates of Patients in Intensive Care Unit of Tertiary Hospital Lameng, Imaculata Sonia Vidaryo; Budayanti, Ni Nyoman Sri; Prilandari, Luh Inta; Adhiputra, I Ketut Agus Indra
Indonesian Journal of Tropical and Infectious Disease Vol. 9 No. 3 (2021)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v9i3.30000

Abstract

Pseudomonas aeruginosa is one of the gram-negative bacteria that causes infection in the Intensive Care Unit (ICU) which is easily resistant. Patients infected with carbapenem-resistant P. aeruginosa are predicted to have a poor prognosis. This study aims to know the resistance profile of meropenem-resistant P. aeruginosa in the ICU. The results of this study can be used as a measure on the success of antimicrobial resistance control, infection control programs and become a reference for empirical therapy in the ICU. This study used a cross-sectional retrospective descriptive research method and was carried out at the Clinical Microbiology Laboratory of Sanglah Hospital Denpasar for three years, from 2018 to 2020. The results showed 38 of the 93 isolates of P. aeruginosa in the ICU were resistant to meropenem and were derived from sputum and urine. The percentage of meropenem-resistant P. aeruginosa isolates was higher in the multi-drug-resistant group and mostly came from sputum specimens. In 2018, Non-MDR meropenem-resistant P. aeruginosa isolates was that 100% sensitive to all other antibiotics used to treat P. aeruginosa infections, including; ceftazidime, cefepime, ciprofloxacin, gentamicin, amikacin, and piperacillin-tazobactam. In 2019 no meropenem-resistant P. aeruginosa isolates were found. In 2020, its sensitivity to antibiotics ceftazidime and piperacillin-tazobactam was 20.0%, ciprofloxacin 60.0% and to antibiotics gentamicin and amikacin 100%. MDR meropenem-resistant P. aeruginosa isolates in 2018 were still sensitive to ceftazidime (15.4%) and amikacin (69.2%) antibiotics, while in 2019 they were only sensitive to amikacin (37.5%). In 2020, P. aeruginosa isolates were sensitive to the antibiotics ceftazidime and cefepime (11.1%), piperacillin-tazobactam (22.2%), and amikacin (88.9%). Amikacin may be the choice of treatment for MDR meropenem-resistant P. aeruginosa.
Fluoroquinolone should be reconsidered as empirical therapy for adult inpatient urinary tract infections in tertiary hospital: a perspective descriptive study from the microbiological and cost-effectiveness aspects Adhiputra, I Ketut Agus Indra; Setiabudy, Marta
Journal of Clinical Microbiology and Infectious Diseases Vol. 3 No. 1 (2023): Available online : June 2023
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v3i1.47

Abstract

Background: Urinary Tract Infections (UTI) has become difficult to treat because of its increasing resistance characteristics to antimicrobial agents, especially to fluoroquinolone. The objective of this study was to describe the effectiveness of fluoroquinolone as empirical therapy for adult inpatient UTI. Methods: This descriptive cross-sectional study was performed at Prof. Dr. I.G.N.G. Ngoerah Hospital, a tertiary Hospital in Denpasar, Bali, from January 2020 until March 2020. All urine specimens were examined using bioMérieux VITEK® 2 System. Result: A total of 155 urine samples met the inclusion and exclusion criteria. We found Escherichia coli (39.4%) as the most common microbes followed by Klebsiella pneumoniae (12.3%). Most of the isolates are multi drug resistant organisms (MDRO) (52.9%) and 57% (49) of the Enterobacteriaceae isolates are extended spectrum beta lactamases (ESBLs). The average duration of the empirical antibiotic therapy was 3.7 days for all fluoroquinolone. Ciprofloxacin (53.5%) is the most common empirical therapy, followed by levofloxacin (16.8%). Antimicrobial sensitivity tests showed that bacteria remained highly sensitive to amikacin (96%) and meropenem (94%). The sensitivity test for ciprofloxacin and levofloxacin was only 26% and 4% respectively. The suitability antibiotic results of fluoroquinolone as empirical therapy were only 20% from 110 isolates. The cost ineffectiveness of fluoroquinolone as empirical therapy is Rp.8,402,400 for 3 months. Conclusion: We concluded that both fluoroquinolone (ciprofloxacin and levofloxacin) have a very low sensitivity rate and are not cost-effective, therefore the use of those antimicrobial agents as empirical therapy should be reconsidered.
Detection of antibacterial activity in chicken meat, eggs, drinking water, animal feed and sewage waste in Tabanan, Bali Setiabudy, Marta; Indraningrat, Anak Agung Gede; Suryanditha, Putu Arya; Budayanti, Ni Nyoman Sri; Yanti, Ni Komang Semara; Adhiputra, I Ketut Agus Indra; Widowati, I Gusti Ayu Rai; Agustina, Kadek Karang
Journal of Clinical Microbiology and Infectious Diseases Vol. 3 No. 1 (2023): Available online : June 2023
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v3i1.51

Abstract

Background: The use of antibiotics that are not in accordance with the indications, doses, and duration can trigger resistance and there is concern that it might leave antibiotic residues in the processed product. Aim of this study was to detect the antibacterial activity of livestock products, namely chicken meat and eggs and the surrounding environment such as drinking water, animal feed and waste disposal. This study was a preliminary study before the establishment of antibiotic wise village, One Health approach for antimicrobial stewardship program. Methods: This study was a descriptive study with a cross sectional design to determine antibacterial activity, particularly tetracycline in livestock products and the environment. The research samples were taken from 5 groups of farmers in one of the villages in Tabanan, Bali. Bioassay method based on the Kirby Bauer method was used in this study. Results: From a total of 44 samples, 6 samples showed weak antibiotic tetracycline activity (13.6%), namely in waste disposal (20%) and animal feed (40%). Antibiotic contamination was likely to occur because the animal feed used in this group contains antibiotics with or without the knowledge of the farmers themselves. Disposal waste came from livestock manure that ate the feed or from animal feed that was scattered around the cage. Conclusion: Samples of livestock meat and eggs did not show antibacterial activity. There were samples that have antibiotic activity but weak and inconsistent, namely in samples of waste disposal and animal feed. This condition cannot necessarily be concluded as antibiotic abuse in livestock however it can be the basis for the importance of providing education regarding antimicrobial resistance. Unless there was indication, antibiotics should not be given to livestock on a daily basis.
Biofilm Formation in Staphylococcus aureus and Coagulase-Negative Staphylococcus Setiabudy, Marta; Masyeni, Dewa Ayu Putri Sri; Indraningrat, Anak Agung Gede; Suryawan, Kadek; Adhiputra, I Ketut Agus Indra; Rahman, Muhammad Amirul bin Abdul
Folia Medica Indonesiana Vol. 59, No. 3
Publisher : Folia Medica Indonesiana

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Highlights: 1. The significance of Staphylococcus aureus and coagulase-negative Staphylococcus, which are more likely to infect immunocompromised patients, needed to be researched in greater depth. 2. Coagulase-negative Staphylococcus was found to form significantly more biofilm than Staphylococcus aureus. 3. Wound care and changing medical devices in immunocompromised patients on a regular basis may provide benefits to prevent biofilm formation by Staphylococcus spp. Abstract Staphylococcus spp. are typically commensal microorganisms that can exist in the human body without causing illness. However, these bacteria have virulence factors, e.g., biofilm formation, that are important to note. Because biofilms shield bacteria from opsonophagocytosis and antimicrobial agents, they can cause persistent or chronic infections. Once they form biofilms, both Staphylococcus aureus and coagulase-negative Staphylococcus (CoNS) can potentially cause incurable infections. This study aimed to compare biofilm formation in Staphylococcus aureus and coagulase-negative Staphylococcus as a guide for the prevention and management of infection, which will maintain and improve the good health of the general population. This was an analytic research with a cross-sectional design. The study began by collecting the samples, identifying the species, and testing the biofilm production with a microtiter plate, which was then analyzed with an enzyme-linked immunosorbent assay (ELISA). Data analysis was conducted using IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, N.Y., USA). Comparison tests were conducted using an independent t-test. A value of p<0.05 was used as the cut-off that indicated significance. The total samples were 36 clinical isolates, consisting of 18 Staphylococcus aureus and 18 coagulase-negative Staphylococcus. The specimens consisted of 20 blood samples (55.6%) and 7 wound swabs (19.4%). The biofilm test on the samples showed that 83.3% of the samples produced biofilms. The data revealed that the isolates formed biofilms, with 14 isolates (38.9%) in the strong category, 10 isolates (27.8%) in the moderate category, and each of 6 isolates (16.7%) in the weak and non-existent categories. Both Staphylococcus spp. appeared to have biofilm-forming activity, but coagulase-negative Staphylococcus appeared to be significantly more dominant (p=0.008). Strong biofilm was produced by 61.1% of coagulase-negative Staphylococcus isolates. In conclusion, coagulase-negative Staphylococcus formed a stronger biofilm than Staphylococcus aureus. Its presence as an infection-causing bacteria, particularly in immunocompromised patients, should not be underestimated.
Co-Authors Indraningrat, Anak Agung Gede Kadek Karang Agustina Lameng, Imaculata Sonia Vidaryo Ni Nyoman Sri Budayanti Prilandari, Luh Inta Putu Arya Suryanditha Rahman, Muhammad Amirul bin Abdul Setiabudy, Marta Sri Masyeni, Dewa Ayu Putri Suryawan, Kadek Widowati, I Gusti Ayu Rai - Yanti, Ni Komang Semara