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All Journal Jurnal Sain Veteriner BALI MEDICAL JOURNAL (BMJ) Archive of Community Health Buletin Veteriner Udayana Itepa : Jurnal Ilmu dan Teknologi Pangan INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Indonesia Medicus Veterinus Bali Journal of Anesthesiology Journal Of Vocational Health Studies Oceana Biomedicina Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Interdental Jurnal Kedokteran Gigi (IJKG) Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) OISAA Journal of Indonesia Emas Bali Dental Journal Oceana Biomedicina Journal Indonesian Journal of Cancer INDONESIAN JOURNAL OF URBAN AND ENVIRONMENTAL TECHNOLOGY Journal of Global Pharma Technology Neurona Indonesian Journal of Pharmacology and Therapy

I Dewa Made Sukrama

Laboratorium Mikrobiologi, Fakultas Kedokteran, Universitas Udayana, Bali

Author-ID : 2542310

Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Civil Engineering, Building, Construction & Architecture Dentistry Education Energy Engineering Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Ekstrak Buah Asam Jawa (Tamarindus indica) dibandingkan Ekstrak Buah Belimbing Wuluh (Averrhoa bilimbi) dalam menghambat pertumbuhan Streptococcus sanguinis I Gusti Agung Ayu Anjani Kartika Dewi; I Dewa Made Sukrama; I Gusti Ayu Fienna Novianthi Sidiartha
Bali Dental Journal Vol. 4 No. 1 (2020): January 2020
Publisher : School of Dentistry Faculty of Medicine Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/bdj.v4i1.266

Background: Controling dental plaque formation can be focused on its causes, one of them by inhibiting the growth of Streptococcus sanguinis bacteria that initiate the formation of the plaque. Bacterial growth can be inhibited using herbs that contain antibacterial substance, such as tamarind (Tamarindus indica) and wuluh starfruit (Averrhoa bilimbi). Objective: The aim of this study was to compare the antibacterial activity of tamarind and wuluh starfruit extract to inhibit the growth of Streptococcus sanguinis bacteria in vitro. Methods: This study used experimental Post Test Only Control Group Design on Streptococcus sanguinis bacteria. Treatment group was given tamarind extract and wuluh starfruit extract, each concentrations were 10%, 30% and 50%. Control group was given vancomycin for positif control and ethanol 96% for negatif control. The antibacterial test method was disc diffusion. Results: Phytochemical test result of tamarind extract showed the presence of saponin, phenol, terpenoid, alkaloid, flavonoid, and tannin, while wuluh starfruit extract showed the same result except the presence of alkaloid. Antibacterial activity test result of tamarind extract showed weak inhibition zone in 10% concentration (10 mm), intermediate inhibition zone in 30% concentration (16,2 mm), and strong inhibition zone in 50% concentration (22,6 mm), while wuluh strafuit extract did not showed any inhibition zone in 10% concentration (0 mm), intermediate inhibition zone in 30% concentration (15,8 mm) and 50% concentration (19,8 mm). Conclusion: It can be conluded that antibacterial activity of tamarind extract is higher than wuluh starfruit extract to inhibit the growth of Streptococcus sanguinis. Latar belakang: Pengendalian pembentukan plak gigi dapat difokuskan pada bakteri penyebabnya, salah satunya dengan menghambat pertumbuhan bakteri Streptococcus sanguinis yang menginisiasi pembentukan plak tersebut. Pertumbuhan bakteri dapat dihambat dengan memanfaatkan bahan-bahan alam yang mengandung daya antibakteri, seperti buah asam jawa (Tamarindus indica) dan belimbing wuluh (Averrhoa bilimbi). Tujuan: Membandingkan daya antibakteri antara ekstrak buah asam jawa dan belimbing wuluh dalam menghambat pertumbuhan bakteri Streptococcus sanguinis. Metode: Telah dilakukan penelitian eksperimental dengan Post Test Only Control Group Design pada bakteri Streptococcus sanguinis. Kelompok perlakuan diberikan ekstrak buah asam jawa dan belimbing wuluh dengan masing-masing konsentrasi uji 10%, 30%, dan 50%. Kelompok kontrol diberikan vancomycin sebagai kontrol positif dan etanol 96% sebagai kontrol negatif. Metode uji antibakteri yang digunakan adalah metode difusi cakram. Hasil: Hasil uji fitokimia pada ekstrak buah asam jawa menunjukkan adanya senyawa saponin, fenol, terpenoid, alkaloid, flavonoid dan tanin, sedangkan ekstrak buah belimbing wuluh menunjukkan hasil yang sama kecuali pada senyawa alkaloid. Hasil uji daya antibakteri pada ekstrak buah asam jawa menunjukkan respon hambat lemah pada konsentrasi 10% (10 mm), respon hambat sedang pada konsentrasi 30% (16,2 mm), dan respon hambat kuat pada konsentrasi 50% (22,6 mm), sedangkan ekstrak buah belimbing wuluh tidak menunjukkan respon hambat pada konsentrasi 10% (0 mm), respon hambat sedang pada konsentrasi 30% (15,8 mm) dan konsentrasi 50% (19,8 mm). Kesimpulan: Daya antibakteri ekstrak buah asam jawa lebih tinggi dibandingkan ekstrak buah belimbing wuluh dalam menghambat pertumbuhan bakteri Streptococcus sanguinis.

Detection of genes encoding ompW and ctxA of Vibrio cholerae isolated from shrimp and shellfish at Kedonganan fish market, Bali-Indonesia Rian Ka Praja; I Dewa Made Sukrama; Ni Nengah Dwi Fatmawati
Denta Journal Kedokteran Gigi Vol 2 No 1 (2019): Oceana Biomedicina Journal Volume 2 Issue (No) 1 January - June 2019
Publisher : Universitas Hang Tuah

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

Contamination of pathogenic bacteria in food can lead to the emergence of foodborne disease. One of foodborne disease which often occurs in some developing countries such as Africa, Southeast Asia, and Latin America is cholera which is caused by Vibrio cholerae. The disease is transmitted through beveragesand food, especially contaminated seafood. V. cholerae has several virulence factors including the outer membrane protein W (ompW) and cholerae toxin (ctx).The ompWacts as a protective barrier and can also be used as a marker specific species of V. cholerae and cholerae toxin is an enterotoxin responsible for the incidence of diarrhea in a cholera outbreak produced by pathogenic V. cholerae. This study was an observational study to determine the level of contamination of V. cholerae by detecting the outer membrane protein W (ompW) and cholerae toxin subunit A (ctxA)gene of V. cholerae in shrimp and shellfish sold at Kedonganan fish market. Samples were taken using total sampling technique and obtained 24 samples consisting of 14 shrimp samples and 10 shellfish samples. Samples were examined using culture methods and biochemical tests, and then further tested using Duplex Polymerase Chain Reaction (dPCR) to detect ompW and ctxA gene. The dPCR assay results showed 8 out of 14 (57.1%) samples from shrimp and 1 out of 10 (10%) samples from the shellfish positive carried ompW gene, and found no positive samples carrying the ctxA gene in samples derived from shrimp and shellfish. Chi square test analysis results indicated contamination of V. cholerae in shrimp washigher than shellfish based on ompW gene (p<0.05). It can be concluded that the shrimp and shellfish at Kedonganan fish market are contaminated by V. cholerae. Further research is needed to detect the virulence factors besides ompW and ctxA ofV. cholerae in seafood.

Survival Analysis of Patients with Luminal and Non-Luminal Subtype Breast Cancer Receiving Vinorelbine Therapy at Sanglah General Hospital, Denpasar, Bali Dewa Putu Satria Juristiasa; Putu Anda Tusta Adiputra; Dewa Made Sukrama
Indonesian Journal of Cancer Vol 16, No 2 (2022): June
Publisher : National Cancer Center - Dharmais Cancer Hospital

Introduction: Breast cancer is the most common type and lethal cancer affecting women. Meanwhile, vinorelbine is one of the chemotherapy agents used for luminal and non-luminal breast cancer. Therefore, this study aims to determine the survival difference between patients with luminal and non-luminal subtype breast cancer treated with vinorelbine.Methods: This study was a retrospective cohort. Women with breast cancer treated with vinorelbine were classified based on estrogen receptor (ER), progesteron receptor (PR), human epidermal growth factor receptor-2 (HER-2) markers, and subtypes. The subjects were followed up to chemotherapy visits with vinorelbine recorded in the medical record. The survival analysis between subtypes was analyzed by the Kaplan-Meier curve.Results: : One hundred women were obtained with a mean age of 52.36 ± 10.45 years. Based on immunohistochemistry, 60% were ER-positive, 53% were PR positive, and 57% were HER-2- positive. Based on the subtype, 67% were luminal, while 33% were non-luminal. All subjects had a mean survival duration of 155.38 days (95% CI 128.05-182.71). The stratified survival analysis showed a significant difference in survival duration based on HER-2 marker and subtype. The subjects with HER-2 positive survived longer with a mean of 203.37 days (190.72–216.02) than those with HER-2 negative with a mean of 90.10 days (65.68-114.53) (p<0.001). In addition, the subjects with the luminal subtype survived longer with a mean of 174.84 (142.72-206.94) than those with non-luminal with a mean of 90.10 (65.68-114.53) (p = 0.04).Conclusion: There was a significant difference in survival duration between women with breast cancer treated with vinorelbine chemotherapy who were HER-2 positive, HER-2 negative, and luminal and non-luminal subtypes.

Detection of genes encoding ompW and ctxA of Vibrio cholerae isolated from shrimp and shellfish at Kedonganan fish market, Bali-Indonesia Rian Ka Praja; I Dewa Made Sukrama; Ni Nengah Dwi Fatmawati
Oceana Biomedicina Journal Vol 2 No 1 (2019): Oceana Biomedicina Journal Volume 2 Issue (No) 1 January - June 2019
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/obj.v2i1.23

Pemberian antibiotik cefotaxime dengan konsentrasi sublethal pada isolat Klebsiella pnuemoniae yang resisten terhadap ampicilin menginduksi Multi Drug Resisten (MDR) Gema Zakharian; Dewa Made Sukrama; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 9 No. 1 (2018): (Available online: 1 April 2018)
Publisher : DiscoverSys Inc.

Background: Antibiotic resistance causes frequent infections to be difficult to treat and may aggravate the condition of infected patients which are requiring longer and more expensive antibiotic therapy. Klebsiella sp. is the most potential germ that causes nosocomial infections in the hospital. Klebsiella sp. which resulted a positive ESBL being perceived to directly exacerbate public health problems and become the center of attention in some countries, including Europe and America. Methods: This study used 32 repetitions with Klebsiella pneumoniae isolate obtained from Clinical Microbiology Installation of Sanglah General Hospital. Isolate was divided into two groups, the first group was not given the treatment of cefotaxime with sublethal concentration and the second group was given the treatment of cefotaxime with sublethal concentration. Resutls: The results of the treatment were tested by Pearson Chi Square method with the result that cefotaxime treatment with sublethal concentration significantly caused resistance to Klebsiella pneumoniae isolate and was proved by p value of 0.014 (p <0.05). Conclusions: Antibiotic test results using Vitex found isolates Klebsiella pneumoniae are resistant to more than two antibiotics and isolates are also germs that have Extended Spectrum Beta-Lactamase (ESBL).

Isolasi bakteri Escherichia coli pada lawar merah babi di kota Denpasar Dennis Yulianto; I Dewa Made Sukrama; Made Agus Hendrayana
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Background: An alarming incidence rate of food-borne diseases in Indonesia become more worrible, especially the one which is caused by Escherichia coli. Based on Food and Drug Supervisory Agency or Badan Pengawas Obat dan Makanan (BPOM) in Indonesia, there are 18.144 people who got infected by food-borne illnesses in 2011. These facts are quite alarming for the people who live in Bali and they are more likely to consume lawar merah babi.Â Lawar merah babi is a traditional Balinese food made from the mix of vegetable, meat, and some other ingredients as well as it is usually mixed by hand which make it susceptible to be contaminated by bacteria such as Escherichia coli. Aim: The study aims to investigate the E. coli contamination within lawar merah in Denpasar. Method: This descriptive cross-sectional study was conducted using 12 samples of lawar merah babi which were sold in 12 different places all across the Denpasar City. These samples were taken to Microbiology Laboratorium at Medical Faculty, Udayana University. There are three variants of dilution for each sample which are 10-1, 10-2, and 10-3. Each sample was cultured using eosin methylene blue agar as the media. Some of the sample without clear representation in the media will go through further identification. The results of Escherichia coli colonization were counted by the total plating count method to produce them in CFU/g for each of the samples.Result: Some of the samples have been contaminated by Escherichia coli (67%) approximately 17x104 CFU/g contamination average level.Conclusion: The samples exceed the contamination limit which is permitted by the BPOM recommendation, where the maximum Escherichia coli contamination level should not exceed over than 3 CFU/g.

Deteksi gen Gtf-B Streptococcus mutans dalam plak dengan gigi karies pada siswa di SD N 29 Dangin Puri I Gusti Agung Dyah Ambarawati; I Dewa Made Sukrama; I Wayan Putu Sutirta Yasa
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Bacteria situated in the formation of dental plaque as a leading cause of caries is Streptococcus mutans. Streptococcus mutans use glycosyltransferase enzymes to convert saccharose saliva into an extracellular polysaccharide (PSE) through glycosylation process. One of the virulence factors of Streptococcus mutans is the gtf-B gene.Aim: This study aims to detect gtf-B gene in plaque with dental caries on students of SD Negeri 29 Dangin Puri.Method: The design of the study was descriptive observational research involved 51 carries children as a sample in SD Negeri 29, Dangin Puri. Bacterial culture was applied to detect colonies of Streptococcus. Additional gram staining and catalase test were also conducted to distinguish Streptococcus against Staphylococcus. After it revealed negative catalase test, PCR was continued optimally about 517 bp in size and 585 bp gtf B gene in size.Result and Conclusion: Streptococcus mutans are as many as 19 samples from 51 samples (37.25%). Three samples from 19 isolates of Streptococcus mutans were detected by gtf-B gen (16%). Bakteri yang berperan penting dalam pembentukan plak gigi sebagai penyebab karies adalah Streptococcus mutans. Streptococcus mutans memiliki enzim glikosiltransferase yang dapat mengubah sakarosa saliva menjadi polisakarida ekstraseluler (PSE) melalui proses glikosilasis. Salah satu faktor virulensi bakteri Streptococcus mutans sebagai penyebab karies gigi adalah gengtf-B Streptococcus mutans. Tujuan: Penelitian ini bertujuan untuk mendeteksi gen gtf-B Streptococcus mutans dalam plak dengan gigi karies pada anak di SD Negeri 29 Dangin Puri.Metode: Penelitian ini menggunakan 51 sampel anak di SD Negeri 29 Dangin Puri yang mengalami karies. Kultur bakteri digunakan untuk mendeteksi koloni Streptococcus Sp. kemudian dilakukan pengecatan gram, uji katalase untuk membedakan Streptococcus dengan Staphylococcus. Hasil uji katalase negatif dilakukan proses PCR Streptococcus Mutans dengan ukuran 517 bp dan gen gtf B Streptococcus mutans dengan ukuran 585 bp.Hasil dan Simpulan: ditemukan bakteri streptococcus mutans sebanyak 19 sampel dari 51 sampel (37,25%). Tiga sampel dari 19 isolat bakteri streptococcus mutans terdeteksi gen gtfB streptococcus mutans (16%).

Pengaruh pemberian kombinasi ekstrak etanol bunga Tahi Kotok (Tagetes erecta l.) dan daun Jamblang (Syzygium cumini l.) terhadap pertumbuhan bakteri Methicillin-resistant Staphylococcus aureus (MRSA) dan Multidrug-resistant Pseudomonas aeruginosa secara Kadek Tresna Yuwana; I Dewa Made Sukrama; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Introduction: The increasing number of resistance cases of Methicillin-resistant Staphylococcus aureus (MRSA) and Multidrug-resistant Pseudomonas aeruginosa (MRPA) to common antibiotics has called the need for new modalities to combat these resistance problems. The ingredients that are thought to influence the growth of MRSA and MRPA are Tahi Kotok flowers (T. erecta) and Jamblang leaves (S. cumini). This study aimed to evaluate the effect of the combined Tahi Kotok flowers and Jamblang leaves ethanol extract on the growth of MRSA and MRPA bacteria.Methods: The research was conducted as a true experimental design using a post test only control group design. The combination of ethanol extract in several concentrations (25%, 50%, 75%, 100%) were tested on MRSA ATCC 3351 bacteria and MRPA bacteria cultured on agar media. The data obtained are the results of laboratory observations with the disk diffusion methods which are then statistically analyzed parametrically using the SPSS application which is shown as mean ± SEM.Results: The inhibitory activity of T. erecta flower extract with MRSA and MRPA bacteria was found. The largest inhibition zone diameter was at 75% extract concentration, with inhibition zones of 17.25 ± 1.25 cm and 11.25 ± 0.50 cm, respectively. The largest inhibition zone of S. cumini leaf experiment with MRSA bacteria was at concentration of 75 percent, which resulted in a 9.50 ± 0.57 cm inhibition diameter. In MRPA bacteria, however, there was no inhibition zone. At a concentration of 75 percent, the combination of T. erecta flower extract and S. cumini leaf had the highest inhibitory activity against MRSA bacteria, but had no inhibitory activity against MRPA bacteria.Conclusion: The concentration of extract combination in 96% ethanol influences the diameter of the MRSA inhibition zone, whereas in MRPA no inhibition zones were generated from this in vitro experiments. Latar Belakang: Meningkatnya kasus resistensi bakteri Methicillin-resistant Staphylococcus aureus (MRSA) dan Multidrug-resistant Pseudomonas aeruginosa (MRPA) terhadap antibiotik menyebabkan perlunya modalitas baru sebagai potensi untuk mengatasi masalah resistensi tersebut. Salah satu bahan yang diduga berpengaruh terhadap pertumbuhan MRSA dan MRPA adalah bunga Tahi Kotok (T. erecta) dan daun Jamblang (S. cumini). Penelitian ini ditujukan untuk melihat adanya pengaruh kombinasi ekstrak etanol bunga Tahi Kotok dan daun Jamblang terhadap pertumbuhan bakteri MRSA dan MRPA.Metode: Penelitian ini menggunakan rancangan true experimental post test only control group design. Kombinasi ekstrak etanol dalam beberapa konsentrasi (25%, 50%, 75%, 100%) diujikan pada bakteri MRSA ATCC 3351 dan MRPA yang dikultur pada media agar. Data yang diperoleh merupakan hasil pengamatan laboratorium dengan metode disk diffusion yang selanjutnya dianalisis secara statistik dengan statistik parametrik menggunakan aplikasi SPSS untuk menghitung nilai mean ± SEM. Hasil: Pada percobaan ekstrak bunga T. erecta dengan bakteri MRSA dan MRPA menunjukkan adanya daya hambat dengan daya hambat tertinggi terdapat pada konsentrasi 75%, zona hambat 17,25 ± 1,25 cm dan 11,25 ± 0,50 cm berturut-turut. Pada percobaan daun S. cumini dengan bakteri MRSA didapatkan zona hambat tertinggi pada konsentrasi 75% sebesar 9,50 ± 0,57 cm. Akan tetapi, tidak terdapat zona hambat pada bakteri MRPA. Kombinasi ekstrak bunga T. erecta dan daun S. cumini memiliki daya hambat terhadap bakteri MRSA yang tertinggi pada konsentrasi 75%, akan tetapi tidak memiliki daya hambat pada bakteri MRPA.Simpulan: Konsentrasi ekstrak kombinasi dalam etanol 96% berpengaruh terhadap diameter zona hambat MRSA tetapi tidak ditemukan zona hambat yang dihasilkan pada MRPA dari percobaan in vitro.

Detection of biofilm formation in clinical isolates of Streptococcus pneumoniae in Sanglah General Hospital, Bali, Indonesia I Made Sathya Vijayananda; Made Agus Hendrayana; I Dewa Made Sukrama; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Streptococcus pneumoniae causes broad-spectrum infections from mild to severe with high morbidity and mortality rates in almost all of the world, namely pneumonia and meningitis. This bacterium has virulence factors that help their survival, one of which is biofilms. Biofilms help Streptococcus pneumoniae become resistant to antibiotics; thus, treating infections caused by these bacteria is difficult to treat. This study aims to determine the biofilm production ability of Streptococcus pneumoniae isolated from the Clinical Microbiology Laboratory of Sanglah General Hospital, Denpasar, Bali, Indonesia using the tissue culture plate method.Methods: The research design used was a descriptive observational study with cross sectional type. The clinical isolate of Streptococcus pneumoniae was isolated from the Clinical Microbiology Laboratory of Sanglah General Hospital. Biofilm formation was measured by the tissue culture plate method and carried out at the Microbiology Laboratory of the Faculty of Medicine, Udayana University. Data were analyzed using SPSS version 20 for Windows.Results: Most of the specimens were collected from blood (59.37%), followed by sputum (31.25%), and others (9.38%). It was found that 1 of 32 (3.10%) clinical isolates could form a biofilm with a strong formation category (the optical density value> 0.38). In contrast, the rest did not form biofilms with an optical density value of ?0.095.Conclusions: Not all clinical isolates of Streptococcus pneumoniae isolated from the Clinical Microbiology Laboratory of Sanglah General Hospital Denpasar were able to form biofilms, suggesting that other virulence factors also play a role in pneumococcal infection. However, a molecular approach is necessary for the detection of genes encoding biofilm-producing isolates in future studies.

Antibiogram and biofilm formation among extended-spectrum ?-lactamase-producing Klebsiella pneumoniae clinical isolates in Sanglah General Hospital, Bali, Indonesia Ichlazul Ma’ruf; Made Agus Hendrayana; I Dewa Made Sukrama; Ni Nengah Dwi fatmawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Klebsiella pneumoniae is a common cause of healthcare-associated infections (HAIs), and has a high level of resistance to antibiotics first, second, extended-spectrum cephalosporins, and monobactam which are a serious threat to public health worldwide. Besides, it is known that this bacterium can form biofilms as virulence factors that contribute to drug resistance. This study aims to determine the antibiotics susceptibility patterns and the capacity of K. pneumoniae to form biofilms.Methods: K. pneumoniae was isolated from clinical specimens (urine, sputum, pus, blood, and others) for the period 2018-2019. Bacterial identification and antibiotic susceptibility testing were performed using the Vitek Compact 2 (bioMérieux®) test in the Clinical Microbiology Laboratory of Sanglah General Hospital. Biofilm formation was checked using the tissue culture plate method (TCP). Data were analyzed using SPSS version 20 for Windows.Results: Most of Extended Spectrum ?-Lactamase (ESBL)-producing K. pneumoniae showed resistance to antibiotics. The susceptible profiles were only towards ertapenem (97.50%), meropenem (97.50%), amikacin (95.00%), and tigecycline (87.50%). The TCP method detected 72 (90.00%) as biofilm producers among 80 clinical isolates, while 8 (10.0%) as non-biofilm producers. Among the biofilm-producer bacteria, there were 6 (7.50%) as strong, 37 (46.25%) moderate, and 29 (36.25%) weak biofilm-producer isolates.Conclusions: Most ESBL-producing K.pneumoniae clinical isolates in Sanglah General Hospital demonstrate multiple resistance to antibiotics and as biofilm producers. However, further research is needed to be conducted using a molecular approach to see the ESBL- and biofilm-encoded genes.

Co-Authors AA. Raka Karsana Adinda Putra Pradhana Amin, Yusuf Sidang Anak Agung Ngurah Jaya Kusuma Anggita Ratri Pusporini Astawa N. M., Astawa N. Astawa P., Astawa Bagus Komang Satriyasa Cokorda Agung Wahyu Purnamasidhi Darren Junior Dennis Yulianto Desak Gde Diah Dharma Santhi Dewa Ayu Fony Prema Shanti Dewa Ayu Putu Rasmika Dewi Dewa Gede Agung Widyadnyana Dewa Ngurah Suprapta Dewa Putu Satria Juristiasa Dewi Anggraini Dik Megaputri Handayani Ekaputra Ekaputra, Ekaputra Ema Surya Pertiwi Gema Zakharian Hendrawan, Gresya Hervina Hervina I D.P. Kartika Pratiwi I Dewa Ayu Agung Warmadewanthi I Dewa Gde Mayun Permana I Gede Purna Weisnawa I Gusti Agung Ayu Anjani Kartika Dewi I Gusti Agung Dyah Ambarawati I Gusti Ayu Fienna Novianthi Sidiartha I Gusti Ayu Mas Putri Dharmayanti I Gusti Ngurah Kade Mahardika I Ketut Agus Somia I Ketut Suwiyoga I Komang Hotra Adiputra I M. Sumarya, I M. I Made Bakta I Made Gustama Heryawan I Made Jawi I Made Reza Pramudya I Made Sathya Vijayananda I Nengah Sujaya I NYOMAN MANTIK ASTAWA I Wayan Adi Pranata I Wayan Arya Biantara I Wayan Muda Suta Arta I Wayan Putu Sutirta Yasa I Wayan Suardana I Wayan Suranadi I. K. Sukardika I.K. Suata Ichlazul Ma’ruf Ida Bagus Nyoman Putra Dwija Ida Bagus Putra Manuaba Ida Sri Iswari Jerry K. Sukardika Kadek Diana Harmayani Kadek Tresna Yuwana Ketut Suryana Ketut Tuti Parwati Merati KOMANG AYU NOCIANITRI Komang Ayu Witarini Komang Januartha Putra Pinatih Luh Wayan Ayu Rahaswanti Made Agus Dwianthara Sueta Made Agus Hendrayana Mantik AN Mia Ayustina Prasetya N. Adiputra Ni Kadek Fiora Rena Pertiwi Ni Kadek Lyming Lestari Ni Luh Putu Harta Wedari Ni Made Adi Tarini Ni Made Ayu Aryati Dinarini Ni Made Susilawathi Ni Nengah Dwi Fatmawati Ni Nengah Dwi Fatmawati Ni Nyoman Puspawati Ni Nyoman Sri Budayanti Ni Wayan Arni Sardi NYOMAN SEMADI ANTARA Pramitasuri, Tjokorda Istri Putra, I Dw. Gd. Bayu Artha Pratama Putu Anda Tusta Adiputra Putu Aprilyana Eka Astuti Putu Bagus Redika Janasuta Putu Kintan Wulandari Putu Wiswananta Parama Raka-Sudewi A. A. Reny Rosalina Rian Ka Praja Rudi Wisaksana Saranova, Hilda Saraswati P. Yogita Satoto D., Satoto Sherly Yunita Sieny Veronica Sonia Elvira Salim Sri Maliawan Steffano Aditya Handoko SUMARNO Suryadi N. T., Suryadi N. Susilawathi, Ni Made Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa W. A., W. Wahyu Hidayati Wayan Redi Aryanta Wibisana, I Dewa Nyoman Adi Ningrat Winatha, I Gde Pangestu Putrama Wira Guna, I Gede Bhima Wiryana M., Wiryana Yan Ramona

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