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Polysaccharide Capsule Serotype and Antibiotic Susceptibility Pattern of Streptococcus pneumoniae Clinical Isolates in Bali Tarini, Ni Made Adi; I Putu Bayu Mayura; Ika Nurvidha Mahayanthi Mantra
Indonesian Journal of Tropical and Infectious Disease Vol. 11 No. 3 (2023)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v11i3.45516

Abstract

Streptococcus pneumoniae (S. pneumoniae) is a causative agent of pneumonia that can spread progressively, cause invasive disease, and increase mortality in humans. Pneumococcal or polysaccharide conjugate vaccination reduces pneumonia rates by vaccine-covered serotypes, but increases infection by non-vaccine serotypes. To determine the polysaccharide capsule serotype of S. pneumoniae isolates that cause infection at Prof. Dr. I.G.N.G. Ngoerah General Hospital and patterns of S. pneumoniae susceptibility to antibiotics from April 2017 to March 2022. All S. pneumoniae isolates from April 2017 and April 2022 were stored in STGG media in a freezer at -80 ℃ then subcultured on sheep blood agar. Polymerase Chain Reaction (PCR) was performed to determine pneumolysin and capsular polysaccharide serotypes of S. pneumoniae. Of the 22 isolates studied, the order of the number of serotypes from the highest was serotype 19F, 3, 6A/B, 33F, 15B/C, 4, and 6V. Seven isolates were untypeable. Antibiotic sensitivity pattern S. pneumoniae was found to be sensitive to linezolid 91%, vancomycin 86%, levofloxacin and benzylpenicillin 82%, ceftriaxone and clindamycin 73%, erythromycin 55%, and chloramphenicol 45%. Serotype 19F was identified as the most dominant capsular serotype; however, serotypes 33F and 15B/C were also found. Interestingly, the 33F serotype is not covered in the 13-valent pneumococcal conjugate vaccine (PCV13) but is covered in pneumococcal polysaccharide vaccine 23 (PPSV23), and the 15B/C serotype is not included in either PCV13 or PPSV23. The antimicrobial susceptibility patterns revealed that S. pneumoniae was susceptible to linezolid, vancomycin, benzylpenicillin, and levofloxacin.
Trends in antimicrobial resistance of extended-spectrum beta-lactamase-producing Escherichia coli in urinary tract infections in ICU and non-ICU settings at Ngoerah Hospital, 2020-2022 Bryan Setiawan; Ni Nyoman Sri Budayanti; Fatmawati, Ni Nengah Dwi; I Putu Bayu Mayura
Journal of Clinical Microbiology and Infectious Diseases Vol. 5 No. 1 (2025): Available online : 1 June 2025
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.v5i1.83

Abstract

Background: Urinary Tract Infection (UTI) is one of the most common nosocomial infections, with Escherichia coli (E. coli) as the primary pathogen. The misuse and overuse of antibiotics has led to the emergence of antibiotic resistance, particularly in Extended-Spectrum Beta-Lactamase (ESBL)-producing E. coli. This resistance presents a significant challenge in managing UTIs, especially among ICU and non-ICU ward patients. This study aims to analyze trends in antibiotic resistance of ESBL-producing E. coli in UTI patients in ICU and non-ICU settings at Ngoerah Hospital during 2020–2022. Methods: A descriptive study with a cross-sectional approach was conducted. The inclusion criteria of this study were samples with identification results of E. coli bacteria with VITEK 2 Compact (bioMérieux, France), which showed E. coli with a probability greater than or equal to 90% and accompanied by sensitivity of E. coli bacteria to antibiotics. Result: Among 789 samples meeting inclusion criteria, 90% (714) were from non-ICU wards, while 10% (75) were from ICU wards. ESBL-producing E. coli accounted for 53% (416), while non-ESBL strains constituted 47% (373). The prevalence of ESBL-producing E. coli in non-ICU wards increased from 43% (96 isolates) in 2020 to 47% (129 isolates) in 2021 and 51% (149 isolates) in 2022. In ICU wards, prevalence rose from 3% (6 isolates) in 2020 to 4% (12 isolates) in 2021 and 8% (24 isolates) in 2022. Tigecycline, meropenem, and ertapenem demonstrated high sensitivity (≥96%), while beta-lactam antibiotics like ampicillin, cefixime, and cefazolin showed 100% resistance. Conclusion: The increasing resistance of ESBL-producing E. coli, particularly in non-ICU settings, highlights the need for strict antibiotic policies and monitoring to prevent further resistance.
Prevalence and antibiotic sensitivity patterns of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in pneumonia patients at Ngoerah Hospital from 2020 to 2022 Arikandini, Dewa Ayu Putu Aisaka Rajeshi; Ni Nyoman Sri Budayanti; Ni Nengah Dwi Fatmawati; I Putu Bayu Mayura
Journal of Clinical Microbiology and Infectious Diseases Vol. 5 No. 1 (2025): Available online : 1 June 2025
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.v5i1.86

Abstract

Background: Pneumonia remains a major global cause of mortality, with Klebsiella pneumoniae recognized as a significant pathogen. The emergence of antibiotic resistance, particularly due to Extended-Spectrum Beta-Lactamase (ESBL) production by K. pneumoniae, complicates treatment efforts. This study aimed to determine the prevalence of ESBL-producing K. pneumoniae in pneumonia patients and assess its antibiotic sensitivity profile. Methods: A descriptive cross-sectional study was conducted retrospectively using secondary data from VITEK 2 Compact (bioMérieux) laboratory results on sputum samples collected from pneumonia patients at Ngoerah Hospital from 2020 to 2022. A total of 515 samples met the inclusion criteria out of 1,350 tested. Results: ESBL-producing K. pneumoniae was identified in 305 isolates (59.2%), with yearly prevalence rates of 63% in 2020, 52% in 2021, and 61% in 2022. Most patients were male (66.6%), aged 60 years or older (40%), and treated in non-ICU settings (69.2%), with expectorated sputum as the most common specimen type (63%). Antibiotic sensitivity testing revealed high susceptibility of ESBL-producing isolates to ertapenem (100%), meropenem (100%), amikacin (93%), and tigecycline (81%). Conclusion: ESBL-producing K. pneumoniae accounted for over half of pneumonia cases, with fluctuating prevalence across the study period. The infection predominantly affected older male patients treated in non-ICU wards. Despite resistance to many beta-lactam antibiotics, high sensitivity to carbapenems and other specific agents highlights their continued relevance in treatment. Surveillance of antibiotic resistance patterns remains essential for effective clinical management.
Unveiling the Toxin Genes of Vibrio cholerae in Seafood: A Collaboration of Phenotypic and Genotypic Approaches Ni Luh Budi Artaningsih; I Putu Bayu Mayura; Ni Nyoman Sri Budayanti
International Journal of Health and Pharmaceutical (IJHP) Vol. 6 No. 2 (2026): May 2026
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v6i2.627

Abstract

Vibrio cholerae is a pathogenic bacterium that causes cholera, a severe diarrheal disease transmitted through contaminated food or water, particularly seafood such as fish, shrimp, and shellfish. This review aims to provide a comprehensive overview of studies that have identified and characterized toxin genes of V. cholerae in seafood using phenotypic and genotypic approaches. The literature review was conducted using online databases including PubMed, ScienceDirect, Scopus, Web of Science, and Google Scholar with keywords “Vibrio cholerae”, “virulence gene”, “cholera toxin”, “phenotypic-genotypic detection”, “cholera infection”. Selected articles were published between 2015 and 2025 in English or Indonesian and discussed the identification of V. cholerae toxin genes from marine products. The findings revealed that V. cholerae isolates from seafood commonly harbor virulence genes such as ctxA, hlyA, ompW, tcpA, zot, ace, and rtx, which play crucial roles in colonization, toxin production, and pathogenicity. Phenotypic detection using TCBS agar and hemolysis tests serves as an initial screening, whereas genotypic identification through PCR and sequencing offers higher sensitivity and specificity. Combining both methods enhances detection accuracy and risk assessment. Therefore, monitoring virulence genes of V. cholerae in seafood is essential for strengthening food safety surveillance and preventing cholera outbreaks in coastal and tourism areas
Article Review: Phenotypic and Genotypic Identification of Bacillus cereus in Soy Milk Ni Ketut Sastraningsih; I Putu Bayu Mayura; Ida Bagus Nyoman Putra Dwija
International Journal of Health and Pharmaceutical (IJHP) Vol. 6 No. 2 (2026): May 2026
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v6i2.633

Abstract

Bacillus cereus  is a Gram-positive, spore-forming bacterium frequently found as a contaminant in various food products, including soy milk, and is recognized as a causative agent of foodborne illnesses. Its pathogenicity mainly arises from the production of toxins such as non-hemolityc enterotoxin (nhe), hemolysin BL (hbl), and cytotoxin K (cytK), which contribute to gastrointestinal disorders. Conventional phenotypic identification methods, including culture, morphological observation, and biochemical assays, are simple but often lack specificity in distinguishing B. cereus from the B. cereus group. Therefore, genotypic approaches based on molecular techniques such as PCR and Whole Genome Sequencing (WGS) are required to achieve higher sensitivity and precision. The gyrB gene serves as a molecular marker for species confirmation, while the nhe gene complex acts as a virulence determinant in identifying toxigenic strains. The integration of phenotypic and genotypic methods provides a more comprehensive understanding of B. cereus contamination in soymilk, elucidating its genetic diversity and pathogenic potential, which are essential aspects of food safety assessment.
Biofilm: a Virulent Form of Bacteria Life In Which Leads an Emerging Battleground of Antibiotic Resistance I Putu Bayu Mayura; Putu Yuliandari
International Journal of Health and Pharmaceutical (IJHP) Vol. 6 No. 2 (2026): May 2026
Publisher : CV. Inara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51601/ijhp.v6i2.634

Abstract

Biofilms represent a highly virulent bacterial lifestyle that substantially contributes to the global escalation of antimicrobial resistance by protecting pathogens from conventional therapies. This study aimed to synthesize current evidence on biofilm structure, developmental stages, and mechanisms underlying antibiotic recalcitrance in clinically important bacteria, including Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. A systematic qualitative literature review was conducted using peer-reviewed articles published between 2016 and 2022 retrieved from Google Scholar, PubMed, and related scientific databases. Approximately 20 relevant studies were purposively selected based on predefined inclusion criteria, and thematic content analysis was applied to identify recurrent resistance mechanisms. The findings showed that biofilm resilience was driven by the synergistic interaction of extracellular matrix barriers, metabolic heterogeneity, persister cells, quorum sensing regulation, altered membrane permeability, stress responses, and multidrug efflux pumps. These mechanisms enabled bacteria to exhibit both genetic resistance and phenotypic tolerance, often increasing antimicrobial survival capacity up to several thousand-fold compared with planktonic cells. The review concluded that biofilm-associated infections cannot be effectively managed through single-antibiotic approaches alone. Integrated therapeutic strategies combining antibiotics with matrix-disrupting agents, quorum sensing inhibitors, and early detection technologies are required to reduce chronic infections and healthcare-associated transmission. These findings provide a conceptual basis for developing precision anti-biofilm interventions and future translational research.