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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.
Uncovering the Enolase Gene (eno) and Its Role in Biofilm Formation in Clinical Isolates of Staphylococcus aureus Setiabudy, Marta; Widhidewi, Ni Wayan; Wijaya, Putu Austin Widyasari; Santoso, Putu Nia Calista; Suryawan, Kadek
Muhammadiyah Medical Journal Vol 5, No 2 (2024): Muhammadiyah Medical Journal (MMJ)
Publisher : Faculty of Medicine and Health Universitas Muhammadiyah Jakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24853/mmj.5.2.97-106

Abstract

Background: Enolase is an enzyme potentially possessed by Staphylococcus aureus (S.aureus) bacteria, which holds essential virulence factors in human infections. The eno gene that encodes enolase is important in attachment to host cells, leading to biofilm formation, evasion of host immune response, and bacterial central metabolism. This biofilm formation might complicate the therapy. Purposes: This study aimed to assess the prevalence of the enolase gene, namely eno, in clinical isolates of S.aureus and its association with biofilm production. Methods: The research was conducted from December 1, 2023, to February 29, 2024, at the Faculty of Medicine and Health Science Research Laboratory, Warmadewa University. This study employed an analytical approach with a cross-sectional design. Result: The collected samples comprised 18 isolates of S.aureus, 66.6% of which produced biofilm. Most of the S.aureus clinical isolates 17 (94.4%) were detected to have the eno gene. Six samples (33.3%) formed weak biofilm followed by strong and moderate, with the same number of 3 isolates each (16.7%). No correlation between the enolase gene and biofilm production in this study suggested phenotypic heterogeneity, environment and time forming biofilm in vivo differences, and various other genes that influence biofilm formation. Conclusion: The high prevalence of the enolase gene in these clinical isolates indicates the potential for more severe infections in patients related to its adherence, which leads to biofilm and resistance problems and metabolic function.
PENDAMPINGAN KELUARGA BALITA UNTUK MENCEGAH STUNTING DI DESA BAYUNG GEDE, KECAMATAN KINTAMANI, BALI Widhidewi, Ni Wayan; Apsari, Putu Indah Budi; Setiabudy, Marta; Indraningra, Anak Agung Gede
Jurnal Pengabdian Masyarakat Medika Vol 4. No. 2, September 2024
Publisher : Universitas Muhamamdiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/jpmmedika.v4i2.5297

Abstract

ABSTRAK Stunting merupakan suatu kondisi balita yang mengalami hambatan dalam pertumbuhan akibat kekurangan gizi dalam jangka waktu lama, sehingga tinggi badan anak tidak sesuai dengan usianya. Masalah stunting masih menjadi salah satu fokus perhatian utama pemerintah Indonesia dalam bidang kesehatan. Meskipun telah terjadi penurunan angka kejadian stunting di Indonesia dari tahun ke tahun, upaya pencegahan stunting harus terus dilakukan. Mitra dari program kemitraan masyarakat (PKM) ini adalah 5 orang anggota keluarga dari anak balita yang ada di Banjar Bayung Gede, Desa Bayung Gede, Kecamatan Kintamani, Kabupaten Bangli. Permasalahan prioritas pada mitra adalah pengetahuan serta keterampilan terkait pemberian makanan sehat untuk anak balita masih kurang. Pengabdian ini bertujuan untuk meningkatkan pengetahuan keluarga balita terkait stunting dan pola makan sehat seimbang untuk mencegah stunting. Kegiatan pengabdian dilaksanakan di balai banjar Bayung Gede dengan metode penyuluhan menggunakan leaflet, pemberian bantuan berupa paket susu tinggi protein serta pelatihan pembuatan makan tambahan dari bahan pangan lokal yaitu jagung dan ubi jalar. Hasil pengabdian mengindikasikan terdapat peningkatan pengetahuan mitra sebesar 26% terkait pemberian makanan sehat bagi balita sesuai “isi piringku”. Peningkatan pengetahuan dan keterampilan keluarga balita serta bantuan yang diberikan diharapkan dapat mencegah terjadinya stunting pada balita di Desa Bayung Gede.   ABSTRACT Stunting is a condition in which a toddler experience growth impediments due to prolonged malnutrition, resulting in their height not matching their age. Stunting remains a major focus of the Indonesian government's health sector. Although the incidence of stunting in Indonesia has decreased year by year, various preventive measures still need to be continuously promoted. The partners of this community partnership program (PKM) are five family members of toddlers in Banjar Bayung Gede, Bayung Gede Village, Kintamani District, Bangli Regency. The primary issue among the partners is the lack of knowledge and skills regarding the provision of healthy food for toddlers. This service aims to increase the knowledge of toddler families about stunting and balanced healthy eating patterns to prevent stunting. The service activities were conducted at the Bayung Gede community hall using the method of counseling with leaflets, providing high-protein milk packages, and training on making additional food from local ingredients such as corn and sweet potatoes. The results of the service indicated a 26% increase in partners' knowledge regarding the provision of healthy food for toddlers according to "my plate". The improvement in the knowledge and skills of toddler families and the assistance provided are expected to prevent stunting among toddlers in Bayung Gede Village.
Pemberdayaan PKK Banjar Kertasari: Penyimpanan dan Penggunaan Obat di Rumah dan Rujukan BPJS Setiabudy, Marta; Santoso, Putu Nia Calista; Lisnawati, Ni Made Ary
Jurnal Peduli Masyarakat Vol 7 No 3 (2025): Jurnal Peduli Masyarakat: Mei 2025
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/jpm.v7i3.5821

Abstract

Penyimpanan obat yang tepat di rumah dan memperhatikan masa kedaluwarsa obat adalah aspek penting dalam menjaga efektivitas dan keamanan obat yang digunakan. Dalam kondisi sakit atau terluka, jika penggunaan pengobatan sederhana di rumah tidak membantu maka penting untuk mengetahui kapan harus mencari pertolongan medis. Memiliki jaminan Kesehatan seperti BPJS tentu sangat membantu. Rujukan berjenjang dalam sistem BPJS Kesehatan memiliki peran penting untuk memastikan akses layanan kesehatan yang lebih efisien dan berkualitas. Dengan menerapkan sistem rujukan berjenjang, masyarakat akan memahami adanya fasilitas layanan kesehatan tingkat pertama (FKTP) seperti puskesmas atau klinik yang berada dalam jangkauan, sebelum dirujuk ke rumah sakit atau spesialis. Tujuan dari kegiatan ini adalah peningkatkan pengetahuan ibu-ibu PKK mengenai penyimpanan obat di rumah dan rujukan berjenjang BPJS. Banjar Kertasari menjadi tempat dilaksanakannya penyuluhan karena kemajemukannya. Proses persiapan kegiatan pengabdian meliputi survey dan diskusi awal dengan mitra yang diwakili oleh kepala banjar Kertasari dan ketua PKK dan dilanjutkan dengan diskusi bersama tim penyuluhan untuk program yang diadakan. Mitra PKM merupakan anggota Pemberdayaan dan Kesejahteraan Masyarakat (PKK) banjar Kertasari, berjumlah 15 orang. Metode pelaksanaan dengan penyuluhan dengan penyampaian materi, diskusi, dan tanya jawab. Hasil yang didapatkan adalah peningkatan pengetahuan tentang cara penyimpanan obat dan rujukan berjenjang pelayanan kesehatan yang dibuktikan melalui kegiatan evaluasi. Evaluasi dilakukan dengan kuesioner yang disebarkan sebelum dan setelah penyuluhan. Kelompok PKK menyambut baik kegiatan ini dan antusias mengikuti pelatihan hingga selesai.
Phytochemicals and Antibacterial Activity of Impatiens balsamina L. Leaf Extracts Against Gram-Positive and Gram-Negative Bacteria Fridayanthi, Putu Utari; Wijaya, Made Dharmesti; Udiyani, Desak Putu Citra; Indraningrat, Anak Agung Gede; Setiabudy, Marta
Biology, Medicine, & Natural Product Chemistry Vol 14, No 1 (2025)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/biomedich.2025.141.327-335

Abstract

The emergence of antibiotic resistance as one of the global public health threats makes research on new antibacterial compounds urgently needed. Among natural resources, the Impatiens balsamina plant has the potential to be explored as the new source of antibacterial agents. This study aimed to identify the phytochemical composition and evaluate the antibacterial activity of I. balsamina leaf extracts against Gram-positive and Gram-negative bacteria. Extracts were prepared using the maceration method with methanol, chloroform, and n-hexane solvents at a 1:5 sample-to-solvent ratio. Phytochemical screening was performed qualitatively, and antibacterial activity was evaluated using the disc diffusion assay. Analysis of methanol extract detected the presence of flavonoids, saponins, tannins, phenols, steroids, and glycosides, while chloroform extract consisted of tannins, phenols, and steroids. On the other hand, steroids were the only compounds detected qualitatively in n-hexane extract. Antibacterial testing revealed that methanol extract exhibited the highest activity, with zones of inhibition (ZOI) of 15.10±0.18 mm, 9.40±0.30 mm, 14.75±1.28 mm, and 8.67±0.50 mm against Streptococcus mutans FNCC 0405, Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, and Klebsiella pneumoniae ATCC 700603, respectively. A concentration-dependent ZOI was observed in the methanol extract, with activity increasing at higher concentrations. GC-MS analysis of the methanol extract identified 32 compounds, including n-hexadecanoic acid (12.12%), 2-acetylbenzoic acid (8.26%), 5-hydroxymethylfurfural (8.21%), and 2-methoxy-4-vinylphenol (4.67%), which are known to possess antimicrobial, antioxidant, and anti-inflammatory activities. Chloroform extract showed moderate activity against S. mutans (7.04±0.15 mm) and S. aureus (7.10±0.31 mm), while n-hexane extract exhibited no antibacterial activity. The significant antibacterial activity of methanol extract is likely due to its rich phytochemical composition, highlighting methanol as an effective solvent for extracting bioactive compounds. These findings provide a strong foundation for further exploration of I. balsamina leaf extracts as a source of antibacterial agents.