Background: Acute otitis media (AOM) is the most common disease in young children requiring antibiotic treatment. Information on AOM-related determinant risk factors in primary school children is still limited, particularly in Indonesia. This study aims to identify risk factors related to AOM in primary school children in Banyumas Regency, Central Java, Indonesia.Design and Methods: This is an analytical study with a case-control design in Banyumas Regency, Indonesia. 3574 children from 6 regions of the Banyumas Regency were recruited for the screening of AOM detection, and confirmation of AOM diagnosis was determined by Otolaryngologist. One hundred and twenty-five cases and 125 control were involved in this study. Data collection was carried out using a structured questionnaire focusing on several variables such as household cooking fuel, house environment, smoking exposure, knowledge of parents, and nutrition status. Univariate, bivariate using chi-square and multivariate with regression logistic was conducted for data analysis. Results: This study highlights the risk of household firewood use (p=0.003), poor nutritional status (p=0.009), and a family history of ear infections (p=0.015) with an increased risk of otitis media.Conclusions: Household firewood use, poor nutritional status and family history of ear infection are factors associated with the occurrence of acute otitis media. It is necessary to provide public health education to prevent exposure to fuel at risk for children and to improve their nutritional status.

Haemophilus influenzae is a Gram-negative opportunistic bacterial pathogen of the human respiratory tract. This study describes the prevalence, serotype distribution, and susceptibility profiles of H. influenzae strains isolated from the nasopharynx of school children with acute otitis media (AOM) in Banyumas Regency, Central Java, Indonesia. H. influenzae was isolated from nasopharyngeal swab specimens using chocolate agar plates supplemented with IsoVitaleX and bacitracin. Serotyping was performed using quantitative polymerase chain reaction. Antimicrobial susceptibility profiles were determined using a microdilution broth assay. H. influenzae was present in 69.7% of samples (85/122). Nontypeable H. influenzae (NHTi) was the most common serotype (95.3%), followed by H. influenzae type b (3.5%) and H. influenzae type f (1.2%). All the H. influenzae isolates were susceptible to levofloxacin, ceftriaxone, imipenem, meropenem, cefuroxime, and cefixime. Most isolates were susceptible to sparfloxacin (99%), cefepime (99%), amoxicillin/clavulanic acid 2 : 1 (99%), ampicillin/sulbactam 2 : 1 (96%), chloramphenicol (94%), tetracycline (93%), ampicillin (87%), and clarithromycin (82%). Nineteen percent of the isolates were resistant to cotrimoxazole, and 11% of the isolates were resistant to ampicillin. This study showed that H. influenzae carriage among samples was dominated by NTHi and less susceptible to cotrimoxazole.

Streptococcus pneumoniae is a common bacterial pathogen that causes acute otitis media (AOM) in children. In this study, we investigated nasopharyngeal carriage rates and serotype distributions of S. pneumoniae among school children with AOM in Banyumas Regency, Central Java, Indonesia, from 2018 to 2019. Nasopharyngeal swab specimens and demographic data were collected from 122 children between the ages of 6 and 12. The specimens were cultured for the identification of S. pneumoniae , and serotyping was performed using a sequential multiplex PCR assay. We found that the S. pneumoniae carriage rate was 73 % (89/122) among children with AOM. Serotypes 23A (11 %) and 6A/6B (10 %) were the most common serotypes among the 91 cultured S. pneumoniae strains, followed by 3 (8 %), 14 (7 %), 6C/6D (7 %), 11A/11D (6 %), 15B/15C (4 %) and 35 B (4 %). Moreover, 41 % of the strains could be covered by the 13-valent pneumococcal conjugate vaccine, PCV13. In conclusion, high nasopharyngeal carriage rates of S. pneumoniae were found in school children with AOM, with almost half of the strains being the vaccine-type. This finding provides a baseline for nasopharyngeal carriage of S. pneumoniae in school children with AOM and supports the implementation of pneumococcal conjugate vaccines in Indonesia.

Background: Methicillin-Resistant Staphylococcus aureus (MRSA) has become a major pathogene and its incidence continues to increase in various countries. The resistance to methicillin is caused by the mecA gene that encodes the expression of Penicillin Binding Protein 2a (PBP2a) so it has a low affinity for beta-lactam antibiotics. One of the factors that can increase the incidence of MRSA is inappropriate antibiotics use. Objective: This study is to identify presence of the mecA gene in MRSA and to compare histories of inappropriate antibiotic uses of healthcare workers and communities in Banyumas. Methods: This was a cross-sectional study conducting 120 samples from nasal swabs. Isolates of MRSA tested by bacteriological examinations and PCR of the mecA genes. Histories of antibiotic uses were assessed by using questionnaires and then analysed descriptively by using Fisher Exact test (SPPS, version 20). Result: One sample of S. aureus from the microbiology examination (0.83%) was an MRSA although there was no a mecA gene identified by using the PCR method. 66.1% of the healthcare workers and 88,3% of the communities used antibiotics inappropriately. The results showed that there was a statistically significant difference in the histories of irrational uses of antibiotics (p˂0.05). Conclusion:A number of the communities who used inappropriate antibiotics was higher than the health workers. Furthermore, one MRSA strain with a negative mecA gene was found in the health worker group. Latar Belakang: Methicillin-Resistant Staphylococcus aureus (MRSA) telah menjadi patogen utama dan angka insidensinya terus meningkat di berbagai negara. Resistensi terhadap methiciline disebabkan karena S.aureus memiliki gen mecA yang menyandi ekspresi dari Penicillin Binding Protein 2a (PBP2a) sehingga memiliki afinitas yang rendah terhadap antibiotik beta-laktam. Salah satu faktor yang dapat meningkatkan insidensi MRSA adalah penggunaan antibiotik tidak rasional Tujuan Penelitian: Tujuan penelitian ini adalah untuk mengetahui keberadaan gen mecA pada MRSA dan membandingkan riwayat penggunaan antibiotik pada tenaga kesehatan dan masyarakat di Banyumas.

Background Chronic suppurative otitis media (CSOM) is a common public health problem worldwide and a major cause of hearing impairment especially in developing countries. The role of Mannose-Binding Lectin (MBL), a component of innate immunity, in CSOM has not been studied. The aim of the study was to examine whether MBL deficiency was more frequently present in cases group of tubotympanic CSOM patients rather than healthy subjects. Material and Methods This was an analytic observational study. Subjects were enrolled in the Otorhinolaryngology Clinic at Margono Soekarjo Hospital, Purwokerto, Indonesia. An independent t-test was used to compare the mean of MBL serum concentration between tubotympanic CSOM subjects and control. Results From 36 tubotympanic CSOM patients, there were 8 (22.22%) patients with MBL deficiency (MBL level < 100 ng/ml), while no deficiency was found in the control group. The mean of MBL level in cases group was 354.88 ng/ml, with the lowest level being 0.001 ng/ml and the highest level 690.24 ng/ml, while in the control group MBL level mean was 376.27 with the lowest level being 188.71 and the highest level 794.54 ng/ml. Conclusion There was no significant difference of MBL serum level between tubotympanic CSOM and control group. However, the presence of subjects with MBL deficiency in the tubotympanic CSOM group might be considered as playing a role in the tubotympanic CSOM.