Objective: The purpose of this research is to study the sensitivity of Mycobacterium tuberculosis (MTB) isolates from suspect TB patients to seromucous of snail and chitosan as an alternative to anti-TB drugs. Methods: The research methods include management specimen, freeze-drying of snail seromucous; formulation of dosage preparation; identification of MTB isolates; and sensitivity testing of MTB isolates to snail seromucous, chitosan, and streptomycin, isoniazid, rifampicin, and ethambutol (SIRE). Results: The characteristics of respondents by sex and age are the majority of male respondents and productive adult age that is 26 years–52 years. MTB isolates used in the study were obtained from the results of the screening of sputum samples of suspect TB patients through microscopic smear examination and molecular rapid test using GeneXpert tools. MTB isolates in patients suspect TB are resistant against seromucous of snails and chitosan that it is compared with SIRE. The dosage of snail seromucous is 8000 mg/l, chitosan 2% is 800 mg/l, and SIRE, respectively (rifampicin 8000 mg/l, isoniazid 20 mg/l, ethambutol 200 mg/l, streptomycin 800 mg/l). Conclusion: MTB isolates from patients suspect who TB is resistant to seromucous of snail (8000 mg/l) and chitosan (800 mg/l).
Tuberculosis (TB) is an infection caused by M. tuberculosis (MTb) and is transmitted through droplets of phlegm in the air from patients or those suspected of having TB. In general, treatment for TB is done with anti-tuberculosis drugs (ATDs), specifically streptomycin, isoniazid, rifampicin, and ethambutol (SIRE) that takes a long time due to the level of resistance of MTb bacteria. The resistance of MTb triggers ATDs based on natural bioactive compounds. Chitosan as a result of chitin deacetylation can function as an antimicrobial agent because it is polycationic, which is biodegradable, biocompatible, and non-toxic. Snail (Achatina fulica) seromucoid contains antibacterial bioactive compounds, namely glycans, peptides, glycopeptides, achasin protein, and chondroitin sulfate. This study aims at testing the sensitivity of MTb isolates against snail seromucoid and chitosan in vitro. This research applied the experimental research method. MTb isolates were obtained from sputum samples of patients suspected of TB at the Surakarta Regional Public Hospital (RSUD Surakarta). The results of screening for MTb were positive, based on the microscopic examination of MTb using the Ziehl Nelson (ZN) method, the MPT 64 rapid test, and the quick molecular test using the Genexpert method. The research was completed through several stages, including the preparation of a suspension of germs with a concentration of 1 mg/ml or Mc. Farland 0.5-1.0; preparation of the stock solution and working solution (WS); drug sensitivity test (DST) against snail seromucoid; chitosan and ATDs (SIRE) on Lowenstein Jensen (LJ) media; and incubation at 37°C for 3-4 weeks. The results were interpreted on day 28 or day 42. The results have revealed that MTb isolates are 100% resistant to snail seromucoid and 2% chitosan. This study concludes that MTb isolates from suspected TB are resilient to 100% snail seromucoid and 2% chitosan.
Prolonged MDR-TB therapy can have side effects, namely a correlation between cure rates and changes in bacterial profiles related to resistance to anti-tuberculosis drugs (ATD) which can affect the incidence rate of MTB and MDR-TB in a region. The research objective was to analyze the effectiveness of the type of ATD against the resistance level of Mycobacterium tuberculosis (MTB) isolates with the incidence of tuberculosis (TB) and MDR-TB. The research method used was a retrospective cohort based on tracing medical record data at the Surakarta City Center General Hospital 2016 until 2017 with total sampling. The independent variable of this study was the type of ATD, while the dependent variable was the resistance level of MTB isolates. The characteristics of the most patient respondent suspect TB were male with the level of resistance of MTB isolates to ATD relatively varied. The results of the analysis of different tests showed a p value of 0.000 so that the p value was 0.05, so there was an effect of the type of ATD (Strepttomycin, Isoniazid, Rifampicin and Ethambutol) on the resistance of TB isolates from patients with suspected TB. This is useful to determine the success of TB therapy in terms of mortality and the effectiveness of therapy in TB patients.
Tuberculosis (TB) as a global emergency is a chronic disease caused by Mycobacterium tuberculosis (Mtb). Mtb plays an important role in inducing or suppressing the production of Interferon Gamma (IFNG) and IL-4 in the regulation of TB homeostasis and pathogenesis. The bioactive compounds of the snail seromucous (Achatina fulica Ferussac) and chitosan function as biological response modifiers. The study aimed to determine the potential effectiveness of snail seromucous and chitosan as bio-immunomodulator for TB therapy. The research method was based on the results of laboratory experiments with the physic-chemical, biochemical, microbiological examination, snail seromucous protein profile, lymphocyte proliferation, measurement of IFNG, and IL-4 levels. The results of the physic-chemical examination of the snail seromucous showed a specific gravity of 1.010; pH 8, glucose 16 mg/dL; cholesterol 9 mg/dL; protein 2.8 mg/dL and heavy metals (Pb, Cu, Hg, Al) negative. The results of microbiological tests showed that a 100% concentration of snail seromucous was antimicrobial against Staphylococcus aureus, Candida albicans, and Pseudomonas aeruginosa. The protein profile of snail seromucous shows that there are 3 protein subunits, namely the range 55 - 72 kDa and 1 specific protein sub-unit 43 kDa as a bioactive compound achasin sulfate. Addition of chitosan dose of 65 µg/mL; snail seromucous dose of 65 µg/mL and a mixture of chitosan (65 µg/mL): snail seromucous (65 µg/mL) ratio 1: 1, can increase lymphocyte proliferation; optimum levels of IFN-γ and IL-4. Snail seromucous and chitosan are effective immunomodulators and potential candidates for TB therapy.
BACKGROUND: Tuberculosis (TB) disease is an infection caused by Mycobacterium tuberculosis and is transmitted through sputum droplets of sufferers or suspect TB in the air. Chitosan as an antimicrobial agent can be used in the biomedical field because it has a number of hydroxyl groups (OH) and amine groups (NH2). The chemical substance of durian peel extract (Durio zibethinus L.) contains pectin which is multifunctional and can be used in the pharmaceutical field. Chemically, pectin is a polysaccharide polymer of D-galacturonic acid linked by -1,4 glycosidic bonds which can dissolve in water to form colloidal solutions or gels. AIM: This study was to determine the antimicrobial effectiveness of chitosan and polysaccharides from durian peel extract (D. zibethinus L.) against M. tuberculosis isolates in vitro. METHODS: The research method is based on an experimental study in vitro. M. tuberculosis isolates in this research from sputum samples of patients suspected of TB in Surakarta Regional General Hospital. The stages of the research were performed that preparation chitosan gel (CG), bioformulation of CG, and polysaccharide gel (PG) durian peel extract are 5%, 10%, 15%, 20%, and 25%, and drug susceptibility testing against M. tuberculosis isolates. RESULTS: CG 10% was effective as an antimicrobial against M. tuberculosis isolates but PG durian peel extract (5%; 10%; 15%; 20%; and 25%) was not effective as an antimicrobial against M. tuberculosis isolates. The types of anti-tuberculosis drug (ATD) that was effective against M. tuberculosis isolates were ethambutol 80% and streptomycin 40%, while isoniazid and rifampicin were not effective as ATD against M. tuberculosis isolates. CONCLUSION: CG 10% was effective as an antimicrobial against M. tuberculosis isolates, while PG 25% durian peel extract was not effective as an antimicrobial against M. tuberculosis isolates. CG has the potential as an ATD based on natural bioactive ingredients for TB therapy.
BACKGROUND: Research on galenic bioactive compounds as antimicrobial agents needs to be developed. Durian peel ethanol extract is a polar polysaccharide consisting of D-galacturonic acid with -1,4 glycosidic bonds and can form a polysaccharide gel. Chitosan can be synthesized through the deacetylation of chitin as a compound (1.4)-2 amino-2deoxy D-glucopyranose and can form a gel in 1.5–2% acetic acid. The properties of chitosan are biodegradable, non-toxic, polycationic antimicrobial, and biocompatible. AIM: The study aimed to determine the effectiveness of the ethanolic extract of PG durian peel and CG as antimicrobial agents. METHODS: The research design was an experimental study and conducted at the Microbiology Laboratory, Faculty of Health, Setia Budi University, Surakarta, in August–December 2020. The research stages were the extraction of durian skin polysaccharides, bioformulation of PG durian peel extract and CG, and antimicrobial activity testing using the diffusion method. RESULTS: The results showed PG durian peel ethanolic extract concentration (100%, 50%, 25%, 12.5%, 1.5%, and CG 1.5% %) or a combination of durian peel extract PG (1.5%) and CG (1.5%) 1:1 ratio; 1:2; 2:1 was antimicrobial against Staphylococcus aureus ATCC 25923, Bacillus subtilis ATCC 6633, Escherichia coli ATCC 25922, Salmonella typhi ATCC 13311, Pseudomonas aeruginosa ATCC 27853, and Candida albicans ATCC 10231. PG durian peel ethanolic extract concentration of 100%, 50%, 25%, 12.5%, 1.5%, and CG 1.5% or a combination of durian peels ethanolic extract PG (1.5%) and CG (1.5%) ratio 1:1; 1:2; and 2:1 as an antimicrobial in vitro. CONCLUSION: PG durian peels ethanolic extract concentration 100% showed optimum effectiveness as an antimicrobial against B. subtilis ATCC 6633. Chitosan 1.5% showed optimal effectiveness as an antimicrobial against P. aeruginosa ATCC 27853. The effectiveness of the mixture of PG 1.5% and CG 1.5% ratio 1:2 showed optimum effectiveness against all test cultures.
Background: Harmful particles from cigarette smoke induces an inflammatory immune response in the lungs, followed by the release of proinflammatory cytokines such as TNF-α and IL-8 and damages histone deacetylase 2 (HDAC2) in the cell core leading to glucocorticoid resistance in COPD. Low dose Theophylline of below 10mg/L has an anti-inflammatory effect by activating HDAC. This study aimed to analyze the effect of low dose theophylline on the clinical improvement of stable COPD patients assessed by the COPD Assessment Test (CAT) score, IL-8 level, and sputum neutrophil count.Methods: We conducted a quasi-experimental clinical study using a pre-post test in stable COPD patients visiting the Pulmonary Outpatient Clinic of DR. Moewardi hospital Surakarta, between July and September 2016. The samples were taken using a consecutive sampling technique, assigned into two groups, treatment, receiving standard therapy plus 70 mg low dose theophylline per 8 hours, and control receiving standard therapy only. CAT score, IL-8 level, and sputum neutrophil count were measured at baseline and four weeks after treatment.Results: The treatment group's CAT score decreased by 3.67±3.58 pg/ml and increased by 2.40±3.38 pg/ml in the control group (p=0.003). IL-8 level decreased by 4.31±13.06 pg/ml in the treatment group and increased by 0.88±13.89 pg/ml in the control group (p=0.116). The sputum neutrophil count decreased in both treatment and control groups by 4.00 ±40.33 pg/ml and 2. 87±39. 91 pg/ml (p=0.939).Conclusion: Statistically low dose theophylline significantly lowers the CAT score of stable COPD patients. It also decreases IL-8 level and sputum neutrophil count, although it is not significant.
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