BackgroundHand hygiene is recognized as an important measure to prevent healthcare-associated infections. Hand hygiene adherence among healthcare workers is associated with their knowledge and perception. This study aimed to evaluate the effect of three different educational programs on improving hand hygiene compliance, knowledge, and perception among healthcare workers in a tertiary care hospital in Indonesia.MethodsThe study was performed from May to October 2014 and divided into a pre-intervention, intervention, and post-intervention phase. This cluster randomized controlled trial allocated the implementation of three interventions to the departments, including role model training-pediatrics, active presentation-surgery, a combination of role model training and active presentation-internal medicine, and a control group-obstetrics-gynecology. Both direct observation and knowledge-perception survey of hand hygiene were performed using WHO tools.ResultsHand hygiene compliance was observed during 2,766 hand hygiene opportunities, and knowledge-perception was assessed among 196 participants in the pre-intervention and 88 in the post-intervention period. After intervention, the hand hygiene compliance rate improved significantly in pediatrics (24.1% to 43.7%; P < 0.001), internal medicine (5.2% to 18.5%; P < 0.001), and obstetrics-gynecology (10.1% to 20.5%; P < 0.001). The nurses’ incorrect use of hand rub while wearing gloves increased as well (P < 0.001). The average knowledge score improved from 5.6 (SD = 2.1) to 6.2 (SD = 1.9) (P < 0.05). In the perception survey, “strong smell of hand alcohol” as a reason for non-compliance increased significantly in the departments with intervention (10.1% to 22.9%; P = 0.021).ConclusionThe educational programs improved the hand hygiene compliance and knowledge among healthcare workers in two out of three intervention departments in a limited-resource hospital in Indonesia. Role model training had the most impact in this setting. However, adjustments to the strategy are necessary to further improve hand hygiene.

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Kaffir lime oil (C. hystrix DC.) is consist of a complex mixture of hydrocarbons terpenoids and terpenoids which contain oxygen are distributed in every part of the plant. In this research tested the antioxidant and antimicrobial activity, both against kaffir lime oil from twigs, leaves and rind including the main components citronellal. The antioxidant was evaluated by testing its ability to catch DPPH radical. Antimicrobial activity is measured by its ability to inhibit the growth of gram-negative bacteria, Escheria coli. Gas chromatography-mass spectrometry (GC-MS) is used to analyze chemical composition of kaffir lime oil. Value of IC50 of kaffir lime oil obtained was 6,43 (L/mL); 6,83 (L/mL); 9,48 (L/mL) and 10,1 (L/mL), consecutive to kaffir lime oil from rind, leaves, twig-leaf mixture and citronellal. Compared to the other kaffir lime oil and major components citronellal, kaffir lime oil from rind show the most vigorous activity in inhibiting growth of Escheria coli bacteria, by MIC values of 12,5 (L/mL). GC-MS analysis showed that citronellal and citronellol as major component on kaffir lime oil from leaves and twig-leaf mixture, while the major component of kaffir lime oil from rind is -pinene, limonene, citronellal dan terpinen-4-ol.

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Acinetobacter baumannii (Acb) is an opportunistic and nosocomial pathogen that ussualy found in clinical specimen from patients with intensive care. The pathogenic mechanism of this bacteria are not fully elucidated especially potential activity of its protein as hemaglutinin and adhesion molecul. The aim of this study is to evaluate the role of 16 kDa fimbriae protein from urnary tract infection (UTI) patient as hemaglutinin and adhesion molecule. Using explorative design this study was started by isolation Acb bacteria from urine of patient that had been determine as UTI clinically and laboratory. After identification this bacteria by microbact system hemaglutination test and isolation of its fimbriae fraction, 12.5% SDS-PAGE had been used to isolated fimbriae protein, following assay in vitro to adhesion test.. The study showed that the 16 kDa fimbriae protein of Acb bacteria was a hemaglutinin protein that could agglutinate 0.5% mice erythrocytes (1/32), and human blood group O erythrocytes (1/8). Hemaglutination test were negative on erythrocytes from rat, guinea pig, sheep, and human blood group A, B. The 16 kDa fimbriae protein (AF16) was also adhesion protein that had been revealed by its activity to adherence to receptor of mice enterocytes. The increasing dose of AF16 molecules will decrease the amount of Acb bacteria to adherence to enterocytes (p<0.05). The fimbriae of Acb is maybe classified P type.

Acinetobacter baumannii (Acb) is an opportunistic or a nosocomial pathogenic bacterium which attacks immunocompromised host. Colonization and infection often occur while hospitalized and could lead to pneumonia infection, urinary tract infection, meningitis, septicemia, and burn or surgical wound infections. In spite of the steady increase of Acb infection cases, little has been revealed about the Acb infection mechanism. The infection process is initiated by the adhesion of bacteria onto the host's cell, followed by multiplication, colonization and infection. Adhesion onto the host's cell is mediated by the adhesin molecule functioning as the virulence factor. Adhesin is usually found in the form of hemaglutinin protein which is bound to the receptor available at the host's cell surface. Target of research is to know weather the bacterium have hemaglutinin protein, by seeing the ability of agglutination red blood of mice 0.5%. Isolate of Acb coming from clinical specimen consisted of urine 35 isolates, sputum 27 isolates, pus 15 isolates, and blood 1 isolat. Acb which from environment 2 isolates. Result of positive hemaglutination test got from urine 13 / 35 (37.14%), sputum 8 / 27 (29.63%), pus 5 / 15 (33.33%) and Acb isolat coming from environment and blood all negativies. This result show Acb isolat of clinical specimen gave positive test has range from 29.63-37.14% that believed to have protein of hemaglutinin the functioningness as protein of adhesin to attach bacterium at hospes cells. Needed by research continue for the characteristic of the hemaglutinin protein and possibility of hemaglutination test of pathogenic bacterium

Purpose: To evaluate the antioxidant activities and chemical compositions of citronellal extract and fractions of essential oils of Citrus hystrix. Methods: Antioxidant activity was examined using 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. Essential oil was produced by steam distillation while isolated citronellal and fractional distillates were obtained on a PiloDist 104-VTU fractional column at 5 mBar pressure and a reflux ratio of 20:10. Gas chromatography-mass spectrometry was used to determine their chemical composition. Results: All the essential oils produced from parts of C. hystrix, i.e., twigs oil (CHT), leaves-twigs oil (CHTL), leaves oil (CHL), and fruit peels oil (CHP), citronellal extract of CHL oil (CHLCE) and the distillation fractions of CHT oil (F1-F9), exhibited antioxidant activity. CHP exhibited the highest antioxidant activity. The chemical composition of CHT, CHTL and CHL was dominated by oxygenated monoterpenes (OMs), whereas that of CHP and F1 comprised mainly of a hydrocarbon monoterpene (HM). Conclusion: The antioxidant activities of essential oils from parts of C. hystrix and the fractions produced by essential oil fractional distillation exhibited a combination of HMs and OMs. Essential oils of CHP and F3 produced from the essential oil fractional distillation of CHT with a nearly equal composition of HM and OM compounds had higher antioxidant activity than the other essential oils and fractions, with IC50 values of 6.43 and 2.40 μL/mL, respectively.