Background. A catheter-associated urinary tract infection (CA-UTI) is preceded by biofilm formation, which is related to several risk factors such as gender, age, diabetic status, duration of catheterization, bacteriuria before catheterization, virulence gene factor, and antibiotic usage. Aims. This study aims to identify the microbial composition of catheter samples, including its corresponding comparison with urine samples, to determine the most important risk factors of biofilm formation and characterize the virulence gene factors that correlate with biofilm formation. Methods. A longitudinal cross-sectional study was conducted on 109 catheterized patients from September 2017 to January 2018. The risk factors were obtained from the patients’ medical records. All catheter and urine samples were cultured after removal, followed by biomass quantification. Isolate identification and antimicrobial susceptibility testing were performed using the Vitex2 system. Biofilm-producing bacteria were identified by the Congo Red Agar (CRA) method. A PCR test characterized the virulence genes of dominant bacteria (E. coli). All data were collected and processed for statistical analysis. Results. Out of 109 catheterized patients, 78% of the catheters were culture positive, which was higher than those of the urine samples (37.62%). The most common species isolated from the catheter cultures were Escherichia coli (28.1%), Candida sp. (17.8%), Klebsiella pneumoniae (15.9%), and Enterococcus faecalis (13.1%). E. coli (83.3%) and E. faecalis (78.6%) were the main isolates with a positive CRA. A statistical analysis showed that gender and duration prior to catheterization were associated with an increased risk of biofilm formation p < 0.05 . Conclusion. E. coli and E. faecalis were the most common biofilm-producing bacteria isolated from the urinary catheter. Gender and duration are two risk factors associated with biofilm formation, therefore determining the risk of CAUTI. The presence of PapC as a virulence gene encoding pili correlates with the biofilm formation. Biofilm-producing bacteria, female gender, duration of catheterization (more than five days), and PapC gene presence have strong correlation with the biofilm formation. To prevent CAUTI, patients with risk factors should be monitored by urinalysis tests to detect earlier the risk of biofilm formation.
Corona Virus Disease 19 (penyakit COVID-19) yang disebabkan oleh virus Corona pertama kali merebak di kota Wuhan di China pada akhir Desember 2019 dan masih berlangsung sampai dengan saat ini. Diagnosis COVID-19 biasanya didasarkan pada anamnesis riwayat perjalanan seseorang dari daerah pandemik, gejala klinis dan beberapa pemeriksaan laboratorium. Pemeriksaan laboratorium yang cepat dan spesifik sangat diperlukan untuk mempercepat penanganan atau mengendalikan kasus. Sampai saat ini metode pemeriksaan yang cepat dan akurat masih terus dikembangkan. Oleh karena itu, pada tulisan ini akan dibahas mengenai beberapa metode pemeriksaan COVID-19, kelebihan dan kekurangannya serta cara memilih metode pemeriksan yang tepat. Metode yang akan dibahas antara lain yaitu metode molekuler, imunoserologi, radiologi, rapid antigen, GeNose, dan metode lainnya.
Burkholderia are intracellular pathogenic bacteria which can produce biofilm. This biofilm protects the intracellular pathogenic bacteria from antibiotic treatment and the immunological system of the host. Therefore, this review aims to describe the capacity of Burkholderia to form a biofilm, the regulation of its biofilm formation, the efficacy of antibiotics to eradicate biofilm, and the novel therapy which targets its biofilm. Burkholderia's biofilm is characterized by its lipopolysaccharides, exopolysaccharides (EPSs), biofilm-associated proteins, and eDNA. Its regulation is made by quorum sensing, c-di-AMP, sRNA, and two component systems. Many antibiotics have been used as sole or mixture agents; however, they are not always effective in eradicating the biofilm-forming Burkholderia. Inhibitors of quorum sensing and other non-conventional antibiotic approaches are promising to discover effective treatment of Burkholderia infections.
Virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus-2) termasuk dalam kelompok β-coronavirus yang merupakan virus RNA sense positif rantai tunggal dengan selubung lipid dan penyakit yang disebabkannya disebut Coronavirus Disease 2019 atau COVID-19. World Health Organization (WHO) secara resmi menyatakan wabah COVID-19 sebagai pandemi global dan pemerintah di seluruh dunia mulai menerapkan strategi untuk memperlambat penyebaran infeksi. Penularan SARS-CoV-2 umumnya melalui droplet tetapi penularan secara airborne (aerosol) juga mungkin terjadi. Ventilasi merupakan salah satu faktor yang memengaruhi transmisi secara airborne sehingga muncul pertanyaan tentang peran sistem heating, ventilation, and air-conditioning (HVAC) dalam penyebaran COVID-19 di lingkungan dalam ruangan. Penulis hendak mengkaji sumber-sumber kepustakaan yang tersedia yang membahas tentang kontaminasi udara dan area permukaan di lingkungan dalam ruangan dan pengaturan sistem HVAC dalam mencegah penyebaran SARS-CoV-2. Tulisan ini disusun dengan mengkaji 10 artikel jurnal penelitian yang berasal dari PubMed. Hasil kajian didapatkan bahwa pencegahan kontaminasi SARS-CoV-2 di dalam ruangan dengan sistem HVAC dapat dilakukan dengan meningkatkan laju ventilasi, menghindari sirkulasi udara kembali, menggunakan filter udara, ultraviolet germicidal irradiation (UVGI), serta rutin melakukan desinfeksi atau sterilisasi ruangan maupun permukaan.
Laporan National Healthcare Safety Network dari tahun 2006 - 2008, menunjukan penyebab paling umum kedua infeksi saluran kemih (ISK) terkait kateter adalah genus Enterococcus setelah Eschericia coli. Pada infeksi saluran kemih terkait kateter urin, faktor yang berperan penting dalam patogenesis infeksi ini, yaitu: pembentukan biofilm pada kateter urin. Peranan Enterococcus faecalis sebagai penyebab infeksi saluran kemih berkaitan dengan kemampuannya dalam membentuk biofilm. Ada beberapa variasi metode untuk mendeteksi pembentukan biofilm seperti Tissue Culture Plate (TCP), Tube method (TM), dan Congo Red Agar (CRA). Tujuan penelitian ini untuk mendapatkan metode deteksi pembentukan biofilm dari E. faecalis yang tepat, cepat, dan mudah dilakukan. Total tigabelas isolat bakteri E. faecalis yang didapat dari hasil isolasi kultur kateter urin dilakukan uji deteksi pembentukan biofilm dengan metode TCP sebagai baku emas dan CRA sebagai pemeriksaan pembanding. Hasilnya, didapatkan 61,5% dan 69,2% bakteri E. faecalis mampu menghasilkan biofilm menggunakan metode TCP dan CRA. Hasil uji diagnostik metode CRA dibandingkan dengan metode TCP untuk deteksi pembentukan biofilm, didapatkan sensitivitas dan spesifisitas dari CRA sebesar 75% dan 40%. CRA merupakan metode yang cepat dan mudah untuk dilakukan, namun memiliki spesifitas yang kurang baik. Hal ini dapat disebabkan pembacaan hasil yang bersifat subjektif dan menimbulkan kesalahan paralaks. Kata kunci : Enterococcus faecalis, Kateter Urin, Biofilm.
Background Infection of Salmonella enterica subsp. enterica serovar Typhi is the primary etiology of typhoid fever globally and is common in many developing countries, especially those with dense populations and poor environmental sanitation. Antibiotic fluoroquinolones were used for the treatment in the 1980s due to the resistance to the first-line antibiotics. However, many cases of treatment failure of fluoroquinolones in typhoidal patients have been reported from numerous countries in Asia, Europe, Africa, and America. Mutations in quinolone resistance determining regions (QRDR) genes, gyrA, gyrB, parC, and parE, are found in fluoroquinolone-resistant Salmonella Typhi. Contrast reports came from the S. Typhi isolates in Indonesia, mainly Jakarta and the surroundings, obtained from patients with typhoid fever, with good sensitivity to the fluoroquinolones, i.e., nalidixic acid, ciprofloxacin, moxifloxacin, and levofloxacin. The present study, therefore, aimed to identify the hotspot sequences of gyrA, gyrB, parC, and parE genes of the local S. Typhi strains based on their susceptibility to fluoroquinolones from patients with typhoid fever in Jakarta and its satellite cities. Results A total of 28 isolates were identified as S. Typhi. All isolates were susceptible to nalidixic acid, levofloxacin, and moxifloxacin. Twenty-seven isolates (96.4%) were susceptible to ciprofloxacin, with one isolate (3.6%) being intermediate. The hotspot sequences of gyrA, gyrB, parC, and parE genes from all isolates were identical to the fluoroquinolone-sensitive reference sequence Salmonella enterica subsp. enterica serovar Typhi Ty2 (NCBI GenBank AE014613.1), including the isolate with intermediate susceptibility. The mutation was not found, and amino acid deduced from all hotspots in susceptible and intermediate isolates showed no replacement in all reported codons. Conclusions This study showed that the local S. Typhi strains from Jakarta and surroundings were susceptible to fluoroquinolones (nalidixic acid, ciprofloxacin, levofloxacin, and moxifloxacin), and the hotspot sequences of the gyrA, gyrB, parC, and parE genes were all identical to the reference sequence. Thus, the hotspot sequences of the gyrA, gyrB, parC, and parE genes seemingly were conserved in Jakarta’s local S. Typhi strains and could be considered wild type. The phenotypic susceptibility was consistent with the genotypic characteristic without non-synonymous mutations associated with drug resistance.
Pada pandemi influenza sebelumnya, koinfeksi bakteri merupakan penyebab kematian terbanyak. Pada pandemi COVID - 19, koinfeksi bakteri juga menyebabkan tingginya angka kematian pada pasien COVID - 19 di ICU. Literatur Riview ini dilakukan untuk mengetahui bakteri penyebab koinfeksi pada pasien COVID - 19 di ICU. Dalam penulisan ini dilakukan pencarian pada database Pubmed dan 7 jurnal dipilih untuk dikaji. Dari hasil analisa jurnal – jurnal tersebut, bakteri yang paling banyak teridentifikasi menyebabkan koinfeksi pada pasien COVID - 19 di ICU adalah Stenotrophomonas maltophilia (33,8%), diikuti dengan Acinetobacter baumannii (22,65%), Pseudomonas aeruginosa (22,44%) dan Staphylococcus aureus (16,77%). Penemuan bakteri – bakteri ini berhubungan dengan lama perawatan di ICU, penggunaan ventilator mekanik serta pemberian antibiotic sebelum masuk ICU.
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