Clinical Characteristics and Microbiological Profiles of Community-Acquired Intra-Abdominal Infections

Background: Intra-abdominal infections (IAIs) have different aspects to consider. One important aspectis the microbiological analyses, especially in the era of broad spread of resistant microorganisms. The studywas designed to describe the clinical characteristics and microbiological profiles of community acquired IAIs. Method: An observational study was performed on medical records of 12 months period (January toDecember 2013) in a General Hospital, Karawaci, Tangerang. Adult patients undergoing surgery for IAIs with positive microbiological culture and identification of microorganisms were included. Data collected were clinical characteristics and microbiological profiles and wereanalyzed statisticallyusing the SPSS version 17. Results: In 12 months period of study, 17 patients of IAIs with a total of 17 intra peritoneal specimens were collected. A total of six microorganisms were cultured. All the IAIs were monomicrobial, with aerobicmicroorganism dominantly Gram-negative bacilli. The dominant microorganism was Escherichia coli (E.coli), found in 58.8% of IAIs. The most common site was appendix (41.2%), and none from small intestine. Thesusceptibility test found that piperacillin tazobactam, tigecycline, meropenem and amikacin were the most activeantimicrobial against E. coli. Multi-drug resistant (MDR) E. coli in this study was 40%. The MDR E. coli had66.6% resistance to levofloxacin and ciprofloxacin, 66.6% susceptibility to ceftriaxone and ceftazidime, and100.0% susceptibility to amikacin. Conclusion: The most common site of community-acquired IAIs was appendix (41.2%). E. coli is still adominant microorganism with the MDR E. coli proportion of 40%

A High Distribution of Resistant Pathogens among Critically Ill Neonates from Secondary Referral Hospital of Indonesia

BACKGROUND፡ The spread of resistant pathogens among critically ill neonates has increased in recent years. Therefore, information about the antimicrobial profile and its susceptibility over time helps to select the most appropriate therapy. The study assesses the distribution of resistant pathogens and itssusceptibility among neonates’ patients.METHODS: Eight hundred and eight suspected neonatal infected from January 2011 to December 2019 were recruited anonymously in our retrospective, observational analysis. The study was conducted in the secondary-care level NICU which located on the western border of Jakarta, Indonesia. The MDROsdefinition was define by Centre for Disease Prevention and Control (CDC) criteria and standardized international terminology. Microbial identification and susceptibility testing were carried out following standard protocols.RESULTS: Culture positivity was found in 132 (16.3%) with dominating MDR-Gram negative bacteria 47 (61.8%). The most common pathogens were extended-spectrum β-lactamase and multidrug-resistant Acinetobacter 18 (38.3%), respectively. There were coagulase negative staphylococci 29 (38.2%) amongMDROs. Most of the Gram negative bacteria were highly susceptible to the combination of cefoperazone/sulbactam (79.6%), amikacin (88.7%), and tigecycline (77.1%). Staphylococcus aureus had a good susceptibility to almost all classes’ antibiotics. Candida isolates showed 100.0% susceptibility to all antifungal classes.CONCLUSIONS: Our study highlighted the microbial profile along with its susceptibility among neonatal patients that able to provide necessary information for antimicrobial guidelines and policies for effective infectious case management

The changing microbiological and antimicrobial susceptibility profile of cerebrospinal fluid organism isolates in a teaching hospital, Tangerang, Indonesia

Central nervous system (CNS) infections have become serious problems that contribute to morbidity and mortality in developing countries. In the recent years, antimicrobial resistance has arisen parallel with the changing trend of infectious pathogens, which resulted in the unavailability of an ideal antimicrobial agent. This study was designed to evaluate the central nervous system pathogens and their susceptibility profile using routine microbiological data. The data of CSF culture and susceptibility testing were collected from January 2010 to August 2015. The majority of eligible sample 68/99 (68.7%) had history of neurosurgical procedures. The most common pathogens isolated were coagulase negative staphylococci (CoNS) 39/99 (39.4%) followed by Acinetobacter baumanii 10/99 (10.1%), Pseudomonas aeruginosa 7/99 (7.1%), Sphingomonas paucimobilis 5/99 (5.0%), and Aeromonas salmonocida 4/99 (4.0%). Almost of all Gram positive cocci were susceptible to tigecycline, linezolide, vancomycin, and trimethoprim/sulfamethoxazole. Most Gram negative bacilli (GNB) in this study were multi-drug resistant with high susceptibility level to amikacin, tigecycline, and trimethoprim/sulfamethoxazole. The overall susceptibility testing to cephalosporins was low, ranging 34.2% to 58.5%. The susceptibility to several antifungal remained high for Candida spp. and Cryptococcus neoformans. The present study notifies the changing pathogens trend of CNS infections along with their antimicrobial susceptibility level in our hospital. There is a need of local antimicrobial recommendation and surveillance system to control the usage of antimicrobial and selection of empirical antimicrobial therapy

Knowledge, attitudes and practices regarding rabies among community members: a cross-sectional study in Songan Village, Bali, Indonesia

Background: Rabies is a preventable yet endemic zoonotic disease caused by a neurotrophic virus, a member of Rhabdoviridae family. Rabies remains a public health threat in Indonesia, specifically Bali Province. The present study aimed to understand the knowledge, attitudes and practices (KAP) regarding rabies among community members in Songan Village, Bali, Indonesia. Materials and methods: We conducted a cross-sectional survey using a structured questionnaire among 175 community members residing in the administrative area of public health centre of Kintamani V in Songan Village of Bangli District, from December 2019 to February 2020. Statistical analyses were performed with SPSS software, version 21. Results: Of the 175 community members, 53 (30.3%) owned a dog. Majority of the respondents were Hindu (98.8%), female (56.0%), aged ≥ 29 years old (54.9%), with an educational background of higher secondary (28.6%), residing in Songan A and B residential village (86.9%), working as farmers (50.9%), with the level of income less than district minimum wage (71.4%). The KAP scores mean ± standard deviation were 6.93 ± 1.83 and 8.04 ± 1.07 (out of 10), respectively. Multivariable logistic regression models were constructed and the KAP of the community members was found to be significantly influenced by occupation (p-value < 0.05). Conclusions: Albeit community members demonstrated some level of KAP regarding rabies, overall, this study revealed critical gaps in their fundamental knowledge of rabies, the prevention in dogs, and the local rules and regulations concerning rabies. In accordance with One Health Approach, further enforcement on the collaborative efforts for comprehensive education programmes, scheduled mass vaccination for dogs, and promotion for healthier attitudes and practices are recommended

A Lethal Case of<i>Sphingomonas paucimobilis</i>Bacteremia in an Immunocompromised Patient

Sphingomonas paucimobilisis a yellow-pigmented, glucose nonfermenting, aerobic, Gram negative bacillus of low pathogenicity. This organism was found in the implantation of indwelling catheters, sterile intravenous fluid, or contaminated hospital environment such as tap and distilled water, nebulizer, ventilator, and hemodialysis device. A 55-year-old female was hospitalized for diabetic foot ulcer in the presence of multiple comorbidities: diabetes mellitus, colonic tuberculosis, end-stage renal disease, and indwelling catheters for central venous catheter and hemodialysis. The patient passed away on the 44th day of admission due to septic shock. The organism found on blood culture on the 29th day of admission was multidrug resistantS. paucimobilis. Severe infection and septic shock due toS. paucimobilishave been reported particularly in immunocompromised patients, but there has been only one reported case of death in a premature neonate with septic shock. This is the first reported lethal case ofS. paucimobilisbacteremia in an adult patient.</jats:p

Flu burung

xv, 105 hl

Risk Factors of Non-typhoidal Salmonella Bacteremia versus Typhoidal Salmonella Bacteremia in Patients from a General Hospital in Karawaci, Tangerang, Indonesia: a five-year Review

&lt;div class="WordSection1"&gt;&lt;p&gt;Salmonella infections including Non-typhoidal Salmonella (NTS) and enteric fever are important global public health problem, causing approximately 94 million human cases of gastroenteritis with 150,000 deaths annually around the globe. The aim of this study was to determine risk factors for NTS&lt;em&gt; &lt;/em&gt;bacteremia patients compared to Typhoidal patients in Indonesia, area with high incidence of enteric fever. This retrospective descriptive study was conducted in Siloam Hospital in Karawaci, Indonesia, from January 2011 to December 2015. Logistic regression model was used to determine independent predictors of NTS bacteremia including demographic and epidemiologic characteristics, clinical presentations, and laboratory results.&lt;strong&gt; &lt;/strong&gt;Out of 129 positive isolates for Salmonella with complete medical records, 18 (13.9%) were positive for NTS. Patients with NTS bacteremia were more likely to belong in the age group below 5 or above 60 year-old, more frequent to have anemia and abnormal leucocyte count. The susceptibility patterns against antimicrobial of NTS bacteremia and Typhoidal bacteremia were similar. In logistic regression analysis, age below 5 or above 60 year-old, hemoglobin level below 12 g/dL and leucocyte count below 4,000/µL or above 12,000/µL were independent risk factors for NTS bacteremia.&lt;/p&gt;&lt;/div&gt;</jats:p