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Context: Tea tree oil (TTO) is an essential oil derived from Melaleuca alternifolia, with high antimicrobial and antifungal potential. Unfortunately, its topical antifungal efficacy is limited because it is volatile, thermolabile and easily oxidized. A formulation has been developed to overcome this problem by encapsulating TTO in a nanostructured lipid carrier (NLC). Aims: To determine the effect of the liquid to solid lipid ratio on the physicochemical properties and the stability of TTO-loaded NLC. Methods: Five formula of TTO-loaded NLCs were produced by high shear homogenization method and characterized according to their particle size, size distribution, polydispersity, zeta potential, thermal characteristics, X-ray diffraction, and terpinen-4-ol concentration. In addition, a stability study was conducted by observing its physical and chemical characteristics during storage in the refrigerator (4 ± 2°C) and at room temperature (27 ± 2°C) for six months. Results: The resulting TTO-loaded NLC had an average droplet size under 400 nm. The particle size increases with increasing amount of liquid lipid in the formula. There were insignificant changes in organoleptic properties, polydispersity index, zeta potential and terpinene-4-ol concentration during stability study for six months. However, the particle size slightly increased during the six months of storage. Furthermore, the NLC 3, which formulated with a 25:95 ratio liquid to solid lipid, was be chosen as the best formula, since it demonstrated the best physicochemical characteristic and stability. Conclusions: TTO-loaded NLC with good physicochemical characteristics and stability has been successfully developed. In addition, NLC 3 is considered as the best NLC formula, which exhibits characteristics and stability that meet the requirements.

Gonorrhea is the second most common sexually transmitted bacterial infection (STI), following Chlamydia. Neisseria gonorrhoeae resistant to antibiotics are increasing globally in the world. In recent years, many studies have reported reduced susceptibility of N.gonorrhoeae to almost all clinically useful antibiotics and also reported cases of multi-resistance. Resistance mechanisms for N. gonorrhoeae can occur through genetic and non-genetic changes. Resistance to cefixime and azithromycin as first-line antibiotics for monotherapy recommended by the World Health Organization (WHO) has been reported from several countries. Genetic changes were reported as the main cause of N.gonorrhoeae resistance to cefixime and azithromycin. Based on the WHO and the United States Centers for Disease Control and Prevention recommendations, countries are increasingly using a combination of cephalosporin and azithromycin for the treatment of gonorrhea. The aim of this review is to analyze genetic variation of N.gonorrhoeae resistance to cefixime and azithromycin. Articles published in English in the last 12 years (from 2010 to 2021) were retrieved from Science Direct, PubMed, Springerlink, Oxford and Nature using relevant searching terms. Mutants of cefixime-resistant N.gonorrhoeae are mediated by mosaic and non-mosaic penA genes encoding penicillin binding protein 2. In addition, mutations in the repressor and promoter genes of mtrR were also found that caused overexpression of the microbial efflux pump. Meanwhile, N. gonorrhoeae resistance to azithromycin reportedly occurs through two strategies, namely overexpression of the efflux pump (mutation of the mtrR codon region) and decreased affinity for antibiotics (single base mutation in the 23S rRNA gene). With the limited choice of antibiotics for the management of N.gonorrhoeae, it is necessary to do regular surveillance for monitoring drug resistance. By understanding the mechanism of resistance, the use of these antibiotics can be rationally optimized.

Fungal infections are common in the tropics. The cause of mycoses depends on the cause and the accompanying risk factors. It is important to do culture and identification to determine the etiology and continue with antifungal sensitivity examination to determine the appropriate management. The method of treating a yeast infection depends on the type of infection, its severity and the part of the body that is infected. As various fungi cause infections, the antifungal drugs used are also very diverse. The study was conducted during 2020 consisting of 350 samples of various specimens with positive cultures of 116 (33.14%). The results of identification using Vitek 2® automated system and slide culture obtained 19 species on fungus, consistinf of 99.14% yeast and 0.87% mold. The most yeast found were C. albicans 26.27% and Aspergillus sp; Rhizopus 0.86 % respectively from mold. The pattern of sensitivity of yeast to several antifungals showed that Fluconazole was effective at 96.43%, followed Voriconazole and Amphothericin B 93.24% respectively. The next are Flucytocin, Micafungin and Caspofungin 91.66%, 86.18% and 85.74% respectively. Culture, identification and sensitivity examination need to be improved to obtain images and information that reflects.Keywords : yeast, mold, sensitivity patterns, antifungal

Azithromycin is an antibiotic used to treat syphilis, especially in the context of penicillin allergy. Although resistance to azithromycin has been widely reported to be associated with one- and/or two-point mutations on the 23S rRNA gene, it has yet to be described in Indonesia. Specimens were collected from 220 patients diagnosed with secondary syphilis. A multiplex nested polymerase chain reaction (PCR) testing system using the 23S rRNA target gene of Treponema pallidum was designed using three primer pairs. The first step involved the use of PCR primer pairs to detect T. pallidum. In the second step, two PCR primer pairs were constructed to identify azithromycin-resistant T. pallidum based on A2058G and A2059G point mutations. T. pallidum detected in samples from Jakarta or Bandung were not resistant to azithromycin. However, azithromycin-resistant T. pallidum were found in samples from Makassar, Medan, and Bali. Specimens from heterosexual males and patients with HIV accounted for the majority of azithromycin resistance noted in the study. This study demonstrated that the azithromycin-resistant T. pallidum detected in Indonesia appear to be a novel variant of resistance, containing both the A2058G and A2059G mutations found in Medan and Makassar.

BACKGROUNDSyphilis is a global health problem, especially in developing countries including Indonesia. Treponema pallidum, the etiologic agent of syphilis, cannot be cultured in vitro. Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. Microscopic examination may support the diagnosis but is rarely used in Indonesia. The aim of this study was to evaluate negative staining using the light microscope to detect T. pallidum in syphilitic lesions. METHODSA cross-sectional study was conducted involving 27 subjects who came to several dermato-venereology clinics in Jakarta. Exudates were collected from genital ulcers, condylomata lata, and dry mucocutaneous rash on palms and soles of syphilis patients. Negative staining using one drop of Indian ink was used to examine for treponemas under the light microscope at 10x100 magnification. RESULTSMicroscopic examination using negative staining showed a few clusters of small and spiral shaped bacteria. Of the 39 specimens from 27 subjects, microscopic examinations were successfully done on 10 specimens. Observations could only be conducted on 5 specimens, 3 (60.0%) of which showed the morphology of spirochetes. This examination is the easiest method for detecting the bacteria. Moreover, the bacteria that were isolated from painless genital ulcers could be observed more clearly than those from erythematous maculopapular lesions. CONCLUSIONTreponema pallidum was successfully detected by microscopic examination in all moist lesions, but was difficult to detect in dry lesions. Negative staining under the light microscope appears to be simple, affordable, and available in most microbiology laboratories in Indonesia.

Background Difficulty in diagnosing Chlamydia trachomatis infections, including chlamydial cervicitis, is a notable challenge in managing sexually transmitted infections in Indonesia. Gram staining is usually done to make a presumptive diagnosis despite its low sensitivity and specificity. Polymerase chain reaction (PCR) is considered the gold standard, but it is costly, technically demanding, and difficult to be performed in low-resource settings. Thus, rapid point-of-care tests with high sensitivity and specificity are needed to diagnose chlamydial cervicitis. Methods This cross-sectional study included symptomatic and asymptomatic high-risk women in the Mulya Jaya Sex Workers Rehabilitation Center in June to July 2020. Endocervical swabs from each participant were taken for QuickStripe™ chlamydia rapid test (CRT), Gram staining, and real-time PCR. Results A total of 41 participants were enrolled. The sensitivity and specificity for QuickStripe™ CRT were 73.6% (95% CI: 48.80%–90.85%) and 81.82% (95% CI: 59.72%–94.81%). Positive and negative predictive values were 77.78% (95% CI: 58.09%–89.84%) and 78.05% (95% CI: 62.39%–89.44%). Proportion of chlamydial cervicitis in study participants based on real-time PCR was 46.3%. Conclusions We concluded that QuickStripe™ CRT can be recommended as an alternative diagnostic test for high-risk populations in Jakarta.

Tea tree oil (TTO) is a promising essential oil that has enormous potential for antifungal development. However, its pharmacological applications have several limitations, including volatility and an extensive range of partition coefficients. To overcome these, TTO can be loaded into a nanostructured lipid carrier (NLC). The combination of solid and liquid lipids and production conditions affect the characteristics of the NLC formed. This study aimed to design TTO-loaded NLCs with appropriate particle sizes to improve the therapeutic efficacy of TTO as an antifungal agent. The novelty of this research is the discovery of a stable and potential TTO loaded NLC formula as a topical antifungal agent. TTO-loaded NLCs were prepared using the high-shear homogenization method with formulas consisting of TTO, solid lipids, liquid lipids, surfactants, and distilled water. Then, they were characterized with particular attention to average particle size, polydispersity, zeta potential, pH, and viscosity. Further tests included physical stability for one month at room temperature (27±2 °C) and in vitro antifungal activity using the well diffusion method. TTO-loaded NLCs combining stearic acid, glyceryl monostearate, and cetyl alcohol (solid lipids) with Miglyol 812 and olive oil (liquid lipids) showed relatively small average particle sizes and low polydispersity index values. Also, the stirring speed did not affect the particle size. It was found that TTO exhibited in vitro antifungal activities as good as ketoconazole cream. This study has successfully combined various solid and liquid lipids to formulate TTO-loaded NLCs with favorable stability for one-month storage and great antifungal potential.

Background and Objectives: Blocking the attachment of diphtheria toxins to host cells through the intact receptor binding site (tox B) was the initial mechanism of action of the diphtheria vaccine. Diphtheria outbreaks in populations with good vaccination coverage can be caused by mutations or changes in the genetic structure of the tox B protein. The aim of this study was to characterize the Tox B protein produced by Corynebacterium diphtheriae isolated from 2018 to 2019 in patients in Jakarta who had already received the diphtheria vaccine. Materials and Methods: Of the 89 throat swab specimens of patients with a clinical diagnosis of diphtheria, 10 were posi- tive for diphtheria and toxin. PCR was used to amplify the tox B DNA fragment in the 10 positive isolates. DNA sequencing was conducted with overlapping primers and the DNA sequences were analysed by using SeqScape V2.7. Results: Of the 10 isolates, nine isolate showed a DNA mutation (G30A), but the mutation did not change the amino acid encoding arginin (silent mutation). Our findings indicate that the efficacy of the diphtheria vaccine used in Indonesia has not decreased because of mutations in the tox B genes not change the amino acid. Conclusion: Overall, there are no amino acid changes in the tox B protein, indicating that the outbreaks are not affected by mutation in tox B. Another possible mechanism – overexpression of the toxin – is likely responsible for causing diphtheria in patients who have a complete history of immunization in Indonesia.

BACKGROUND Cotrimoxazole, which has been one of the drugs of choice for urinary tract infections (UTIs) since 1960, must be evaluated to determine whether it is still a relevant drug for this use. This study aimed to assess the susceptibility patterns to cotrimoxazole of the bacteria that cause UTIs from urine samples of female outpatients (community-acquired [CA]-UTI) and inpatients (hospital-acquired [HA]-UTI) in Jakarta. METHODS This study was conducted from December 2014 to December 2015. Susceptibility testing of bacteria causing UTIs was conducted on 27 of 311 female outpatient urine samples collected from six clinics in Jakarta, and secondary data susceptibility testing was performed on 27 of 107 urine samples of inpatients from hospitals in Jakarta. These samples were examined in the Clinical Microbiology Laboratory, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital. RESULTS Susceptibility to cotrimoxazole was reported in 83% of the bacteria causing UTIs in CA-UTI and 44% of the bacteria in HA-UTI patients. Klebsiella pneumoniae was the most common cause of CA-UTI, with all isolates susceptible to cotrimoxazole (100%). Conversely, Escherichia coli was the most common cause of HA-UTI but was only susceptible in some isolates (44%). Bacteria from CA-UTI patients were almost twice as susceptible to cotrimoxazole compared with HA-UTI patients (p = 0.003). CONCLUSIONS Based on the susceptibility patterns identified, cotrimoxazole can be used as a treatment for CA-UTI but not for HA-UTI patients in Jakarta, Indonesia.

Acne is a chronic inflammatory disease. The pathogenesis of acne is multifactorial; one of them is caused by an overgrowth of microbes like S. aureus. Clindamycin is one of the antibiotics recommended for acne therapy. Still, the use of clindamycin causes various side effects such as changes in intestinal function associated with intestinal flora, pseudomembranous colitis, and increases the risk of resistance. Silver nanoparticles are potent antimicrobials, have broad-spectrum activity, and can reduce the development of resistance. Despite having potent activity, the long-term use of silver nanoparticles is reported to have side effects argyria. The use of antimicrobial combinations is a strategy to reduce side effects and increase the effectiveness of therapy. Antimicrobial combinations can use low concentrations but still have the potential to inhibit microbial growth. This research aim is to determine the antibacterial synergism of a combination of silver nanoparticles and clindamycin against S. aureus. Determination of the minimum inhibitory concentration (MIC) of silver nanoparticles, clindamycin, and synergism test was carried out by microdilution using 96-well microplates. Synergy test is carried out using the Checkerboard method by calculating the value of the Fractional Index Concentration (FIC). The results showed the MIC values ​​of silver nanoparticles and clindamycin were 16 µg/ml and 64 µg/ml, respectively. The synergy test of the combination of silver nanoparticles yielding an FIC value of 0.75. Based on the result of the study, it was concluded that the combination of silver nanoparticles and clindamycin had partial synergy properties. The Minimum bactericidal Concentration (MBC) value clindamycin alone compared in combination with silver nanoparticles 16 µg/ml reduces from 256 µg/ml to 128 µg/ml. Combinations of silver nanoparticle and clindamycin are the potential to reduce side effects and overcome resistance.

Background and Objectives: Diphtheria is a potentially fatal disease caused by toxigenic bacterial infection, particularly from Corynebacterium diphtheriae (C. diphtheriae). Isolation of C. diphtheriae is technically lacking in sensitivity, and Elek’s test to detect toxin production has several difficulties associated with its application. Duplex real-time PCR to throat swab of suspected diphtheria patients can detect both bacteria and toxin-encoding genes simultaneously, faster, with higher sensitivity and specificity. Materials and Methods: A total of 89 consecutive throat swabs from suspected diphtheria patients were collected from Sulianti Saroso Infectious Disease Hospital, Jakarta, during 2018 to 2019. Two pairs of primers and probes, targeting the rpoB gene of C. diphtheriae and the A-subunit of the diphtheria toxin gene, were used in this study. Parameters including annealing temperature, concentration of primers and probes, inhibitors, cross-reaction and detection limit were all optimized. Elek’s toxigenicity test and clinical data were analyzed for comparison. Results: The optimum annealing temperature was 55°C. The concentrations of Cd primer, Tox primer, Cd probe and Tox probe were 0.4, 0.6, 0.5 and 0.625 µM, respectively. DNA elution and template volumes were 50 µL and 5 µL. The detection limit was 2 CFU/mL. No cross-reaction with other microorganisms was observed. Of the 89 samples, duplex real-time PCR gave better results than the standard test, with 19 (21.3%) and 10 (11.2%) patients diagnosed with diphtheria, respectively. Conclusion: Duplex real-time PCR increases the rate of laboratory diagnosis of diphtheria, compared to the standard method to detect potentially toxigenic C. diphtheriae.

Background and Objectives: Diphtheria is a potentially fatal disease caused by toxigenic bacterial infection, particularly from Corynebacterium diphtheriae (C. diphtheriae). Isolation of C. diphtheriae is technically lacking in sensitivity, and Elek’s test to detect toxin production has several difficulties associated with its application. Duplex real-time PCR to throat swab of suspected diphtheria patients can detect both bacteria and toxin-encoding genes simultaneously, faster, with higher sensitivity and specificity. Materials and Methods: A total of 89 consecutive throat swabs from suspected diphtheria patients were collected from Sulianti Saroso Infectious Disease Hospital, Jakarta, during 2018 to 2019. Two pairs of primers and probes, targeting the rpoB gene of C. diphtheriae and the A-subunit of the diphtheria toxin gene, were used in this study. Parameters including annealing temperature, concentration of primers and probes, inhibitors, cross-reaction and detection limit were all optimized. Elek’s toxigenicity test and clinical data were analyzed for comparison. Results: The optimum annealing temperature was 55°C. The concentrations of Cd primer, Tox primer, Cd probe and Tox probe were 0.4, 0.6, 0.5 and 0.625 µM, respectively. DNA elution and template volumes were 50 µL and 5 µL. The detection limit was 2 CFU/mL. No cross-reaction with other microorganisms was observed. Of the 89 samples, duplex real-time PCR gave better results than the standard test, with 19 (21.3%) and 10 (11.2%) patients diagnosed with diphtheria, respectively. Conclusion: Duplex real-time PCR increases the rate of laboratory diagnosis of diphtheria, compared to the standard method to detect potentially toxigenic C. diphtheriae.

Yasmon A, Rosana Y, Usman D, Prilandari LI, Hartono TS. 2020. Short Communication: Identification and phylogenetic analysis of Corynebacterium diphtheriae isolates from Jakarta, Indonesia based on partial rpoB gene. Biodiversitas 21: 3070-3075. Indonesia is a developing country with the greatest potential of diphtheria, so accurate identification is needed to detect C. diphtheriae. The genetic relationship analysis is important to be determined so that this transmittable disease can be prevented. In this study, we reported the identification and phylogenetic analysis of C. diphtheriae based on partial rpoB gene. Twelve samples from throat swabs of diphtheria suspected patients from 2018 to 2019 were used in this study. The result of VITEK 2 ANC-Automated Testing identified that all isolates were C. diphtheriae. However, the identification based on partial rpoB gene analysis showed that only 10 out of 12 isolates were C. diphtheriae, while 2 other isolates were C. argentoratense. Of 10 C. diphtheriae strains/isolates, 2 strains were unique for Indonesia. Thus, it is needed to evaluate the accuracy of VITEK 2 ANC-Automated Testing and to conduct further comprehensive studies on the genetic relationships of C. diphtheriae strains based on multiple virulence genes, multilocus sequence typing and/or whole-genome analysis.

Background: Azithromycin-resistant strains of Treponema pallidum is associated with the mutation of 23S rRNA gene of T. pallidum. Although these strains are now prevalent in many countries, there is no laboratory test kit to detect and identify these mutations. Thus, in this study we developed a nested multiplex polymerase chain reaction (PCR) to detect and identify A2058G and A2059G mutations in 23S rRNA gene.Methods: Three primer sets were designed for nested PCR reactions. To obtain maximum PCR reaction, all parameters were optimized. The specificity of the primer sets was evaluated towards some microorganisms. A sensitivity test was conducted to get detection limit of deoxyribonucleic acid (DNA). Forty-five whole blood specimens were tested by PCR, and positive results were confirmed by the DNA sequencing.Results: The assay could detect at least 4,400 DNA copy number and showed no cross reaction with other microorganisms used in the specificity test. A total 13 of 45 whole blood specimens were PCR positive for T. pallidum, and no single mutations (either A2058G or A2059G) were detected. Two positive specimens were confirmed by the DNA sequencing and showed no mutation.Conclusion: Nested multiplex PCR developed in this study showed a specific and sensitive test for the detection and identification of A2058G and/or A2059G mutations of 23S rRNA T. pallidum gene.

Urinary Tract Infection (UTI) is an infection in any part of the urinary system. Women are 3 times more likely to have UTI than men. The UTI accounts for 15% infection cases in outpatients and 24% cases in hospitalized patients. Although the most common cause of UTI is certain bacteria, but it was not easy to choose the appropriate antimicrobial therapy. Strategy for choosing empiric antimicrobial treatments for UTI in female out- and hospitalized patients should be based on the pattern of the causative organisms. The aim of this study was to understand the microbial pattern causing UTI in female out- and hospitalized patients in Jakarta. The UTI -1 causative microorganisms were obtained from urine culture containing 100,000 cfu/mL . Twenty nine microorganisms were found as the causative agents of UTI in 317 pregnant women who came to six Community Health Centres (Puskesmas) in Jakarta: Makassar; Pulogadung, Cakung, Pasar Rebo, Duren Sawit, and Kramat Jati for antenatal care. Twenty nine microorganisms were isolated from 114 urine samples of female hospitalized patients who were diagnosed of UTI. The samples were obtained from the Microbiology Laboratory Clinic of FKUI-RSCM. The most common microorganisms causing UTI in female out- and hospitalized patients were Gram negative bacteria. In female outpatients, Klebsiella sp was the most common causative bacteria (31%), followed by Escherichia coli (24.1%). In female hospitalized patients, Escherichia coli was the most common causative bacteria (30%), followed by Candida sp (24.1%) and Klebsiella pneumonia (6.8%). There was more variation in the pattern of UTI causative organisms in hospitalized female patients in comparison to that of the outpatients. Candida sp. was only found in hospitalized UTI patients but not in outpatients.

Basic slide culture as a morphological identification was known as the most common method for the identification of pathogenic mold fungi. This method preserved the morphological features relatively undisturbed compared with adhesive tape preparations. However, it was necessary to modify method of basic slide culture to improve its usability and shorten the time it needed to identify mold fungi. There were four kinds of method carried out in this study; two kinds of modified slide culture, one kind of direct culture on slant agar plate, and a basic slide culture for identifying mold fungi, which result would be compared with each other. These four methods were tested to 4 species of dermatophytes which were known as mold fungi that could infect skin, hair, and nails in human; those were Trichophyton mentagrophytes , Microsporum canis , Microsporum gypseum , and Epidermophyton floccosum . Result of this study showed that both modified slide culture and direct culture on slant agar plate could visualize the structure of dermatophytes faster than basic slide culture method. These methods were also easier to prepare compared to basic culture method. Conclusion of this study showed that basic slide culture method needed to be modified for better identification of mold fungi.

Fluconazole is the standard treatment for oropharyngeal candidiasis, which is the third most common opportunistic infection in human immunodeficiency virus (HIV)/AIDS patients in Indonesia. Overuse of this drug could lead to the emergence of resistance. The objective of this study was to analyse the role of ERG11, CDR1, CDR2 and MDR1 gene overexpression and mutations in the ERG11 gene as a genetic mechanism of fluconazole resistance in Candida albicans isolated from HIV patients in Indonesia. Overexpression of ERG11, CDR1, CDR2 and MDR1 was analysed by real-time reverse transcription PCR, while ERG11 gene mutation analysis was performed using sequencing methods. Seventeen isolates out of 92 strains of C. albicans isolated from 108 HIV patients were found to be resistant to azole antifungals. The highest gene overexpression of ERG11 was found in C. albicans resistant to single fluconazole, while the highest gene overexpression of CDR2 was detected in all isolates of C. albicans resistant to multiple azoles. Amino acid substitutions were observed at six positions, i.e. D116E, D153E, I261V, E266D, V437I and V488I. The amino acid substitution I261V was identified in this study and was probably associated with fluconazole resistance. The combination of overexpression of CDR2 and ERG11 and mutation in the ERG11 gene was found to be a genetic mechanism of fluconazole resistance in C. albicans isolated from HIV patients in Indonesia.

Background: This study examined the susceptibility of Gram-negative bacteria in the bloodstream to antimicrobials with the aim of providing information relevant to the guidance of therapy. Methodology: Blood specimens received by the Laboratory of Clinical Microbiology, Faculty of Medicine, University of Indonesia, from 2002 to 2008, were analyzed for the presence of Gram-negative bacteria and their susceptibility to four antibiotic groups frequently administered in hospitals and community settings. Results: During the seven-year period leading up to 2008, approximately 68% of Gram-negative bacteria were identified among all positive isolates from blood specimens. The eight most frequent species found were Acinetobacter anitratus (25.8%), Pseudomonas aeruginosa (19.5%), Klebsiella pneumoniae subsp. pneumoniae (14.5%), Enterobacter aerogenes (8%), Salmonella Typhi (7.5%), Escherichia coli (6.2%), Alcaligenes faecalis (5.6%) and Klebsiella oxytoca (3.2%). At 80% susceptibility or greater, Ceftriaxone and Cefotaxime were active only on E. coli and S. Typhi. Cefepime demonstrated activity on all eight species tested except K. pneumonia while Amikacin showed activity against five species, A. faecalis , E. aerogenes , E. coli , K. pneumoniae subsp. pneumoniae and S. Typhi. Gentamycin was active against three species: E. aerogenes , K. oxytoca and S. Typhi. Ciprofloxacin and Levofloxacin significantly differed in their spectrum: while Ciprofloxacin was active against four of the eight species tested ( E. aerogenes , E. coli , K. oxytoca , and S. Typhi ), Levofloxacin was similar to Cefepime and was active against all eight species except K. pneumoniae subsp. pneumonia. Conclusions: Since antimicrobials are broadly used in Jakarta, it is important that the information captured in this study be disseminated.

Aim To do in vitro test to assess the efficacy of hydrophobic dressing Cutimed® Sorbact® to bind multiresistant bacteria that caused wound infection, the methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa.Method This was a cross sectional study that was conducted in the Department of Microbiology, Faculty of Medicine, University of Indonesia, on January 2009. In-vitro testing of sterile hydrophobic dressing to bind microorganisms was conducted by counting MRSA and Pseudomonas aeruginosa that were bound to 1 square centimetre of single layersterile hydrophobic dressing (Cutimed® Sorbact®). Every test was done in triplicate at 0.5, 1, 5, 10, 30 minutes, 1, 2, 3, and 4 hours. To compare the hydrophobic dressing capability to bind microorganisms, in vitro testing of sterile conventional dressing to bind microorganisms on 0.5 minutes and 2 hours was done.Result The binding capacity of sterile hydrophobic dressing began at 0.5 minutes and teached a maximum at 2 hours. Compared with conventional dressing, sterile hydrophobic dressing had more binding capability to MRSA and Pseudomonas aeruginosa.Conclusion Hydrophobic dressing (Cutimed® Sorbact®) had a higher capability to bind MRSA and Pseudomonas aeruginosa compared to conventional dressing. (Med J Indones 2009;18:155-60)Key words: hydrophobicity, MRSA, Pseudomonas aeruginosa

The spread of drug resistant microbes is a global public health challenge which impairs the efficacy of antimicrobial agents and causes substantial increase in morbidity and mortality rates, including healthcare-associated costs. Monitoring of antimicrobial drug resistance from documented microbial epidemiology & resistance rate is useful in preventing the emergence of resistance. This study reports on the pattern of bacterial resistance against ceftriaxone in the past 4 years. The data were obtained from specimens examined in the Clinical Microbiology Laboratory, Department of Microbiology Faculty of Medicine, University of Indonesia from 2002 to 2005. Microbial species were determined from culture and identification tests. Disc diffusion method was used for sensitivity testing of ceftriaxone to 14 Gram-negative and 7 Gram-positive bacteria. Although resistance rates were increased from 2002 to 2005, resistance rates of ceftriaxone were found to be less than 50%. Low resistance rates (< 3%) were observed for Salmonella typhi, Salmonella paratyphi A, Shigella flexneri, Serratia marcescens, and Streptococcus pneumoniae. These results could be useful in developing guidelines on the use of ceftriaxone in Indonesia. (Med J Indones 2007; 16:3-6) Keywords: Microbial drug resistance, disc diffusion method, Gram-positive, Gram-negative