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Background: Heterologous priming with the inactivated SARS-CoV-2 vaccine (CoronaVac) and boosting with mRNA-based COVID-19 vaccine (Moderna or Pfizer) is currently recommended in Indonesia. The reactogenicity data of these heterologous vaccine regimens are not entirely available, particularly in young adults.The present study, therefore, aimed to evaluate the solicited local and systemic reactions in the first seven days post-vaccination either with Moderna or Pfizer vaccine among previous recipients of two doses of CoronaVac.Materials and Methods: An electronic-based cross-sectional study was conducted among medical students at the Pelita Harapan University, Banten, Indonesia, who received mRNA-based COVID-19 vaccine following two doses of CoronaVac. Samples were collected using a cluster sampling technique. Comparison between groups was performed by Fisher’s exact test.Results: A total of 72 participants, with 23 (32%) of which received the Moderna vaccine and 49 (68%) received the Pfizer vaccine, were included in this study. The median age of participants was 21 (IQR 19-22) years old. The most common local and systemic events for mRNA-based COVID-19 vaccines were injection site pain, fever, headache, fatigue, myalgia, and arthralgia. Solicited local and systemic reactions were reported more frequently in Moderna recipients than Pfizer recipients. Most local and systemic reactions were graded as mild to moderate and did not lead to hospitalization.Conclusions: The reactogenicity of the heterologous prime-boost with CoronaVac and mRNA-based COVID-19 vaccine booster among young adults is reassuring, and no unexpected concerns were identified.

BACKGROUND: Antimicrobial resistance is one of the world’s problems. It occurs due to misuse of antimicrobials in dealing with infectious diseases, making antimicrobial drugs less effective in treating infectious diseases. Antimicrobial sensitivity pattern is useful for directing clinicians in empirical therapy and preventing antimicrobial abuse so that resistance to antimicrobial drugs does not occur. AIM: This research is conducted to identify the microorganism spectrum and its sensitivity pattern at the intensive care unit (ICU) of a secondary care teaching hospital in Tangerang, Indonesia. METHODS: This study is a cross-sectional observational retrospective study done in the ICU of secondary care teaching hospital in Tangerang, Indonesia from January 2019to June 2020. This study used 1,341 isolated extracted from the ICU of a secondary care teaching hospital in the Tangerang database. All the samples would be analyzed using Microsoft Excel 2013 and Statistical Package for the Social Science 25 (SPSS 25) using ANOVA analysis. RESULTS: From 1,341 isolates, the most common microorganism found was Klebsiella pneumoniae 221(16%) and the most common specimen is sputum 905 (67,48%). Gram-negative bacteria had the highest sensitivity to amikacin 62% and imipenem 59%. Gram-positive bacteria had the highest sensitivity to tigecycline 98% and doxycycline 95%. While Candida spp. had the highest sensitivity to micafungin (96%) and voriconazole (97%). CONCLUSIONS: This study showed that the sensitivity of antimicrobials was no longer effective in treating infection. Therefore, the government and doctors must play an important role in socializing the correct way of using antimicrobial.

Mucorales is the cause of mucormycosis, an emerging opportunistic infection in the era of coronavirus disease 2019 (COVID-19) pandemic. Condition of hyperglycemia, diabetes mellitus, and acidosis; dysregulated iron homeostasis in the form of hyperferritinemic syndrome, and high concentration of iron in circulation; and endothelial injury related to abundance glucose regulated protein 78 (GRP78), which are present in severe COVID-19, could favor Mucorales infection. In this short communication, we summarized how the dysregulated iron homeostasis in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection benefits Mucorales.

Background As healthcare workers (HCWs) are at high risk for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), they have priority for receipt of the coronavirus disease 2019 (COVID-19) vaccine. The inactivated SARS-CoV-2 vaccine has been used in Indonesia to induce an antibody response against SARS-CoV-2 infection in HCWs. However, information regarding the kinetics of antibodies induced by this vaccine remains scarce. Objective To investigate the magnitude and durability of antibodies against the spike (S) protein (anti-S) in fully-vaccinated HCWs using an electrochemiluminescence immunoassay. Results Seroconversion of anti-S antibodies was observed among 159 (99.4%) of 160 HCWs without prior SARS-CoV-2 infection 14 days after full-dose vaccination. The level of anti-S antibodies decreased significantly by day 42 post-vaccination compared with day 14 post-vaccination, but persisted for up to 98 days post-vaccination. In contrast, vaccinated HCWs with prior SARS-CoV-2 infection had significantly higher, stable levels of anti-S antibodies compared with vaccinated HCWs without prior SARS-CoV-2 infection. Conclusion The remarkable decline and lower level of anti-S antibodies among HCWs without prior SARS-CoV-2 infection may indicate the need for an additional booster dose of SARS-CoV-2 vaccine for protection against COVID-19. This study of antibody responses induced by the inactivated SARS-CoV-2 vaccine among HCWs may contribute to future policy decisions regarding vaccination.

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 its susceptibility 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 MDROs definition 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%) among MDROs. 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.

Objective:Health-care workers (HCWs) in Indonesia have been participating in the war against the coronavirus disease-2019 since March 2020. Ever since HCWs were exposed to the regular use of personal protective equipment (PPE) with varying levels and maintain hand hygiene more as recommended by the World Health Organization. Adverse skin reactions to PPE in Indonesia has yet to be acknowledged. This study aimed to study the prevalence and characteristics-, possible risk factors-, and suggest possible solutions towards adverse skin reactions to PPE among HCWs in a multi-center setting of Indonesia.Methods:A cross-sectional survey was conducted online among HCWs in the Siloam Hospitals Group of Banten province. HCWs of Banten Province were surveyed from June 1 to August 31, 2020. The data was obtained using avalidated online survey questionnaire including (1) demographic characteristics;(2) occupational-related characteristics;(3) adverse skin reactions.Results:A response rate of 40.2% was obtained and 200 valid respondents were yielded. The mean age of respondents was (26.94±7.23) years old. Adverse skin reactions (66.5%) were reported primarily in female (73.7%) working as doctors (82.7%) of a non-referral center for coronavirus disease-2019 (60.2%) wearing level 2 and 3 PPE (43.6% and 37.6%, respectively). The cheeks and chin was the most common site involved (69.9%) with dryness/tightness (63.9%) and acne (77.4%) as the highest symptoms and signs reported. Sex, age group classification, level of PPE worn, hand hygiene frequency, and duration of PPE worn daily were factors considerably associated with adverse skin reactions to PPE (P

Background : Antibiotic resistance has been a long - debated topic since decades ago. The development of stronger, newer antibiotics, implementation of antibiotic stewardship and revised guidelines remain t he main focus of our society to prevent resistancy. But is it really resistancy that cause higher mortality to patients with multidrug resistance (MDR) infections? Methods : We conducted a cohort retrospective study from 2016 to 2019 in our Intensive care u nit (ICU). Antimicrobial susceptibility test (AST) results were analyzed for their association with patient mortality outcomes. Results : Over the four - year period, 381 positive bacterial cultures were analyzed and 51% of them grew MDR pathogens upon their first culture. The overall mortality rate was 19% (38/195), and there was no significant association between MDR and mortality; p 0.387. A strong association was however found between patients with medical cases with an OR 1.76; CI 1.76 - 2.55; p 0.003 and t hose with APACHE scores ≥20 upon admittance to the ICU, OR 1.32; CI 1.68 - 8.29; p 0.001 . Conclusion : Resistancy is not the true cause of mortality. Infection by resistant microbes does not necessarily mean the worst outcome since virulency is the actual cau se of pathogenicity, and thus mortality

Background Healthcare workers (HCWs) compared to the general population are at an increased risk of exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease-19 (COVID-19). Therefore, they are given priority for the COVID-19 vaccine in the national COVID-19 vaccination campaign in Indonesia. However, when the daily new COVID-19 cases are still high, and the data regarding the vaccine’s efficacy in healthcare settings remains unavailable, the vaccinated HCWs still likely to get COVID-19 infection and at risk for further transmission. Objective To identify COVID-19 cases among vaccinated HCWs at Siloam Teaching Hospital, Indonesia, via active and passive surveillance conducted by the hospital’s COVID-19 infection prevention and control unit Results Among 1,040 HCWs who have received the first and second vaccination, 13 (1.25%) HCWs were positive for SARS-CoV-2 RNA detection by reverse-transcriptase polymerase chain reaction (RT-PCR) from 2-11 days (median five days) after the second vaccination. Conclusion The early laboratory-confirmed COVID-19 among post-vaccinated HCWs indicates that HCWs are still at risk to acquire COVID-19 disease during the vaccination campaign. Therefore, the presence of symptoms after vaccination cannot be considered as vaccine-related symptoms, and regular COVID-19 testing should be conducted among HCWs.

The presented cases describe the concurrent SARS-CoV-2 infection and inactivated SARS-CoV-2 vaccination among eight healthcare workers (HCWs). These cases highlighted the importance of broad hospital screening during the COVID-19 vaccination campaign. Further study regarding the durability of antibody response induced by infection and first-dose vaccination is required to determine the appropriate time for giving a second dose of inactivated SARS-CoV-2 vaccine among these cases.

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.

Ventricular infection due to XDR-Acinetobacter baumanii(A. baumanii) is the most severe complication after neurosurgery which associated with high morbidity and mortality. ManagingA. baumaniiventriculitis/shunt infection and multiple brain abscesses is challenging since its nature that tends to be pandrug resistant to all antibiotics used. Thus, we present the first such case with problems in administration based on the available data.

Since the occurrence of the coronavirus disease-2019 pandemic, healthcare workers (HCWs) have been strictly adhering to infection control practices within healthcare facilities. However, regular use of personal protective equipment (PPE) and hand hygiene have led to increased prevalence of skin damage, subsequently impacting the quality of life (QoL).To analyse the connection between skin damage and the QoL among HCWs in a multicenter setting in Indonesia.A cross-sectional survey was conducted among HCWs working in hospitals in Banten Province, Indonesia. The data was obtained using a reliable self-reported questionnaire (Cronbach α 0.765) and a validated Indonesian version of the Dermatology Life Quality Index.A total of 113 respondents (56.5%) who experienced at least one self-perceived PPE-related skin damage and had worn PPE of any level within the last 7 days were analysed. The mean age ± SD of respondents was 26.09 ± 6.22 years old, while the mean DLQI score ± SD was 5.46 ± 4.88, with a median of 4.0 (range, 0-24). The regression model showed that the level of PPE used (Skin damage due to PPE affects HCWs physically and emotionally. It is crucial to recognise its impact on life and reinforce awareness, prevention, and treatment of skin damage. Dermatologist referral and intervention should be considered for optimum management.

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 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. 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.

Menyebarnya penyakit dengue di dunia, khususnya Indonesia adalah sebagai akibat dari pengaruh meningkatnya proporsi kasus dewasa. Infeksi virus dengue seringkali memberikan gejala klinis non-spesifik dan singkatnya waktu infeksi, karena itu uji diagnostik laboratorium cepat, dan identifikasi penanda dengue yang dapat segera dilakukan dan mudah diperoleh tetap menjadi prioritas. Deteksi dini pada pasien infeksi virus dengue secara substansial ditujukan untuk mengkonfirmasi dan mengendalikan manajemen klinis. WHO (Organisasi Kesehatan Dunia) dan beberapa penelitian menunjukkan bahwa deteksi antidengue NS-1 dengan/atau tanpa IgM sebagai faktor indicator untuk menyingkirkan infeksi virus lainnya. Risiko kejadian penyakit dengue yang parah dan dirawat di rumah sakit sering tidak nampak pada pasien dewasa yang lebih tua, hal ini menunjukkan bahwa kelompok pasien ini harus mendapatkan manfaat dari deteksi dini. Pada pasien dewasa yang mempunyai gejala demam dan leukopenia harus dilakukan pemeriksaan terhadap virus dengue. Namun demikian, gejala klinis demam, trombositopenia, leukopenia, dan monositosis lebih konsisten ditemukan pada pasien terinfeksi virus dengue daripada kasus negatif.

Meningitis kriptokokus adalah infeksi sistem saraf pusat dengan onset subakut atau kronis, disebabkan oleh sel ragi berkapsul Cryptococcus neoformans. Pasien dengan MK biasanya adalah pasien imunodefisiensi/imunokompromais. Di negara-negara Asia Tenggara, penyakit infeksi oportunistik yang sering dijumpai pada pasien Human Immnunodeficiency Virus (HIV) stadium lanjut adalah MK. Meningitis kriptokokus juga ditemukan pada riwayat penggunaan steroid sistemik, terapi immunosuppresive, transplantasi organ, gagal ginjal, keganasan, penyakit reumatik, diabetes melitus, dan systemic lupus erythematosus atau bahkan pada pasien yang imunokompeten sekalipun. Penelitian ini merupakan studi deskriptif retrospektif potong lintang yakni pengambilan data rekam medis hasil pemeriksaan neurologis dan analisa carian serebrospinal (CSS) penderita MK yang dirawat di Siloam Hospitals Lippo Village dari bulan Januari 2009 hingga September 2014. Teknik pengumupulan data pada penelitian ini dengan mengumpulkan data dari rekam medis. Dari 8 subyek penelitian yang memenuhi kriteria inklusi diperoleh hasil: pasien meningitis kriptokokus dengan HIV (+) sebanyak 6 orang (75%) dan dengan HIV (-) sebanyak 2 orang (25%). Proporsi pria dan wanita sebesar 3:1. Rentang usia subyek dari 4 hingga 55 tahun dimana sebagian besar subyek penelitian berusia sekitar 20-40 tahun dengan hasil pemeriksaan HIV (+). Saat masuk rumah sakit, secara keseluruhan gejala yang paling sering ditemukan pada subyek berupa nyeri kepala (87.5%). Meskipun memiliki sejumlah kelemahan data hasil penelitian ini diharapkan dapat bermanfaat bagi perkembangan neurologi khususnya neuroinfeksi di Banten. Di masa yang akan datang diharapkan dapat dilakukan penelitian dengan skala yang lebih besar dan komprehensif.

Patogen MDRO, seperti vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), Acinetobacter spp., extended spectrum beta-lactamase (ESBL)-producing bacteria, dan Clostridium defficile seringkali menyebabkan kolonisasi/healthcare-associated infection (HAI) di lingkungan ICU. Sejumlah penelitian membuktikan bahwa petugas kesehatan menularkan pathogen ini melalui kontak langsung dengan tangan atau sarung tangan setelah menyentuh permukaan yang terkontaminasi atau pasien. Lingkungan berperan penting pada penyebaran hospital-acquired pathogens (HAP) dan terjadinya HAI. Metode pembersihan dan dekontaminasi rutin yang telah diterapkan dan dilakukan di lingkungan rumah sakit seringkali gagal ataupun tidak efektif dalam menggurangi penyebaran patogen MDRO. Kegagalan ini disebabkan tidak seluruh permukaan medis dan rumahtangga yang seringkali tersentuh tidak terdekontaminasi dengan sempurna. Untuk itu diperlukan tindakan lanjutan berupa pembersihan terminal menggunakan metode baru, seperti (1) hydrogen peroxide vapor (HPV) dan (2) sinar UV yang telah terbukti efektif secara mikrobiologi, aman dan mudah digunakan.

Background: Multi-Drug Resistance Organisms (MDROs) are defined as organisms that acquired non-susceptibility to more than one antimicrobial agent. Intensive care patients are immune-compromised patients, using catheter and are given broad-spectrum antibiotics. Hence, the chance to develop microbial resistance is high. The aim of this study is to see the etiology and the microbial susceptibility pattern of catheter-associated urinary tract infection patients treated in intensive care.Materials and Methods: The urine samples were taken from catheterized patients admitted to intensive care in Siloam Lippo Village, Tangerang, Indonesia in a one year period from July 2013 until June 2014. We confirmed species identification with Vitex-2 Compact® from Biomérieux, France. The susceptibility of antibiotics is according to Clinical and Laboratory Standard Institute (CLSI). Results: We managed to get 113 urine culture results with mean of age 57.03 ± 18.505 (years). There were 67 males (59.3%) and 46 females (40.70%) that were acquired in the sample. The result of species identification showed that Escherichia coli was the dominant isolate from the urine culture (40.63%), followed by Klebsiella pneumoniae (12.5%). The percentage of MDRO was found to be 71.9%. The antibiotics susceptibility of Escherichia coli for Amoxicilin, Ampicillin/Sulbactam, Ciprofloxacin and Levofloxacin are 50%, 58%, 76% and 75% respectively. Meanwhile the susceptibility against Amikacin and Meropenem are 100% for Escherichia coli and Klebsiella pneumoniae. Conclusion: The proportion of Escherichia coli was the highest among with susceptibility of Meropenem was still high susceptibility for both gram negative and gram positive bacteria.

The World Health Organization (WHO) 1997 / WHO (Regional Office of South-East Asia) SEARO 2011 and WHO 2009 dengue guideline emphasized different aspects. Indonesia as a limited resources hyperendemic area will a large number of patients hopitalized using the WHO 2009. This study compared the adult non severe dengue cases in out-patient settings using both classification. This retrospective cohort study on 85 patients found 48 dengue cases confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) on the period of August 2011 – January 2012, in 5 out-patient settings health facilities. The sensitivity and spesificity of WHO 1997 / WHO SEARO 2011 were 48.93% and 23.68%, while the WHO 2009 were 78.72% and 68.42%. Out of 8 secondary infection patients, 25% in WHO 1997 / WHO SEARO 2011 and 0% in WHO 2009 were classified as the more severe form. The WHO 2009 shown higher sensitivity and specificity, but the WHO 1997 / WHO SEARO 2011 could diagnose more patient that would have suffered severe forms of dengue and also more secondary infection who have the probability of severe forms compared to WHO 2009.Keywords: dengue, out-patient setting, world health organization

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%. Keywords: intra-abdominal infections, clinical characteristics, microbiological profiles

Acinetobacter baumanii (A. baumanii) has arisen as the most important cause of nosocomial infection, typically in severely ill patients with many comorbidities and medical supportive devices. Tigecycline is a therapeutic option for treating this infection because of its potential ability against wide spectrum of bacterias, including multi-drug resistance A. baumannii (MDRAB). Our study determine the in vitro susceptibility of tigecycline against A. baumanii isolates and the emergence of MDRAB. The frequency of isolates that were not inhibited at MIC ≤ 0.5 µg/ml was 50.46%, at MIC = 1µg/ml was 2.38%, and at MIC = 2 µg/ml was 19.07%. The susceptibility rate of tigecycline against A. baumanii was 68.27% in 2015, 79.58% in 2016, and 67.87% in 2017. In vitro result demonstrated that tigecycline had good value of MIC against A. baumanii at the range of 0.5 to 2 µg/ml.

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.