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Objective:Acinetobacter baumanniiis a Gram-negative opportunistic bacteria with carbapenemase-associated antibiotic resistance accounting for a majority of nosocomial infections globally. We sought to detectcarbapenemase producers among carbapenem-resistant A. baumannii(CRAB) clinical isolates using Blue-Carba Test(BCT).Methods: This study was an observational descriptive study. At first, A. baumanniiclinical isolates (142) were collected from January 2014 to September 2017and stored at the Microbiology Laboratoryof the Faculty of Medicine, Atma Jaya Hospital. Next step involved the identification of the carbapenem-resistant isolates using WHONET 5.3 software (https://whonet.org/software.html). Here, Imipenem and Meropenem served as markers. Finally, the identified carbapenem-resistant isolates were subjected to Blue-Carba Test. Results: Among 142 A. baumannii isolates, 51.4% (73/142) were identified as CRAB. Of these, 36 isolates were revived and all were found to be carbapenemase positive. Conclusion: Conclusively, a cent percent (36/36) prevalence of carbapenemase producers was observed in the CRAB group, which is an important clinical finding for antibiotic selection against A. baumannii infection.©2022iGlobal Research and PublishingFoundation. All rights reserved.

Introduction: Deep neck abscess is a pus accumulation in the space and tissue of the cervical fascia caused by an infection and has the potential for several complications. Appropriate use of antibiotics can prevent these complications, but long culture time has been a main concern. Diabetes and oral hygiene are identified as commonly found risk factors for deep neck abscess. This study aims to analyze patients’ characteristics and the usage of antibiotics in treating deep neck abscess patients in Atma Jaya Hospital as well as assessing the effect of diabetes and oral hygiene as the causes for deep neck abscess. Methods: This was a cohort retrospective, descriptive analytic study. The samples were from 23 deep neck abscess patients undergoing treatment in Atma Jaya Hospital and met the inclusion and exclusion criteria. Chi square and Fisher exact test were used to determine the significance effect of diabetes and higiene oral in relation to deep neck abscess. Results: There were more male patients than female patients with age range 20-30 years old. Streptococcus viridans and Streptococcus pyogenes were the most common bacteria causing deep neck abscesses. Metronidazole, gentamicin and ceftriaxone were the most widely used antibiotics and it had shown great compatibility to fight against germs found in this disease. Statistical test results on the effect of oral hygiene oral to submandibular abscesses, peritonsillar, and Ludwig’s angina were p(AS)=0.605, p(AP)=1.000, and p(LA)=1.000, while of diabetes were p(AS)=0.685, p(AP)=0.657, and p(LA)=1.000. Conclusion: Deep neck abscess tends to occur in male patients of productive age. Metronidazole, gentamicin and ceftriaxone were the recommended empiric antibiotics. There was no significant relationship between oral hygiene and diabetes on the occurrence of deep neck abscesses.

Introduction: : Practicing hand hygiene is a way to control an infection. The recent COVID-19 pandemic, hand hygiene has become the necessity. Using antiseptic which contain chemical active ingredients causes skin problem. Camellia sinensis is a natural ingredient which its antimicrobial properties is due to the presence of catechin. The study was aimed to determine the effectivity of ethanol extract of Camellia sinensis tea leaves as hand antiseptic. Methods: This research was a comparative experimental analytic to 32 respondents conducted in the Microbiology Laboraroty of Faculty Medicine and Health Sciences–Atma Jaya Jakarta Catholic University of Indonesia. Sampling was carried out by taking bacterial swabs on the right palms. Followed by dilution using serial dilution method and inoculated onto nutrient agar using the spread plate technic. After incubation at 37oC overnight the bacterial colonies were calculated using colony counter within a range of 30-300 colonies per plate. Wilcoxon and Mann-Whitney was used for data analysis. Results: The total number of bacterial colonies after sanitizing using 50% ethanol extract of Camellia sinensis tea leaves was reduced by 55.04% (p=0.003). Meanwhile, 70% alcohol curb the bacterial colonies by 76.84% (p=0.000). The comparison of the effectivity of 50% ethanol extract of Camellia sinensistea leaves versus 70% alcohol as hand antiseptic was insignificance (p=0.300). Conclusion: 50% ethanol extract of Camellia sinensis tea leaves showed activity against hand’s microorganisms. However, the percentages of Camellia sinensis extract might be increased so as to achieve the effectivity of 70% alcohol.

Introduction: Acinetobacter baumannii, a multidrug-resistant Gram-negative opportunist has been known among the cause of nosocomial infection. Risk factors of infection related to A. baumannii have been reported elsewhere. This study aimed to find the association of A. baumannii positive culture and invasive procedures in patients hospitalized in the Intensive Care Unit and Hospital ward in Jakarta. Methodology: This study was a retrospective, 1:1 matched case-control study with total sampling method from in-patients in the ICU and the Internal Medicine Wards (IMW) of a Private Hospital, North Jakarta in 2015 - 2018. Data retrieved were positive culture of A. baumannii. Positive cultures of multi-sensitive bacteria were included as a control group. Antibiotic susceptibility test was carried out as recommended by Clinical and Laboratory Standards Institute. Results: A total of 88 in-patients were studied, and A. baumannii isolates were identified from 44 patients. Most of A. baumannii showed resistant to almost all antibiotics tested, except for colistin. Bivariate analysis showed a significant association of A. baumannii positive culture and the use of ventilator in the ICU (p = 0,039), and with urinary catheters in the IMW (p = 0,022). Multivariate analysis showed that length of stay also has a significant association to A. baumannii positive culture in the ICU. Conclusion: The use of ventilators and urinary catheters showed a significant association with Acinetobacter baumannii positive culture in patients in the ICU and in the IMW respectively. All of the A. baumannii isolates were susceptible to colistin.

Objective The prevalence of Mycoplasma hominis and Ureaplasma urealyticum (genital mycoplasma) amongst Indonesian women is poorly understood because of limited availability of diagnostic techniques. We sought to compare the diagnostic parameters of the AF Genital System® with those of culture methods and PCR as the gold standard for identification of M. hominis and U. urealyticum in vaginal swab specimens. Methods This was an observational diagnostic study. Eighty-eight specimens were collected from patients with abnormal vaginal discharge. Detection of M. hominis and U. urealyticum was performed using the AF Genital System®, culture methods, and PCR. Results Compared with PCR and culture methods, respectively, the AF Genital System® had sensitivities of 66.6% and 57% ( M. hominis) and 55.5% and 77.8% ( U. urealyticum). Compared with PCR and culture methods, respectively, the AF Genital System® had specificities of 82.9% and 86.5% ( M. hominis) and 82.3% and 84.8% ( U. urealyticum). Conclusion The sensitivity of the AF Genital System® for detection of M. hominis and U. urealyticum from vaginal swab samples was lower than that of PCR, but specificity was reasonably good (82% to 83%).

Latar belakang: Pneumonia akibat bakteri Legionella masih menjadi masalah di berbagai tempat di dunia; menjadi penyebab 2-15 % dari pneumonia yang perlu di rawat di Rumah Sakit. Kasus legionellosis di Indonesia dilaporkan terjadi di Bali pada tahun 1996 dan di Tangerang tahun 1999. Keberadaan Legionella di fasilitas Pelayanan Kesehatan berpotensi sebagai penyebab infeksi nosokomial. Bakteri Legionella hidup di lingkungan perairan hangat dan lembab, juga ditemukan diberbagai sumber air seperti, sumber air sistem pendingin ruangan, kolam renang, tempat penampungan air di rumah sakit, perkantoran, hotel, dan perumahan sehingga turut berkontribusi dalam terjadinya community acquired dan pneumonia nosokomial. Metode: Penelitian ini merupakan penelitian deskriptif yang bertujuan untuk penapisan keberadaan Legionella pneumophila diberbagai sumber dan penampungan air di Rumah Sakit (RS) di Jakarta dengan menggunakan medium Legionella Charcoal Yeast Extract (CYE) dan dengan berbagai suplemen. Tujuh belas sampel air yang berasal dari berbagai sumber air di dua RS yang berlokasi diJakarta Utara dan Barat telah diteliti. Hasil: Dua puluh satu koloni yang ditemukan memiliki karakterisitik L. pneumophila dari semua varian medium, namun pada tes agglutinasi latex tidak memberikan reaksi positif. Kesimpulan: L. pneumophila tidak ditemukan diberbagai sumber air dari dua RS ini. Penggunaan metode yang lebih sensitif dan spesifik perlu dilakukan untuk memastikan ditemukannya L. pneumophila. Kata kunci: Legionellosis, Legionella pneumophila, medium BCYE Abstract Background: Pneumonia due to Legionella bacteria is still a problem in various places in the world, causes 2 15% of pneumonia that need hospitalization. In Indonesia, legionellosis cases have been reported in Bali in 1996 and Tangerang in 1999. The existence of Legionella in healthcare facilities is potential to cause nosocomial infections. Legionella bacteria live in warm and humid waters, and are also commonly found in various water sources, such as water cooling systems, swimming pools, water reservoirs in hospitals, offices, hotels and housing. These bacteria contribute to the occurrence of community-acquired and nosocomial pneumonia. Methods: This study was a descriptive research, and aimed to screen water sources and reservoirs in the hospitals in Jakarta for the existence of Legionella pneumophilla using Legionella Charcoal Yeast Extract (CYE) medium with various supplements. A total of 17 water samples from 2 hospitals located in West and North Jakarta have been examined. Results: The results showed a total of 21 colonies with characteristics as of L. pneumophila were obtained from those water samples, however, none showed positive results in the latex agglutination test. Conclusion: L. pneumophila was not found thus far in the water sources in these two hospitals. A more sensitive and specific approaches might be used to enable the findings of L. pneumophila. Keywords: Legionellosis, Legionella pneumophila, BCYE medium

BACKGROUND: Antibiotic resistance has become a worldwide problem. Among Asia countries, Indonesia has high prevalence of multi-drug resistant organisms mainly due to Gram-negative bacilli Enterobacteriaceae. This study aimed to find out whether gene family of AmpC and AmpC/ESBL-producing Enterobacteriaceae were present in the Intensive Care Unit (ICU) of Cipto Mangunkusumo Hospital, Jakarta, Indonesia. METHODS: Specimens were obtained from several body sites of adult patients with infection hospitalised in ICU of Cipto Mangunkusumo Hospital. VITEK®2 was used to identify the microorganisms. Antibiotic susceptibility tests were conducted using VITEK®2 and disc diffusion technique according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Double disc synergy (DDS) test method was employed to detect AmpC activity. Gene families of ampC were identified using multiplex polymerase chain reaction (PCR). RESULTS: Forty five isolates were identified as putative AmpC, extended-Spectrum β-lactamases (ESBL) and AmpC/ESBL-producing Enterobacteriaceae. Klebsiella pneumoniae (n=32) were predominant, followed by Escherichia coli (n=6), Enterobacter cloacae (n=5) and Enterobacter aerogenes (n=2). AmpC activity was detected in 9 isolates, in which 4 isolates were AmpC producing and 5 isolates were AmpC/ESBL. In vitro , AmpC-producing Enterobacteriaceae showed good susceptibility to many antibiotic tested, while those of AmpC/ESBL-producing only to Amikacin. The gene families of ampC were DHA, EBC and CIT identified from 6 isolates. CONCLUSION: DHA, EBC and CIT gene families were identified from AmpC and AmpC/ESBL-producing Enterobacteriaceae in the ICU of Cipto Mangunkusumo Hospital. While the AmpC-producing was still susceptible to almost all antibiotics tested, the AmpC/ESBL-producing showed resistant except for Amikacin. KEYWORDS: Enterobacteriaceae, β-lactamases, AmpC, ESBL

Introduction: Potentially toxigenic Corynebacteria (Corynebacterium diphtheriae, Corynebacterium ulcerans, and Corynebacterium pseudotuberculosis) can produce diphtheria toxin and stated as diphtheria causative agent. The bacteria causing diphtheria could be identified by Cystinase test on the Tinsdale medium, while its toxigenicity determined by Elek test on the Elek medium. This study aims to develop a new modified medium for both Cystinase and Elek tests simultaneously.Methods: There were ten reference strains of bacteria used for the modified medium optimization. Moreover, 15 clinical isolates were used as samples in the modified medium testing. The result of Cystinase and Elek tests on the modified medium was compared with the standardized tests on the Tinsdale and Elek mediums.Results: Twelve of 25 isolates tested on the modified medium were identified as toxigenic strain, corresponding with the result from standardized Elek test on the Elek medium. Moreover, 16 of 25 isolates tested on the modified medium were identified as positive for Cystinase test. The similar result was obtained using the standardized Cystinase test on the Tinsdale medium. This result was visible 24 hours after incubation. The modified medium was in excellent condition with the consistent result after stored in half-finished condition for 32 days at 2-8 oC.Conclusion: The modified medium developed in this study was a new good medium that could be used for Cystinase and toxigenicity tests simultaneously.

Quick and precise methods have always been needed in the medical field to correctly identify the agent of infection. Automated systems for diagnosis of infectious pathogen such Pseudomonas aeruginosa from critical patients with infections in the Intensive Care Unit is essential. This study aimed to compare the capability of automated biochemistry-based identification system, TDR-300B and VITEK®2, to the one of Matrix-Assisted Laser Desorption/Ionization - Time of Flight (MALDI-TOF), VITEK®-MS, in the identification of P. aeruginosa.Samples were P. aeruginosa isolates collection from Laboratory of Microbiology, Faculty of Medicine and Health Science UNIKA Atma Jaya. These isolates were refreshed; one single colony of oxidase-positive Gram-negative rods was further inoculated in TDR-300B NF-64 cards and VITEK®2 GN cassettes. The bacterial identification was also carried out using VITEK®-MS as gold-standard. Positivity of TDR-300B and VITEK®2 in the identification of P. aeruginosa was 87.09% (27/31) and 90.32% (28/31) in the species level, and 87.09%, 96.77% in the genus level respectively. The congruity of TDR-300B/ VITEK®2 in the species and genus level was 83.87% and 87.09%. When compared to VITEK®-MS, congruence of VITEK®2 was 93.30% (24/26) and TDR-300B was 80.76% (21/26). Sensitivity value for TDR-300B and VITEK®2 was high, 95.45% and 100%, positive predictive value and accuracy were lower in TDR-300B than VITEK®2; Fisher’ exact value was >0.05, thus there were no significant differences in the capability of TDR-300B and VITEK®2 in the identification of P. aeruginosa.

Objective Automated systems are needed for the rapid and accurate diagnosis of Pseudomonas-associated nosocomial infections among critically ill patients admitted to the intensive care unit. We assessed the performance of TDR-300B and VITEK®2 for the identification of P. aeruginosa using VITEK®-MS as the gold standard. Methods This analytical study employed a cross-sectional approach. First, 44 clinical isolates of P. aeruginosa were collected and refreshed. Next, a single colony of oxidase-positive, gram-negative rods (30 samples) was inoculated into a TDR-300B NF-64 card and VITEK®2 GN cassette for each isolate. Finally, bacterial identification was performed using VITEK®-MS for comparative analysis. Results Compared with the results for VITEK®-MS, the congruence rates for TDR-300B and VITEK®2 were 80.76% (21/26) and 92.30% (24/26), respectively. Further, high sensitivity was observed for TDR-300B and VITEK®2 (95.45% and 100%, respectively). In addition, TDR-300B had a lower positive predictive value and accuracy than VITEK®2, albeit without significance. Conclusions Conclusively, there were no significant differences regarding the diagnostic efficiency of TDR-300B and VITEK®2 for P. aeruginosa.

Aim: to report the presence of environmental microorganisms, A. anitratus, in blood of hospitalized patients in Jakarta from 2002 to 2008 and their susceptibility to antibiotics.Methods: A Retrospective study w as performed on all blood specimens that were received in Clinical Microbiology Laboratory (CML) Faculty of Medicine University of Indonesia during 2002-2008. Culture and antimicrobialsusceptibility examination were carried out according to up to date standard practice in CML and Clinical Laboratory Standard Institute, recpectively. Data was collected by WHONET 5.4 program. All Gram-negative microorganisms that were isolated from blood specimens were tabulated, and so the antibiotics susceptibility of A. anitratus. The origin of the specimens in term of institutions where the specimens came from was also analyzed.Results: In a 7 year period up to 2008, A. anitratus was found in blood specimens, and these invironmental bacteria were in fact the most predominant isolated Gram negative microorganisms. Together with another environmental microorganism, Pseudomonas aeruginosa, it composed nearly 50%. Antimicrobial susceptibility test of this microorganism showed some degree of resistance to all tested antibiotics. The origin of those blood specimens which yielded A. anitratus were mainly from government-owned hospitals, that was 88 specimens (74%), followed by private hospitals (18 specimens, 15%), individuals (3 specimens, 3%), and unknown source (10 specimens, 8%).Conclusion: Persistent occurrence of A. anitratus in blood specimens of hospitalized patients in hospitals in Jakarta was observed. In the near future, a study to fi nd risk factors for the acquisition of A. anitratus bacteremia is needed to reduce potential hospital associated infection. Moreover, genotyping is advised in order to determine the relationship of hospital and patient derived strains. (Med J Indones 2009; 18:227-32)Keywords: gram-negative microorganisms, antimicrobial susceptibility

BACKGROUND: Typhoid fever remains a worldwide problem, but it is particularly common in Southeast Asia, including Indonesia. The causative agent Salmonella Typhi is known to have significant genome plasticity. METHODOLOGY: This study describes genetic fingerprints using restriction fragment length polymorphism with SpeI of chromosomal DNA and pulsed-field gel electrophoresis (PFGE) of S. Typhi isolated from different geographic areas spreading from west to east across Indonesia. RESULTS: A total of 33 SpeI digested S. Typhi chromosomal DNA gave 22 schizotypes, 20 pulsotypes, and 12 subtypes indicating genomic diversity and the presence of more than one clone of S. Typhi. Cluster analysis at a degree of similarity of ≥80% showed four clusters, three of which were associated with geographic area. One cluster (Dice coefficient 0.727-1.000) contained isolates from three different geographic areas (Jakarta, Makasar, Jayapura), spread across Indonesia. CONCLUSIONS: Genetic fingerprinting of S. Typhi in Indonesia showed the presence of endemic strains in localized geographic areas, as well as the movement of one strain type throughout the archipelago.

Microbiota present in human intestinal are diverse, and imbalance in composition of intestinal flora may cause diarrhea.This study aimed to obtain a profile of intestinal bacteria in children with and without diarrhea and assess their presence with incidence of diarrhea. An analitical descriptive with cross sectional design study was carried out. A stool specimen was collected from each children of 2-12 years old with and without diarrhea who lived in North Jakarta. DNA extraction was performed prior to detection of microbes using Polymerase Chain Ceaction/Electrospray Ionization-Mass Spectrometry.Eighty stool specimens consisted of 33 and 47 specimens from children with and without diarrhea were included in the study. Thirty single and 6 multiple matches were detected in 30 specimens of the diarrhea group; 28 single and 8 multiple matches were found in 34 specimens of the non-diarrhea.Escherechiacoli and Klebsiella pneumonia were predominant in both groups. Firmicutes, Proteobacteria and Bacteroidetes were deteced in the diarrhea group, while Actinobacteria, Proteobacteria and Verrucomicrobia were in the non-diarrhea. The relationship of incidence of diarrhea and the present of enteropathogens in the stool was not significant, however, there was a strong correlation of the risk of suffering diarrhea due to the presence of enteropathogens (OR = 0.724 with 95%, CI: 0.237-2.215).In conclusion, most bacteria detected in both groups were similar, nonetheless, Actinobacteria was present only in the non-diarrhea. The chance to have diarrhea was higher when enteropathogen was detected in the stool.

Pseudomonas aeruginosais is an opportunistic Gram negative microorganism, usually related to serious infections within hospital environment and causes significant increase in patient’s morbidity and mortality. This study aimed to report antibiotic susceptibility of P. aeruginosa originated from all kind of specimens received at Clinical Microbiology Laboratory of the Faculty of Medicine, University of Indonesia, Jakarta, from 2004 to 2010, and evaluate their trend of susceptibility to certain antibiotics. Culture and identification of specimens were performed according to standard microbiology procedures. Antibiotic susceptibility tests were carried out according to performance standards for antimicrobial susceptibility testing from the Clinical and Laboratory Standards Institute. The data was processed using WHO-NET Version 5.6 program. P. aeruginosa was constantly found between 12 and 19% among other Gram negative bacteria. A significant decrease in susceptibility against ceftazidim, cefepime, cefoperazone, gentamicin, amikacin, tobramycin, ciprofloxacin, levofloxacin, meropenem and imipenem was observed. Susceptibility to aztreonam and piperacilline-tazobactam was decrease, though it was not statistically significant. In 2010, among the anti-pseudomonas antibiotics, imipenem showed good activity (80%). Overall, declining trend of susceptibility to all antibiotic tested was significantly observed. Imipenem was found to be the only anti-pseudomonas antibiotic with good activity (80%). Key words: Gram negative bacteria, P. aeruginosa, antibiotic susceptibility.

Lucky H. Moehario1, Enty Tjoa2, Veronica N. K. D. Kalay3 and Angela Abidin4 1Department of Microbiology Faculty of Medicine University of Indonesia, Jakarta 2Department of Microbiology Faculty of Medicine Catholic University of Atmajaya Indonesia, Jakarta 3Department of Microbiology Faculty of Medicine Christian University of Indonesia Jakarta and Division of Microbiology, Siloam Hospital Kebon Jeruk, Jakarta 4Division of Microbiology, St. Carolus Hospital, Jakarta 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.

A study of genotyping (pulsotyping) of Salmonella typhi (S. typhi) isolates using pulse-field gel electrophoresis (PFGE) methods was performed to examine their genetic diversity, and relationship between genetic characteristics and clinical outcomes. Sixty-six S. typhi isolates obtained from sporadic hospitalized typhoid fever cases were used in this study. Four isolates were found identical and the dendogram constructed showed 33 pulsotypes in which 13 of them can be divided into 30 subtypes. Diversity among them were high as shown by the Dice coefficients that ranged from 0.486 to 1.000. Cluster analysis showed 2 main clusters with 65% degree of similarity, suggested that they were not originated from one clone. Further, at 90% degree of similarity, 9 clusters containing at least 3 isolates were determined to explore any possible existence of relationship between genetic profile and particular clinical outcomes. Clinical manifestations ranged from mild to severe were in fact distributed diversely among these clusters. Although the clinical data obtained were incomplete, 2 out of 4 patients infected by the S. typhi belonged to cluster 1 showed an elevation of total bilirubin, whereas it was not found in 19 other patients distributed in other 8 clusters. Even though specific clinical manifestations were apparently not found to relate with particular clusters of genotypes, S. typhi isolates grouped in cluster 1 seemed to show trophism to hepatobiliary system. (Med J Indones 2003; 12: 13-20) Keywords: S. typhi , typhoid fever, Pulsed-field Gel electrophoresis (PFGE)

[no abstract available]

Background: Hospital Acquired Infection (HAI)-Blood Stream infection (BSI) cause considerable morbidity, mortality and health care costs. This study aimed to assess the HAI-BSI in neonates with birth weight 1000-2000 g in Neonatal Unit Cipto Mangunkusumo National Hospital (RSUPNCM), Jakarta, during 4 months period (Oct 2010-Jan 2011), and to review the possibility of sources and transmission of environment microbes to the presence of HAI-BSI in the unit.Methods: Subjects of this study were neonates (birth weight 1000-2000 g) with clinically sepsis and within 48 hours or more being hospitalized, no clearly focal infection detected, with catheter lines. Two blood specimens from two separate venipunctures, drawn simultaneously, were cultivated. Identification and antimicrobial susceptibility tests were performed for each isolates. Cultures from environment in the unit and other suspected clinical specimens were also examined.Results: From 29 neonates with 39 episodes of sepsis, 5 positive isolates from blood cultures were obtained i.e. Enterobacter asburiae (2), Enterobacter cloacae (1), Pseudomonas aeruginosa (1) and Klebsiella oxytoca (1). The laboratory confirmed HAI-BSI was 12.8%, and HAI-BSI rate was 1.46 per 1000 catheter line days during 4 months period (Oct 2010-Jan 2011). Cultures performed for environment specimens gave yield some species which were as those from clinical specimens. Antibiogram analysis showed those of environment isolates i.e E. asburiae and P. aeruginosa shared similarity to those of neonates’ blood isolates.Conclusion: Gram-negative bacteria were responsible to the occurrence of HAI-BSI in the Neonatal Unit RSUPNCM. Despite of low HAI-BSI rate found in this study, analysis of antibiogram profiles of the isolates originated from neonates’ blood and environment strongly suggested that cross infection was present in the unit. (Med J Indones 2012;21:32-7)Keywords: Antibiogram, blood stream infection, hospital acquired infection, neonates

Background Vascular access may increase the risk of bloodstream infections, especially in newborn infants with weak immune systems and requiring invasive supportive care. Skin disinfection prior to peripheral venous catheter insertion lowers the risk of infection. However, antiseptics chosen for this task should be effective and safe for newborn infants.Objective To compare the effectiveness of 70% alcohol (BD alcohol swabs ®), 10% povidone-iodine (Pharma-RSUPNCM), and octenidine (Octenisept ®) as antiseptics for reducing skin bacteria for pre-invasive procedures in neonates.Methods Infants aged less than 28 days, regardless of gestational age, at the Neonatal Unit of Cipto Mangunkusumo Hospital (RSUPNCM) were included in our study. Infants were divided into three groups, each tested with different skin antiseptics (alcohol, povidone-iodine or octenidine). Skin swabs were performed before and after application of skin antiseptic, followed by inoculation onto blood agar plates. Colony-forming units were counted after 18 hours of incubation at 37ºC.Results Ninety subjects were divided into 3 groups of 30, each group using either 70% alcohol swabs, 10% povidone-iodine, or octenidine as skin antiseptic. Skin swabs were taken before and after antiseptic application and drying, as well as 5 minutes after application. The mean reductions in CFU/cm2 (%) after antiseptic application (and fully dried) were 97.54% for povidone-iodine, 97.52% for octenidine, and 89.07% for alcohol. There were no significant differences in mean CFU reductions among the three antiseptics groups (P=0.299). Furthermore, 5 minutes after application, there were still no significant differences in the three antiseptic groups (P=0.289).Conclusions Although octenidine showed a significant bacterial count reduction after application, it was not significantly different from those of alcohol or povidone-iodine. [Paediatr Indones. 2011;51:277-81].

DNA genomes of Salmonella typhi ( S. typhi ), which were isolated from sporadic typhoid fever cases who were hospitalized in Persahabatan Hospital, Jakarta, during the 1st semester of 1998, were examined for their genetic diversities. Pulsed-field gel electrophoresis (PFGE) of genomic DNA digested with Xbal was performed for 25 isolates. Electrophoresis patterns of most isolates varied and 18 PFGE types were identified. Cluster analysis showed that all isolates originated from two main groups; and at ≥ 84% level of similarity, 7 clusters were found. Thus, the results showed that genetic diversity of S. typhi was considerably high, and that S. typhi isolated from sporadic typhoid fever cases were derived from multiple clones. (Med J Indones 2001; 10: 158-63) Keywords: typhoid fever, sporadic cases, Xbal, cluster analysis

In this study, we carried out Widal test to establish whether it is still signifcant as a routine early diagnostic tool of typhoidfever in the present time. We used three groups of patients: the first two Broups were hospitalized patients with fever, of which singLe blood specimen were taken and conjirmed by culture as positive (group I) and negative (group II), and the third group was healthy blood donors. AntiOagglutinintitersregardedasposilivewerethoseexceedingl:S0.ThesensitivityofsingleWidaltestwas3TVo,speciflcity gTVo,positivepredictivevaLueglVo,andnegativepredictivevalueT3Vo. Otherserologytestsdevelopedcurrently,amongotherstheuse of outer membrane protein preparation of Salmonella typhi as an antigen in the ELISA test, have shown higher sensitivity and specifcity thantheWidaltest. Therefore,theuseoftheWidaltestasarouiineearlydiagnostictoolfortyphoidfevermightneedtobereconsidered.