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OBJECTIVE: Surgical site infection (SSI) is a devastating complication in orthopedic surgery. Methicillin-resistant Staphylococcus aureus (MRSA) is a notorious organism in SSI, especially in orthopedic patients. We aimed to understand the association between MRSA carriers and the rate of SSI caused by MRSA in orthopedic patients. PATIENTS AND METHODS: We prospectively performed a cohort investigation on patients admitted to the Department of Orthopedic between April and August 2023. Samples were taken preoperatively from the nose and post-operatively in surgical wounds. All samples were grown in MeReSa Agar and defined as positive with MRSA characteristics. Data analysis was performed using SPSS Statistics. A significant difference between groups was assessed using either the Chisquare test or Fisher's exact test. Statistical significance was set at p<0.05. RESULTS: We obtained 526 nasal swabs of patients, and 140 (26.6%) samples were positive for MRSA. Our study revealed significant associations between MRSA carriers and the following factors: history of recent hospitalization (OR: 1.81; 95% CI: 1.172-2.795; p=0.007), smoking history (OR: 1.55; 95% CI: 1.011-2.383; p=0.044), and antibiotic exposures (OR: 2.19; 95% CI: 1.305-3.703; p=0.003). Our findings showed a significant association between SSI and the following factors: history of antibiotic exposures (OR: 2.89; 95% CI: 1.264-6.566; p=0.003), blood loss volume >500 ml (OR: 2.522; 95% CI: 1.245-5.108; p=0.008) and contaminated surgical wounds (OR: 5.97; 95% CI: 2.907-12.266; p=0.001). Patients with MRSA carriers tended to have an increased risk of having an MRSA SSI with an odds ratio of 3.44 (95% CI: 1.13-10.48; p=0.047). CONCLUSIONS: Our study highlights the increased risk of MRSA carriage in patients with a history of smoking, recent hospital admission, or antibiotic exposure. Our reports also identify potential risk factors for SSI, such as previous antibiotic exposure, blood loss, and contaminated wounds. Furthermore, our research establishes an association between MRSA colonization and MRSA SSI, which emphasizes the criticality of decolonization strategies. A further prospective multicenter study is needed to elaborate on our study findings. [ABSTRACT FROM AUTHOR]

Nickel (Ni) is an essential micronutrient known for improving the growth and yield of various crops at low concentrations. However, the nickel’s adequate information on shallots is insufficient. This study found out the effect of Ni fertilization with four concentrations (0.0, 0.025, 0.1, and 0.4 mg L -1 derived from NiSO4.6H2O) on plant and bulb weight, nutrient solution usage, and bulb nickel and nitrate content of two shallot cultivars (Lokananta and Sanren F1) using hydroponic condition, arranged in a split-plot design under field conditions. Increased Ni concentration (0.4 mg L -1 ) negatively affected plant height, total plant weight, bulb weight per plant, and total nutrient solution usage, while it increased the bulb nickel and leaf carotenoid contents. The Ni concentration (0.025 mg L -1 ) can be safer for shallot plant absorption with optimum growth and yield. Shallot cultivar Sanren F1 provides considerably better results in terms of yield components than cultivar Lokananta. Bulb weight per plant appeared positively correlated with the number of leaves, bulbs, total bulb diameter, and total volume of nutrient solution used per plant. The total bulb diameter per plant showed a better direct effect on the shallot bulb yield at various Ni levels. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) is an airborne disease caused by Mycobacterium tuberculosis (M. tuberculosis). The world is currently facing challenges due to the spread of anti-tuberculosis drug-resistant of M. tuberculosis. Isoniazid-resistant (INH), is one of the first-line anti-tuberculosis agents that has a high resistance case. This study used Multiplex allele-specific Polymerase Chain Reaction (MAS-PCR) to detect the most common mutations associated with isoniazid resistance on inhA, katG, and ahpC gene., Methods: This study used samples from clinical isolates of M. tuberculosis which had been tested for their antibiotic sensitivity of first-line anti-tuberculosis drugs. The DNA extraction process was carried out using the boiling method and then amplified with specific primers for inhA, katG, and ahpC genes using the MAS-PCR method. The results are then read on the electrophoretic gel with an interpretation of the mutation gene when the target gene DNA bands were absent according to the allele-specific fragments target., Results: A total of 200 isolates were tested in this study consisting of isoniazid-resistant and susceptible with the largest distribution of Multi-Drug Resistant (MDR) isolates with a total of 146 isolates (73%). The most significant gene mutation was on the ahpC gene in 61 isolates (30,5%) and the combination mutation of the katG + ahpC gene in 52 isolates (26%) with sensitivity and specificity of the test reaching 87% and 42% for the detection of INH-resistant., Conclusion: Mutation on the ahpC gene has the highest percentage in this study. AhpC gene can be considered one of the essential genes to be tested for the cause of isoniazid-resistant. Using MAS-PCR for detecting gene mutation in isoniazid-resistant was simple and easy, it has the potential to be widely used as a rapid screening molecular test., (Copyright © 2023. Published by Elsevier B.V.)

Background: Mycobacterial infections can manifest in various anatomical sites, necessitating the analysis of nonsputum specimens for accurate diagnosis. The aim of this study was to identify the molecular cases of mycobacterial infections in nonsputum specimens using polymerase chain reaction based assays and gene sequencing methods., Methods: This observational study examined 161 nonsputum samples that have been stored in the Clinical Microbiology Laboratory at Hasanuddin University Hospital. Samples were analyzed by microscopy and molecular detection methods according to the standard methods at the Clinical Microbiology Laboratory of Hasanuddin University. Descriptive statistics were utilized to summarize patient demographics, infection characteristics, and outcomes., Results: The samples were collected from patients with an average age of 39.82 years. The anatomical sites of specimen collection varied, with musculoskeletal organs and eyes being the most common. Microbiological analysis revealed a predominance of Gram positive bacteria, with polymicrobial morphology observed. Methicillin susceptible Staphylococcus aureus were the most frequently isolated organisms. Acid fast bacilli were detected in 8.1% of samples. Phylogenetic analysis, based on 16S rRNA gene sequencing, revealed similarities between the samples and known mycobacterial species, including Mycobacterium parmense, Mycobacterium lacus, and Mycobacterium dioxanotrophicus., Conclusions: The findings highlight the microbial diversity observed in these infections. The study advocates for comprehensive diagnostic evaluations and targeted testing strategies based on both clinical and laboratory findings. This knowledge can contribute to improved diagnostic accuracy and optimized treatment strategies for mycobacterial infections., Competing Interests: None

Introduction: This study aimed to perform mutation and phylogenetic analyses of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Delta variants and analyze the characteristic signs and symptoms of patients infected with SARS-CoV-2 Delta variant originated from Makassar during the Delta outbreak.Methods: We collected samples from patients who were infected with coronavirus disease 2019 (COVID-19) between June and October 2021. We selected the Quantitative Reverse Transcription-Polymerase Chain Reaction (PCR)-positive samples with a cycle threshold value of <30 for whole genome sequencing. Total viral ribonucleic acid (RNA) was isolated from 34 PCR-positive nasopharyngeal swab samples, and whole genome sequencing was performed using the Oxford Nanopore GridlON sequencer. Phylogenetic and maximum clade credibility analyses were performed using the Bayesian Markov chain Monte Carlo method., Results: It was found that 33 patients were infected with the SARS-CoV-2 Delta variant in this cohort study, among whom 63.6% (21) patients were female. According to the clinical data, 24 (72.7%), 7 (21.2%), and 2 (6.1%) patients had mild, moderate, and severe COVID-19 infections. Phylogenetic analysis based on the spike and RNA-dependent RNA polymerase (RdRp) genes showed that the collected samples were clustered in the main lineage of B.1.617.2 (Delta variant). The Delta variants had a high frequency of distinct mutations in the spike protein region, including T19R (94.12%), L452R (88.23%), T478K (91.17%), D614G (97%), P681R (97%), and D950 N (97%). Other unique mutations found in a smaller frequency in our samples were present in the N-terminal domain, including A27T (2.94%) and A222V (14.70%), and in the receptor-binding domain, including Q414K (5.88%), G446V (2.94%), and T470 N (2.94%)., Conclusion: This study revealed the unique mutations in the S protein region of Delta variants. T19R, L452R, T478K/T478R, D614G, P681R, and D950 N were the most common substitutions in Makassar's Delta variant., Competing Interests: The authors declare no competing interests., (© 2023 The Authors.)

Maternal hepatitis B e Antigen (HBeAg) positivity poses a risk for hepatitis B virus (HBV) mother-to-child transmission (MTCT). In resource-constrained settings, HBeAg testing is recommended as an alternative to HBV DNA testing to establish antiviral prophylaxis eligibility. Nevertheless, the high prevalence of HBeAg-negative chronic hepatitis B (e-CHB) in many countries should not be overlooked. We studied HBV characteristics and explored the potential MTCT risk among HBeAg-negative/HBsAg-positive expectant mothers in an area prevalent of e-CHB. Among 1348 pregnant mothers screened for HBV infection, 81 (6.0%) were HBsAg-positive. These women were examined for HBeAg, HBV DNA, and cord blood HBV DNA. Sixteen (19.8%) of the HBsAg-positive mothers were HBeAg-positive, whereas 65 (80.2%) were HBeAg-negative, including eight inactive carriers (HBsAg <100 IU/ml, HBV DNA ≤ 2000 IU/ml, and ALT < 40 IU/L). Of the remaining 57 HBeAg-negative mothers, ten revealed HBV Basal Core Promoter or Precore mutations, with three having high viremia (HBV DNA > 200 000 IU/mL), which is associated with a high MTCT risk and therefore qualifies them for antiviral prophylaxis. This pilot study provides a cautionary note to the interpretation of negative HBeAg test results when determining eligibility for MTCT antiviral prophylaxis in situations with limited resources and in regions where e-CHB is prevalent., (© 2022 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.)

Introduction: The placenta is a specialized organ that only performs during pregnancy and serves as an immunological barrier in preventing pathogens to reach the fetus. It has been known that toll-like receptors (TLRs) on the placenta respond to antigens, such as zymosan, lipopolysaccharide, and other viral infections. This study analyzes the distribution of TLR2 protein and hepatitis B DNA virus (HBV DNA) virus identification to gain an understanding of hepatitis B viral transmission from the mother to child., Methods: We performed enzyme-linked immunoadsorbent assay of HBeAg, HBsAg titer, Anti-HBs, and Anti-HBc to 59 HBsAg-positive pregnant women and identified HBV DNA using nested PCR in their cord blood during delivery for evidence of exposure to HBV DNA. The expression of TLR2 protein in the placenta was performed using immunohistochemistry analysis., Results: Intrauterine exposure to the hepatitis B virus occurred in 69.5% of all pregnant women who were HbsAg positive. TLR2 expression was predominantly identified in syncytiotrophoblast and cytotrophoblast cells with the highest score in mothers aged 20-35 years (75%), multigravida (58.3%), and mothers with term pregnancies (70.8%). Statistical analysis results showed that placental TLR2 expression did not indicate any association with hepatitis B virus DNA identified in cord blood with a p value of 0.730 and an OR of 0.650 (95% CI 0.173-2.440)., Conclusion: TLR2 expression is not associated with intrauterine exposure of hepatitis B virus., Competing Interests: The authors declare no conflicts of interest concerning the research, authorship, and/or publication of this article., (Copyright © 2022 Dian Utami et al.)

Introduction: A global surge in SARS-CoV-2 cases is occurring due to the emergence of new disease variants, and requires continuous adjustment of public health measures. This study aims to continuously monitor and mitigate the impact of SARS-CoV-2 through genomic surveillance, to determine the emergence of variants and their impact on public health., Methods: Data were collected from 50 full-genome sequences of SARS-CoV-2 isolates from Makassar, South Sulawesi, Indonesia. Mutation and phylogenetic analysis was performed of SARS-CoV-2 from Makassar, South Sulawesi, Indonesia., Results: Phylogenetic analysis showed that two samples (4%) were of the B.1.319 lineage, while the others (96%) were of the B.1.466.2 lineage. Mutation analysis of the spike (S) protein region showed that the most common mutation was D614G (found in 100% of the sequenced isolates), followed by N439K (98%) and P681R (76%). Several mutations were also identified in other genomes with a high frequency, including P323L (nsp12), Q57H (ns3-orf3a), and T205I (nucleoprotein)., Conclusion: Our findings highlight the importance of continuous genomic surveillance to identify new viral mutations and variants with possible impacts on public health., Competing Interests: The authors declare there are no competing interests, (©2022 Massi et al.)

&lt;b&gt;Background and Objective:&lt;/b&gt; Developing rice (&lt;i&gt;Oryza sativa&lt;/i&gt; L.) varieties with increased yield potential has been a major concern for genetic improvement. This study aimed to evaluate aromatic rice lines and the relationship among their twelve agronomic traits using heatmap Pearson correlation and multivariate analysis to identify high yield lines using grain yield as a marker-trait. &lt;b&gt;Materials and Methods:&lt;/b&gt; Twelve aromatic rice genotypes (eleven mutant lines and one control) were evaluated in the M&lt;sub&gt;4&lt;/sub&gt; generation. The experiment was conducted at Tana Toraja regency following Randomized Complete Block Design (RCBD) with two replications. &lt;b&gt;Results:&lt;/b&gt; The darker and lighter colour scale produced by heatmap revealed contrasting nature of genotypes. A significant positive correlation observed for yield was the number of fertile grains and grain weight per panicle, while a negative correlation was days to flowering. The first four components account for 83.46% of the total cumulative variation. Cluster analysis grouped 11 lines and one control into three clusters. &lt;b&gt;Conclusion:&lt;/b&gt; The results concluded that the PB-A.5.3.45 line could be used for hybridization programs to develop high-yielding mutant-derived aromatic rice varieties for further improvement.

Objective: A phylogenetic study was carried out on the avian influenza virus (AIV) isolated from a disease outbreak in Sidenreng Rappang Regency, South Sulawesi, Indonesia, in 2018., Material and Methods: Oropharyngeal swabs and organ samples were obtained from ducks that showed clinical symptoms: torticollis, fascial edema, neurological disorders, the corneas appear cloudy, and death occurs less than 1 day after symptoms appear. In this study, isolate A/duck/Sidenreng Rappang/07180110-11/2018 from duck was sequenced and characterized., Results: It was found that each gene segment of the virus has the highest nucleotide homology to the Indonesian highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.2.1c. Multiple alignments of the sample Hemagglutinin (HA) gene with the avian influenza references virus showed that the pattern of amino acid arrangement in the cleavage site PQRERRRK-RGLF is the characteristic of the HPAI virus. In addition, the HA gene contained Q222 (glutamine) and G224 (glycine), signifying a high affinity to avian receptor binding specificity (SA α2,3 Gal). Furthermore, there was no genetic reassortment of this virus based on the phylogenetic analysis of HA, NA, PB1, PB2, PA, NP, M, and NS genes., Conclusion: The HPAI H5N1 clade 2.3.2.1c virus was identified in duck farms in South Sulawesi, Indonesia., Competing Interests: The authors declare that there is no conflict of interest., (Copyright: © Journal of Advanced Veterinary and Animal Research.)

Background: Hepatitis B virus (HBV) infection is a world health problem with an estimated 257 million chronically infected people. Indonesia, with 7.1% prevalence of hepatitis B surface antigen (HBsAg), is classified as a moderately endemic country. Healthcare workers (HCWs) are at high occupational risk for HBV infection and potentially becoming transmitters for further infections. In Indonesia, the extent of hepatitis B among HCWs and specific control strategy are not available. This study evaluated the seroprevalence of HBV infection and associated risk factors in HCWs from four areas in South Sulawesi, Indonesia., Methods: A total of 467 HCWs (median age 28 years, male/female 89/378) were recruited. All HCWs were classified into three age groups (< 20-29, 30-39, and ≥ 40 years old), three work types (administration, non-intervention, and intervention), and three service periods (< 5, 5-9, and ≥ 10 years). Data on socio-demographic characteristics and risk factors were obtained by questionnaire and serum samples were tested for HBV markers (HBsAg, its antibody [anti-HBs], and antibody to core antigen [anti-HBc]. Chi-square or Fisher's exact test was used to determine differences in categorical variables, while risk factors were reported as odds ratios (OR)., Results: The prevalence of current HBV infection (HBsAg+), exposure to HBV (anti-HBc+), and immunity to HBV (anti-HBs+) was 6.2, 19.2, and 26.1%, respectively. Two thirds (66.17%) of all HCWs did not express any of HBV markers. In relation to the age groups, intervention work-type, and service period of HCWs, increasing trends were observed in the exposure to HBV (p < 0.001, p < 0.001, and p < 0.010, respectively) and the immunity to HBV by natural infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004, p < 0.001, and p < 0.010, respectively). Needlestick injury contributed the highest risk factor (OR = 1.71; 95% CI: 1.05-2.77; p = 0.029) for infection acquisition, which mostly occurred in the intervention group (p = 0.046)., Conclusion: Exposure to HBV showed significant association with HCWs' age, work type, and service period. Needlestick injury was the highest risk factor for the acquisition of HBV, with highest events in the intervention work-type. Two thirds of HCWs were still susceptible to HBV infection. Intervention strategies at the national level are required to mount prevention, control, and management of HBV infection in HCWs.

Hepatitis B virus (HBV) infection is a global health problem with an estimated 257 million chronically infected people. Indonesia is a moderately hepatitis B-endemic country with 7.1% prevalence of hepatitis surface antigen (HBsAg). This infection is considered as an important occupational hazard among health care workers (HCWs), who may become further transmitters of this infection. The extent of hepatitis B among HCWs and specific control strategy are not available in Indonesia. A study was done on 644 HCWs, who were categorized into administration, nonintervention, and intervention groups. The prevalence of HBsAg, antibody to HBV core antigen (anti-HBc), and antibody to HBsAg (anti-HBs) was 4.7, 18.5, and 36.7% respectively, while 57.3% were negative for all seromarkers, indicating susceptibility to this infection. Increasing trend with age was observed in the exposure to infection (anti-HBc) (p <0.001) and the marker of resolved infection (HBsAg-, anti-HBc+, anti-HBs+) (p = 0.004), suggesting accumulated exposure to HBV infection by increasing age. Rising trend of exposure rate was also observed across the administration, nonintervention, and intervention groups (p < 0.001). By length of service period, significant escalation of exposure (p = 0.010) and resolved infection (p < 0.001) were also observed, suggesting increasing occupational risk to HBV infection. There is an urgent need to safeguard the HCWs with hepatitis B vaccination and provide continuing education at various health care setups. The establishment of a national policy and a roadmap for effective and efficient intervention is required for the prevention, diagnosis, postexposure management, and treatment of HBV infection in this special population. How to cite this article: Muljono DH, Wijayadi T, Sjahril R. Hepatitis B Virus Infection among Health Care Workers in Indonesia. Euroasian J Hepato-Gastroenterol 2018;8(1):88-92., Competing Interests: Source of support: Research grant from the Ministry for Research and Technology, and Higher Education, Republic of Indonesia Conflict of interest: Nil