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The Sensitivity Pattern of Extended Spectrum Beta Lactamase-Producing Bacteria Against Six Antibiotics that Routinely Used in Clinical Setting Kuntaman, Kuntaman; Santoso, Sanarto; Wahjono, Hendro; Mertaniasih, Ni Made; Lestari, Endang S.; Farida, Helmia; Hapsari, Rebriarina; Firmanti, Stefani Candra; AS, Noorhamdani; Santosaningsih, Dewi; Purwono, Priyo Budi; Kusumaningrum, Deby
Journal of the Indonesian Medical Association Vol. 61 No. 12 December 2011
Publisher : Journal of the Indonesian Medical Association

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Abstract

The validated study of extended-spectrum b-lactamase (ESBL) producing bacteria inIndonesia is scarce. Multi-centre study on susceptibility of ESBLs producers is our point of view. A survey was carried out in three teaching hospitals in Surabaya (Dr. Soetomo), Malang (Dr. Saiful Anwar) and Semarang (Dr. Kariadi). Clinical ESBL-producers were collected in over four months period (January to April 2010) up to 300 strains. The susceptibility against 6antibiotics below were used as a point of view in analysis. As many as 300 isolates were collected, 140 (Surabaya), 85 (Semarang) and 75 (Malang) respectively. The three most prevalent ESBL producers were: E. coli (42.7%), Klebsiella pneumoniae (47.3%) and Enterobacter spp (7%). The other 9 strains were: Citrobacter spp, Klebsiella oxytoca, Proteus mirabilis and Serratia spp. The susceptibility analysis was then performed on the three most prevalent isolates. The sensitivity rate of E. coli, Klebsiella pneumoniae and Enterobacter spp against tested antibiotics were 3%, 4% and 5% for cefotaxim; 91%, 87% and 90% for Amikacin; 27%, 54% and 43% for Ciprofloxacin; 98%, 93% and 100% for Cefoperason-Sulbactam; 100%, 96% and 100% for Meropenem; 95%, 94% and 86% for Fosfomycin. As a conclusion, we found that amikacin, cefoperason-sulbactam, meropenem and fosfomycin, are prospective for emperic therapy in clinical setting of health services where ESBL producing bacteria were prevalent as causative. J Indon Med Assoc. 2011;61:482-6.Keywords: Extended Spectrum Beta Lactamases (ESBL), antibiotic, antimicrobial resistance,sensitivity.
The Potency of Dextranase from Arthrobacter sp. Strain B7 as Dental Plaque Removal BAKTIR, AFAF; ZAINI, NOOR CHOLIES; MURDIYATMO, UNTUNG; KUNTAMAN, KUNTAMAN
HAYATI Journal of Biosciences Vol 12, No 4 (2005): December 2005
Publisher : Bogor Agricultural University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.646 KB) | DOI: 10.4308/hjb.12.4.162

Abstract

Dextranase of Arthrobacter sp. strain B7 (B7DEX enzyme) was characterized in this study. This enzyme hydrolyzed sucrose and dextran, but not other glucans (starch, nigeran, cellulose, -soluble glucan). It also hydrolyzed glucan from dental plaque with the activity of 7.38 +/- 66 U/ml, where the activity toward dextran was 31.88 +/- 1.24 U/ml. The enzyme exhibited the pH optimum of 7 and the temperature optimum of 50 0C. Its optimum stability was at pH 7 and 50 0C. The enzyme was inhibited by Fe3+, Cu2+, Zn2+, and Ag+, but not by the anionic detergent (SDS) and the nonionic detergent (Triton-X). The enzyme was activated by Ca2+, Na+, Mg2+, and saliva.
PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS? Hadi, Usman; Kuntaman, Kuntaman; Qiptiyah, Mariyatul; Paraton, Hari
Indonesian Journal of Tropical and Infectious Disease Vol 4, No 4 (2013)
Publisher : Institute of Topical Disease

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Abstract

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.
The role of inducible Nitric Oxide Synthase in teeth periapical lesions immunopathogenesis caused by Enterococcus faecalis Yuanita, Tamara; Mooduto, Latief; Kuntaman, Kuntaman
Dental Journal (Majalah Kedokteran Gigi) Vol 46, No 1 (2013): (March 2013)
Publisher : Faculty of Dental Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/j.djmkg.v46.i1.p14-17

Abstract

Background: Periapical lesions, are characterized by an immune response to the invading bacteria consequences periapical bone destruction. In root canal treatment failure was found Enterococcus faecalis (E. faecalis) as most species. iNOS found an important role in protection against infection, plays vital roles in fighting pathogens and contributing to disease pathology. Purpose: This study was to observed the role of iNOS in teeth periapical lessions immunopathogenesis caused by E. faecalis. Methods: The randomized post-only control group design used in this study, This study used 24 Wistar rats, were divided into three groups (each group consisted of 8 rats), as negative controls group is a normal teeth, in the positive controls group was made by drilling the upper right first molar to penetrate the dental pulp and was induced with 10µl BHI-b then filled with Glass Ionomer Cement (GIC) and the treatment group, after drilling the teeth, then inoculated with E. faecalis ATCC 29212 106 CFU into 10µl BHI-b then filled with GIC to prevent contamination. It takes 21 days to get periapical lesions and rat were sacrificed, and then the expression of iNOS was measured. Results: Statistical analysis using ANOVA found a significant differenced between control and treatment groups (p<0.05). Conclusion: This study concluded that iNOS role in teeth periapical lesions immunopathogenesis caused by E. faecalis.Latar belakang: Lesi periapikal merupakan hasil suatu respon imun untuk melawan invasi bakteri yang mengakibatkan destruksi tulang periapikal. Pada perawatan saluran akar yang mengalami kegagalan ditemukan Enterococcus faecalis sebagai spesies terbanyak. iNOS berperan penting untuk proteksi terhadap bakteri, mempunyai peran yang vital untuk melawan patogen dan berkonstribusi secara patologik untuk menyebabkan suatu penyakit. Tujuan: Penelitian ini bertujuan untuk mengobservasi peran iNOS secara imunohistokimia pada lesi periapikal tikus Wistar. Metode: Penelitian ini menggunakan disain randomized post-only control group, digunakan 24 ekor tikus Wistar yang dibagi menjadi tiga kelompok yang masing-masing terdiri dari 8 ekor tikus, sebagai kelompok kontrol negatif adalah gigi normal, pada kelompok kontrol positif dilakukan pengeboran pada gigi molar pertama rahang atas sampai menembus pulpa kemudian diinduksi 10µl BHI-b kemudian ditumpat (Glass Ionomer Cement) GIC dan pada kelompok perlakuan, setelah dilakukan pengeboran dilakukan induksi E. faecalis ATCC 29212 sebanyak 106 CFU ke dalam 10 µl BHI-b kemudian ditumpat GIC untuk mencegah kontaminasi. Diperlukan waktu 21 hari untuk mendapatkan lesi periapikal pasca perlakuan kemudian tikus dikorbankan lalu dihitung sel-sel yang mengekspresikan iNOS. Hasil: Analisis menggunakan ANAVA membuktikan bahwa ada perbedaan yang bermakna antara kelompok kontrol dan kelompok perlakuan (p<0,05). Kesimpulan: iNOS berperan pada imunopatogenesis lesi periapikal gigi akibat E. faecalis.
PROBLEM OF ANTIBIOTIC USE AND ANTIMICROBIAL RESISTANCE IN INDONESIA: ARE WE REALLY MAKING PROGRESS? Hadi, Usman; Kuntaman, Kuntaman; Qiptiyah, Mariyatul; Paraton, Hari
Indonesian Journal of Tropical and Infectious Disease Vol 4, No 4 (2013)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (485.975 KB) | DOI: 10.20473/ijtid.v4i4.222

Abstract

Background: Based on the results Antimicrobial Resistance in Indonesia: prevalence and prevention-study (AMRIN-study), the Ministry of Health of Indonesia in 2005 began a program antibiotic resistance control (PPRA) in some government hospitals, and is currently developing to all government teaching hospitals in Indonesia. Aim: The core activities of the PPRA are to implement standardized surveillance emergence of antibiotic resistant bacteria, and the surveillance of antibiotic use in terms of quantity and quality. Method: Our research in the years 2003 showed the proportion of antibiotic use 84% of patients in a hospital. The use of inappropriate antibiotics was very high, 42% no indication. Result: In 2012 the results of surveillance showed decline of inappropriate use of antibiotic, but prevalence extended-spectrum b-lactamase (ESBL)-producing K.pneumoniae (58%), and E.coli (52%) andmethicillin-resistant S.aures (MRSA) (24%) were increasing. Conclusion: It was needed to implement the most appropriate programs to prevent the growth and development of bacteria resistant to antibiotics.
Comparation of Phenotypic and Genotypic Profile of Carbapenemase Producing Escherichia coli Sutandhio, Silvia; Budiono, Budiono; Hardiono, Hardiono; Kuntaman, Kuntaman; Wasito, Eddy Bagus; Lusida, Maria Inge
Folia Medica Indonesiana Vol 54, No 1 (2018): March
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v54i1.8045

Abstract

Carbapenemase-producing Escherichia coli (E. coli) has caused trouble in therapeutic antibiotic selection. Carbapenemase screening procedure in laboratories is usually based on inacurate semi-automatic system. Confirmation and classification of carbapenemases according to Ambler can be done with combination of phenotypic methods, i.e., Modified Hodge Test (MHT), Sodium Mercaptoacetic Acid (SMA), and 3-Aminophenylboronic Acid (PBA). This study aimed to compare profiles of carbapenemase-producing E. coli which were confirmed and classified phenotypically with the genotypic profiles. E. coli isolates from urine specimens which were potential as carbapenemase-producers according to semi-automatic system BD Phoenix were phenotypically tested with MHT, SMA, and PBA. Isolates were grouped as carbapenemase-producers and non carbapenemase-producers. Phenotypic carbapenemase-producer isolates were classified based on Ambler criteria. All isolates were then tested with Polymerase Chain Reaction (PCR) for the presence of OXA-48, IMP1, IMP2, GES, VIM, NDM, KPC genes. Out of 30 isolates, 6 isolates (20.0%) were MHT positive, and 25 isolates (83.3%) were SMA positive, which indicated that most isolates produced were carbapenemase Ambler B. PCR confirmed 12 isolates (40.0%) had VIM gene which were classified as carbapenemase Ambler B. Phenotypic confirmatory test had 100% sensitivity and 22.2% specificity. Classification with phenotypic confirmatory test had 91.7% match with PCR. Phenotypic confirmatory test detected more carbapenemase than PCR. This low specificity may be caused by inappropriate use of diagnostic gold standard. PCR should not be used for routine carbapenemase confirmation because of vast diversity of carbapenemases. Phenotypic confirmatory test can classify carbapenemase according to Ambler classification.
Pattern of disease and type of operation of Surgical Site Infection in obstetrics and gynecology at Dr Soetomo Hospital, Surabaya, Indonesia Marsanto, Ardi Eko; Kuntaman, Kuntaman; Paraton, Hari; Prasetyo, Budi
Majalah Obstetri & Ginekologi Vol 27, No 2 (2019): August
Publisher : Department of Obstetrics and Gynecology, Faculty of Medicine, Airlangga University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mog.V27I22019.49-55

Abstract

Objectives: to find correlation between risk factors and classification of SSI, the distribution of SSI, and cost in Soetomo Hospital.Materials and Methods: descriptive retrospective observational with correlation analysis between risk factors and SSI classification according to Centers for Disease Control (CDC) definition with univariate analysis. Sub-group descriptive analysis on microbiology result, length of stay (LOS) and cost was also performed. All patients was diagnosed SSI between January 2015 until June 2017.Results: age, referral cases, Body Mass Index, Hemoglobin and Albumin results, types of surgery, types of case are the risk factors we included. Analysis result shows no strong and significance correlation in all risk factors (r 0.053 – 0.447; p 0.072 – 0.971). According to SSI types, the distribution are: superficial (7; 13.2%), deep (26; 49.1%), organ/space (20; 37.7%). Extended-Spectrum Beta-Lactamase (ESBL) was obtained in 19 (14 Obstetrics; 5 Gynecology) from 28 patients with microbiology results. Five deaths occured in ESBL patients (1 Obstetrics; 4 Gynecology; ratio 1 : 11.2). Mean length of stay in Obstetrics and Gynecology was 41.7 and 19.2 days, respectively. Mean cost per day in Obstetrics and Gynecology was 1.2 amd 2.6 million rupiah, respectively.Conclusions: no strong and significant results in all risk factors. Death rate in SSI and malignancy with positive ESBL result are high. Less cost needed for SSI patients, but with longer LOS. Comprehensive approaches are needed to patients at risk of SSI, further study with larger sample are needed.
Prevalensi dan Pola Gen Extended Spectrum B-lactamase Bakteri Usus Sapi Perah dan Penduduk Sekitar Peternakan di Surabaya Imasari, Triffit; Tyasningsih, Wiwiek; Wasito, Eddy Bagus; Kuntaman, Kuntaman
Jurnal Veteriner Vol 19 No 3 (2018)
Publisher : Faculty of Veterinary Medicine, Udayana University and Published in collaboration with the Indonesia Veterinarian Association

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Abstract

Since identified in 1980s, the multiple drug resistant organisms such as Extended Spectrum Beta Lactamases (ESBL) producing bacteria is increasing. These bacteria Enterobacteriaceae strain are mostly resistant against third and also fouth generation cephalosporin. ESBL-producing bacteria are identified in both of human, environment and also in animal. There are three main ESBL genes that are commonly found namely SHV, TEM and CTX-M. The aims of this study were to explore the prevalence and pattern of ESBL gene among dairy cows and people around the farm. The faecal samples were collected from dairy cows and people around the farm, cultured on MacConkey agar supplemented with cefotaxim 1 mg/L,&nbsp;incubated at 37oC for 24 hours. Then the growing colony were tested for ESBL producer by Double Disk Synergy Test (DDST), then followed by Polymerase Chain Reaction (PCR) for ESBL gene. Total sampling technique with inclusion and exclusion criteria, Total 49 samples were collected, consisting of 25 dairy cows faeces and 24 people faeces. Among these, were identified 18 samples (72%) positive in dairy cows and 19 samples (79.1%) positive results in the people around the dairy farm. The ESBL gene, SHV, TEM, CTX-M were identified dairy cows were zero for SHV, TEM (12%), CTX-M (72%) while in people around the farm SHV (25%), TEM (16.7%), CTX-M (66.7%). There were significant different (p &lt; 0.05) between dairy cows and people around the farm, of SHV ESBL gene and not different (p&gt;0.05) of TEM and CTX-M ESBL gene respectively. The ESBL genes have spread among dairy cows and people around the farm.&nbsp;
EXPRESSION OF FOUR CYTOKINE/CHEMOKINE GENES IN PERIPHERAL BLOOD MONONUCLEAR CELLS INFECTED WITH DENGUE VIRUS Sri Masyeni, Dewa Ayu Putri; Hadi, Usman; Kuntaman, Kuntaman; Yohan, Benediktus; Margyaningsih, Nur Ita; Sasmono, R Tedjo
Indonesian Journal of Tropical and Infectious Disease Vol 7, No 4 (2019)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (193.265 KB) | DOI: 10.20473/ijtid.v7i4.7860

Abstract

Overproduction of numerous pro-inflammatory cytokines, during dengue virus (DENV) infection, has been related to plasma leakage in the vascular endothelium and studied elsewhere with conflicting results. The current study objective is to evaluate the expression of four cytokine/chemokine genes following DENV-2 infection within peripheral blood mononuclear cells (PBMC) isolated from a healthy donor. Venous blood was drawn,  and PBMCs were isolated using Ficoll density gradient centrifugation. Cells were maintained in culture medium and infected with Indonesian isolate of DENV-2. Cells were harvested and followed by total RNA extraction and reverse-transcription into cDNA using oligo d(T) primers and Reverse Transcriptase enzyme system. The SYBR Green-based quantitative qRT-PCR was used to calculate the relative expression of IL-6, IL-8, IP-10 and MIP-1β- encoding genes during infection time points, compared to uninfected cell controls. The observation of the cytokine was on the 6 and 18 hours post-infection. The different expression profiles of cytokines/chemokines were observed. The up-regulation of gene expression was observed for IL-8 and IP-10. In contrast, the down-regulatory of IL-6 and MIP-1β genes expression was documented during the infection period. The cytokine IL-8 and IP-10 are potent chemoattractants  in the recruitment  of neutrophil, basophil, and lymphocytes in response to an infection. The highlight of this study is on the up-regulation of IL-8 and IP-10 genes expression which may confirm the roles of these chemokines in the pathogenesis of dengue infection.
MICROBIAL PATTERN AND ANTIBIOTIC SUSCEPTIBILITY IN PEDIATRIC INTENSIVE CARE UNIT DR. SOETOMO HOSPITAL, SURABAYA A.A.W., I Wayan Putra; Irwanto, Irwanto; Dharmawati, ira; Setyaningtyas, Arina; Puspitasari, Dwiyanti; Wahyu, Agung Dwi; Kuntaman, Kuntaman
Indonesian Journal of Tropical and Infectious Disease Vol 7, No 5 (2019)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (520.415 KB) | DOI: 10.20473/ijtid.v7i5.5737

Abstract

Gram-negative bacterial are known as common pathogen caused infection in Pediatric Intensive Care Unit (PICU). Microbial Pattern and Antibiotic Susceptibility are needed as clinical data for selected appropriate antibiotic therapy. In PICU Dr. Soetomo hospital until now still lacking of Microbial Pattern and Antibiotic Susceptibility data. This descriptive study is to recognized Microbial Pattern and Antibiotic Susceptibility in PICU patients from blood, urine, sputum, stool, cerebrospinal fluid, endotracheal tube, pus swab and pleural fluid culture specimens. Patients whose admitted into PICU without signs of infections were excluded from the study. The inclusion criteria are patients with sign infection as follows: fever < 36,5°C or > 37.5°C, leukocyte < 4000/mm3 or > 10000/mm3, marker infections CRP >10 mg/L or PCT >0,3 ng/mL, bradycardia or tachycardia, tachypnea, infiltrates on chest X-ray, turbid urine, dysuria, thrombophlebitis, abdominal pain or tenderness, and mucous or skin lesion. Medical record data from 2011 to 2016, revealed 1138 patients had positive microbial culture result, wherein positive result came from blood 44.46%, urine 19.15%, sputum 11.59%, stool 8.96%, cerebrospinal fluid 7.50%, endotracheal tube 4.04%, pus swab 2.89%, and pleural fluid 1.41%. The microorganisms found in PICU Dr. Soetomo was dominated with gram negative bacteria. Commonest bacterial that recognized from blood was B. cepacea, urine was E. coli, sputum was P. aeruginosa, Stool was E. coli, Cerebrospinal fluid was S. cohnii, endotracheal tube was K. pneumoniae ESBL, pus swab was S. aureus, and pleural fluid was S. maltophilia. Both gram-negative bacteria and gram-positive bacteria isolates revealed multiple drug resistance to commonly used antibiotic, but still had good susceptibility for antibiotic such as; amikacin, cefoperazone-sulbactam, linezolid, vancomycin and carbapenem group.