South East Asia Journal of Clinical Epidemiology and Evidence Based Medicine

Deteksi Kuman Penghasil Extended Spectrum Beta-Lactamase (ESBL) pada Hewan Ternak di Surakarta

M Izdad Irfani Fanada, Maryani Maryani, Widana Primaningtyas — Wed, 30 Jun 2021 00:00:00 +0000

Pendahuluan: MDRO (salah satunya ESBL) merupakan penyebab masalah kesehatan masyarakat yang krusial. Bakteri ini muncul akibat penggunaan antibiotik yang tidak terukur, terutama pada hewan ternak. Bakteri tersebut tidak hanya ditemukan pada manusia, tetapi juga pada hewan ternak. Manusia dapat terinfeksi bakteri resisten antibiotik tersebut. Penelitian ini bertujuan untuk mengetahui gambaran kejadian ESBL pada hewan peternakan dan pola resistensi antibiotiknya dibandingkan dengan isolat klinis

Metode: Penelitian ini merupakan penelitian deskriptif observasional, yang dilakukan pada bulan September – November. Pengambilan sampel dilakukan di tiga peternakan ayam dan pengujian sampel dilakukan di Laboratorium Mikrobiologi FK UNS. Subjek penelitian adalah 30 sampel swab kloakal ayam. Kuman ditumbuhkan dalam MacConkey agar. Konfirmasi ESBL menggunakan double disc synergy test (DDST). Uji kepekaan antibiotik dilakukan terhadap sampel positif ESBL dan isolat klinis dengan metode kirbey bauer menggunakan 10 antibiotik. Data yang diperoleh dianalisis dengan tabel dummy menggunakan Ms. Excell.

Hasil: Terdapat 45 bakteri tumbuh dalam MacConkey, dimana 28 diantaranya merupakan E.coli, 3 Klebsiella, 9 Pseudomonas, dan 5 Salmonella. Dari 45 bakteri, terkonfirmasi 6 bakteri merupakan penghasil ESBL. Semua sampel yang diuji resisten terhadap ampicillin, cefoperazone-sulbactam, dan amoxycillin dan susceptible terhadap antibiotik meropenem dan amikacin. sebagian besar resisten ampicillin-sulbactam cefotaxime, ciprofloksasin. 50% resisten tetracyclin, dan ceftazidime.

Kesimpulan: Peternakan ayam dapat menjadi sumber potensial kuman penghasil ESBL dengan telah ditemukannya bakteri ESBL pada 2 dari 3 peternakan yang menjadi tempat penelitian dan 20% sampel yang diuji merupakan kuman penghasil ESBL. sensitifitas isolat terhadap antibiotik beragam dan terdapat kemiripan pola resistensi antibiotik antara isolat klinis dengan isolate sampel.

Kata Kunci: ESBL, hewan ternak, peternakan ayam, pola resistensi, antibiotik.

Effects of Zinc Chelator TPEN in Bacterial Susceptibility to Antibiotics Beta-Lactam and Aminoglycoside

Wed, 30 Jun 2021 00:00:00 +0000

Background: Previous research showed that zinc plays significant roles in bacterial virulence, including bacterial resistance to antibiotics which has been increasing over the year. This research aims to elucidate the effect of the addition of zinc chelator TPEN on bacterial susceptibility towards beta-lactam and aminoglycoside antibiotics.

Methods: This was an experimental study using 30 clinical isolates of Gram positive and negative bacteria. Bacteria were inoculated into Mueller Hinton agar as control and Mueller Hinton with addition of 30 µM and 20 µM zinc chelator TPEN. Antibiotic susceptibility test was conducted using Kirby Bauer method. The difference of inhibition zone diameter was compared and analyzed using Mann-Whitney test.

Results: There was a significant difference in inhibition zone diameter of meropene (p<0.05) while no significant differences was observed in ceftriaxone, cefotaxime, ampicillin, imipenem, kanamycin, amikacin, gentamicin, and tobramycin (p>0.05). Statistical test using the whole pair of data, showed no significant difference in inhibition diameter of control and experimental group in both beta-lactam (p>0.05) and aminoglycoside antibiotics (p>0.05).

Conclusions: The addition of zinc chelator TPEN in Mueller Hinton agar increase bacterial susceptibility to meropenem significantly. Meanwhile, it did not influence bacterial susceptibility to the other beta-lactam and aminoglycoside antibiotics.

Relationship between Gender and Education Level of Public Healthcare Officers with Perceptions of Tuberculosis in the Context of Tuberculosis Infection Prevention and Control in Surakarta

Nurul Asyrofah Hidayatunnisa, Ari Natalia Probandari, Maryani Maryani — Wed, 30 Jun 2021 00:00:00 +0000

Background: Public healthcare officers are at the forefront of healthcare in Indonesia. Public healthcare officers have a major role in implementing programs at the public healthcare, one of which is the Infection Prevention and Control Program (IPC) especially in Tuberculosis. The aim of this study was to determine the relationship between gender and education level of public healthcare officers with perceptions of Tuberculosis in the context of Tuberculosis Infection Prevention and Control in Surakarta.

Methods: This study was an analytic observational study with a cross-sectional approach. The data collection method used total sampling. The research was conducted in all public healthcare Surakarta City in November 2019. The questionnaire used was the Respondent Data questionnaire and the questionnaire Health Belief Model was developed from the TB Measurement Guidance and the Tuberculosis IPC Guidelines in Health Care Facilities. The total number of respondents who met the inclusion criteria was 451 people. The data analyzed were gender, level of education and perceived value of tuberculosis. The data analysis used the Spearman correlation test.

Results: The correlation test Spearman for the relationship between gender and the perception of tuberculosis obtained a correlation coefficient (r) = 0.042 and a significance value (p) = 0.373> 0.05. The results of the Spearman correlation test for the relationship between the level of education and the perception of tuberculosis, the correlation coefficient value (r) = -0.528 and a significance value (p) = <0.001.

Conclusion: The results of this study indicate that there is no significant relationship between gender and Perception of Tuberculosis. And there is a significant relationship between education level and Perception of Tuberculosis.

Effects of 100% Fruit Juice Consumption on Weight in Adults: A Systematic Review

Rahma Adiba, Dono Indarto, Ari Natalia Probandari — Wed, 30 Jun 2021 00:00:00 +0000

Background: There are claims of the harms of fruit juice for health due to its natural sugar leading to weight gain. Those claims are being used by several national and global health institution/s as a reference for recommendations to avoid fruit juice consumption. The current study investigating the effect of fruit juice consumption in adults that focuses on weight using RCT as evidence is limited.

Method: Reviewers searched PubMed, ProQuest, ScienceDirect, and Scopus on December 12nd, 2020, and January 17th, 2021. The eligible criteria for the study is an experimental trial with control. Reviewer synthesized the result of studies fulfilling the criteria using Cochrane Handbook for Systematic Review guideline and Synthesis Without Meta-analysis (SWiM) guideline. The risk of bias was assessed using RoB 2 with two independent reviewers, and a senior reviewer helped resolved the difference in judgment.

Results: 15 data points from 14 RCTs (parallel and crossover) has a low risk of bias (1), moderate risk of bias (4), and high risk of bias (10). Those data show that short-term 100% fruit juice consumption (2-12 weeks) yields no significant effect on weight in healthy and other adults. The effect size was measured using median change in the intervention (0.4 kg), statistical sign test (p=0.0923), and clinical change value (1.6%).

Conclusions: Fruit juice consumption in adults does not significantly affect weight. Following research regarding the optimal dose to obtain the benefits from fruit juice needs to be conducted.