Resistance patterns of microbes isolated from gastrointestinal tract.

Background: Digestive tract infection with clinical manifestation of diarrhea is an infectious disease that has the highest morbidity and mortality rate, especially in developing countries. Diarrhea causes mortality mostly in infants under one year old. Improvement in management is done continuously, but advances in diagnosis and therapy cannot be reached by developing countries. One of the etiological agents causing infection of digestive tract is bacteria. Therefore, knowledge of bacteria that cause gastrointestinal infection and their resistance patterns may support the management of this disease. The aim of this study was to examine microbes that were isolated from the digestive tract and their resistance patterns against antibiotics. Methods: Samples (stool, rectal/anal swab) were collected from the Clinical Microbiology Laboratory, FKUI during 2005-2008. Isolation, identifi cation and sensitivity test were conducted according to standard laboratory procedures. Interpretation of sensitivity test was done according to NCCLS/CLSI guidance. Data was analyzed using WHOnet version 5.3. Results: We found 28 isolates of pathogenic Escherichia coli, 1 isolate of S. paratyphi A and 4 isolates of yeasts. Pathogenic Escherichia coli were still sensitive against some antibiotics, but the sensitivity was reduced against amoxicillin, sulbenicillin, ticarcillin and trimethoprim/sulfamethoxazole. Conclusion: The most predominant gastrointestinal tract infection causing microbes was pathogenic Escherichia coli. These bacteria showed decrease sensitivity against some antibiotics commonly used to treat patients with gastrointestinal tract infection.

Development of multiplex-PCR assay for rapid detection of Candida spp.

Aim Candida spp. infection commonly occur in immunocompromised patients. Biochemical assay for identifi cation of Candida spp. is time-consuming and shows many undetermined results. Specifi c detection for antibody, antigen and metabolites of Candida spp. had low sensitivity and specifi city. In this study, we developed a rapid diagnostic method, Multiplex-PCR, to identify Candida spp. Methods Five Candida spp. isolates were cultured, identifi ed with germ tube and API® 20 C AUX (BioMerieux® SA) kit. Furthermore, DNA was purifi ed by QIAamp DNA mini (Qiagen®) kit for Multiplex-PCR assay. Results DNA detection limit by Multiplex-PCR assays for C. albicans, C. tropicalis, C. parapsilosis, C. krusei and C. glabrata were 4 pg, 0,98 pg, 0,98 pg, 0,5 pg and 16 pg respectively. This assay was also more sensitive than culture in that Multiplex-PCR could detect 2.6-2.9 x 100 CFU/ml, whereas culture 2.6-2.9 x 102 CFU/ml. Conclusion Multiplex-PCR is much more sensitive than culture and thus, can be recommended as a sensitive and specifi c assay for identifi cation of Candida spp.

Correlation between group discussion and examination result in Problem Based Learning.

Background: Problem-based Learning (PBL) is one method used in conducting a competence-based curriculum. Group discussion plays an important role in PBL, and students have the opportunity of obtaining more information to meet their learning objectives and improve their knowledge. The aim of this research was to study the correlation between group discussion results and the final score of the theoretical examination. Method: Second-year medical students Faculty of Medicine, University of Indonesia (n=214, 85 males and 127 females), who took the Cardiovascular module completely were included in this study. Group discussion and summative test scores were collected and analyzed using SPSS program version 10. Results and Discussion: The correlation between scores obtained in the group discussion and theoretical test was significant, with Pearson Correlation = 0.218, significant at 0.01 level (2- tailed). Conclusion: There was a significant correlation between group discussion scores and theoretical test scores.

Water quality of Angke River: Microbiological point of view.

This research is a part of a multidisciplinary research in the Angke River. The aim of this research is to study the river’s water quality from the microbiological point of view in several locations along the Angke River. The locations under this study included: Duri Kosambi, Pesing Poglar, Teluk Gong, Pantai Indah Kapuk and Estuary (4 points). The examinations were held in term of microbiological aspects, based on the guide published by the Ministry of Health, the Republic of Indonesia and concluded according to Government Regulation. The parameter of microbiological tests was the most probability number (MPN) of total and fecal coliform. The method used was done in 2 steps: presumptive and confirmed test. Completed test was conducted to confirm the presence of E.coli and other bacteria in water. The result showed that the water quality of the Angke River was poor; therefore, it is not recommended to be used as drinking water. It is categorized as the 2nd class quality that means it can only be used for water recreation, veterinary, showering plants and or other purposes that require the same quality of water. The MPN of total coliform at Pantai Indah Kapuk and the outer side of river mouth (estuary area) was lower than other areas. People who live in Pantai Indah Kapuk are having a higher economic level. Therefore, it can be assumed that they are more educated people who have more insight about hygiene. Further, the water at the outer side of river mouth contains a higher salt concentration that can kill pathogenic bacteria. In conclusion, the water quality of the Angke River is categorized as 2nd class quality not recommended to be used as dringking water except the water from Pantai Indah Kapuk and estuary area that can be used as dringking water after boiling.

Patterns of bacterial resistance against Ceftriaxone from 2002 to 2005 in the Clinical Microbiology Laboratory of the Faculty of Medicine, University of Indonesia.

The spread of drug resistant microbes is a global public health challenge which impairs the efficacy of antimicrobial agents and causes substantial increase in morbidity and mortality rates, including healthcare-associated costs. Monitoring of antimicrobial drug resistance from documented microbial epidemiology & resistance rate is useful in preventing the emergence of resistance. This study reports on the pattern of bacterial resistance against ceftriaxone in the past 4 years. The data were obtained from specimens examined in the Clinical Microbiology Laboratory, Department of Microbiology Faculty of Medicine, University of Indonesia from 2002 to 2005. Microbial species were determined from culture and identification tests. Disc diffusion method was used for sensitivity testing of ceftriaxone to 14 Gram-negative and 7 Gram-positive bacteria. Although resistance rates were increased from 2002 to 2005, resistance rates of ceftriaxone were found to be less than 50%. Low resistance rates (< 3%) were observed for Salmonella typhi, Salmonella paratyphi A, Shigella flexneri, Serratia marcescens, and Streptococcus pneumoniae. These results could be useful in developing guidelines on the use of ceftriaxone in Indonesia.