Bacterial pattern in adult decompensated liver cirrhosis ascitic fluid infection during first 5 months of second wave Covid-19 pandemic at tertiary hospitals in Jakarta Indonesia

Objectives: To find out bacterial pattern of ascitic bacterial infection in adult decompensated liver cirrhosis during Covid-19 pandemic at three tertiary referral hopsitals in Jakarta. Materials and Methods: 18 years old or more decompensated liver cirrhosis patient due to any cause with grade 2 or more ascites admitted consecutively to emergency room, inpatient and outpatient unit in Jakarta's three tertiary referral hospitals: Cipto Mangunkusumo National General Hospital, Gatot Soebroto Central Army Hospital, Fatmawati General Hospital would be performed paracentesis ascitic tap during January to May 2021. Bedsite aerobic and anaerobic bacterial blood culture bottles of 10 mL inoculation ( aerobic BACT/ALERT® FA Plus and anaerobic BACT/ALERT® FN Plus bioMerieux Incorporation) were acquired under aseptic and antiseptic standards before antibiotic administration or at least 4 h after it. Diphtheroids species, Bacillus species and Staphylococcus epidermidis were considered contaminant. Results: There were 98 ascitic culture specimens from 98 grade 2 and more ascites decompensated liver cirrhosis patients. Basic characterisitic data included: 32.6% female, 67.4% male, history of hospitalization and antibiotic admission in the last previous 3 months 76.5%, due to viral hepatitis B 38.5%. Bacterial growth was found in 11 specimens ( 11.1%) including 6 aerobic gram negative ( 54.5%): Aeromonas hydrophila, Enterobater aerogenes, Klebsiella pneumonia ( 2 specimens), Acinetobacter species, Pseudomonas aeruginosa and 5 aerobic gram positive ( 45.4%): Enterococcus faecalis, Staphylococcus cohnii ssp cohnii, Staphylococcus cohnii ssp urealyticus, Staphylococcus haemolyticus, Micrococcus luteus. There were no positive culture for Escherichia coli and anaerobic bacteria. Conclusion: During second wave of Covid-19 pandemic in Jakarta, there were almost equal proportion of gram positive and negative bacterial in adult decompensated liver cirrhosis ascitic fluid bacterial infection patients in tertiary hospitals. This result reminds clinicians of bacterial pattern shift in ascitic fluid infection in decompensated liver cirrhosis during pandemic.

A review on ethnomedicinal and phytopharmacological potential of traditionally wild and endemic plant Berberis tinctoria Lesch

Introduction: Berberis tinctoria an evergreen shrub, endemic and predominantly found at a higher altitude of the Nilgiri Biosphere Reserve, India. This leaf and fruit are edible, which are also used in homeopathic remedies for countless illnesses. Objectives: B. tinctoria with diverse ethnomedicinal uses was focused in the prevailing study to detailed the phytochemical and pharmacological properties for further imminent research in this species. Materials and methods: Published data in this review were all gathered from the online bibliographical databases: PubMed, Elsevier, Scopus, Google Scholar, Web of Science, and local ethnic community peoples of Kurumba and Toda. Results: B. tinctoria was used as a Ayurvedic and homeopathy medicine by the tribal communities. The previous findings of B. tinctoria were used for skin diseases, wound healing, inflammatory, menorrhagia, diarrhea, jaundice, and a snakebites. The phytochemical studies revealed that secondary metabolites, antioxidants, and antimicrobial activity as a result of major alkaloid isoforms of berberine, berbamine, jatrorrhizine, etc. Conclusion: B. tinctoria is an important plant due to the presence of bioactive phytochemicals, especially berberine protoberberine group of benzylisoquinoline. As a result of its diverse ethnopharmacological importance, as well as numerous commercial products and novel bioactive compounds yet to be discovered for future drug discovery and development.