Maksum Radji

Antimicrobial activity of green tea extract against isolates of methicillin-resistant Staphylococcus aureus and multi-drug resistant Pseudomonas aeruginosa.

OBJECTIVE To evaluate antibacterial activity of the Indonesian water soluble green tea extract, Camellia sinensis, against clinical isolates of methicillin-resistant Staphylococcus aureus (S. aureus) (MRSA) and multi-drug resistant Pseudomonas aeruginosa (MDR-P. aeruginosa). METHODS Antimicrobial activity of green tea extract was determined by the disc diffusion method and the minimum inhibitory concentration (MIC) was determined by the twofold serial broth dilutions method. The tested bacteria using in this study were the standard strains and multi-drug resistant clinical isolates of S. aureus and P. aeruginosa, obtained from Laboratory of Clinical Microbiology, Faculty of Medicine, University of Indonesia. RESULTS The results showed that the inhibition zone diameter of green tea extracts for S. aureus ATCC 25923 and MRSA were (18.970 ± 0.287) mm, and (19.130 ± 0.250) mm respectively. While the inhibition zone diameter for P. aeruginosa ATCC 27853 and MDR-P. aeruginosa were (17.550 ± 0.393) mm and (17.670 ± 0.398) mm respectively. The MIC of green tea extracts against S. aureus ATCC 25923 and MRSA were 400 µg/mL and 400 µg/mL, respectively, whereas the MIC for P. aeruginosa ATCC 27853 and MDR-P. aeruginosa were 800 µg/mL, and 800 µg/mL, respectively. CONCLUSIONS Camellia sinensis leaves extract could be useful in combating emerging drug-resistance caused by MRSA and P. aeruginosa.

Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital,Indonesia

OBJECTIVE To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit (ICU) of a tertiary care of Fatmawati Hospital Jakarta Indonesia. METHODS A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods, and their antibiotic susceptibility testing was performed using disk diffusion method. RESULTS Specimens were collected from 385 patients who were given antimicrobial treatment, of which 249 (64.68%) were cultured positive and 136 (35.32%) were negative. The most predominant isolate was Pseudomonas aeruginosa (P. aeruginosa) (26.5%) followed by Klebsiella pneumoniae (K. pneumoniae) (15.3%) and Staphylococcus epidermidis (14.9%). P. aeruginosa isolates showed high rate of resistance to cephalexin (95.3%), cefotaxime (64.1%), and ceftriaxone (60.9%). Amikacin was the most effective (84.4%) antibiotic against P. aeruginosa followed by imipenem (81.2%), and meropenem (75.0%). K. pneumoniae showed resistance to cephalexin (86.5%), ceftriaxone (75.7%), ceftazidime (73.0%), cefpirome (73.0%) and cefotaxime (67.9%), respectively. CONCLUSIONS Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins, and quinolone antibiotics. Regular surveillance of antibiotic susceptibility patterns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

Isolation of fungal endophytes from Garcinia mangostana and their antibacterial activity

In order to reduce the cost and time of in vitro raised plants of Trichosanthes dioica Roxb., a minimal medium has been formulated by substituting costly growth regulators from the medium with a cost effective constituent, the coconut milk. A semisolid Murashige and Skoogs’s medium supplemented exclusively with 15% coconut milk showed the highest percentage of plantlet regeneration (99%) in the explants. When nodal, shoot-tip and immature leaf explants were cultured on this medium, rhizogenesis was observed in about 5 to 6 days of inoculation, followed by shoot formation in about 8 to 10 days. The fully developed plantlets, 10 to 12 cm in length with professed roots were obtained in about 20 days of inoculation in a single step without adding/changing growth regulators. After transplantation in the potted soil, these plantlets showed similar growth patterns as compared to the plants obtained from a conventional three-four step method of tissue culture experiments. Keywords: Coconut milk, tissue culture, Trichosanthes dioica Roxb

Antibiotic therapy for diabetic foot infections in a tertiary care hospital in Jakarta, Indonesia.

AIMS The purpose of this study was to determine the microbiology of diabetic foot infections and to assess the antibiotic susceptibility patterns. MATERIALS AND METHODS A cross sectional retrospective study of 35 patients with diabetic foot infections hospitalized at the internal medicine clinic of Dr. Mintohardjo Navy Hospital, Jakarta. The data were collected from patient medical records retrospectively. The classification of the diabetic foot infections was evaluated according to Meggit-Wagners Classification. Identification of causative microorganisms was performed by standard microbiologic methods. Antibiotic susceptibility testing was performed using disk-diffusion method. RESULTS During January to December 2012, a total of 288 of diabetic patients were admitted to hospital, and 35 patients had diabetic foot infections. According to Meggit-Wagners classification the most common disease was grade 3 in 31.4% patients, followed by grade 2 in 25.7%, and grade 4 in 17.3% of patients. Conservative diabetic control care was carried out in 37.1% of patients, and surgical intervention was carried out in 62.9% of patients. A total of 59 pathogens were identified. The most common infecting microorganism isolated on pus cultures was Staphylococcus aureus (47.5%), followed by Pseudomonas spp (16.9%), E. coli (10.2%), Streptococcus spp. (8.5%), Enterobacter spp. (7.0%), Proteus spp. (6.7%), and Acinetobacter spp. (3.2%). Overall, 37.2% of the diabetic foot infection caused by a single microorganism, and 62.8% had polymicrobial infections. The most frequently administrated antibiotic was ceftriaxone (40.0%), followed by ciprofloxacin (11.4%), and meropenem (8.6%). CONCLUSION Diabetic foot infections (62.8%) were polymicrobial. S. aureus was most commonly found in the foot infection. Most of the microorganisms isolated from diabetic foot infection were resistant to many types of antibiotics.

Evaluation of antibiotic prophylaxis administration at the orthopedic surgery clinic of tertiary hospital in Jakarta, Indonesia

Objective To evaluate the effectiveness of the use of antibiotic prophylaxis in preventing surgical site infections, at orthopedic surgery unit in tertiary hospital, Dr. Mintohardjo Navy Hospital, Jakarta, Indonesia.

Cross sectional study on antibiotic prescription for acute respiratory tract infection of children under age of 5 at tertiary general hospital in Jakarta Indonesia.

ABSTRACT Aim: The purpose of this study was to evaluate the use of antibiotics in acute respiratory infections in children in Dr Mintohardjo Navy Hospital, Jakarta. Place and Duration of Study: Pediatric Clinic of Dr. Mintohardjo Navy Hospital, Jakarta, Indonesia during January to December 2012. Methodology: This study is a cross-sectional study consisting of children under the age of 5 years, who suffered from acute respiratory tract infections and hospitalized at pediatric clinic of Dr. Mintohardjo Navy Hospital, Jakarta. The data were collected from patient medical records retrospectively. The assessment of antibiotic prescribing patterns for children younger than 5 years was carried out based on the Indonesian Guideline of antibiotic use in acute respiratory tract infections in children. Results: A total of 96 patients enrolled in this study consisted of 53.1% males and 46.9% females. The types of acute respiratory tract infections were acute pharyngotonsilitis (95.8%), acute pneumonia (3.1%) and acute laryngitis (1.1%). The most commonly used antibiotics were ceftriaxone (42.5%), cefotaxime (30.0%), gentamicin (6.3%), cefadroxil Original Research Article