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"Methicillin-resistant Staphylococcus aureus (MRSA) adalah salah satu jenis Multidrug-resistant organism (MDRO) yang cukup endemik di banyak fasilitas kesehatan, terutama di rumah sakit bagian Intensive Care Unit (ICU). Riwayat rawat pasien sebelum masuk ICU dinilai telah menjadi salah satu faktor risiko terjadinya kolonisasi MRSA pada pasien. Permasalahan muncul ketika diketahui bahwa pasien ICU yang memiliki kolonisasi MRSA berisiko tinggi mengalami infeksi MRSA. Oleh karena itu, diperlukan data mengenai kejadian kolonisasi MRSA yang dihubungkan dengan riwayat rawat pasien sebelum masuk ICU. Dengan demikian, kejadian kolonisasi MRSA di rumah sakit Indonesia dapat diturunkan. Penelitian ini merupakan studi cross sectional analitik dengan menggunakan data sekunder hasil pemeriksaan mikrobiologi swab (hidung, ketiak, dan rektum) dan rekam medik 109 pasien ICU Pusat RSCM dari bulan Januari 2011 sampai Agustus 2011. Pemilihan sampel dilakukan dengan consecutive sampling. Hasil pemeriksaan mikrobiologi yang dilihat adalah hasil uji resistensi MRSA baik pada pasien yang memiliki riwayat rawat di rumah sakit sebelum masuk ICU ataupun tidak. Data dianalisis dengan uji Chi-square. Hasil perbandingan data antara proporsi pasien yang positif memiliki kolonisasi MRSA dan memiliki riwayat rawat di rumah sakit sebelumnya dengan proporsi pasien positif mengalami kolonisasi MRSA dan tidak dirawat di rumah sakit sebelumnya adalah RP=1,206 dengan nilai kemaknaan p=0,307 dan IK95% -3,087; 5,499. Hal ini menunjukkan bahwa tidak terdapat hubungan bermakna antara kolonisasi MRSA dengan riwayat rawat pasien sebelum masuk ICU.

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Methicillin-resistant Staphylococcus aureus (MRSA) is one of the Multidrug-resistant organism (MDRO) which has been quite endemic in many healthcare facilities, especially in the Intensive Care Unite (ICU) of hospitals. History of patients’ hospitalization before ICU admission was considered to be one of risk factors for MRSA colonization in patients. Problems arised after known that ICU patients with MRSA colonization are at high risk of MRSA infection. Therefore, we need data of MRSA colonization associated with history of patients’ hospitalization before ICU admission. So that, the incidence of MRSA colonization in Indonesia hospitals can be reduced.

This is an analytic cross sectional study using secondary data results from microbiological examination of swabs (nose, armpit, and rectum) and medical records of 109 patients from the Central ICU RSCM on January 2011 until August 2011. Samples selection was done by consecutive sampling. Microbiological examination results which are used in this study were the results of MRSA resistance test both in patients who had history of hospitalization before ICU admission or those who had not. Data is analyzed with Chi-square.

The result of data comparison between proportion of patients with positive MRSA colonization and had history of hospitalization to the proportion of patients with positive MRSA colonization and had not history of hospitalization before is RP=1,206 with significance value p=0,307 and IK95% -3,087; 5,499. This suggests that there is no significant relationship between MRSA colonization and the history of patients’ hospitalization before ICU admission."

"Infeksi methicillin-resistant Staphylococcus aureus atau MRSA merupakan salah satu ancaman bagi pelayanan orthopaedi dan traumatologi. Rancangan penelitian adalah potong lintang, dilaksanakan pada bulan Desember 2010 - Desember 2011. Analisis data dilakukan secara deskriptif dengan menghitung angka karier MRSA dan dilakukan uji Fisher untuk mencari faktor-faktor yang berhubungan. Didapatkan angka infeksi MRSA pada pasien pasca operasi 0,5%, angka karier pada pasien 50%, angka karier keluarga 25%, namun tidak ditemukan karier pada penyedia layanan kesehatan. Tidak terdapat hubungan yang bermakna antara status karier keluarga dan status karier penyedia layanan kesehatan dengan status karier MRSA pada pasien.

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Methicillin-resistant Staphylococcus aureus (MRSA) infection has become a threat towards Orthopedic and Traumatology care. Cross-sectional study design was used as the methodology in this study. The time frame was from December 2010 until Desember 2011. Data analysis method used was descriptive method by calculating the MRSA carrier number. Afterwards, Fisher test was done to find out the relative factors. MRSA infection rate on post surgery patient was 0.5%,; carrier rate among patients, family, and healthcare providers were 50%, 25%, and 0% . There was no significant correlation between status of family carrier, and healtcare provider carrier with the status of patient carrier among after surgery MRSA infected patient ."

"Multidrug Resistant Organism adalah bakteri yang resisten terhadap satu atau lebih kelas antibiotika. Infeksi MDRO menyebabkan kegagalan terapi pada beberapa jenis antibiotik dan meningkatkan kesulitan untuk penyembuhan. Infeksi MDRO cukup banyak ditemukan pada pelayanan kesehatan terutama di bagian Intensive Care Unit karena pengaruh beberapa faktor risiko yang diantaranya pemakaian alat medis intensif, status imunologis yang lemah, dan transmisi dari petugas kesehatan. Penggunaan alat medis intensif terutama adalah tracheal tube adalah faktor risiko terjadinya kolonisasi bakteri Pseudomonas sp yang tidak jarang ditemukan di ICU adalah MDR-Pseudomonas sp. Oleh karena itu, data mengenai kejadian kolonisasi MDR-Pseudomonas sp. yang dihubungkan dengan riwayat penggunaan tracheal tube di ICU dibutuhkan untuk melakukan usaha pencegahan infeksi MDR-Pseudomonas sp. di rumah sakit. Penelitian ini merupakan studi cross-sectional analitik yang dilakukan di Rumah Sakit Cipto Mangunkusumo , Jakarta Pusat pada bulan Januari hingga Juni 2012. Data diambil dari data sekunder yang berasal dari kultur sputum dari 111 pasien yang dirawat di ICU pusat RSCM. Sampel diambil dengan metode consecutive sampling. Data yang didapat oleh peneliti dianalisis dengan metode chi-square, dengan p=0.05. Hasil yang didapatkan adalah prevalensi 8,1%, RP>1, nilai kemaknaan p=0.164, dan IK 95% 0.986 ; 2.787. Hasil yang didapat menunjukkan bahwa tidak terdapat hubungan yang bermakna antara riwayat penggunaan tracheal tube dengan infeksi MDR-Pseudomonas sp.

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Multidrug Resistance Organism (MDRO) is bacteria resist with one or more antibiotics group. MDRO can cause the failure of treatment in some types of antibiotics and increases the difficulty for healing. MDRO infection commonly found in health services, especially in the Intensive Care Unit due to the influence of several risk factors including intensive use of medical devices, the lack of immunological status, and transmission of health workers. The use of medical devices, particularly tracheal tube, is a risk factor of colonization MDR- Pseudomonas sp. Therefore, we need data of MDR- Pseudomonas sp. colonization in Indonesia Hospital associated with administration history of tracheal tube in patients of adult ICU. So the practitioner can use these data for prevention and control of infection MDR- Pseudomonas sp. in hospital especially in ICU.

This is an analytical cross sectional study conducted at central ICU of Cipto Mangunkusumo Hospital on January, 2011 until June, 2012. Samples taken from secondary data derived from sputum examinations and medical records of 111 patients in ICU RSCM. We select the sample by consecutive sampling method. Data were analyzed with chi-square method, with p = 0.05. The results are prevalence 8,1%, RP> 1, the value of significance p = 0164, and 95% CI 0986; 2787. These results suggest that there is no association between administration history of tracheal tube and incidence of infection by MDR- Pseudomonas sp."

"Pseudomonas sp. Dikenal karena kemampuannya yang bersifat pathogen oportunis.Beberapa data epidemiologis menyatakan bahwa resistensi bakteri ini terhadap antibiotika semakin meningkat berdasarkan isolasi dari laboratorium. Prevalensi Pseudomonas sp.didapatkan lebih banyak secara bermakna pada Intensive Care Unit (ICU) dibandingkan pada ruang perawatan non-intensif, Salah satunya adalah akibat ICU memungkinkan terjadinya antibiotic pressure yang lebih besar karena penggunaan antibiotika yang lebih agresif, dimana penggunaan antibiotika dinilai telah menjadi factor risiko diperolehnya organism ini. Dengan mengetahui hubungan factor risiko dengan kejadian bakteri Pseudomonas sp. Yaitu penggunaan antibiotik, diharapkan para praktisi kesehatan lebih waspada dalam penanganan pasien infeksi terutama di ICU. Penelitian ini merupakan studi cross sectional analitik dengan menggunakan data sekunder hasil pemeriksaan mikrobiologi kultur (darah, sputum, dan/ataujaringan) dan rekam medik 111 pasien ICU Dewasa RSCM dari tanggal 10 Januari 2011 hingga 9 Agustus 2011. Pemilihan sampel dilakukan dengan consecutive sampling. Hasil pemeriksaan mikrobiologi yang dilihat adalah hasil uji resistensi Pseudomonas sp.baik pada pasien yang memiliki riwayat penggunaan antibiotikaa taupun yang tidak. Data dianalisisdenganuji Chi-square, p=0.05. Hasilperbandingan data antaraproporsipasien yang positif terinfeksi bakteri Pseudomonas sp.dan memiliki riwayat penggunaan antibiotika dengan proporsi pasien positif terinfeksi bakteri tersebut dan tidak menggunakan antibiotika adalah RP >1 dengan nilai kemaknaan p=1.000 dan IK95% 1.259; 1.779. Hal ini menunjukkan bahwa penggunaan antibiotika dapat menjadi factor risiko terhadap kejadian infeksi bakteri Pseudomonas sp.

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Pseudomonas sp. known for its ability to be opportunistic pathogens.Some epidemiological shows that bacterial resistance to antibiotics is increasing by the isolation of the laboratory.Pseudomonas sp. bacteria is a microorganism which produce an enzyme that could hydrolyze penicillin, first, second, and third generation cephalosporins, and aztreonam (except cephamycin and carbapenem) which its activity could be inhibited by beta lactam inhibitor. The prevalence of Pseudomonas sp. was showed more significant in Intensive Care Unit (ICU) than in non-intensive care unit, because the bigger antibiotic pressure is more liable to happen in ICU where the antibiotic use is more aggressive. The use of antibiotic is considered to be the risk factor of Pseudomonas sp. infection. Therefore, we need the data of prevalence of Pseudomonas sp. bacteria associated with the use of antibiotics in ICU in Indonesia, so the health practitioner could use it to prevent and control the infection of Pseudomonas sp. bacteria in ICU.

This is an analytical cross sectional study conducted at adult ICU of Cipto Mangunkusumo Hospital on 10th of January, 2011 until 9th of August, 2011. Samples were taken from secondary data derived from culture examinations and medical records 111 patients in ICU RSCM. The samples were selected by consecutive sampling.

This study use the result of Pseudomonas sp.resistance test in patients with or without history of antibiotic use. The data were analyzed with Chi-square method, p=0.05. The results are RP >1, the value of significance p=1.000 and 95% CI 1.259; 1.779. These results show that the use of antibiotics may be a risk factor of Pseudomonas sp. bacteria infection."

"Methicillin Resistant Staphylococcus Aureus (MRSA) merupakan salah satu penyebab infeksi nosokomial. Meskipun telah terdeteksi sejak tahun 1961, angka kejadian MRSA di rumah sakit semakin meningkat sampai sekarang, sehingga tingkat pengetahuan perawat yang baik tentang MRSA menjadi sangat penting dalam upaya pencegahan terjadinya MRSA. Tujuan dari penelitian deskriptif ini adalah untuk mengetahui gambaran tingkat pengetahuan perawat tentang infeksi MRSA di RS. Awal Bros Bekasi. Tehnik pemilihan sampel adalah total sampling dan dianalisis dengan menggunakan analisis univariat. Hasil penelitian menunjukkan sebanyak 48,2% responden memiliki tingkat pengetahuan yang baik, dan sebanyak 15,7% memiliki tingkat pengetahuan berkategori kurang. Hasil penelitian ini merekomendasikan untuk dilakukan sosialisasi tentang MRSA sebagai upaya meningkatkan patient safety.

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Methicillin Resistant Staphylococcus Aureus (MRSA) is one of the causes of nosocomial infection. Although it has been detected since 1961, the incidence of MRSA in hospitals is increasing until now, so a good level of nurse’s knowledge about MRSA become very important in the prevention of the occurrence of MRSA. The purpose of this descriptive research was to identify the level of nurse’s knowledge about MRSA infections at Awal Bros Hospital Bekasi. The sample selection technique was total sampling and the results were analyzed using univariate analysis. The results showed that 48.2% of respondents have a good level of knowledge, and 15.7% had less knowledge level category. Based on the research results, the researcher suggested that MRSA socialization should be done in order to enhanced patient safety and complete the support facilities."

"Methisillin Resistant Staplylococcus aureus (MRSA) adalah strain Staphylococcus aureus yang telah mengalami resisten terhadap antibiotika metisilin dan lainnya dalam 1 golongan. Mekanisme resistensi MRSA terjadi karena Sraphylococcus aureus menghasilkan Penicillin Binding Protein (PBP2a atau PBP2?) yang dikode oleh gen mecA yang memiliki afinitas rendah terhadap metisilin. Saat ini MRSA diuji dengan cara uji resistensi dengan cara Cakram Oxacillin 1 ug. Cara ini memerlukan isolat murni dan kultur bakteri, sehingga hasilnya baru bisa diketahui paling cepat 5 hari. Dalam upaya untuk mencari teknik diagnostik yang cepat dan tepat untuk mendeteksi MRSA, deteksi gen mecA dengan teknik PCR merupakan salah satu diagnostik alternatif. Tujuan penelitian ini adalah mencari alternatif teknik diagnostik yang cepat dan tepat untuk pemeriksaan MRSA, dalam hal ini PCR. Pengujian dibagi dalam 2 tahap, yaitu : (1). Isolasi dan Identifikasi MRSA secara fenotipik, (2). Deteksi gen mecA pada isolat MRSA dengan teknik PCR yang terdiri dari: optimasi uji PCR untuk deteksi gen mecA, spesifisitas uji PCR, sensitifitas dan spesifisitas deteksi gen mecA sebagai uji diagnostik alternatif MRSA. Hasil isolasi dan identifikasi secara fenotipik dari 114 isolat diperoleh MRSA sebanyak 76 isolat, dan MSSA sehesar 38 isolat. Berdasarkan hasil penelitian deteksi gen mecA pada isolat MRSA dengan teknik PCR diperoleh 75 isolat menunjukkan hasil positif terhadap gen mecA, sedangkan 1 isolat menunjukkan hasil negatif terhadap gen mecA, isolat tersebut adalah 1295/MUT yang diperoleh dari Laboratorium Mikrobiologi Klinik (LMK) FKUI. Dari hasil penelitian ini diperoleh hasil uji PCR gen mecA terhadap beberapa bakteri lain yaitu Staphylococcus epidermidis, Scitreus, B. subrilis, Streptococcus bera haemolyricus, E. coli, K. pneumoniae dan P. aeruginosa, ternyata S. epidermidis dan S.citreus menunjukkan hasil PCR positif terhadap gen mecA, sedangkan bakteri lain menunjukkan hasil negatif terhadap gen mecA. Hasil uji PCR gen mecA dibandingkan dengan baku emas pemeriksaan sensitivitas dan spesifisitas secara fenotipik terhadap isolat MRSA dan MSSA adalah 98,7% dan 100%, dan nilai Posistive Predictive Value (PPV)& Negative Predictive Value (NPV) adalah 100% & 97,4%."

"[ABSTRAKStaphylococcus spp. peragi manitol merupakan flora normal kulit terbanyak dan sering bersifat multiresisten, serta dapat menjadi salah satu penyebab healthcare associated infection (HAI). Di Indonesia, data mengenai Staphylococcus spp. peragi manitol yang resisten metisilin belum tersedia. Penelitian ini bersifat retrospektif untuk mengetahui pola kepekaan dan karakteristik genotipik (mecA dan tipe SCCmec I-V) flora normal Staphylococcus spp peragi manitol yang diisolasi dari pasien ICU Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM) tahun 2011, 2013 dan 2014. Dari 187 isolat, 15% di antaranya merupakan methicillin resistant Staphylococcus aureus (MRSA) yang sebagian besar resisten terhadap gentamisin (64,3%), klindamisin (50%), golongan fluorokuinolon (64,3-71,4%) dan tetrasiklin (57,1%). Sedangkan 55,6% merupakan Staphylococcus koagulase negatif resisten metisilin (MR-CoNS) yang sebagian besar resisten terhadap gentamisin (55%), fluorokuinolon (62,5-88,5%), eritromisin (91,3%), klindamisin (75%) dan rifampisin (82,7%). Resisten metisilin pada MRSA hampir semuanya disebabkan oleh gen mecA (96,4%), sedangkan pada MR-CoNS, gen mecA ditemukan pada 76,9% isolat. Tipe SCCmec yang paling banyak ditemukan pada kedua kelompok yaitu SCCmec tipe I. Dapat disimpulkan bahwa sebagian besar Staphylococcus spp. peragi manitol yang merupakan flora normal pasien yang dirawat di ICU RSUPNCM, merupakan pembawa gen mecA. Surveilens berkelanjutan dibutuhkan untuk mengetahui kecenderungan perubahan pola kepekaan dan pencegahan transmisi di fasilitas kesehatan.

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ABSTRACTStaphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.;Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.;Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities., Staphylococcus spp. mannitol fermenters are the most abundant skin normal flora. It is frequently resistant to many drugs and could become one of the causes of the healthcare associated infection (HAI). There is no data about Methicillin Resistant Staphylococcus spp. mannitol fermenters in Indonesia yet. In this restrospective study we aim to identify the susceptibility patterns and genotypic characteristics (mecA gene and SCCmec type I-V) of normal flora Staphylococcus spp. mannitol fermenters isolated from Intensive Care Unit patients of Cipto Mangunkusumo Hospital during 2011, 2013 and 2014. This study found that 15% of 187 isolates were methicillin resistant Staphylococcus aureus (MRSA) and mostly resistant to gentamycin (64,3%), clindamycin (50%), fluoroquinolone (64,3-71,4%) and tetracycline (57,1%). While 55,6% of the isolates were methicillin resistant coagulase negative Staphylococcus (MR-CoNS) and mostly resistant to gentamycin (55%), fluoroquinolone (62,5-88,5%), erithromycin (91,3%), clindamycin (75%) and rifampicin (82,7%). Methicillin-resistant on almost MRSA, carried mecA gene (96.4%), while in the MR-CoNS, mecA gene was found in 76.9% of all isolates. The most common SCCmec type found was SCCmec type I. Thus, mecA gene carrier Staphylococcus spp. mannitol fermenters were found as normal flora in intensive care patients of Cipto Mangunkusumo Hospital. Continuous surveillance is however, necessary to determine the tendency of changing susceptibility patterns and transmission prevention in health facilities.]"

"ABSTRAKMethicillin resistant Staphylococcus aureus (MRSA) merupakan bakteri yang resistenterhadap antibiotik methicillin dan antibiotik golongan β-laktam lainnya. MRSA adalahpatogen umum di rumah sakit dan masyarakat. Isolasi MRSA tidak mudah dilakukankarena seringkali bercampur atau terkontaminasi dengan flora normal seperti coagulasenegative Staphylococci (CoNS) yaitu Staphylococcus epidermidis dan Staphylococcushaemolyticus. Studi ini menggunakan metode fenotipik berupa pengamatan morfologi,pengecatan Gram, Uji biokimia, serta kepekaan antibiotik sedangkan uji genotipik(metode molekular) berupa PCR gen nuc dan mec, SCCmec typing, MLST dansekuensing. Subyek penelitian sebanyak 48 isolat tersimpan di LaboratoriumBakteriologi Molekular, Lembaga Eijkman Jakarta. Diperoleh sebanyak 33 sampel(68.75) memiliki tipe 5 ccr, 9 sampel (18.75) tipe 2 ccr dan 6 sampel (12.5 )nontypeable. Sequence type (ST) yang dominan pada penelitian ini adalah ST239 (2-3-1-1-4-4-3) dan merupakan strain yang multidrug resistant dominan. Pada penelitian inisemua isolat MRSA yang berjumlah 48 isolat telah dikonfirmasi memiliki ciri-cirifenotipik yang sesuai, yaitu Gram positif coccus menyerupai buah anggur, hemolisis,oksidase negatif, katalase positif dan koagulase positif. Sifat bakteri MRSA secaragenotipik mempunyai gen nuc dan gen mecA positif. Hubungan antara sifat genotipedan sifat fenotipe MRSA yang terlihat dalam penelitian ini adalah semua isolat MRSAyang multidrug resistant (uji secara fenotipik) juga merupakan sequence type yangdominan di rumah sakit (uji genotipik).

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ABSTRACTMethicillin resistant Staphylococcus aureus (MRSA) is a bacterium that is resistant tothe methicillin antibiotics and other β-lactam group antibiotics. MRSA is a commonpathogen in hospitals and communities. Isolation of MRSA is not easy to do because itis often mixed or contaminated with normal flora such as coagulase negativeStaphylococci (CoNS), namely Staphylococcus epidermidis and Staphylococcushaemolyticus. This study used phenotypic methods in the form of morphologicalobservations, Gram staining, biochemical tests, and antibiotic sensitivity whilegenotypic tests (molecular methods) in the form of nuc and mec PCR, SCCmec typing,MLST and sequencing. The research subjects were 48 isolates stored in the MolecularBacteriology Laboratory, Eijkman Institute Jakarta. Thirty three samples (68.75) hadtype 5 ccr, 9 samples (18.75) type 2 ccr and 6 samples (12.5) nontypeable. Thedominant sequence type (ST) in this study is ST239 (2-3-1-1-4-4-3) and is a multidrugresistant dominant strain. In this study, all isolates of MRSA, total of 48 isolates, wereconfirmed to have appropriate phenotypic features, which are Gram positive cocciresembling grapes,-hemolysis, negative oxidase, positive catalase and positivecoagulase. Genotypically all isolates have positive nuc gene and mecA gene. Therelationship between genotype features and MRSA phenotype seen in this study is thatMRSA isolates that are multidrug resistant (phenotypic test) are also the dominantsequence types in the hospital (genotypic test)."

"Methicillin resistant Staphylococcus aureus (MRSA) merupakan bakteri yang resisten terhadap antibiotik methicillin dan antibiotik golongan β-laktam lainnya. MRSA adalah patogen umum di rumah sakit dan masyarakat. Isolasi MRSA tidak mudah dilakukan karena seringkali bercampur atau terkontaminasi dengan flora normal seperti coagulase negative Staphylococci (CoNS) yaitu Staphylococcus epidermidis dan Staphylococcus haemolyticus. Studi ini menggunakan metode fenotipik berupa pengamatan morfologi, pengecatan Gram, Uji biokimia, serta kepekaan antibiotik sedangkan uji genotipik (metode molekular) berupa PCR gen nuc dan mec, SCCmec typing, MLST dan sekuensing. Subyek penelitian sebanyak 48 isolat tersimpan di Laboratorium Bakteriologi Molekular, Lembaga Eijkman Jakarta. Diperoleh sebanyak 33 sampel (68.75%) memiliki tipe 5 ccr, 9 sampel (18.75 %) tipe 2 ccr dan 6 sampel (12.5 %) nontypeable. Sequence type (ST) yang dominan pada penelitian ini adalah ST239 (2-3- 1-1-4-4-3) dan merupakan strain yang multidrug resistant dominan. Pada penelitian ini semua isolat MRSA yang berjumlah 48 isolat telah dikonfirmasi memiliki ciri-ciri fenotipik yang sesuai, yaitu Gram positif coccus menyerupai buah anggur, β-hemolisis, oksidase negatif, katalase positif dan koagulase positif. Sifat bakteri MRSA secara genotipik mempunyai gen nuc dan gen mecA positif. Hubungan antara sifat genotipe dan sifat fenotipe MRSA yang terlihat dalam penelitian ini adalah semua isolat MRSA yang multidrug resistant (uji secara fenotipik) juga merupakan sequence type yang dominan di rumah sakit (uji genotipik).

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Methicillin resistant Staphylococcus aureus (MRSA) is a bacterium that is resistant to the methicillin antibiotics and other β-lactam group antibiotics. MRSA is a common pathogen in hospitals and communities. Isolation of MRSA is not easy to do because it is often mixed or contaminated with normal flora such as coagulase negative Staphylococci (CoNS), namely Staphylococcus epidermidis and Staphylococcus haemolyticus.

This study used phenotypic methods in the form of morphological observations, Gram staining, biochemical tests, and antibiotic sensitivity while genotypic tests (molecular methods) in the form of nuc and mec PCR, SCCmec typing, MLST and sequencing. The research subjects were 48 isolates stored in the Molecular Bacteriology Laboratory, Eijkman Institute Jakarta. Thirty three samples (68.75%) had type 5 ccr, 9 samples (18.75%) type 2 ccr and 6 samples (12.5%) nontypeable. The dominant sequence type (ST) in this study is ST239 (2-3-1-1-4-4-3) and is a multidrug resistant dominant strain.

In this study, all isolates of MRSA, total of 48 isolates, were confirmed to have appropriate phenotypic features, which are Gram positive cocci resembling grapes, β-hemolysis, negative oxidase, positive catalase and positive coagulase. Genotypically all isolates have positive nuc gene and mecA gene. The relationship between genotype features and MRSA phenotype seen in this study is that MRSA isolates that are multidrug resistant (phenotypic test) are also the dominant sequence types in the hospital (genotypic test). "

"Penggunaan antibiotika yang tidak rasional dapat meningkatkan angka kejadian infeksi Enterobacteriaceae penghasil extended spectrum beta-lactamase (ESBL). Prevalensi Enterobacteriaceae penghasil ESBL berbeda di berbagai rumah sakit, dan dapat mempersulit pengobatan, memperpanjang lama rawat, dan meningkatkan angka kematian. Penelitian ini bertujuan untuk mengetahui prevalensi Enterobacteriaceae penghasil ESBL di ICU Pusat RSCM dan hubungannya dengan penggunaan antibiotika. Penelitian merupakan studi cross sectional menggunakan 111 data sekunder hasil uji resistensi ESBL dari pemeriksaan mikrobiologi kultur sesuai standar The Clinical and Laboratory Standards Institute (CLSI) dan rekam medik pasien ICU Pusat RSCM dalam tahun 2011. Hasil uji laboratorium menunjukkan 8 dari 111 sampel (7,2%) mengalami infeksi Enterobacteriaceae penghasil ESBL. Data dianalisis dengan uji chi-square, p=0,05. Hasil analisis statistik menunjukkan bahwa RP>1 dengan nilai kemaknaan p=1.000 dan IK95% 1.039; 1.179. Berdasarkan hasil tersebut, dapat disimpulkan bahwa tidak terdapat hubungan bermakna antara penggunaan antibiotika dengan kejadian infeksi Enterobacteriaceae penghasil ESBL di ICU Pusat RSCM pada tahun 2011.;

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Irrational use of antibiotics can increase the incidence of infection by extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae. Prevalence of ESBL-producing Enterobacteriaceae varies among hospitals, and which its resistance could complicate the treatment, extend hospital length of stay, and increase the mortality.

The aim of this study is to determine the prevalence of ESBL-producing Enterobacteriaceae and its association with antibiotic use. This study was a cross sectional study, involving 111 secondary data derived from ESBL resistance test of culture examinations which used the standardized method according to The Clinical and Laboratory Standards Institute (CLSI) and patients? medical records in Central ICU RSCM in 2011.

Laboratory test results showed that 8 from 111 samples (7,2%) were infected with Enterobacteriaceae producing ESBL. Data were analyzed using chi-square test, p=0,05. Statistical analysis results were RP>1 with the value of significance p=1.000 and 95% CI 1.039; 1.179. It is concluded that there is no association between antibiotic use and ESBL-producing Enterobacteriaceae infection in Central ICU RSCM in 2011."