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"Paparan biologis akibat resistensi antimikroba (AMR), khususnya ESBL E. coli di peternakan, menjadi ancaman kesehatan kerja dan global. Kesehatan dan Keselamatan Kerja (K3) berperan penting dalam melindungi pekerja dari risiko tersebut. Studi ini bertujuan mengidentifikasi hotspot ESBL E. coli di peternakan terpadu dan merancang intervensi optimal berbasis logika fuzzy untuk meningkatkan K3 dalam kerangka One Health. Studi ini menggunakan metode HAZOP – Delphi untuk menentukan 12 lokasi pengambilan sampel secara sistematis. Sebanyak 134 sampel dari berbagai sumber di peternakan dikumpulkan untuk isolasi dan karakterisasi ESBL E. coli, termasuk analisis genom utuh (WGS) terhadap 18 isolat. Paparan pekerja terhadap feses diukur melalui studi eksperimental, dengan memperkirakan fecal ingestion rate. Risiko paparan E. coli dan ESBL E. coli dianalisis menggunakan pendekatan QMRA dan metode William T. Fine. Skenario intervensi K3 – One Health dirancang dan diprioritaskan menggunakan logika fuzzy dua tahap untuk menentukan strategi perlindungan pekerja yang paling efektif. ESBL E. coli ditemukan pada 34,6 (45/130) contoh uji, konsentrasi tertinggi pada pupuk asal unggas (7,4 log₁₀ CFU/g) dan feses broiler (6,7 log₁₀ CFU/g). Analisis WGS menunjukkan adanya gen pembawa kode resisten dan peluang E. coli patogen ekstraintestinal (ExPEC E. coli). Hotspots utama ditetapkan pupuk asal unggas, feses broiler dan feses itik, seluruhnya berada di peternakan unggas. Rata-rata incidental fecal ingestion rate oleh pekerja bervariasi dari 0,3 – 23,5 mg/hari (unggas) dan 6,8 - 8,6 mg/hari (ruminansia). Setelah paparan ESBL E. coli dihitung dari perkalian antara konsentrasi bakteri dengan fecal ingestion rate, diperoleh nilai tertinggi berasal dari pupuk unggas (median >5.000 log10 CFU/d, skor risiko William T. Fine 80 - 110). Usulan intervensi berupa program kontrol K3 – One Health meliputi: substitusi (alat semi-otomatis, reduksi fecal ingestion rate 50%), kontrol teknik (penyimpanan pakan di silo mereduksi paparan E. coli 81,1 – 87,6%; modifikasi pengomposan mereduksi ESBL E. coli 40 - 63%; barrier rumah kompos mereduksi E. coli hampir 100%), dan pemakaian APD (mengurangi ingesti sekitar 99%). Pekerja di area unggas menjadi prioritas, dan program K3 – One Health yang mengkombinasikan reduksi paparan 60 - 100% dengan pemilihan biaya menengah hingga tinggi dipilih berdasarkan logika fuzzy. Diproyeksikan intervensi terpilih mampu mengurangi paparan E. coli dan ESBL E. coli dengan rata-rata reduksi sebesar 62,6% [60.5 – 64.7% CI]. Keberhasilan program juga ditopang oleh platform logika fuzzy dan strategi adaptif lintas sektor peternakan.

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This comprehensive study aimed to identify hotspots of ESBL E. coli in an integrated farm and develop optimal intervention scenarios using fuzzy logic to enhance occupational health and safety (OHS) within the One Health framework. Biological exposure due to antimicrobial resistance (AMR), particularly ESBL E. coli in farms, poses a threat to occupational and global health. OHS plays a crucial role in protecting workers from these risks. This study employed the HAZOP–Delphi method to systematically determine 12 sampling locations. A total of 134 samples from various farm sources were collected for ESBL E. coli isolation and characterization, including whole genome sequencing (WGS) of 18 isolates. Worker exposure to stool was measured experimentally by estimating fecal ingestion rates. The risk of exposure to E. coli and ESBL E. coli was analyzed using QMRA and the William T. Fine methods. OHS–One Health intervention scenarios were designed and prioritized using a two-stage fuzzy logic approach to determine the most effective worker protection strategies. ESBL E. coli was detected in 34.6% (45/130) of samples, with the highest concentrations found in poultry fertilizer (7.4 log₁₀ CFU/g) and broiler stools (6.7 log₁₀ CFU/g). WGS analysis revealed the presence of resistance genes and the potential presence of extraintestinal pathogenic E. coli (ExPEC). Key hotspots were identified as poultry fertilizer, broiler stools, and duck stools, all located in poultry farms. The average incidental fecal ingestion rates by workers ranged from 0.3–23.5 mg/day (poultry) and 6.8–8.6 mg/day (ruminants). Exposure to ESBL E. coli, calculated by multiplying bacterial concentration with ingestion rate, was highest from poultry manure (median >5,000 log₁₀ CFU/day; William T. Fine risk score: 80–110). Proposed interventions for the OHS–One Health program include substitution (semi-automatic tools reducing ingestion rate by 50%), engineering controls (feed storage in silos reducing E. coli exposure by 81.1–87.6%; composting modifications reducing ESBL E. coli by 40–63%; compost house barriers reducing E. coli by nearly 100%), and use of PPE (reducing ingestion by ~99%). Poultry area workers were prioritized, and the selected OHS–One Health program combined 60–100% exposure reduction with medium-to high-cost options, chosen via fuzzy logic. The projected outcome was an average reduction in E. coli and ESBL E. coli exposure by 62.6% [CI: 60.5–64.7%]. The program will be succeeded by fuzzy logic platform adaptation and dynamic cross-sectoral strategies in livestock farming."

"Seven antibiotics including norfloxacin (NOR) were tested via disk susceptibility test on E. coliculture isolated from the MLSS of the two types of lab-scale sequencing batch reactors (SBR), acommon SBR and an SBR with rnicrofiltration membrane (SB-MBR) for treatment of syntheticmunicipal wastewater. The same experiment treating the NOR-added wastewater to examine thepossible induction of resistance to itself and the other antibiotics. The MLSS from Banglculture (TISTR780) were spiked daily into both reactors. The reactors were continuously operatedunder 2hr/2hr of aeration/non-aeration cycle and resistances to antibiotics of E. coli in MLSS weremonitored. When NOR was not added, the SB-MBR showed lower percentages of resistant E. colithan the SBR did to amoxicillin/clavulanic acid, amikacin, nalidixic acid, tetracycline andchloramphenicol. Oppositely, the SB-MBR treating the NOR-added wastewater appeared topromote resistances of E. coli to nalidixic acid, sulfamethoxasole and tetracycline probably due to along SRT and low DO compared to that of SBR. Although its mechanism should be analyzed withmolecular techniques in further studies, this NOR-induced expression of resistance resulted in ahigher occurrence of multidrug resistant E. coli in the SB-MBR than that in the SBR."

"Extraintestinal pathogenic Escherichia coli (ExPeC) merupakan bakteri dengan presentase sekitar 17% - 37% dari total bakteri yang diisolasi dari pasien dengan Bloodstream Infection (BSI) secara global. Kemampuan bakteri ini dalam mengembangkan resistensi terhadap antibiotik menyebabkan masalah serius. Penelitian ini bertujuan untuk menganalisis keterkaitan antara profil fenotipik dan genotipik pada isolat Escherichia coli (E. coli) penyebab BSI. Isolasi bakteri E. coli penyebab BSI dan isolasi DNA dilakukan pada 11 isolat tersimpan asal LMK FKUI dan 2 isolat asal BB Binomika, Jakarta. Penelitian ini dilakukan dengan menggunakan Vitek 2 compact untuk analisis profil fenotipik dan juga menggunakan metode Whole Genome Sequencing (WGS) untuk mengkarakterisasi seacra genotipik bakteri E. coli. Berdasarkan data fenotipik yang diperoleh menggunakan VITEK-2, resistensi tertinggi isolat dalam penelitian ini secara berturut-turut terdapat pada antibiotik ampisilin (53,8%), siprofloksasin (46,2%), dan seftriakson (38,5%). Identifikasi gen resistensi untuk ampisilin, seftriakson, dan siprofloksasin juga telah berhasil diidentifikasi melaui teknik WGS. Beberapa gen yang dikaitkan dengan resistensi terhadap ampisilin adalah blaTEM 1-B dan variannya seperti blaTEM-116, blaTEM-141, dan blaTEM-206. Gen blaTEM-1B merupakan gen yang mendominasi pada mekanisme resistensi betalaktam (30,76%), diikuti oleh gen blaCTX-M-55 (15,35%). Sedangkan mekanisme resistensi pada fluorokuinolon banyak dimediasi oleh adanya mutasi pada target antibiotik, seperti mutasi pada gyrA, parC, dan AcrAB-TolC. Isolat selanjutnya dikelompokkan menggunakan skema Achtman dalam 12 ST yang berbeda yaitu ST73, 117, 10, 410, 83, 169, 95, 1844, 101, 457, 744 dan ST 127. Terdapat kesesuaian antara resistensi fenotipik dan resistensi genotipik terhadap antibiotik betalaktam pada isolat E. coli yang diteliti, dimana gen resistensi terdeteksi pada seluruh isolat yang resisten betalaktam secara fenotipik.

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Extraintestinal pathogenic Escherichia coli (ExPEC) accounts for approximately 17% - 37% of the total bacteria isolated from patients with bloodstream infections (BSI) globally. The ability of these bacteria to develop resistance to antibiotics poses serious problems. This study aims to analyze the relationship between phenotypic and genotypic profiles in Escherichia coli (E. coli) isolates causing BSI. Isolation of E. coli causing BSI and DNA isolation were carried out on 11 stored isolates from LMK FKUI and 2 isolates from BB Binomika, Jakarta. This study was conducted using the Vitek 2 compact system for phenotypic profile analysis and the Whole Genome Sequencing (WGS) method to characterize the genotypic profiles of E. coli. Based on the phenotypic data obtained using VITEK-2, the highest resistance among isolates in this study was observed for ampicillin (53.8%), ciprofloxacin (46.2%), and ceftriaxone (38.5%). Resistance genes for ampicillin, ceftriaxone, and ciprofloxacin were successfully identified through the WGS technique. Some of the genes associated with resistance to ampicillin include blaTEM-1B and its variants such as blaTEM-116, blaTEM-141, and blaTEM-206. The blaTEM-1B gene is predominant in the betalactam resistance mechanism (30.76%), followed by the blaCTX-M-55 gene (15.35%). Resistance to fluoroquinolones is primarily mediated by mutations in antibiotic targets, such as mutations in gyrA, parC, and AcrAB-TolC. Isolates were further grouped using the Achtman scheme into 12 different STs, including ST73, 117, 10, 410, 83, 169, 95, 1844, 101, 457, 744, and ST127. There was concordance between phenotypic resistance and genotypic resistance to betalactam antibiotics in the E. coli isolates studied, where resistance genes were detected in all isolates that were phenotypically betalactam-resistant."

"Praktik Kerja Profesi Apoteker di RSUP Fatmawati bertujuan untuk menganalisis profil penggunaan antibiotik meropenem pada bulan Mei tahun 2023 di RSUP Fatmawati. Kajian dilakukan dengan menggunakan metode deskriptif. Tahapan kajian meliputi pengumpulan data pasien dari sistem informasi rumah sakit (ISIMRS), SIMGOS dan Open Labs, penyajian data dalam bentuk tabel deskriptif dan penarikan kesimpulan. Hail kajian menunjukkan arakteristik pasien antibiotik meropenem di RSUP Fatmawati pada Bulan Mei Tahun 2023 mencakup 184 pasien, dengan mayoritas berjenis kelamin laki-laki dan berasal dari kelompok pasien geriatri (61-70 tahun) dengan kesudahan pasien pulang dari rumah sakit. Karakteristik peresepan antibiotik meropenem di RSUP Fatmawati pada Bulan Mei Tahun 2023 sebanyak 5669 vial meropenem dengan regimen dosis paling banyak yaitu 3x1 gram dan asal ruangan pasien yang diberikan antibiotik paling banyak yaitu gedung bougenville, lantai 4 - ICU. Hasil biakan kultur menunjukkan resistensi terhadap Acinetobacter baumannii

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Pharmacist Professional Work Practices at Fatmawati Hospital aims to analyze the profile of use of the antibiotic meropenem in May 2023 at Fatmawati Hospital. The study was carried out using descriptive methods. The study stages include collecting patient data from the hospital information system (ISIMRS), SIMGOS and Open Labs, presenting the data in the form of descriptive tables and drawing conclusions. The results of the study show that the characteristics of meropenem antibiotic patients at Fatmawati General Hospital in May 2023 included 184 patients, the majority of whom were male and came from the geriatric patient group (61-70 years) with the patients later returning home from the hospital. Characteristics of meropenem antibiotic prescriptions at Fatmawati General Hospital in May 2023 were 5669 vials of meropenem with the highest dose regimen being 3x1 gram and the room where the most antibiotics were given was the Bougainville building, 4th floor - ICU. Culture results showed resistance to Acinetobacter baumannii."

"Latar Belakang: Penggunaan antibiotik yang tidak rasional dapat menyebabkan resistensi antibiotik. Sebagai salah satu profesi yang banyak meresepkan antibiotik untuk mengobati infeksi pada rongga mulut, dokter gigi memainkan peran penting dalam memantau penggunaan antibiotik. Konsumsi antibiotik yang berlebihan dan tidak tepat dapat memperburuk masalah resistensi antibiotik ini sehingga sangat penting untuk dilakukannya upaya untuk mengawasi penggunaan antibiotik. Tujuan: Penelitian ini dilaksanakan untuk mengevaluasi pola penggunaan antibiotik, pola bakteri, dan uji sensitivitas antibiotik untuk mengetahui apakah antibiotik yang banyak diresepkan di Unit Pelayanan Periodonsia RSKGM FKG UI masih efektif terhadap bakteri pada sampel plak subgingiva dari pasien periodontitis di Unit Pelayanan Periodonsia. Metode: Jenis penelitian ini merupakan penelitian deskriptif observasional pada resep yang masuk ke unit Farmasi RSKGM FKG UI periode Juli—November 2024 dan uji in vitro terhadap sampel plak subgingiva dari Unit Pelayanan Periodonsia RSKGM FKG UI. Sampel plak subgingiva diuji dengan uji sensitivitas antibiotik dengan metode disk diffusion dan uji RT-qPCR. Hasil: Rasio PDD/DDD dari antibiotik yang diresepkan oleh Unit Pelayanan Periodonsia RSKGM FKG UI berada di bawah 1. Uji RT-qPCR dapat mendeteksi keberadaan bakteri red complex pada sampel plak subgingiva pada kelompok periodontitis maupun kelompok sehat. Zona hambat amoksisilin menunjukkan kategori sensitif, intermediet dan resisten. Zona hambat amoksisilin+asam klavulanat menunjukkan kategori sensitif sebesar 100%. Zona hambat klindamisin menunjukkan kategori sensitif dan resisten. Zona hambat metronidazol menunjukkan kategori resisten sebesar 100%. Kesimpulan: Antibiotik yang paling banyak diresepkan di Unit Pelayanan Periodonsia RSKGM FKG UI pada periode Juli—November 2024 adalah amoksisilin+asam klavulanat 625 mg. Rasio PDD/DDD dari antibiotik yang diresepkan di Unit Pelayanan Periodonsia RSKGM FKG UI menunjukkan bahwa penggunaannya tergolong subuse. Proporsi bakteri red complex pada sampel plak subgingiva kelompok periodontitis lebih tinggi dibandingkan pada sampel kelompok sehat, namun perbedaannya tidak bermakna secara statistik. Amoksisilin, amoksisilin+asam klavulanat, dan klindamisin masih efektif melawan bakteri pada sampel plak subgingiva dari pasien periodontitis di Unit Pelayanan Periodonsia RSKGM FKG UI.

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Background: Irrational use of antibiotics can lead to antibiotic resistance. As one of the professions that widely prescribe antibiotics to treat infections in the oral cavity, dentists play an important role in monitoring antibiotic use. Excessive and inappropriate consumption of antibiotics can exacerbate this antibiotic resistance problem so it is very important to monitor antibiotic use. Objective: This study was conducted to evaluate antibiotic use pattern, bacterial pattern, and antibiotic sensitivity testing to determine whether antibiotics that are widely prescribed from the Periodontal Care Unit of RSKGM FKG UI are still effective against bacteria in subgingival plaque samples from periodontitis patients in Periodontal Care Unit. Methods: This type of research is an observational descriptive study on prescriptions submitted to the Pharmacy Unit of RSKGM FKG UI for the period July-November 2024 and in vitro tests on subgingival plaque samples from periodontitis patients in Periodontal Care Unit of RSKGM FKG UI. Subgingival plaque samples were tested with antibiotic sensitivity test by disk diffusion method and RT-qPCR. Results: The PDD/DDD ratio of antibiotics prescribed by the Periodontal Care Unit of RSKGM FKG UI was below 1. RT-qPCR test can detect the presence of red complex bacteria in subgingival plaque samples from the periodontitis group and the healthy group. Inhibition zone of amoxicillin showed sensitive, intermediate, and resistant category. The inhibition zone of amoxicillin + clavulanic acid antibiotics showed sensitive category of 100%. The inhibition zone of clindamycin showed sensitive and resistant category. The inhibition zone of metronidazole showed resistant category of 100%. Conclusion: The most prescribed antibiotic in the Periodontal Care Unit of RSKGM FKG UI in the July-November 2024 period was amoxicillin+clavulanic acid 625 mg. The PDD/DDD ratio of antibiotics prescribed in the Periodontal Care Unit of RSKGM FKG UI shows that their use is classified as subuse. The proportion of red complex bacteria in the subgingival plaque samples of the periodontitis group was higher than in the healthy group samples, but the difference was not statistically significant. Amoxicillin, amoxicillin+clavulanic acid, and clindamycin are still effective against bacteria in subgingival plaque samples from periodontitis patients in the Periodontal Care Unit of RSKGM FKG UI."

"Latar Belakang: Penggunaan antibiotik yang tidak rasional dapat menyebabkan resistensi antibiotik. Sebagai salah satu profesi yang banyak meresepkan antibiotik untuk mengobati infeksi pada rongga mulut, dokter gigi memainkan peran penting dalam memantau penggunaan antibiotik. Konsumsi antibiotik yang berlebihan dan tidak tepat dapat memperburuk masalah resistensi antibiotik ini sehingga sangat penting untuk dilakukannya upaya untuk mengawasi penggunaan antibiotik. Tujuan: Penelitian ini dilaksanakan untuk mengevaluasi pola penggunaan antibiotik, pola bakteri, dan uji sensitivitas antibiotik untuk mengetahui apakah antibiotik yang banyak diresepkan di Unit Pelayanan Periodonsia RSKGM FKG UI masih efektif terhadap bakteri pada sampel plak subgingiva dari pasien periodontitis di Unit Pelayanan Periodonsia. Metode: Jenis penelitian ini merupakan penelitian deskriptif observasional pada resep yang masuk ke unit Farmasi RSKGM FKG UI periode Juli—November 2024 dan uji in vitro terhadap sampel plak subgingiva dari Unit Pelayanan Periodonsia RSKGM FKG UI. Sampel plak subgingiva diuji dengan uji sensitivitas antibiotik dengan metode disk diffusion dan uji RT-qPCR. Hasil: Rasio PDD/DDD dari antibiotik yang diresepkan oleh Unit Pelayanan Periodonsia RSKGM FKG UI berada di bawah 1. Uji RT-qPCR dapat mendeteksi keberadaan bakteri red complex pada sampel plak subgingiva pada kelompok periodontitis maupun kelompok sehat. Zona hambat amoksisilin menunjukkan kategori sensitif, intermediet dan resisten. Zona hambat amoksisilin+asam klavulanat menunjukkan kategori sensitif sebesar 100%. Zona hambat klindamisin menunjukkan kategori sensitif dan resisten. Zona hambat metronidazol menunjukkan kategori resisten sebesar 100%. Kesimpulan: Antibiotik yang paling banyak diresepkan di Unit Pelayanan Periodonsia RSKGM FKG UI pada periode Juli—November 2024 adalah amoksisilin+asam klavulanat 625 mg. Rasio PDD/DDD dari antibiotik yang diresepkan di Unit Pelayanan Periodonsia RSKGM FKG UI menunjukkan bahwa penggunaannya tergolong subuse. Proporsi bakteri red complex pada sampel plak subgingiva kelompok periodontitis lebih tinggi dibandingkan pada sampel kelompok sehat, namun perbedaannya tidak bermakna secara statistik. Amoksisilin, amoksisilin+asam klavulanat, dan klindamisin masih efektif melawan bakteri pada sampel plak subgingiva dari pasien periodontitis di Unit Pelayanan Periodonsia RSKGM FKG UI.

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Background: Irrational use of antibiotics can lead to antibiotic resistance. As one of the professions that widely prescribe antibiotics to treat infections in the oral cavity, dentists play an important role in monitoring antibiotic use. Excessive and inappropriate consumption of antibiotics can exacerbate this antibiotic resistance problem so it is very important to monitor antibiotic use. Objective: This study was conducted to evaluate antibiotic use pattern, bacterial pattern, and antibiotic sensitivity testing to determine whether antibiotics that are widely prescribed from the Periodontal Care Unit of RSKGM FKG UI are still effective against bacteria in subgingival plaque samples from periodontitis patients in Periodontal Care Unit. Methods: This type of research is an observational descriptive study on prescriptions submitted to the Pharmacy Unit of RSKGM FKG UI for the period July-November 2024 and in vitro tests on subgingival plaque samples from periodontitis patients in Periodontal Care Unit of RSKGM FKG UI. Subgingival plaque samples were tested with antibiotic sensitivity test by disk diffusion method and RT-qPCR. Results: The PDD/DDD ratio of antibiotics prescribed by the Periodontal Care Unit of RSKGM FKG UI was below 1. RT-qPCR test can detect the presence of red complex bacteria in subgingival plaque samples from the periodontitis group and the healthy group. Inhibition zone of amoxicillin showed sensitive, intermediate, and resistant category. The inhibition zone of amoxicillin + clavulanic acid antibiotics showed sensitive category of 100%. The inhibition zone of clindamycin showed sensitive and resistant category. The inhibition zone of metronidazole showed resistant category of 100%. Conclusion: The most prescribed antibiotic in the Periodontal Care Unit of RSKGM FKG UI in the July-November 2024 period was amoxicillin+clavulanic acid 625 mg. The PDD/DDD ratio of antibiotics prescribed in the Periodontal Care Unit of RSKGM FKG UI shows that their use is classified as subuse. The proportion of red complex bacteria in the subgingival plaque samples of the periodontitis group was higher than in the healthy group samples, but the difference was not statistically significant. Amoxicillin, amoxicillin+clavulanic acid, and clindamycin are still effective against bacteria in subgingival plaque samples from periodontitis patients in the Periodontal Care Unit of RSKGM FKG UI."

"Penggunaan antibiotik harus dilakukan dan kontrol penggunaan antibiotik sudah direkomendasikan dari WHO. Hal ini bertujuan untuk menekan resistensi mikroba terhadap antibiotik karena ancaman resistensi antibiotik adalah salahsatu yang dikhawatirkan oleh WHO. Dalam perespan dan penggunaan antibiotik dapat dianalisis dengan metode ATC/DDD untuk evaluasi rasionalitas penggunaan antibiotik. Analisis menggunakan metode ATC/DDD ini dilakukan di Puskesmas Kecamatan Duren Sawit pada periode Januari-Desember 2022. Setelah dilakukan analisis didapatkan penggunaan antibiotik di Puskesmas Kecamatan Duren Sawit pada periode Januari – Desember 2022 tergolong sangat tinggi terutama pada golongan antibiotik beta laktam dengan kecenderungan peresepan yang kurang rasional. Dari hasil analisis ini dapat dilakukan pengetesan resistensi mikroba terhadap antibiotik di lingkungan Puskesmas Kecamatan Duren Sawit untuk melihat sebaran mikroba resisten terhadap golongan antibiotik sebagai evaluasi pendekatan pengobatan yang optimal.

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The use of antibiotics must be carried out and control of antibiotic use has been recommended by WHO. This aims to suppress microbial resistance to antibiotics because the threat of antibiotic resistance is one that WHO is concerned about. The prescription and use of antibiotics can be analyzed using the ATC/DDD method to evaluate the rationality of antibiotic use. Analysis using the ATC/DDD method was carried out at Puskesmas Kecamatan Duren Sawit in the period January-December 2022. After the analysis was carried out, it was found that the use of antibiotics in Puskesmas Kecamatan Duren Sawit in the January-December 2022 period was classified as very high, especially in the beta-lactam antibiotics group with a high prescribing tendency. less rational. From the results of this analysis, testing for microbial resistance to antibiotics can be carried out in Puskesmas Kecamatan Duren Sawit environment to see the distribution of microbes that are resistant to antibiotic groups as an evaluation of optimal treatment approaches."

"Peresepan antibiotik adalah salah satu yang harus dikontrol. Hal ini bertujuan untuk mencegah terjadinya resistensi antibiotik yang berlebihan. Hal ini menjadi signfikan ketika berada di lingkup rumah sakit karena banyak dokter yang meresepkan antibiotik untuk lini pertama pengobatan sehingga menyebabkan banyaknya mikroba resisten. Oleh karena itu diharuskan adanya analisis peresepan dan penggunaan antibiotik. Analaisis ini dapat dilakukan dengan menggunakan analisis ATC/DDD yang sudah ditetapkan oleh WHO untuk menganalisis penggunaan antibiotik. Maka dari itu, dilakukan analisis peresepan dan penggunaan antibiotik di RSUP Fatmawati dengan periode Juli – Desember 2022. Hasil analisis ATC/DDD yang dilakukan menunjukkan penggunaan antibiotik di RSUP Fatmawati yang masih tinggi terutama pada antibiotik untuk mengobati TB seperti rifampicin dan ethambutol, antibiotik lain yang tinggi penggunaannya adalah antibiotik cefixim yang biasanya diresepkan sebagai lini pertama ISPA. Oleh karena itu perlunya diadakan pemantauan lebih terkait penggunaan antibiotik tersebut terutama pengetesan berkala mikroba terkait ISPA dan TB yang berada di RSUP Fatmawati untuk melihat resistensi antimikroba yang bertujuan untuk mencegah untreatable nosocomial invection.

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Antibiotic prescribing is one that must be controlled. This aims to prevent excessive antibiotic resistance. This becomes significant when in the hospital setting because many doctors prescribe antibiotics as the first line of treatment, causing many resistant microbes. Therefore, it is necessary to analyze the prescribing and use of antibiotics. This analysis can be carried out using the ATC/DDD analysis which has been established by WHO to analyze antibiotic use. Therefore, an analysis of the prescribing and use of antibiotics was carried out at Fatmawati Hospital for the period July – December 2022. The results of the ATC/DDD analysis carried out showed that the use of antibiotics at Fatmawati Hospital was still high, especially antibiotics to treat TB such as rifampicin and ethambutol, other antibiotics that The highest use is the antibiotic cefixim which is usually prescribed as the first line of ARI. Therefore, it is necessary to carry out more monitoring regarding the use of antibiotics, especially periodic testing of microbes related to ARI and TB at Fatmawati General Hospital to see antimicrobial resistance with the aim of preventing untreatable nosocomial infections."

"Resistensi antibiotik terjadi akibat bakteri berevolusi dan rentan terhadap antibiotik sehingga dapat meningkatkan risiko penyebaran penyakit serta kematian. Antibiotik golongan karbapenem merupakan antibiotik kelompok reserve, yang dapat diakses namun penggunaannya harus disesuaikan dengan pasien dan kondisi yang sangat spesifik, ketika antibiotik lainnya telah gagal atau tidak sesuai dalam pengobatan. Penggunaan meropenem di RSUP Fatmawati dibanding antibiotik lini ke 3 lainnya sangat jauh berbeda signifikan, oleh karena itu perlu dikaji terkait karakteristik pasien, regimen, indikasi, ada tidaknya konsultasi KPRA (Komite Pengendalian Resistensi Antimikroba) dan hasil kultur serta sensitivitas antimikroba. Karakteristik pasien yang menggunakan terapi antibiotik reserve meropenem pada April 2023 didominasi oleh laki-laki (52,8%) daripada perempuan (47,2%) dengan rentang usia 51-60 yang terbanyak (23,9%). Kultur dan sensitivitas yang dilakukan (389 kali/April 2023) menyatakan bahwa hasil terbanyak berupa biakan negatif (76,6%), disusul dengan Acinetobacter baumannnii (6,9%) dan Klebsiella pneumonia (6,4%). Hasil biakan yang tidak negatif atau ditemukannya kuman patogen terdapat 91 biakan (23,4%) dari 389 biakan. Sampel yang masih sensitif terhadap antibiotik meropenem sebanyak 38 sampel (41,8%), sampel yang sudah resisten sebanyak 39 sampel (42,9%) dan yang tidak diketahui sebanyak 14 sampel (15,3%). Konsultasi terhadap tim PPRA dilakukan hanya 129 dari 176 pasien. Hasil konsultasi dapat diterima pemberiannya (32 pasien), ditolak pemberiannya (22 pasien), dan tidak direspon oleh tim PPRA (75 pasien)

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Antibiotic resistance occurs because bacteria evolve and become susceptible to antibiotics, increasing the risk of disease spread and death. Carbapenem class antibiotics are reserve group antibiotics, which can be accessed but their use must be tailored to patients and very specific conditions, when other antibiotics have failed or are not suitable in treatment. The use of meropenem at Fatmawati General Hospital compared to other 3rd line antibiotics is significantly different, therefore it is necessary to study patient characteristics, regimens, indications, the presence or absence of KPRA (Antimicrobial Resistance Control Committee) consultation and culture results and antimicrobial sensitivity. The characteristics of patients who used meropenem reserve antibiotic therapy in April 2023 were dominated by men (52.8%) rather than women (47.2%) with the highest age range of 51-60 (23.9%). The culture and sensitivity performed (389 times/April 2023) stated that the most results were negative cultures (76.6%), followed by Acinetobacter baumannnii (6.9%) and Klebsiella pneumonia (6.4%). There were 91 cultures (23.4%) out of 389 cultures that were not negative or found pathogenic germs. There were 38 samples (41.8%) that were still sensitive to meropenem, 39 samples (42.9%) that were resistant, and 14 samples (15.3%) that were unknown. Consultation with the PPRA team was conducted for only 129 out of 176 patients. The results of the consultation were accepted (32 patients), rejected (22 patients), and not responded to by the PPRA team (75 patients)."

"Potensi bahaya merupakan hal yang umum ditemukan dalam kegiatan sehari-hari, begitu juga dengan kegiatan praktikum. Studi ini mengenai analisis risiko pada praktikum jasa boga di Sekolah Menengah Kejuruan Negeri 2 Depok Tahun 2015. Tujuannya untuk melakukan identifikasi bahaya dan mengetahui tingkat risiko di laboratorium jasa boga. Identifikasi bahaya dilakukan dengan menggunakan Job Hazard Analysis (JHA) dan analisis risiko dilakukan dengan menentukan besaran nilai risiko menggunakan formula semikuantitatif W.T. Fine. Pada aktivitas praktikum ditemukan 4 jenis bahaya (fisik, kimia, biologi dan ergonomi) dengan jumlah 41 bahaya keselamatan dan kesehatan kerja dan bahaya yang paling banyak ditemukan adalah bahaya fisik. Hasil analisis risiko dibedakan menjadi basic risk, existing risk dan predictive risk. Pengelolaan risiko yang disarankan berupa pengendalian administratif seperti pembuatan Standar Operational Procedure (SOP) beserta penerapannya di setiap kegiatan praktikum jasa boga.

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Potential hazard is commonly found in every daily activities, as well as practicum activities. The focus on this study is risk analysis in culinary service practicum in Vocational High School 2 Depok in 2015. This aim to identify the hazards and determine level of risk in the culinary service laboratory. Hazard identification method using the Job Hazard Analysis (JHA) and risk were calculated by semi-quantitative W.T. Fine's formula. In the practicum activity was found four types of hazards (physical, chemical, biological, and ergonomics) and 41 occupational health and safety hazard with the most common hazard is a physical hazard. The results of risk analysis can be divided into basic risk, existing risk and predictive risk. The recommendation to risk control in the form of administrative control such as Standard Operational Procedure (SOP) and its implementasion in each culinary service practicum."