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Abstrak :
Resistensi Neisseria gonorrhoeae terhadap antibiotika merupakan masalah global di dunia. Sulitnya pertumbuhan N. gonorrhoeae di laboratorium menyebabkan uji kepekaan antibiotika sulit dilakukan secara reguler. Tujuan penelitian ini untuk mendeteksi N. gonorrhoeae dari spesimen endoserviks dan karakterisasi mutasi gen terkait resistensi terhadap sefiksim dan azitromisin sebagai antibiotika pilihan yang direkomendasikan WHO dan Kemenkes RI. Spesimen endoserviks dari wanita pekerja seks (WPS) dilakukan pewarnaan Gram, kultur, dan uji kepekaan antibiotika. Uji molekuler SYBR green real time PCR digunakan untuk mendeteksi N. gonorrhoeae, mutasi gen penA (Ala501Val/Pro, Gly545Ser) dan 23S rRNA (A2059G, C2611T). Resistensi 9 isolat N. gonorrhoeae terhadap sefiksim, levofloksasin, kanamisin sebesar 11,1%, 33,3%, 77,8% secara berurutan. Tidak ditemukan resistensi terhadap azitromisin dan seftriakson. Sedangkan resistensi terhadap penisilin, tetrasiklin, dan siprofloksasin ditemukan pada semua isolat. Uji SYBR green real time PCR berhasil mendeteksi N. gonorrhoeae dari spesimen endoserviks dan karakterisasi mutasi gen terkait resistensi terhadap sefiksim dan azitromisin. Dibandingkan pewarnaan Gram dan kultur, uji ini meningkatkan tingkat kepositifan sebesar 27% dan 15%. Tidak ditemukan mutasi pada gen penA dan 23S rRNA. ......Antimicrobial resistance in Neisseria gonorrhoeae is a global problem in the world. Due to N. gonorrhoeae is difficult to grow in the laboratory, antimicrobial susceptibility testing cannot be performed regularly. The aim of this study is to detect N. gonorrhoeae from endocervical specimens and to characterize gene mutations associated with cefixime and azithromycin resistance as the drugs of choice recommended by WHO and the Indonesian Ministry of Health. Endocervical specimens from female sex workers (FSW) were examined using Gram staining, culture, and susceptibility testing. Molecular SYBR green real-time PCR were used to detect N. gonorrhoeae and mutations in penA (Ala501Val/Pro, Gly545Ser) and 23S rRNA (A2059G, C2611T). Resistance of 9 isolates N. gonorrhoeae to cefixime, levofloxacin, kanamycin, were 11,1%, 33,3%, 77,8%, respectively. Resistance to azithromycin and ceftriaxone were not found. Whereas resistance to penicillin, tetracycline, and ciprofloxacin were found in all isolates. SYBR green real time PCR was successfully detect N. gonorrhoeae from endocervical specimens and characterize gene mutations associated with cefixime and azithromycin resistance. Compared to Gram and culture, this method could increase positivity rates as much as 27% and 15%. Mutation in penA and 23S rRNA were not found.

Abstrak :
[ABSTRAK
Penggunaan antibiotik secara sembarangan telah menyebabkan berkembangnya bakteri resisten antibiotik. Instalasi Pengolahan Air Limbah (IPAL) dicurigai sebagai pusat penyebaran bakteri resisten antibiotik. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh IPAL Rumah Sakit Dr. Cipto Mangunkusumo terhadap resistensi E. coli pada antibiotik Meropenem, Ciprofloxacin, dan Cefixime dengan menggunakan metode Kirby Bauer. IPAL menggunakan lumpur aktif, filtrasi dengan media polistiren, dan klorinasi untuk mengolah air limbah rumah sakit tersebut. Persen resistensi E. coli terhadap Meropenem, Ciprofloxacin, dan Cefixime adalah 6,25%; 62,13%; dan 62,87%. Di influen IPAL terdapat sebanyak 4.6x104 CFU E. coli, dengan persen resistensi Meropenem 3,8%; Ciprofloxacin 53,8%; dan Cefixime 56,3%; sementara efluen IPAL terdapat sebanyak 1.3x103 CFU E. coli dengan persen resistensi Meropenem 20%; Ciprofloxacin 60%; dan Cefixime 80%. Disimpulkan bahwa proses di IPAL RSCM meningkatkan jumlah bakteri resisten E. coli. Resisten terhadap Meropenem, yaitu antibiotik kelas Carbapenem yang biasa digunakan untuk melawan bakteri resisten, telah mulai berkembang. ABSTRACT
The abasement uses of antibiotic have encouraged antibiotic resistant bacteria to develop. Wastewater treatment plant (WWTP) is believed to be the hotspot for the dissemination of antibiotic resistant bacteria. This research is conducted to know the effect of WWTP in Dr. Cipto Mangunkusumo hospital to the resistance profile of E. coli toward three antibiotics, Meropenem, Ciprofloxacin, and Cefixime using Kirby Bauer method. The WWTP apply activated sludge, polystyrene filtration, and chlorination treatment process to treat the hospital wastewater. Overall, E. coli resistance against Meropenem, Ciprofloxacin, and Cefixime are 6,25%; 62,13%; dan 62,87%. respectively. Raw wastewater has 4.6x104 CFU E. coli, with resistance profile Meropenem 3.8%; Ciprofloxacin 53.8%; and Cefixime 56.3%; while treated wastewater has resistance profile Meropenem 20%; Ciprofloxacin 60%; and Cefixime 80% respectively for 1.3x103 CFU E. coli. WWTP in Dr. Cipto Mangunkusumo hospital has found to increase the percentage of antibiotic resistant E. coli. E. coli begins to resist Meropenem, the Carbapenem class antibiotic known for its effectiveness in dealing resistant antibiotic. , The abasement uses of antibiotic have encouraged antibiotic resistant bacteria to develop. Wastewater treatment plant (WWTP) is believed to be the hotspot for the dissemination of antibiotic resistant bacteria. This research is conducted to know the effect of WWTP in Dr. Cipto Mangunkusumo hospital to the resistance profile of E. coli toward three antibiotics, Meropenem, Ciprofloxacin, and Cefixime using Kirby Bauer method. The WWTP apply activated sludge, polystyrene filtration, and chlorination treatment process to treat the hospital wastewater. Overall, E. coli resistance against Meropenem, Ciprofloxacin, and Cefixime are 6,25%; 62,13%; dan 62,87%. respectively. Raw wastewater has 4.6x104 CFU E. coli, with resistance profile Meropenem 3.8%; Ciprofloxacin 53.8%; and Cefixime 56.3%; while treated wastewater has resistance profile Meropenem 20%; Ciprofloxacin 60%; and Cefixime 80% respectively for 1.3x103 CFU E. coli. WWTP in Dr. Cipto Mangunkusumo hospital has found to increase the percentage of antibiotic resistant E. coli. E. coli begins to resist Meropenem, the Carbapenem class antibiotic known for its effectiveness in dealing resistant antibiotic. ]

Abstrak :
Cefixime merupakan obat yang termasuk ke dalam kelompok antibiotik cephalosporin. Cefixime digunakan dalam berbagai pengobatan untuk infeksi yang disebabkan oleh bakteri. Di beberapa negara dan penelitian cefixime diberikan kepada pasien yang terserang virus dan salah satunya adalah demam berdarah dengue. Pada penelitian ini, dilakukan modifikasi struktur dari cefixime (antibiotik generik) yang biasanya digunakan sebagai antibakteri. Prinsip dalam memodifikasi cefixime dengan merubah beberapa gugus yang ada agar hasil modifikasi menjadi lebih polar dan hidrofil. Setelah dilakukan screening terhadap cefixime, ligan standar Bz-Nle-K-R-R-H dan 648 modifikasinya, dilakukan docking terhadap 12 ligan terbaik yang memiliki nilai ΔG lebih kecil bila dibandingkan ligan standar Bz-Nle-K-R-R-H. Ligan dengan kode C261, C385, dan C386 menjadi tiga ligan terbaik yang memiliki nilai ΔG terkecil. Berdasarkan hasil ADMET Test ke tiga ligan modifikasi cefixime terbaik memiliki sifat yang sama baiknya berdasarkan sifat bioavailabilitas oral, sifat hidrofobisitas, dan sifat toksisitas. Cefixime memiliki empat ikatan hidrogen dengan NS2B-NS3 protease dengan satu ikatan hidrogen tersebut berikatan dengan sisi aktif. Dapat disimpulkan cefixime memiliki kemampuan sebagai inhibitor NS2B-NS3 protease yang cukup baik. Berdasarkan beberapa parameter yang dilakukan, ligan C261 merupakan ligan modifikasi cefixime terbaik. ......Cefixime, which used to treat many different types of infections caused by bacteria, is in a group of drugs called cephalosporin antibiotics. But in some countries and researchs, cefixime administered to patients who suffered virusbased disease and one of them is Dengue Haemorrhagic Fever (DHF). In this research, structure of cefixime (a generic antibiotic) which usually used as an antibacterial is modified. The principle in modifying cefixime is by changing some of the atom groups that exist, so cefixime becomes more polar and hydrophilic. After screening standard cefixime, a standard ligand Bz-Nle-K-R-RH and 648 cefixime modifications, performed the best 12 ligands docking based on ΔG values that smaller than standard ligand Bz-Nle-K-R-R-H. Ligands with codes C261, C385, and C386 into three of the best ligand has the smallest values of ΔG. Based on the results of the ADMET Test three best cefixime modification ligand have similar properties based on oral bioavailability and hydrophobicity properties. Standard cefixime has four hydrogen bonds with the NS2B-NS3 protease include one hydrogen bond with the active side. Result shows that cefixime has a good ability as a NS2B-NS3 protease inhibitors. Based on several parameters in this research, the ligand C261 is the best ligand of cefixime modification.

Abstrak :
Kejadian resistensi antibiotik meningkat di seluruh dunia. Unit pengolahan limbah rumah sakit dapat menjadi sumber penularan serta tempat berkembang biak maupun munculnya bakteri resisten antibiotik. Penelitian ini dilakukan untuk mengetahui jumlah bakteri resisten antibiotik yang direpresentasikan dengan Escherichia coli (E. coli) pada influen dan effluen unit pengolahan limbah rumah sakit IPAL Terpadu 2 RSUPN Dr. Cipto Mangunkusumo (RSCM). Sebagian besar air limbah terdiri dari buangan feses dan urin pasien rawat inap di Gedung A RSCM. Antibiotika yang diuji untuk resistensi adalah Meropenem, Cefixime, dan Ciprofloxacin melalui metode disk diffusion test. Hasil yang didapatkan menunjukkan E. coli resistensi terhadap Ciprofloxacin, Cefixime, dan Meropenem masing-masing sebesar 50,96%, 47,63%, dan 14,18%. Efisiensi terbesar dalam mengurangi jumlah mikroorganisme pada unit pengolahan di IPAL Terpadu 2 RSCM adalah pada unit disinfeksi, yaitu sebesar 97,14%. ......The incidence of antibiotic resistance is increasing worldwide. Hospital wastewater treatment plant can become a source for transmission as well as place for breeding and development of antibiotic resistance bacteria. The study was conducted to determine the number of antibiotic-resistant bacteria that is represented by Escherichia coli (E. coli) in the influent and effluent hospital wastewater treatment plant in Wastewater Treatment Plant 2 of RSUPN Dr. Cipto Mangunkusumo. The wastewater mostly consisted of faeces and urine from hospitalized patients in Building A RSCM. The antibiotics to be tested for resistance are Meropenem, Cefixime, and Ciprofloxacin using disk diffusion test method. The results showed E. coli resistance to Ciprofloxacin, Cefixime, and Meropenem are respectively 50,96%, 47,63%, and 14,18%. The highest eficiency in decreasing the number of microorganism in IPAL Terpadu 2 RSCM is achieved by the disinfection unit, that is 97,14%.