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Abstrak :
Background and objective: Antimicrobial resistance is a global problem and the prevalence is high in many Asian countries. Methods: A prospective observational study of the prevalence of bacterial pathogens and their antimicro-bial susceptibilities in patients with acute exacerba-tions of chronic bronchitis (AECB) was conducted in Indonesia, Philippines, Korea, Thailand, Malaysia, Taiwan and Hong Kong from August 2006 to April 2008. The diagnosis of AECB was based on increased cough and worsening of two of following: dyspnoea, increased sputum volume or purulence. Patients who had taken antibiotics within 72 h of presentation were excluded. All bacterial strains were submitted to a central labo-ratory for re-identification and antimicrobial suscepti-bility testing to 16 antimicrobial agents according to Clinical and Laboratory Standards Institute. Results: Four hundred and seven isolates were iden-tified among 447 patients of AECB. The most frequent organisms isolated were Klebsiella pneumoniae and associated species (n = 91 + 17), Haemophilus influen-zae (n = 71), Pseudomonas aeruginosa (n = 63), Streptococcus pneumoniae (n = 32), Acinetobacter baumannii (n = 22) and Moraxella catarrhalis (n = 21). According to Clinical and Laboratory Standards Insti-tute susceptibility breakpoints, 85.7% and >90% of these pathogens were susceptible to levofloxacin and cefepime respectively. Other options with overall lower susceptibilities include imipenem, ceftazidime, ceftri-axone and amoxicillin/clavulanate. Conclusions: Gram-negative bacteria including Kleb-siella spp., P. aeruginosa and Acinetobacter spp. consti-tute a large proportion of pathogens identified in patients with AECB in some Asian countries. Surveil-lance on the local prevalence and antibiotic resistance of these organisms is important in guiding appropriate choice of antimicrobials in the management of AECB.

Abstrak :
Latar Belakang : Pekerja di manufaktur sepatu setiap harinya terpajan beragam hazard. Salah satu pajanan adalah pelarut organik. berbagai penelitian melaporkan hubungan yang kuat antara pajanan pelarut organik dengan gangguan fungsi paru obstruksi dan restriksi. Namun belum banyak studi dilakukan untuk mempelajari antara hubungan antara pajanan pelarut organik di manufaktur sepatu dengan faktor-faktor risiko dan gejala klinis gangguan fungsi paru. Metode : Desain potong lintang melibatkan 134 subyek, Cementing n=67 dan stockfit n=67. Pada bagian cementing terpajan pelarut Aseton, bagian stockfit oleh campuran pelarut Aseton dan klorin. Seluruh subyek dilakukan pemeriksaan fungsi paru dengan menggunakan spirometer menilai KVP dan VEP1/KVP. Subyek dilakukan interview untuk mengetahui gejala klinis, riwayat penyakit dahulu dan riwayat pekerjaan. Kadar pelarut organik di kedua tempat diukur. Analisis statistik menggunakan Chi square dengan p0,05. Multivariat menggunakan regresi logistik metode enter. Hasil : Didapatkan 23 orang (17%) mengalami gangguan fungsi paru testriksi. Tidak ada hubungan bermakna antara pejalan pelarut organik, faktor-faktor risiko demografi dan okupasi dengan gejala klinis gangguan fungsi paru restriksi (p>-.05) /disebabkan masa kerja < 10 tahun. Proporsi subyek dengan gejala bronkitis kronik, di cementing 40.3%, stockfit 62.7%. analisis chi-square menegaskan adanya hubungan bermakna. Di bagian cementing, diperoleh hasil berikut, faktor risiko umur (p < 0.015), masa kerja (p < 0.05), dan total kumulatif pajanan p < 0.05). Dan hasil uji regresi logistik didapat bahwa di bagian cementing, masa kerja faktor risiko dominan terhadap gejala bronkitis kronik p. Kesimpulan : Dari studi dapat disimpulkan bahwa pajanan pelarut organik mengakibatkan gejala klinis bronkitis kronik yang berhubungan dengan faktor risiko usia, masa kerja, dan total kumulatif pajanan. Tidak ada hubungan bermakna antara panajan pelarut organik terhadap gangguan fungsi paru. Perlu langkah preventif guna mencegah berkembangnya gejala bronkitis kronik menjadi gangguan fungsi paru. Dilakukan dengan pemakaian alat pelindung diri sesuai dengan pajanan kimia dan pemasangan local exhaust. ......Background : Depending on the kinds of production sites, Shoe factory workers are exposed to many kinds of occupational hazards with one of them being exposure to organic solvent. Organic solvent exposure has been reported to have adverse pulmonary effects including obstructive and restrictive pulmonary diseases. The study aimed to investigate association between organic solvent exposure, risk factor, and clinical symptoms of pulmonary functions impairment among shoe factory workers. Methods : Cross sectional study group consist of 134 workers in two different production parts i.e cementing n 67 and stockfit n 67. Subjects works in cementing part were exposed to aceton, while in stockfit to a combination of aceton and chlorine. To all subjecs, pulmonary functions testing including measurement of FVC and FEV1 FVC Value were perfomed asking about clinical symptoms and the histories of both their health and work records. Statistic analysis using Chi square p,0,05 and logistic regretion for multivariate. Result : All of subject, 23 17 suffered from restrictive diseases. However bivariate analysis using chi square did not show significant correlation between organic solvent exposure, demografic risk factors, clinical symptoms and restrictive lung diseases p 0.05. This probably due to the short work duration of the subject 10 years. Despite this observation, it is important to note that the study strongly identified chronic bronchitis symptoms among workers in both cementing 40.3 and in stockfit 62.7. Furthermore chi square analysis showed significant correlation between risk factors and chronic bronchitis symptoms in both places. in cementing, it was observed that age (p < 0.05), work duration (p < 0.05) and total cumulative exposure (p < 0.015) were significantly contributed to the symtoms. Whereas in stockfit, the risk factors were as follows, work duration (p < 0.05) and total cumulative exposure (p < 0.05). Logistic regression analysis showed that in cementing, work duration was observed to be the greatest risk factor to the bronchitis related-symtoms, p < 0.008, OR 12.100 and CI95% (1.92-76.23, whereas in stockfit, total cumulative exposure was associated the most with the symtoms p0.039 OR 6.667 CI95% )1.099-40.434). Conclusions : The result from the present studi indicate that occupational exposure to organic solvent has significant association with clinical symtoms related to chronic bronchitis. Risk factors sucs as age, work duration, and total cumulative exposure are observed to contribute to the symtoms. However, exposure to organic solben did not significantly caused lung function disorger. Preventions are required to avoid the clinical symtoms develope into pulmonary impairment, such as the use personal protection equipment and local exhaust apparatus.

Abstrak :
Hasil penelitian terdahulu memperlihatkan bahwa pada perokok.dengan bronkitis kronis dan Penyakit Paru Obstruktif Kronis (PPOK) terdapat hipersekresi mukus dan hiperplasia sel goblet pada saluran napas. Beberapa penelitian lain juga mengesankan bahwa faktor utama yang menyebabkan hiperplasia sel goblet adalah pajanan asap rokok pada paru secara konis. Penelitian ini bertujuan untuk mengetahui apakah hiperplasia sel goblet akibat asap rokok terjadi juga pada keadaan akut. Pada penelitian ini digunakan sampel sebanyak 20 ekor tikus dewasa jantan dari galur Swiss Webster dengan berat badan 250 -- 300 gram yang dibagi menjadi 2 kelompok yaitu kelompok kontrol dan kelompok perlakuan. Kelompok perlakuan diberi paparan asap rokok sebanyak 5 batang perhari selama 20 menit (kecuali hari Minggu) selama 12 minggu. Hasil penelitian menunjukkan bahwa terdapat perbedaan bermakna jumlah sel goblet antara kelompok kontrol dan kelompok perlakuan ( p< 0,025) . lni berarti bahwa terjadi hiperplasia sel goblet akibat asap rokok. Hasil ini diperkuat oleh pemeriksaan penunjang Electron Spin Resonance (ESR) untuk radikal bebas dalam darah tikus perlakuan yang menunjukkan peningkatan yang signifikan (p<0,025 ). Acute Effects of Kretek Cigarette Smoke on Goblet Cell Hyperplasia in the Airway of Swiss Webster RatsPrevious investigations have shown that in smokers with chronic bronchitis and Chronic Obstructive Pulmonary Disease (COPD) hyper secretion of mucus and goblet cell hyperplasia at the respiratory tract is present. A number of other investigations suggest that the main factor causing goblet cell hyperplasia is chronic exposure to cigarette smoke. The aim of this investigation is to find out whether goblet cell hyperplasia due to cigarette smoke also occurs in the acute state. In this investigation a sample of 20 adult male rats weighing 250 -- 300 g was used, divided into a treated group and control group. Each animal in the treated group was exposed daily for 20 minute to 5 the smoke of cigarettes for 12 weeks (except on Sunday). The result of the investigation showed that there was a significant difference in the number of goblet cell between the control and the treated group (p value < 0,025), indicating the occurrence of goblet cell hyperplasia due to cigarette smoke. This result was confirmed by Electron Spin Resonance (ESR) tests for free radical concentration in blood (p value < 0,025).