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"Many infectious diseases of recent concern, including malaria, cholera, plague, and Lyme disease, have emerged from complex ecological communities, involving multiple hosts and their associated parasites. Several of these diseases appear to be influenced by human impacts on the environment, such as intensive agriculture, clear-cut forestry, and habitat loss and fragmentation; such environmental impacts may affect many species that occur at trophic levels below or above the hostcommunity. These observations suggest that the prevalence of both human and wildlife diseases may be altered in unanticipated ways by changes in the structure and composition of ecological communities. Predicting the epidemiological ramifications of such alteration in community composition will require strengthening the current union between community ecology and epidemiology."

"ABSTRAKRuang Lingkup dan Cara PenelitianPembawa mikroba patogen merupakan suatu keadaan yang sangat berpengaruh dan beresiko tinggi bagi seorang tenaga penjamah makanan / Food handler, dimana pada keadaan itu tenaga kerja tersebut berada dalam fungsi tubuh sehat tetapi mengandung bibit penyakit dan dapat menularkannya atau mengakibatkan orang lain sakit.Penelitian tentang upaya penurunan prevalensi pembawa mikroba patogen pada tenaga kerja di bagian Food and beverage suatu hotel belum banyak dilakukan di luar negeri, terutama di Indonesia.Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor - faktor yang dapat menyebabkan terjadinya pembawa mikroba patogen tersebut pada pekerja di bagian F & B hotel X Jakarta. Prevalensi tersebut diketahui berdasarkan pemeriksaan usap dubur.Disain penelitian adalah riset operasional terhadap 123 subyek penelitian. Pengumpulan data dasar dilakukan dengan menggunakan kuesioner / wawancara, pemeriksaan usap dubur pertama, pengambilan contoh makanan, contoh usap alat, contoh air bersih dan contoh air kolam renang. Intervensi yang dilakukan berupa penyuluhan, terapi antibiotika untuk 42 orang pekerja yang + (positif) mikroba pada pemeriksaan usap dubur pertama.Evaluasi dengan melihat perubahan sikap dan perilaku pekerja serta penurunan prevalensi pembawa mikroba patogen pada pemeriksaan usap dubur kedua.Hasil dan KesimpulanDari 123 subyek penelitian pada pemeriksaan usap dubur pertama didapatkan 42 orang (34.14%) positif mengandung mikroba atau menjadi pembawa mikroba patogen. Setelah dilakukan intervensi dengan pemberian terapi antibiotika yang sesuai, didapatkan penurunan prevalensi pembawa mikroba patogen menjadi 23 orang (18,69%).Faktor yang dapat menyebabkan seseorang tenaga kerja menjadi pembawa mikroba patogen adalah riwayat penyakit yang pernah diderita selama satu tahun terakhir sebelum pemeriksaan, sedangkan faktor lain tidak menunjukkan hubungan yang bermakna.Dari pemeriksaan sampel lingkungan tidak menunjukkan adanya kontaminasi dengan mikroba patogen.

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ABSTRACT

Operational Research Decreasing the Prevalence of Microbe Pathogen Carrier among Employees of Food and Beverage Department Hotel X, Jakarta 1997Scope and Methodology

Microbe pathogen carriers are potential hazards in food handlers, since they were functionally healthy, but sometime were reservoir agents for healthy people.

The design of study is an operational research with the objective to improve the health of workers in the sub department F & B in hotel X. The specific objectives of this study were to identify the prevalence of microbe carriers, to decrease the prevalence and to identify relationship between prevalence of several risk factors.

Until now there were no study reported had been carried out on this issue among employees of food and beverage department of hotels in Indonesia.

Results and Conclusions

Out of 123 subjects, 42 persons (34,14%) were tested positively in the first rectal swab examination as microbe pathogen carriers. Post intervention by giving appropriate antibiotic therapy, there was a decrease in the prevalence to 23 persons (18,69%).

The major factor that might significantly influenced the condition of microbe pathogen carriers was nourishment besides personal hygiene, sex, age, marital status, education, and working period.

Samples were takes also for environmental factors, such as tableware swabs, food samples, water samples, pool water samples showed no contamination with microbe pathogen."

"Latar Belakang : Data World Health Organization (WHO) tahun 2019 menunjukkan infeksi saluran napas bawah menjadi penyebab kematian keempat di dunia dengan angka kematian 6.1%. Pneumonia merupakan salah satu infeksi saluran napas bawah yang disebabkan oleh mikroorganisme. Jenis pneumonia yang banyak di masyarakat adalah pneumonia komunitas. Tingginya angka kejadian penumonia komunitas yang disebabkan oleh bakteri menyebabkan meningkatnya kebutuhan antibiotik sebagai pengobatan. Pemberian antibiotik dapat berupa empirical antibiotic treatment (EAT) atau pathogen-directed treatment (PDT). Penelitian ini bertujuan untuk melihat keberhasilan pengobatan pasien pneumonia komunitas rawat inap dengan EAT atau PDT.Metode : Penelitian ini merupakan penelitian observasional menggunakan desain kohort retrospektif dengan pengambilan data rekam medis di RSUP Persahabatan. Subjek peneltian ini adalah pasien pneumonia komunitas rawat inap periode 1 Januari 2021 hingga 31 Desember 2022. Pemilihan sampel menggunakan metode total sampling.Hasil : Subjek penelitian terdiri dari 220 pasien EAT dan 62 pasien PDT. Mayoritas bakteri yang ditemukan pada biakan sputum adalah gram negatif (82%) dengan jenis terbanyak adalah Klebsiella pneumonia (29.3%), Acinetobacter baumanii (16.7%) dan Eschericia coli (15.3%). Antibiotik terbanyak pada EAT adalah levofloksasin (87.3%) dan pada PDT adalah meropenem (34%). Keberhasilan pengobatan pasien dengan EAT sebesar 74.5% yang dipengaruhi oleh skor PSI (OR 5.318 (IK 95% 2.046 - 13.820, p=<.001), lama perawatan (OR 1.949 (IK 95% 1.043 - 3.641, p=0.035) dan riwayat penggunaan ventilator (OR 29.364 (IK 95% 12.80 - 67.34, p= <.001). Keberhasilan pengobatan pasien dengan PDT sebesar 46.8% yang dipengaruhi oleh riwayat penggunaan ventilator (OR 9.615 (IK 95% 2.712-34.08, p=<.001) dan hasil biakan sputum Acinetobacter baumanii (OR 2.608 (IK 95% 1.089 - 6.246), p = 0.028).Kesimpulan : Keberhasilan pengobatan pasien dengan EAT sebesar 74.5% dipengaruhi oleh skor PSI, lama perawatan dan riwayat penggunaan ventilator. Keberhasilan pengobatan pasien dengan PDT sebesar 46.8% dipengaruhi oleh riwayat penggunaan ventilator dan biakan sputum Acinetobacter baumanii.

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Background: Data from the World Health Organization (WHO) in 2019 shows that lower respiratory tract infections are the fourth cause of death in the world with a mortality rate of 6.1%. Pneumonia is a lower respiratory tract infection caused by microorganisms. The type of pneumonia that is common is community-acquired pneumonia. The high incidence of community-acquired pneumonia caused by bacteria causes an increased need for antibiotics as treatment. Antibiotics can be given as empirical antibiotic treatment (EAT) or pathogen-directed treatment (PDT). This study aims to see the success rate of inpatient community-acquired pneumonia with EAT or PDT.

Methods : This study was an observational study using a retrospective cohort design by collecting medical record data at Persahabatan Hospital. The subjects of this study were inpatient community-acquired pneumonia patients for the period January 1, 2021 to December 31, 2022. The total sampling method was selected for the study.

Results : The subjects in this study consisted of 220 EAT patients and 62 PDT patients. The majority of bacteria found were gram-negative (82%) with the most common types were Klebsiella pneumonia (29.3%), Acinetobacter baumannii (16.7%) and Escherichia coli (15.3%). The most antibiotics in EAT was levofloxacin (87.3%) and in PDT was meropenem (34%). The success rate of patients with EAT was 74.5%, which was affected by PSI score (OR 5.318 (IK 95% 2.046 - 13.820, p=<.001), length of stay (OR 1.949 (IK 95% 1.043 - 3.641, p=0.035) and history of ventilator use (OR 29.364 (IK 95% 12.80 - 67.34, p= <.001). The success rate of PDT was 46.8%, influenced by the history of ventilator use (OR 9.615 (IK 95% 2.712-34.08, p=<.001) and Acinetobacter baumanii in sputum culture (OR 2.608 (IK 95% 1.089 - 6.246), p = 0.028).

Conclusions : The success rate of patients with EAT was 74.5%, influenced by PSI score, length of stay and history of ventilator use while those with PDT were 46.8%, influenced by the history of ventilator use and Acinetobacter baumanii in sputum culture.

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"Bawang merah (Allium ascalonicum L.) adalah komoditas sayuran dengan ancaman penyakit hawar daun bakteri yang disebabkan oleh Pantoea sp. dalam produksinya. Pemanfaatan agen biokontrol dari bakteri yang berasosiasi dengan akar tanaman berpotensi tinggi menghasilkan mekanisme penghambatan patogen pada tanaman. Penelitian ini bertujuan untuk memperoleh isolat bakteri agen biokontrol yang mampu menghambat pertumbuhan patogen Pantoea sp., mempelajari karakterisasi dan mekanisme aktivitas agen biokontrol dalam penghambatan patogen Pantoea sp., serta mengidentifikasi isolat bakteri agen biokontrol. Kultur bakteri kandidat agen biokontrol diisolasi dari tanah perakaran tanaman bawang merah di lahan pertanian bawang merah di Cirebon dan Majalengka, Jawa Barat, serta Brebes, Jawa Tengah. Pengujian aktivitas meliputi uji antagonisme dan karakterisasi aktivitas biokontrol (produksi enzim protease, kitinase, selulase, siderofor, hidrogen sianida, ammonia, peroksidase dan aktivitas katalase) secara in vitro. Identifikasi isolat bakteri agen biokontrol dengan dilakukan gen 16S rRNA dan dilanjutkan dengan pembuatan rekonstruksi pohon filogenetik. Berdasarkan hasil penelitian, diperoleh 5 isolat rizobakteri (I-8, L1-9, L1-12, BM-L3(2), dan BM-L3(3)) yang memiliki kemampuan antagonis terhadap patogen Pantoea sp. penyebab penyakit hawar daun bakteri pada bawang merah. Kelima isolat tersebut menunjukkan hasil positif pada uji aktivitas enzim protease, kitinase, selulase, siderofor, hidrogen sianida, ammonia, peroksidase dan aktivitas katalase. Hanya isolat BM-L3(2) yang tidak memiliki kemampuan dalam produksi enzim kitinase. Isolat BM-L3(2) dan BM-L3(3) teridentifikasi sebagai Brevibacillus schisleri dan Bacillus sp., sedangkan isolat I-8, L1-9, dan L1-12 teridentifikasi sebagai Streptomyces rochei berdasarkan sifat morfologi, analisis sekuens 16S rRNA, dan kekerabatan pada hasil rekonstruksi pohon filogeni.

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Shallot (Allium ascalonicum L.) is vegetable commodity that has the threat of bacterial leaf blight caused by Pantoea sp. in its production. Utilization of biocontrol agents from bacteria associated with plant roots has high potential to produce pathogen inhibition mechanisms in plants. This research aims to obtain bacterial isolates of biocontrol agents that are able to inhibit the growth of Pantoea sp., study the characterization and mechanism activity of biocontrol agents, and identify bacterial of biocontrol agents. Bacterial of biocontrol agent candidates were isolated from root soil of shallot plants in Cirebon, Majalengka, and Brebes. The activity of the antagonism and biocontrol charaterization (enzyme production of protease, chitinase, cellulase, siderophore, HCN, ammonia, peroxidase and catalase) was tested by in vitro. Identification of biocontrol agent bacterial with the 16S rRNA gene was carried out and continued with phylogenetic tree reconstruction. Based on the results of the study, 5 rhizobacterial isolates (I-8, L1-9, L1-12, BM-L3(2), and BM-L3(3)) were obtained that have antagonism activity as biocontrol agent bacteria against the pathogen Pantoea sp. causing bacterial leaf blight in shallots. The five isolates showed positive results in the enzyme activity tests of protease, chitinase, cellulase, siderophore, hydrogen cyanide, ammonia, peroxidase, and catalase. Only isolate BM-L3 (2) does not have the ability to produce chitinase enzyme. Isolates BM-L3(2) and BM-L3(3) were identified as Brevibacillus schisleri and Bacillus sp., while isolates I-8, L1-9, and L1-12 were identified as Streptomyces rochei based on morphological characters, 16S rRNA sequence analysis, and kinship on phylogeny tree reconstruction results."

"Prevalensi periodontitis di Indonesia sangat tinggi yaitu 74,1%. Patogen keystone sebagai manipulator respons host dimediasi oleh patobion yang menjadi patogen dalam lingkungan dysbiosis yang akan memicu respons imun adaptif sehingga menyekresikan antibodi. Penelitian bertujuan untuk menganalisis hubungan antara keberadaan polimikrobial dengan respons imun humoral saliva berdasarkan keparahan periodontitis dan status periodontal. Desain penelitian ini adalah observasional potong-lintang. Pemeriksaan status periodontal dan pengambilan sampel saliva dilakukan pada 39 subjek periodontitis berbagai stage dan periodontal sehat. Keberadaan antigen dan respons imun humoral saliva dideteksi menggunakan teknik berbasis imunologi. Keberadaan antigen A. actinomycetemcomitans tertinggi pada kelompok periodontitis stage IV. Respons imun IgA saliva terhadap antigen F.nucleatum (p=0,014) dan C.albicans (p=0,009) menunjukkan perbedaan signifikan berdasarkan keparahan periodontitis. Hubungan signifikan ditemukan antara indeks plak dengan respons imun IgG saliva terhadap C.albicans. Hasil analisis menunjukkan hubungan antara indeks kebersihan mulut dengan respons imun IgA saliva terhadap antigen A. actinomycetemcomitans (p=0,008) dan C. albicans (p=0,031). Terdapat hubungan antara indeks perdarahan papila dengan respons imun IgA saliva terhadap antigen A. actinomycetemcomitans (p=0,003), F.nucleatum (p=0,002), dan C.albicans (p=0,008). Antigen A.actinomycetemcomitans, respons imun IgA serta IgG saliva terhadap antigen F.nucleatum dan C.albicans dapat menjadi biomarker keparahan periodontitis.

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The prevalence of periodontitis in Indonesia remains high (74.1%). Keystone pathogens as manipulators of the host response are mediated by pathogens that become pathogens in a dysbiotic environment that will trigger antibodies. The objective was to analyze the relationship between the presence of polymicrobial and salivary humoral immune responses based on the severity of periodontitis and periodontal status. The study design was cross-sectional. Saliva sampling were performed in 39 subjects with periodontitis and healthy periodontal. The presence of antigens and immunoglobulins were detected by immunology-based techniques. The presence of A.actinomycetemcomitans antigen was higher in the stage IV periodontitis group. The salivary IgA against F. nucleatum (p=0.014) and C. albicans (p = 0.009) showed significant differences based on the severity of periodontitis. A significant relationship was found between the plaque index and salivary IgG against C. albicans. It showed a relationship between the oral hygiene index and the salivary IgA immune response against A. actinomycetemcomitans (p=0.008) and C.albicans (p=0.031). There was a relationship between the papillary bleeding index and salivary IgA against A. actinomycetemcomitans (p=0.003), F.nucleatum (p=0.002) and C.albicans (p=0.008). The A.actinomycetemcomitans antigen, the salivary IgA and IgG against F.nucleatum and C.albicans antigens can be biomarkers for periodontitis severity."

"Pekerja kesehatan berisiko terpapar darah dan cairan tubuh yang terinfeksi (bloodborne pathogen) yang dapat menimbulkan infeksi HBV, HCV dan HIV melalui berbagai cara, salah satunya melalui luka tusuk jarum atau benda tajam lainnya. Di RSUD Cianjur kejadian luka tusuk karena jarum pada perawat cukup tinggi walaupun sudah dilakukan pelatihan terintegrasi. Melihat permasalahan tersebut maka penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan terjadinya luka tusuk karena jarum atau benda tajam lainnya; mengidentifikasi jenis tindakan dan keadaan tidak aman, hubungan tindakan dan keadaan tidak aman dengan terjadinya luka tusuk karena jarum.Penelitian ini menggunakan Metoda Deskriptif Analitik dengan menggunakan pendekatan Cross Sectional. Sampel dalam penelitian ini adalah Perawat di Instalasi Rawat Inap, Bedah Sentral dan Gawat Darurat dengan Metoda Purposive sampling dan jumlah sampel total sampling.Hasil penelitian menunjukkan jumlah perawat yang mengalami luka tusuk cukup tinggi, penyebab luka tusuk terbanyak karena jarum suntik atau jarum jahit jaringan, jenis tindakan tidak aman yang terjadi adalah; tidak menggunakan sarung tangan, menempatkan spuit/peralatan diatas meja tindakan, beban kerja berlebihan dan tidak menggunakan teknik satu tangan. Tindakan tidak aman berhubungan secara bermakna dengan terjadinya luka tusuk karena jarum atau benda tajam lainnya, tindakan tidak aman juga secara bermakna berhubungan dengan terjadinya luka tusuk karena jarum atau benda tajam lainnya pada Perawat berpengetahuan baik, berketerampilan baik dan pernah dilatih. Keadaan tidak aman yang teridentifikasi adalah: tidak selalu tersedia alat pelindung, keadaan tidak aman tidak memiliki hubungan yang bermakna dengan tingkat pengetahuan, keterampilan dan Perawat yang pernah dilatih tetapi berhubungan secara bermakna dengan Perawat yang belum pernah dilatih. Standar kerja dan peralatan yang dimiliki masih kurang. Untuk mencegah terjadinya luka tusuk karena jarum atau benda tajam lainnya maka perlu peningkatan surveilans kecelakaan dan penyakit akibat kerja, pelatihan dan perbaikan prosedur kerja serta pemenuhan sarana peralatan.

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Health workers pose some risks from the exposure to blood borne pathogen such as HBV, HCV and HIV such as those needle stick injury. Nurses in the needlestick injury incidents at Cianjur Regional Hospital is high, don. The objective of this research are to investigate the factors related with occurrence of needlestick injury; to identify type of unsafe act and unsafe condition contributed to accident resulted into needlestick injury.

The research design was based on analytical descriptive with cross sectional approach. Sample was taken from the nurses at the Installations of Inpatient, Central Surgery and Emergency using the purposive sampling method.

Result suggested that the nurses which high occurrence needlestick injury caused by hollowbome needle and suturing needle. Unsafe act related with needlestick injury and significantly with good knowledge, good skill and trained nurses. Identified unsafe condition is not usually available of personal protective equipment (PPE), unsafe condition is not related with good knowledge, good skill, trained nurses but significantly related to untrained nurses. Working standard procedure and equipment are improperly. To prevent needlestick injury, the improvement shell be taken by surveillance of work accident, work related diseases, training, work procedure and to full fill equipment and facility."

"ABSTRAKLatar belakang : Infeksi saluran kemih ISK berulang adalah ISK yang timbul kembali pasca pengobatan, dengan kejadian 40-50 dari ISK pertama. Kekerapan berulangnya ISK meningkatkan komplikasi gagal ginjal kronik. Salah satu faktor penyebab adalah kolonisasi bakteri patogen feses dari saluran cerna di daerah periuretra. Bakteri saluran cerna terdiri dari 3 kelompok, bakteri patogen, komensal dan bakteri menguntungkan. Penelitian membuktikan disbiosis antara bakteri patogen dan menguntungkan berkaitan dengan kejadian penyakit sistemik, namun belum ada penelitian tentang pengaruh hal tersebut pada ISK berulang.Tujuan : Mengetahui kondisi disbiosis yaitu perbedaan proporsi Escherichia coli dan Bifidobacterium sp. saluran cerna pada anak ISK berulang.Metode : Penelitian uji potong lintang pada anak ISK berulang usia 6 bulan sampai dengan

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ABSTRACTBackground Recurrent urinary tract infection UTIr is repeated UTI post antibiotic treatment, with recurrency is 40 50 from the first infection. Recurrency of UTI increases possibility of chronic renal failure as complication. One of the causal factors is colonization of faecal pathogens from gastrointestinal tract in periurethra. Gastrointestinal tract bacteria is divided into 3 groups pathogens, comensal, and beneficial bacteria. Studies proved that imbalance of condition or dysbiosis between pathogens and beneficial bacteria lead to systemic diseases, but there were no studies in UTIr.Objective To know about dysbiosis condition based on proportion differences between gastrointestinal Escherichia coli and Bifidobacterium sp. in UTIr.Methods A cross sectional studies with children with UTIr, aged 6 months old until 18 years old, in Pediatric Departement Cipto Mangunkusumo Hospital as a subject. Healty child which had been matched by sex and age was choosen as a control group. Faecal samples from both groups underwent DNA extractions, using real time PCR method, to look for Escherichia coli and Bifidobacterium sp. amount and proportions.Results There was a total of 25 subjects, 8 32 were classifed as simplex UTI and 17 68 were complex UTI, also 25 healthy children as control. The total amount of Escherichia coli in UTIr compared to control was 1.099.271 vs 453.181 p 0,240. The total amount of Bifidobacterium sp. in UTIr compared to control was 1.091.647 vs 359.336 p 0,148. Escherechia coli proportion in UTIr compared to control was 10,97 vs 4,74 p 0,014 that shown a significant different, while Bifidobacterium sp. 6,54 vs 9,33 p 0,594. In UTIr group, proportion differences beetwen Escherichia coli and Bifidobacterium sp. was 10,97 vs 6,54 p 0,819, while in control group 4,74 vs 9,33 p 0,021 which showed that Bifidobacterium sp. has a significant different. The total amount of Escherichia coli in simplex compared to complex UTIr was 996.004 vs 1.099.271 p 0,798, while amount of Bifidobacterium sp. 835.921 vs 1.196.991 p 0,711. Logarithm of Escherichia coli proportion in simplex and complex UTIr was 5,50 SB 1,45 vs 5,92 SB 0,71 p 0,333, while Bifidobacterium sp. 5,85 SB 0,75 vs 6,04 SB 5,50 p 0,562 showed no significant differences.Conclusions Escherchia coli proportion was higher in UTIr children and Bifidobacterium sp. proportion was higher in healthy children. The proportion of both bacteria was equal in simplex and complex UTIr."

"Latar Belakang: Dalam beberapa tahun terakhir, permasalahan yang sering muncul pada pneumonia komunitas adalah terkait timbulnya patogen penyebab yang bersifat resisten obat. Skor DRIP merupakan suatu model prediksi terhadap Patogen Resisten Obat (PRO) pada pneumonia komunitas. Skor DRIP memiliki akurasi prediksi patogen PRO yang lebih baik dibandingkan dengan beberapa alternatif skor lain termasuk kriteria HCAP. Belum adanya studi validasi terhadap penggunaan skor DRIP di Indonesia sehingga belum diketahui tingkat akurasi prediksi skor ini pada populasi, karakteristik pasien dan pola kuman di Indonesia terutama di RSUPN dr. Cipto Mangunkusumo Jakarta.Tujuan: Penelitian ini dilakukan untuk mengetahui performa skor DRIP sebagai instrumen dalam memprediksi infeksi akibat patogen PRO pada pneumonia komunitas di RSUPN dr. Cipto Mangunkusumo Jakarta.Metode: Suatu penelitian dengan menggunakan desain potong lintang. Subyek penelitian adalah pasien pneumonia komunitas yang dirawat di RS Cipto Mangunkusumo pada periode Januari 2019 hingga Juni 2020. Penelitian dilakukan dengan mengambil data rekam medis pasien pneumonia komunitas yang dirawat inap. Didefinisikan sebagai PRO apabila dari hasil kultur sputum didapatkan resisten terhadap antibiotik golongan β-laktam non pseudomonas (ceftriaxone, cefotaxime, ampicilin sulbaktam), Makrolid (azitromisin) dan fluorokuinolon respirasi (levofloxacin, moxifloxacin). Performa skor dianalisis dengan menentukan nilai kalibrasi dan diskriminasi menggunakan uji Hosmer-Lemeshow dan AUROC.Hasil: Sebanyak 254 subyek yang memenuhi kriteria pemilihan diikutkan dalam penelitian. Terbagi menjadi kelompok PRO 103 pasien (40,6%) dan non PRO 151 pasien (59,4%). Hasil analisis kalibrasi skor DRIP dengan uji Hosmer-Lemeshow didapatkan nilai p=0,001 (p<0,05). Sementara untuk analisis diskriminasi skor DRIP dari kurva ROC didapatkan nilai AUC 0,759 (IK95%;0,702-0,810). Pada skor ≥ 4, skor DRIP memiliki nilai sensitivitas 70,9%, spesifisitas 92,7%, nilai prediksi positif 86,9%, dan nilai prediksi negatif 82,3%.Simpulan: Skor DRIP memiliki performa yang baik untuk memprediksi infeksi akibat patogen PRO pada pneumonia komunitas.

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Background: In recent years, problems that often arise in community-acquired pneumonia are related to drug-resistant pathogens. The DRIP score is a predictive score model for Drug-Resistant Pathogens (DRP) in community-acquired pneumonia. It also has a better DRP pathogen prediction accuracy compared to other alternative scores including HCAP. There is no validation study on the use of the DRIP score in Indonesia, so the accuracy of this score prediction in the population, patient characteristics and germ patterns in Indonesia is not known, especially in RSUPN dr. Cipto Mangunkusumo Jakarta.

Objective: This study aims to determine the performance of the DRIP score as an instrument in predicting infection due to DRP pathogens in community-acquired pneumonia at Cipto Mangunkusumo Hospital Jakarta, Indonesia.

Methods: A study with cross-sectional design, on community-acquired pneumonia patients who were treated at Cipto Mangunkusumo Hospital in the period January 2019 to June 2020. Furthermore, this was conducted by reviewing medical records of inpatients. It is defined as DRP if the sputum culture results show resistance to non pseudomonas β-lactam antibiotics (ceftriaxone, cefotaxime, ampicillin-sulbactam), macrolides (azithromycin) and respiratory fluoroquinolones (levofloxacin, moxifloxacin). Score performance analyzed by determining the calibration and discrimination values using the Hosmer-Lemeshow and AUROC tests.

Results: 254 subjects who met the selection criteria were included in the study. It was divided into a PRO group of 103 patients (40.6%) and a non-PRO of 151 patients (59.4%). The results of the calibration analysis of the DRIP score with the Hosmer- Lemeshow test obtained a value of p=0.001 (p<0.05). Discrimination analysis from ROC curve got an AUC value of 0.759 (CI95%; 0.702-0.810). At a threshold ≥ 4 points, DRIP score demonstrated a sensitivity of 70,9%, a specificity of 92,7%, a positive predictive value of 86,9%, a negative predictive value of 82,3%.

Conclusions: The DRIP score have good performance to predict infections due to DRP pathogens in community-acquired pneumonia."

"Observation on infection of fungus entomopathogen metarhizium anisopliae on insect brown plant hopper was carried out using scanning electron microscope (SEM) ...."