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Background: Infection of Salmonella enterica subsp. enterica serovar Typhi is the primary etiology of typhoid fever globally and is common in many developing countries, especially those with dense populations and poor environmental sanitation. Antibiotic fluoroquinolones were used for the treatment in the 1980s due to the resistance to the first-line antibiotics. However, many cases of treatment failure of fluoroquinolones in typhoidal patients have been reported from numerous countries in Asia, Europe, Africa, and America. Mutations in quinolone resistance determining regions (QRDR) genes, gyrA, gyrB, parC, and parE, are found in fluoroquinolone-resistant Salmonella Typhi. Contrast reports came from the S. Typhi isolates in Indonesia, mainly Jakarta and the surroundings, obtained from patients with typhoid fever, with good sensitivity to the fluoroquinolones, i.e., nalidixic acid, ciprofloxacin, moxifloxacin, and levofloxacin. The present study, therefore, aimed to identify the hotspot sequences of gyrA, gyrB, parC, and parE genes of the local S. Typhi strains based on their susceptibility to fluoroquinolones from patients with typhoid fever in Jakarta and its satellite cities., Results: A total of 28 isolates were identified as S. Typhi. All isolates were susceptible to nalidixic acid, levofloxacin, and moxifloxacin. Twenty-seven isolates (96.4%) were susceptible to ciprofloxacin, with one isolate (3.6%) being intermediate. The hotspot sequences of gyrA, gyrB, parC, and parE genes from all isolates were identical to the fluoroquinolone-sensitive reference sequence Salmonella enterica subsp. enterica serovar Typhi Ty2 (NCBI GenBank AE014613.1), including the isolate with intermediate susceptibility. The mutation was not found, and amino acid deduced from all hotspots in susceptible and intermediate isolates showed no replacement in all reported codons., Conclusions: This study showed that the local S. Typhi strains from Jakarta and surroundings were susceptible to fluoroquinolones (nalidixic acid, ciprofloxacin, levofloxacin, and moxifloxacin), and the hotspot sequences of the gyrA, gyrB, parC, and parE genes were all identical to the reference sequence. Thus, the hotspot sequences of the gyrA, gyrB, parC, and parE genes seemingly were conserved in Jakarta's local S. Typhi strains and could be considered wild type. The phenotypic susceptibility was consistent with the genotypic characteristic without non-synonymous mutations associated with drug resistance., (© 2022. The Author(s).)

Objectives: Community-acquired pneumonia (CAP) is a global health condition that affects populations from all age groups. The laboratory identification of Mycoplasma pneumoniae as a causative agent of CAP is challenging because of its atypical and fastidious nature. Therefore, this study assessed the diagnostic potential of PneumoCLART bacteria® in identifying M. pneumoniae as a causative agent of pneumonia in hospitalized adults., Methods: This prospective study used a cross-sectional approach to assess the diagnostic potential of PneumoCLART bacteria® for detecting M. pneumoniae in sputum samples procured from 27 patients with pneumonia who required hospitalization., Results: The PneumoCLART bacteria® results illustrated that 7 of 27 patients with pneumonia were positive for M. pneumoniae (26%). However, the quality of sputum varied among the M. pneumoniae -positive and M. pneumoniae -negative samples. Fifty percent of the specimens obtained from patients positive for M. pneumoniae were saliva-contaminated and unsuitable for analysis., Conclusions: Because the leukocyte count was low and sputum specimens were saliva-contaminated, these findings require further validation to prove the utility of CLART® microarray technology for the identification of M. pneumoniae in pneumonia-positive patients. Conclusively, this prospective study included a small number of clinical samples, which likely affected its outcomes.

Objective: The prevalence of Mycoplasma hominis and Ureaplasma urealyticum (genital mycoplasma) amongst Indonesian women is poorly understood because of limited availability of diagnostic techniques. We sought to compare the diagnostic parameters of the AF Genital System® with those of culture methods and PCR as the gold standard for identification of M. hominis and U. urealyticum in vaginal swab specimens., Methods: This was an observational diagnostic study. Eighty-eight specimens were collected from patients with abnormal vaginal discharge. Detection of M. hominis and U. urealyticum was performed using the AF Genital System®, culture methods, and PCR., Results: Compared with PCR and culture methods, respectively, the AF Genital System® had sensitivities of 66.6% and 57% ( M. hominis ) and 55.5% and 77.8% ( U. urealyticum ). Compared with PCR and culture methods, respectively, the AF Genital System® had specificities of 82.9% and 86.5% ( M. hominis ) and 82.3% and 84.8% ( U. urealyticum )., Conclusion: The sensitivity of the AF Genital System® for detection of M. hominis and U. urealyticum from vaginal swab samples was lower than that of PCR, but specificity was reasonably good (82% to 83%).

Objective: Automated systems are needed for the rapid and accurate diagnosis of Pseudomonas -associated nosocomial infections among critically ill patients admitted to the intensive care unit. We assessed the performance of TDR-300B and VITEK®2 for the identification of P. aeruginosa using VITEK®-MS as the gold standard., Methods: This analytical study employed a cross-sectional approach. First, 44 clinical isolates of P. aeruginosa were collected and refreshed. Next, a single colony of oxidase-positive, gram-negative rods (30 samples) was inoculated into a TDR-300B NF-64 card and VITEK®2 GN cassette for each isolate. Finally, bacterial identification was performed using VITEK®-MS for comparative analysis., Results: Compared with the results for VITEK®-MS, the congruence rates for TDR-300B and VITEK®2 were 80.76% (21/26) and 92.30% (24/26), respectively. Further, high sensitivity was observed for TDR-300B and VITEK®2 (95.45% and 100%, respectively). In addition, TDR-300B had a lower positive predictive value and accuracy than VITEK®2, albeit without significance., Conclusions: Conclusively, there were no significant differences regarding the diagnostic efficiency of TDR-300B and VITEK®2 for P. aeruginosa .

Introduction: Acinetobacter baumannii, a multidrug-resistant Gram-negative opportunist has been known among the cause of nosocomial infection. Risk factors of infection related to A. baumannii have been reported elsewhere. This study aimed to find the association of A. baumannii positive culture and invasive procedures in patients hospitalized in the Intensive Care Unit and Hospital ward in Jakarta., Methodology: This study was a retrospective, 1:1 matched case-control study with total sampling method from in-patients in the ICU and the Internal Medicine Wards (IMW) of a Private Hospital, North Jakarta in 2015 - 2018. Data retrieved were positive culture of A. baumannii. Positive cultures of multi-sensitive bacteria were included as a control group. Antibiotic susceptibility test was carried out as recommended by Clinical and Laboratory Standards Institute., Results: A total of 88 in-patients were studied, and A. baumannii isolates were identified from 44 patients. Most of A. baumannii showed resistant to almost all antibiotics tested, except for colistin. Bivariate analysis showed a significant association of A. baumannii positive culture and the use of ventilator in the ICU (p = 0,039), and with urinary catheters in the IMW (p = 0,022). Multivariate analysis showed that length of stay also has a significant association to A. baumannii positive culture in the ICU., Conclusions: The use of ventilators and urinary catheters showed a significant association with Acinetobacter baumannii positive culture in patients in the ICU and in the IMW respectively. All of the A. baumannii isolates were susceptible to colistin., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2020 Lucky H Moehario, Tasia Esterita, Valencia Shirleen, Thomas Robertus, Yohanna Angelina.)

Acinetobacter baumannii (A. baumannii) is Gram-negative coccobacilli that has emerged as a nosocomial pathogen. Several reports in Indonesia showed the continuous presence of A. baumannii. This study aimed to determine the incidence of A. baumannii bacteremia in neonates in the Neonatal Unit Dr. Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia, and assess its role in blood stream infection using antibiogram and genotyping by pulsed-field gel electrophoresis (PFGE). Subjects were neonates with clinical sepsis. Blood specimens from the neonates and samples of suspected environment within the Neonatal Unit were cultivated. Antimicrobial resistance profiles were classified for analysis purpose. A. baumannii isolates were genotyped by PFGE to determine their similarity. A total of 24 A. baumannii were isolated from 80 neonates and the environment during this period of study. Seven isolates from the neonates showed multiple antimicrobial resistance (MDR), and 82% (n = 17) of the environment isolates were also MDR. Antibiotype "d" seemed to be predominant (62.5%). PFGE analysis showed a very close genetic relationship between the patients and environment isolates (Dice coefficient 0.8-1.0). We concluded that a mode of transmission of environmental microbes to patients was present in the Neonatal Unit of RSCM and thus needed to be overcome.

Background: This study examined the susceptibility of Gram-negative bacteria in the bloodstream to antimicrobials with the aim of providing information relevant to the guidance of therapy., Methodology: Blood specimens received by the Laboratory of Clinical Microbiology, Faculty of Medicine, University of Indonesia, from 2002 to 2008, were analyzed for the presence of Gram-negative bacteria and their susceptibility to four antibiotic groups frequently administered in hospitals and community settings., Results: During the seven-year period leading up to 2008, approximately 68% of Gram-negative bacteria were identified among all positive isolates from blood specimens. The eight most frequent species found were Acinetobacter anitratus (25.8%), Pseudomonas aeruginosa (19.5%), Klebsiella pneumoniae subsp. pneumoniae (14.5%), Enterobacter aerogenes (8%), Salmonella Typhi (7.5%), Escherichia coli (6.2%), Alcaligenes faecalis (5.6%) and Klebsiella oxytoca (3.2%). At 80% susceptibility or greater, Ceftriaxone and Cefotaxime were active only on E. coli and S. Typhi. Cefepime demonstrated activity on all eight species tested except K. pneumonia while Amikacin showed activity against five species, A. faecalis, E. aerogenes, E. coli, K. pneumoniae subsp. pneumoniae and S. Typhi. Gentamycin was active against three species: E. aerogenes, K. oxytoca and S. Typhi. Ciprofloxacin and Levofloxacin significantly differed in their spectrum: while Ciprofloxacin was active against four of the eight species tested (E. aerogenes, E. coli, K. oxytoca, and S. Typhi ), Levofloxacin was similar to Cefepime and was active against all eight species except K. pneumoniae subsp. pneumonia., Conclusions: Since antimicrobials are broadly used in Jakarta, it is important that the information captured in this study be disseminated.

Background: Typhoid fever remains a worldwide problem, but it is particularly common in Southeast Asia, including Indonesia. The causative agent Salmonella Typhi is known to have significant genome plasticity., Methodology: This study describes genetic fingerprints using restriction fragment length polymorphism with SpeI of chromosomal DNA and pulsed-field gel electrophoresis (PFGE) of S. Typhi isolated from different geographic areas spreading from west to east across Indonesia., Results: A total of 33 SpeI digested S. Typhi chromosomal DNA gave 22 schizotypes, 20 pulsotypes, and 12 subtypes indicating genomic diversity and the presence of more than one clone of S. Typhi. Cluster analysis at a degree of similarity of >or=80% showed four clusters, three of which were associated with geographic area. One cluster (Dice coefficient 0.727-1.000) contained isolates from three different geographic areas (Jakarta, Makasar, Jayapura), spread across Indonesia., Conclusions: Genetic fingerprinting of S. Typhi in Indonesia showed the presence of endemic strains in localized geographic areas, as well as the movement of one strain type throughout the archipelago.

A major issue in the study of the pathogenesis of primary biliary cirrhosis is whether the E2 subunit of the pyruvate dehydrogenase complex (PDH-E2), the major autoantigen in the disease, exists as a tissue-specific isoform. cDNA clones spanning a segment of the 3'-catalytic region of PDH-E2 (nt 1158-1361) have been isolated from human kidney, placenta and bile epithelium cells. Nucleotide sequence analysis of the clones showed differences consistent with the presence of normal variants of PDH-E2 in the human population. However, the existence of tissue-specific isoforms of PDH-E2 cannot yet be discounted.

Tissue specific isoforms of an enzyme autoantigen were sought in an attempt to explain a possible disease-associated translocation of the enzyme. A human heart cDNA clone (0.66 kb) coding for part of the lipoate acetyl transferase component of pyruvate dehydrogenase complex, recently identified as one of the major autoantigens of primary biliary cirrhosis was isolated. The cloned cDNA corresponded to nucleotides 1545-2201 of a previously published placental sequence, but showed some differences which give rise to differences in the inferred amino acid sequences of proteins. This may indicate the existence of tissue-specific isoforms of the lipoate acetyl transferase component of pyruvate dehydrogenase complex coded for by a multi-gene family.