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  • 1
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    Online Resource
    Impact of the COVID-19 pandemic on inpatient antibiotic use in Indonesia and the Philippines
    Cambridge University Press (CUP) ; 2023
    In:  Antimicrobial Stewardship & Healthcare Epidemiology Vol. 3, No. S2 ( 2023-06), p. s1-s2
    Details
    In: Antimicrobial Stewardship & Healthcare Epidemiology, Cambridge University Press (CUP), Vol. 3, No. S2 ( 2023-06), p. s1-s2
    Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic severely affected Southeast Asia, with 〉 35 million cases and ~360,000 deaths. Despite relatively low rates of secondary bacterial infection among inpatients with COVID-19, several countries reported increased antibiotic use; raising concerns for worsening antimicrobial resistance. We assessed the impact of the COVID-19 pandemic on the use of antibiotics commonly used to treat respiratory infections in Southeast Asia. Methods: We evaluated intravenous antibiotic use among hospitalized adults in acute-care wards in 6 hospitals; 3 in Indonesia and 3 in the Philippines. We abstracted data on antibiotics that are commonly used to treat respiratory infections in these hospitals. We calculated antibiotic use rates for the 25 included antibiotics as monthly defined daily dose per 1,000 patient days (or patient discharges where patient days was unavailable) using data from pharmacy dispensing records and administrative records. Median antibiotic use rates for the prepandemic period (March 2018–February 2020) and the pandemic period (March 2020–February 2021) were compared, and percentage changes were calculated for (1) all 25 antibiotics combined; (2) ceftriaxone; (3) vancomycin and linezolid combined (anti-MRSA); and (4) broad-spectrum antibiotics with activity against Pseudomonas aeruginosa (anti-PSA). Monthly antibiotic use and COVID-19 patient discharges were graphed over the 36-month study period (March 2018–February 2021) to visualize trends (Fig. 1). The Wilcoxon rank-sum test was used to determine whether differences in median antibiotic use rates were statistically significant (2-tailed P 〈 .05). Results: Overall, trends in antibiotic use were higher during months with increased COVID-19 patient discharges (Fig. 1). Use of all 25 antibiotics combined significantly increased in 4 of 6 hospitals (6.9%–63.6%) during the pandemic period compared to the prepandemic period. Ceftriaxone use significantly increased in 3 of 6 hospitals (37.1%–55.4%) and decreased in 3 of 6 hospitals (15.9%–31.9%). Anti-PSA antibiotic use significantly increased in 4 of 6 hospitals (16.1%–161.5%). Although anti-MRSA antibiotic use was low (comprising 〈 2% of the overall included antibiotic use in Indonesia and 〈 11% in the Philippines), use during the pandemic increased in 3 of 6 hospitals (59.8%–212.6%). Conclusions: We observed substantial increases in antibiotic use among hospitalized adults in Indonesia and the Philippines during the COVID-19 pandemic. The increased use of broad-spectrum antibiotics is concerning given the potential consequence of worsening antimicrobial resistance. Understanding how increases in antibiotic use compares to rates of bacterial infection, antimicrobial resistance, and antibiotic availability and accessibility during this time is important to contextualize results. These findings reinforce the importance of antibiotic stewardship practices to optimize antibiotic use, especially during pandemics. Disclosure: None
    Type of Medium: Online Resource
    ISSN: 2732-494X
    URL: Article
    DOI: 10.1017/ash.2023.209
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 3074908-6
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  • 2
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    Distribution of Carbapenemase Genes among Carbapenem-Non-Susceptible Acinetobacter baumanii Blood Isolates in Indonesia: A Multicenter Study
    MDPI AG ; 2022
    In:  Antibiotics Vol. 11, No. 3 ( 2022-03-09), p. 366-
    Details
    In: Antibiotics, MDPI AG, Vol. 11, No. 3 ( 2022-03-09), p. 366-
    Abstract: Carbapenem non-susceptible Acinetobacter baumannii (CNSAB) is an important pathogen that causes nosocomial bacteremia among critically ill patients worldwide. The magnitude of antibiotic resistance of A. baumanii in Indonesia is expected to be significant; however, the data available are limited. The aim of this study was to analyze the genetic profiles of CNSAB isolates from patients with bacteremia in Indonesia. CNSAB isolates from blood cultures of bacteremia patients in 12 hospitals in Indonesia were included. The blood cultures were conducted using the BacT/Alert or BACTEC automated system. The CNSAB were identified with either Vitek 2 system or Phoenix platform followed by a confirmation test using a multiplex polymerase chain reaction (PCR) assay, targeting the specific gyrB gene. The carbapenemase genes were detected by multiplex PCR. In total, 110 CNSAB isolates were collected and were mostly resistant to nearly all antibiotic classes. The majority of CNSAB isolates were susceptible to tigecycline and trimethoprim-sulfamethoxazole (TMP-SMX), 45.5% and 38.2%, respectively. The blaOXA-51-like gene was identified in all CNSAB isolates. Out of the total, 83.6% of CNSAB isolates had blaOXA-23-like gene, 37.3% blaOXA-24-like gene, 4.5% blaNDM-1 gene, 0.9% blaIMP-1 gene, and 0.9% blaVIM gene. No blaOXA-48-like gene was identified. The blaOXA-23-like gene was the predominant gene in all except two hospitals. The presence of the blaOXA-24-like gene was associated with resistance to tigecycline, amikacin, TMP-SMX and cefoperazone-sulbactam, while blaOXA-23-like gene was associated with resistance to TMP-SMX and cefoperazone-sulbactam. In conclusion, the blaOXA-23-like gene was the predominant gene among CNSAB isolates throughout Indonesia. A continuous national surveillance system needs to be established to further monitor the genetic profiles of CNSAB in Indonesia.
    Type of Medium: Online Resource
    ISSN: 2079-6382
    URL: Article
    DOI: 10.3390/antibiotics11030366
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2681345-2
    SSG: 15,3
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  • 3
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    Correlation of Osteocalcin Urine Levels with Bone Mass Density in Menopause Women in H. Adam Malik General Hospital Medan
    Institute of Medico-legal Publications Private Limited ; 2020
    In:  Indian Journal of Public Health Research & Development Vol. 11, No. 1 ( 2020-01-01), p. 1011-
    Details
    In: Indian Journal of Public Health Research & Development, Institute of Medico-legal Publications Private Limited, Vol. 11, No. 1 ( 2020-01-01), p. 1011-
    Type of Medium: Online Resource
    ISSN: 0976-5506 , 0976-0245
    URL: Article
    DOI: 10.37506/v11/i1/2020/ijphrd/193969
    Language: Unknown
    Publisher: Institute of Medico-legal Publications Private Limited
    Publication Date: 2020
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  • 4
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    PREVALENCE OF ACINETOBACTER BAUMANNII ISOLATED FROM CLINICAL SPECIMENS IN ADAM MALIK HOSPITAL
    Universitas Andalas ; 2015
    In:  Majalah Kedokteran Andalas Vol. 37, No. 1 ( 2015-05-03), p. 1-
    Details
    In: Majalah Kedokteran Andalas, Universitas Andalas, Vol. 37, No. 1 ( 2015-05-03), p. 1-
    Abstract: AbstrakAcinetobacter baumannii merupakan spesies Acinetobacter spp. tersering diisolasi darimanusia, dan lebih sering dijumpai pada infeksi nosokomial dibandingkan dengan infeksi dikomunitas. Eksistensi bakteri ini di lingkungan terkait dengan keragaman reservoir, kemampuanmemperoleh gen pembawa sifat resisten antimikroba, dan sifat resisten terhadap pengeringan.Infeksi disebabkan strain A.baumannii yang resisten terhadap banyak antibiotik tidak mudahdikendalikan dan menjadi permasalahan di berbagai negara. Penelitian ini bertujuan untukmengetahui prevalensi A.baumannii dari spesimen klinis di instalasi mikrobiologi klinik RSUPHaji Adam Malik serta pola kepekaannya terhadap berbagai antibiotik. Identifikasi dan ujikepekaan menggunakan mesin otomatis Vitek 2 dengan Advanced Expert System (AES).Penelitian ini menemukan 644/3693 (17,44%) isolat A.baumannii dari berbagai spesimen klinis.A.baumannii paling banyak diisolasi dari spesimen dahak. Penelitian ini menemukan 147/644(23%) bahwa isolat carbapenem-resistent A.baumannii (imipenem dan meropenem). Sebagianbesar isolat sensitif terhadap colistin, amikacin dan tigecycline. Prevalensi A.baumanni yangditemukan pada penelitian ini adalah rendah namun resistensinya tinggi terhadap antibiotikterutama golongan penicillin, cephalosporin dan fluoroquinolon.AbstractAcinetobacter baumannii is the most frequent species of Acinetobacter spp. isolated fromhumans and more common in nosocomial infection than it is in community acquired infection.A.baumannii existence in environment is associated with the diversity of its reservoirs, itscapacity to accumulate genes of antimicrobial resistence, and its resistence to desiccation.Infection of Multidrug resistent (MDR) strain of A.baumannii is not easy to manage and it hasbecome a problem in many countries. The aim of this retrospective study was to investigatethe prevalence of A.baumannii from routine clinical specimens sent to clinical microbiologylaboratory RSUP HAM Medan and its susceptibility pattern to various antibiotics. Identificationand susceptibility testing of A. baumannii was performed by Vitek 2 with Advanced ExpertSystem (AES). A total of 644/3693 (17.44%) A.baumannii isolates were identified from variousclinical specimens. From those isolates, there were 147 (23%) isolates of carbapenemresistentA.baumannii (imipenem and meropenem). A.baumannii mainly isolated from sputumspecimens, and most isolates were highly sensitive to colistin, amikacin and tigecycline.Low prevalence of A.baumannii was found in this study. However, the isolates showed highresistence level to antibiotics, particularly penicillin, cephalosporin and fluoroquinolones.
    Type of Medium: Online Resource
    ISSN: 2442-5230 , 0126-2092
    URL: Article
    DOI: 10.22338/mka.v37.i1.p1-7.2014
    Language: Unknown
    Publisher: Universitas Andalas
    Publication Date: 2015
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  • 5
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    Effect of Butyric Acid on p53 Expression and Apoptosis in Colon Epithelial Cells in Mice after Treated with 9,10-dimethyl-1,2-benz(a)anthracene
    Elsevier BV ; 2016
    In:  Procedia Chemistry Vol. 18 ( 2016), p. 141-146
    Details
    In: Procedia Chemistry, Elsevier BV, Vol. 18 ( 2016), p. 141-146
    Type of Medium: Online Resource
    ISSN: 1876-6196
    URL: Article
    DOI: 10.1016/j.proche.2016.01.022
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2016
    detail.hit.zdb_id: 2515983-5
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