Klebsiella pneumoniae(K. pneumoniae) can synthesize beta lactamase enzymes that have the ability to open lactam beta rings and cause resistance to antibiotics such as amoxicillin, third generation cephalosporins namely cefotaxim, ceftazidim, ceftriaxone and monobactam groups such as aztreonam. Extended spectrum beta lactamase (ESBL) is a plasmid enzyme that mediates the occurrence of hydrolysis and inactivation of beta lactam antibiotics. Infections caused by ESBL-producing bacteria become a serious problem for hospitals worldwide. ESBL isolate susceptibility tests against antibiotics are required to provide a sensitivity pattern that can be used as a reference in more rational antibiotic selection. This study was conducted to describe the prevalence of ESBL group K. pneumoniae and antibiotic resistance pattern at Ulin General Hospital Banjarmasin. The method of this research used secondary data material in the form of reporting document of antibiotic sensitivity test result that isolation and identification using VITEK 2, and then be analyzed using Microsoft Excel. The culture examination toward 50 patients in the Dahlia ward, Ulin General Hospital Banjarmasin was taken from January until May 2017, with the results arefrom 24 data Staphylococius aureus (S.aureus) isolate, more than half of it are ESBL group (54.16%). The results of sensitivity test of K.Pneumoniae of ESBLpositive to antibiotic group were found to be antibiotics that still have> 90% sensitive were meropenem (100%), amikacin (100%), tigecycline (92,85%), ertapenem (92,86%). The antibiotics with resistance> 50% was found in ampicillin antibiotics (100%), ceftriaxone (78.5%), ceftazidime (64.28%), cefepime (57.14%) and aztreonam (71.4%). As for ESBL negative results obtained sensitive> 90% for all antibiotics except ampicillin, ampicillin / sulbactam, and nitrofurantoin. Meropenem (100%), amikacin (100%), tigecycline (92.85%), ertapenem (92.86%) are antibiotic choices that are still sensitive to ESBL infection Keywords: antibiotic resistance, ESBL pattern, Vitek 2

Lung cancer is the primary cause of mortality in the world. It is able to manipulate the host immune response system through many mechanisms, such as through alteration of cytokines structure, forming regulator T-cells, obstruction of cellular immunity function, and the interference of tumor antigen presenting process. The new therapy approachment is produced by stimulating anti-cancer immune response, therefore the growth of lung cancer is able to inhibit. Immune checkpoint inhibition is considered as therapy for non-small cell lung carcinoma (NSCLC) after the unsuccessful treatment by platinum-based chemotherapy. Recent study shows that immune checkpoint inhibition monotherapy is more distinguished as first line therapy than platinum-based chemotherapy. Nonetheless, the effect of immunotherapy is only available for small population (30%) which has more than 50% PD-L1 programmed by the tumor. Therefore, some strategies are investigated to solve this issue. Nowadays, immunotherapy is expected to overcome lung cancer which is still being investigated in many studies.