Tuberkulosis (TB) masih menjadi masalah global. TB menduduki peringkat kedua penyebab kematian dari seluruh penyakit infeksi di dunia. Kelemahan dalam mendiagnosis dan pengobatan cepat selain dapat berdampak pada pasien, juga terhadap perkembangan resistensi sekunder dan penyebaran dari penyakit ini. Sebagai alternatif, teknik molekuler diagnostik dapat mempercepat TAT dan meningkatkan sensitifitas dan spesifisitas. Tes GeneXpert MTB/RIF merupakan mesin otomatis dengan penggunaan mudah dan cepat yang menggunakan prinsip nested real-time PCR dan teknologi molekuler untuk mendeteksi M. tuberculosis (MTB) dan resistensi obat rifampicin (RIF). Penelitian ini merupakan studi observasional analitik di laboratorium dengan pendekatan purposive sampling. Penilaian hasil  sensitivitas dan spesifisitas GE memiliki nilai 97% dan 93% terhadap mikroskopis BTA; Sensitivitas dan spesifisitas GE memiliki nilai 97% dan 62% terhadap kultur MTBC; Persentase deteksi Rifampisin resisten pada GE sebesar 167(31%) lebih tinggi dari pada kultur MTBC sebesar 103(21.7%); Ada 3 sampel dari 5 sampel yang hasil BTA positif dan GE negatif yang memiliki gen hsp65 yang menunjukkan adanya bakteri MOTT

Background: Carbapenems are the treatment of choice for multidrug-resistant (MDR) and extensively drug-resistant (XDR) Acinetobacter baumannii infections, but the emergence of carbapenem-resistant A. baumannii (CRAB) has rendered it ineffective in the vast majority of cases. Combination therapy has grown in popularity over the last decade; this study aims to analyze A.baumannii growth kinetics after exposure to meropenem and ampicillin-sulbactam compared with meropenem and amikacin antibiotic combinations in clinically relevant concentrations.  Methods: This experimental laboratory study was conducted on the A. baumannii ATCC 19606 isolate and three clinical isolates that were intermediate or resistant to tested antibiotics. Meropenem and ampicillin-sulbactam, as well as meropenem and amikacin, were tested at four different concentrations against isolates. Turbidity measurements were taken at predetermined time points of 0, 1, 2, 4, 6, 8, and 24 hours following exposure; bacterial concentration was enumerated using the agar plate method, with the results plotted in a time-kill curve.   Results: A bactericidal effect was achieved in isolates that were intermediate to ampicillin-sulbactam and resistant to meropenem after the administration of meropenem and ampicillin-sulbactam combination with a concentration of 4 µg/ml and 16/8 µg/ml, respectively. The combination of meropenem and ampicillin-sulbactam demonstrated bacteriostatic activity against isolates that were resistant to both antibiotics. Isolates treated with resistant antibiotics showed an increased growth rate compared to the growth control.  Conclusion: The combination of meropenem and ampicillin-sulbactam could be a promising combination therapy in treating CRAB infections. The mechanism and degree of antibiotic resistance in the isolates affect the efficacy of antibiotic combinations; further research is needed to corroborate the findings of this study.

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Vancomycin is the first-line therapy for MRSA infections, even though the standard dose is inadequate for biofilm eradication. This study aimed to asses the efficacy of vancomycin in eradicating biofilms and the influence of exposure on the emergence of hVISA isolates. The biofilm formed by MRSA isolates was exposed to vancomycin concentrations of 1 times the MIC, 1,000 times the MIC, and 10,000 times the MIC; exposed continously for 24 hours vs intermittently for 6 hours/day for 3 days.  Measurement of the optical density of the biofilm was carried out to determine the percentage of biofilm eradication. Biofilm specimens exposed to vancomycin were subcultured onto BHIA-VC selective media to isolate hVISA. The highest biofilm eradication effect was found in isolates exposed to vancomycin at a concentration of 10,000 times the MIC. Vancomycin exposure correlated with the emergence of hVISA isolates, especially after exposure to low concentrations of vancomycin. For optimum eradication of MRSA biofilms, vancomycin concentrations exceeding 1.000 times the MIC are required. Exposure to vancomycin at a dose equal to one-times the MIC had no effect on biofilm eradication and was associated with the emergence of MRSA isolates with decreased susceptibility to vancomycin.