Streptococcus pneumoniae is a human pathogenic bacterium able to cause invasive pneumococcal diseases. Some studies have reported medicinal plants having antibacterial activity against pathogenic bacteria. However, antibacterial studies of medicinal plants against S. pneumoniae remains limited. Therefore, this study aims to describe the antibacterial activity of medicinal plants in Indonesia against S. pneumoniae. Medicinal plants were extracted by maceration with n-hexane, ethanol, ethyl acetate and water. Antibacterial activity was defined by inhibition zone and minimum inhibitory concentration (MIC). Bactericidal activity was measured by culture and time-killing measurement. Methods used to describe the mechanism of action of the strongest extract were done by absorbance at 595 nm, broth culture combined with 1% crystal violet, qRT-PCR targeting lytA, peZT and peZA, and transmission electron microscope to measure bacterial lysis, antibiofilm, LytA and peZAT gene expression, and ultrastructure changes respectively. Among 13 medicinal plants, L. inermis Linn. ethyl acetate extract showed the strongest antibacterial activity against S. pneumoniae with an MIC value of 0,16 mg/ml. Bactericidal activity was observed at 0,16 mg/ml for 1 hour incubation. Lawsonia inermis extract showed some mechanism of actions including bacterial lysis, antibiofilm, and ultrastructure changes such as cell wall disruption, decreasing cell membrane integrity and morphological disorder. Increasing of lytA and decreasing of peZA and peZT expression were also observed after incubation with the extract. In addition, liquid chromatography mass spectrophotometer showed phenolic compounds as the commonest compound in L. inermis ethyl acetate extract. This study describes the strong antibacterial activity of L. inermis with various mechanism of action including ultrastructure changes.

Acute otitis media (AOM) is one of the most common infectious diseases in pediatric clinical facilities and has a significant impact on health care. It is a polymicrobial disease and is usually preceded by a viral upper respiratory tract infection. Data on the spectrum of viruses that cause AOM in Indonesia are still limited. This study analyzed nasopharynx (NP) samples collected from 119 school children with AOM in Banyumas Regency, Central Java, Indonesia. Viral RNA was extracted for cDNA synthesis, followed by PCR and sequencing tools for detection of a panel of respiratory viruses using family-level primers for Coronaviridae, Enterovirus, Bocavirus, and Pneumovirinae for bocavirus. In total, 37 out of 119 NP samples (31.1%) tested positive for viruses. Human rhinovirus B was the predominant virus identified (32.4%) followed by rhinovirus C (29.7%), human rhinovirus A (27%), and human bocavirus (5.4%). Rhinovirus are predominant viral pathogens within school children with AOM in Central Java, Indonesia.

none belonged to global epidemic clone ST258. Interestingly, IncL plasmid known to carry bla OXA48-like was absent in Indian isolates despite high rates of bla OXA48-like . Plasmid mediated colistin resistance is absent. There is threat of ST23 MDR hypervirulent Kp. High rate of colistin resistance is worrisome for management of these infections. Therapeutic options for Indian Kp are different from other regions due to prevalence of OXA48-like and NDM carbapenemases.

We investigated the resistance genes, pilus islet, biofilm formation ability, and sequence types of multidrug-resistant Streptococcus pneumoniae (MDRSP) isolated from the healthy children below 5 years of age in Indonesia. In all, 104 archived MDRSP isolates were screened for the presence of antibiotic resistance genes and  the rrgC  (pilus islet 1) and pitB (pilus islet 2) genes. Multilocus sequence typing and  biofilm formation was determined by DNA sequencing and the ability of cells to adhere to the walls respectively. Results have shown that the mefA, ermB, and tetM genes were found in 93%, 52%, and 100% of MDRSP isolates respectively. The insertion of arginine, proline, and Ile-100-Leu were the most common mutations in the folA and folP genes. Pilus islet 1 and type 2 were discovered in 93% and 82% of MDRSP isolates respectively. The MDRSP isolates showed no biofilm formation ability (64%) and  the most of sequence type was ST1464. This finding can be used to provide further considerations in implementing and monitoring pneumococcal vaccination in Indonesia.

We investigated the nasopharyngeal (NP) carriage and antimicrobial susceptibility profile of Streptococcus pneumoniae among adults and children with acute respiratory tract infection (ARTI). NP swabs were collected from ARTI patients in Tabanan, Bali, Indonesia, in 2017. Serotyping of S. pneumoniae and antibiotic susceptibility profile were performed by multiplex sequential PCR and the disk diffusion method, respectively. Out of 200 ARTI patients, S. pneumoniae strains were carried by 22.6% and 2.4% of children (36/159) and adults (1/41), respectively. Serotype 6A/6B was the most common serotype among cultured strains (21%) followed by 19F (18%) and 14 (8%). Most isolates were susceptible to chloramphenicol (87%), followed by clindamycin (74%), erythromycin (72%), sulfamethoxazole-trimethoprim (59%), and tetracycline (44%). This finding provides baseline information on the serotype distribution of S. pneumoniae carriage among ARTI patients in Indonesia.