Performance of TDR-300B and VITEK®2 for the identification of Pseudomonas aeruginosa in comparison with VITEK®-MS

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.

Association of Acinetobacter Baumannii with invasive procedures in hospitalized patients in Jakarta

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.

Screening of Legionella pneumophila from water sources in the hospitals in Jakarta

Latar belakang: Pneumonia akibat bakteri Legionella masih menjadi masalah di berbagai tempat di dunia; menjadi penyebab 2-15 % dari pneumonia yang perlu di rawat di Rumah Sakit. Kasus legionellosis di Indonesia dilaporkan terjadi di Bali pada tahun 1996 dan di Tangerang tahun 1999. Keberadaan Legionella di fasilitas Pelayanan Kesehatan berpotensi sebagai penyebab infeksi nosokomial. Bakteri Legionella hidup di lingkungan perairan hangat dan lembab, juga ditemukan diberbagai sumber air seperti, sumber air sistem pendingin ruangan, kolam renang, tempat penampungan air di rumah sakit, perkantoran, hotel, dan perumahan sehingga turut berkontribusi dalam terjadinya community acquired dan pneumonia nosokomial. Metode: Penelitian ini merupakan penelitian deskriptif yang bertujuan untuk penapisan keberadaan Legionella pneumophila diberbagai sumber dan penampungan air di Rumah Sakit (RS) di Jakarta dengan menggunakan medium Legionella Charcoal Yeast Extract (CYE) dan dengan berbagai suplemen. Tujuh belas sampel air yang berasal dari berbagai sumber air di dua RS yang berlokasi diJakarta Utara dan Barat telah diteliti. Hasil: Dua puluh satu koloni yang ditemukan memiliki karakterisitik L. pneumophila dari semua varian medium, namun pada tes agglutinasi latex tidak memberikan reaksi positif. Kesimpulan: L. pneumophila tidak ditemukan diberbagai sumber air dari dua RS ini. Penggunaan metode yang lebih sensitif dan spesifik perlu dilakukan untuk memastikan ditemukannya L. pneumophila.  Kata kunci: Legionellosis, Legionella pneumophila, medium BCYE   Abstract Background: Pneumonia due to Legionella bacteria is still a problem in various places in the world, causes 2 15% of pneumonia that need hospitalization. In Indonesia, legionellosis cases have been reported in Bali in 1996 and Tangerang in 1999. The existence of Legionella in healthcare facilities is potential to cause nosocomial infections. Legionella bacteria live in warm and humid waters, and are also commonly found in various water sources, such as water cooling systems, swimming pools, water reservoirs in hospitals, offices, hotels and housing. These bacteria contribute to the occurrence of community-acquired and nosocomial pneumonia. Methods: This study was a descriptive research, and aimed to screen water sources and reservoirs in the hospitals in Jakarta for the existence of Legionella pneumophilla using Legionella Charcoal Yeast Extract (CYE) medium with various supplements. A total of 17 water samples from 2 hospitals located in West and North Jakarta have been examined. Results: The results showed a total of 21 colonies with characteristics as of L. pneumophila were obtained from those water samples, however, none showed positive results in the latex agglutination test. Conclusion: L. pneumophila was not found thus far in the water sources in these two hospitals. A more sensitive and specific approaches might be used to enable the findings of L. pneumophila.  Keywords: Legionellosis, Legionella pneumophila, BCYE medium