The study will be divided into two parts. The first part of the study aims to define the gap and barriers in implementing the guidelines in Indonesia. Additionally, we will define resistance genes encoding ESBL and carbapenamase to understand spread of the resistance.
The second part of the study will be a part of the development of the new APDT modality against multi-drug resistance gram-positive and gram-negative bacteria. The intracellular localization of photosensitizer (PS) is currently elusive, whereas the type of damage and subsequent cell death as well as activation of survival pathways are dependent on PS localization. Currently very little is known about the mechanisms of APDT- induced cell death and whether bacteria activate cell survival pathways. By investigating these biochemical and physiological processes we can design PS delivery systems that target to the pharmacologically most important locations and co-encapsulate inhibitors of survival pathways to optimize APDT efficacy. Thus, our 2nd objective is to elucidate the molecular mechanisms underlying APDT-induced cell death and survival in MDRGN bacteria and correlate these to PS localization.