JOURNAL MIDWIFERY (JM)
Jurnal Jurusan Kebidanan.
Poltekkes Kemenkes Gorontalo P-ISSN .
E-ISSN .
8-523X)
http://jurnal.
id/index.
php/JM/index DOI: http://dx.
org/10.
52365/jm.
COMPARATIVE STUDY OF PARTUS SET DECONTAMINATION:
CHLORINE AND ENZYMATIC ALKAZYME IN INFECTION
PREVENTION
Ambar Susanti1.
Listyaning Eko Martanti2.
Dhita Aulia Octaviani3
1,2,3
Department of Midwifery.
Poltekkes Kemenkes Semarang Email: ambar.
susanti220177@gmail.
com1, listy@poltekkes-smg.
id2, dhitaaulia@poltekkes-smg.
ABSTRACT
Introduction: Childbirth is a daily miracle and a source of joy for families.
To reduce maternal and neonatal mortality rates, providing clean and safe delivery care is essential, including infection prevention.
One method of infection prevention is decontaminating the partus set.
Chlorine-based decontamination is commonly used.
however, it has drawbacks, such as causing corrosion at low pH levels.
Enzymatic solutions, such as Alkazyme, provide an alternative for decontaminating delivery equipment.
Objectives: This study aims to describe the decontamination of the partus set using chlorine and enzymatic Alkazyme as an infection prevention effort at Boja II Community Health Center.
Methods: This was a descriptive observational study.
The samples consisted of delivery instruments used in childbirth, selected through accidental sampling.
The study focused on a single variable: the decontamination of partus sets using chlorine and enzymatic Alkazyme.
Results: Decontamination using chlorine at Boja II Health Center showed bacterial presence of 315 CFU/cmA with an average of 52.
5 CFU/cmA.
Meanwhile, decontamination using enzymatic Alkazyme resulted in 127.
4 CFU/cmA with an average of 21.
2 CFU/cmA.
Conclusions: Enzymatic Alkazyme leaves fewer bacterial residues than chlorine.
Midwives can consider using enzymatic solutions as an alternative method for decontaminating partus sets.
Keywords: chlorine, enzymatic decontamination, partus set A2025 Ambar Susanti.
Listyaning Eko Martanti.
Dhita Aulia Octaviani.
Under the licence CC BY-SA 4.
*Listyaning Eko Martanti.
Poltekkes Kemenkes Semarang.
Indonesia Jl.
Tirto Agung Pedalangan Banyumanik.
Semarang.
Jawa Tengah.
Indonesia, listy@poltekkes-smg.
Ambar Susanti1.
Listyaning Eko Martanti2.
Dhita Aulia Octaviani3 / Journal Midwifery Vol.
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2, 2025 .
provide delivery services, supported by a total
INTRODUCTION
Infections remain a major contributor of 634 midwives.
Among them.
Boja II Health to maternal mortality, responsible for about Center employs 21 midwives (Profil Kesehatan 10% of deaths during pregnancy, childbirth.
Kendal, 2.
Specifically, it should be applied and the postpartum period.
One significant during the provision of basic care in antenatal type is nosocomial infection, which refers visits, labor, and the postpartum period.
These to illnesses acquired in hospitals that affect practices must be integrated into all aspects of patients during the course of their treatment care to protect the mother, newborn, family, and (Situmorang, 2.
birth attendants.
(Kementrian Kesehatan RI.
Several factors contribute to maternal non-aseptic contaminated instruments, and inadequate infection control practices (Gidhar et al.
To protect mothers, newborns, and healthcare workers, midwives as the main providers of maternity care must strictly adhere to infection control protocols during childbirth and the postpartum period (Nafiah et al.
, 2014.
Badawi, 2.
Air, surgical instruments, the patient's skin, internal organs .
, and blood are all potential sources of infection.
Bacteria and microbes can travel from one location to another using various carriers.
These pathogens may be transmitted by humans, animals .
uch as insect.
, or contaminated objects .
uch as medical supplie.
Therefore, in such situations, surgical equipment, staff, and doctors all have (Sjamsuhidajat, 2.
The steps taken by midwives to prevent infection are directly Infection prevention is an essential related to the incidence of infection during component of comprehensive maternal and Findings showed that 56.
2% .
of newborn care, and it must be implemented 110 respondent.
had experienced a needlestick injury from used needles (Andhini et al.
, 2.
midwifery services.
All normal deliveries in Kendal Regency are now conducted at Primary Health Centers (Puskesma.
that are equipped to handle childbirth, where midwives serve as the primary healthcare providers during delivery.
According to data from the Kendal District Health Office, 30 Puskesmas have been certified to Normal Delivery Care (Asuhan Persalinan Normal/APN) is an approach designed to ensure clean and safe deliveries (Pramesti & Pascawati.
The goal of Normal Delivery Care (Asuhan Persalinan Normal/APN) is to ensure the survival and achieve the highest possible health status for both the mother and her baby Ambar Susanti1.
Listyaning Eko Martanti2.
Dhita Aulia Octaviani3 / Journal Midwifery Vol.
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through comprehensive and integrated sterilized (Ibrahim, 2.
Hence, it is crucial to efforts with minimal intervention, so that the principles of safety and quality of care chemical agents to reduce the risk of infection can be maintained at an optimal level Decontamination is a process (Rismayanti, 2.
The Infection Prevention and Control (IPC) Unit is an essential component of the healthcare service system, with a strategic role in enhancing the quality of health Its primary goal is to protect patients, healthcare workers, and the wider community from infections related to medical procedures or treatments provided in healthcare facilities (Ardiansyah, 2.
microorganisms on medical instruments to make them safer for use (Romadhoni & Widowati, 2.
Stated that there are various types of decontamination techniques, including washing and disinfection (Rutala et al.
, 2.
Decontamination with a chlorine solution is the process of eliminating or reducing the number of harmful microorganisms, including bacteria, viruses, and fungi, from a surface or object using a chlorine-based solution.
Chlorine solutions.
IPC programs are carried out through various measures, such as implementing preventing nosocomial infections, and providing training for healthcare personnel.
In addition, regular audits and evaluations are conducted to ensure that infection such as bleach, work by damaging the cell structure of microorganisms, rendering them inactive or killing them (Annisa, 2.
The mechanism of action involves 0.
5% chlorine and 70% alcohol destroying microorganisms through oxidation and protein denaturation.
(Muzhidah et al.
, 2.
control standards are consistently upheld Enzymatic cleaners such as Alkazyme are (Putra et al.
, 2.
commonly used to break down proteins and One of the main sources of infection medical equipment.
Instruments used in childbirth, such as forceps, scissors, clamps, and others, are highly susceptible to Previous studies have shown that surgical tools can be a source of infection if not properly cleaned and instruments without posing risks to healthcare workers (Infinita Bioteh, 2.
This study compares the effectiveness of chlorine solution Alkazyme Boja Community Health Center.
Unlike previous research, no study has directly examined these two methods in primary healthcare facilities Ambar Susanti1.
Listyaning Eko Martanti2.
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(Puskesma.
Addressing this gap, the present study provides novel evidence to Laboratory for microbiological analysis.
The guide infection prevention strategies in variable examined in this study was the maternity services and to support efforts to decontamination of partus sets using chlorine reduce preventable maternal and neonatal prevention measures.
The microbial count on It aims to reduce the risk of infection and other complications that may arise Semarang Alkazyme Health the partus sets was measured by calculating the microscope and A Colony Forming Unit (CFU) during childbirth.
counter, which indicates the presence of Although training on infection control evaluations of the actual implementation of childbirth-capable (Puskesmas Mampu Bersali.
in Kendal Regency remain limited (Rangkuti, 2.
This gap highlights the need for research to determine the extent to which infection prevention practices, particularly proper delivery instruments, are being applied in local healthcare facilities.
Therefore, the primary objective of this study is to describe the decontamination of partus sets used in delivery procedures with two methodsAichlorine microorganisms capable of causing infection.
enzymatic AlkazymeAiand to assess the effectiveness of each method in reducing microbial presence on partus sets after use.
Two partus sets used during deliveries at Boja II Health Center between October and December 2023 were included in the study.
However, the very small sample size .
constitutes a major limitation and represents a significant weakness of the study.
The partus set instruments consisted of a half Kocher clamp, artery clamp, metal catheter, suturing needle, umbilical cord scissors, episiotomy scissors, and needle holder.
Each set was decontaminated using one of two methods: one set with chlorine and the other with enzymatic Alkazyme.
The decontamination process lasted 10 minutes, followed by rinsing with clean water, drying, and placing in a sterile plastic bag before being sent to the Semarang Health Laboratory for microbial analysis.
Samples were selected using accidental sampling.
two partus sets were randomly chosen after delivery procedures, with METHOD each set decontaminated using one of the This study was conducted at Boja II designated methods.
After decontamination.
Community Health Center in Semarang, in both sets were taken to the laboratory for Ambar Susanti1.
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Categorical microbiological techniques.
Primary data proportions or percentages, without the use of were collected directly from laboratory test more complex statistical analyses, such as results, while secondary data included microbial identification results from the lab predominantly categorical.
This study received The data collection process ethical clearance from the Ethics Committee of involved several administrative steps, such Poltekkes Kemenkes Semarang with approval as obtaining research permissions from number 1252/EA/KEPK/2023 dated November relevant authorities including the ethics 27, 2023.
All research procedures adhered to Head Department Midwifery ethical research principles, including protection Poltekkes Kemenkes of research subjects and data confidentiality.
Semarang, and the Head of Boja II Community Health Center.
The instruments used in this study included a microscope to RESULTS observe and count microbial colonies on the This study presents data on the number of decontaminated partus sets.
Microbial microbes found on partus set instruments colony identification and enumeration were decontaminated using chlorine and enzymatic conducted using the CFU method.
Alkazyme.
The research was conducted at Boja The distribution of microbial counts on partus sets decontaminated with both methods.
Since the methodology employed was purely descriptive, it restricted the ability to statistical comparisons between the two decontamination methods.
Consequently, the results may not be generalizable to broader populations or different healthcare Further research with analytical or experimental designs and larger sample sizes is recommended to strengthen the evidence and validate these findings.
II Community Health Center in collaboration with the Semarang Health Laboratory.
The instruments tested included: half Kocher clamp, artery clamp, metal catheter, suturing needle, umbilical cord scissors, episiotomy scissors, and needle holder.
Microbial Count on Partus Set with Chlorine Decontamination Tabel 1.
Microbial Count on Partus Set with Chlorine Decontamination Instrument Bacterial Count (CFU/cmA) Half Kocher Clamp Artery Clamp Metal Catheter Suturing Needle Umbilical Cord Ambar Susanti1.
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Scissors Needle Holder Total Average instruments tested using enzymatic Alkazyme 4 CFU/cmA, with an average of 21.
CFU/cmA.
Source: Priamary data processed by the author Table 1 shows that the highest bacterial The data presented in Tables 1 and 2 count using chlorine decontamination was indicate a clear difference in microbial reduction found on the half Kocher clamp .
effectiveness between chlorine and enzymatic CFU/cmA), while the lowest was on the Alkazyme decontamination methods.
While needle holder .
CFU/cmA).
The total both are commonly used in clinical settings, bacterial count from all instruments after Alkazyme CFU/cmA, an average contamination on most instruments.
Chlorine, though widely used due to its affordability and CFU/cmA.
disinfectant properties, yielded a higher total microbial count .
CFU/cmA) compared to Alkazyme .
4 CFU/cmA).
This limitation may be attributed to chlorineAos reduced ability to remove organic debris, such as blood and tissue Microbial Count on Partus Set with remnants, which can interfere with subsequent Enzymatic Alkazyme Decontamination Table 2.
Microbial Count on Partus Set with Enzymatic Alkazyme Decontamination Partus set Bacterial Count (CFU/cm.
Half Kocher Clamp Artery Clamp Metal Catheter Suturing Needle Umbilical Cord Scissors Needle Holder Total Average Source: Priamary data processed by the author `Table 2 shows that the highest bacterial Alkazyme decontamination was found on the artery clamp .
0 CFU/cmA), while the lowest was on the umbilical cord scissors .
CFU/cmA).
The total bacterial count from all Enzymatic Alkazyme contains enzymes specifically designed to break down proteins and organic matter, facilitating more thorough This is evident in the lower average bacterial count .
2 CFU/cmA) observed after Alkazyme treatment.
However, the artery clamp still showed a relatively high microbial count .
0 CFU/cmA), indicating that instrument complexity and initial contamination levels can impact cleaning efficacy, regardless of the Additionally, instruments with simpler surfaces, such as the metal catheter and umbilical cord scissors, consistently showed low bacterial counts.
Ambar Susanti1.
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reinforcing the importance of instrument design in cleaning outcomes.
THANK YOU
The researchers would like to express their Overall, these findings support the sincere gratitude to the Director of Poltekkes effectiveness of enzymatic cleaners in Kemenkes Semarang and the Director of Semarang City Hospital for the opportunities especially when used alongside proper and support provided, which enabled the handling techniques and sufficient contact completion of this study within the designated time frame.
CONCLUSIONS
REFERENCES