Prevalensi dan Pola Sensitivitas Enterobacteriaceae Penghasil ESBL di RSUD Arifin Achmad Pekanbaru

Authors

  • Dewi Anggraini Medical Faculty of Riau University
  • Uswathun Hasanah Sholihin Medical Faculty of Riau University
  • Maya Savira Medical Faculty of Riau University
  • Fauzia Andrini Djojosugito Medical Faculty of Riau University
  • Dino Irawan Medical Faculty of Riau University
  • Ruza Prima Rustam Medical Faculty of Riau University

DOI:

https://doi.org/10.21776/ub.jkb.2018.030.01.9

Keywords:

ESBL, Escherichia coli, Klebsiella pneumonae, pola sensitivitas

Abstract

Resistensi antibiotik merupakan masalah besar baik di rumah sakit maupun di masyarakat, resistensi menyebabkan pilihan terapi infeksi menjadi terbatas. Prevalensi resistensi antibiotik cenderung makin meningkat, salah satu diantaranya adalah bakteri ESBL (extended spectrum beta lactamases), suatu kelompok bakteri penghasil enzim yang dapat menghidrolisis antibiotik beta laktam yang mengandung grup oxyimino seperti sefalosporin generasi satu sampai ketiga dan aztreonam. Penelitian ini  dilakukan secara deskriptif retrospektif yang bertujuan untuk mengetahui prevalensi ESBL pada Klebsiella pneumoniae dan Escherichia coli, serta pola sensitivitasnya di RSUD Arifin Achmad Pekanbaru. Data diambil dari hasil kultur bakteri dan uji resistensi antibiotik dari berbagai spesimen klinik yang diperiksa di Laboratorium Mikrobiologi RSUD Arifin Achmad selama tahun 2015. Uji ESBL dilakukan dengan alat VITEK 2 compact yang membandingkan antara proporsi penurunan pertumbuhan bakteri terhadap antibiotik sefalosporin saja dengan antibiotik kombinasi sefalosporin ditambah asam klavulanat. Hasil penelitian menunjukkan ESBL-K. pneumoniae sebesar 66,2%, dan ESBL-E. coli 62,2%, dan total rata-rata pada kedua bakteri 65,2%. Prevalensi ESBL-K. pneumoniae dan ESBL-E. coli paling tinggi berasal dari ruangan Instalasi Perawatan Intensif Anak dan berasal dari spesimen sputum dan pus, namun secara statistik tidak didapatkan perbedaan bermakna proporsi ESBL positif dan negatif berdasarkan asal ruangan dan jenis spesimen. Sensitivitas ESBL-K. pneumoniae dan ESBL-E. coli paling baik dengan antibiotik golongan karbapenem, amikasin dan tigesiklin. Penelitian ini menunjukkan tingginya prevalensi K. pneumoniae dan E. coli penghasil ESBL di RSUD Arifin Achmad dibanding beberapa rumah sakit rujukan nasional dii Indonesia. Saran untuk menurunkan angka ESBL dengan cara mencegah transmisi melalui penerapan kewaspadaan kontak dan kewaspadaan berbasis transmisi, aspek pencegahan dan pengendalian infeksi dan peningkatkan rasionalisasi penggunaan antimikroba harus dilakukan.

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References

Paterson D and Bonomo RA. Extended-Spectrum β-Lactamase: A Clinical Update. Clinical Microbiology Reviews. 2015; 18(4): 657-686.

Shaikh J, Fatima J, Shakil S, Rizvi S, and Kamal M. Antibiotic Resistance and Extended Spectrum Beta-Lactamase: Types, Epidemiology, and Treatment. Saudi Journal of Biological Sciences. 2015; 22(1): 90-101.

Goyal A, Prasad KN, Prasad A, Gupta S, Ghoshal U, and Ayyagari A. Extended Spectrum β-Lactamases in Escherichia coli & Klebsiella pneumoniae & Associated Risk Factors. Indian Journal of Medical Research. 2009; 129(6): 695-700.

Komite Pengendalian Resistensi Antimikroba KEMENKES RI. AMR Masalah Nasional dan Global. Proceeding Workshop PPRA. Semarang, Maret 13-16, 2016.

Bindu MH, Kasturi T, Reddy CM and Indu K. Prevalence of ESBL Production in Eschericia coli and Klebsiella spp from Different Clinical Samples-A Study in a Teaching Hospital in Telangana, India. International Journal of Current Microbiology and Applied Sciences. 2015; 4(3): 236-243.

Khurana S, Mathur P, Kapil A, Valsan C, and Behera B. Molecular Epidemiology of Beta-lactamase producing Nosocomial Gram-negative Pathogens frmo North and South Indian Hospitals. Journal Medical Microbiology. 2017; 66(7): 999-1004.

Rupinder B, Geeta W, and Shikha J. Prevalence of Extended Spectrum β-Lactamases in Multidrug Resistant Strains of Gram negative Bacilli. Journal of Academia Industrial Research. 2013; 1(9): 558-560.

Sankar S, Narayanan H, Kuppanan S, and Nandagopal B. Frequency of Extended Spectrum Beta-Lactamase (ESBL) Producing Gram Negative Bacilli in a 200-Bed Multi-Specialty Hospital in Vellore District, Tamil Nadu, India. Infection. 2012; 40(4): 425-429.

Nasa P, Juneja D, Singh O, Dang R, and Singh A. An Observational Study on Bloodstream Extended-Spectrum Beta-Lactamase Infection in Intensive Care Unit: Incidence, Risk Factors and Its Impact on Outcome. European Journal of Internal Medicine. 2012; 23(2): 192-195.

Hawkey P. Prevalence and Clonality of Extended-Spectrum Beta-Lactamases in Asia. Clinical Microbiology and Infection. 2008; 14(1): 159-165.

Al-Agamy MMH, Ashour EMS, and Wiegand I. First Description of CTXM Beta-Lactamase-Producing Clinical Escherichia coli Isolates from Egypt. International Journal of Antimicrobial Agents. 2006; 27(6): 545-548.

The European Centre for Disease Prevention and Control. Antimicrobial Resistenace Surveillance in Europe 2012. (Online) 2013. https://ecdc.europa.eu/en/publications-data/antimicrobial-resistance-surveillance-europe-2012. [diakses tanggal 20 September 2016].

Bhusal Y, Mihu CN, Tarrand JJ, and Rolston KV. Incidence of Fluoroquinolone-Resistant and Extended-Spectrum Beta-Lactamse-Producing Escherichia coli at a Comprehensive Cancer Center in the United States. Chemotherapy. 2011; 57(4): 335-338.

Sanchez GV, Master RN, Karlowsky JA and Bordon JM. In Vitro Antimicrobial Resistance of Urinary Escherichia coli Isolates among US Outpatients from 2000 to 2010. Antimicrobial Agents and Chemotherapy. 2012; 56(4): 2181-2183.

Moland ES, Black JA, Ourada J, Reisbig MD, Hanson ND, and Thomson KS. Occurence of Newer Beta-Lactamases in Klebsiella pneumoniae Isolates from 24 US Hospitals. Antimicrobial Agents and Chemotherapy. 2002; 46(12): 3837-3842.

Saurina G, Quale JM, Manikal VM, Oydna E, and Landman D. Antimicrobial Resistance in Enterobacteriaceae in Brooklyn, NY: Epidemiology and Relation to Antibiotic Usage Patterns. Journal of Antimicrobial Chemotherapy. 2000; 45(6): 895-898.

Mathai D, Lewis MT, Kugler KC, Pfaller MA, Jones RN, and SENTRY Participants Group (North America). Antibacterial activity of 41 Antimicrobials Tested Against Over 2773 Bacterial Isolates From Hospitalized Patients with Pneumonia: I-Results From SENTRY Antimicrobial Surveillance Program (North America, 1998). Diagnostic Microbiology and Infectious Disease. 2001; 39(2): 105-116.

Singh N, Pattnaik D, Neogi D, Jenit J, and Mallick B. Prevalence of ESBL in Eschericia coli Isolates Among ICU Patients in a Tertiary Care Hospital. Journal of Clinical and Diagnostic Research. 2016; 10(9): 19-22.

Saharman Y and Lestari D. Phenotype Characterization of Beta-Lactamase Producing Enterobacteriaceae in the Intensive Care Unit (ICU) of Cipto Mangunkusumo Hospital in 2011. Acta Medica Indonesiana. 2013; 45(1): 11-16.

Al-Bayssari C, Dabboussi F, Hamze M and Rolain JM. Detection of Expanded-Spectrum β-Lactamses in Gram-Negative Bacteria in the 21st Century. Expert Review of Anti-Infective Therapy. 2015; 13(9): 1139-1158.

Clinical Laboratory Standard Institute. Performance Standards for Antimicrobial Susceptibility Testing. 26th edition. USA: Clinical Laboratory Standard Institute; 2017.

Spanu T, Sanguinetti M, Tumbarello M, et al. Evaluation of the New VITEK 2 Extended-Spectrum Beta-Lactamase (ESBL) Test for Rapid Detection of ESBL Production in Enterobacteriaceae Isolates. Journal of Clinical Microbiology. 2006; 44(9): 3257-3262.

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Published

2018-02-28

Issue

Vol 30, No. 1 (2018)

Section

Research Article

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