RESISTENSI Klebsiella sp TERHADAP MEROPENEM DI RSUD PROF. DR. MARGONO SOEKARJO PURWOKERTO

Afifah Afifah (1) , Tunggul Adi Purwonegoro (2) , IDSAP Peramiarti (3)


(1) Fakultas Kedokteran, Universitas Jenderal Soedirman
(2) Fakultas Ilmu-Ilmu Kesehatan, Universitas Jenderal Soedirman
(3) Fakultas Kedokteran, Universitas Jenderal Soedirman



DOI: 10.20884/1.sb.2017.4.2.378


Abstract


Resistant Gram-negative bacteria, particularly Klebsiella sp., has become a serious problem in hospitals as one of the main causes of nosocomial infections spread through urine catheterization. Infections of Klebsiella sp. producing extended-spectrum beta-lactamase (ESBL) can lead to significant economic and clinical negative outcome. This study was aimed to determine the sensitivity of ESBL Klebsiella sp. against meropenem as a cause of nosocomial infections in Prof. Dr. Margono Soekarjo hospital. This research obtained urine samples from the urinary catheter of patients hospitalized for at least two days in the surgical ward and intensive care unit. ESBL examination conducted by the initial screen test, meanwhile, sensitivity test to meropenem done by using disk diffusion test. Among the 40 patients examined in this study 7.5% isolates were Klebsiella sp-positive. This research identified five percent of the total patients as ESBL positive with the level of sensitivity against meropenem was revealed as resistant.


Keywords


Klebsiella sp., extended spectrum beta lactamase (ESBL), meropenem, sensitivity

Full Text:

PDF

References


Afifah A, Dwi Utami A. 2011. Identification of extended spectrum betalactamase (ESBL) producing bacteria cause of nosocomial infection in RSUD Prof. Dr. Margono Soekarjo, Purwokerto. In: Totok A, Rifda N, Hardiansyah, Erna KW, Friska CA, Santi DA, Siti ZW, Ali M, Diah P, editors. Proceedings of the Seminar Nasional Pengembangan Sumber Daya Pedesaan dan Kearifan Lokal Berkelanjutan; 2011 Nov.; Purwokerto: LPPM Unsoed; p.502¬–508.

Ahmadi F, Abolghasemi S, Parhizgari N, Moradpour F. 2013. Effect of silver nanoparticles on common bacteria in hospital surfaces. Jundishapur J Microbiol. 6(3): 209 – 214. https://doi.org/10.5812/jjm.4585

Aly SA, Tawfeek RA, Mohamed IS. 2016. Bacterial catheter-associated urinary tract infection in the intensive care unit of Assiut University Hospital. Al Azhar Assiut Medical Journal. 14(2):52–58. https://doi.org/10.4103/1687-1693.192652

Biswas R, Rabbani R, Ahmed HS, Sarker MAS, Nahida Z, Rahman MM. 2014. Antibiotic sensitivity pattern of urinary tract infection at a tertiary care hospital. Bangladesh Crit Care J. 2 (1): 21–24. https://doi.org/10.3329/bccj.v2i1.19952

Cockerill FR, Wikler MA, Bush M, Dudley MN, Eliopoulus GM, Hardy, DJ, et al. 2010. Performance standards for antimicrobial susceptibility testing: twentieth informational supplement. In CLSI Document M100-S20. Pennsylvania: Clinical Standarad and Laboratory Institute. 13(1): pp.40–160.

Doumith M, Ellington MJ, Livermore DM, Woodford N. 2009. Molecular mechanisms disrupting porin expression in ertapenem-resistant Klebsiella and Enterobacter spp. clinical isolates from the UK. J Antimicrob Chemother. 63(4):659–667. https://doi.org/10.1093/jac/dkp029

Ferreira CM, Ferreira WA, Almeida NCOS, Naveca FG, Barbosa MGV. 2011. Extended-spectrum beta-lactamase-producing bacteria isolated from hematologic patients in Manaus, State of Amazonas, Brazil. Brazilian Journal of Microbiology. 42(3):1076–1084. https://doi.org/10.1590/S1517-83822011000300028

Goldfarb D, Harvey SB, Jessamine K, Jessamine P, Toye B, Desjardins M. 2009. Detection of plasmid-mediated KPC-producing Klebsiella pneumoniae in Ottawa, Canada: evidence of intrahospital transmission. J Clin Microbiol. 47(6):1920–1922. https://doi.org/10.1128/JCM.00098-09

Hernandez-Alles S, Alberti S, Alvarez D, Doménech-Sánchez A, Martinez-Martinez L, Gil J, Tomás JM, Benedí VJ. 1999. Porin expression in clinical isolates of Klebsiella pneumoniae. Microbiology. 145(3):673–679. https://doi.org/10.1099/13500872-145-3-673

Holt SR, Murray EGD, Smith RN. 2000. Bergey's manual determinative of bacteriology. 9th ed. Baltimore: Waverly Press.

Jeong SH, Bae IK, Kwon SB, Lee K, Yong D, Woo GJ, Lee JH, Jung HI, Jang SJ, Sung KH, Lee SH. 2005. Investigation of a nosocomial outbreak of Acinetobacter baumannii producing PER-1 extended-spectrum beta-lactamase in an intensive care unit. J Hosp Infect. 59(3):242–248. https://doi.org/10.1016/j.jhin.2004.09.025

Kaczmarek FM, Dib-Hajj F, Shang W, Gootz TD. 2006. High-level carbapenem resistance in a Klebsiella pneumoniae clinical isolate is due to the combination of bla(ACT-1) beta-lactamase production, porin OmpK35/36 insertional inactivation, and down-regulation of the phosphate transport porin phoe. Antimicrob Agents Chemother. 50(10):3396–3406. https://doi.org/10.1128/AAC.00285-06

Kaoutar B, Joly C, L'Hériteau F, Barbut F, Robert J, Denis M, Espinasse F, Merrer J, Doit C, Costa Y, Daumal F, Blanchard HS, Eveillard M, Botherel AH, Brücker G, Astagneau P. 2004. Nosocomial infections and hospital mortality: a multicentre epidemiology study. J Hosp Infect. 58(4):268–275. https://doi.org/10.1016/j.jhin.2004.06.006

Kontopoulou K, Protonotariou E, Vasilakos K, Kriti M, Koteli A, Antoniadou E, Sofianou D. 2010. Hospital outbreak caused by Klebsiella pneumoniae producing KPC-2 beta-lactamase resistant to colistin. J Hosp Infect. 76(1):70–73. https://doi.org/10.1016/j.jhin.2010.03.021

Ludden C, Cormican M, Vellinga A, Johnson JR, Austin B, Morris D. 2015. Colonisation with ESBL - producing and carbapenemase - producing Enterobacteriaceae, vancomycin - resistant enterococci, and meticillin-resistant Staphylococcus aureus in a long-term care facility over one year. BMC Infect Dis. 15:168. https://doi.org/10.1186/s12879-015-0880-5

Mojtahedzadeh M, Panahi Y, Fazeli MR, Najafi A, Pazouki M, Navehsi BM, Bazzaz A, Naghizadeh MM, Beiraghdar F. 2008. Intensive care unit-acquired urinary tract infections in patients admitted with sepsis: etiology, risk factors, and pattern s of antimicrobial resistance. Int J Infect Dis. 12(3):312–318. https://doi.org/10.1016/j.ijid.2007.09.005

Ndugulile F, Jureen R, Harthug S, Urassa W, Langeland N. 2005. Extended spectrum beta-lactamases among Gram-negative bacteria of nosocomial origin from intensive care unit of a tertiary health facility in Tanzania. BMC Infect Dis. 5:86. https://doi.org/10.1186/1471-2334-5-86

Peleg AY, Hooper DC. 2010. Hospital acquired infections due to Gram-negative bacteria. N Engl J Med. 362(19):1804 – 1813. https://doi.org/10.1056/NEJMra0904124

Purnomo BP. 2008. Kateterisasi dan Sirkumsisi. In Dasar-Dasar Urologi. Jakarta: Sagung Seto. p.237–244.

Putri SI, Djamal A, Rahmatini. 2014. Sensitivitas bakteri penyebab sepsis neonatorum terhadap meropenem di neonatal intensive care unit dan perinatologi RSUP DR M Djamil Padang Padang Tahun 2012. Jurnal Kesehatan Andalas. 3(3):475 – 479.

Salmanzadeh S, Yousefi F, Ahmadi F, Geravandi S, Moien M, Mohammadi MJ, Kohi AM, Alavi SMA, Esfarjani NM. 2015. Evaluation of nosocomial infections in a teaching hospital. Avicenna J Clin Microb Infect. 2(3):21 – 26. https://doi.org/10.17795/ajcmi-29760

Superti SV, Augusti G, Zavascki AP. 2009. Risk factors for and mortality of extended-spectrum- β-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections. Rev Inst Med Trop Sao Paulo. 51(4):211–216. https://doi.org/10.1590/S0036-46652009000400006

Tsering DC, Das S, Adhiakari L, Pal R. Singh TS. 2009. Extended spectrum beta lactamase detection in Gram-negative bacilli of nosocomial origin. J Global Infect Dis. 1(2):87 – 92. https://doi.org/10.4103/0974-777X.56247

Tuon FF, Kruger M, Terreri M, Penteado-Filho SR, Gortz L. 2011. Klebsiella ESBL bacteremia-mortality and risk factors. Braz J Infect Dis. 15(6):594–598. https://doi.org/10.1590/S1413-86702011000600016

Unal S, Garcia-Rodriguez JA. 2005. Activity of meropenem and com-parators against Pseudomonas aeruginosa and Acinetobacter spp. isolated in the MYSTIC Program, 2002-2004. Diagn Microbiol Infect Dis. 53(4):265–271. https://doi.org/10.1016/j.diagmicrobio.2005.10.002

Widodo D. 2010. Kebijakan penggunaan antibiotika bertujuan meningkatkan kualitas pelayanan pasien dan mencegah resistensi kuman. Cermin Dunia Kedokteran. 37(1): 7–10.

Zarb P, Coignard B, Griskevicienne J, Muller A, Vankerckhoven V, Weist K, Goossens M, Vaerenberg S, Hopkins S, Catry B, Monnet D, Goosens H, Suetens C. 2012. The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use. Euro Surveill. 17(46):1 – 16.

Zhanel GG, Wiebe R, Dilay L, Thomson K, Rubinstein E, Hoban DJ, Noreddin AM, Karlowsky JA. 2007. Comparative review of carbapenem. Drugs. 67(7):1027–1052. https://doi.org/10.2165/00003495-200767070-00006

Zolldann D, Haefner H, Poetter C, Buzello S, Sohr D, Luetticken R, Lemmen SW. 2003. Assessment of a selective surveillance method for detecting nosocomial infections in patients in the intensive care department. Am J Infect Control. 31(5):261–265. https://doi.org/10.1067/mic.2003.72


Article Reads

Total: 2111 Abstract: 1353 PDF: 758

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

 

Daily Visit

The last two months

View complete Google Analytics report here
 

This website is maintained by:
Bio Publisher
The Faculty of Biology Publishing

Faculty of Biology
Universitas Jenderal Soedirman
Jalan dr. Suparno 63 Grendeng
Purwokerto 53122

Telephone: +62-281-625865
Email: biologi@unsoed.ac.id

T his website uses:
OJS | Open Journal System
A free journal management and publishing system that has been developed by the PKP (Public Knowledge Project) version 2.4.8.0.

All article content metadata are registered to:
Crossref
An official nonprofit  Registration Agency of the International Digital Object Identifier (DOI) Foundation.

Articles in this journal are indexed by:

Complete index list  »