Multidrug-Resistant Infections Among Hospitalized Adults With Community-Acquired Pneumonia In An Indonesian Tertiary Referral Hospital

Objectives: To evaluate the clinical and microbiological appearance among hospitalized pneumonia patients focusing on resistance and risk factors for mortality in a referral hospital. Patients and methods: The study was an observational retrospective study on patients with CAP from 2014 to 2016 at D...

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Bibliographic Details
Published in:Infection and drug resistance 2019-11, p.3663
Main Authors: Purba, Abdul KR, Ascobat, Purwantyastuti, Muchtar, Armen, Wulandari, Laksmi, Rosyid, Alfian Nur, Purwono, Priyo Budi, van der Werf, Tjip S, Friedrich, Alex W, Postma, Maarten J
Format: Article
Language:English
Subjects:
Adults
Antibacterial agents
Bacteria
Beta lactam antibiotics
Beta lactamases
Cephalosporins
Gram-negative bacteria
Hospital patients
Imipenem
Lactams
Medical research
Meropenem
Microbial drug resistance
Microbiology
Pathogenic microorganisms
Sulbactam
Tazobactam
Ticarcillin
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Summary:Objectives: To evaluate the clinical and microbiological appearance among hospitalized pneumonia patients focusing on resistance and risk factors for mortality in a referral hospital. Patients and methods: The study was an observational retrospective study on patients with CAP from 2014 to 2016 at Dr Soetomo referral hospital of Surabaya, Indonesia. All positive cultures with antimicrobial susceptibility results from blood and respiratory specimens were included. Patients infected with drug-susceptible pathogens and MDR organisms were also assessed in terms of clinical characteristics, day-3 clinical improvement, and 14-day mortality. Results: Of 202 isolates, 181 possessed antimicrobial susceptibility data. S. pneumoniae was the most prevalent pathogen causing CAP (18.3%). Most patients were empirically treated with ceftriaxone (n=75; 41.4%). Among beta-lactam antibiotics, the susceptibility to the third-generation cephalosporins remained relatively high, between 67.4% and 82.3%, compared with the other beta-lactams such as amoxicillin/clavulanate and ampicillin/sulbactam (a sensitivity rate of 36.5% and 47.5, respectively). For carbapenem antibiotics, imipenem and meropenem susceptibility was 69.6% and 82.3% respectively. Approximately 22% of isolates were identified as MDR that showed significant differences in clinical outcomes of 14-day mortality rates (p
ISSN:1178-6973
1178-6973
DOI:10.2147/1DR.S217842