Email this article 
Tren Penggunaan Antibiotik dan Profil Resistensi pada Kelompok Critical-Priority Bacteria di ICU Rumah Sakit “X” Provinsi Bali (2017-2019)
Abstract
Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, dan Escherichia coli merupakan kelompok critical-priority bacteria yang telah mengalami multi drug resistant (MDR) dan sering ditemukan di Intensive Care Unit (ICU). Isolat bakteri-bakteri berjumlah lebih dari 75% mengalami MDR di ICU sebuah rumah sakit umum daerah di Bali, Indonesia. Penggunaan antibiotik yang tinggi berkaitan dengan tingkat resistensi bakteri terhadap antibiotik. Pola resistensi bakteri terhadap antibiotik dapat berbeda di setiap wilayah yang disebabkan oleh adanya perbedaan lingkungan dan perbedaan tingkat penggunaan antibiotik di wilayah tersebut. Penelitian ini bertujuan untuk mengetahui tren penggunaan antibiotik sistemik, pola resistensi dan hubungan antara tingkat penggunaan dengan persentase resistensi bakteri terhadap antibiotik pada kelompok critical-priority bacteria di ICU rumah sakit “X” provinsi Bali. Penelitian ini merupakan penelitian ekologikal yang menggunakan data sekunder selama tahun 2017-2019. Analisis tren penggunaan antibiotik dianalisis menggunakan time series analysis. Hubungan antara tingkat penggunaan antibiotik dan persentase resistensi bakteri prioritas kritis dianalisis dengan regresi linier. Hasil penelitian menunjukkan bahwa antibiotik gentamisin, amikasin, dan siprofloksasin mengalami peningkatan tren penggunaan sedangkan ampisilin, ampisilin-sulbaktam, seftazidim, dan meropenem mengalami penurunan tren penggunaan. Time series analysis menunjukkan penggunaan antibiotik yang fluktuatif. Selain itu, didapatkan bahwa A. baumannii masuk dalam dua kategori fenotipik CDC yaitu, carbNS_Acine dan MDR_Acine sedangkan K. pneumoniae masuk dalam kategori ESCklebsiella. Tingkat penggunaan antibiotik sistemik di ICU dengan persentase resistensi E. coli, K. pneumoniae, dan P. aeruginosa di ICU (p<0,05) terdapat hubungan signifikan, tetapi tidak terdapat hubungan yang signifikan antara penggunaan antibiotik sistemik pada pasien di ICU dengan persentase resistensi bakteri A. baumannii (p>0,05).
Keywords
Full Text:
PDFReferences
Al Mutair, A., Alhumaid, S., Al Alawi, Z., Zaidi, A. R. Z., Alzahrani, A. J., Al-Tawfiq, J. A., Al-Shammari, H., Rabaan, A. A., Khojah, O., dan Al-Omari, A. (2021). Five-Year Resistance Trends in Pathogens Causing Healthcare-Associated Infections at A Multi-Hospital Healthcare System in Saudi Arabia, 2015–2019. Journal of Global Antimicrobial Resistance, 25, 142–150.
Amaha, N. D., Weldemariam, D. G., dan Berhe, Y. H. (2020). Antibiotic Consumption Study in Two Hospitals in Asmara From 2014 to 2018 Using WHO’s Defined Daily Dose (DDD) Methodology. PloS One, 15(7), e0233275. https://doi.org/doi.org/10.1371/journal.pone.0233275
Bengtsson-Palme, J., Kristiansson, E., dan Larsson, D. G. J. (2018). Environmental Factors Influencing The Development and Spread of Antibiotic Resistance. FEMS Microbiology Reviews, 42(1), fux053.
Centers for Disease Control and Prevention. (2022). Antimicrobial-Resistant Phenotype Definitions. 1–3. National Center for Emerging and Zoonotic Infectious Disease. https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/phenotype_definitions.pdf
Collignon, P. C., Conly, J. M., Andremont, A., McEwen, S. A., Aidara-Kane, A., World Health Organization Advisory Group, dan Bogotá Meeting on Integrated Surveillance of Antimicrobial Resistance (WHO-AGISAR). (2016). World Health Organization Ranking Of Antimicrobials According To Their Importance In Human Medicine: A Critical Step For Developing Risk Management Strategies To Control Antimicrobial Resistance From Food Animal Production. Clinical Infectious Diseases, 63(8), 1087–1093. https://doi.org/10.1093/cid/ciw475
Cunha, C. B. (2018). Antimicrobial Stewardship Programs (ASP): Perspective on Problems and Potential. Rhode Island Medical Journal, 101(5), 18–21.
Cunha, C. B., dan Opal, S. M. (2018). Antibiotic Stewardship: Strategies to Minimize Antibiotic Resistance While Maximizing Antibiotic Effectiveness. Medical Clinics, 102(5), 831–843.
Dahlan, M. S. (2013). Statistik Kedokteran dan Kesehatan. Salemba Medika: Jakarta.
Dell’Annunziata, F., Dell’Aversana, C., Doti, N., Donadio, G., Dal Piaz, F., Izzo, V., De Filippis, A., Galdiero, M., Altucci, L., dan Boccia, G. (2021). Outer Membrane Vesicles Derived from Klebsiella pneumoniae are A Driving Force for Horizontal Gene Transfer. International Journal of Molecular Sciences, 22(16), 8732.
Fadlilah, U., Hasmono, D., Wibisono, Y. A., Melinda, M., Airlangga, U., dan Hospital, M. W. (2016). Antibiogram Study and Antibiotic Use Evaluation Using Gyssen Method in Patients with Diabetic Foot. Folia Medica Indonesiana, 52(3), 198–208.
Fair, R. J., dan Tor, Y. (2014). Antibiotics and Bacterial Resistance in The 21st Century. Perspectives in Medicinal Chemistry, 6, PMC-S14459.
Fatmah, S., Aini, S. R., dan Pratama, I. S. (2019). Tingkat Pengetahuan Mahasiswa Tahun Pertama Bersama (TPB) tentang Penggunaan Antibiotik dalam Swamedikasi. Jurnal Sains Farmasi & Klinis, 6(3), 200. https://doi.org/10.25077/jsfk.6.3.200-205.2019
Francisco, E. M. (2018). Fluoroquinolone and Quinolone Antibiotics: PRAC Recommends New Restrictions on Use Following Review of Disabling Potentially Long-Lasting Side Effects. European Medicines Agency.(23 December 2020; https://www.ema.europa.eu/en/news/fluoroquinolone-quinolone-antibiotics-prac-recommends-new-restrictions-use-following-review).
Gaşpar, C.-M., Cziszter, L. T., Lăzărescu, C. F., Ţibru, I., Pentea, M., dan Butnariu, M. (2021). Antibiotic Resistance Among Escherichia coli Isolates From Hospital Wastewater Compared To Community Wastewater. Water, 13(23), 3449.
Hodoșan, V., Daina, C. M., Zaha, D. C., Cotrău, P., Vladu, A., Pantiș, C., Dorobanțu, F. R., Negrău, M., Maghiar, A., dan Daina, L. G. (2022). Pattern of Antibiotic Use in the Perinatal Period in a Public University Hospital in Romania. Medicina, 58(6), 772.
Kementerian Kesehatan Republik Indonesia. (2020). Profil Kesehatan Indonesia 2019. Jakarta: Kementerian Kesehatan Republik Indonesia.
Kim, B., Kim, Y., Hwang, H., Kim, J., Kim, S.-W., Bae, I.-G., Choi, W. S., Jung, S. I., Jeong, H. W., dan Pai, H. (2018). Trends and Correlation Between Antibiotic Usage And Resistance Pattern Among Hospitalized Patients At University Hospitals in Korea, 2004 to 2012: A nationwide multicenter study. Medicine, 97(51). https://doi.org/10.1097/MD.0000000000013719
Kiponza, R., Balandya, B., Majigo, M. V, dan Matee, M. (2019). Laboratory Confirmed Puerperal Sepsis in A National Referral Hospital In Tanzania: Etiological Agents And Their Susceptibility To Commonly Prescribed Antibiotics. BMC Infectious Diseases, 19, 1–7.
Lee, M.-C., Lu, C.-H., Lee, W.-Y., dan Lee, C.-M. (2021). Correlation Between Nosocomial Carriage of Vancomycin-Resistant Enterococci And Antimicrobial Use in Taiwan. The American Journal of Tropical Medicine and Hygiene, 104(3), 1131.
Li, M., Liu, Q., Teng, Y., Ou, L., Xi, Y., Chen, S., dan Duan, G. (2019). The Resistance Mechanism of Escherichia coli Induced by Ampicillin in Laboratory. Infection and Drug Resistance, 2853–2863.
Luyt, C.-E., Bréchot, N., Trouillet, J.-L., dan Chastre, J. (2014). Antibiotic Stewardship in The Intensive Care Unit. Critical Care, 18(5), 1–12. https://doi.org/10.1186/s13054-014-0480-6
Meriyani, H., Sanjaya, D. A., dan Adrianta, K. A. (2021a). Antibiotic Consumption and Resistance Pattern of 3 Coagulase-Negative Staphylococci Species: An Ecological Study. Indonesian Journal of Pharmacy, 251–257. https://doi.org/10.22146/ijp.1154
Meriyani, H., Sanjaya, D. A., Sutariani, N. W., Juanita, R. R. A., dan Siada, N. B. (2021b). Penggunaan dan Resistensi Antibiotik di Instalasi Rawat Intensif Rumah Sakit Umum Daerah di Bali: Studi Ekologikal selama 3 Tahun. Jurnal Farmasi Klinik Indonesia, 10(3).
Molton, J. S., Tambyah, P. A., Ang, B. S. P., Ling, M. L., dan Fisher, D. A. (2013). The Global Spread of Healthcare-Associated Multidrug-Resistant Bacteria: A Perspective From Asia. Clinical Infectious Diseases, 56(9), 1310–1318.
Munnangi, S., dan Boktor, S. W. (2017). Epidemiology of Study Design. Statpearls Publishing: Treasure Island. https://www.statpearls.com/
Pachori, P., Gothalwal, R., dan Gandhi, P. (2019). Emergence of Antibiotic Resistance Pseudomonas aeruginosa in Intensive Care Unit; A Critical Review. Genes & Diseases, 6(2), 109–119.
Pang, Z., Raudonis, R., Glick, B. R., Lin, T.-J., dan Cheng, Z. (2019). Antibiotic Resistance In Pseudomonas aeruginosa: Mechanisms And Alternative Therapeutic Strategies. Biotechnology Advances, 37(1), 177–192. https://doi.org/10.1016/j.biotechadv.2018.11.013
Pechijareva-Sadikarijo, I., Naumovska, Z., Petrovski, O., Stavrikj, K., dan Balkanov, T. (2020). Antibiotic Consumption in Hospitalized Children at the University Clinic for Pediatric Diseases–Skopje. Open Access Macedonian Journal of Medical Sciences, 8(E), 405–410.
Popović, R., Tomić, Z., Tomas, A., Anđelić, N., Vicković, S., Jovanović, G., Bukumirić, D., Horvat, O., dan Sabo, A. (2020). Five-Year Surveillance and Correlation of Antibiotic Consumption and Resistance of Gram-Negative Bacteria at An Intensive Care Unit in Serbia. Journal of Chemotherapy, 32(6), 294–303. https://doi.org/10.1080/1120009X.2020.1755588
Reygaert, W. C. (2018). An Overview Of The Antimicrobial Resistance Mechanisms Of Bacteria. AIMS Microbiology, 4(3), 482.
Rezaie, A., Pimentel, M., dan Rao, S. S. (2016). How To Test And Treat Small Intestinal Bacterial Overgrowth: An Evidence-Based Approach. Current Gastroenterology Reports, 18(2), 1–11. https://doi.org/10.1007/s11894-015-0482-9
Sanjaya, D. A., Meriyani, H., Juanita, R. R. A., dan Siada, N. B. (2022). Kajian Literatur: Profil Resistensi Salmonella typhi dan Pemilihan Antibiotik Pada Demam Tifoid. JPSCR: Journal of Pharmaceutical Science and Clinical Research, 7(2), 107–121. https://doi.org/10.20961/jpscr.v7i2.56656
Sankar, A., Swanson, K. M., Zhou, J., Jena, A. B., Ross, J. S., Shah, N. D., dan Karaca-Mandic, P. (2021). Association of Fluoroquinolone Prescribing Rates With Black Box Warnings From The US Food And Drug Administration. JAMA Network Open, 4(12), e2136662–e2136662.
Sedláková, M. H., Urbánek, K., Vojtová, V., Suchánková, H., Imwensi, P., dan Kolář, M. (2014). Antibiotic Consumption And Its Influence On The Resistance In Enterobacteriaceae. BMC Research Notes, 7(1), 1–10. https://doi.org/10.1186/1756-0500-7-454
Shamsizadeh, Z., Nikaeen, M., Nasr Esfahani, B., Mirhoseini, S. H., Hatamzadeh, M., dan Hassanzadeh, A. (2017). Detection of Antibiotic Resistant Acinetobacter baumannii In Various Hospital Environments: Potential Sources For Transmission Of Acinetobacter Infections. Environmental Health and Preventive Medicine, 22, 1–7.
Sharma, G., Sharma, S., Sharma, P., Chandola, D., Dang, S., Gupta, S., dan Gabrani, R. (2016). Escherichia coli Biofilm: Development And Therapeutic Strategies. Journal of Applied Microbiology, 121(2), 309–319.
Tao, H., Wang, J., Li, L., Zhang, H.-Z., Chen, M.-P., dan Li, L. (2017). Incidence and Antimicrobial Sensitivity Profiles Of Normal Conjunctiva Bacterial Flora In The Central Area Of China: A Hospital-Based Study. Frontiers in Physiology, 8, 363. https://doi.org/10.3389/fphys.2017.00363
Tran, P. T., Antonelli, P. J., Hincapie-Castillo, J. M., dan Winterstein, A. G. (2021). Association of US Food and Drug Administration Removal Of Indications For Use Of Oral Quinolones With Prescribing Trends. JAMA Internal Medicine, 181(6), 808–816.
Türkel, İ., Yıldırım, T., Yazgan, B., Bilgin, M., dan Başbulut, E. (2018). Relationship Between Antibiotic Resistance, Efflux Pumps, And Biofilm Formation In Extended-Spectrum Β-Lactamase Producing Klebsiella pneumoniae. Journal of Chemotherapy, 30(6–8), 354–363.
Vázquez-López, R., Solano-Gálvez, S. G., Juárez Vignon-Whaley, J. J., Abello Vaamonde, J. A., Padró Alonzo, L. A., Rivera Reséndiz, A., Muleiro Álvarez, M., Vega López, E. N., Franyuti-Kelly, G., dan Álvarez-Hernández, D. A. (2020). Acinetobacter baumannii Resistance: A Real Challenge For Clinicians. Antibiotics, 9(4), 205.
Ventola, C. L. (2015). The Antibiotic Resistance Crisis: Part 1: Causes And Threats. Pharmacy and Therapeutics, 40(4), 277.
Versporten, A., Zarb, P., Caniaux, I., Gros, M. F., Drapier, N., Miller, M., Jarlier, V., Nathwani, D., Goossens, H., the Global-PPS network. (2018). Antimicrobial Consumption And Resistance In Adult Hospital Inpatients In 53 Countries: Results Of An Internet-Based Global Point Prevalence Survey. The Lancet Global Health, 6(6), e619–e629. https://doi.org/10.1016/S2214-109X(18)30186-4
World Health Organization. (2016). World Health Statistics 2016: Monitoring Health For The Sdgs Sustainable Development Goals. World Health Organization.
World Health Organization. (2017). WHO Publishes List Of Bacteria For Which New Antibiotics Are Urgently Needed. https://www.who.int/news/item/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed
World Health Organization. (2018). WHO Report on Surveillance of Antibiotic Consumption. World Health Organization
World Health Organization. (2019). Critically Important Antimicrobials For Human Medicine. World Health Organization
Yang, P., Chen, Y., Jiang, S., Shen, P., Lu, X., dan Xiao, Y. (2018). Association between Antibiotic Consumption And The Rate Of Carbapenem-Resistant Gram-Negative Bacteria From China Based On 153 Tertiary Hospitals Data In 2014. Antimicrobial Resistance & Infection Control, 7(1), 1–7.
Zhu, Y., Huang, W. E., dan Yang, Q. (2022). Clinical Perspective Of Antimicrobial Resistance In Bacteria. Infection and Drug Resistance, 735–746.
Ziglam, H., Elahmer, O., Amri, S., Shareef, F., Grera, A., Labeeb, M., dan Zorgani, A. (2012). Antimicrobial Resistance Patterns Among Acinetobacter baumannii Isolated From Burn Intensive Care Unit In Tripoli, Libya. International Arabic Journal of Antimicrobial Agents, 2(3), 1–5. https://doi.org/10.3823/716
Refbacks
- There are currently no refbacks.
