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Karakteristik sensitivitas dan resistansi antibiotik pada kasus infeksi saluran kemih escherichia coli di rumah sakit tersier di bali pada januari 2019 hingga desember 2019

Abstract

Escherichia coli (E. coli) is the most common cause of Urinary Tract Infections (UTI). E. coli UTI has become difficult to treat because of its increasing resistance characteristics pattern to antimicrobial agents, especially to empirical therapy such as Ciprofloxacin. Aminoglycosides, such as amikacin can be given for E. coli UTI. The objective of this study was to determine the sensitivity characteristics pattern of E. coli to several antimicrobial agents, especially amikacin. This descriptive cross-sectional study were performed at Sanglah Hospital, a tertiary Hospital in Denpasar, Bali, with a period of 12 months, from January 2019 until December 2019. All urine culture with positive result of Escherichia coli were included in this study. All urine specimen were examine using bioMérieux VITEK® 2 System. A total of 317 urine isolates met the inclusion criteria. Extended spectrum beta lactamase (ESBLs) positive E. coli were found from 167 isolates (52.7%). The urine E. coli isolates were mostly found in hospital setting (70.7%), adult (85.5%), and in female patients (59.3%). The most sensitive antibiotic in this study is Amikacin (98.4%) followed by Fosfomycin (95%) and Nitrofurantoin (89.9%). The least sensitive antibiotic is Ampicillin (9.5%) followed by Ciprofloxacin (24.9%) and Cotrimoxazole (34.7%). From this study, it is observed that sensitivity rate of E. coli UTI to Ampicillin, Ciprofloxacin, and Cotrimoxazole is very low and the use of these antimicrobial agents as empirical therapy should be reconsidered. Based on the sensitivity characteristics of E. coli UTI, Amikacin should be considered as empirical therapy for tertiary hospital, along with Fosfomycin and Nitrofurantoin.

 

Escherichia coli (E.coli) merupakan penyebab tersering dari Infeksi Saluran Kemih (ISK). ISK yang disebabkan oleh E.coli menjadi semakin sulit untuk diterapi karena meningkatnya karakteristik resistansi E.coli terhadap berbagai jenis agen antimikroba, terutama terhadap terapi empiris seperti ciprofloxacin. Aminoglikosida, seperti amikasin dapat diberikan sebagai terapi terhadap ISK yang disebabkan oleh E.coli. Tujuan dari penelitian ini adalah untuk menentukan karakteristik dan pola sensitivitas antibiotik dari E.coli terhadap beberapa jenis agen antimikroba, terutama amikasin. Penelitian ini merupakan penelitian deskriptif potong lintang yang dilakukan di Rumah Sakit Umum Pusat Sanglah, Denpasar, Bali, yang juga merupakan rumah sakit rujukan tingkat tiga. Penelitian ini dilakukan dengan mengambil data selama 12 bulan, yaitu dari bulan Januari 2019 hingga Desember 2019. Semua hasil kultur urine dengan hasil positif E.coli dimasukkan ke dalam penelitian ini. Semua spesimen urine diperiksa dengan menggunakan bioMérieux VITEK® 2 System. Sebanyak 317 isolat memenuhi kriteria inklusi. Sebanyak 167 isolat (52,7%) merupakan E. coli penghasil Extended spectrum beta lactamase (ESBLs). Isolat urine E. coli paling banyak ditemukan dari spesimen rawat inap (70,7%), dewasa (85,5%), dan pasien perempuan (59,3%). Antibiotik yang paling sensitif adalah Amikasin (98,4%) diikuti oleh Fosfomycin (95%), dan Nitrofurantoin (89,9%). Antibiotik dengan tingkat sensitivitas terendah adalah Ampisilin (9,5%), diikuti oleh Ciprofloxacin (24,9%), dan Cotrimoxazole (34,7%). Dari penelitian ini, ditemukan bahwa angka sensitivitas dari ISK E.coli terhadap Ampisilin, Ciprofloxacin, dan Cotrimoxazole sangatlah rendah, sehingga penggunaan antibiotik tersebut sebagai terapi empiris harus dipertimbangkan kembali. Berdasarkan karakteristik sensitivitas dari ISK E.coli, Amikasin sebaiknya dipertimbangkan sebagai terapi empiris pada rumah sakit rujukan tingkat tiga, begitu pula dengan Fosfomycin dan Nitrofurantoin.

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How to Cite

Agus Indra Adhiputra, I. K., Setiabudy M, Sukrama IDM, & Budayanti NNS. (2021). Karakteristik sensitivitas dan resistansi antibiotik pada kasus infeksi saluran kemih escherichia coli di rumah sakit tersier di bali pada januari 2019 hingga desember 2019. Medicina, 52(3), 103–107. https://doi.org/10.15562/medicina.v52i3.1097

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