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Submitted
September 2, 2019
Accepted
July 17, 2020
Published
August 31, 2020
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Abstract

Background: Klebsiella pneumoniae is a Gram-negative bacterium that often causes nosocomial infections. Use of broad-spectrum antibiotics as an empiric therapy has contributed to increases of K. Pneumoniae strains that are resistant to antibiotics. Therefore, a test on antibiotic susceptibility of K. pneumoniae is needed as a guide in treating a definitive therapy.
Objective: This study aimed to measure the percentages of multidrug-resistant (MDR) of K. pneumoniae and its susceptibility at dr. Soeradji Tirtonegoro Central Hospital, Klaten, Central Java in 2017.
Methods: This study was a descriptive study using secondary data at the Clinical Microbiology Laboratorium of dr. Soeradji Tirtonegoro Central Hospital, Klaten. The K. pneumoniae was isolated from patients hospitalized in the hospital from January 1, 2017, to December 31 2017. Identifications of the K. pneumoniae were conducted by a colony morphology observation, a gram staining, and a biochemical test. The test of antibiotics susceptibility used Kirby-Bauer method based on Clinical and Laboratory Standards Institute (CLSI). The data were analyzed by univariate analysis.
Results: In 2017, there were 213 K. pneumoniae isolates from various clinical samples. Among them, 122 isolates were MDR K. pneumoniae (57.28%). The majority of MDR K. pneumoniae were resistant to a wide range of antibiotics. The MDR K. pneumoniae had only a good sensitivity to meropenem (98.43%), amikacin (93.75%), nitrofurantoin (88.89%), and fosfomycin (88.89%). In contrast, all non-MDR K. pneumoniae had good sensitivity to all tested antibiotics, except to ampicillin.
Conclusion: The percentage of MDR K. pneumoniae isolates at the dr. Soeradji Tirtonegoro Cental in 2017 was 57%. Meropenem and amikacin could be considered as empirical therapies to cure an MDR K. pneumoniae infection.

 

Keywords

Klebsiella pneumoniae antibiotic susceptibility multidrug-resistant

Article Details

How to Cite
Virawan, H., Nuryastuti, T., & Nirwati, H. (2020). Multidrug-resistant Klebsiella pneumoniae from clinical isolates at dr. Soeradji Tirtonegoro central hospital Klaten. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 11(2), 109–120. https://doi.org/10.20885/JKKI.Vol11.Iss2.art3
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References

  1. Tian L, Tan R, Chen Y, Sun J, Liu J, Qu H, et al. Epidemiology of Klebsiella pneumoniae bloodstream infections in a teaching hospital: Factors related to the carbapenem resistance and patient mortality. Antimicrobial Resistance and Infection Control. 2016;5(1).
  2. Apondi OE, Oduor OC, Gye BK, Kipkoech MK. High prevalence of multidrug resistant Klebsiella Pneumoniae in a tertiary teaching hospital in Western Kenya. African Journal of Infectious Diseases. 2016;10(2):89–95.
  3. Chung DR, Song JH, Kim SH, Thamlikitkul V, Huang SG, Wang H, et al. High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia. American Journal of Respiratory and Critical Care Medicine. 2011;184(12):1409–17.
  4. Murni IK, Duke T, Daley AJ, Kinney S, Soenarto Y. Antibiotic resistance and mortality in children with nosocomial bloodstream infection in a teaching hospital in indonesia. Southeast Asian Journal of Tropical Medicine and Public Health. 2016;47(5):983–93.
  5. Kidd TJ, Mills G, Sá-Pessoa J, Dumigan A, Frank CG, Insua JL, et al. A Klebsiella pneumoniae antibiotic resistance mechanism that subdues host defences and promotes virulence. EMBO Molecular Medicine. 2017;9(4):430–47.
  6. Karam G, Chastre J, Wilcox MH, Vincent JL. Antibiotic strategies in the era of multidrug resistance. Critical Care. 2016;20(1):1–9.
  7. Alebachew Woldu M. Klebsiella pneumoniae and its growing concern in healthcare settings. Clinical and Experimental Pharmacology. 2016;6(1):1–7.
  8. Kuntaman K, Mertaniasih NM, Hadi U. Multiresistance pattern of extended spectrum ? -Lactamase (Esbl). Folia Medica Indonesiana. 2006;42(1):40–6.
  9. Hadi U, Kuntaman K, Qiptiyah M, Paraton H. Problem of antibiotic use and antimicrobial resistance in Indonesia: Are we really making progress? Indonesian Journal of Tropical and Infectious Disease. 2013;4(4):5.
  10. Fitri NN, Rusli M, Wahyunitisari RM. Antibiotic use is not a risk factor of infection by extended-spectrum Beta-Lactamase producing bacteria in dr. Soetomo Hospital Surabaya. Microbiology Indonesia. 2015;9(4):150–6.
  11. Kuntaman K, Santoso S, Wahjono H, Mertaniasih NM, Lestari ES, Farida H, et al. The sensitivity pattern of extended spectrum Beta Lactamase-Producing bacteria against six antibiotics that routinely used in clinical setting. Journal of Indonesia Medical Association. 2011 December 1;61(12):482–6.
  12. Sinanjung K. Proporsi Klebsiella Pneumoniae isolat klinik penghasil extended spectrum Beta Lactamase (ESBL) beserta pola kepekaannya terhadap antibiotika di RSUP dr Soeradji Tirtonegoro Klaten [Internet]. Universitas Gadjah Mada; 2019. http://etd.repository.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=170392&is_local=1
  13. Madahiah M, Noor S, Abdul S, Ali Abbas Q. Klebsiella pneumoniae urinary tract infections associated with long-term catherterizaton and spinal cord injuries. Jornal of Medical Sciences [Internet]. 2002;2(5–6):227–9.
  14. Cepas V, López Y, Muñoz E, Rolo D, Ardanuy C, Martí S, et al. Relationship between biofilm formation and antimicrobial resistance in Gram-Negative bacteria. Microbial Drug Resistance. 2019;25(1):72–9.
  15. Moremi N, Claus H, Mshana SE. Antimicrobial resistance pattern: A report of microbiological cultures at a tertiary hospital in Tanzania. BMC Infectious Diseases. 2016;16(1):1–7.
  16. Franklin R. Cockerill, III M, Jean B. Patel, PhD D. M100-S25 performance standards for antimicrobial susceptibility testing; twenty-fifth informational supplement. Clinical and Laboratory Standards Institute. 2015;
  17. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance. Clinical Microbiology and Infection. 2012;18(3):268–81.
  18. Menkes RI. Permenkes RI No. 8 Tahun 2015 tentang program pengendalian resistensi antimikroba di rumah sakit. Hukor Depkes RI. 2015;
  19. Setyati A, Murni IK. Pola kuman pasien pneumonia di instalasi rawat intensif anak (IRIA) RSUP Dr. Sardjito. Media Medika Indonesiana. 2012;46(3):195–200.
  20. Manikandan C, Amsath A. From urine samples. International Journal of Current Microbiology and Applied Sciences. 2013;2(8):330–7.
  21. Paczosa MK, Mecsas J. Klebsiella pneumoniae: Going on the offense with a strong defense. Microbiology and Molecular Biology Reviews. 2016;80(3):629–61.
  22. Peña C, Pujol M, Ardanuy C, Ricart A, Pallares R, Liñares J, et al. Epidemiology and successful control of a large outbreak due to Klebsiella pneumoniae producing extended spectrum ß-lactamases. Antimicrobial Agents and Chemotherapy. 1998;42(1):53–8.
  23. Dao TT, Liebenthal D, Tran TK, Vu BNT, Nguyen DNT, Tran HKT, et al. Klebsiella pneumoniae oropharyngeal carriage in rural and urban Vietnam and the effect of alcohol consumption. Plos One. 2014;9(3).
  24. Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: Epidemiology, taxonomy, typing methods, and pathogenicity factors. Clinical Microbiology Reviews. 1998.
  25. Pitout JD, Laupland KB. Extended-spectrum ß-lactamase-producing Enterobacteriaceae: An emerging public-health concern. The Lancet Infectious Diseases. 2008;8(3):159–66.
  26. Akter J, Masudul Azad Chowdhury AM, Forkan M Al. Study on prevalence and antibiotic resistance pattern of Klebsiella isolated from clinical samples in South East Region of Bangladesh. American Journal of Drug Discovery and Development. 2014;4(1):73–9.
  27. Osagie RN, Eyaufe A., Iserhienrhien O, Okodua M, Unuabonah F, Daibo O. Antibiotic susceptibility profile of Klebsiella pneumoniae isolated from sputum samples amongst hospitalized adults in parts of Edo State, South-South, Nigeria. Merit Research Journal of Medicine and Medical Sciences. 2017;5(8):378–83.
  28. Dasgupta S, Das S, Chawan NS, Hazra A. Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian Journal of Critical Care Medicine. 2015;19(1):14–20.
  29. Tran GM, Ho-Le TP, Ha DT, Tran-Nguyen CH, Nguyen TSM, Pham TTN, et al. Patterns of antimicrobial resistance in intensive care unit patients: A study in Vietnam. BMC Infectious Diseases. 2017;17(1):1–7.
  30. Rammaert B, Goyet S, Beauté J, Hem S, Te V, Try PL, et al. Klebsiella pneumoniae related community-acquired acute lower respiratory infections in Cambodia: Clinical characteristics and treatment. BMC Infectious Diseases. 2012;12(1):3.
  31. Anggraini D, Hasanah U, Savira M, Andrini F, Irawan D, Prima R. Prevalence and Susceptibility Profile of ESBL-producing Enterobacteriaceae in Arifin Achmad General Hospital Pekanbaru. Jurnal Kedokteran Brawijaya. 2018;30(1):47–52.
  32. Trojan R, Razdan L, Singh N. Antibiotic Susceptibility patterns of bacterial isolates from pus samples in a tertiary care hospital of Punjab, India. International Journal of Microbiology. 2016;2016 (January 2014).
  33. Mahat P, Manandhar S, Baidya R. Bacteriological profile of wound infection and antibiotic susceptibility pattern of the isolates. Journal of Microbiology & Experimentation. 2017;4(5):126–33.
  34. Sarathbabu DR. Antibiotic susceptibility pattern of Klebsiella pneumoniae isolated from sputum, urine and pus samples. IOSR Journal of Pharmacy and Biological Sciences. 2012;1(2):4–9.
  35. Ravichitra KN, Prakash PH, Subbarayudu S, Rao US. Isolation and antibiotic sensitivity of Klebsiella pneumoniae from pus, sputum and urine samples. International Journal of Current Microbiology and Applied Sciences. 2014;3(3):115–9.
  36. Dairo MT. Pola kuman berdasarkan spesimen dan sensitivitas terhadap antibiotik pada penderita community-acquired pneumonia (CAP) di RSUP Dokter Kariadi Semarang. Universitas Diponegoro; 2014.
  37. Kurniawan J. Artikel penelitian pola kepekaan bakteri penyebab pneumonia terhadap antibiotika di laboratorium mikrobiologi RSUP Dr . M . Djamil. Jurnal Kesehatan Andalas. 2011;4(2):562–6.
  38. Shivannavar CT. Antibiotic susceptibility pattern of ESßL producing Klebsiella pneumoniae isolated from urine samples of pregnant women in Karnataka. Journal of Clinical and Diagnostic Research. 2014;8(10):8–11.
  39. Erami M, Soltani B, Ardakani AT, Moravveji A, Moini AS, Rezaei MH, et al. Multidrug-resistant Escherichia coli and Klebsiella pneumoniae isolated from patients in Kashan, Iran. Jundishapur Journal of Microbiology. 2015;8(10).
  40. Rath S, Padhy RN. Prevalence of two multidrug-resistant Klebsiella species in an Indian teaching hospital and adjoining community. Journal of Infection and Public Health. 2014;7(6):496–507.
  41. Mascellino MT, Angelis M De, Oliva A. Multi-drug resistant gram-negative bacteria: Antibiotic-resistance and new treatment strategies. Diagnostic Pathology: Open Access. 2017;02(02):10–3
  42. Petrosillo N, Giannella M, Lewis R, Viale P. Treatment of carbapenem-resistant Klebsiella pneumoniae: The state of the art. Expert Review of Anti-Infective Therapy. 2013;11(2):159–77.