Abstract:

Background. Antimicrobial resistance (AMR) has become serious problem globally. Surveillance AMR is important to be part of quality indicator in antimicrobial stewardship program (ASP). Method. Surveillance of microbial pattern and their antibiotics susceptibility in Indonesia 2017 were developed by Indonesian Association of Clinical Pathology and Laboratory Medicine. Data aggregation was sourced from 31 hospitals antibiogram report which were joined the system of national data collection in forlabinfeksi.or.id. with standardized inclusion criteria. Data was analyzed descriptively, based on hospital type-A-B-C.     Result. There were 15.302 isolates included, 4.761 (31,1%) were positive Gram and 10.541 (68,9%) were negative Gram, 61,6% reported by type-A hospital, 16,4% by type-B and 22% by type-C. Positive and negative Gram patterns respectively were E. faecalis and E.coli  (blood and urine), Streptococcus spp and K. pneumoniae (sputum), S. aureus and E.coli (pus), E. faecalis and E.coli  (wound), coagulase negative Staphylococcus and Enterobacteriaceae (CSF). Antibiotic susceptibility pattern was slightly different among various types of hospital and among various clinical specimens. Positive Gram bacteria had good vancomycin susceptibility in all hospital types, except in sputum from Type-A and B hospital, also in blood and urine from Type-C hospital, similarly with linezolide susceptibility. Susceptibility pattern among Gram negative- bacteria for carbapenem and amikacin was good, in all hospital types, except on A. baumannii.  For A. baumannii, antibiotic carbapenem, amikacin and ceftazidime susceptibility were 20-66%, 35-80%, and up to 83%, respectively. For P. aeruginosa, antibiotic susceptibility pattern was equal among all hospital types. Their susceptibility against cephalosporin (ceftazidime), fluoroquinolone (ciprofloxacin) and aminoglycoside (amikacin) were better in higher type-hospital. Conclusion. This result may become part of national epidemiological data for ASP program evaluation. This data may also be referred for local empirical antibiotic guideline among limited resources appropriate hospital. There will be improvement forward for more representative beneficial data.

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