Prevalence of multi-drug-resistant bacteria from sputum’s isolates of respiratory infections from Indonesian pneumonia patients

Document Type : Original Article

Authors

1 Department of Medical Laboratory Technology, Faculty of Nursing and Health Science, Universitas Muhammadiyah Semarang. Jl. Kedungmundu Raya No. 18, Semarang 50273, Central Java, Indonesia

2 Department of Biology, Faculty of Science and Technology, Islamic State University Maulana Malik Ibrahim Malang, Gajayana 50th Lowokwaru, Malang 65144 East Java Indonesia

3 Research Center for Pharmaceutical Ingredients and Traditional Medicine, Research Organization for Health, National Research and Innovation Agency (BRIN). Komplek Cibinong Science Center – BRIN. Jalan Raya Bogor Km 46, Cibinong 16911, Bogor, West Java, Indonesia

4 Microbiology laboratory, Gunung Jati Hospital, Cirebon, Indonesia

Abstract

Background: The prevalence of multidrug-resistant (MDR) bacteria in respiratory infections has emerged as a significant public health challenge, particularly in developing countries like Indonesia. Despite the growing body of literature on antibiotic resistance globally, there is a notable lack of comprehensive studies focused on the prevalence and types of MDR bacteria isolated from respiratory infections in Indonesian pneumonia patients. This gap highlights the need for localized research to effectively improve treatment strategies and public health policies. Aim to assess the prevalence of MDR bacterial isolates from respiratory infections in pneumonia patients in Indonesia. Specific objectives include identifying the bacterial species involved, determining their resistance patterns, and evaluating the clinical implications of these findings. Methods: A cross-sectional study was undertaken over three years (January 2020 to December 2022) at Gunung Jati Regional Hospital in Cirebon, Indonesia, resulting in the collection of 349 bacterial isolates from patients with respiratory illnesses. The study categorizes bacteria types, antibiotic resistance patterns, and multidrug resistance (MDR) by gender and age. The preliminary identification includes Gram staining, colony morphology evaluation, biochemical assays, and antimicrobial susceptibility testing using the VITEK®2 Compact system. Results: The predominant Gram-negative bacteria were Klebsiella pneumoniae (38.96%), Pseudomonas aeruginosa (24.35%), and Acinetobacter baumannii (22.73%), whereas Streptococcus pneumoniae (63.41%) was the most prevalent Gram-positive bacterium. Out of 349 bacterial isolates, 175 (50%) were multidrug-resistant (MDR). Acinetobacter baumannii demonstrated the highest multidrug resistance (MDR) rate among Gram-negative bacteria at 75.7%, whereas Streptococcus pneumoniae exhibited the highest MDR rate among Gram-positive bacteria at 30.8%. MDR was predominantly observed in male patients aged > 60 years (75%) and those aged 20–29 years (71.4%). Conclusion: The results of this study highlightthe urgent need for targeted interventions to address the increasing prevalence of MDR bacteria in respiratory tract infections among pneumonia patients in Indonesia. This study provides important insights aimed at combating antibiotic resistance, which may ultimately improve patient treatment outcomes and reduce the healthcare burden associated with pneumonia treatment.

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