Bacterial Profile and Antimicrobial Resistance Patterns of Pleural Empyema in Pekanbaru Hospitals

Indra Yovi, Dodi Safari, Nur Afrainin Syah, Dewi Anggraini, Zulfa Nur Hanifah, Vanesya Zahrani Shapira, Aisyah Elliyanti

Abstract


Background: Empyema is a problem worldwide due to its high incidence, mortality, and morbidity rates. So, administering antibiotics is mandatory to treat the disease. It should be sensitive to the causal microorganisms and avoid resistant ones for treatment efficacy. This research aimed to determine bacterial profile and antimicrobial resistance, which can be fundamental foundations for clinical practices in the treatment of patients, especially in Pekanbaru.

Methods: This was a cross-sectional study from medical records at Arifin Achmad and Eka Hospitals from January 1, 2015, to December 31, 2022, including culture and antibiotic resistance test results with samples from pleural fluid and antibiotic susceptibility test using VITEK 2.0.

Results: A total of 197 pleural fluid specimens were obtained. Gram-negative bacteria were found to be the most prevalent at 79.7%, namely Klebsiella pneumoniae (18.5%), Escherichia coli (12.0%), and Pseudomonas aeruginosa (11.0%). Gram-positive bacteria were found at 12.2%, the most common being Staphylococcus aureus (6.1%) and Enterococcus faecalis (2.0%). Antibiotic sensitivity tests for Gram-negative bacteria showed that amikacin and tigecycline were the most sensitive, and Gram-positive bacteria showed the most sensitivity to linezolid, tigecycline, and vancomycin. The resistance of Klebsiella pneumoniae and Escherichia coli to cephalosporins was 18.5% and 75.0%, respectively. The resistance of Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa to carbapenems was 8.0%, 13.0%, and 53.0%, respectively.

Conclusion: Gram-negative is the most common microorganism found in pleural empyema. The resistance of multiresistant bacteria to antibiotics is high and requires supervision to apply appropriate antibiotic administration based on local antimicrobial patterns and the need to strengthen antimicrobial stewardship programs.

 


Keywords


Klebsiella pneumoniae, Staphylococcus aureus, amikacin, tigecycline

Full Text:

PDF

References


Perhimpunan Dokter Paru Indonesia. Panduan Umum Praktik Klinis Penyakit Paru Dan Pernapasan. (Kosasih A, Sutanto YS, Susanto AD, eds.). Perhimpunan Dokter Paru Indonesia; 2021.

Arnold DT, Hamilton FW, Morris TT, et al. Epidemiology of pleural empyema in English hospitals and the impact of influenza. Eur Respir J. 2021;57(6):2003546.

Garvia V, Paul M. Empyema. StatPearls Publishing; 2023.

Hassan S, Ahmed Z, Agha S, et al. The updated estimate of prevalence, mortality and hospital length of stay in patients with parapneumonic empyema in the us: Distribution of health outcomes across various demographic groups. Chest. 2019;156(4):A425-A426.

Lehtomäki A, Nevalainen R, Ukkonen M, Nieminen J, Laurikka J, Khan J. Trends in the incidence, etiology, treatment, and outcomes of pleural infections in adults over a decade in a Finnish University Hospital. Scand J Surg. 2020;109(2):127-132.

Hassan M, Cargill T, Harriss E, et al. The microbiology of pleural infection in adults: A systematic review. Eur Respir J. 2019;54(3):1900542.

Atif M, Naseem M, Sarwar S, et al. Spectrum of microorganisms, antibiotic resistance pattern, and treatment outcomes among patients with empyema thoracis: A descriptive cross-sectional study from the Bahawal Victoria Hospital Bahawalpur, Punjab, Pakistan. Front Med (Lausanne). 2021;8:665963.

Sharma A, Agarwal S. Bacteriological profile in pleural fluid and its antibiotic susceptibility pattern among patients admitted in tertiary care teaching hospital in Solapur, Maharashtra. International Journal of Medical and Health Research. 2018;4(12):129-131.

Habibie YA, Hamdani K. Bacteriological profile of pleural empyema: Surgical management plays an important role in comprehensive treatment. Aceh Experiences. Heart Lung Circ. 2018;27:S559.

McCauley L, Dean N. Pneumonia and empyema: Causal, casual or unknown. J Thorac Dis. 2015;7(6):992-998.

Anggraini D, Sholihin UH, Savira M, Djojosugito FA, Irawan D, Rustam RP. Prevalensi dan pola sensitivitas enterobacteriaceae penghasil ESBL di RSUD Arifin Achmad Pekanbaru. Jurnal Kedokteran Brawijaya. 2018;30(1):47-52.

Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia. Surveilans Resistensi Antibiotik Rumah Sakit Di Indonesia Tahun 2021. (Kuntaman, Karuniawati A, Gunardi WD, et al., eds.). Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia; 2022.

Kawamura K, Nagano N, Suzuki M, Wachino J ichi, Kimura K, Arakawa Y. ESBL-producing escherichia coli and its rapid rise among healthy people. Food Saf (Tokyo). 2017;5(4):122-150.

Wahyunita, Sjahril R, Hamid F. Antibiotic susceptibility pattern in clinical isolates of pseudomonas aeruginosa. Original Article Template Nusantara Medical Science J. 6(2):66-73.

Aulia A, Nurrokhman, Mustafa M. Pola Kepekaan Acinetobacter Baumannii Terhadap Beberapa Antibiotik Di RSUP Dr. Soeradji Tirtonegoro Pada Tahun 2012-2013. Skripsi. Universitas Gadjah Mada; 2014.

Anggraini D, Yulindra UG, Savira M, et al. Prevalensi dan pola sensitivitas antimikroba multidrug resistant pseudomonas aeruginosa di RSUD Arifin Achmad. Majalah Kedokteran Bandung. 2018;50(1):6-12.

Anggraini D, Kemal RA, Hadi U, Kuntaman K. The susceptibility pattern and distribution of blaOXA-23 genes of clinical isolate Acinetobacter baumannii in a tertiary hospital, Indonesia. J Infect Dev Ctries. 2022;16(5):821-826.

Kyriakidis I, Vasileiou E, Pana ZD, Tragiannidis A. Acinetobacter baumannii Antibiotic Resistance Mechanisms. Pathogens. 2021;10(3):373.

Ramirez D, Giron M. Enterobacter Infections. StatPearls Publishing; 2023.

Zhang H, Xu J, Xiao Q, et al. Carbapenem-sparing beta-lactam/beta-lactamase inhibitors versus carbapenems for bloodstream infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae: A systematic review and meta-analysis. Int J Infect Dis. 2023;128:194-204.

Gibb J, Wong DW. Antimicrobial treatment strategies for stenotrophomonas maltophilia: A focus on novel therapies. Antibiotics. 2021;10(10):1226.

Flamm RK, Shortridge D, Castanheira M, Sader HS, Pfaller MA. In vitro activity of minocycline against U.S. isolates of acinetobacter baumannii-acinetobacter calcoaceticus species complex, stenotrophomonas maltophilia, and burkholderia cepacia complex: Results from the SENTRY Antimicrobial Surveillance Program, 2014 to 2018. Antimicrob Agents Chemother. 2019;63(11):e01154-19.

Anggraini D, Santosaningsih D, Kuntaman ., Ihsan M, Ridha SF. Description of methicillin-resistant staphylococcus aureus infection at Arifin Achmad General Hospital, Riau Province from 2015-2019. In: Proceedings of the 1st Jenderal Soedirman International Medical Conference in Conjunction with the 5th Annual Scientific Meeting (Temilnas) Consortium of Biomedical Science Indonesia. Scitepress; 2021:184-189.

Harun MGD, Anwar MMU, Sumon SA, et al. Rationale and guidance for strengthening infection prevention and control measures and antimicrobial stewardship programs in Bangladesh: A study protocol. BMC Health Serv Res. 2022;22:1239-11.




DOI: https://doi.org/10.36497/jri.v44i1.590

Refbacks

  • There are currently no refbacks.




Copyright (c) 2024 Indra Yovi, Dodi Safari, Nur Afrainin Syah, Dewi Anggraini, Zulfa Nur Hanifah, Vanesya Zahrani Shapira, Aisyah Elliyanti


INDEXING & PARTNER

SINTA Garuda Indonesian Scientific Journal Database (ISJD) Indonesia One Search (IOS) Crossref

ROAD-ISSN Dimensions Google Scholar 

 

Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org


An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-ShareAlike 4.0 International License

Statcounter