INFEKSI OLEH BAKTERI PENGHASIL EXTENDED-SPECTRUM BETA-LACTAMASE (ESBL)DI RSUP Dr. KARIADI SEMARANG:FAKTOR RISIKO TERKAIT PENGGUNAAN ANTIBIOTIK

Abstract

Background: Excessive use of antibiotics, especially cephalosporin and fluoroquinolone classes can increase the incidence of infection by bacteria producing extended-spectrum -lactamases (ESBL). Eighty percent of patients hospitalized at Dr. Kariadi hospital receive antibiotic therapy. This study aimed to determine the relationship prior use of antibiotics, especially cephalosporin and fluoroquinolon class on the incidence of infection by ESBL producing bacteria in Dr. Kariadi Hospital. Methods: This study was a case control study, involving patients with culture and sensitivity results that ESBL positive as case group and ESBL negative result as the control group. Historical use of antibiotics during hospitalization in Dr. Kariadi traced in medical records retrospectively. Data were analyzed using chi-square test or fisher alternative test followed by odd ratio calculation. Results: a total of 141 patients (57.4% with E. coli, 21.3% with Enterobacter Sp. and 21.3% with Klebsiella sp.), 70 patients are included into the case group and 71 into the control group. Bivariate analysis showed that a history of antibiotic use in general (p = 0.100), cephalosporin group (p = 0.355), fluoroquinolone group (p = 0.795) and combination in antibiotics therapy (p = 0.448) did not have a significant relationship with the incidence of infection by bacteria ESBL producers. Historical use of ampicillin (p = 0.027, OR = 2.7, CI = 1.097 to 6.773) and Gentamycin (p = 0.011, OR = 4.1, CI = 1.304 to 13.445) has a significant relationship with the incidence of infection by ESBL-producing bacteria. Conclusion: In this study, a history of antibiotic use in general, cephalosporin and fluoroquinolone class in combination therapy is not a risk factor for infection by ESBL-producing bacteria. Prior use of Ampicillin and Gentamycin is a risk factor for infection by bacteria producing ESBL. Key word: ESBL, antibiotic, cephalosporin, fluoroquinolone