FAKTOR RISIKO TERKAIT PERAWATAN MEDIS INFEKSI OLEH BAKTERI PENGHASIL EXTENDED-SPECTRUM BETA-LACTAMASE (ESBL) DI RSUP DR. KARIADI SEMARANG

Abstract

Background: Nosocomial infection caused by extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae have been frequently reported worldwide. We have no information on such problems in Semarang, Indonesia. This study is aimed to determine the risk factors of ESBL producing Enterobacteriaceae in dr Kariadi Hospital, Semarang, Indonesia. Methods: This was a case control study, using 141 consecutive clinical isolates of Enterobacteriaceae collected between January and April 2010 at Dr. Kariadi Hospital, Semarang, Indonesia, that have been examined phenotypically for ESBL production. We compared 70 patients with a diagnosis of ESBL positive infection (cases) and 71 patients infected by non-ESBL producing Enterobacteriaceae (controls). Various risk factors associated with ESBL infections were analyzed. Result: Based on multivariate analysis, ICU and high risk baby ward (BBRT) admission was independent risk factor for ESBL producing Enterobacteriaceae infection (adjusted odds ratio= 3.4; 95% confidence interval= 1,48-7,76;p=0.03). Urine catheterization, use of intravenous device, prior antibiotic exposure and length of hospital stay were not risk factors for ESBL producing Enterobacteriaceae infection. Conclusion: The finding that ICU or high risk baby ward admission were risk factors for ESBL producing Enterobacteriaceae infection requires attention. Program focusing on rational use of antibiotics, invasive treatments, and nursing care in those rooms are mandatory for prevention and control of such infections. Keywords: ESBL, Enterobacteriaceae, risk factor