Risk factors for acquisition of ESBL-producing Escherichia coli and Klebsiella pneumoniae on non-ventilator-associated hospital-acquired pneumonia in a tertiary care hospital in Indonesia

Dewi Santosaningsih; Helena E Millennie; Diandra P Tunjungsari; Shafiyyah M Shalihah; Chintyadewi H Ramadhani; Iin N Chozin; Ungky A Setyawan

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Risk factors for acquisition of ESBL-producing Escherichia coli and Klebsiella pneumoniae on non-ventilator-associated hospital-acquired pneumonia in a tertiary care hospital in Indonesia

Author: Dewi Santosaningsih ^{1
,

2} ; Helena E. Millennie ³ ; Diandra P. Tunjungsari ³ ; Shafiyyah M. Shalihah ³ ; Chintyadewi H. Ramadhani ³ ; Iin N. Chozin ⁴ ; Ungky A. Setyawan ⁴
Author Information

1. Department of Clinical Microbiology, Faculty of Medicine, Brawijaya University, Malang, Indonesia. &
2. Department of Clinical Microbiology, Dr. Saiful Anwar Hospital, Malang, Indonesia.
3. Department of Clinical Microbiology, Faculty of Medicine, Brawijaya University, Malang, Indonesia.
4. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Brawijaya University/Dr. Saiful Anwar Hospital, Malang, Indonesia.
Publication Type:Journal Article
Keywords: ESBL; Escherichia coli; Indonesia; Klebsiella pneumonia; Non-ventilator hospital-acquired pneumonia (NV-HAP)
MeSH: beta-Lactamases; Escherichia coli; Klebsiella pneumoniae; Cross Infection; Healthcare-Associated Pneumonia; Tertiary Care Centers
From:Malaysian Journal of Microbiology 2022;18(4):432-436
CountryMalaysia
Language:English
Abstract: Aims:This study was aimed to identify the risk factors for the acquisition of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae on non-ventilator hospital-acquired pneumonia (NV-HAP) patients in a tertiary care hospital in Indonesia.
Methodology and results:A case-control study was performed between March 31, 2018, and August 31, 2019. Twenty-eight ESBL-producing E. coli and K. pneumoniae isolates and 28 susceptible strains of E. coli and K. pneumoniae obtained from NV-HAP patients were included in this study. Phenotypic screening for ESBL production was performed by the Vitek2 system and subsequently confirmed by double-disk synergy tests. The use of 3rd generation cephalosporin as initial antibiotic therapy for more than three days was the significant risk factor for the acquisition of ESBL-producing E. coli and K. pneumoniae among NV-HAP patients (odds ratio [OR] 41.827; p=0.001). The length of stay of patients with NV-HAP acquiring the ESBL strains was longer than 10 days (OR 17.334; p=0.001).
Conclusion, significance and impact of study:The use of 3rd generation cephalosporin as the initial antibiotic for NV-HAP should be restricted to prevent the emergence of ESBL-producing strains. Infection prevention measures are required to control the acquisition of ESBL-producing E. coli and K. pneumoniae in NV-HAP patients.
Full text:20.2022my0045.pdf