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Publikasi Scopus 2010 s/d 2022
Publikasi Scopus 2010 s/d 2022
Blood culture utilization and epidemiology of antimicrobial-resistant bloodstream infections before and during the COVID-19 pandemic in the Indonesian national referral hospital
2022
Antimicrobial Resistance and Infection Control
11
1
73
7
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85130365548&doi=10.1186%2fs13756-022-01114-x&partnerID=40&md5=133f6c795fdfdee7746fe1b06e40fae5
Division of Tropical and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National Hospital - Faculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Faculty of Medicine Universitas Indonesia, Jakarta Pusat, DKI Jakarta, 10440, Indonesia; Infection and Antimicrobial Resistance Control Committee, Cipto Mangunkusumo National Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, OX3 7LG, United Kingdom; Department of Internal Medicine, Cipto Mangunkusumo National Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Faculty of Medicine Universitas Indonesia, Center for Clinical Epidemiology and Evidence Based Medicine, Cipto Mangunkusumo National Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Department of Clinical Pathology, Cipto Mangunkusumo National Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Department of Child Health, Cipto Mangunkusumo National Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Director of Medical Service and Nursing, Board of Directors, Cipto Mangunkusumo National Hospital, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Centre for Neonatal and Paediatric Infection, St George’s, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom; Eijkman-Oxford Clinical Research Unit, Jakarta Pusat, DKI Jakarta, 10430, Indonesia; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand; Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
Background: There is a paucity of data regarding blood culture utilization and antimicrobial-resistant (AMR) infections in low and middle-income countries (LMICs). In addition, there has been a concern for increasing AMR infections among COVID-19 cases in LMICs. Here, we investigated epidemiology of AMR bloodstream infections (BSI) before and during the COVID-19 pandemic in the Indonesian national referral hospital. Methods: We evaluated blood culture utilization rate, and proportion and incidence rate of AMR-BSI caused by WHO-defined priority bacteria using routine hospital databases from 2019 to 2020. A patient was classified as a COVID-19 case if their SARS-CoV-2 RT-PCR result was positive. The proportion of resistance was defined as the ratio of the number of patients having a positive blood culture for a WHO global priority resistant pathogen per the total number of patients having a positive blood culture for the given pathogen. Poisson regression models were used to assess changes in rate over time. Results: Of 60,228 in-hospital patients, 8,175 had at least one blood culture taken (total 17,819 blood cultures), giving a blood culture utilization rate of 30.6 per 1,000 patient-days. A total of 1,311 patients were COVID-19 cases. Blood culture utilization rate had been increasing before and during the COVID-19 pandemic (both p < 0.001), and was higher among COVID-19 cases than non-COVID-19 cases (43.5 vs. 30.2 per 1,000 patient-days, p < 0.001). The most common pathogens identified were K. pneumoniae (23.3%), Acinetobacter spp. (13.9%) and E. coli (13.1%). The proportion of resistance for each bacterial pathogen was similar between COVID-19 and non-COVID-19 cases (all p > 0.10). Incidence rate of hospital-origin AMR-BSI increased from 130.1 cases per 100,000 patient-days in 2019 to 165.5 in 2020 (incidence rate ratio 1.016 per month, 95%CI:1.016–1.017, p < 0.001), and was not associated with COVID-19 (p = 0.96). Conclusions: In our setting, AMR-BSI incidence and etiology were similar between COVID-19 and non-COVID-19 cases. Incidence rates of hospital-origin AMR-BSI increased in 2020, which was likely due to increased blood culture utilization. We recommend increasing blood culture utilization and generating AMR surveillance reports in LMICs to inform local health care providers and policy makers. © 2022, The Author(s).
carbapenem; clarithromycin; imipenem; pyrazinamide; vancomycin; antiinfective agent; Acinetobacter; antibiotic resistance; antibiotic sensitivity; article; Article; bacterium culture; bacterium identification; blood culture; body mass; controlled study; coronavirus disease 2019; DNA extraction; dried blood spot testing; Enterobacter; Escherichia coli; general aspects of disease; health care personnel; human; incidence; Indonesia; Klebsiella pneumoniae; methicillin resistant Staphylococcus aureus; microorganism detection; middle income country; minimum inhibitory concentration; Neisseria gonorrhoeae; pandemic; patient referral; Poisson regression; Propionibacterium acnes; Pseudomonas aeruginosa; retrospective study; Severe acute respiratory syndrome coronavirus 2; Staphylococcus aureus; Str
Wellcome Trust; Department of Internal Medicine, University of Utah; Lembaga Pengelola Dana Pendidikan
This study is funded by Research Fund of Division of Tropical and Infectious Diseases, Department of Internal Medicine, Cipto Mangunkusumo National Hospital. RS is funded by Indonesian Education Scholarship (Beasiswa Pendidikan Indonesia [BPI]) [202101182688] from the Ministry of Education, Culture, Research, and Technology Republic of Indonesia: Directorate General of Higher Education, Research,
BioMed Central Ltd
20472994
35590391
Article
Q1
1286
2738
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