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All Journal Pharmaciana: Jurnal Kefarmasian Jurnal Ilmiah Medicamento
Mahaputra, I Putu Yudistira
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Health Professions Medicine & Pharmacology Public Health

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Cross-resistance to antibiotics of Escherichia coli in the inpatient installation of general regional hospital “X” Bali, Indonesia Mahaputra, I Putu Yudistira; Sanjaya, Dwi Arymbhi; Meriyani, Herleeyana; Juanita, Rr Asih; Siada, Nyoman Budiartha; Kamalia, Made Gek Adisti; Adrianta, Ketut Agus; Noviani, Lusy
Pharmaciana Vol. 15 No. 1 (2025): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/pharmaciana.v15i1.29209

Abstract

Escherichia coli (E. coli) is a critical-priority group of MDR bacteria and its spread can occur in hospital inpatient settings. Several studies showed that antibiotics consumption for inpatients can cause E. coli resistance to other antibiotics called cross-resistance. The aim of this study to determine the cross-resistance in E. coli to antibiotics in the inpatient installation of the regional general hospital "X" in Bali, Indonesia by analyzing the relationship between the antibiotic consumption and the percentage of antibiotic resistance of E. coli. This research is an ecological study with the independent variable is the antibiotics consumption defined as defined daily doses/100 bed-days and the dependent variable is the percentage of E. coli resistance during 2017-2020. The correlation between the level of antibiotic consumption and the percentage of E. coli resistance to antibiotics was analyzed using the Pearson correlation tests. The results showed that the consumption of tetracycline had a significant correlation with increased resistance of E. coli to meropenem and piperacillin-tazobactam (r=0.8-1.0; p<0.05). This showed that there is cross-resistance in E. coli. This incident is associated with selective pressure, horizontal and vertical gene transfer in E. coli. The consumption of tetracycline, apart from inducing the production of the tet gene which is the cause of resistance to tetracycline, can also induce the production of resistance genes to broad-spectrum beta-lactam antibiotics such as piperacillin-tazobactam and meropenem.
Antibiotic consumption and resistance: a 3-years ecological study for four critical groups of bacteria in a general regional hospital Sanjaya, Dwi Arymbhi; Siada, Nyoman Budiartha; Juanita, Rr Asih; Mahaputra, I Putu Yudistira; Kamalia, Made Gek Adisti; Meriyani, Herleeyana
Pharmaciana Vol. 14 No. 1 (2024): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/pharmaciana.v14i1.27321

Abstract

Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae are the most critical groups of multi-drug resistant (MDR) bacteria that cause a threat in hospitals. This study identified the trend of antibiotic consumption, antibiotic resistance pattern, and the relationship between antibiotic consumption and antibiotic resistance in a critical group of bacteria in a general regional hospital. This ecological study was based on retrospective data from inpatient databases in a general regional hospital over three years (2017-2019). The trend for annual antibiotic consumption over 2017-2019 was defined as defined daily doses/100 bed-days. The relationship between total antibiotic consumption and the percentage of antibiotic resistance among four isolated critical bacteria was explored in time series analysis and linear regression. The most frequently used antibiotic was ampicillin (220.33 DDD/100 bed-days), ciprofloxacin (126.86 DDD/100 bed-days), and ampicillin-sulbactam (126.34 DDD/100 bed-days). There was a significant relationship between antibiotic consumption (ampicillin, ampicillin-sulbactam, ceftazidime, gentamicin, amikacin, and ciprofloxacin) in DDD/100 bed-days and antibiotic resistance in E. coli, K. pneumoniae, and P. aeruginosa (p<0.05) but not statically significant in A. baumannii (p=0.062). The annual usage fluctuated or remained stable, with no statistically significant trends change. The relationship between antibiotic consumption and antibiotic resistance was significant in three out of four critical groups of bacteria.
Association Between Antibiotic Consumption and Pseudomonas aeruginosa Non-Susceptibility: A Five-Year Ecological Study at Bali Regional General Hospital Sanjaya, Dwi Arymbhi; Meriyani, Herleeyana; Juanita, Rr. Asih; Siada, Nyoman Budiartha; Mahaputra, I Putu Yudistira
Jurnal Ilmiah Medicamento Vol 12 No 2 (2026): Jurnal Ilmiah Medicamento
Publisher : Fakultas Farmasi Universitas Mahasaraswati Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36733/medicamento.v12i2.14763

Abstract

Background: Pseudomonas aeruginosa is a major cause of healthcare-associated infections (HAIs), which are difficult to eradicate because of the bacterium’s intrinsic and acquired resistance mechanisms. However, evidence regarding the association between hospital antibiotic consumption and antimicrobial resistance remains inconsistent.Objective: This study determines the association between systemic antibiotic consumption and P. aeruginosa non-susceptibility using five years of hospital surveillance data.Methods: A retrospective ecological study was conducted using surveillance data from Bali Regional General Hospital between January 2019 and December 2023. The relationship between antibiotic consumption [defined as daily doses (DDD) per 100 patient-days] and resistance was analyzed by a generalized linear model in which the number of non-susceptible isolates was used as the dependent variable. Moreover, antibiotic consumption, the bed occupancy rate (BOR), the calendar year, and the antibiotic agent (with meropenem taken as the reference category) were used as independent variables.Results: The study included 77 P. aeruginosa isolates and 35 antibiotic-year observations. No statistically significant association was found between antibiotic consumption and non-susceptibility (OR 1.049, 95% CI 0.980–1.122; p = 0.168) or between BOR and non-susceptibility (OR 1.024, 95% CI 0.992–1.057; p = 0.152). Calendar year was inversely associated with the modeled non-susceptibility outcome (OR 0.716, 95% CI 0.592–0.866; p < 0.001). Ceftazidime and cefepime had higher odds of non-susceptibility than meropenem.Conclusion: Antibiotic consumption does not fully explain P. aeruginosa non-susceptibility. Factors such as antibiotic-specific resistance mechanisms and infection prevention and control practices might also have a role in the differences in non-susceptibility.
Co-Authors Dwi Arymbhi Sanjaya Herleeyana Meriyani Kamalia, Made Gek Adisti Ketut Agus Adrianta Lusy Noviani Nyoman Budiartha Siada RR. Asih Juanita