Bacterial Patterns and Sensitivity to Antibiotics in Patients Treated with Ventilators at the Intensive Care Unit of Sanglah Hospital Denpasar, Bali, Indonesia

Abstract

Abstract
 BACKGROUND: Ventilator use to treat patients with respiratory failure in the Intensive Care Unit (ICU) is crucial to prevent further organ failure caused by inadequate oxygenation. However, as an invasive procedure, the use of a ventilator could lead to nosocomial infection, such as Ventilator-Associated Pneumonia (VAP) caused by opportunistic microorganisms in the ICU. Hence, the author is interested in finding the microbial patterns and its antibiotic sensitivity as a source of data for further researches and providing consideration on antibiotics usage for patients treated with ventilators in the ICU of Sanglah Hospital Denpasar.
 AIM: This study is conducted to obtain the microbial pattern and antibiotics sensitivity on patients treated with ventilators in the ICU of Sanglah Hospital Denpasar.
 MATERIALS AND METHODS: This research is based on the cross-sectional descriptive method. Research samples were chosen with consecutive sampling that is included in the research’s inclusion criteria. Patient data were collected from the 1st January 2021 to 30th June 2021 within the ICU of Sanglah Hospital Denpasar. Variables in this research were listed as followed: demographic data of the patients that include age, gender, comorbid, diagnosis, ventilator usage indication, bacterial culture, and bacterial susceptibility test.
 RESULTS: 185 culture samples were obtained from 113 patients. 18 different species of bacterias were found with the three most common microorganisms being Pseudomonas aeruginosa (22.2%), Acinetobacter baumanii (20%), and Klebsiella pneumoniae (17.3%). Susceptibility pattern found as follows: The prevalence of P aeruginosa was found sensitive towards ceftazidime (68,3%), gentamicin (68,3%), and amikacin (65,9%), A. Baumanii are mostly sensitive to amikacin (56,8%), gentamicin (32,4%), and tigecyline (32,4%), K. Pneumoniae are mostly sensitive to amikacin (83,9%), meropenem (77,4%), and piperacillin/tazobactam (54,8%). Resistance pattern found as follows: The prevalence of P aeruginosa was found resistant towards cefixime (70,7%), cefazolin (58,5%), and cefuroxime (58,5%), A. baumanii are mostly resistant to cefixime (86,5%), cefoperazone (81,1%), and piperacillin/tazobactam (75,7%), K. pneumoniae are mostly resistant to ciprofloxacin (61,3%) and levofloxacin (48,4%).
 CONCLUSION: To decrease the spreading of multi-drug resistant organisms that have been found in ventilated patients, prevention strategies and rational use of antibiotics needs to be performed correctly.
 Key-words: Ventilator, microbial pattern, antibiotics, sensitivity, resistance