Correlation of Blashv And Blatem Genes in Extended-Spectrum Beta-Lactamase (Esbl) - Producing Acinetobacter Baumannii With Patient’s Outcome at Dr. Wahidin Sudirohusodo Hospital, Makassar

Abstract

Acinetobacter baumannii causes the high morbidity and mortality. Acinetobacter baumannii has ESBL enzyme that makes it resistant to the mostly beta-lactam antibiotics. Some ESBL – coding genes are blaSHV and blaTEM. The purpose of this study was to evaluate correlation blaSHV and blaTEM genes in Extended Spectrum Beta-Lactamase (ESBL) - producing Acinetobacter baumannii with outcome (length of stay and death) at Dr. Wahidin Sudirohusodo Hospital, Makassar. The study used cross-sectional method conducted on Acinetobacter baumannii isolates and medical record at Dr. Wahidin Sudirohusodo, Makassar. ESBL was detected with automated culture, blaSHV and blaTEM genes was detected with PCR. Statistical analysis used Chi Square, Fisher Exact, Independent-t and Pearson’s Correlation tests. Significance of test if p<0.05. Research of 57 Acinetobacter baumannii isolates, ESBL was found in 20 isolates (35%). Average length of stay (LOS) in positive ESBL (26.3 days) was significantly longer than in negative ESBL (16,5 days)(p = 0,016). Mortality rate was higher in positive ESBL (55%) than negative ESBL (35,1%), but statistically not significant (p = 0.147). The blaTEM gene found in 53 isolates (93%) and there was no isolate bringing blaSHV gene. In positive ESBL, average length of stays (LOS) in positive blaTEM was 25.4 days while in negative blaTEM was 42 days; Mortality rate was higher in positive blaTEM compared to negative blaTEM (57.9%, 0.0%, consecutively), but statistically not significant (p>0.05). It was concluded that blaTEM gene was found 93% and blaSHV was not found. The LOS in positive ESBL was significantly longer.