Factors Causing Acinetobacter Baumannii Resistance to Carbapenem Antibiotics in Patients with Healthcare Associated Infection (HCAI) at Dr. Moewardi Hospital, Surakarta

Abstract

Background: Acinetobacterbaumannii is a negative gram opportunistic bacteriumhaving high survival ability in the environment. Carbapenem is a drug of choice for infections caused by Acinetobacterbaumannii , which in the last decade prevalence of Carbapenem Resistant Acinetobacterbaumannii (CRAB) has increased. CRAB is commonly found in a nosocomial infection case and even into disease outbreak and epidemics in various hospitals. However, CRAB in community-associated infection data is still limited primarily in Indonesia. Therefore the researchers intend to do study factors causing CRAB in hospital and community setting in patients with Healthcare Associated Infection (HCAI). Subjects and Method: This study was an observational analytic study, with case control design. The study was conducted in RS Dr. Moewardi Surakarta in March-August 2017. Taking subject used fixed disease sampling method with the number of samples were 104 subjects. The dependent variable was the incidence of Acinetobacterbaumannii resistance to carbapenem antibiotics in HCAI patients. Independent variables were history of antibiotic use, patient functional status, intensive unit maintenance and comorbid conditions. Dependent and independent variables were measured by using a questionnaire checklist and then analyzed by using multiple logistic regression analysis. Result s : Previous antibiotic conformity history (OR = 0.12; 95% CI = 0.03 to 0.45; p = 0.002) and the patient functional status (OR = 6.72; 95% CI = 2.08 to 21.68; p = 0.001) increased risk of resistance of Acinetobacterbaumannii to carbapenem (CRAB) in Healthcare-Associated Infections (HCAI) patients and was statistically significant. Treatment at intensive unit (OR = 0.76; 95% CI = 0.26 to 2.23; p = 0.613) and comorbid conditions (OR = 0.38; 95% CI = 0.12 to 1.23; p = 0.106) increased risk of Acinetobacterbaumannii resistance to carbapenem (CRAB) in Healthcare Associated Infections (HCAI) patients although it was statistically insignificant. Conclusion: Previous antibiotic conformity history and functional status of patients are a factor affecting Acinetobacterbaumannii resistance to carbapenem (CRAB) in Healthcare-Associated Infections (HCAI) patients. Keyword: Acinetobacterbaumannii , carbapenem, healthcare associated infection. Correspondence : Widana Primaningtyas. Master Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: widanadoctor@gmail.com Mobile: +6285229035800. Indonesian Journal of Medicine (2017), 2(2): 125-138 https://doi.org/10.26911/theijmed.2017.02.02.07