Abstract

Antimicrobial resistance (AMR) is considered a global public health threat. The prevalence of fecal carriage of ESBL-producing gut flora is increasing in healthcare facilities and communities. Antibiotic usage is believed as one of the major drivers of AMR both in healthcare facilities and communities. However, few data analyze fecal carriage of ESBL-producing gut flora in patients and healthy individuals simultaneously in Indonesia. Detection of fecal carriage of ESBL-producing gut flora is important to prevent the outbreak and suppress the spread. This study's aim is to analyze the molecular patterns and antibiotic use as risk factors for fecal carriage of ESBL-producing gut flora isolated from patients and their families. One hundred rectal swabs were collected from ICU and medical ward patients and their families. The samples were then cultivated in MacConkey agar containing cefotaxime 2 g/ml. Colonies grew on MacConkey agar and were then confirmed as ESBL producers using a modified double-disk diffusion method. The genes of ESBL-producing isolates were detected using PCR. Antibiotic usage history was taken from medical records and questionnaires. Statistical analysis was performed to detect the correlation between antibiotic use and ESBL-producing gut flora carriage. The total carriage rate was 82 (82%) of 100 participants. The highest rate was among ICU patients (n=19/29, 95%). Mostly detected gene was blaCTX-M (n=62/90, 68.9%). There was no significant correlation between antibiotic use and carriage of ESBL-producing gut flora among patients and families.

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