Abstract
Acinetobacter baumanii is an opportunistic pathogen known to cause hospital acquired infection presenting with varying clinical feature from simply to much more severe manifestation. More importantly, widely improper and overuse of antibiotics consumption have caused an endemic of multidrug-resistant-Acinetobacter baumanii leading to prolonged hospital stay and poorer prognosis for intensive care patients. A descriptive study of pre- and post-education was conducted at an intensive care setting in Indonesia. The microbiology data were collected to evaluate the benefit of education on hand hygiene and management of antibiotic use to reduce the number of MDR-Acinetobacter baumanii infection. Based on the result of previous local susceptibility patterns, Cefoperazone/Sulbactam and Amikacin are favored as the empirical therapy. Chi-square analysis shows the significant reduction of Acinetobacter baumanii cases from 70.8% (17/24) to 38% (3/8) with P-value 0.006. Similarly, the susceptibility rate significantly increased, from 21% to 100% to Amikacin; from 5% to 89% to Piperacillin/Tazobactam, and from 42% to 89% to Meropenem. Education improving around hand hygiene, appropriate antibiotic prescribing following local hospital guidelines and the result of antibiotic susceptibility has been shown to reduce the transmission of MDR-Acinetobacter baumanii in the intensive care in our unit within this Indonesian hospital.
Highlights
Acinetobacter spp. is non-fermentative gram-negative coccobacillus which has been increasing recently in accordance with rising cases of multi-drug resistant organisms [1] [2]
In June 2012-June 2013, a total of 23/39 (60%) patients were suffering from bacterial infection consist of Acinetobacter baumanii 17/24 (70.8%), Acinetobacter iwolfii 1/24 (4.2%), Pseudomonas aeruginosa 2/24 (8.3%), and 16.7% gram positive bacteria isolates (Figure 1)
Staphylococcus aureus and Coagulase negative staphylococci (CoNS) isolates consisted of Staphylococcus capitis1/13 (7.7%), Staphylococcus hominis1/13 (7.7%), Staphylococcus hemoliticus1/13 (7.7%), Staphylococcus saprophyticus1/13 (7.7%) were the highest isolates found in October 2013 to March 2014 (Figure 1)
Summary
Acinetobacter spp. is non-fermentative gram-negative coccobacillus which has been increasing recently in accordance with rising cases of multi-drug resistant organisms [1] [2]. The clinical feature is ranging from colonization to severe manifestation [1] [2]. This condition is often met in hospitalized patients with severe illness and impaired host defense that needs medical support. MDR-Acinetobacter baumanii can lead to the poorer prognosis of the patients in intensive care and hospital infection control has to be done to prevent transmission among patients and healthcare workers. Strategy on education and appropriate antibiotics use is essential in order to reduce health care-associated infections. We sought to evaluate the benefit of hand hygiene promotion on health care worker and appropriate antibiotic use in reducing the number of MDR-Acinetobacter baumanii infection among intensive care patients
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