The Prevalence of Extended Spectrum Beta-Lactamase (ESBL) Producing gut flora among Pregnant Women peripartum in Community and Hospital, Indonesia

Abstract

The data of the carrier rate of ESBL producing bacteria in pregnant women in Indonesia is limited. ESBLproducing bacteria colonization among women during labor is one of the risks for spreading and infection to the neonate. This study aimed to compare the carrier rate of ESBL-producing bacteria in pregnant women in the community and hospitals. This study was an observational analytic study with cross-sectional approach. Samples were collected from rectal swab of pregnant women who visited during antenatal care at the Primary Health Center (PHC), and inpatient pregnant women that referred to Dr. Soetomo referral hospital, Surabaya. The samples were cultured on MacConkey Agar media supplemented with cefotaxime 1 mg/L, incubation 37oC overnight. The growth colonies that were suspected ESBL producer were further identified by biochemically and confirmed the ESBL using the DDST (Double Disk Synergy Test) method. Among 200 samples (101 from PHC and 99 from hospital), 79 ESBL producers were identified, 28 (40%) from PHC and 51 (68.9%) from hospital. The carrier rate of ESBL producing bacteria was significantly different between PHC and hospital (p=0.001; 95%CI= 1.54–4.98). The antibiotic consumed by pregnant women was higher in hospital rather than PHC (p=0.001). Conclusion: The carrier rate of ESBL producing bacteria among pregnant women in hospital was higher than PHC. Antibiotic used was identified as risk factor.