A six-month epidemiologic study of carbapenem-resistant Acinetobacter baumannii and carbapenem-resistant Pseudomonas aeruginosa in early pandemic at Dr. Soetomo Hospital Surabaya

Pristiawan Navy Endraputra, Kuntaman, Eko Budi Khoendori
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Abstract

Background: Nosocomial infection is derived from the patient itself or transmitted across patients, healthcare workers, or the hospital environment. Carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA) have been recognized as the most common pathogen for nosocomial infections in Southeast Asia. Afterward, CRAB and CRPA infections increase morbidity, mortality, length of stay, and cost. This study examined the prevalence of CRAB and CRPA at Dr. Soetomo Hospital, Surabaya, from January to June 2020. Methods: This descriptive study was conducted retrospectively by collecting data from the first isolate per specimen per patient of Acinetobacter baumannii and Pseudomonas aeruginosa, resistant either to meropenem or imipenem from urine, blood, pus, or sputum in Dr. Soetomo Hospital, Surabaya within January to June 2020. Results: A total of 311 Acinetobacter baumannii and 425 Pseudomonas aeruginosa were collected with 134 CRAB and 79 CRPA. The resistance rate of CRAB was ≥90% except for amikacin, cefoperazone-sulbactam, levofloxacin, tigecycline, trimethoprim-sulfamethoxazole, and fosfomycin. Moreover, CRPA had resistance ≥90% regardless of intrinsic resistance against imipenem and colistin. There was an increase in CRAB and CRPA, with the highest incidence in June 2020 in early 2020. Conclusion: The prevalence of CRAB and CRPA were 43% and 19%, respectively, in the early six months of 2020 at Dr. Soetomo Hospital, Surabaya.
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泗水Soetomo医生医院大流行早期耐碳青霉烯鲍曼不动杆菌和耐碳青霉烯铜绿假单胞菌六个月流行病学研究
背景:医院感染来源于患者自身或在患者、医护人员或医院环境中传播。耐碳青霉烯鲍曼不动杆菌(CRAB)和铜绿假单胞菌(CRPA)是东南亚地区最常见的医院感染病原体。之后,CRAB和CRPA感染会增加发病率、死亡率、住院时间和费用。本研究调查了2020年1月至6月泗水Soetomo医生医院的CRAB和CRPA患病率。方法:本描述性研究回顾性收集了2020年1月至6月泗水Dr. Soetomo医院每位患者的尿液、血液、脓液或痰中对美罗培南或亚胺培南耐药的鲍曼不动杆菌和铜绿假单胞菌的首个样本分离物的数据。结果:共检出鲍曼不动杆菌311株,铜绿假单胞菌425株,其中CRAB 134株,CRPA 79株。除阿米卡星、头孢哌酮-舒巴坦、左氧氟沙星、替加环素、甲氧苄啶-磺胺甲恶唑、磷霉素外,其他5种药物的耐药率均≥90%。此外,无论对亚胺培南和粘菌素的内在耐药性如何,CRPA的耐药率均≥90%。螃蟹和CRPA呈上升趋势,2020年初以2020年6月发病率最高。结论:泗水Dr. Soetomo医院2020年上半年的CRAB和CRPA患病率分别为43%和19%。
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