ABSTRACT
Background and Objectives: Anaerobic bacteria are a common cause of endogenous infections, some of which can be life threatening. These bacteria are not easily cultured and isolated and often cannot even found from infected sites. Delayed or inappropriate treatment of these microorganisms can lead to failure in eradicating these infections. The purpose of this study was to determine the diversity of anaerobic bacteria at present and their pattern of sensitivity to several antibiotics. Materials and Methods: A retrospective study was conducted over a period of two years on various specimens. Specimens derived from body fluids are inoculated on a BacT/Alert (bioMérieux). Anaerobic isolates were identified by Gram staining and continued identification using Vitek 2® automated system. Antibiotic sensitivity examination was carried out using ATBTM ANA (bioMérieux). Results: A total of 440 specimens were received in microbiology laboratory for anaerobic culture from patients with multiple infections from 13 hospitals in Jakarta. Our research was able to identify 18 species on anaerobic bacteria, consisting 52.5% Gram positive and 47.5% Gram negative bacteria. The most common bacteria found were Clostridium perfringens (15%) from Gram positive and Provetella bivia (10%) from Gram negative. The sensitivity pattern shows that antibiotic piperacilline-tazobactam is 100% effective against anaerobic bacteria, while metronidazole as the drug of choice is only 75% effective. Against Gram positive, several antibiotics such as piperacilline-tazobactam, ticarcilin-clavunic acid, cefoxitin, cefotetan, imipenem and chloramphenicol were 100% effective, however metronidazole occupied the lowest position (61.9%). Meanwhile against Gram negative antibiotics piperacilline-tazobactam is 100% effective and chloramphenicol in the second position (94.75%). Conclusion: Clostridium perfringens and Provetella bivia are the most common bacteria found. The antibiotics piperacilline-tazobactam is 100% effective against both Gram positive and negative. The accuracy of specimen management, isolation, identification and sensitivity examination will determine the successful microbiological investigations.
ABSTRACT
BACKGROUND: This study examined the susceptibility of Gram-negative bacteria in the bloodstream to antimicrobials with the aim of providing information relevant to the guidance of therapy. METHODOLOGY: Blood specimens received by the Laboratory of Clinical Microbiology, Faculty of Medicine, University of Indonesia, from 2002 to 2008, were analyzed for the presence of Gram-negative bacteria and their susceptibility to four antibiotic groups frequently administered in hospitals and community settings. RESULTS: During the seven-year period leading up to 2008, approximately 68% of Gram-negative bacteria were identified among all positive isolates from blood specimens. The eight most frequent species found were Acinetobacter anitratus (25.8%), Pseudomonas aeruginosa (19.5%), Klebsiella pneumoniae subsp. pneumoniae (14.5%), Enterobacter aerogenes (8%), Salmonella Typhi (7.5%), Escherichia coli (6.2%), Alcaligenes faecalis (5.6%) and Klebsiella oxytoca (3.2%). At 80% susceptibility or greater, Ceftriaxone and Cefotaxime were active only on E. coli and S. Typhi. Cefepime demonstrated activity on all eight species tested except K. pneumonia while Amikacin showed activity against five species, A. faecalis, E. aerogenes, E. coli, K. pneumoniae subsp. pneumoniae and S. Typhi. Gentamycin was active against three species: E. aerogenes, K. oxytoca and S. Typhi. Ciprofloxacin and Levofloxacin significantly differed in their spectrum: while Ciprofloxacin was active against four of the eight species tested (E. aerogenes, E. coli, K. oxytoca, and S. Typhi ), Levofloxacin was similar to Cefepime and was active against all eight species except K. pneumoniae subsp. pneumonia. CONCLUSIONS: Since antimicrobials are broadly used in Jakarta, it is important that the information captured in this study be disseminated.
