Aetiology and Antibiotic Susceptibility of Common Bacterial Infections in Hospitalised Patients: A 2019 Multisite Cross-Sectional Survey in Jakarta, Indonesia.

OBJECTIVES: To describe the aetiology and antibiotic susceptibility patterns of common bacterial infections in hospitalised patients in Jakarta, Indonesia.

METHODS: We conducted a hospital-wide point prevalence survey in six hospitals in 2019, capturing data from routinely ordered bacterial cultures taken before the start of antibiotic treatment. We report relevant bacteria-antibiotic combinations for Escherichia coli and the ESKAPE group of pathogens.

RESULTS: A total of 562 patients (52% women, median age 46 years) were diagnosed with 587 infections, comprising 414 community-acquired and 173 hospital-acquired infections, with pneumonia most frequent (258, 44%). From 615 samples collected, 279 (45%) bacterial isolates were identified, of which 213 (76%) gram-negative, including Klebsiella pneumoniae (68, 24%), Escherichia coli (37, 13%) and Pseudomonas aeruginosa (35, 13%) among others, and 66 (24%) gram-positive, including Enterococcus faecalis (17, 6%) and Staphylococcus aureus (11, 4%) among others. Proportions of bacteria resistant to third-generation cephalosporins (3GC) were 75% (47/63) for Klebsiella pneumoniae , and 69% (22/32) for E. coli , and to carbapenems 64% (7/11) for Acinetobacter spp., 60% (3/5) for Enterobacter spp., 43% (3/7) for E. coli, 30% (7/23) for P. aeruginosa and 29% (9/31) for K. pneumoniae . Four of 11  S. aureus isolates were methicillin-resistant. A blood culture was done in only 52% (16/31) of sepsis patients, and the results of positive blood cultures were reported after a median of 4 days.

CONCLUSIONS: This survey identified that a high proportion of common gram-negative bacteria exhibited reduced susceptibility to first-choice antibiotics and considerable underuse of bacterial cultures. These findings warrant enhanced infection prevention and control and antimicrobial stewardship.