Trends in antimicrobial susceptibility of Gram-negative bacteria isolated from blood in Jakarta from 2002 to 2008

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.