Distribution of Multidrug Resistant Escherichia coli and Klebsiella pneumoniae Isolates among clinical specimens in the Zainoel Abidin General Hospital, Banda Aceh, Indonesia

Abstract

Inappropriate antibiotic use and diagnosis might contribute to the increasing occurrences of multidrug resistant (MDR) Escherichia coli and Klebsiella pneumoniae infections in both the community and hospitals settings. This study aimed to determine the distribution and antibiotic susceptibility of MDR Escherichia coli and Klebsiella pneumoniae based on clinical specimens, time interval, and patients’ gender at RSUDZA during a study period of February 2019-January 2021. Methods Isolation of Escherichia coli and Klebsiella pneumoniae was carried out using culture technique on blood agar and MacConkey agar. Identification of Escherichia coli and Klebsiella pneumoniae and antibiotic sensitivity tests were performed using VITEK® 2 Compact. The results showed that during the study period, there were a total of 669 isolates of Escherichia coli obtained with a percentage of MDR E. coli of 30.90% (208 isolates); and 525 isolates of Klebsiella pneumoniae with a percentage of MDR K. pneumoniae of 25.15% (132 isolates). Both MDR E. coli and MDR K. pneumoniae isolates showed their resistance to more than three classes of antibiotics. Based on clinical specimens, both MDR E. coli and K. pneumoniae were predominantly found in urine specimens, namely 122 isolates (58.65%) and 49 isolates (37.12%), respectively. Based on gender, MDR E. coli infection was commonly found in women, namely 114 isolates (54.80%), whereas MDR K. pneumoniae infection was commonly found in men, namely 72 isolates (54.13%). Overall, both MDR E. coli and K. pneumoniae were predominantly found as pathogens especially causing urinary tract infections in female patients during the time period of study. This study may suggest to effectively implement the surveillance programs and infections control in order to manage these MDR bacterial infections particularly within healthcare settings.