ORIGINAL ARTICLE

Outcome of urinary tract infection caused by Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in Dr Zainoel Abidin General Hospital Aceh

Zinatul Hayati , Kurnia F. Jamil, Afrianda Azhari, Wilda Mahdani, Teuku Fadrial Karmil, Asyriva Yossadania, Dahril Dahril, Yopie Afriandi Habibie

Zinatul Hayati
Department of Microbiology, Faculty of Medicine, Universitas Syiah Kuala / Dr Zainoel Abidin General Hospital, Banda Aceh 23126, Indonesia. Email: hayatikarmil@unsyiah.ac.id

Kurnia F. Jamil
Department of Internal Medicine, Faculty of Medicine, Universitas Syiah Kuala / Dr Zainoel Abidin General Hospital, Banda Aceh 23126, Indonesia

Afrianda Azhari
Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia

Wilda Mahdani
Department of Microbiology, Faculty of Medicine, Universitas Syiah Kuala / Dr Zainoel Abidin General Hospital, Banda Aceh 23126, Indonesia

Teuku Fadrial Karmil
Department of Clinical Veterinary, Faculty of Veterinary Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia

Asyriva Yossadania
Department of Public Health, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia

Dahril Dahril
Department of Urology, Faculty of Medicine, Universitas Syiah Kuala / Dr Zainoel Abidin Hospital, Banda Aceh 23126, Indonesia

Yopie Afriandi Habibie
Division of Thoracic Cardiac & Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Syiah Kuala / Dr Zainoel Abidin General Hospital, Banda Aceh 23126, Indonesia
Online First: June 30, 2021 | Cite this Article
Hayati, Z., Jamil, K., Azhari, A., Mahdani, W., Karmil, T., Yossadania, A., Dahril, D., Habibie, Y. 2021. Outcome of urinary tract infection caused by Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in Dr Zainoel Abidin General Hospital Aceh. Bali Medical Journal 10(2): 544-548. DOI:10.15562/bmj.v10i2.2385


Introduction : Extended-spectrum ?-lactamase (ESBL) is a mutated ?-lactamase enzyme that can hydrolyze beta-lactam antibiotics. The aim of this study was to determine the incidence rate, characteristics of patients, antibiotic use and outcome of urinary tract infections (UTIs) due to ESBL-producing Escherichia coli and Klebsiella pneumoniae at Dr Zainoel Abidin General Hospital Aceh.

Method : The samples of this study were all Escherichia coli and Klebsiella pneumoniae isolated from urine culture of UTI cases. Patient characteristics and antibiotic use data were extracted from medical records. UTIs outcome was assessed as clinical improvement or death within a maximum of 30 days of treatment.

Result : The results of this study obtained 63 patients with UTIs caused by E. coli and K. pneumonia of which 52.4% of them were ESBL producers. The incidence of UTIs due to E. coli was higher than that of K. pneumoniae, 63.5% and 36.5% respectively. E. coli ESBL producers were more in number than non-ESBL, conversely K. pneumoniae were mostly non-ESBL. The characteristics of patients with UTIs caused by E. coli and K. pneumoniae were predominant women 52.4%,  and most cases were at 56-64 years old. Antibiotic therapy that given before and after culture results to UTI patients were generally ceftriaxone. UTIs outcome due to ESBL producing Escherichia coli and Klebsiella pneumoniae showed that 26/33 (78.8%) patients experienced improvement, however, 7/33 (21.2%) patients died.

Conclusion : The irrational use of ceftriaxone in patients with UTI caused by ESBL producing E. coli and K. pneumoniae has led to a poor outcome for the patient.

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