Annual Scientific Meeting of PAMKI P-107

In Conjunction with
The 3rd Global Health and Innovation Conference
A Five-Year Retrospective Study of ESBL-Producing
Escherichia coli: Prevalence and Antibiotic Susceptibility
Gajah Nauli Dalimunthe1, Dimas Seto Prasetyo2, Delly Chipta Lestari2
1 Clinical Microbiology Specialist Program, Faculty of Medicine, Universitas Indonesia, Jakarta 10320, Indonesia;
2 Department of Clinical Microbiology, Faculty of Medicine, Universitas Indonesia/dr. Cipto Mangunkusumo Hospital, Jakarta 10320, Indonesia

Table 1. Antimicrobial susceptibility of ESBL-producing E. coli isolates

BACKGROUND
AMP %S SAM %S TZP %S CZO %S CAZ %S CRO %S FEP %S ATM %S
Escherichia coli is a Gram-negative bacillus that is part of the
normal intestinal flora but can also cause infection in 0.0 37.9 72.4 0.0 41.2 0.2 58.2 20.2
humans, ranging from mild gastroenteritis to kidney failure
and septic shock. E. coli can evade the host immune system ETP %S MEM %S AMK %S GEN %S CIP %S TGC %S SXT %S NIT %S
defenses and develop resistance to antibiotics.
99.9 99.9 99.7 47.7 25.8 99.8 32.2 82.7
Multidrug-resistant (MDR) E. coli is becoming a serious threat
to public health worldwide due to the inappropriate use of
antibiotics, especially third-generation cephalosporin. The DISCUSSION
most common resistance mechanism found in E. coli is
Results from this study showed that the most frequent
extended-spectrum β-lactamases (ESBL).
specimen type containing ESBL-producing E. coli was urine,
which was detected in over 50%. Other specimens were
This study aim to determine the prevalence and susceptibility
tissue, pus, and blood. Meanwhile relatively low in sputum.
of antibiotics to ESBL-producing E. coli. The results of this
These common sample types are consistent with similar
study are expected to enrich MDR data in Indonesia.
studies done elsewhere.1,2
METHODS AND MATERIALS
The study found the prevalence of ESBL-producing E. coli
within five years to be 24.8%, with the highest annual
This cross-sectional retrospective study uses secondary data
prevalence in 2020 at 42.1%. This result was lower compared
from clinical specimens (screening and environment samples
to a systematic review reported in 2020.2
were excluded) examined at the Clinical Microbiology
Laboratory, Faculty of Medicine, Universitas Indonesia (LMK
Some antibiotics showed high sensitivity, while others
FKUI) during 2017 – 2021. WHONET software ver. 2022 was
showed very high resistance levels. Therefore, antibiotics
used for analysis.
should be used judiciously, accompanied by implementing
infection control to prevent the emergence of resistance.
RESULTS

Eight hundred E. coli isolates were identified within years. Of CONCLUSION

these, 227 strains (24.8%) were ESBL-positive. The highest
prevalence of ESBL-producing E. coli was in 2020 (42.1%) ESBL-producing E. coli has been reported in many nations,
(Figure 1). The most common sample type for ESBL-producing including Indonesia, and poses a significant public health
E. coli is urine, detected in over 50%, followed by tissue, pus, threat, requiring antibiotic management and infection control
and blood (Figure 2). Isolates E. coli that produce ESBL were to prevent the spread of resistant bacteria in communities.
remain susceptible to carbapenem, amikacin, nitrofurantoin,
tigecycline, and piperacillin/tazobactam. However, other REFERENCES
antibiotics showed high resistance (Table 1).
1. Alqasim A, Abu Jaffal A, Alyousef AA. Prevalence of multidrug resistance
Others
and extended-spectrum β -Lactamase carriage of clinical uropathogenic
Stool Escherichia coli isolates in Riyadh, Saudi Arabia , Int J Microbiol; 2018.
Sputum 2. Tufa TB, Fuchs A, Tufa TB, Stötter L, Kaasch AJ, Feld T, et al. High rate of
Blood extended-spectrum beta-lactamase-producing gram negative infections
and associated mortality in Ethiopia: A systematic review and meta-
Pus
Urine
analysis. Antimicrob Resist Infect Control. 2020.

Tissue CONFLICT OF INTEREST

The authors have no conflicts of interest to declare.
Figure 2. ESBL-producing E. coli
Figure 1. Prevalence of ESBL-producing E. coli in 2017-2021 specimens type

CONTACT
Gajah Nauli Dalimunthe
ACKNOWLEDGMENT
ACKNOWLEDGEMENT
Clinical Microbiology Specialist Program, Faculty of Medicine,
Universitas Indonesia. We thank dr. R. Fera Ibrahim, M.Sc., Ph.D., Sp.MK(K)., head of UKK LMK FKUI,
Email: iditapatuan@gmail.com for giving access to the data.
Phone: 081360397300