Penggunaan Antibiotik dan Resistensi Escherichia coli and Klebsiella pneumoniae: Studi Ekologikal Lima Tahun di Sebuah Rumah Sakit Umum Daerah
DOI:
https://doi.org/10.36733/medicamento.v11i2.11156Kata Kunci:
DDD/100 bed-days, Escherichia coli, Klebsiella pneumoniae, meropenem, resistensi silangAbstrak
Resistensi bakteri merupakan ancaman kesehatan global yang semakin meningkat, yang sebagian disebabkan oleh tingginya tingkat penggunaan antibiotik. Organisasi Kesehatan Dunia (WHO) telah mengidentifikasi critical-priority bacteria, termasuk Escherichia coli dan Klebsiella pneumoniae, karena meningkatnya resistensi mereka terhadap berbagai jenis antibiotik. Penelitian ini bertujuan mengetahui korelasi antara tingkat penggunaan antibiotik dan tingkat resistensi pada Escherichia coli dan Klebsiella pneumoniae. Studi ekologikal ini dilakukan di sebuah Rumah Sakit Umum Daerah di Indonesia berdasarkan data retrospektif pasien rawat inap dari Januari 2019 hingga Desember 2023. Populasi dalam studi ini mencakup seluruh data penggunaan antibiotik sistemik berdasarkan kategori J01 dari sistem klasifikasi Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD), serta antibiogram dari basis data pasien rawat inap. Analisis korelasi Pearson dan Spearman dilakukan untuk menilai hubungan antara tingkat penggunaan antibiotik sistemik dan persentase resistensi Escherichia coli dan Klebsiella pneumoniae terhadap antibiotik lain. Antibiotik yang sering digunakan adalah sefiksim (305,664 DDD/100 hari rawat inap), levoflokasasin (139,552 DDD/100 hari rawat inap), dan seftriakson (109,805 DDD/100 hari rawat inap). Terdapat korelasi yang kuat dan signifikan secara statistik antara penggunaan doksisiklin dan resistensi Escherichia coli terhadap meropenem (r=0,894; p=0,041). Selain itu, penggunaan sefazolin, seftazidim, sefepim, dan siprofloksasin berkorelasi dengan resistensi Escherichia coli terhadap seftriakson (p<0,05), sementara penggunaan sefoperazon menunjukkan korelasi sangat kuat dan signifikan secara statistik dengan resistensi Escherichia coli terhadap ampisilin-sulbaktam (r=0,952; p=0,012). Sebaliknya, tidak ditemukan korelasi yang signifikan antara penggunaan antibiotik dan resistensi pada Klebsiella pneumoniae, yang mengindikasikan bahwa faktor lain seperti mekanisme resistensi intrinsik, elemen genetik mobil, dan reservoir lingkungan mungkin lebih berperan dalam perkembangan resistensi.
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Hak Cipta (c) 2025 Dwi Arymbhi Sanjaya, Herleeyana Meriyani, Rr. Asih Juanita, Nyoman Budiartha Siada, Yudistira Mahaputra, Made Gek Adisti Kamalia
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