Abstract

Objective: To determine the differences in bacterial and antibiotic sensitivity patterns among pPneumonia patients at the Sanglah Hospital Denpasar, Bali.
Materials and Methods: This study is a cross-sectional restrospective study conducted at Clinical Microbiology Installation of Sanglah Hospital from 1 January- 31 March 2019. Sputum specimens were obtained from patients diagnosed with pneumonia.There were 87 samples that had been consecutively selected and fullfiled the inclusion and exclusion criteria.
Results: The mean age of patients undergoing sputum culture was 54.66 years old with most of them were male. Sputum specimens were taken, on average,after the 3rd day of treatment and patients had received antibiotic therapy (82.6%) which was dominated by combined antibiotic therapy.Cefoperazone with Levofloxacin was the most commonly used antibiotic therapy (36%). Of the bacteria isolated from patients’ sputum, 96.6% were Gram Negative bacteria and 56.3% were resistant to multiple antibiotcs. Gram Negative bacteria weresensitive to Amikacin (91.5%) and Meropenem (80.5%) while Gram Positive bacteria were sensitive to Vancomycin (100%) and Linezolid (100%). Pseudomonas aeruginosa (27.6%), Klebsiella pneumoniae (26.4%), Acinetobacter baumannii (20.7%) and Escherichia coli (12.6%) were isolated from the patients’ sputum. The types of isolated bacteria showed no significant difference between CAP and HAP patients (p> 0.05). Multi-drug resistant (MDR) bacteria were commonly found in HAP patients (66.0%) (p = 0.034). MDR Pseudomonas aeruginosa had a significant diferrence between those who were isolated from CAP and HAP (p=0.036). Amikacin and meropenem showed ≥80% sensitifity in both CAP and HAP patients (p>0.05).
Conclusion: The type of bacteria and antibiotic sensitivity found in CAP and HAP patients treated at Sanglah Hospital Denpasar showed no significant difference. The difference was only found in the MDR Pseudomonas aeruginosa. Sampling of specimens is expected to be done on the first day of treatment and the selection of empirical antibiotic therapy needs to refer to the hospital germ pattern.

Key words: pneumonia, bacterial patterns, antibiotic sensitivity patterns, MDR