Antibiotic Consumption and Resistance Pattern of 3 Coagulase-Negative Staphylococci Species: An Ecological Study

Abstract

A group of coagulase-negative staphylococci (CoNS) was historically classified as a nonpathogenic bacteria. Over the last few decades, nosocomial infections caused by CoNS as opportunistic pathogens have increased and become one of the major nosocomial pathogens. The aim of this study was to identify the relationship between the use of an antibiotic agent for CoNS in Bali’s regional public hospital and the development of antibiotic resistance during 3 years period. This study was a retrospective ecological study of antibiotic resistance and antibiotic consumption secondary data collected prospectively. It was conducted over a three years period of inpatient data. Susceptibility of CoNS to antibiotics was obtained from the hospital antibiogram of all isolates from 2017 to 2019. Sensitivity results in antibiogram were based on the standards provided by the Clinical and Laboratory Standards Institute (CLSI) with the disk diffusion method. Antibiotic consumption in DDDs/100 bed-days. The relationships between DDDs/100 bed-days of each antibiotic and rates of antibiotic resistance of each resistant strain of CoNS were tested using Spearman correlation and logistic regression. There was no significant correlation between antibiotic consumption (DDD) and the percentage of antibiotic resistance among the three CoNS species (p>0.05). However, this study found there was an inverse relationship between DDD and antibiotic resistance in Staphylococcus hominis species (OR = 0.063; CI [0.004-0.915]; p=0.043). We conclude that no significant correlation between antibiotic consumption and antibiotic resistance of the 3 CoNS species. There needs to be further research to identify antibiotic consumption, antibiotic resistance and other factors affecting antibiotic resistance.

Kajian Literatur: Study Design Dalam Farmakoepidemiologi Untuk Mengetahui Resistensi Bakteri Terhadap Antibiotik

“…Madagaskar, Kamboja dan Senegal Isolat Komunitas (Meriyani et al, 2021) Untuk melihat hubungan antara penggunaan antibiotik dengan resistensi 3 spesies CoNS selama 3 tahun.…”

“…Rancangan penelitian ini dapat menggambarkan data pada tingkat populasi, namun tidak dapat merefleksikan secara akurat data penggunaan antibiotik pada tingkat individu. (Meriyani et al, 2021) Desain studi case-control tidak memerlukan banyak waktu untuk menunggu dampak dari paparan. Pengumpulan data dimulai dengan outcome dan kemudian melihat ke belakang untuk mengamati paparan yang terjadi sebelumnya secara retrospektif.…”

“…Penelitian ini memiliki beberapa kelebihan seperti lebih mudah dilakukan karena pengumpulan data dilakukan pada tingkat grup atau kelompok, biaya yang diperlukan lebih murah, apabila dilakukan ditingkat geografi tertentu dapat menggambarkan variasi dalam penggunaan antibiotik dan cenderung reproducible. Akan tetapi desain ini juga memiliki beberapa kekurangan seperti tidak dapat melihat perbedaan atau hubungan sebab akibat pada level individu (Meriyani et al, 2021).…”

Tren Penggunaan Antibiotik dan Profil Resistensi pada Kelompok Critical-Priority Bacteria di ICU Rumah Sakit “X” Provinsi Bali (2017-2019)

“…Nilai koefisien determinasi (R 2 ) pada keempat bakteri prioritas kritis yang tidak mencapai 100% menunjukan bahwa terdapat faktor-faktor lain yang mempengaruhi persentase resistens i bakteri prioritas kritis terhadap antibiotik selain dari tingkat penggunaan antibiotik. Faktorfaktor lain yang mempengaruhi persentase resistensi bakteri dapat dijelaskan dari berbagai aspek, antara lain aspek mikrobiologi, aspek antibiotik yang digunakan, dan aspek metodologi penelitian (Cunha, 2018;Cunha & Opal, 2018;Meriyani et al, 2021a;Meriyani et al, 2021b;Pang et al, 2019).…”

Antibiotic consumption and resistance: a 3-years ecological study for four critical groups of bacteria in a general regional hospital

“…A previous study in Indonesia's general regional hospital analyzed the relationships between antibiotic consumption and antibiotic resistance to coagulase-negative staphylococci (Meriyani et al, 2021). In Indonesia, there are no studies on the relationship between antibiotic consumption and antibiotic resistance in a critical group of MDR bacteria.…”