Prevalence ESBL Producing Escherichia Coli among Children in Indonesia

Abstract

Introduction: Beta-lactam antimicrobials are the most often antibiotic used for the treatment of infections worldwide, including Indonesia. Continuous exposure of these antimicrobials will induce the increasing of antimicrobial resistance, such as extended spectrum β-lactamase (ESBL). The carrier of ESBL among people will be serve as a risk factor to get an infection, especially among low immune response hospitalized patients. The aims of this study was to explore the ESBL producing gut flora and carrier rate among children visiting Primary Health Center (PHC) in Surabaya. The cross sectional study was conducted in three PHCs since February 2019 until April 2019. The total 200 children were swabbed from rectal, 100 from neonatal age and 100 from post neonatal age, then sub-cultured in MacConkey medium supplemented with cefotaxime 2 micrograms per milliliter. The growth colonies were then confirmed by DDST (Double Disk Synergy test) for ESBL producer and biochemical test for bacterial diagnosis. Result: Among 100 neonatal age were identified 14 (14%) producing ESBL consist of 9 (64,3%) ESBL producing Escherichia coli,5 (35,7%) ESBL producing non Escherichia coli. Whether among 100 post neonatal age were 37 (37%) producing ESBL consist of 25 (67,6%) ESBL producing Escherichia coli and 12 (32,4%) producing ESBL non Escherichia coli. Conclusion:Prevalence ESBL producing Escherichia coli on post neonatal age was significantly different than neonatal age (p = 0,001). Risk Factors of ESBL producing Escherichia coli on Post neonatal age and neonatal age are history of visiting hospital (p = 0,026), history of antibiotics used by mother (p = 0,043), mode of delivery (p = 0,032