Prof. Dr. Kuntaman, dr., MS., Sp.MK-K

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ESBL's Clinical Impact

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Extended-spectrum b-Lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae from Clinical Isolates in Dr. Soetomo Hospital Surabaya and Antimicrobial alternative drugs


By: Kuntaman

Department of Clinical Microbiology,

School of Medicine Airlangga University / Dr. Soetomo Hospital



Presented: Annual Meeting IKABI, Yogyakarta 2007



The prevalence of ESBL producing Escherichia coli and Klebsiella pneumoniae isolated from clinical specimens in Dr. Soetomo Hospital Surabaya, Indonesia was high,  29 % (115 of 403) and 36 % (105 of 292), respectively. The ESBL producers were isolated from urine (66%), faeces (20%), wound swabs or pus (11%) for Escherichia coli and from urine (45%), wound swabs or pus (23%), sputum/bronchial aspirate (22%) for Klebsiella pneumoniae.

Antimicrobial resistance rates of ESBL-producing bacteria’s to third generation cephalosporin were high, i.e.: Cefotaxime (90.4%), Ceftriaxone (95.7%), Ceftazidime (55.7%) for Escherichia coli and 81.9%, 94.3%, 87.8% for Klebsiella pneumoniae, respectively. The resistance rate against ciprofloxacin (79% for Escherichia coli, 60% for Klebsiella pneumoniae) was likewise high. Highly active drugs against ESBL-producing Escherichia coli and Klebsiella pneumoniae were Meropenem (resistance rate: 2.6% and 1.9%), Cefotetan (1% and 0%), Cefoxitin (7% and 10.3%) and Fosfomycin (8.7% and 13.3%). The resistance rates of other antimicrobial drugs were as follows: Cefepime (48% & 56%), Amikacin (19% & 28%), Amoxycillin-Clavulanic acid (40% & 44%) and Cefoperazone-sulbactam (15% & 27%).

The principles of the prudent use of antimicrobial drug should be implemented in hospital, especially hospital with high incidence of antimicrobial resistance.


Keywords: Extended Spectrum Beta-Lactamase (ESBL), Escherichia coli, Klebsiella pneumoniae, Prevalence, susceptibility testing. 

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