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Antimicrobial resistance among commensal isolates of Escherichia coli and Staphylococcus aureus in the Indonesian population inside and outside hospitals

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Abstract

The prevalence of antimicrobial resistance among the commensal microflora was examined in the Indonesian population inside and outside hospitals. A total of 3,995 individuals were screened in two major urban centers. Among Escherichia coli from rectal samples (n = 3,284) the prevalence of resistance to ciprofloxacin and other classes of antibiotics was remarkably high, especially in individuals at the time of discharge from hospital. Staphylococcus aureus isolates (n = 361) were often resistant to tetracycline (24.9%), but this was not associated with hospital stay. Two S. aureus isolates harbored the mecA gene. Regional differences in resistance rates exist, suggesting regional differences in selection pressure, i.e., antibiotic usage patterns. The results show that antimicrobial resistance among commensal E. coli and S. aureus has emerged in Indonesia.

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Acknowledgements

We thank the deans of the Medical Faculty, University of Airlangga, Surabaya, Indonesia, and the Medical Faculty, University of Diponegoro, Semarang, Indonesia, the directors of the Dr. Soetomo Hospital, Surabaya, Indonesia, and the Dr. Kariadi Hospital, Semarang, Indonesia, who have facilitated our work in these teaching hospitals. We also thank the staff in the microbiology laboratory, School of Medicine, Airlangga University/Dr. Soetomo Hospital Surabaya and School of Medicine, Diponegoro University/Dr. Kariadi Hospital Semarang, the staff in the Tropical Disease Center, Airlangga University and Province Laboratory East Java, Surabaya, Indonesia, who have been involved in the isolation and susceptibility testing of bacteria. We also gratefully acknowledge the contribution of medical students Diana Huis in‘t Veld, Susanne Werter, Rianne de Jong, and Rozemarijn van der Meulen from the Radboud University Medical Center, Nijmegen, The Netherlands, who helped us with the collection of specimens in Indonesia. This work was supported by the Royal Netherlands Academy of Arts and Sciences (KNAW), Science Programme Indonesia Netherlands (SPIN, Project 99-MED-03), and the CORDAID/PERDHAKI organization (Association of Voluntary Health Services of Indonesia).

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Authors and Affiliations

  1. Department of Clinical Microbiology, Dr. Kariadi Hospital - School of Medicine, Diponegoro University, Semarang, Jl. Dr. Soetomo 16–18, Semarang, 50231, Indonesia

    E. S. Lestari & H. Wahjono

  2. Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, ’s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    J. A. Severin, P. M. G. Filius & H. A. Verbrugh

  3. Department of Clinical Microbiology, Dr. Soetomo Hospital - School of Medicine, Airlangga University, Surabaya, Jl. Prof. Dr. Moestopo 6–8, Surabaya, 60132, Indonesia

    K. Kuntaman

  4. Department of Infectious Diseases, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    D. O. Duerink

  5. Department of Internal Medicine, Dr. Soetomo Hospital - School of Medicine, Airlangga University, Surabaya, Jl. Prof. Dr. Moestopo 6–8, Surabaya, 60132, Indonesia

    U. Hadi

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  1. E. S. Lestari
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  2. J. A. Severin
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  3. P. M. G. Filius
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On behalf of the study group Antimicrobial Resistance in Indonesia: Prevalence and Prevention (AMRIN)

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Correspondence to E. S. Lestari.

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Members of the AMRIN study group: Dr. Soetomo Hospital-School of Medicine, Airlangga University Surabaya, Indonesia: Prof. Widjoseno Gardjito, M.D.; Erni P. Kolopaking, MPPM; Prof. Karjadi Wirjoatmodjo, M.D.; Prof. Djoko Roeshadi, M.D., Ph.D.; Prof. Eddy Suwandojo, M.D.; Prof. Eddy Rahardjo, M.D., Ph.D.; Prof. Ismoedijanto M.D., Ph.D.; Prof. Paul Tahalele, M.D., Ph.D.; Prof. Hendromartono, M.D., Ph.D.; Hari Parathon, M.D.; Usman Hadi, M.D.; Nun Zairina, Hosp. Pharm.; Mariyatul Qibtiyah, Hosp. Pharm.; Endang Isbandiati, M.D., Ph.D.; Kartuti Deborah, M.D.; Prof. K. Kuntaman, M.D. Ph.D.; Ni Made Mertaniasih, M.D., Ph.D.; Marijam Purwanta, M.Sc.; Lindawati Alimsardjono, M.D.; Maria Inge Lusida, M.D., Ph.D. Dr. Kariadi Hospital-School of Medicine, Diponegoro University Semarang, Indonesia: Prof. Ariawan Soejoenoes, M.D.; Budi Riyanto, M.D.; Proj. Hendro Wahjono, M.D., Ph.D.; Musrichan Adhisaputro, M.D.; Winarto, M.D., Bambang Isbandrio, M.D., Subakir, M.D., Bambang Triwara, Hosp. Pharm.; Johnny Syoeib, M.D.; Endang Sri Lestari, M.D.; Bambang Wibowo, M.D.; Muchlis AU Sofro, M.D.; Helmia Farida, M.D., M.Sc.; M.M.D.E.A.H. Hapsari, M.D. Leiden University Medical Center, Leiden, The Netherlands: Prof. Peterhans van den Broek M.D., Ph.D.; D. Offra Duerink, M.D., M.A. Erasmus MC University Medical Center, Rotterdam, The Netherlands: Prof. Henri A. Verbrugh, M.D., Ph.D.; Inge C. Gyssens, M.D., Ph.D. Radboud University Medical Center, Nijmegen, The Netherlands: Monique Keuter, M.D., Ph.D.

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Lestari, E.S., Severin, J.A., Filius, P.M.G. et al. Antimicrobial resistance among commensal isolates of Escherichia coli and Staphylococcus aureus in the Indonesian population inside and outside hospitals. Eur J Clin Microbiol Infect Dis 27, 45–51 (2008). https://doi.org/10.1007/s10096-007-0396-z

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