Bacterial and Antibiotics Sensitivity Patterns among Pneumonia Patients at Sanglah Hospital Denpasar, Bali

ABSTRACT Objective: To determine the differences in bacterial and antibiotic sensitivity patterns among CommunityAcquired Pneumonia (CAP) and Hospital-Acquired Pneumonia (HAP) patients at the Sanglah Hospital Denpasar, Bali. Materials and Methods: This study is a cross-sectional retrospective study conducted at Clinical Microbiology Installation of Sanglah Hospital from 1 January-31 March 2019. Sputum specimens were obtained from patients diagnosed with pneumonia. Eighty-seven samples had been consecutively selected and fulfilled 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 antibiotics. Gram-Negative bacteria were sensitive 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 difference between those who were isolated from CAP and HAP (p=0.036). Amikacin and meropenem showed ?80% sensitivity 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. A 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. KEYWORDS pneumonia, bacterial patterns, antibiotic sensitivity patterns, MDR