Determinants of carriage of resistant Staphylococcus aureus among S. aureus carriers in the Indonesian population inside and outside hospitals

被引:9
|
作者
Lestari, Endang Sri [1 ]
Duerink, D. Offra [2 ]
Hadi, Usman [3 ]
Severin, Juliette A. [4 ]
Nagelkerke, Nico J. D. [5 ]
Kuntaman, Kuntaman [6 ]
Wahjono, Hendro [1 ]
Gardjito, Widjoseno [7 ]
Soejoenoes, Ariawan [8 ]
van den Broek, Peterhans J.
Keuter, Monique [9 ]
Gyssens, Inge C. [4 ,10 ,11 ]
Verbrugh, Henri A.
机构
[1] Diponegoro Univ, Fac Med, Dept Clin Microbiol, Semarang, Indonesia
[2] Leiden Univ, Med Ctr, Dept Infect Dis, Leiden, Netherlands
[3] Dr Soetomo Hosp, Dept Internal Med, Surabaya, Indonesia
[4] Erasmus Univ, Med Ctr, Dept Med Microbiol & Infect Dis, Rotterdam, Netherlands
[5] United Arab Emirates Univ, Dept Community Med, Al Ain, U Arab Emirates
[6] Airlangga Univ, Dept Clin Microbiol, Surabaya, Indonesia
[7] Airlangga Univ, Fac Med, Dept Urol, Surabaya, Indonesia
[8] Diponegoro Univ, Fac Med, Dept Obstet & Gynaecol, Semarang, Indonesia
[9] Univ Nijmegen, Ctr Infect Dis Int Hlth, Dept Internal Med, Nijmegen, Netherlands
[10] Canisius Wilhelmina Hosp, Dept Med Microbiol & Infect Dis, Nijmegen, Netherlands
[11] Radboud Univ Nijmegen, Med Ctr, Dept Med, Nijmegen Inst Infect Inflammat & Immun N4i, Nijmegen, Netherlands
关键词
antimicrobial agents; drug resistance; risk factors; ANTIMICROBIAL RESISTANCE; METHICILLIN-RESISTANT; NASAL CARRIAGE; DEVELOPING-COUNTRIES; ESCHERICHIA-COLI;
D O I
10.1111/j.1365-3156.2010.02600.x
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
OBJECTIVES To identify determinants of carriage of resistant Staphylococcus aureus in both hospitalized patients and individuals from the community in two urban centres in Indonesia. METHODS Staphylococcus aureus cultures and data on recent antibiotic use, demographic, socioeconomic, disease-related and healthcare-related variables were collected from 3995 community dwellers and hospitalized persons. Nasal S. aureus carriage was found in 362 persons (9.1%). Logistic regression analysis was performed to identify which variables were independently associated with carriage of resistant S. aureus. RESULTS The penicillins were the most frequently used antibiotics both in the community and in hospitalized patients. In the community, admission to a hospital was associated with carriage of S. aureus resistant to any of the tested antibiotics [odds ratio (OR) 2.5, 95% confidence interval (95% CI) 1.3-4.9] and any tetracycline resistance (OR 2.4, 95% CI 1.1-5.1). Having no symptoms was associated with less carriage of S. aureus with resistance to any of the tested antibiotics (OR 0.5, 95% CI 0.3-0.9) and any tetracycline resistance (OR 0.5, 95% CI 0.3-0.9). Crowding (OR 4.5, 95% CI 1.2-4.9) and low income (OR 8.9, 95% CI 1.8-43.9) were associated with multidrug resistance. In hospitalized patients, the use of penicillins was associated with resistance to any of the tested antibiotics (OR 3.9, 95% CI 1.4-11.6) and any tetracycline resistance (OR 3.7, 95% CI 1.1-12.0). CONCLUSIONS Antibiotic policies including proper diagnosis, treatment and drug delivery process should be made by healthcare providers in Indonesia to help limit the emergence of antibiotic resistance.
引用
收藏
页码:1235 / 1243
页数:9
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