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Microbial and Resistance Profile in Isolate from Adult Sepsis Patients: An Observational Study at an Indonesian Private Hospital during 2009-2012

Sepsis is a systemic infection with a high mortality rate. The common pathogen that is found in sepsis is a bacterial pathogen, therefore, appropriateness in antibiotic use is very important to decrease the mortality and morbiditys rate in patients with sepsis. The selection of antibiotics requires information about the location of source infection, the common pathogen that develops into an infection, and the local sensitivity pattern of antibiotics. This study aimed to analyze the pattern of the infection source, the organism isolated from various specimens, and the local resistance of antibiotics in adult patients with sepsis in order to support the rational of antibiotics use in septic patients. An observational retrospective study was conducted at a Bandung private hospital in Indonesia from March to May 2012. Data were collected from the hospital medical record department on the adult patient population diagnosed with sepsis during January 2009-March 2012. Thirty-nine patients met the criteria as subject population with 67% on the mortality rate. Respiratory source infection (36%) was the highest source infection that developed to sepsis in the subject population. Microbial culture showed that only 50% tested positive. Escherichia coli, Streptococcus viridans, and Candida sp were the highest microbials that were detected in culture. Of the subject population, 37.14% showed a level of antibiotic resistance ≥50%, there were levofloxacine, ceftriaxone, doripenem, ciprofloxacine, cefotaxime, cefepime, gentamiycine, and canamycine. A policy on the use of antibiotics with a high resistance level and a collaboration among medical doctors, clinical pharmacists, microbiologists and nurses are needed to increase the rational use of antibiotics in patients with sepsis.