title: Antimicrobial resistance of bacterial pathogens associated with diarrheal patients in Indonesia.
abstract: The antimicrobial susceptibility patterns for 2,812 bacterial pathogens isolated from diarrheal patients admitted to hospitals in several provinces in the cities of Jakarta, Padang, Medan, Denpasar, Pontianak, Makassar, and Batam, Indonesia were analyzed from 1995 to 2001 to determine their changing trends in response to eight antibiotics: ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, tetracycline, cephalothin, ceftriaxone, norfloxacin, and ciprofloxacin. Vibrio cholerae O1 (37.1%) was the pathogen most frequently detected, followed by Shigella spp. (27.3%), Salmonella spp. (17.7%), V. parahaemolyticus (7.3%), Salmonella typhi (3.9%), Campylobacter jejuni (3.6%), V. cholerae non-O1 (2.4%), and Salmonella paratyphi A (0.7%). Of the 767 Shigella spp. isolated, 82.8% were S. flexneri, 15.0% were S. sonnei, and 2.2% were S. dysenteriae (2.2%). The re-emergence of Shigella dysenteriae was noted in 1998, after an absence of 15 years. Shigella spp. were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline. Salmonella typhi and Salmonella paratyphi A were susceptible to all antibiotics tested, while Salmonella spp. showed various resistance patterns according to species grouping. A small number of V. cholerae O1 were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline; however, they were still sensitive to ceftriaxon, norfloxacin, and ciprofloxacin. Similar results were shown for V. cholerae non-O1. Campylobacter jejuni showed an increased frequency of resistance to ceftriaxone, norfloxacin, and ciprofloxacin, but was susceptible to erythromycin. This study shows that except for C. jejuni and V. parahaemolyticus, which appeared to be resistant to ciprofloxacin, the majority of the enteric pathogens tested were still susceptible to fluoroquinolones.
authors.affiliation: United States Naval Medical Research Unit No. 2, Jakarta, Indonesia.
authors.forename: Periska
authors.initials: P
authors.lastname: Tjaniadi
authors.forename: Murad
authors.initials: M
authors.lastname: Lesmana
authors.forename: Decy
authors.initials: D
authors.lastname: Subekti
authors.forename: Nunung
authors.initials: N
authors.lastname: Machpud
authors.forename: Shinta
authors.initials: S
authors.lastname: Komalarini
authors.forename: Wasis
authors.initials: W
authors.lastname: Santoso
authors.forename: Cyrus H
authors.initials: CH
authors.lastname: Simanjuntak
authors.forename: Narain
authors.initials: N
authors.lastname: Punjabi
authors.forename: James R
authors.initials: JR
authors.lastname: Campbell
authors.forename: William K
authors.initials: WK
authors.lastname: Alexander
authors.forename: H James
authors.initials: HJ
authors.lastname: Beecham
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Corwin
authors.forename: Buhari A
authors.initials: BA
authors.lastname: Oyofo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000472:pathogenicity; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents