title: Determinants of carriage of resistant Staphylococcus aureus among S. aureus carriers in the Indonesian population inside and outside hospitals.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Clinical Microbiology, Medical Faculty, Diponegoro University, Semarang, Indonesia.
authors.forename: Endang Sri
authors.initials: ES
authors.lastname: Lestari
authors.forename: D Offra
authors.initials: DO
authors.lastname: Duerink
authors.forename: Usman
authors.initials: U
authors.lastname: Hadi
authors.forename: Juliëtte A
authors.initials: JA
authors.lastname: Severin
authors.forename: Nico J D
authors.initials: NJ
authors.lastname: Nagelkerke
authors.forename: Kuntaman
authors.initials: K
authors.lastname: Kuntaman
authors.forename: Hendro
authors.initials: H
authors.lastname: Wahjono
authors.forename: Widjoseno
authors.initials: W
authors.lastname: Gardjito
authors.forename: Ariawan
authors.initials: A
authors.lastname: Soejoenoes
authors.forename: Peterhans J
authors.initials: PJ
authors.lastname: Van Den Broek
authors.forename: Monique
authors.initials: M
authors.lastname: Keuter
authors.forename: Inge C
authors.initials: IC
authors.lastname: Gyssens
authors.forename: Henri A
authors.initials: HA
authors.lastname: Verbrugh
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002353:Carrier State / Q000175:diagnosis*; D024881:Drug Resistance, Bacterial; D006760:Hospitalization; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D016015:Logistic Models; D008826:Microbial Sensitivity Tests; D009296:Nasal Cavity / Q000382:microbiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification*; D013753:Tetracycline Resistance
chemical_list: D000900:Anti-Bacterial Agents