Identifikasi Pola Bakteri Aerob dan Uji Sensitivitas Antibiotik di Ruang Hemodialisis RSUD ODSK Provinsi Sulawesi Utara
DOI:
https://doi.org/10.35790/c1wtk090Keywords:
kontaminasi bakteri; multidrug-resistant; healthcare-associated infectionsAbstract
Abstract: Healthcare-Associated Infections (HAIs) pose a serious threat in healthcare facilities, particularly in hemodialysis units where patients are highly susceptible to infections due to immunocompromised conditions. This study aimed to identify aerobic bacterial contamination patterns and antibiotic sensitivity profiles in the hemodialysis unit environment. This was a descriptive observational study with a cross-sectional approach conducted at the general and VIP hemodialysis rooms of RSUD ODSK, North Sulawesi Province. Environmental samples were collected using swabs from walls, floors, air, medical equipment, and non-medical equipment (18 samples), followed by bacterial isolation, identification, and antibiotic sensitivity testing. The results showed that 17 out of 18 samples (94.4%) had bacterial growth, all being Gram-positive bacteria. The identified bacteria were Coagulase-negative Staphylococci (CoNS) (41.2%), Staphylococcus aureus (29.4%), and Bacillus sp. (29.4%). Isolates showed high sensitivity to tetracycline, meropenem, ciprofloxacin, and gentamicin, but high resistance to aztreonam (100%) and cephalosporins. Five isolates (29.4%) were categorized as Multidrug-Resistant (MDR). In conclusion, CoNS, Staphylococcus aureus, and Bacillus sp., are susceptible to tetracycline, meropenem, ciprofloxacin, gentamicin, and sulphamethoxazole/ trimethoprim, but demonstrated resistance to aztreonam, cephalothin, and cefepime.
Keywords: bacterial contamination; multidrug-resistant; healthcare-associated infections
Abstrak: Healthcare-Associated Infections (HAIs) merupakan ancaman serius di fasilitas kesehatan, khususnya di unit hemodialisis dimana pasien sangat rentan terhadap infeksi akibat kondisi imunokompromais. Penelitian ini bertujuan mengidentifikasi pola kontaminasi bakteri aerob dan profil sensitivitas antibiotik pada lingkungan ruang hemodialisis. Jenis penelitian ialah observasional deskriptif dengan desain potong lintang. Penelitian dilakukan di ruang hemodialisis umum dan VIP RSUD ODSK Provinsi Sulawesi Utara. Sampel lingkungan diambil dengan cara swab dari dinding, lantai, udara, peralatan medis, dan peralatan non-medis (18 sampel), dilanjutkan dengan isolasi bakteri, identifikasi, dan uji sensitivitas antibiotik. Hasil penelitian mendapatkan sebanyak 17 dari 18 sampel (94,4%) menunjukkan pertumbuhan bakteri, semuanya merupakan bakteri Gram-positif. Bakteri yang teridentifikasi ialah Coagulase-negative Staphylococci (CoNS) (41,2%), Staphylococcus aureus (29,4%), dan Bacillus sp. (29,4%). Isolat menunjukkan sensitivitas tinggi terhadap tetracycline, meropenem, ciprofloxacin, dan gentamicin, namun resistansi tinggi terhadap aztreonam (100%) dan cephalosporin. Terdapat lima isolat (29,4%) dikategorikan sebagai Multidrug-Resistant (MDR). Simpulan penelitian ini ialah terdapat CoNS, Staphylococcus aureus, dan Bacillus sp. yang masih sensitif terhadap tetracycline, meropenem, ciprofloxacin, gentamicin, dan sulphamethoxazole/ trimethoprim, namun resistan terhadap aztreonam, cephalothin dan cefepime.
Kata kunci: kontaminasi bakteri; multidrug-resistant; healthcare-associated infections
References
1. Tobin EH, Zahra F. Nosocomial Infections. Dalam: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 Dec 4]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK559312/
2. Sikora A, Zahra F. Nosocomial Infections. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Available from: http://www.ncbi.nlm.nih.gov/books/NBK559312/
3. Sazkiah ER, Ismah Z. The epidemiological determination of nosocomial infection in inpatients at Adam Malik General Hospital, Medan. Placentum. 2022;10(2):99–111. Doi: https://doi.org/10.20961/placentum.v10i2.54505
4. Goh LPW, Marbawi H, Goh SM, Bin Abdul Asis AK, Gansau JA. The prevalence of hospital-acquired infections in Southeast Asia (1990-2022). J Infect Dev Ctries. 2023;17(02):139–46. Doi: https://doi.org/10.3855/jidc.17135
5. Homenta H, Julyadharma, Saharman YR, Kuntaman K, Susianti H, Santosaningsih D, et al. Molecular characterization of clinical carbapenem-resistant Acinetobacter baumannii isolates from two tertiary care hospitals in Indonesia. Research Journal of Pharmacy and Technology. 2022;15(7):2917–22. Doi: https://doi.org/10.52711/0974-360X.2022.00486
6. Gach MW, Lazarus G, Simadibrata DM, Sinto R, Saharman YR, Limato R, et al. Antimicrobial resistance among common bacterial pathogens in Indonesia: a systematic review. Lancet Reg Health Southeast Asia. 2024;26:100414. Doi: https://doi.org/10.1016/j.lansea.2024.100414
7. Anggraini D, Santosaningsih D, Saharman YR, Endraswari PD, Cahyarini C, Saptawati L, et al. Distribution of carbapenemase genes among carbapenem-non-susceptible Acinetobacter baumanii blood isolates in Indonesia: a multicenter study. Antibiotics (Basel). 2022;11(3):366. Doi: https://doi.org/10.3390/antibiotics11030366
8. Homenta H, Rares FES, Waworuntu OA, Matandung LF, Sandjaya SF, Togas BC, et al. The molecular detection of blaVIM in carbapenem-resistant Acinetobacter baumannii-calcoaceticus complex infections in Indonesia. Res J Pharm Technol. 2024;17(10):5031–5. Doi: https://doi.org/10.52711/0974-360X.2024.00773
9. Homenta H, Julyadharma J, Susianti H, Noorhamdani N, Santosaningsih D. Molecular epidemiology of clinical carbapenem-resistant Acinetobacter baumannii-calcoaceticus complex isolates in tertiary care hospitals in Java and Sulawesi Islands, Indonesia. Trop Med Infect Dis. 2022;7(10):277. Doi: https://doi.org/10.3390/tropicalmed7100277
10. Alfano G, Morisi N, Giovanella S, Frisina M, Amurri A, Tei L, et al. Risk of infections related to endovascular catheters and cardiac implantable devices in hemodialysis patients. J Vasc Access. 2025;26(2):400–16. Doi: https://doi.org/10.1177/11297298241240502
11. Nguyen DB, Arduino MJ, Patel PR. Hemodialysis-associated infections. In: Chronic Kidney Disease, Dialysis, and Transplantation. Elsevier; 2019. p. 389-410.e8. Doi: https://doi.org/10.1016/B978-0-323-52978-5.00025-2
12. Shimohata T, Mawatari K, Uebanso T, Honjo A, Tsunedomi A, Hatayama S, et al. Bacterial contamination of hemodialysis devices in hospital dialysis wards. J Med Investig. 2019;66(1.2):148–52. Doi: https://doi.org/10.2152/jmi.66.148
13. Kobstan MN. Identifikasi bakteri udara di ruang hemodialisa RSUD Undata Palu tahun 2016 [Skripsi]. Palu: Universitas Tadulako; 2018.
14. Taylor TA, Unakal CG. Staphylococcus aureus Infection. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Availabe from: http://www.ncbi.nlm.nih.gov/books/NBK441868/
15. Scheuch M, von Rheinbaben FS, Kabisch A, Engeßer J, Ahrendt S, Dabers T, et al. Staphylococcus aureus colonization in hemodialysis patients: a prospective 25 months observational study. BMC Nephrol. 2019;20(1):153. Doi: https://doi.org/10.1186/s12882-019-1332-z
16. Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG. Staphylococcus aureus Infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015;28(3):603–61. Doi: https://doi.org/10.1128/CMR.00134-14
17. Michels R, Last K, Becker SL, Papan C. Update on coagulase-negative Staphylococci—what the clinician should know. Microorganisms. 2021;9(4):830. Doi: https://doi.org/10.3390/microorganisms9040830
18. Garcia RA, Spitzer ED, Beaudry J, Beck C, Diblasi R, Gilleeny-Blabac M, et al. Multidisciplinary team review of best practices for collection and handling of blood cultures to determine effective interventions for increasing the yield of true-positive bacteremias, reducing contamination, and eliminating false-positive central line-associated bloodstream infections. Am J Infect Control. 2015;43(11):1222–37. Doi: https://doi.org/10.1016/j.ajic.2015.06.030
19. Aamir M, Anam N, Muneeb MY, Imran M, `Qaisar F, Javaid A. Microbial profile and antibiotic resistance patterns of organisms causing venous catheter infections in hemodialysis units. Infect Dis J Pak. 2025;34(3):186–92. Doi: https://doi.org/10.61529/idjp.v34i3.441
20. McDowell RH, Sands EM, Friedman H. Bacillus Cereus. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available from: http://www.ncbi.nlm.nih.gov/books/NBK459121/
21. Qian J, Wang Y, Hu Z, Shi T, Wang Y, Ye C, et al. Bacillus sp. as a microbial cell factory: advancements and future prospects. Biotechnology Advances. 2023;69:108278. Doi: https://doi.org/10.1016/j.biotechadv.2023.108278
22. Durnaś B, Fiedoruk K, Cieśluk M, Deptuła P, Król G, Piktel E, et al. Lysozyme increases bactericidal activity of ceragenin CSA-13 against Bacillus subtilis. 2019;35(1):1–9. Doi: https://doi.org/10.5114/ms.2019.83847
23. Sangiorgio G, Calvo M, Stefani S. Aztreonam and avibactam combination therapy for metallo-β-lactamase-producing gram-negative bacteria: a narrative review. Clin Microbiol Infect. 2025;31(6):971–8. Doi: https://doi.org/10.1016/j.cmi.2024.11.006
24. Herrmann J, Burgener-Gasser AV, Goldenberger D, Roth J, Weisser M, Tamma PD, et al. Cefepime versus carbapenems for treatment of AmpC beta-lactamase-producing Enterobacterales bloodstream infections. Eur J Clin Microbiol Infect Dis. 2024;43(2):213–21. Doi: https://doi.org/10.1007/s10096-023-04715-5
25. Munita JM, Arias CA. Mechanisms of antibiotic resistance. Microbiol Spectr. 2016;4(2):10.1128/ microbiolspec.vmbf-0016–2015. Doi: https://doi.org/10.1128/microbiolspec.vmbf-0016-2015
26. Marciniak K, Tyczewska A, Grzywacz K. Genetics of antibiotic resistancein methicillin-resistant Staphylococcus aureus (MRSA). BioTechnologia. 2024;105(2):169–77. Doi: https://doi.org/10.5114/bta.2024.139756
27. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268–81. Doi: http://dx.doi.org/10.1111/j.1469-0691.2011.03570.x
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Alfi D. M. Mallebbang, Olivia A. Waworuntu, Velma Buntuan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
