Clinical Features And Antimicrobial Resistance Pattern Of Patients With Cap Caused By K. Pneumoniae In Jakarta, Indonesia

Background:K. pneumoniae is the major etiology of CAP in Asian countries that causes high mortality index. In contrast, it is rarely found in Western countries. We aimed to investigate the clinical features of CAP patients who were infected by K. pneumoniae and the pattern of antimicrobial resistance. Methods: We performed a cross-sectional study among CAP patients treated in Persahabatan Hospital Jakarta, Indonesia. We collected patients data and specimens from sputum, blood, and pleural fluid. All specimens would be cultured for microorganism identification and tested for antibiotic resistance. Results: Among 97 CAP patients, positive monomicrobial K. pneumoniae was identified in 23 patients. Most of them were 19-64 years old (82.6%), males (60.9%), had pulmonary comorbidity (60.9%), and malnutrition (65.2%). %). The predominant symptoms were dypsneu (100%), cough (91.3%), and fever (82.6%). In addition, chest pain symptom was found in 9 (39.1%) patients and it was statistically significant (p<0.05). Chest radiograph showed infiltrates in 91.3% cases and 50% from 4 cases of pleural effusion were found in K. pneumoniae group. Extended spectrum beta-lactamase (ESBL) K. pneumoniae was detected in 2 (8.7%) isolates and they were still susceptible to carbapenem and amikacin. All non-ESBL isolates were resistant to ampicillin, but they were susceptible to quinolon, aminoglycosides, cephalosporin, and carbapenem. Conclusion: The proportion of K. pneumoniae related CAP in Jakarta, Indonesia was 23% and the frequency of ESBL K. pneumoniae was 8.7%. It was frequently found in adult patients < 65 years old, males, and patients who had pulmonary comorbidity.