Kuntaman
Department of Microbiology,
School of Medicine Airlangga University
Dr. Soetomo Hospital Surabaya
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VAP
1. the presence of new or progressive radiographic
infiltrates plus clinical evidence that these
infiltrates are of infectious origin.
2. Mostly caused by commen/saphr microbials
from environments
3. Earlier identifiation of clinical sign and
symptoms are benefecial.
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Luna1 and Chirino.Critical Care 2004, 8:425-426 (DOI 10.1186/cc2988)
ESBL Multicentre Study 2010
Surabaya, Semarang, Malang
Producing microbes Total %
Citrobacter spp 3 1.5
Ent aerogenes 1 0.5
Entero cloacae 12 6
E coli 91 44
Kleb oxytoca 2 1
Kleb pneumo 93 45
Proteus mir 1 0.5
Seratia fonficola 1 0.5
Seratia marcescens 1 0.5
Total 205 100
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ESBL Producers 2010
Surabaya, Semarang, Malang
E coli Kleb pne
(n=91) (n=93)
Antibiotic Res (%) Res (%)
CTX 89 97,8 87 93,55
MEM 0 0 3 3,23
FOS 4 4,4 3 3,23
Cefo-Sulb 3 3,3 4 4,30
AK 7 7,7 8 8,60
CIP 68 74,7 43 46,24
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Isolates 2010
Specimens: ESBL Producers SBY,
MLG
Kleb pne
E coli (%) (%)
Spec Malang Sby Malan
Sby (n=18) (n=44 g
(n=46) ) (n=26)
Ur 46 39 22 19
Blo 8 11 13 8
Pus 13 33 29 35
Spu 11 11 31 31 11
Team work is the best solution for
Diagn & management of VAP
Clinician/s
Clin Microbiologist
Clin Pharmacist
Infection Control practitioner
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