PhD Defence Y.R. (Yulia) Saharman

Antimicrobial resistance constitutes a threat to global health, especially in lower-middle income countries (LMICs) including Indonesia. Intensive care units (ICUs) are high-risk areas for acquisition of resistant bacteria. Carbapenem class antibiotics are often used in this setting and carbapenem resistance has emerged. We here describe the epidemiology of carbapenem-non-susceptible Acinetobacter baumannii (CNAB), Klebsiella pneumoniae (CNKP) and Pseudomonas aeruginosa (CNPA) in two ICUs in the National Referral Hospital in Jakarta, Indonesia. After an initial baseline phase, an intervention to reduce the acquisition of resistant strains was applied using a set of inexpensive measures that were deemed feasible to implement in a low-resource ICU. We found the resistance genes  blaOXA-23-like , blaOXA-24-like, in combination with OXA-23/OXA-58, OXA-23/NDM-1 genes in CNAB. In CNKP we demonstrated the presence of the blaNDM gene in all isolates. CNPA was mainly due to the presence of blaGES-5, blaVIM-2-8, and blaIMP-1-7-43 genes. These three species were endemic in the ICU with a few clones circulating among ICU patients and the environment. The multimodal intervention was essentially feasible and shown to be quite effective in these ICUs.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall of the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.