Extended spectrum beta-lactamase-producing Escherichia coli surveillance in the human, food chain, and environment sectors: Tricycle project (pilot) in Indonesia
Nelly Puspandari,
Sunarno Sunarno,
Tati Febrianti,
Dwi Febriyana,
Ratih Dian Saraswati,
Indri Rooslamiati,
Novi Amalia,
Sundari Nursofiah,
Yudi Hartoyo,
Herna Herna,
Mursinah Mursinah,
Fauzul Muna,
Nurul Aini,
Yenni Risniati,
Pandji Wibawa Dhewantara,
Puttik Allamanda,
Dwi Nawang Wicaksana,
Rinto Sukoco,
Efadeswarni,
Erni Juwita Nelwan,
Cahyarini,
Budi Haryanto,
Benyamin Sihombing,
Ricardo J. Soares Magalhães,
Manish Kakkar,
Vivi Setiawaty,
Jorge Matheu
Affiliations
Nelly Puspandari
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; Corresponding author.
Sunarno Sunarno
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Tati Febrianti
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Dwi Febriyana
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Ratih Dian Saraswati
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Indri Rooslamiati
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Novi Amalia
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Sundari Nursofiah
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Yudi Hartoyo
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Herna Herna
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Mursinah Mursinah
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Fauzul Muna
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Nurul Aini
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Yenni Risniati
Centre for Research and Development of Health Resources and Services, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Pandji Wibawa Dhewantara
Centre for Research and Development of Public Health Efforts, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Puttik Allamanda
Disease Investigation Center Subang, West Java, Indonesia
Dwi Nawang Wicaksana
Disease Investigation Center Subang, West Java, Indonesia
Rinto Sukoco
Disease Investigation Center Subang, West Java, Indonesia
Efadeswarni
Research and Development for Environmental Quality and Laboratory Center, Banten, Indonesia
Erni Juwita Nelwan
Ciptomangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
Cahyarini
Persahabatan Hospital, Jakarta, Indonesia
Budi Haryanto
Persahabatan Hospital, Jakarta, Indonesia
Benyamin Sihombing
WHO, Indonesia
Ricardo J. Soares Magalhães
School of Veterinary Science, University of Queensland, Australia
Manish Kakkar
WHO South-East Asian Regional Officer, India
Vivi Setiawaty
Centre for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia
Jorge Matheu
WHO Food Safety and Zoonoses Department, Geneva, Switzerland
The World Health Organization (WHO) has been implementing antimicrobial surveillance with a “One Health” approach, known as the Global Surveillance ESBL E. coli Tricycle Project. We describe the implementation of the Tricycle Project (pilot) in Indonesia, focusing on its results, challenges and recommendations. The samples were 116 patients with bloodstream infections caused by ESBL E. coli, 100 rectal swabs collected from pregnant women, 240 cecums of broiler, and 119 environmental samples, using the standardized method according to the guidelines. ESBL-producing E. coli was found in 40 (40%) of the 100 pregnant women, while the proportion of ESBL-producing E. coli was 57.7% among the total E. coli-induced bloodstream infections. ESBL-producing E. coli was isolated from 161 (67.1%) out of 240 broilers. On the other hand, the average concentration of E. coli in the water samples was 2.0 × 108 CFU/100 mL, and the ratio of ESBL-producing E. coli was 12.8% of total E. coli. Unfortunately, 56.7% of questionnaires for patients were incomplete. The Tricycle Project (pilot) identified that the proportion of ESBL-producing E. coli was very high in all types of samples, and several challenges and obstacles were encountered during the implementation of the study in Indonesia. The finding of this study have implication to health/the antimicrobial resistance (AMR) surveillance. We recommend continuing this project and extending this study to other provinces to determine the AMR burden as the baseline in planning AMR control strategies in Indonesia. We also recommend improving the protocol of this study to minimize obstacles in the field.