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Risk Factors for Multi-Drug Resistance (MDR) Infections in COVID-19 Patients with Secondary Bacterial Infections

ACTA MEDICA INDONESIANA · Vol. 58 No. 3 (2026)

ISSN
2338-2732, 0125-9326
Terbit
2026-09-28
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: The COVID-19 pandemic has significantly affected global health, contributing to an increase in secondary bacterial infections caused by multidrug-resistant (MDR) pathogens, thereby increasing morbidity and mortality. This study aims to evaluate the risk factors of MDR bacterial infections in affected COVID-19 patients. Methods: This retrospective cohort study analyzed medical records, as well as clinical and epidemiological data of COVID-19 patients with secondary bacterial infections hospitalized in Cipto Mangunkusumo General Hospital during 2020 – 2021. During the procedures, only patients with positive microbial culture results were included. Bivariate and multivariate analyses were carried out to evaluate risk factors of MDR bacterial infections. Results: A total of 3203 medical records of COVID-19 patients were assessed, and 192 subjects were enrolled. The results showed that the most common secondary infection and pathogen were pneumonia and Acinetobacter baumanii, respectively. In addition, the most common MDR pathogen was A.baumanii. In the multivariate log-binomial analysis, the risk factors associated with MDR bacterial infections in COVID-19 were female gender (RR 1,194;CI95% 1,024 – 1,393 p 0,020), comorbidity (RR 1,181;CI95% 1,006 – 1,385, p 0,041), prior antibiotic use (RR 1.718; CI95% 1,127 – 2,620 p 0,012), and history of invasive procedure (RR 1,979;CI95% 1,423 – 2.753 p <0,001). Conclusion: Comorbidities, female gender, prior antibiotic use, and a history of invasive procedures were risk factors for secondary bacterial infections with an MDR pathogen in hospitalized COVID-19 patients.

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  • National Research and Innovation Agency
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Rekan penulisOrganisasiArtikel bersama
Hamzah ShatriAfiliasi tidak diketahui24
Leonard NainggolanAfiliasi tidak diketahui23
Sharifah ShakinahAfiliasi tidak diketahui14
Siti SetiatiAfiliasi tidak diketahui12
Rudi PutrantoAfiliasi tidak diketahui11
Adeline PasaribuAfiliasi tidak diketahui10
Evy YunihastutiAfiliasi tidak diketahui10
Sukamto KoesnoeAfiliasi tidak diketahui9
Murdani AbdullahAfiliasi tidak diketahui9
Anshari Saifuddin HasibuanAfiliasi tidak diketahui8
Randy AdiwinataAfiliasi tidak diketahui8
Chyntia Olivia Maurine JasirwanAfiliasi tidak diketahui8
Suzy MariaAfiliasi tidak diketahui7
Iris RengganisAfiliasi tidak diketahui7
Irsan HasanAfiliasi tidak diketahui7
Eka GinanjarAfiliasi tidak diketahui7
Muhadi MuhadiAfiliasi tidak diketahui6
Andhika RachmanAfiliasi tidak diketahui6
Pringgodigdo NugrohoAfiliasi tidak diketahui6
Juferdy KurniawanAfiliasi tidak diketahui6
Lugyanti SukrismanAfiliasi tidak diketahui5
Adityo SusiloAfiliasi tidak diketahui5
Rudy HidayatAfiliasi tidak diketahui5
Dyah PurnamasariAfiliasi tidak diketahui5
Soekamto KoesnoeAfiliasi tidak diketahui5
Imam SubektiAfiliasi tidak diketahui5
Arif MansjoerAfiliasi tidak diketahui5
Mira YuliantiNational Research and Innovation Agency4
Em YunirUniversity of Indonesia4
Ika Prasetya WijayaAfiliasi tidak diketahui3
Kuntjoro HarimurtiAfiliasi tidak diketahui3

Afiliasi berasal dari OpenAlex; metadata OAI-PMH jurnal tidak memuatnya. Penulis tanpa ID OpenAlex dicocokkan berdasarkan nama, sehingga dua orang bisa tergabung atau satu orang bisa terpisah.

Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Risk Factors for Multi-Drug Resistance (MDR) Infections in COVID-19 Patients with Secondary Bacterial Infections</dc:title>
	<dc:creator>Lie, Khie Chen</dc:creator>
	<dc:creator>Rianto, Rezky Ananda</dc:creator>
	<dc:creator>Sinto, Robert</dc:creator>
	<dc:creator>Rumende, Cleopas Martin</dc:creator>
	<dc:creator>Sakinah, Sharifah</dc:creator>
	<dc:creator>Nelwan, Erni Juwita</dc:creator>
	<dc:creator>Nasution, Sally Aman</dc:creator>
	<dc:creator>Rinaldi, Ikhwan</dc:creator>
	<dc:creator>Widhani, Alvina</dc:creator>
	<dc:subject xml:lang="en-US">COVID-19</dc:subject>
	<dc:subject xml:lang="en-US">secondary bacterial infection</dc:subject>
	<dc:subject xml:lang="en-US">MDR bacterial infection</dc:subject>
	<dc:description xml:lang="en-US">Background: The COVID-19 pandemic has significantly affected global health, contributing to an increase in secondary bacterial infections caused by multidrug-resistant (MDR) pathogens, thereby increasing morbidity and mortality. This study aims to evaluate the risk factors of MDR bacterial infections in affected COVID-19 patients. Methods: This retrospective cohort study analyzed medical records, as well as clinical and epidemiological data of COVID-19 patients with secondary bacterial infections hospitalized in Cipto Mangunkusumo General Hospital during 2020 – 2021. During the procedures, only patients with positive microbial culture results were included. Bivariate and multivariate analyses were carried out to evaluate risk factors of MDR bacterial infections. Results: A total of 3203 medical records of COVID-19 patients were assessed, and 192 subjects were enrolled. The results showed that the most common secondary infection and pathogen were pneumonia and Acinetobacter baumanii, respectively. In addition, the most common MDR pathogen was A.baumanii. In the multivariate log-binomial analysis, the risk factors associated with MDR bacterial infections in COVID-19 were female gender (RR 1,194;CI95% 1,024 – 1,393 p 0,020), comorbidity (RR 1,181;CI95% 1,006 – 1,385, p 0,041), prior antibiotic use (RR 1.718; CI95% 1,127 – 2,620 p 0,012), and history of invasive procedure (RR 1,979;CI95% 1,423 – 2.753 p &amp;lt;0,001). Conclusion: Comorbidities, female gender, prior antibiotic use, and a history of invasive procedures were risk factors for secondary bacterial infections with an MDR pathogen in hospitalized COVID-19 patients.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2026-09-28</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2810</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 58 No. 3 (2026): Acta Medica Indonesiana; 369</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2810/886</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2026 khie chen Lie, Rezky Ananda Rianto, Robert Sinto, Cleopas Martin Rumende, Sharifah Sakinah, Erni Juwita Nelwan, Sally Aman Nasution, Ikhwan Rinaldi, Alvina Widhani</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>