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ndonesia will soon have its first national figure on antimicrobial resistance prevalence, enabling health officials to establish policies in tackling the resistance.

“We need to establish special policies to rationalize the use of available antimicrobial agents at hospitals and other health care facilities. Antimicrobial resistance will cause a longer duration of illness, resulting in longer treatment that will be too costly,” Supriyantoro, the Health Ministry’s Health Management Efforts director general, said Saturday.

However, he said, tackling antimicrobial resistance could not be done without national data on antimicrobial resistance prevalence and the pattern of its resistance.

“We actually have data on the antimicrobial susceptibility pattern of bacteria isolated at hospitals nationwide, but we haven’t integrated the data,” said Supriyantoro at the 7th National Symposium of Indonesia Antimicrobial Resistance Watch (IARW) recently. “I hope we can have the data by the end of this year.”

Indonesia is a country with a high number of antimicrobial resistance cases, he said.

Antimicrobial resistance is resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive, the World Health Organization (WHO) reports.

The antimicrobial resistance data will include multidrug-resistant tuberculosis (MDR-TB), antiretroviral drug resistance and methicillin-resistant staphylococcus aureus (MRSA).

Amin Soebandrio, a clinical microbiologist from the University of Indonesia’s School of Medicine, said hospitals in Indonesia had different antimicrobial resistance both in the number of cases and patterns.

“In some hospitals, the prevalence of antimicrobial resistance can reach only less than 10 percent, but in other hospitals the prevalence can reach up to 30 percent,” Amin said.

Big hospitals with excessive use of antibiotics may have a higher prevalence of antimicrobial resistance. On the contrary, Amin said, hospitals in remote areas might have lower prevalence if they do not use antibiotics excessively.

More patients at hospitals and long-term health care facilities in Indonesia are affected by MRSA caused by the wrong use of antimicrobials, microbiologists say.

Endang Sri Lestari, a clinical microbiologist from Karyadi teaching hospital in Semarang, Central Java, said patients infected with MRSA continued to grow due to inappropriate management of affected patients.

Citing recent research held at Semarang’s Karyadi hospital, Endang said of a thousand respondents enrolled in her two-year survey, about 7.1 percent were MRSA positive. “The figure was quite high,” Endang said.

MRSA is exacerbated by medical workers’ negligence in sanitation, health experts said. Many nurses and doctors neglect to wash their hands after treating wounds, for example. MRSA commonly shows in skin rashes.

Khanchit Limpakarnjanarat, the WHO representative for Indonesia, said antimicrobial resistance was possibly the single biggest threat facing the world in the area of infectious diseases.

Few hospitals provide a standard treatment guideline, causing irrational use of available antimicrobial agents. “If it is provided, only a few have the will to implement it,” Khanchit said.

Multidrug-resistant tuberculosis (TB) has also become a serious problem in Indonesia. Despite improved public health, the prevalence of such TB cases among new cases continue to grow due to the increasing number of newly diagnosed HIV /AIDS cases. Multidrug resistant cases are increasingly common among people with HIV.

According the WHO, there are 440,000 new multidrug-resistant TB cases each year that cause at least 150,000 deaths per year. In 2009, Indonesia ranked 8th of 27 countries with the highest cases in the world.