Bacterial Spectrum and Antibiotic Resistance Profiles in Infected Severe Head Injury Patients at Ngoerah Hospital, January–December 2024

A BSTRACT Background: Severe head injuries are conditions that often cause death and high morbidity. Patients with severe head injuries are more susceptible to nosocomial infections, which can develop into sepsis due to the use of invasive medical devices and a weakened immune system. With increasing bacterial resistance to antibiotics, treating infections has become difficult. Therefore, to choose the right empirical therapy, local data on the types of bacteria and their resistance patterns are needed. Methods: This study was a descriptive observational study with a cross-sectional design. Data were obtained from the medical records of severe head injury patients who developed infections and underwent bacterial culture and antibiotic susceptibility testing at Ngoerah General Hospital from January to December 2024. The variables included patient characteristics, type of infection, causative bacterial isolates, and antibiotic resistance patterns. Data were analyzed descriptively using SPSS version 29.1. Results: Out of 138 severe head injury patients treated in the intensive care unit (ICU), 43 patients (31.2%) developed infections, in the form of pneumonia (86%) and urinary tract infection (14%). Most patients were male and of productive age. All patients used invasive medical devices, and the majority had undergone surgical procedures. The most frequently isolated bacteria were Klebsiella pneumoniae (35%), followed by Pseudomonas aeruginosa (21%), Staphylococcus aureus (14%), and Escherichia coli (14%). Antibiotic susceptibility testing revealed high resistance rates to cephalosporins, particularly cefazolin and ceftriaxone, especially among Gram-negative bacteria. Meropenem remained relatively effective against most bacterial isolates. Conclusion: Infections in severe head injury patients treated in the ICU at Ngoerah General Hospital were predominantly sepsis caused by Gram-negative bacteria, particularly K. pneumoniae . The high level of resistance to cephalosporins underscores the importance of continuous surveillance of local bacterial patterns and antibiotic resistance. Strict implementation of antimicrobial stewardship programs is essential to support rational antibiotic use and to control the spread of antimicrobial resistance in hospital settings.