Insidensi Infeksi Nosokomial Gastroenteritis pada Pasien Anak di RSUP Dr. Sardjito Yogyakarta

Ananda Savira Tri Octaviani, Prof. dr. Indah Kartika Murni, M.Kes., Sp.A(K)., Ph.D ; dr. Sasmito Nugroho, Sp.A (K)

2025 | Skripsi | PENDIDIKAN DOKTER

Latar belakang: Infeksi nosokomial gastroenteritis sering terjadi di bangsal perawatan anak dan berkontribusi signifikan terhadap morbiditas dan mortalitas anak di seluruh dunia. Infeksi ini dapat memperpanjang masa rawat inap, meningkatkan biaya perawatan, dan menurunkan kualitas hidup pasien anak. Di Indonesia, insidensinya mencapai 15,74%, melebihi rata-rata negara maju. Penyebab infeksi meliputi bakteri seperti Salmonella dan Escherichia coli, serta virus enterik seperti rotavirus dan norovirus yang sering ditemukan pada pasien anak yang dirawat di rumah sakit. Meskipun infeksi nosokomial gastroenteritis menjadi masalah kesehatan yang signifikan, data terkait insidensinya di Indonesia, khususnya di RSUP Dr. Sardjito Yogyakarta, masih terbatas. Oleh karena itu, diperlukan penelitian lebih lanjut untuk memahami beban infeksi ini serta mengevaluasi efektivitas strategi pencegahan infeksi nosokomial gastroenteritis pada pasien anak.

Metode : Penelitian ini menggunakan studi kohort retrospektif yang menggunakan rekam medis pasien anak usia 1 bulan sampai kurang dari 18 tahun yang dirawat inap di bangsal anak dan pediatric ICU di RSUP Dr. Sardjito periode Juni tahun 2016 - Maret tahun 2018.

Tujuan: Penelitian ini bertujuan untuk mengetahui insidensi infeksi nosokomial Gastroenteritis pada pasien anak di RSUP Dr. Sardjito, Yogyakarta pada periode Juni tahun 2016 - Maret tahun 2018.

Hasil : Insidensi infeksi nosokomial gastroenteritis di RSUP Dr. Sardjito Yogyakarta pada periode 2016-2018 mencapai 41,61%, yang tergolong tinggi. Analisis bivariat menunjukkan bahwa usia dan durasi rawat inap memiliki pengaruh signifikan terhadap risiko infeksi nosokomial gastroenteritis. Anak usia 12-18 tahun memiliki risiko lebih rendah dibandingkan dengan usia 0-5 tahun dengan odds ratio sebesar 0,051 (95% CI: 0,011 – 0,227; p-value = 0,001). Durasi rawat inap yang lebih pendek juga menurunkan risiko infeksi dengan odds ratio sebesar 0,360 (95% CI: 0,140 – 0,927; p-value = 0,034). Status gizi normal menunjukkan efek protektif dibandingkan dengan gizi buruk dengan odds ratio sebesar 0,364 (95% CI: 0,159 – 0,834; p-value = 0,017), tetapi odds ratio untuk keseluruhan status gizi tidak signifikan. Sementara itu, jenis kelamin dan komorbiditas tidak menunjukkan pengaruh signifikan terhadap risiko infeksi nosokomial gastroenteritis.

Kesimpulan : Usia dan durasi rawat inap merupakan faktor yang secara signifikan mempengaruhi insidensi infeksi nosokomial gastroenteritis pada pasien anak di RSUP Dr. Sardjito Yogyakarta.

Kata kunci: Infeksi nosokomial, insidensi, gastroenteritis, anak

Backgrounds : Gastroenteritis nosocomial infections are common in pediatric care wards and contribute significantly to pediatric morbidity and mortality worldwide. These infections can prolong hospitalization, increase the cost of care, and reduce the quality of life of pediatric patients. In Indonesia, the incidence reaches 15.74%, exceeding the average of developed countries. Causes of infection include bacteria such as Salmonella and Escherichia coli, as well as enteric viruses such as rotavirus and norovirus which are frequently found in hospitalized pediatric patients. Although gastroenteritis nosocomial infection is a significant health problem, data related to its incidence in Indonesia, especially in Dr. Sardjito Hospital Yogyakarta, is still limited. Therefore, further research is needed to understand the burden of this infection and evaluate the effectiveness of strategies to prevent nosocomial gastroenteritis infection in pediatric patients.

Methods: This study used a retrospective cohort study using medical records of pediatric patients aged 1 month to less than 18 years who were hospitalized in the pediatric ward and pediatric ICU at RSUP Dr. Sardjito for the period June 2016 - March 2018.

Objective : This study aims to determine the incidence of Gastroenteritis nosocomial infection in pediatric patients at Dr. Sardjito General Hospital, Yogyakarta from June 2016 to March 2018. This study applied a retrospective cohort study using medical records of pediatric patients aged 1 month to less than 18 years who were hospitalized in the pediatric ward and pediatric ICU at Dr. Sardjito Hospital for the period June 2016 - March 2018.

Results : The results showed that the incidence of nosocomial gastroenteritis infection at Dr. Sardjito Hospital Yogyakarta in the 2016-2018 period reached 41.61%, which is classified as high. Bivariate analysis showed that age and duration of hospitalization had a significant influence on the risk of nosocomial gastroenteritis infection. Children aged 12-18 years had a lower risk than those aged 0-5 years with an odds ratio of 0.051 (95% CI: 0.011 - 0.227; p-value = 0.001). Shorter duration of hospitalization also decreased the risk of infection with an odds ratio of 0.360 (95% CI: 0.140 - 0.927; p-value = 0.034). Normal nutritional status showed a protective effect compared to poor nutrition with an odds ratio of 0.364 (95% CI: 0.159 - 0.834; p-value = 0.017), but overall OR for nutritional status was not significant. Meanwhile, gender and comorbidity did not show a significant effect on the risk of nosocomial gastroenteritis infection.

Conclusion : Age and duration of hospitalization are factors that significantly affect the incidence of nosocomial gastroenteritis infection in pediatric patients at Dr. Sardjito Hospital Yogyakarta.

Keywords: Nosocomial infections, incidence, gastroenteritis, children

Kata Kunci : Infeksi nosokomial, insidensi, gastroenteritis, anak