Profil Pasien dengan Infeksi Nosokomial di Ruang Perawatan Pediatric Intensive Care Unit (PICU) dan Luka Bakar RSUP dr. Sardjito 2014

SAMUEL YUDHISTIRA, dr. Andaru Dahesihdewi, M.Kes., Sp.PK(K); dr. Nurnaningsih, Sp.A(K)

2015 | Skripsi | PENDIDIKAN DOKTER

Latar belakang: Infeksi nosokomial (INOS) menyebabkan beban baik pada pasien maupun petugas kesehatan. Pengadaan surveilans secara rutin perlu dilakukan untuk mengurangi angka kejadian INOS. Tujuan: Mengetahui prevalensi dan profil pasien dengan INOS di ruang Pediatric Intensive Care Unit (PICU) dan luka bakar RSUP dr. Sardjito. Metode: Penelitian ini memiliki rancangan deskriptif observasional. Data karakteristik diambil dari rekam medis pasien dirawat di ruang PICU dan luka bakar RSUP. dr. Sardjito periode bulan April-Oktober 2014. Hasil: Prevalensi INOS ruang PICU adalah 9,6% dan luka bakar 0% dengan karakteristik: 10 (50%) berjenis kelamin laki-laki; 11 (55%) berumur di bawah 2 tahun; rata-rata durasi rawat inap 21 hari; diagnosis utama gangguan respirasi 6 (30%), gastrointestinal 5 (25%), kardiovaskuler 4 (20%), neurologis 4 (20%), dan genitourinari 1 (5%); riwayat penggunaan IV line 20 (100%), ventilator 19 (95%), kateter urin 17 (85%), NGT 17 (85%), CVC 2 (10%), antibiotik 19 (95%), H2 antagonis 11 (55%), dan steroid 10 (50%). Ventilator-associated pneumonia merupakan jenis infeksi tersering (n=12; 50%), diikuti oleh ISK (n=5; 20,8%), HAP (n=5; 20,8%), dan ILO (n=2; 8,4%). Sebanyak 15 (75%) penderita keluar dengan status meninggal. Kesimpulan: Ventilator-associated pneumonia merupakan jenis INOS terbanyak. Kebanyakan penderita berumur di bawah 2 tahun. Diagnosis utama yang paling sering ditemukan adalah gangguan respirasi. Kebanyakan pasien memiliki riwayat penggunaan IV line dan pengobatan dengan antibiotik.

Background: Nosocomial infection (NI) increases patient and health personnel burden. Routine surveillance is needed to reduce the nosocomial infection prevalence. Aim: To determine NI prevalence and NI patients' characteristics in Pediatric Intensive Care Unit (PICU) and burn unit of RSUP dr. Sardjito. Method: An observational descriptive study was performed in PICU and burn unit between April and October 2014. Data was collected from patients' medical record. Results: The prevalence of NI for PICU and burn unit were 9,6% and 0% respectively. Ten (50%) patients were male. Eleven (55%) patients were below 2 years of age. Most patients has a mean length of stay of 21 days. The most common primary diagnosis were respiratory disease (n=6, 30%) followed by cardiovascular disease (n=4, 20%), neurological disease (n=4, 20%), and genitourinary disease (n=1, 5%). The most used device were IV line (n=20, 100%), followed by ventilator (n=19, 95%), urinary catheter (n=17, 85%), NGT (n=17, 85%), CVC (n=2, 10%). Nineteen (95%) patients were treated with antibiotic, 11 (55%) with H2 antagonist, and 10 (50%) with steroid. Ventilator-associated pneumonia has the highest incidence rate (n=12; 50%), followed by UTI (n=5; 20,8%), HAP (n=5; 20,8%), and surgical wound infection (n=2; 8,4%). The mortality rate among NI patients were 75% (n=15). Conclusions: Ventilator-associated pneumonia has the highest incidence rate. Most NI patients were below 2 years of age. Respiratory diseases were the most common primary diagnosis among NI patients. Most patients were using IV line and treated with antibiotic.

Kata Kunci : profil, infeksi nosokomial, RSUP dr. Sardjito, pediatric intensive care unit, luka bakar