Hubungan Kejadian Infeksi Carbapenem Resistant Acinetobacter baumannii dengan Penggunaan Antibiotika Golongan Karbapenem pada Pasien di Rumah Sakit St. Carolus
Abstract
Acinetobacter baumannii (Acb) adalah salah satu bakteri gram negatif oportunis yang ada di lingkungan. Karbapenem merupakan salah satu agen antibiotik yang digunakan untuk pengobatan infeksi Acb. Laju resistensi Acb terhadap karbapenem dalam beberapa tahun terakhir selalu mengalami peningkatan dengan prevalensi di seluruh dunia mencapai 30%. Penelitian ini bertujuan untuk melihat hubungan kejadian infeksi Carbapenem Resistant Acinetobacter baumannii (CRAB) dengan penggunaan antibiotik karbapenem di rumah sakit St. Carolus. Metode penelitian ini yaitu observasional analitik dengan desain studi case control. Penelitian dilakukan di Rumah Sakit St. Carolus pada bulan Juni–Agustus 2019. Jumlah sampel dalam penelitian ini adalah 149 pasien (110 pasien terinfeksi CRAB, 39 pasien terinfeksi Carbapenem Sensitive Acinetobacter baumannii (CSAB)). Data yang diperoleh dianalisis secara univariat, bivariat dan multivariat menggunakan SPSS versi 22. Analisis multivariat dilakukan dengan analisis regresi logistik etiologik. Hasil analisis multivariat penelitian ini adalah penggunaan antibiotik karbapenem pada pasien dengan riwayat masuk Intensive Care Unit (ICU) memiliki peluang meningkatkan risiko CRAB (odds ratio (OR)=32,266; p=0,020). Penggunaan antibiotik golongan karbapenem paling tidak 24 jam sebelum pengambilan spesimen kultur Acb pada pasien yang menerima perawatan di ICU dalam periode inap merupakan faktor risiko terjadinya infeksi CRAB menjadi lebih tinggi.
Kata kunci: Acinetobacter baumannii, CRAB, karbapenem, resistensi antibiotik
The Relationship between Infection of Carbapenem Resistant Acinetobacter baumannii and the Use of Carbapenem on Patients at St. Carolus Hospital
Abstract
Acinetobacter baumannii (Acb) is one of the negative-gram opportunistic bacteria existing in the environment. However, carbapenem antibiotic agent is used for the treatment of this infection. Furthermore, the rate of Acb resistance to carbapenem has been increasing in recent years with the worldwide p revalence reaching 30%. Therefore, this research aims to determine the relationship between the incidence of Carbapenem Resistant Acinetobacter baumannii (CRAB) and the effects of carbapenem antibiotics on patients at St. Carolus Hospital. This was an observational analytic study using case-control design, and conducted at St. Carolus Hospital from June to August 2019. The number of samples were 149 patients, 110 were infected with CRAB, while 39 were with Carbapenem Sensitive Acinetobacter baumannii (CSAB). The obtained data were analyzed using univariate, bivariate, and multivariate analyses with SPSS. The multivariate analysis was performed with etiologic logistic regression. The use of carbapenem antibiotics on patients with the history of Intensive Care Unit (ICU) increased the probability of CRAB infection (odds ratio (OR)=32.266; p=0.020). In addition, the administration of carbapenem antibiotics to patients in ICU, 24 hours before collecting Acb specimen, was a risk factor that increased CRAB infection.
Keywords: Acinetobacter baumannii, antibiotic resistance, carbapenem, CRAB
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DOI: https://doi.org/10.15416/ijcp.2020.9.3.189
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