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ABSTRAK
Ventilator-Associated Pneumonia (VAP) merupakan infeksi nosokomial yang sampai saat ini masih menjadi masalah di bidang kesehatan. Hal ini disebabkan oleh tingkat mortalitas dan morbiditas VAP yang tinggi, biaya pengobatan yang besar, serta banyaknya bakteri penyebab VAP yang resisten terhadap antibiotik. Pola kepekaan bakteri penyebab VAP terhadap antibiotik sangat dibutuhkan sebagai acuan pemberian terapi empiris sehingga penangangan terhadap VAP dapat dilakukan secara cepat dan tepat. Tujuan penelitian ini adalah untuk mengetahui pola kepekaan bakteri penyebab VAP di ICU RSUP H. Adam Malik periode Juli-Desember 2014.
Penelitian ini merupakan penelitian deskriptif dengan desain potong lintang
dengan sumber data dari data rekam medis pasien yang didagnosis VAP di RSUP H.Adam Malik Periode Juli-Desember 2014 yang diisi dengan lengkap dan mempunyai data uji kepekaan terhadap antibiotik.
Didapatkan 27 isolat bakteri, 19 onset cepat dan 8 onset lambat. Dari 27 isolat, 26 isolat (96,3%) diantaranya merupakan bakteri Gram negatif. Bakteri yang paling dominan Acinetobacter baumannii (48,1%), diikuti Klebsiella pneumonia (25,9%), Escherichia coli (14,8%), Pseudomonas aeruginosa (3,7%), lalu Stenotrophomonas maltophilia
(3,7%). Bakteri Gram positif penyebab VAP adalah Staphylococcus aureus 1 isolat
(3,7%). Berdasarkan uji kepekaan, Acinetobacter baumannii (N=13) peka terhadap
amikacin (6 isolat), Escherichia coli (N=4) peka terhadap amikacin,
trimethoprim/sulfamethoxazole, dan tigecycline (4 isolat), Klebsiella pneumonia (N=7)
peka terhadap amikacin dan tigecycline (6 isolat), Pseudomonas aeruginosa (N=1) peka
terhadap meropenem dan tigecycline (1 isolat), Stenotrophomonas maltophilia (N=1)
peka terhadap tigecycline, dan Staphylococcus aureus (N=1) masih peka terhadap banyak antibiotik. Prevalensi VAP pada penelitian ini adalah 3,35%.
Kesimpulan penelitian ini adalah Acinetobacter baumannii merupakan penyebab
utama VAP dan rata-rata bakteri Gram negatif peka terhadap golongan carbapenem, amikacin, tigecycline, dan trimethoprim/sulfamethoxazole.
Kata kunci : Ventilator-associated pneumonia, kepekaan, bakteri, prevalensi
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ABSTRACT
Ventilator associated pneumonia (VAP) is a nosocomial infection that still become a health problem until now. This is caused by high rates of mortality and morbidity of VAP, high medical expenses, as well as the number of VAP-causing bacteria that are resistant to antibiotics. Susceptibility pattern VAP-causing bacteria to antibiotics is needed as a reference so that the handling of empirical therapy for VAP can be done quickly and accurately.
The purpose of this study was to determine the prevalence and the susceptibility pattern of bacteria isolated from VAP suspected patients. This is a descriptive study with cross sectional method. The source data is from the VAP patient’s medical record, who were hospitalized in RSUP H. Adam Malik on July-December 2014, that were filled completely with the data of antibiotic susceptibility test.
From this study, there were 27 isolates, that consist of 19 early onset and 8 late onset. Twenty six from 27 isolates (96,3%) were Gram-negative bacteria. The most dominant bacteria was Acinetobacter baumannii (48,1%), followed by Klebsiella pneumonia (25,9%), Escherichia coli (14,8%), Pseudomonas aeruginosa (3,7%), and onether isolate was Stenotrophomonas maltophilia (3,7%). Gram-positive bacteria that found in this study is Staphylococcus aureus 1 isolate (3,7%). Based on susceptibility test, Acinetobacter baumannii (N=13) were sensitive to amikacin (6 isolates), Escherichia coli (N=4) were sensitive to amikacin, trimethoprim/sulfamethoxazole, and tigecycline (4 isolates), Klebsiella pneumonia (N=7) were sensitive to amikacin and tigecycline (6 isolates), Pseudomonas aeruginosa (N=1) was sensitive to meropenem and tigecycline (1 isolates), Stenotrophomonas maltophilia (N=1) was sensitive to tigecycline, and Staphylococcus aureus (N=1) still sensitive to most of the tested antibiotics. The prevalence of VAP in this study was 3,35% .
In conclusion, Acinetobacter baumannii is a major cause of VAP. Most of the Gram-negative bacteria are sensitive to carbapenem class, amikacin, tigecycline, and trimethoprim/sulfamethoxazole.
