scholarly journals Pola Kuman dan Uji Kepekaan Antibiotik pada Pasien Unit Perawatan Intensif Anak di Rumah Sakit Umum Daerah Koja, Jakarta

Sari Pediatri ◽  
2017 ◽  
Vol 19 (2) ◽  
pp. 103
Author(s):  
Riza Mansyoer ◽  
Ivan R. Widjaja

Latar belakang. Pasien di unit perawatan intensif (UPI) anak (pediatric intensive care unit/PICU) merupakan pasien dengan penyakit kritis sehingga sebagian besar pasien menggunakan antibiotik. Profil resistensi bakteri akan membantu untuk pemilihan terapi empirik yang akan digunakan pada suatu unit.Tujuan. Untuk mendapatkan profil bakteri di PICU RSUD Koja berdasarkan hasil kultur, Metode. Hasil kultur yang dilakukan pada seluruh pasien yang masuk ke PICU pada periode Mei 2015 – April 2016 pada hari kerja pertama dikumpulkan dari departemen patologi klinik RSUD KojaHasil. Didapatkan 486 hasil kultur, 410 di antaranya tidak menunjukkan pertumbuhan kuman. Hasil positif terdapat pada 64 bakteri Gram-positif dan 12 Gram-negatif. Bakteri Gram positif terbanyak ditemukan adalah Staphylococcus hominis (19), Staphylococcus epidermidis (18), Staphylococcus haemolyticus (13), dan Staphylococcus aureus (9). Sementara itu, bakteri Gram negatif terbanyak ditemukan adalah Salmomella typhi (6) dan Acinetobacter baumanii (2). Pada kelompok bakteri Gram positif, antibiotik yang paling sensitif adalah vancomisin (95,2%), gentamisin (68,3%), cotrimoxazole (44,4%), cefotaxime (31,7%), dan ceftriaxone (31,7%). Pada kelompok bakteri Gram negatif, antibiotik yang paling sensitif adalah meropenem (84,6%), cotrimoxazole (84,6%), amikasin (61,5%), gentamisin (53,8%), and cefepime (46,2%).Kesimpulan. Vankomisin merupakan antibiotik yang paling poten untuk digunakan. Cefotaxime dan gentamicin kami pilih untuk digunakan sebagai antibiotik empirik di unit kami, dengan meropenem sebagai lini berikutnya. Vankomisin kami gunakan hanya pada kasus khusus.

2012 ◽  
Vol 45 (4) ◽  
pp. 475-479 ◽  
Author(s):  
Juliana Pena Porto ◽  
Orlando Cesar Mantese ◽  
Aglai Arantes ◽  
Claudete Freitas ◽  
Paulo Pinto Gontijo Filho ◽  
...  

INTRODUCTION: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI. METHODS: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and children with NI (cases) were compared with a group (matched controls) in a case-control fashion. RESULTS: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI. CONCLUSIONS: The incidence of NI acquired in this unit was high and was associated with extrinsic factors.


2008 ◽  
Vol 29 (12) ◽  
pp. 1174-1176 ◽  
Author(s):  
Aaron M. Milstone ◽  
Xiaoyan Song ◽  
Claire Beers ◽  
Ivor Berkowitz ◽  
Karen C. Carroll ◽  
...  

Routinely, children's hospitals use data from clinical cultures to estimate the burden of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) carriage. In our pediatric intensive care unit, a program of weekly surveillance cultures uncovered an unrecognized reservoir of MRSA and VRE carriers. This weekly surveillance enabled more accurate estimates of the incidence rates of MRSA and VRE carriage and led to an increased number of isolation-days for patients.


2011 ◽  
Vol 5 (08) ◽  
pp. 587-591 ◽  
Author(s):  
Khaled Menif ◽  
Asma Bouziri ◽  
Ammar Khaldi ◽  
Asma Hamdi ◽  
Sarra Belhadj ◽  
...  

Introduction: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an increasing problem worldwide. In developing countries, there is little data on CA-MRSA infection in children. This study reviewed the clinical features and outcomes of children admitted in a Tunisian pediatric intensive care unit with severe CA-MRSA infections. Methodology: Retrospective chart review of patients coded for CA-MRSA over 10 years. Results: There were 14 (0.32% of all admissions) patients identified with severe CA-MRSA infections. The median age was three months (range, 0.5-156 months). All patients had pulmonary involvement. Six children (42.8%) developed septic shock. Two (14.3%) patients had multifocal infection with deep venous thrombosis. Two (14.3%) patients died. Conclusions: Severe CA-MRSA pneumonia dominated presentation. The mortality of CA-MRSA infection in our series is lower than that previously reported.


2003 ◽  
Vol 24 (4) ◽  
pp. 299-300 ◽  
Author(s):  
Philippe Berthelot ◽  
Florence Grattard ◽  
Pascal Fascia ◽  
Christine Fichtner ◽  
Martine Moulin ◽  
...  

AbstractThis outbreak of colonization of neonates in a 10-bed pediatric intensive care unit illustrates the probable role of a healthcare worker (HCW) in the transmission of methicillin-resistant Staphylococcus aureus, despite good hygienic practices. It raises the issue of preventive exclusion of HCWs affected by chronic skin disease from high-risk units.


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