I Wayan Putra A.A.W (2019) Pola Bakteri Penyebab Infeksi Dan Kepekaan Antibiotik Di Pediatric Intensive Care Unit (PICU). Thesis thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Background: Gram-negative bacterial are known as common pathogen caused infection in Pediatric Intensive Care Unit (PICU). Microbial Pattern and Antibiotic Susceptibility are needed as clinical data for selected appropriate antibiotic therapy. In PICU Dr. Soetomo hospital until now still lacking of Microbial Pattern and Antibiotic Susceptibility data. Objective: To recognized Microbial Pattern and Antibiotic Susceptibility in PICU patients from blood, urine, sputum, stool, cerebrospinal fluid, endotracheal tube, pus swab and pleural fluid culture specimens. Method: This descriptive study observer medical record from patients whose admitted into PICU. Patient without signs of infections were excluded from the study. The inclusion criteria are patients with sign infection as follows: fever < 36,5° C or >37.5°C, leukocyte < 4000/mm3 or> 10000/mm3, marker infections CRP >10 mglL or PCT >0,3 ng/mL, bradycardia or tachycardia, tachypnea, infiltrates on chest X-ray, turbid urine, dysuria, thrombophlebitis, abdominal pain or tenderness, and mucous or skin lesion. Results: Medical record data from 2016 to 2018, revealed 1093 patients had positive microbial culture result, wherein positive result came from blood 34,12%, urine 22,28%, sputum 23,18%, stool 28,39%, cerebrospinal fluid (CSF) 33,66%, endotracheal tube (ETT) 30,79%, pus swab 37,93%, and pleural fluid 18,75%. The microorganisms found in PICU Dr.Soetomo was dominated with gram negative bacteria (GNB). Commonest bacterial that recognized from blood was K. Pneumonia ESBL (+), urine was E. coli, sputum was P. aeruginosa, Stool was E. coli, CSF was S.cohn ii, ETT was K. pneumoniae ESBL (+), pus swab was S. aureus, and pleural fluid was S. maltophilia. Both gram-negative bacteria (GNB) and gram-positive bacteria (GPB) isolates revealed multiple drug resistance to commonly used antibiotic, but still had good susceptibility for antibiotic such as; amikacin, cefoperazone-sulbactam, linezolid, vancomycin and carbapenem group. Conclusion: GNB are predominant pathogen in all PICU isolates sampling, both GNB and GPB isolates showed mUltiple drug resistance to commonly used antibiotic.

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