Pola Resistensi Antibiotik Pasien Infeksi Pneumonia Nosokomial: Tantangan Dalam Pengelolaan Infeksi Di RSUP Dr.Hasan Sadikin Bandung

Nurul Kamilah Sadli, Eli Halimah, Rina Winarni, Leonardus Widyatmoko

Sari


Infeksi Hospital-Acquired Pneumonia (HAP) dan Ventilator-Associated Pneumonia (VAP) merupakan infeksi nosokomial yang sering terjadi pada pasien rawat inap, terutama setelah tindakan intubasi, dan dapat menyebabkan perpanjangan lama rawat inap serta peningkatan mortalitas sehingga memerlukan tatalaksana antibiotik yang tepat. Penelitian ini bersifat deskriptif observasional retrospektif bertujuan menggambarkan pola penggunaan antibiotik, pola resistensi, dan profil bakteri penyebab pneumonia nosokomial serta hubungannya terhadap luaran klinis lama rawat inap dan mortalitas di RSUP Dr. Hasan Sadikin periode 2019–2021. Teknik pengambilan sample dilakukan dengan total sampling, sehingga diperoleh 46 sampel yang memenuhi kriteria inklusi. Hasil menunjukkan bahwa patogen terbanyak adalah Acinetobacter baumannii (31%), Klebsiella pneumoniae (26%), Pseudomonas aeruginosa (14%), Stenotrophomonas maltophilia (12%), dan Escherichia coli (7%). Regimen antibiotik yang paling sering digunakan adalah kombinasi seftazidim + levofloksasin (34%) dan meropenem + levofloksasin (30%). Beberapa antibiotik β-laktam (ampisilin-sulbaktam, seftazidim, sefepime, meropenem) menunjukkan tingkat resistensi terhadap A. baumannii, K. pneumoniae, P. aeruginosa, dan E. coli (0%–91%), dan terhadap antibotik florokuinolon (40-100%), sedangkan tigesiklin tetap menunjukkan tingkat resistensi relatif rendah terhadap A.baumannii (17%), K. pneumoniae (32%) dan E. coli (0%). Infeksi yang disebabkan oleh A.baumannii dan S. maltophilia, serta isolat Carbapenem-Resistant A.baumannii (CR-Ab), Carbapenem-Resistant K. pneumoniae (CR-Kp) dan Extended-Spectrum Beta-Lactamase (ESBL), berkaitan secara signifikan terhadap lama rawat inap.


Kata Kunci


Restensi; Antibiotik; Hospital-Acquired Pneumonia; Ventilator-Acquired Pneumonia

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DOI: https://doi.org/10.33024/jikk.v12i9.19748

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