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Prevalensi dan Pola Sensitivitas Enterobacteriaceae Penghasil ESBL di RSUD Arifin Achmad Pekanbaru

Dewi Anggraini, Uswathun Hasanah Sholihin, Maya Savira, Fauzia Andrini Djojosugito, Dino Irawan, Ruza Prima Rustam
  Jurnal Kedokteran Brawijaya, Vol 30, No. 1 (2018),  pp.47-52  

Abstract


Resistensi antibiotik merupakan masalah besar baik di rumah sakit maupun di masyarakat, resistensi menyebabkan pilihan terapi infeksi menjadi terbatas. Prevalensi resistensi antibiotik cenderung makin meningkat, salah satu diantaranya adalah bakteri ESBL (extended spectrum beta lactamases), suatu kelompok bakteri penghasil enzim yang dapat menghidrolisis antibiotik beta laktam yang mengandung grup oxyimino seperti sefalosporin generasi satu sampai ketiga dan aztreonam. Penelitian ini  dilakukan secara deskriptif retrospektif yang bertujuan untuk mengetahui prevalensi ESBL pada Klebsiella pneumoniae dan Escherichia coli, serta pola sensitivitasnya di RSUD Arifin Achmad Pekanbaru. Data diambil dari hasil kultur bakteri dan uji resistensi antibiotik dari berbagai spesimen klinik yang diperiksa di Laboratorium Mikrobiologi RSUD Arifin Achmad selama tahun 2015. Uji ESBL dilakukan dengan alat VITEK 2 compact yang membandingkan antara proporsi penurunan pertumbuhan bakteri terhadap antibiotik sefalosporin saja dengan antibiotik kombinasi sefalosporin ditambah asam klavulanat. Hasil penelitian menunjukkan ESBL-K. pneumoniae sebesar 66,2%, dan ESBL-E. coli 62,2%, dan total rata-rata pada kedua bakteri 65,2%. Prevalensi ESBL-K. pneumoniae dan ESBL-E. coli paling tinggi berasal dari ruangan Instalasi Perawatan Intensif Anak dan berasal dari spesimen sputum dan pus, namun secara statistik tidak didapatkan perbedaan bermakna proporsi ESBL positif dan negatif berdasarkan asal ruangan dan jenis spesimen. Sensitivitas ESBL-K. pneumoniae dan ESBL-E. coli paling baik dengan antibiotik golongan karbapenem, amikasin dan tigesiklin. Penelitian ini menunjukkan tingginya prevalensi K. pneumoniae dan E. coli penghasil ESBL di RSUD Arifin Achmad dibanding beberapa rumah sakit rujukan nasional dii Indonesia. Saran untuk menurunkan angka ESBL dengan cara mencegah transmisi melalui penerapan kewaspadaan kontak dan kewaspadaan berbasis transmisi, aspek pencegahan dan pengendalian infeksi dan peningkatkan rasionalisasi penggunaan antimikroba harus dilakukan.

Keywords


ESBL; Escherichia coli; Klebsiella pneumonae; pola sensitivitas

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References


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DOI: http://dx.doi.org/10.21776/ub.jkb.2018.030.01.9

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