Parameter Bakteremia pada Anak dengan Keganasan dan Demam Neutropenia
DOI:
https://doi.org/10.21776/ub.jkb.2010.026.02.9Abstract
ABSTRAKDemam netropenia merupakan komplikasi yang serius dan sering pada anak dengan keganasan dan dapat mengancam
nyawa. Meskipun demikian bukti menunjukkan bahwa infeksi lokal maupun sistemik ditemukan pada 48-60% dari
episode demam netropenia namun hanya16-20% diantaranya mengalami bakteremia. Bakteremia merupakan baku emas
diagnosis infeksi bakteri yang mempengaruhi prognosis dan dapat meningkatkan resiko kematian. Studi cross-sectional ini
dilakukan in bangsal Hematologi-Onkologi Anak RS dr. Saiful Anwar untuk mengidentifikasi gejala dan gambaran klinis
infeksi serta parapmeter bakteremia pada anak dengan keganasan dan febrile netropenia. Subjek penelitian melibatan 68
pasien anak dengan keganasan dan demam netropenia yang dirawat di rumah sakit dan mendapatkan kemoterapi.
Parameter bakteremia yang dianalisis terdiri dari infeksi klinis, suhu tubuh saat episode demam netropenia, jumlah
lekosit, neutrofil, monosit dan fagosit absolut. Secara klinis 65 dari 68(95.5%) mengalami infeksi tetapi bakteremia hanya
ditemukan pada 14 dari 68 kultur darah pasien(20,6%). Infeksi klinis yang terkait dengan baktermia adalah infeksi saluran
pernafasan akut non pneumonia (p=0.047; OR=3.7; CI 95% 0,96-14,40). Parameter klinis yang terbukti berhubungan
dengan bakteremia adalah jumlah netrofil absolute (p = 0,003) dan fagosit absolut (p = 0,013). Dapat disimpulkan bahwa
infeksi saluran pernafasan akut non pnemoni, jumlah netrofil dan fagosit absolut dapat digunakan sebagai parameter
klinis bakteremia pada anak dengan keganasan dan demam netropenia.
Kata Kunci : Anak, bakteremia, demam netropenia, keganasan
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