USIA < 18 TAHUN, MALNUTRISI DAN TERAPI IMUNOSUPRESAN SEBAGAI FAKTOR RISIKO KEJADIAN INFEKSI ALIRAN DARAH YANG DISEBABKAN OLEH COAGULASE NEGATIVE STAPHYLOCOCCI PADA PASIEN RAWAT INAP

nia krisniawati  -  Universitas Jenderal Soedirman Purwokerto, Indonesia
Vincentia Rizke Ciptaningtyas*  -  Departemen Mikrobiologi Klinik Fakultas Kedokteran Universitas Diponegoro, Indonesia
Winarto Reki  -  , Indonesia

(*) Corresponding Author

LATAR BELAKANG: Coagulase-negative Staphylococci (CoNS) merupakan penyebab utama terjadinya infeksi aliran darah  nosokomial dan kontaminan yang paling sering ditemukan pada kultur darah. Di Indonesia sendiri belum pernah ada yang meneliti faktor risiko yang berkaitan dengan infeksi aliran darah oleh CoNS.

TUJUAN: Untuk mengidentifikasi faktor risiko kejadian infeksi aliran darah yang disebabkan oleh CoNS pada pasien rawat inap.

METODE: Disain penelitian adalah cross sectional retrospektif menggunakan data sekunder dengan hasil kultur darah CoNS periode 1 Januari-31 Desember 2016 di RSUP Dr. Kariadi Semarang. Analisis bivariat dengan Chi square test atau Fischer exact test, dan analisis multivariat dilakukan dengan regresi logistik multipel.

HASIL: Dari  total 272 pasien dilibatkan dalam  penelitian ini,  158  (58,1%) adalah  kasus infeksi aliran darah yang disebabkan oleh CoNS. Faktor risiko terjadinya infeksi aliran darah oleh CoNS adalah : Kelompok usia <18 tahun (PR= 1,661, p<0,0001), prematuritas (PR=1,620, p=0,002), BBLR (PR=1,620, p=0,002), immunocompromised (PR=1,468, p<0,0001), malnutrisi (PR=1,554, p<0,0001), terapi imunosupresan (PR=1,374, p=0,032), pemakaian  infus perifer (PR=1,480, p=0,025). Analisis multivariat menunjukkan faktor risiko yang bermakna adalah:  kelompok usia <18 tahun (PR=3,992, p<0,0001),  malnutrisi (PR=4,051, p=0,008) dan  terapi imunosupresan (PR=3,711, p=0,042).   

KESIMPULAN: Kelompok usia <18 tahun, malnutrisi dan terapi imunosupresan adalah faktor risiko  yang meningkatkan kejadian infeksi aliran darah yang disebabkan oleh CoNS.

Keywords: Faktor Risiko, Coagulase Negative Staphylococci (CoNS), Multivariat, Bivariat

  1. Karsten becker CH, Georg Peters. Coagulase-Negative Staphylococci. Clinical Microbiology Reviews 2014;27: 870–926.
  2. M. A. Dudeck LMW, K. Allen-Bridson et al. National Healthcare Safety Network (NHSN) report, data summary for 2012, device-associated module. American Journal of Infection Control;41:1148-66.
  3. World Health Organization (WHO). Report on the Burden of Endemic Health Care Associated Infection Worldwide. 2016. (Accessed: 5 May 2018,
  4. Mahesh B Savithri VI, Mark Jones,, Trent Yarwood DL. Epidemiology and significance of coagulase-negative staphylococci isolated in blood cultures from critically ill adult patients. Crit Care Resuscitacion 2011;13:103-7.
  5. L. Elzi BB, N. Vo¨ geli, R. Laffer, M. Dangel. . How to discriminate contamination from bloodstream infection due to Coagulase-negative Staphylococci: a prospective study with 654 patients. Clin Microbiol Infect 2012;18:E355-E61.
  6. Kirn TJ, and Weinstein,M.P. Update on blood cultures :how to obtain, process, report, and interpret. ClinMicrobiolInfect 2013;19:513-20.
  7. Elizabeth A.Marchant GKB, Manish Sadarangani and Pascal M. Lavoie. Neonatal Sepsis due to Coagulase-Negative Staphylococci. Clinical and Developmental Immunology 2013;2013:1-10.
  8. Infection due to coagulase-negative staphylococci: Epidemiology, microbiology, and pathogenesis. 2017. (Accessed: 5 May 2018, at www.uptodate.com.)
  9. Nguyen TH, Matthew D. Park, and Michael Otto. “Host Response to Staphylococcus Epidermidis Colonization and Infections". Frontiers in Cellular and Infection Microbiology 2017;7.
  10. De Oliveira A SP, Lyra JC, Bentlin MR, Rugolo LMSS Risk Factors for Infection with Coagulase-Negative Staphylococci in Newborns from the Neonatal Unit of a Brazilian University Hospital Clinical Medicine Insights Pediatrics 2012;6:1-9.
  11. Hilal Ozkan MC, Nilgün Koksal, Solmaz Celebi, Mustafa Hacımustafaoglu. Culture-proven neonatal sepsis in preterm infants in a neonatal intensive care unit over a 7 year period: Coagulase-negative Staphylococcus as the predominant pathogen. 2014;56:60-6.
  12. Soeorg Hiie HKM, Parm Ülle MD, PhD. Genetic Relatedness of Coagulase-negative Staphylococci From Gastrointestinal Tract and Blood of Preterm Neonates With Late-onset Sepsis. The Pediatric Infectious siDisease Journal 2013;32:389-93.
  13. Matthew J. Bizzarro MD VSM, Robert S. Baltimore MD. Neonatal Sepsis 2004-2013: The Rise and Fall of Coagulase-Negative Staphylococci. The Journal of Pediatrics 2015;166:1193-9.
  14. Adilson de Oliveira, Patrícia Sanches, João C. Lyra, Maria R. Bentlin. Risk Factors for Infection with Coagulase-Negative Staphylococci in Newborns from the Neonatal Unit of a Brazilian University Hospital. Clin Med Insights Pediatr. 2012; 6: 1–9
  15. M. Bjorkqvist, M. Liljedahl, J. Zimmermann, J. Schollin, and B. ¨ Soderquist, “Colonization pattern of coagulase-negative staphylococci in preterm neonates and the relation to bacteremia,” European Journal of Clinical Microbiology & Infectious Diseases, vol. 29, no. 9, pp. 1085–1093, 2010.
  16. Shailpreet K.Shidu et al. Significance of coagulase negative Staphylococcus from blood cultures: persisting problems and partial progress in resource constrained settings. Volume 8 Number 6 (December 2016) 366-37.
  17. Uduak A. Okomo et al. Bacterial Isolates and Antibiotic Sensitivity among Gambian Children with Severe Acute Malnutrition International Journal of Pediatrics Volume 2011, Article ID 825123, 8 pages
  18. E. Montassier EB, T. Gastinne, G. Potel M. F. de La Cochetière. Recent changes in bacteremia in patients with cancer: a systematic review of epidemiology and antibiotic resistance. European Journal of Clinical Microbiology & Infectious Diseases 2013;32:841-50.
  19. George Samonis KZ, Vardakas Sofia. A prospective study of characteristics and outcomes of bacteremia in patients with solid organ or hematologic malignancies. Supportive Care in Cancer 2013;21:2521-6.
  20. Karakullukçu A, et al, Determination of clinical significance of coagulase-negative staphylococci in blood cultures, Diagn Microbiol Infect Dis (2016), http://dx.doi.org/10.1016/j.diagmicrobio.2016.12.006

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ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

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