PENGARUH EXTENDED-SPECTRUM BETA-LACTAMASE (ESBL) TERHADAP MORTALITAS PASIEN PNEUMONIA

Raja Merlinda Veronica; Dani Rosdiana; Anwar Bet; Agustiawan

doi:10.30743/ibnusina.v24i1.703

Raja Merlinda Veronica Fakultas Kedokteran Universitas Riau
Dani Rosdiana Fakultas Kedokteran Universitas Riau
Anwar Bet Fakultas Kedokteran Universitas Riau
Agustiawan Fakultas Kedokteran Institut Kesehatan Helvetia Medan

DOI: https://doi.org/10.30743/ibnusina.v24i1.703

Keywords: Extended-spectrum beta-lactamase, Infeksi, Multi drug resistance

Abstract

Pendahuluan: Resistensi antimikroba merupakan krisis kesehatan global dalam beberapa tahun terakhir. Extended-spectrum beta-lactamase (ESBL) merupakan enzim yang diproduksi oleh bakteri yang mampu memghidrolisis golongan antibiotik beta laktam spektrum luas dan merupakan salah satu kelompok multi drug resitance (MDR). Penelitian ini bertujuan untuk mengetahui pengaruh ESBL terhadap tingkat kematian pasien pasien pneumonia. Metode: Studi observasional dengan pendekatan kohort retrospektif menggunakan data rekam medis. Pengambilan sampel dilakukan dengan consecutive sampling. Analisis bivariat dilakukan menggunakan uji chi square, dimana perbedaan signifikan jika nilai p <0,05. Hasil: Pasien dalam penelitian didominasi oleh laki-laki (59,5%) dan mereka dengan kategori usia <60 tahun (94,0%). Penderita pneumonia infeksi ESBL yang meninggal dunia sebanyak 41 orang (48,8% dari 84 orang sampel dan 89,1% dari total ESBL positif). Patogen Gram negatif terbanyak adalah Acinetobacter sp (16,7%), Escherichia coli (15,5%), Pseudomonas aeruginosa (10,7%), Stenoptrophomonas maltophilia (4,8%), Burkhoideria (24%), sedangkan patogen Gram positif yang ditemukan adalah Staphilococcus aureus (2,4%) dan Staphilococcus haemoliticus (2,4%). Sebanyak 89,1% pasien ESBL mengalami kematian, sedangkan sisanya tidak. Odds ratio (OR) mortalitas selama perawatan pada pasien dengan ESBL adalah 22,9 dengan interval kepercayaan (IK) 95% (7,1-74,4). Kesimpulan: Paparan infeksi bakteri ESBL dikaitkan dengan tingkat kematian yang lebih tinggi. Hal ini menunjukkan perlunya strategi pencegahan dan manajemen pasien dengan baik.

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