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Mikroorganisme Penyebab Infeksi Kateter Lumen Ganda pada Pasien Hemodialisis Dengan dan Tanpa Diabetes Mellitus



Abstract

Background: One of the complications of double lumen catheter (DLC) access in hemodialysis patients is bloodstream infection which increases patient mortality and morbidity. Diabetes mellitus (DM) is one of the comorbid factors. Acknowledging the bacteria causing DLC infection in hemodialysis patients with or without DM at Sanglah Hospital is the aim of this study. 

Materials and methods: This was a cross-sectional descriptive study with a period of 12 months, January to December 2019. The sample included adult hemodialysis regular patients who diagnosed with DLC infection with suspected catheter-related Blood Stream Infection (CRBSI). 

Results: Samples were 72 patients with 58.3% male. There were 50 blood cultures, 60 DLC cultures, and 19 swab cultures. Recorded as many as 52 patients (72%) were examined for 2 types of specimens and 4 patients (5%) had all three. Thirty-four percent (17) of blood culture specimens exhibited the same bacterial growth with DLC or swab cultures or both. The predominant bacteria were Staphylococcus aureus 47% (8 samples), almost half were methicillin-resistant Staphylococcus aureus (MRSA) followed by coagulase-negative staphylococci and Enterococcus spp.  Total of 44.4% (32 patients) known to have DM but revealed no significant correlation with the incidence of DLC infection and CRBSI. The pattern of microorganism growth in cultures was same in DM and non DM groups. 

Conclusion: Staphylococcus aureus and coagulase-negative staphylococci indicated as the most common bacteria found in DLC infections at Sanglah Hospital in 2019.

 

Latar belakang: Salah satu komplikasi penggunaan akses kateter lumen ganda (KLG) pada pasien hemodialisis adalah infeksi aliran darah yang meningkatkan mortalitas dan morbiditas. Diabetes mellitus (DM) menjadi salah satu faktor komorbidnya. Mengetahui mikroorganisme penyebab kejadian infeksi kateter lumen ganda pada pasien hemodialisis dengan atau tanpa DM di RSUP Sanglah menjadi tujuan  penelitian ini.

Bahan dan metode: Ini adalah studi deskriptif potong lintang dengan jangka waktu 12 bulan (Januari hingga Desember 2019). Sampel meliputi pasien hemodialisis dewasa dengan akses KLG, terdiagnosis KLG terinfeksi dengan kecurigaan infeksi aliran darah terkait kateter (Catheter-Related Blood Stream Infection atau CRBSI).

Hasil: Sampel berjumlah 72 dengan 58,3% laki-laki. Spesimen kultur darah berjumlah 50, kultur KLG 60 dan kultur swab 19. Total 52 pasien (72%) diperiksa 2 jenis spesimennya sedangkan 4 pasien (5%) diperiksa ketiganya. Kultur darah menunjukkan pertumbuhan bakteri yang sama dengan kultur lainnya pada 17 spesimen (34%). Bakteri yang mendominasi adalah Staphylococcus aureus 47% (8 pasien) dengan hampir setengahnya methicillin resistant Staphylococcus aureus (MRSA) diikuti oleh Staphylococcus koagulase negatif dan Enterococcus spp. Sebanyak 44,4% (32 pasien) memiliki riwayat DM namun tidak menunjukkan korelasi yang signifikan dengan kejadian infeksi KLG dan infeksi aliran darah terkait kateter. Pola pertumbuhan mikroorganisme dari kultur ditemukan serupa pada kelompok pasien DM dan tidak DM.

Kesimpulan. Staphylococcus aureus dan Staphylococcus koagulase negatif merupakan bakteri penyebab infeksi KLG terbanyak di RSUP Sanglah pada tahun 2019.

Keywords: Catheter-Related Blood Stream Infection DLC culture blood culture swab culture

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How to Cite

Setiabudy, M., I Ketut Agus Indra Adhiputra, Agus Eka Darwinata, & Ni Nengah Dwi Fatmawati. (2021). Mikroorganisme Penyebab Infeksi Kateter Lumen Ganda pada Pasien Hemodialisis Dengan dan Tanpa Diabetes Mellitus. Medicina, 52(2), 97–102. https://doi.org/10.15562/medicina.v52i2.1092
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Marta Setiabudy
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Medicina Journal

I Ketut Agus Indra Adhiputra
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Agus Eka Darwinata
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Ni Nengah Dwi Fatmawati
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