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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.

References

  1. Widiana IGR. Dialysis treatment in Indonesia : focus on Bali Dialysis treatment in Indonesia : focus on Bali. 2018. doi:10.1088/1757-899X/434/1/012334
  2. Basri NS. Infection of Double Lumen Catheter as Hemodialysis Access. 2017;2(1):25-28. doi:10.7454/nrjs.v2i1.18
  3. Wilcox TA. Catheter-Related Bloodstream Infections. 2009;1(212):139-143. doi:10.1055/s-0029-1222458.
  4. Fysaraki M, Samonis G, Valachis A, Daphnis E, Karageorgopoulos DE. Incidence , Clinical , Microbiological Features and Out- come of Bloodstream Infections in Patients Undergoing Hemodialysis. 2013;10. doi:10.7150/ijms.6710
  5. Haga Y, Miyanari N, Takahashi T, et al. Risk factors for catheter-related bloodstream infections in adult hospitalized patients — multicenter cohort study hospitalized patients — multicenter cohort study. 2013;5548(October 2017). doi:10.3109/00365548.2013.807936
  6. Camargos, Viviane RosadoI; Roberta M. de C. Romanelli PAM. Risk factors and preventive measures for catheter-related bloodstream infections. doi:10.1590/S0021-75572011000600003
  7. Bicudo D, Batista R, Furtado GH, Sola A, Alexandrino E, Medeiros S De. ORIGINAL Risk factors for catheter-related bloodstream infection : a prospective multicenter study in Brazilian intensive care units. Brazilian J Infect Dis. 2011;15(4):328-331. doi:10.1016/S1413-8670(11)70200-8
  8. Unver S, Atasoyu M, Evrenkaya TR, Ardic N, Ozyurt M. Risk Factors for the Infections Caused by Temporary Double-Lumen Hemodialysis Catheters. 2006;37:348-352. doi:10.1016/j.arcmed.2005.07.010
  9. Turken M, Toker AK, Zincirlioglu C. Risk factors and Incidence of Catheter-Related Bloodstream Infections in a Tertiary Hospital ICU. 2019;3(1):32-36. doi:10.14744/ejmi.2018.0001
  10. Ãguila-arcos S, Ãlvarez-rodríguez I, Garaiyurrebaso O. Biofilm-Forming Clinical Staphylococcus Isolates Harbor Horizontal Transfer and Antibiotic Resistance Genes. 2018;8(October 2017):1-12. doi:10.3389/fmicb.2017.02018
  11. Aoki EE, Pizzolitto AC, Garcia LB, Pizzolitto EL. Staphylococcus aureus Biofilms on Central Venous Haemodialysis Catheters. 2005:342-346.
  12. Amirmorteza Ebrahimzadeh Namvar1, Babak Asghari1, Gholamreza Azizi2 ARL. Detection of the intercellular adhesion gene cluster ( ica ) in clinical Staphylococcus aureus isolates. 2013;8(1):1-4.
  13. Ryder MA. Catheter-related infections : It ’ s all about biofilm Catheter-Related Infections : It ’ s All About Biofilm. 2018;(January).
  14. Mermel LA, Allon M, Bouza E, et al. Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection : 2009 Update by the Infectious Diseases Society of America. 2009;02903:1-45. doi:10.1086/599376
  15. Leber AL. Clinical Microbiology Procedures Handbook. fourth. (Leber AL, ed.). American Society of Microbiology; 2016. doi:10.1128/9781555818814
  16. Mougari F, Jacquier H, Oliary J. High medical impact of implementing the new polymeric bead-based BacT / ALERT ® FAPlus and FNPlus blood culture bottles in standard care. 2015. doi:10.1007/s10096-015-2319-8
  17. Recommendations for Blood Culture Collection a Summary of Good Practice. 2012.
  18. Marconi C, Lourdes M De, Cunha RS, Lyra JC, Bentlin MR, Batalha JEN. Comparison Between Qualitative and Semiquantitative Catheter-Tip Cultures: Laboratory Diagnosis of Catheter-Related Infection in Newborns. 2008:262-267.
  19. Aruna Jadhav1, Vaishali Dohe2, Anju Kagal3 RB. Role of Biofilms in Staphylococcus Colonising Intravenous Catheters. 2016;8(11):15-22.
  20. Ryder MA, Science R. The Role of Biofilm in Vascular Catheter-Related Infections. 2019;(October).
  21. Regunath YHPAH. Central Line Associated Blood Stream Infections (CLABSI). 2020.

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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Medicina Journal