Pola Bakteri dan Resistensi Antimikroba pada Infeksi Terkait Fraktur Terbuka di RSUP Prof. Dr. R. D. Kandou Manado
Authors: Senduk Ryan A. , Lengkong Andriessanto , Sunaryo Haryanto 
Published: March 2024

Abstract: Fracture-related infection is a serious complication in orthopedic trauma, both in terms of infection and surgery. The use of antibiotics is a crucial component in the management of fracture-related infection, however, it can also lead to antibiotic resistance. This study aimed to evaluate the patterns of bacteria and antimicrobial resistance in open fracture-related infections at Prof. Dr. R. D. Kandou Hospital in Manado. This was a descriptive study with a cross-sectional design. Samples consisted of patients with open fracture-related infections and had microbiological culture and drug sensitivity data. Secondary data were collected and analyzed using categorical and numerical data. The results obtained 20 subjects with the average age of 42.8±19.0 years, dominated by males (80%), and the most common location of fracture was tibia/fibula (65%). The highest multidrug resistance rates by bacterial type were found in Klebsiella and Enterobacter (medians of 9 and 7, respectively). Based on bacterial type and antimicrobial resistance, the most common bacteria were Staphylococcus aureus and Enterobacter (30%), followed by MRSA and Klebsiella (15%), Acinetobacter baumanni and Pseudomonas (1%). The highest percentage of antibiotic resistance was found in ampicillin-sulbactam, ciprofloxacin, and gentamicin. Meanwhile, the highest distribution of antibiotic sensitivity was found in trimethoprim sulfamethoxazole, amikacin, clindamycin, and meropenem. In conclusion, open fracture cases are most commonly associated with Staphylococcus aureus and Enterobacter. Antibiotic resistance is predominantly observed in ampicillin sulbactam, ciprofloxacin, and gentamicin.
Keywords: infection; open fracture; antibiotics; bacterial resistance
 
Abstrak: Infeksi terkait fraktur merupakan komplikasi serius dalam trauma ortopedi, baik dari segi infeksi maupun pembedahan. Penggunaan antibiotik menjadi salah satu bagian dalam penatalaksanaan infeksi, namun hal ini dapat mengakibatkan resistensi antibiotik. Penelitian ini bertujuan untuk mengevaluasi pola bakteri dan resistensi antimikroba pada infeksi terkait fraktur terbuka di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang. Sampel penelitian ialah pasien dengan infeksi terkait fraktur terbuka yang memiliki data hasil pemeriksaan kultur mikroba dan sensitivitas obat. Pengumpulan data melalui data sekunder dan dianalisis melalui data kategorik dan numerik. Hasil penelitian mendapatkan 20 subjek, dengan rerata usia 42,8±19,0 tahun. Majoritas subjek ialah laki-laki (80%), dan jenis fraktur terbanyak di tibia/fibula (65%). Hasil multidrug resistance tertinggi menurut jenis bakteri ialah pada Klebsiella dan Enterobacter dengan median masing-masing 9 dan 7. Berdasarkan jenis bakteri dan resistensi antimikroba, yang terbanyak yaitu Staphylo-coccus aureus dan Enterobacter (30%), diikuti MRSA dan Klebsiella (15%), Acinetobacter baumanni dan Pseudomonas (1%). Distribusi resistensi antibiotik tertinggi pada ampicilin-sulbactam, ciprofloxacin, dan gentamisin, sedangkan distribusi sensitivitas antibiotik tertinggi pada trimethoprim sulfomethoxa-zole, amikasin, clindamycin, dan meropenem. Simpulan penelitian ini ialah pada kasus patah tulang terbuka jenis bakteri terbanyak ialah Staphylococcus aureus dan Enterobacter. Resistensi antibiotik didominasi oleh ampicillin sulbactam, ciproflocacin, dan gentamicin.
Kata kunci: infeksi; fraktur terbuka; antibiotik; resistensi bakteri