GAMBARAN BAKTERI DAN SENSITIVITAS ANTIBIOTIK PADA PASIEN STROKE DENGAN SEPSIS DI RUANG NEUROLOGI RSUP HAJI ADAM MALIK MEDAN
Authors: Ekayana Etiya , Fithrie Aida , Nasution Irina Kemala 
Published: April 2021

BACTERIAL PATTERN AND ANTIBIOTICS SENSITIVITY OF SEPSIS STROKE PATIENTS IN NEUROLOGY INPATIENT ROOMS OF HAJI ADAM MALIK GENERAL HOSPITAL MEDANABSTRACTIntroduction: Stroke patients are at high risk of sepsis because of the immune-suppressive effect of cerebral damage and the immobilization due to neurological deficit. The choice of empiric antibiotics for sepsis depends on epidemiology data of the bacterial pattern and antibiotics sensitivity.Aims: To know the incidence rate, bacterial pattern and antibiotics sensitivity of sepsis stroke patients in Haji Adam Malik General Hospital.Methods: A descriptive study of sepsis stroke patients in intensive stroke corner care and neurology ward of Adam Malik General Hospital, Medan, during February 2018-June 2018. The diagnosis of sepsis was based on the Criteria of American College of Chest Physicians (ACCP) and Society of Critical Care Medicine (SCCM).Results: From total of 153 stroke patients admitted between February and June 2018, 28.2% stroke patients were identified with sepsis; 20 patients in stroke corner and 23 patients in neurology ward. The average of time to develop sepsis was 4.74±1.9 days based on the increasing of procalcitonin level in blood. Aerobic and gram negative organisms were dominating the microbiologic spectrum (97.7% and 86%, respectively). The most common etiology of sepsis in were Klebsiella Pneumonia and Acinetobacter Baumanii. The most sensitive antibiotics were Amikacin and Meropenem.Discussion: There were 28.3% subjects diagnosed with sepsis due to Klebsiella Pneumonia (40%) and Acinetobacter Baumanii (39.1%) infection which are aerobic gram negative bacteria. Amikacin and meropenem were the most sensitive antibiotics against the bacteria which cause the sepsis.Keywords: Antibiotic sensitivity, bacterial pattern, sepsis, strokeABSTRAKPendahuluan: Adanya kerusakan serebral (cerebral injury) berefek penekanan terhadap sistem imun serta imobilisasi akibat defisit neurologis menyebabkan pasien stroke berisiko tinggi untuk mengalami sepsis. Pemilihan antibiotik empiris pada sepsis tergantung pada data epidemiologi dari pola bakteri dan sensitivitas antibiotik.Tujuan: Untuk mengetahui persentase kejadian sepsis dan gambaran bakteri dan sensitivitas antibiotik pada pasien stroke dengan sepsis di ruang rawat inap Neurologi RSUP Haji Adam Malik.Metode: Studi deskriptif pada pasien stroke dengan sepsis di ruang intensif stroke corner dan ruang rawat inap terpadu (Rindu) RSUP Haji Adam Malik, Medan selama Februari-Juni 2018. Diagnosis sepsis didasarkan pada Kriteria American College of Chest Physicians (ACCP) dan Society of Critical Care Medicine (SCCM).Hasil: Dari total 152 pasien stroke yang dirawat pada bulan Februari hingga Juni 2018 dijumpai sebanyak 28,2% yang mengalami sepsis; yang terdiri dari 20 orang di stroke corner dan 23 orang di bangsal neurologi. Rerata waktu terjadinya sepsis adalah 4,74±1,9 hari dengan peningkatan rerata kadar prokalsitonin. Bakteri yang paling banyak dijumpai adalah tipe aerob (97,7%) dan gram negatif (86%). Jenis bakteri penyebab sepsis tersering adalah Klebsiella Pneumonia, Acinetobacter Baumanii. Antibiotik yang paling sensitif adalah amikasin dan meropenem.Diskusi: Didapatkan 28,2% subjek yang mengalami sepsis dengan bakteri penyebab terbanyak adalah Klebsiella Pneumonia (40,0%) dan Acinetobacter Baumanii (39,1%) yang merupakan bakteri aerob gram negatif. Amikasin dan meropenem merupakan antibiotik yang memiliki sensitivitas yang tinggi terhadap bakteri penyebab sepsis tersebut.Kata Kunci: Gambaran bakteri, sensitivitas antibiotik, sepsis, stroke