Perbedaan antara Faktor Intrinsik dan Ekstrinsik pada Pasien Infeksi Nosokomial di Bagian Bedah dan Medikal RSUP. Dr. Hasan Sadikin Bandung

Bayu Wahyudi, Elsa Puji Setiawati, Nurhalim Shahib, Firman F. Wirakusumah

Abstract


Infeksi nosokomial merupakan satu masalah komplikasi di rumah sakit dan menjadi permasalahan penting bagi kesehatan publik di dunia. Kecenderungan pasien menderita infeksi nosokomial (HAIs) ditentukan oleh faktor intrinsik dan faktor ekstrinsik. Metode penelitian yang digunakan adalah potong lintang. Terdapat 287 pasien yang mengalami infeksi nosokomial yang disebabkan oleh Klebsiella pneumoniae di Bagian Bedah dan Medikal Rumah Sakit Dr. Hasan Sadikin Bandung (RSUP) selama periode Januari sampai Juni tahun 2015 yang telah memenuhi kriteria inklusi dan tidak termasuk eksklusi. Hasil penelitian menunjukkan perbedaan antara faktor intrinsik dan ekstrinsik pada pasien infeksi nosokomial yang disebabkan oleh klebsiella pneumoniae di bagian Bedah dan Medikal RSUP Dr. Hasan Sadikin Bandung dengan nilai p<0,05. Terdapat perbedaan kejadian resistensi terhadap karbapenem pada kasus infeksi nosokomial selain kadar Hb adalah tindakan medis untuk tindakan medis sedang mempunyai risiko 2,06 kali (IK 95%; 1,0–4,28 ), pada tindakan medis berat 3,03 kali (IK 95%; 1,21–7,61) bila dibanding dengan tindakan medis ringan. Terdapat perbedaan dengan ketidaksembuhan pada kasus infeksi nosokomial adalah kasus rawat medikal, leukosit >16.600, tindakan medis berat, dan keadaan kulit terbuka dengan OR masing masing 2,89; 2,09; 5,05; dan 1,88. Saran, untuk memberikan pelayanan yang prima dengan memperhatikan faktor intrinsik pasien baik usia, jenis kelamin, keadaan luka kulit dan status gizi, juga memperhatikan faktor ektrinsik berupa lamanya masa rawat, tempat pengambilan sampel, dan tindakan medik yang dilakukan.

Kata kunci: Faktor intrinsik dan ekstrinsik, infeksi Klebsiella pneumoniae, kasus bedah dan medikal, nosokomialinfeksi


Difference between Intrinsic and Extrinsic Factors of  Nosocomial Infection Patients in The Surgery and Medical Ward of Dr. Hasan Sadikin General Hospital Bandung

Nosocomial infection or Hospital-Acquired Infection (HAI) occurs as a complication during hospitalization in hospitals and becomes an important global public health problem. The tendency of patients suffering from nosocomial infectionis determined by intrinsic and extrinsic factors. This was a cross-sectional study on 287 patients with nosocomial infection caused by Klebsiella pneumoniae at the Surgical and Medical wards of Dr. Hasan Sadikin General Hospital during the period January to June 2015 who met the inclusion and exclusion criteria. Results showed the difference in intrinsic and extrinsic factors in patients with nosocomial infections caused by Klebsiella (p<0.05). There was a difference in the resistance towards Carbanepem in nosocomial infections. Factors influencing this were Hb level and medical actions. Patients with intermediate medical procedures had 2.06 times higher risk (CI 95%; 1.0–4.28 ) while in those with complicated medical procedures, the risk was 3.03 times higher (CI 95%; 1.21–7.61) when compared to those receiving simple medical procedures. A difference was also seen in the failure to recover in nosocomial infection between the medical inpatient cases (leucocyte of >16,600), complicated medical procedure, and open-skin condition with ORs of 2.89; 2.09; 5.05; and 1.88, respectively. It is suggested to provide excelent services by paying atttention to the intrinsic factors of patients, i.e. age, gender, skin wound status, and nutrition status and the extrinsic factors, i.e. length of stay, sampling sites, and medical procedures performed.

Key words: Intrinsic and extrinsic factors , Klebsiella pneumoniae infection, nosocomial infection, surgical andmedical cases


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DOI: https://doi.org/10.15395/mkb.v50n4.1576

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