Korelasi Jumlah Cluster of Differentiation 4 dengan Jenis Bakteri Penyebab Infeksi Paru dari Kultur Bilasan Bronkoalveolar pada Pasien Human Immunodeficiency Virus

Abstract

Infeksi paru bakteri adalah penyebab utama morbiditas dan mortalitas pasien human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Infeksi HIV menyebabkan disfungsi sistem kekebalan yang dimanifestasikan penurunan jumlah cluster of differentiation 4 (CD4). Tujuan penelitian menentukan hubungan jumlah CD4 dengan jenis bakteri penyebab infeksi paru dari kultur bilasan bronkoalveolar pasien HIV di RS Dr. Hasan Sadikin Bandung. Penelitian analitik observasional dengan rancangan potong lintang. Pengambilan sampel sejak November 2011 sampai Oktober 2013 di Departemen Ilmu Penyakit Dalam RS Dr. Hasan Sadikin Bandung. Subjek 39 orang memenuhi kriteria inklusi, didapatkan usia rata-rata 32 tahun. Jumlah median CD4 18 (rentang, 0–190) sel/mm3. Hasil kultur jenis bakteri batang gram negatif 29/39 sampel dan kokus gram positif 10/39 sampel. Spesies terbanyak Pseudomonas aeruginosa 11/39 sampel, Klebsiella pneumoniae 11/39 sampel dan Streptococcus viridans 10/39 sampel. Analisis statistik berdasarkan point biserial correlation terdapat korelasi lemah (r=0,232) dan tidak bermakna antara CD4 dan jenis bakteri penyebab dengan nilai p=0,209 (p>0,05). Arah korelasi menunjukkan semakin kecil jumlah CD4 semakin besar kemungkinan bakteri batang gram negatif sebagai penyebab infeksi paru. Penelitian ini menunjukkan korelasi lemah antara jumlah CD4 dan jenis bakteri penyebab infeksi paru dari bilasan bronkoalveolar pada pasien infeksi HIV di RS Dr. Hasan Sadikin Bandung. [MKB. 2016;48(1):32–8]

Kata kunci: Bilasan bronkoalveolar, human immunodeficiency virus (HIV), infeksi paru bakteri, jumlah CD4

Correlation between Cluster of Differentiation 4 Cell Counts and Types of Bacteria Causing Lung Infection from Cultured Washing of Bronchoalveolar Lavage in Human Immunodeficiency Virus Patients

Abstract

Bacterial lung infection is the leading cause of morbidity and mortality of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). HIV infection causes immune system dysfunction, which is manifested by decreased cluster of differentiation 4 (CD4) cell counts. The purpose of this study was to determine the correlation between CD4 cell counts and the type of bacteria that caused lung infection from cultured washing of bronchoalveolar lavage in HIV patients in Dr. Hasan Sadikin Hospital Bandung. This was an observational analytic study with a cross-sectional design. Subjects were collected from November 2011 to October 2013 in Internal Departement Dr. Hasan Sadikin Hospital Bandung. There were 39 subjects enrolled with the average age of patients was 32 years. The median CD4 cell counts was 18 (range, 0–190) cell/mm3. The type of gram-negative rods bacteria was 29/39 samples and gram-positive cocci was 10/39 samples. Most species were Pseudomonas aeruginosa 11/39 samples, Klebsiella pneumoniae 11/39 samples and Streptococcus viridans 10/39 samples. Statistical analysis based on a point biserial correlation showed weak (r=0.232) and no significant correlation between CD4 cell counts and the type of bacteria (p>0.05). The weak correlation was the smaller the number of CD4 cell counts, the greater possibility of the gram-negative rod bacteria being the cause of the infection. This study concluded that there is only a weak and no correlation between the number of CD4 cell counts and the type of bacteria causing the lung infection obtained from bronchoalveolar lavage in patients with HIV in Dr. Hasan Sadikin Hospital Bandung. [MKB. 2016;48(1):32–8]

Key words: Bacterial lung infection, bronchoalveolar lavage, CD4 cell counts, human immunodeficiency virus