GAMBARAN INFEKSI Klebsiella pneumoniae PENGHASIL Extended-spectrum β-lactamase (ESBL) PADA PASIEN COVID-19 DI RSUP DR. MOHAMMAD HOESIN PERIODE JANUARI 2021-JUNI 2021

Abstract

ABSTRACT Background: ESBL-producing Klebsiella pneumoniae infection can make medical costs increase, patients become longer in the hospital, and a worse prognosis in Covid-19 patients. Therefore, this study aims to find out the prevalence, characteristics of age, gender, specimen type, inpatient room, and pattern of antibiotic sensitivity of ESBL-producing Klebsiella pneumoniae in Covid-19 patients so as to help patients in the prevention and control of HAIs in Dr. Mohammad Hoesin Hospital. Method: This observational research used secondary data in the form of the status of Covid-19 patients identified as ESBL-producing Klebsiella pneumoniae at the Central Laboratory Installation of Mohammad Hoesin Hospital Palembang during the period January 2021-June 2021. The samples in this study were all medical records of Covid-19 patients who met the inclusion criteria. Data was processed and analyzed by univariate to determine the frequency distribution of each variable studied. Result: Prevalence of ESBL-producing Klebsiella pneumoniae in Covid-19 patients at Dr. Mohammad Hoesin Hospital is 48,6%. Based on Age, prevalence of ESBL-producing Klebsiella pneumoniae in Covid-19 patients are often found in elderly (41,2%). Based on gender, prevalence of ESBL-producing Klebsiella pneumoniae in Covid-19 patients are often found in female (64,7%). Based on specimen type, prevalence of ESBL-producing Klebsiella pneumoniae in Covid-19 patients are often found in sputum (47,1%). Based on the inpatient room, prevalence of ESBL-producing Klebsiella pneumoniae in Covid-19 patients are often found in non-intensive care unit (79,5%). Based on sensitivity patterns, isolates ESBL-producing Klebsiella pneumoniae are resistance to ampicilin/AMP (100%), cefazoline (100%), ceftriaxon (100%), aztreonam (91,2%), ceftazedim (85,3%), ampisilin/Sulbaktam (76,5%), ciprofloxacin (76,5%), trimethoprim/ sulfamethoxazole (58,8%) and gentamicin (55,9%). Conclusion: Prevalence of ESBL-producing Klebsiella pneumoniae in Covid-19 patients at the Central Laboratory Installation of Mohammad Hoesin Hospital Palembang during the period January 2020-June 2020 is 48,6%. Antibiotics that resistance to ESBL-producing Klebsiella pneumoniae in Covid-19 patients are ampicilin/AMP, cefazoline, ceftriaxon, aztreonam, ceftazdim, ampisilin/sulbaktam, ciprofloxacin, trimethoprim/sulfamethoxazole and gentamicin. Keywords: ESBL, Covid-19, HAIs   ABSTRAK Pendahuluan: Infeksi Klebsiella pneumoniae penghasil ESBL bisa membuat biaya pengobatan menjadi bertambah, pasien menjadi lebih lama di rumah sakit, dan prognosis yang lebih buruk pada pasien Covid-19. Oleh karena itu, penelitian ini bertujuan untuk mengetahui prevalensi, karakteristik berdasarkan usia, jenis kelamin, jenis spesimen, asal ruang rawat inap, dan pola sensitivitas antibiotik Klebsiella pneumoniae penghasil ESBL pada pasien Covid-19 sehingga dapat membantu pasien dalam pencegahan dan pengendalian HAIs di RSUP Dr. Mohammad Hoesin. Metode: Penelitian deskriptif observasional ini menggunakan data sekunder berupa status pasien Covid-19 yang teridentifikasi Klebsiella pneumoniae penghasil ESBL di instalasi laboratorium sentral RSUP Dr. Mohammad Hoesin Palembang selama periode Januari 2021-Juni 2021. Sampel pada penelitian ini adalah seluruh data rekam medik pasien Covid-19 yang memenuhi kriteria inklusi. Data diolah dan dianalisis secara univariat untuk mengetahui distribusi frekuensi setiap variabel yang diteliti. Hasil: Prevalensi Klebsiella pneumoniae penghasil ESBL pada pasien Covid-19 di RSUP Dr. Mohammad Hoesin sebesar 48,6%. Berdasarkan usia, Klebsiella pneumoniae penghasil ESBL pada pasien Covid-19 banyak ditemukan pada lansia (41,2%). Berdasarkan jenis kelamin, Klebsiella pneumoniae penghasil ESBL pada pasien Covid-19 banyak ditemukan pada perempuan (64,7%). Berdasarkan jenis spesimen, Klebsiella pneumoniae penghasil ESBL pada pasien Covid-19 banyak ditemukan pada sputum (47,1%). Berdasarkan ruang rawat inap, Klebsiella pneumoniae penghasil ESBL pada pasien Covid-19 banyak berasal dari ruang rawat non intensif (79,5%). Berdasarkan pola sensitivitas, Klebsiella pneumoniae penghasil ESBL resisten terhadap ampisilin/ AMP (100%), sefazolin (100%), seftriakson (100%), aztreonam (91,2%), seftazdim (85,3%), ampisilin/ sulbaktam (76,5%), siprofloksasin (76,5%), trimetoprim/ sulfametoksazol (58,8%), dan gentamisin (55,9%) Kesimpulan: Prevalensi Klebsiella pneumoniae penghasil ESBL pada pasien Covid-19 di Instalasi Laboratorium Mikrobiologi RSUP Dr. Mohammad Hoesin Palembang selama periode Januari 2021-Juni 2021 sebesar 48,6%. Antibiotik yang resisten pada Klebsiella pneumoniae penghasil ESBL yaitu ampisilin/AMP, sefazolin, seftriakson, aztreonam, seftazdim, ampisilin/sulbaktam, siprofloksasin, trimetoprim/sulfametoksazol dan gentamisin. Kata kunci: ESBL, Covid-19, HAI