Infeksi Nosokomial Saluran Kencing (Insk) di Rumah Sakit Khusus Penyakit Menular, Jakarta

Abstract

A prospective survey to establish the incidence of urinary tract nosocomial infection (UTNI) was conducted at the Infectious Diseases Hospital of Jakarta for one year duration in 1982-1983. The study was done by taking random samples from patients hospitalized for longer than 2 days through urine cultures on day 1, 3 and 7 and other necessary examination. From 2288 patients hospitalized during that period, 723 patients (aged 2 months-70 years) met the requirement to be included in the study, and 115 (15.9%) of them met the criteria for UTNI. Female patients had higher rate of UTNI compared to male patients (19.8% vs 12.4%). The age group with highest rate of UTNI was children with < 1 year of age and the rate of UTNI decreased as the age of patients increased. Febrile patients had significantly higher rate of UTNI compared to diarrhea patients (33.4% vs 2,4%, p < 0.001). Patients who had catheterization had significantly higher rate of UTNI compared to patients without catheter placement (85.7% vs 12.3% p <0.05). Antibiotics treatment prior to hospitalization was associated with higher rate of UTNI compared to patients without it (22.8% vs 12.6% p < 0.01) as it was also observed with hospitalization for 7 days or longer (15.8% vs 11.9%) of it is compared to shorter duration of hospitalization. Gram negative bacterias were the most commonly recovered from the urine cultures compared to gram positive (89.8% vs 10.2%) with E. coli (24.2%) as the leading organism. Other recovered organism, Proteus spp and Citrobacter bacilli showed high resistancy toward antibiotics commonly used in the hospital. Average duration of hospitalization for patients with UTNI (9.6 days) was longer compared to average duration for patients without UTNI (4.4 days). Six out of 115 patients with UTNI died (5.2%) compared to only 1.3% mortality in patients without UTNI. No single factor was significantly shown to be responsible for higher mortality rate of patients with UTNI, possibly was due to more severe condition of underlying disease of patients with UTNI