Faktor risiko healthcare associated infection pada pasien intensive care unit Mei 2016 – Desember 2017 = Risk factors of healthcare associated infection within intensive care unit patients on May 2016 – December 2017

Salim, Jonathan (2018) Faktor risiko healthcare associated infection pada pasien intensive care unit Mei 2016 – Desember 2017 = Risk factors of healthcare associated infection within intensive care unit patients on May 2016 – December 2017. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Background 10% of infection cases in developing countries, like Indonesia, are Healthcare Associated Infection (HCAI). World Health Organization (WHO) stated that ≥ 30% ICU patients have/had experienced HCAI. Prevention is primarily done by identifying prevalent factors, thus it can be done effectively. Aim This study aim is to discover the association of ICU patients’ risk factors to HCAI Material & Methods This cross-sectional study is conducted on 261 patients, where 94 are HCAI positive. Sample was gathered from Siloam Teaching Hospital ICU Patients’ secondary database on May 2016 – December 2017 by purposive sampling. P-value (< 0.05) are computed by chi-square for categorical data, Mann-Whitney for numerical data, and logistic regression for multivariate. Result 36.02% (94/167) patients contracted HCAI with average age of 57.90 ± 20.242. The most prevalent microorganism was gram negative bacteria categorically with 45.83% cases (132/288) and Candida spp. by species with 31.94% cases (92/288). Therapy were 74.25% (545/734) antibiotics with utilization mostly Penems by 39.63% cases (216/545). Significant risk factors were stay duration (p = 0.000; odd ratio [OR], 10.927; 95% confidence interval [CI95], 4.666-25.591), urinary catheter (p = 0.043; odd ratio [OR], 7.382; 95% confidence interval [CI95], 1.066-51.119), and neurosurgery comorbidity (p = 0.032; odd ratio [OR], 8.685; 95% confidence interval [CI95], 1.202-62.754). Mortality was 19.15% (18/94) for HCAI patients and 11.98% (20/167) for non-HCAI. Conclusion Significant HCAI risk factors are stay duration, urinary catheter, and neurosurgery comorbidity. Gram negative bacteria are categorically HCAI leading cause; however, Candida spp. is leading by species / Latar Belakang 10% kasus infeksi di negara berkembang seperti Indonesia adalah Healthcare associated infection (HCAI). Menurut world health organization (WHO), ≥ 30% pasien ICU telah/sedang menderita HCAI. Pencegahan HCAI dimulai dengan identifikasi serta penentuan prevalensi agar penanggulangan dilakukan mulai dari yang sering dan signifikan. Objektif & Tujuan Penelitian ini bertujuan untuk melihat hubungan faktor risiko HCAI pada pasien ICU Materi & Metode Studi obervasional potong lintang ini dilakukan pada 261 subyek dengan 94 positif HCAI. Data diperoleh dengan pencatatan dari database sekunder pasien ICU secara sampling purposive. Nilai p didapat dengan chi-square untuk data kategorik, Mannwhitney untuk data numerik, dan regresi logistic untuk multivariat. Hasil 36.02% (94/167) pasien menderita HCAI dengan rerata umur 57.90 ± 20.242. Kultur tertinggi didapatkan pada bakteri gram negatif 45.83% (132/288) dan Candida spp. 31.94% (92/288) secara spesifik. Ditemukan terapi adalah 74.25% (545/734) antibiotik dengan golongan 39.63% (216/545) Penems (39.63%). Hasil signifikan pada analisis multivariat adalah lama perawatan (p = 0.000; odd ratio [OR], 10.927; 95% confidence interval [CI95], 4.666-25.591), kateter urin (p = 0.043; odd ratio [OR], 7.382; 95% confidence interval [CI95], 1.066-51.119), dan komorbid bedah saraf (p = 0.032; odd ratio [OR], 8.685; 95% confidence interval [CI95], 1.202-62.754). Mortalitas HCAI ICU adalah 19.15% (18/94) dan 11.98% (20/167) pada non-HCAI. Konklusi Faktor risiko HCAI signifikan adalah lama perawatan, penggunaan kateter urin, dan komorbid bedah saraf. Bakteria gram negatif merupakan kategori agen patogenik yang tertinggi, tetapi Candida spp. tertinggi secara spesies.

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