Main Article Content
Abstract
Penelitian ini dilakukan dengan pendekatan studi deskriptif observasional analitik cross sectional, sampel diambil dengan teknik purposive sampling. Semua pasien baru yang dirawat di ruang rawat inap bedah di Rumah Sakit Dr. Soetomo Surabaya dilibatkan dalam penelitian ini yang memenuhi kriteria inklusi dan eksklusi. Spesimen klinis kolonisasi MRSA diambil dari swab hidung, swab tenggorokan dan swab luka dimasukkan di fenil manitol broth, 370C diinkubasi 24 jam, pada hari berikutnya disubkultur pada media kromogenik Brilliance MRSA 2 Agar. Koloni tersangka MRSA berwarna biru denim disubkultur pada media Mannitol Salt Agar (MSA), diinkubasi 370C selama 24 jam. Untuk konfirmasi koloni S.aureus yang tumbuh kuning, dilanjutkan uji koagulase positif menggunakan Staphyrex. Data pasien yang diambil dari rekam medis dengan menggunakan formulir laporan kasus (CRF) . penelitian yang berlangsung mulai bulan Mei- Juli tahun 2015, didapatkan 143 pasien pada saat masuk dan keluar dari Rumah Sakit dari ruang rawat inap bedah. 9 orang pasien (6,3%) positif ditemukan kolonisasi MRSA pada saat MRS dan 10 orang pasien (7,0%) pada saat KRS. Riwayat opname berhubungan dengan kejadian kolonisasi MRSA pada pasien sebelum MRS, namun bukan merupakan faktor risiko. Adanya tindakan pembedahan, penggunaan antibiotik, lama rawat inap dan adanya penyakit penyerta tidak berhubungan dengan kejadian kolonisasi MRSA pada pasien saat KRS di ruang perawatan bedah RSUD Dr Soetomo Surabaya. Kontak antar pasien diduga menjadi sebagai cara penularan dan faktor risiko kolonisasi MRSA pada di ruang perawatan bedah RSUD Dr Soetomo Surabaya. Riwayat opname, adanya tindakan pembedahan, penggunaan antibiotik, lama rawat inap dan adanya penyakit penyerta bukan merupakan faktor risiko pada pasien dengan kolonisasi MRSA di ruang perawatan bedah RSUD Dr Soetomo Surabaya
Kata kunci : MRSA, kolonisasi, bedah, RSUD Dr Soetomo
Article Details
References
- Daftar Pustaka
- Corea, E., de Silva, T., Perera, J. (2003). Methicillin-Resistant Staphylococcus aureus: Prevalence, Incidence And Risk Factors Associated With Colonization In Sri Lanka. Journal of Hospital Infection; 55, pp 145–148.
- Fisher IAC,GmcKew, OMFisher, Vharish, Tgottlieb, PKMMaitz. (2015). Risk factors for, and the effect of MRSA colonization on the clinical outcomes of severely burnt patients. JBUR-4604; No. of Pages1-9.
- Fraser, S., BradyR, CGraham, SPaterson, Alan P Gibb. (2010). Methicillin-Resistant Staphylococcus aureus In Surgical Patients: Identification Of High-Risk Populations For The Development Of Targeted Screening Programmes. Ann R Coll Surg Engl; 92: pp 311–315.
- Goldsack, Jennifer C., CDeRitter, MPower, ASpencer, CLTaylor, SFKim, RKirk , MDrees. (2014). Clinical, Patient Experience And Cost Impacts Of Performing Active Surveillance On Known Methicillin-Resistant Staphylococcus aureus Positive Patients Admitted To Medical-Surgical Units. American Journal of Infection Control; 42, pp 1039-1043.
- Graffunder, E & Richard A. (2002). Risk Factor Associated with Nosocomial Methicilin Resistant Staphylococcus aureus (MRSA) Infection including Previous Use of Antimicrobials. Journal Of Antimicrobial Chemotherapy;49, pp 999-1005.
- Insana A, Purwanta M, Kuntaman K. 2016. Penyebaran Galur Methicillin Resistant Staphylococcus aureus (MRSA) pada Pasien Keluar di Ruang Rawat Inap Bedah dan Penyakit Dalam RSUD Dr Soetomo Surabaya Berdasarkan Sidik Jari Fenotipik Antibiogram. Tesis, Universitas Airlangga Surabaya.
- Jang Lee Y, JZChen, HCLin, HYLiu, SYLin, HHLin, CTFang, PRHsueh. (2015). Impact Of Active Screening For Methicillin-Resistant Staphylococcus aureus (MRSA) And Decolonization On MRSA Infections, Mortality And Medical Cost: A Quasi Experimental Study In Surgical Intensive Care Unit. Journal Of Critical Care; 19:143
- Kalra, L, FCamacho, CJWhitener, PDu, MMiller, CZalonis D, KGJulian. (2013). Risk Of Methicillin Resistant Staphylococcus aureus Surgical Site Infection In Patients With Nasal MRSA Colonization. American Journal of Infection Control; 41, pp 1253-1257.
- Lelitawati M, EBKoendhori, KuntamanK. 2016. Distribusi Gen SCCmec Tipe III,IV dan V pada Isolat Methicillin Resistant Staphyloccous aureus (MRSA) Pasien Ruang Rawat Inap Bedah RSUD Dr Soetomo Surabaya. Tesis, Universitas Airlangga.
- Pan, A., ALee, BCooper, AChalfine, GLDaikos, SGarilli, HGoossens, SMKumar, J.A. Martı´nez, A. Patroni, S. Harbarth. (2013). Risk Factors For Previously Unknown Meticillin-Resistant Staphylococcus aureus Carriage On Admission To 13 Surgical Wards In Europe. J.Hosp Inf; 83, pp 107-113
- Ramarathnam , V, BDMarco, AOrtegon, DKemp, JLuby, PSreeramoju. (2013). Risk Factors For Development Of Methicillin-Resistant Staphylococcus aureus Infection Among Colonized Patients. American Journal of Infection Control; 41, pp 625-628.
- Samad,A. DBanerjee, NCarbarnsy and SGhosh. (2002). Prevalence Of Methicillin-Resistant Staphylococcus aureus Colonization In Surgical Patients, On Admission To A Welsh Hospital. Journal of Hospital Infection; 51, pp 43-46.
- Santosaningsih, D, SSantoso, NSBudayanti, Kuntaman, ESLestari, HFarida, RHapsari, PHadi, WWinarto, CMilheiric¸o, KMaquelin, DWErix, AVBelkum, JASeverin dan HAVerbrugh. (2014). Epidemiology of Staphylococcus aureus Harboring the mecA or Panton-Valentine Leukocidin Genes in Hospitals in Java and Bali, Indonesia. Am.J.Trop.Med.Hyg: 90(4), pp 728-734.
- Shukla,S, MNixon, MAcharya, MTKorim, R.Pandey. (2009). Incidence Of MRSA Surgical-Site Infection In MRSA Carriers In An Orthopaedic Trauma Unit. J Bone Joint Surg;91, pp 225-228
- Shah, DRSI. (2011). Skrinning Methicillin Resistant Staphylococcus aureus (MRSA) Terhadap Tenaga Medis dan Paramedis Instalasi Perawatan Intensif (Intensive Care Unit dan Ruang Gawat Bedah) Rumah Sakit Umum Daerah DR. Moewardi Surakarta. Skripsi. Fakultas Kedokteran Universiras Sebelas Maret. Surakarta.
- Tyagi,A., AKapil, PSingh. (2008). Incidence of Methicillin Resistant Stahylococcus aureus (MRSA) in Pus Samples at a Tertiary Care Hospital, AIIMS, New Delhi. JIACM; 9(1), pp 33-35.
- Wang, F.D, YYChen, TLChen, YTLin, CPFung. (2011). Risk Factors And Mortality Of Nosocomial Infections Of Methicillin-Resistant Staphylococcus aureus In An Intensive Care Unit. Journal of Critical Care; 26, pp 82–88.
- WHO.(1996). Recommendations for the Control of Methicillin-Resistant Staphylococcus aureus (MRSA). World Health Organization Emerging and other Communicable Diseases, Surveillance and Control
References
Daftar Pustaka
Corea, E., de Silva, T., Perera, J. (2003). Methicillin-Resistant Staphylococcus aureus: Prevalence, Incidence And Risk Factors Associated With Colonization In Sri Lanka. Journal of Hospital Infection; 55, pp 145–148.
Fisher IAC,GmcKew, OMFisher, Vharish, Tgottlieb, PKMMaitz. (2015). Risk factors for, and the effect of MRSA colonization on the clinical outcomes of severely burnt patients. JBUR-4604; No. of Pages1-9.
Fraser, S., BradyR, CGraham, SPaterson, Alan P Gibb. (2010). Methicillin-Resistant Staphylococcus aureus In Surgical Patients: Identification Of High-Risk Populations For The Development Of Targeted Screening Programmes. Ann R Coll Surg Engl; 92: pp 311–315.
Goldsack, Jennifer C., CDeRitter, MPower, ASpencer, CLTaylor, SFKim, RKirk , MDrees. (2014). Clinical, Patient Experience And Cost Impacts Of Performing Active Surveillance On Known Methicillin-Resistant Staphylococcus aureus Positive Patients Admitted To Medical-Surgical Units. American Journal of Infection Control; 42, pp 1039-1043.
Graffunder, E & Richard A. (2002). Risk Factor Associated with Nosocomial Methicilin Resistant Staphylococcus aureus (MRSA) Infection including Previous Use of Antimicrobials. Journal Of Antimicrobial Chemotherapy;49, pp 999-1005.
Insana A, Purwanta M, Kuntaman K. 2016. Penyebaran Galur Methicillin Resistant Staphylococcus aureus (MRSA) pada Pasien Keluar di Ruang Rawat Inap Bedah dan Penyakit Dalam RSUD Dr Soetomo Surabaya Berdasarkan Sidik Jari Fenotipik Antibiogram. Tesis, Universitas Airlangga Surabaya.
Jang Lee Y, JZChen, HCLin, HYLiu, SYLin, HHLin, CTFang, PRHsueh. (2015). Impact Of Active Screening For Methicillin-Resistant Staphylococcus aureus (MRSA) And Decolonization On MRSA Infections, Mortality And Medical Cost: A Quasi Experimental Study In Surgical Intensive Care Unit. Journal Of Critical Care; 19:143
Kalra, L, FCamacho, CJWhitener, PDu, MMiller, CZalonis D, KGJulian. (2013). Risk Of Methicillin Resistant Staphylococcus aureus Surgical Site Infection In Patients With Nasal MRSA Colonization. American Journal of Infection Control; 41, pp 1253-1257.
Lelitawati M, EBKoendhori, KuntamanK. 2016. Distribusi Gen SCCmec Tipe III,IV dan V pada Isolat Methicillin Resistant Staphyloccous aureus (MRSA) Pasien Ruang Rawat Inap Bedah RSUD Dr Soetomo Surabaya. Tesis, Universitas Airlangga.
Pan, A., ALee, BCooper, AChalfine, GLDaikos, SGarilli, HGoossens, SMKumar, J.A. Martı´nez, A. Patroni, S. Harbarth. (2013). Risk Factors For Previously Unknown Meticillin-Resistant Staphylococcus aureus Carriage On Admission To 13 Surgical Wards In Europe. J.Hosp Inf; 83, pp 107-113
Ramarathnam , V, BDMarco, AOrtegon, DKemp, JLuby, PSreeramoju. (2013). Risk Factors For Development Of Methicillin-Resistant Staphylococcus aureus Infection Among Colonized Patients. American Journal of Infection Control; 41, pp 625-628.
Samad,A. DBanerjee, NCarbarnsy and SGhosh. (2002). Prevalence Of Methicillin-Resistant Staphylococcus aureus Colonization In Surgical Patients, On Admission To A Welsh Hospital. Journal of Hospital Infection; 51, pp 43-46.
Santosaningsih, D, SSantoso, NSBudayanti, Kuntaman, ESLestari, HFarida, RHapsari, PHadi, WWinarto, CMilheiric¸o, KMaquelin, DWErix, AVBelkum, JASeverin dan HAVerbrugh. (2014). Epidemiology of Staphylococcus aureus Harboring the mecA or Panton-Valentine Leukocidin Genes in Hospitals in Java and Bali, Indonesia. Am.J.Trop.Med.Hyg: 90(4), pp 728-734.
Shukla,S, MNixon, MAcharya, MTKorim, R.Pandey. (2009). Incidence Of MRSA Surgical-Site Infection In MRSA Carriers In An Orthopaedic Trauma Unit. J Bone Joint Surg;91, pp 225-228
Shah, DRSI. (2011). Skrinning Methicillin Resistant Staphylococcus aureus (MRSA) Terhadap Tenaga Medis dan Paramedis Instalasi Perawatan Intensif (Intensive Care Unit dan Ruang Gawat Bedah) Rumah Sakit Umum Daerah DR. Moewardi Surakarta. Skripsi. Fakultas Kedokteran Universiras Sebelas Maret. Surakarta.
Tyagi,A., AKapil, PSingh. (2008). Incidence of Methicillin Resistant Stahylococcus aureus (MRSA) in Pus Samples at a Tertiary Care Hospital, AIIMS, New Delhi. JIACM; 9(1), pp 33-35.
Wang, F.D, YYChen, TLChen, YTLin, CPFung. (2011). Risk Factors And Mortality Of Nosocomial Infections Of Methicillin-Resistant Staphylococcus aureus In An Intensive Care Unit. Journal of Critical Care; 26, pp 82–88.
WHO.(1996). Recommendations for the Control of Methicillin-Resistant Staphylococcus aureus (MRSA). World Health Organization Emerging and other Communicable Diseases, Surveillance and Control