BAKTEREMIA
Pembimbing :
Dr. dr. Koernia Swa Oetomo, SpB.
FINACS(K)TRAUMA. FICS
Oleh :
Dzikrullah Akbar
201710401011010
Laporan terbaru menunjukkan bahwa E. coli dan batang Gram negatif lainnya
penyebab paling umum bakteremia pada awal masa bayi terhitung sebanyak 42%
kasus.
(Nielsen. 2015)
(Cantey2016)
(Nielsen, 2015)
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Definisi
Bakteremia adalah adanya bakteri patogen
dalam aliran darah. Mikroba masuk ke tubuh
melalui kulit, saluran pencernaan, dan saluran
pernapasan. Bakteremia yang paling umum
adalah infeksi bakteri yang berasal dari saluran
kemih dan infeksi intra abdomen .
(Salihi. Antibiotic Resistant of Causes Bacteremia in Kirkuk City. Technical Collage. Scholar Academic Journal of Pharmacy. Kirkuk. Iraq. 2017)
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Tahun 2015, sebanyak 37.273
Tahun 2013 di Amerika Serikat
kasus bakteremia karena
ditemukan 2901 kasus
Escherichia Coli dilaporkan di
(Cantey, 2016)
Inggris (Nielsen, 2015)
EPIDEMIOLOGI
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ETIOLOGI
Bakteri yang paling sering
menyebabkan bakteremia adalah
Escherichia coli dan Streptococcus
grup B.
Tempat penderita
Fokus infeksi
terinfeksi bakteri
Mikroorganisme
penyebab
Nielsen. The Insidence and Prognosis of Patients with Bacteremia. Danish Medical Journal. Departement of Infectious Disease. Odense University Hospital. 2015.
Patofisiologi
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PATOFISIOLOGI
Host Organisme
Respon Inflamatori
Septikemia
(Opota. Blood Culture Diagnosis of Bacteremia : state of the art. Institute of Microbilogy. Infectious Disease Service. University of Lausanne and University Hospital
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Center. Lausanne. Switzerland. 2015)
TANDA DAN GEJALA
(Nicholas. Bacteremia. Medical Director. Division of Pediatric Infectious Diseases and Immunology, Connecticut Children's Medical Center. Medscape. 2016)
DIAGNOSIS
ANAMNESIS
1. Demam
2. Menggigil
PEMERIKSAAN FISIK
3. Terdapat gangguan
1. Vital Sign
pernapasan
2. Pemeriksaan
4. Riwayat abortus
kardiovaskular
5. Riwayat infeksi
3. Paru LABORATORIUM
pada saluran
4. Abdomen 1. DL penurunan
kemih
5. Status mental jumlah WBC, jumlah
6. infeksi pada kulit
6. Periksa kateter, neutrofil yang
dan jaringan lunak.
perangkat intravena, meningkat,
7. gejala
atau tabung leukositosis,
imunkompromais
drainase trombositopenia.
(misal, keganasan,
7. Kulit di sekitar alat 2. Pewarnaan Gram
konsumsi steroid,
perkutan harus 3. Kultur darah
neutropenia)
dipalpasi untuk
8. kateter yang
kehangatan,
terpasang
eritema, atau
9. alat vaskular, atau
drainase purulen
penggunaan
saluran intravena
1
0
(Coburn. Does This Adult Patient With Suspected Bacteremia Require Blood Cultures. American Medical Association. 2012)
Untuk mencari sumber penyebab dapat dilakukan:
• urinalisis (infeksi saluran kemih),
• radiografi dada (pneumonia),
• lumbal pungsi (meningitis),
• foto polos abdomen (apendicitis dan kolelitiasis).
• Kultur dari sumber dapat dilakukan untuk mencari bakteri
patogen penyebab bakteremia
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Mikroba terbanyak yang terdeteksi melalui pemeriksaan kultur darah selama 1 tahun
(Opota. Blood Culture Diagnosis of Bacteremia : state of the art. Institute of Microbilogy. Infectious Disease Service. University of Lausanne and University Hospital Center. Lausanne. Switzerland. 2015)
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PENATALAKSANAAN
Terapi empiris yang memiliki sensitivitas tinggi terhadap Escherichia coli adalah
imipenem 1-2 gram dan meropenem 1 gram (Alotaibi, 2017).
Pada hasil penelitian Purohit (2017) tidak ditemukan resistensi iminem dan
meropenem dari semua gen karbapenem yang diuji.
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PROGNOSIS
Insiden kematian tertinggi kasus bakteremia pada pasien yang dirawat di ICU
sebanyak (40%) atau dengan shock septik sebanyak (51%).
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(Nielsen. The Insidence and Prognosis of Patients with Bacteremia. Danish Medical Journal. Departement of Infectious Disease. Odense University Hospital. 2015)
Kesimpulan
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DAFTAR PUSTAKA
1. Nicholas. 2016. Bacteremia. Medical Director. Division of Pediatric Infectious Diseases and Immunology, Connecticut Children’s
2. Nielsen. 2015. The Insidence and Prognosis of Patients with Bacteremia. Danish Medical Journal. Departement of Infectious Disease.
http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show.
3. Cantey. 2016. Bacteremia in Early Infancy : Etiology and Management. Pediatric Infectious Disease. Springer. New York. View: 3 juli
4. Alotaibi. 2017. Escherichia Coli Bacteremia : Clinical Features, Risk Factors and Clinical Implicaton of Antimicrobial Resistance.
Departement of Pathology and Laboratory Medicine. King Saud University. Saudi Arabia. African Journal of Microbiology
5. Salihi. 2017. Antibiotic Resistant of Causes Bacteremia in Kirkuk City. Technical Collage. Scholar Academic Journal of Pharmacy.
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DAFTAR PUSTAKA
6. Nouvellet. 2016. Potential Impact of Novel Diagnostics and Treatments on Burden of Resistant in Escherichia Coli. National Institute
for Health Research Health Protection Research Unit in Modelling Methodology.Imperial Collage London. Faculty of
http://www.biorxiv.org/content/biorxiv/early/2016/05/13/052944.full.pdf
7. Irwin. 2015. Etiology of Childhood Bacteremia and Timely Antibiotics Administration in the Emergency Departement. Medical School
http://pediatrics.aappublications.org/content/early/2015/03/04/peds.2014-2061
8. Biondi. 2013. Epidemiology of Bacteremia in Febrile Infants in the United States. Departement of Pediatric. University of Rochester.
9. Coburn. 2012. Does This Adult Patient With Suspected Bacteremia Require Blood Cultures. American Medical Association.
10. Opota. 2015. Blood Culture Diagnosis of Bacteremia : state of the art. Institute of Microbilogy. Infectious Disease Service. University of
Lausanne and University Hospital Center. Lausanne. Switzerland. View: 7 juli 2017. available from:
https://www.ncbi.nlm.nih.gov/pubmed/25753137 17
DAFTAR PUSTAKA
11. Purohit. 2017. Antibiotic Resistance in an Indian Rural Community : A One Health Observational Study on Commensal Coliform
from Humans, Animal, Water. International Journal of Environmental Research and Public Health.
Departement of Public Health. Karolinska Institue. Stockholm. Sweden. . View: 7 juli 2017. available
from: https://www.ncbi.nlm.nih.gov/pubmed/28383517
12. Abernety. 2017. Epidemiology of Escherichia coli Bacteremia in England : Result of an Enhanced Sentinel Surveillance
Programme. Journal of Hospital Infection. Public Health England. London. . View: 7 juli 2017. available from:
http://www.journalofhospitalinfection.com/article/S0195-6701(16)30579-5/pdf
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