Bloodstream Infection (C R B I)
di Intensive Care Unit
Marino P. The Little ICU Book 2nd Edition. New York: Wolters-Kluwer; 2017
EPIDEMIOLOGI
• Lebih dari 250.000 CRBI terjadi
setiap tahun di Amerika Serikat dan
lebih dari 80.000 di antaranya
terjadi di ICU.
• Infeksi ini berkaitan dengan > LoS
10 hingga 20 hari dan peningkatan
biaya perawatan mencapai $4000
hingga $56.000.
Tabel - Insiden CRBI berdasarkan jenis kateter
Shah H, Bosch W, Thompson KM, Hellinger WC. Intravascular catheter-related bloodstream infection.
The Neurohospitalist. 2013;3(3): 144-51.
FAKTOR RESIKO
• Skill operator
• Lokasi insersi
• Antisepsis
• Jenis lumen
• Lama penggunaan
• PPE
O'Grady, Naomi & Alexander, Mary & Burns, Lillian & Dellinger. (2011). Guidelines for the Prevention of Intravascular Catheter-related Infections. Clinical infectious
diseases : an official publication of the Infectious Diseases Society of America. 52. e162-93. 10.1093/cid/cir257. Fletcher S. Catheter Related Bloodstream Infection. Continuing
Education in Anaesthesia, Critical Care & Pain. 2015.Vol 5: 2
PATOFISIOLOGI 2
3
1
4
Shah H, Bosch W, Thompson KM, Hellinger WC. Intravascular catheter-related bloodstream infection.
The Neurohospitalist. 2013;3(3): 144-51.
MIKROORGANISME PENYEBAB
Shah H, Bosch W, Thompson KM, Hellinger WC. Intravascular catheter-related bloodstream infection.
The Neurohospitalist. 2013;3(3): 144-51.
DIAGNOSIS
Marino P. The Little ICU Book 2nd Edition. New York: Wolters-Kluwer; 2017
TATALAKSANA
Terapi empirik biasanya
diberikan setelah dilakukan
pengambilan sampel. Sambil
menunggu hasil kultur terdapat
beberapa antimikroba yang
direkomendasikan untuk terapi
empirik pada pasien yang
dicurigai CRBI.
ANTIBIOTIK
EMPIRIK
Marino P. The Little ICU Book 2nd Edition. New York: Wolters-Kluwer; 2017
Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009
Update by the Infectious Diseases Society of America [published correction appears in Clin Infect Dis. 2010 Apr 1;50(7):1079
Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009
Update by the Infectious Diseases Society of America [published correction appears in Clin Infect Dis. 2010 Apr 1;50(7):1079
PENCEGAHAN
CATHETER RELATED
BLOODSTREAM INFECTION
(C R B I)
CDC RECOMMENDATIONS, 2011
PENCEGAHAN (1)
• Lakukan edukasi dan pelatihan kepada tenaga kesehatan
terkait
• Pemilihan jenis kateter dan lokasi pemsangan dengan
tepat
• Terapkan metode hand hygiene dan teknik aseptic
• Gunakan APD sesuai standar
O'Grady, Naomi & Alexander, Mary & Burns, Lillian & Dellinger. (2011). Guidelines for the Prevention of Intravascular Catheter-related Infections. Clinical infectious
diseases : an official publication of the Infectious Diseases Society of America. 52. e162-93. 10.1093/cid/cir257. Fletcher S. Catheter Related Bloodstream Infection. Continuing
Education in Anaesthesia, Critical Care & Pain. 2015.Vol 5: 2
PENCEGAHAN (2)
• Lakukan Skin preparation sesuai dengan
rekomendasi
• Gunakan dressing sesuai standar
• Jaga higienitas pasien
• Gunakan sutureless securement devices
O'Grady, Naomi & Alexander, Mary & Burns, Lillian & Dellinger. (2011). Guidelines for the Prevention of Intravascular Catheter-related Infections. Clinical infectious
diseases : an official publication of the Infectious Diseases Society of America. 52. e162-93. 10.1093/cid/cir257. Fletcher S. Catheter Related Bloodstream Infection. Continuing
Education in Anaesthesia, Critical Care & Pain. 2015.Vol 5: 2
PENCEGAHAN (3)
• Gunakan anti-microbial coated catheter
• Tidak disarankan penggunaan antibiotika
profilaksis untuk mencegah CRBI
• Penggantian CVC harus dengan pertimbangan
yang tepat dan sesuai indikasi
O'Grady, Naomi & Alexander, Mary & Burns, Lillian & Dellinger. (2011). Guidelines for the Prevention of Intravascular Catheter-related Infections. Clinical infectious
diseases : an official publication of the Infectious Diseases Society of America. 52. e162-93. 10.1093/cid/cir257. Fletcher S. Catheter Related Bloodstream Infection. Continuing
Education in Anaesthesia, Critical Care & Pain. 2015.Vol 5: 2
TERIMAKASIH