Electronic Theses and Dissertation

Bakteremia merupakan kondisi terdapatnya bakteri di dalam aliran darah yang dikonfirmasi dengan kultur darah positif. Bakteremia dapat disebabkan oleh berbagai patogen, salah satunya adalah Escherichia coli (E. coli). E. coli mampu menghasilkan enzim extended-spectrum betalactamase (ESBL) yang memicu resistansi terhadap antibiotik golongan β-laktam. Resistansi antibiotik memperburuk morbiditas dan mortalitas pasien bakteremia E. coli. Tujuan penelitian ini untuk mengetahui pola dan kepekaan bakteri Escherichia coli yang diisolasi pada kultur darah di RSUD dr. Zainoel Abidin. Jenis penelitian ini adalah deskriptif retrospektif dengan desain cross sectional yang mengkaji data rekam medis dan data laboratorium mikrobiologi klinik periode Januari 2020 – Desember 2022. Sampel dalam penelitian ini adalah 108 isolat. Hasil penelitian menunjukkan bahwa prevalensi E. coli yang diisolasi dari kultur darah sebanyak 108 isolat (1,03%) dari total kultur darah yang dilakukan pada tahun 2020 – 2022. 108 isolat terbagi atas 74 isolat (68,5%) E. coli ESBL dan 34 isolat (31,5%) E. coli non ESBL. Mayoritas pasien berjenis kelamin laki-laki (53,3%), Rentang usia terbanyak yaitu 45 – 59 tahun (43,5%) dengan rata-rata usia 53 ± 18,9 tahun. Sebagian besar pasien dirawat di ruang rawat non ICU (69,4%). Lama rawat pasien mayoritas 7 – 14 hari (43,5%) dengan rata-rata 11 ± 7,3 hari. Fokus infeksi terbanyak pada sistem urinaria (37,1%) dan sumber tidak diketahui (38,7%). Diagnosis lain yang banyak teridentifikasi adalah sepsis (27,4%) dan penyakit lainnya (35,5%). Luaran pasien meninggal dan perbaikan memiliki prevalensi yang sama (50,0%). Antibiotik dengan kepekaan tertinggi adalah amikacin, doripenem, meropenem, imipenem, dan cefoperazone/sulbactam. E. coli memiliki kepekaan yang rendah terhadap ampicillin, amoxicillin, ceftriaxone, cefotaxime, dan levofloxacin.

Kata Kunci : Bakteremia, Escherichia coli, ESBL, Antibiotik

Bacteremia is a condition where bacteria are present in the bloodstream which is confirmed by a positive blood culture. Bacteremia can be caused by various pathogens, one of which is Escherichia coli (E. coli). E. coli is capable of producing the extended-spectrum betalactamase (ESBL) enzyme which triggers resistance to β-lactam antibiotics. Antibiotic resistance worsens the morbidity and mortality of patients with E. coli bacteremia. The aim of this research was to determine the pattern and sensitivity of Escherichia coli bacteria isolated in blood culture at RSUD dr. Zainoel Abidin. This type of research is a retrospective descriptive study with a cross sectional design that examines medical record data and clinical microbiology laboratory data for the period January 2020 – December 2022. The sample in this study was 108 isolates. The results of the study showed that the prevalence of E. coli isolated from blood cultures was 108 isolates (1.03%) from the total blood cultures carried out in 2020 - 2022. The 108 isolates were divided into 74 isolates (68.5%) of E. coli ESBL and 34 isolates (31.5%) E. coli non ESBL. The majority of patients were male (53.3%), the largest age range was 45 – 59 years (43.5%) with an average age of 53 ± 18.9 years. Most of the patients were treated in non-ICU wards (69.4%). The majority of patients' length of stay was 7 – 14 days (43.5%) with an average of 11 ± 7.3 days. The most common focus of infection was in the urinary system (37.1%) and the source was unknown (38.7%). Other diagnoses that were frequently identified were sepsis (27.4%) and other diseases (35.5%). The patient outcomes of death and improvement had the same prevalence (50.0%). The antibiotics with the highest sensitivity are amikacin, doripenem, meropenem, imipenem, and cefoperazone/sulbactam. E. coli has low sensitivity to ampicillin, amoxicillin, ceftriaxone, cefotaxime, and levofloxacin. Keywords : Bacteremia, Escherichia coli, ESBL, Antibiotik