Electronic Theses and Dissertation

Latar Belakang. Sepsis merupakan salah satu infeksi paling serius dalam praktik klinis dan menjadi penyebab tingginya mortalitas. Terdapat banyak faktor yang memengaruhi mortalitas pada bayi dan anak dengan sepsis.
Tujuan. Menganalisis pengaruh faktor risiko klinis (usia, jenis kelamin, status gizi, tingkat kesadaran, laju denyut jantung, laju pernapasan, suhu, penyakit primer, kejadian syok, penggunaan ventilator, lama rawatan, outcome) dan bakteriologis terhadap mortalitas pada bayi dan anak dengan sepsis.
Metode. Penelitian ini merupakan studi observasional analitik dengan pendekatan kohort retrospektif yang menggunakan data rekam medis. Subjek penelitian adalah pasien usia 1 bulan sampai 18 tahun dengan diagnosis sepsis yang dirawat di Ruang Anak dan Pediatric Intensive care Unit (PICU) RSUD dr. Zainoel Abidin/RSUDZA Januari hingga Desember 2023. Pasien dengan kelainan kongenital multipel dieksklusi dari penelitian. Data dianalisis secara bivariat dan multivariat menggunakan analisis regresi logistik.
Hasil. Insidensi sepsis pada bayi dan anak di RSUDZA tahun 2023 adalah 5,2% didominasi kelompok usia 1−12 bulan (28,7%), mayoritas laki-laki (57,3%), malnutrisi 58,7%, dengan mortalitas 48%. Pola kuman penyebab sepsis pada bayi dan anak relatif sama (p=0,473) dengan bakteri Gram positif didominasi Staphylococcus hominis (14,3%) dan Staphylococcus epidermidis (8,3%), bakteri Gram negatif Acinetobacter baumanii (11,9%), Pseudomonas aeruginosa (9,5%) dan Klebsiella pneumoniae (9,5%). Seftriakson merupakan antibiotik empiris yang paling banyak digunakan namun menunjukkan tingkat resistensi 85%. Analisis multivariat mendapatkan faktor determinan mortalitas meliputi GCS

Background. Sepsis is one of serious infection in clinical practice and cause of high mortality. There are many factors that influence mortality in infant and children with sepsis. Objective. Determining the clinical factor (age, sex, nutritional status, level of consciousness, heart rate, respiratory rate, temperature, primary disease, incidence of shock, using ventilator, length of stay, outcome) and bacteriological profile for predicting mortality in infant and children with sepsis. Methods. This study was an analytic observational design with a retrospective cohort approach using medical record. The subjects were patients aged 1 month to 18 years with sepsis diagnosed who were admitted to the pediatric ward and pediatric intensive care unit (PICU) at dr. Zainoel Abidin General Hospital from January to December 2023. Patients with multiple congenital abnormalities were excluded from the study. Data were analyzed bivariately and followed by multivariate logistic regression analysis. Results. The incidence of sepsis in infant and children in this study was 5.2%. There were dominated by the age of 1-12 months (28.7%), mostly male (57.3%), and malnutrition 58.7%. with mortality rate 48%. The bacteriological profile was relatively similar (p=0.473) between Gram-positive and negative bacteria. The Gram-positive bacteria dominated by Staphylococcus hominis (14.3%) and Staphylococcus epidermidis (8.3%), Gram-negative bacteria dominated by Acinetobacter baumanii (11.9%), Pseudomonas aeruginosa (9.5%) and Klebsiella pneumoniae (9.5%). The most widely empirical antibiotic prescribing was ceftriaxone but showed a resistance rate of 85%. Multivariate analysis revealed that the determinants of mortality factor included level of consciousness with GCS