Electronic Theses and Dissertation

Penyakit jantung merupakan salah satu penyebab utama morbiditas dan mortalitas di Indonesia. Pasien dengan gangguan jantung berat memerlukan perawatan intensif di Intensive Cardiac Care Unit (ICCU), di mana penggunaan alat invasif dan penurunan daya tahan tubuh meningkatkan risiko infeksi nosokomial. Penelitian ini bertujuan mengetahui pola bakteri dan kepekaan antibiotik dari spesimen klinis, serta menggambarkan lama rawat dan luaran klinis pasien yang dirawat di ICCU RSUD dr. Zainoel Abidin (RSUDZA) Banda Aceh periode 2020–2024. Penelitian menggunakan desain deskriptif observasional retrospektif berdasarkan data hasil kultur laboratorium Mikrobiologi Klinik dan rekam medis di RSUDZA. Sebanyak 268 pasien dengan total 318 spesimen dianalisis. Hasil kultur menunjukkan pertumbuhan sebanyak 70,1% dan tidak tumbuh 29,9%. Spesimen tumbuh terbanyak berasal dari saluran napas bawah (36,5%), diikuti darah (28,9%), cairan tubuh lainnya (3,8%), dan urin (0,9%). Mayoritas pasien berusia 19–59 tahun (56,7%) dan laki-laki (64,9%). Lama rawat terbanyak adalah 3–12 hari (61,2%), sedangkan mortalitas keseluruhan mencapai 84,3%. Bakteri Gram-negatif mendominasi (54,7%), terutama Aci. baumannii (15,2%), K. pneumoniae (14,8%), Ps. aeruginosa (6,3%), Esch. coli (6,3%), dan Achro. denitrificans (2,7%). Kelompok Gram-positif (40,8%) didominasi Staph. aureus (13,0%), Staph. haemolyticus (10,8%), Staph. hom. hominis (5,8%), Staph. epidermidis (4,5%), dan Staph. capitis (2,7%). Isolat jamur ditemukan sebesar 4,5%, terdiri atas C. albicans (2,2%), C. tropicalis (1,3%), Crypto. neoformans (0,4%), dan C. ciferrii (0,4%). Bakteri Gram-negatif paling sensitif terhadap amikasin, sedangkan Gram-positif menunjukkan sensitivitas tertinggi terhadap doxycycline, linezolid, minocycline, nitrofurantoin, dan vancomycin. Temuan ini menegaskan pentingnya pemantauan resistensi serta penggunaan antibiotik dan antijamur yang rasional di ICCU.

Cardiovascular disease is one of the leading causes of morbidity and mortality in Indonesia. Patients with severe cardiac disorders require intensive care in the Intensive Cardiac Care Unit (ICCU), where the use of invasive devices and decreased immunity increases the risk of nosocomial infections. This study aimed to identify the bacterial patterns and antibiotic susceptibility profiles of clinical specimens, as well as to describe the length of stay and clinical outcomes of patients treated in the ICCU of Dr. Zainoel Abidin General Hospital (RSUDZA), Banda Aceh, during 2020–2024. This research employed a retrospective descriptive observational design based on microbiology culture results and medical records from RSUDZA. A total of 268 patients with 318 specimens were analyzed. Culture results showed growth in 70.1% of specimens and no growth in 29.9%. The highest proportion of positive cultures originated from lower respiratory tract specimens (36.5%), followed by blood (28.9%), other body fluids (3.8%), and urine (0.9%). Most patients were aged 19–59 years (56.7%) and male (64.9%). The most common length of stay was 3–12 days (61.2%), while the overall mortality rate reached 84.3%. Gram-negative bacteria dominated (54.7%), primarily Aci. baumannii (15.2%), K. pneumoniae (14.8%), Ps. aeruginosa (6.3%), Esch. coli (6.3%), and Achro. denitrificans (2.7%). Gram-positive isolates (40.8%) were dominated by Staph. aureus (13.0%), Staph. haemolyticus (10.8%), Staph. hom. hominis (5.8%), Staph. epidermidis (4.5%), and Staph. capitis (2.7%). Fungal isolates accounted for 4.5%, consisting of C. albicans (2.2%), C. tropicalis (1.3%), Crypto. neoformans (0.4%), and C. ciferrii (0.4%). Gram-negative bacteria showed the highest susceptibility to amikacin, whereas Gram-positive bacteria were most susceptible to doxycycline, linezolid, minocycline, nitrofurantoin, and vancomycin. These findings highlight the importance of continuous surveillance of antimicrobial resistance and rational use of antibiotics and antifungals in the ICCU.