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Kesesuaian pewarnaan gram dengan kultur darah sebagai prediktor nilai kritis kasus bakteremia di Rumah Sakit Umum Pusat Sanglah, Denpasar

  • Putu Yoska Arya Harindana ,
  • Ida Sri Iswari ,
  • Indramawan Setyojatmiko ,
  • Ni Nengah Dwi Fatmawati ,

Abstract

Background: One of the considerations for giving empiric antibiotics in bacteremia cases is gram staining (GS) results. Accurate and fast results are required in distinguishing infection-caused bacteria. However, the data on how much the corresponding gram stain results with bacterial growth in blood cultures are still insufficient.

Aim: The study aims to compare Gram stain results with bacterial growth in positive blood cultures.

Methods: A cross-sectional analytic study obtained data from the VITEK® 2 Compact (bioMérieux) results for six months (January - June 2020). Data involved all blood cultures examined as many as 509.

Results: Of the 509 blood samples, 46 were reported as critical values for bacteremia. Gram-negative bacillus bacteria were identified in 39.13% of the gram staining (GS) and 45.65% of the blood culture (BC) samples. Gram-positive bacteria appeared in 56.52% of GS and 52.17% of BC. MBRO (multidrug-resistant organisms) bacteria were identified in the proportion of 11%, then 13% from ESBL (extended-spectrum beta-lactamase) bacteria, and they remain as 4% MRSA (methicillin-resistant Staphylococcus aureus) bacteria. The higher result, 76% of the data was confirmed from the non-ICU patients.

Conclusion: GS can be used as a reference for empiric antibiotic therapy due to its effectiveness, and it has a high degree of similarity with positive blood culture results.

 

 

Latar belakang: Salah satu pertimbangan pemberian antibiotika empiris pada kasus bakteremia adalah berdasarkan hasil pewarnaan gram. Dibutuhkan hasil yang akurat dan cepat dalam membedakan bakteri penyebab infeksi. Namun sedikit data tentang berapa besar kesesuaian hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah. Untuk membandingkan hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah yang positif.

Metode: Penelitian ini merupakan penelitian analitik cross-sectional. Data diperoleh dari hasil VITEK® 2 Compact (bioMérieux) selama enam bulan (Januari – Juni 2020). Sampel penelitian adalah semua kultur darah yang diperiksa pada periode penelitian berjumlah 509.

Hasil: Dari 509 sampel spesimen darah, 46 sampel dilaporkan sebagai nilai kritis prediktor bakteremia. Bakteri batang gram negatif teridentifikasi pada 39,13% sampel pewarnaan gram dan 45,65% sampel hasil kultur darah. Bakteri gram positif muncul pada 56,52% sampel pewarnaan gram dan 52,17% sampel hasil kultur darah. Bakteri MDRO (multidrug resistant organisms) teridentifikasi sebanyak 11%, 13% bakteri ESBL (extended spectrum beta lactamase), dan 4% bakteri MRSA (methicillin-resistant Staphylococcus aureus). Proporsi 76% sampel berasal dari pasien non-ICU.

Simpulan: Hasil pewarnaan gram dapat digunakan sebagai acuan terapi antibiotika empiris karena memiliki tingkat kesesuaian yang tinggi dengan hasil kultur darah positif.

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How to Cite

Harindana, P. Y. A., Iswari, I. S., Setyojatmiko, I., & Fatmawati, N. N. D. (2021). Kesesuaian pewarnaan gram dengan kultur darah sebagai prediktor nilai kritis kasus bakteremia di Rumah Sakit Umum Pusat Sanglah, Denpasar. Intisari Sains Medis, 12(2), 494–499. https://doi.org/10.15562/ism.v12i2.1038

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Putu Yoska Arya Harindana
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Ida Sri Iswari
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Indramawan Setyojatmiko
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Ni Nengah Dwi Fatmawati
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