ABSTRAK
Latar belakang: Diare masih merupakan masalah kesehatan masyarakat dinegara berkembang karena morbiditas dan mortalitasnya yang masih tinggi. Diaredapat disebabkan oleh virus, bakteri dan parasit yang penting diketahui untukmemberikan tatalaksana yang tepat, namun saat ini belum ada data mengenaibakteri penyebab diare di Indonesia. Tujuan: Mengetahui gambaran klinis anak dengan diare akut dan mengetahui jenis bakteri enteropatogen penyebab diare akut dengan menggunakan real-timePCR di Rumah Sakit Cipto Mangunkusumo. Metode: Penelitian potong lintang pada anak dengan diare akut berusia 1-15tahun di Rumah Sakit Cipto Mangunkusumo. Hasil: Subyek penelitian ini terdiri dari 60 subyek dengan diare akut. Sebagian besar berusia 1-3 tahun, status gizi baik, berasal dari ibu dengan pendidikansedang dengan status ekonomi keluarga menengah rendah, sebagian besar belummendapat antibiotik sebelum ke rumah sakit tetapi sudah mendapat cairanrehidrasi oral. Gambaran klinis diare akut akibat infeksi bakteri yaitu frekuensidiare ≤5X/hari (p=0,018), tanpa leukositosis feses (p=0,015) dan malabsorpsilemak (p=0,031). Sebaran infeksi bakteri patogen penyebab diare akutberdasarkan real-time PCR sebagai berikut: Campylobacter jejuni 7 subyek,Escherichia coli patogen 17 subyek yang terdiri dari EPEC 9 subyek, EIEC 5subyek dan ETEC 3 subyek. Infeksi bakteri campuran pada subyek sebagaiberikut: EPEC+EIEC 2 subyek , C.jejuni+EPEC 1 subyek, C.jejuni+EPEC+EIEC1 subyek dan C.jejuni+EPEC+ETEC 1 subyek. Simpulan: Sebagian besar diare terjadi pada usia 1-3 tahun dengan status pasiengizi baik dengan status keluarga menengah rendah. Sekitar 48% anak dengandiare akut didapatkan bakteri dari hasil real-time PCR feses dengan proporsiterbanyak yaitu EPEC, diikuti Campylobacter jejuni, EIEC dan ETEC.ABSTRACT
Background: Diarrhea is still a public health problem in developing countriesdue to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteriaand parasites. It is important to know the etiology to provide proper management,but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acutediarrhea and determine the type of enteropathogens bacteria causing acutediarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stoolspecimens were collected from patients aged 1-15 years with acute diarrhea andtested for bacterial enteropathogens using real-time PCR.Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritionalstatus, from low income families and secondary education mothers, most have notreceived antibiotics prior to hospital admission but had received oral rehydrationfluids. The clinical features of acute diarrhea caused by bacterial infection isdiarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption.From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved byreal-time PCR. Distribution of pathogenic bacterial infection causes acute diarrheaby real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenicEscherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjectsand ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject andC.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCRstool with the highest proportion is EPEC, followed by Campylobacter jejuni,EIEC and ETEC.;Background: Diarrhea is still a public health problem in developing countriesdue to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteriaand parasites. It is important to know the etiology to provide proper management,but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acutediarrhea and determine the type of enteropathogens bacteria causing acutediarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stoolspecimens were collected from patients aged 1-15 years with acute diarrhea andtested for bacterial enteropathogens using real-time PCR.Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritionalstatus, from low income families and secondary education mothers, most have notreceived antibiotics prior to hospital admission but had received oral rehydrationfluids. The clinical features of acute diarrhea caused by bacterial infection isdiarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption.From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved byreal-time PCR. Distribution of pathogenic bacterial infection causes acute diarrheaby real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenicEscherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjectsand ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject andC.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCRstool with the highest proportion is EPEC, followed by Campylobacter jejuni,EIEC and ETEC.;Background: Diarrhea is still a public health problem in developing countriesdue to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteriaand parasites. It is important to know the etiology to provide proper management,but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acutediarrhea and determine the type of enteropathogens bacteria causing acutediarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stoolspecimens were collected from patients aged 1-15 years with acute diarrhea andtested for bacterial enteropathogens using real-time PCR.Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritionalstatus, from low income families and secondary education mothers, most have notreceived antibiotics prior to hospital admission but had received oral rehydrationfluids. The clinical features of acute diarrhea caused by bacterial infection isdiarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption.From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved byreal-time PCR. Distribution of pathogenic bacterial infection causes acute diarrheaby real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenicEscherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjectsand ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject andC.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCRstool with the highest proportion is EPEC, followed by Campylobacter jejuni,EIEC and ETEC.