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"ABSTRACTPurpose: The development of surgical site infection (SSI) after biliary reconstruction is highly influenced by the presence of preoperative bacteria in the bile juice. We selected vancomycin and piperacillin/tazobactam (VCM + PIPC/TAZ) as perioperative prophylactic antibiotics for patients undergoing pancreaticoduodenectomy. This study aimed to retrospectively analyze the effectiveness of VCM + PIPC/TAZ compared to cefmetazole.Methods: Seventy-two patients who underwent pancreaticoduodenectomy between April 2015 and March 2017 at our department were evaluated. Forty patients were administered cefmetazole as the perioperative prophylactic antibiotic, and 32 were administered VCM + PIPC/TAZ. The intraoperative VCM blood concentration (incision, biliary reconstruction, and wound closure) was measured during surgery to confirm the hemodynamics.Results: The frequency of SSIs was significantly lower in the VCM + PIPC/TAZ group (8/32 patients) than in the cefmetazole group (20/40 patients, P = 0.031). Postoperatively, significantly fewer patients in the VCM + PIPC/TAZ group (4/32 patients) required ≥ 15 days of additional antibiotic administration compared to those in the cefmetazole group (14/40 patients, P = 0.033). Six of 32 patients in the VCM + PIPC/TAZ group showed redneck syndrome symptoms. There was no significant difference in the VCM blood concentration between patients with and without SSIs.Conclusions: The use of VCM + PIPC/TAZ can reduce the incidence of SSI after pancreaticoduodenectomy and also reduce the need for the additional administration of antibiotics for ≥ 15 days after surgery."

"PURPOSE: Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs); however, SSI after hepatobiliary and pancreatic surgery (HBPS) has not been well investigated in a large cohort of patients. This study analyzed the factors associated with SSI following HBPS in Japan, using a Japanese national database.METHODS: Data on HBPS performed between 2012 and 2014 were extracted from a national monitoring system for HAI: The Japan Nosocomial Infections Surveillance. Using multivariate logistic regression, I assessed the factors associated with SSI.RESULTS: The cumulative incidence of SSI following HBPS was 15.6% (2873/18,398). The incidence of SSI after pancreatoduodenectomy was 28.0%, which was significantly higher than that after liver resection and other types of HBPS (8.8 and 15.5%, respectively). Among the four traditional risk factors, the American Society of Anesthesiologists score was ineffective for predicting SSI in the final model of all three types of surgery. Additional risk factors were identified, including age and male gender.CONCLUSIONS: The incidence of and factors associated with SSI after the three types of HBPS analyzed differed significantly. To accurately compare hospital performance in relation to SSI following HBPS, the operative procedure category in the surveillance system must be divided into three types."

"Surgical site infection is a harmful problem both for the operator or the patient. Commonly, antibiotics is used irrationally to prevent surgical site infection. In the other hand, irrational use of antibiotics might lead to microbial resistency. Plastic reconstructive surgeryof the ears and nose is classified into clean or clean contaminated surgery which only requires prophylactic antibiotics. The aim of this study is to acquire supporting data for a rational use of antibiotics in plastic reconstructive surgery in ENT-HNS Department FMUI - CMH. This study is a pilot study with negative trial design which includes 12 subjects. Subjects are randomly divided into prophylaxis antibiotic only and combination of prophylaxis antibiotic and post operative antibiotic. This study found 1 subject form the prophylaxis antibiotic only group with surgical site infection. There was no surgical site infection in the control group. There is no significant difference between the two groups. The use of post surgery antibiotic is not neccesary in plastic reconstructive surgery to prevent surgical site infection. Further study is required to support findings of this study.

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Infeksi luka operasi adalah suatu masalah yang sangat merugikan baik bagi operator maupun pasien. Seringkali antibiotika digunakan secara tidak rasional untuk mencegah terjadinya infeksi luka operasi. Di lain pihak, penggunaan antibiotika secara tidak rasional dapat meningkatkan resistensi mikroba. Operasi plastik rekonstruksi telinga dan hidung adalah operasi bersih atau bersih terkontaminasi yang hanya membutuhkan antibiotika profilaksis. Penelitian ini bertujuan untuk mendapatkan data dukung ilmiah untuk penggunaan antibiotika yang rasional dalam tatalaksana operasi rekonstruksi telinga dan hidung di Departemen THT-KL FKUI - RSUPN Dr. Cipto Mangunkusumo. Penelitian ini merupakan suatu penelitian pendahuluan dengan desain uji klinis negatif dengan melibatkan 12 subyek. Subyek penelitian dibagi secara acak menjadi kelompok antibiotika profilaksis saja dan kombinasi antibiotika profilaksis - pasca operasi. Terdapat 1 subyek pada kelompok antibiotika profilaksis yang mengalami infeksi luka operasi. Pada kelompok kombinasi antibiotika profilaksis - pasca operasi tidak terdapat infeksi luka operasi. Tidak terdapat perbedaan bermakna proporsi angka kejadian infeksi luka operasi pada kedua kelompok. Pemberian antibiotika pasca operasi tidak diperlukan dalam operasi plastik rekonstruksi telinga dan hidung untuk mencegah infeksi luka operasi. Penelitian lebih lanjut diperlukan untuk mendukung hubungan yang tidak bermakna antara kedua kelompok."

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Infeksi Daerah Operasi (IDO) merupakan salah satu infeksi terkait pelayanan kesehatan yang dapat terjadi pada pasien yang menjalani operasi. Salah satu upaya pencegahan terjadinya infeksi daerah operasi adalah dengan melakukan penerapan care bundle infeksi daerah operasi. Penerapan care bundle dianggap patuh apabila elemen care bundle dilakukan secara menyeluruh. Penelitian ini bertujuan untuk mengetahui hubungan penerapan care bundle IDO dengan kejadian infeksi daerah operasi (IDO) di Rumah Sakit Fatmawati tahun 2023. Desain penelitian ini dengan menggunakan studi kasus kontrol dimana pengambilan data secara retrospektif dengan menggunakan sampel 388 dari data surveilans infeksi Healthcare Associated Infections (HAIs) dan data audit penerapan care bundle IDO Komite Pencegahan dan Pengendalian Infeksi Rumah Sakit Fatmawati, terdiri dari kelompok kasus 97 terjadi IDO dan kelompok kontrol 291 tidak terjadi IDO. Analisa data dilakukan dengan menggunakan regresi logistik. Hasil penelitian ini mendapatkan bahwa penerapan care bundle tidak patuh memiliki risiko 1,66 kali terjadi infeksi daearah operasi (IDO) dibandingkan dengan penerapan care bundle  patuh dengan (OR=1,66; 95% CI: 1,007-2,735) dan terbukti signifikan secara statistik  dengan p-value 0,046 (<0,05) setelah dikontrol oleh variabel umur dan variabel klasifikasi luka. Variabel kovariat yang juga berhubungan terhadap kejadian infeksi daerah operasi (IDO) di Rumah Sakit Fatmawati adalah umur ≥ 60 tahun berisiko 2,05 kali terjadi infeksi daerah operasi (IDO) dibandingkan umur < 60 tahun (OR= 2,05; 95% CI=1,08-3,89) dan variabel klasifikasi luka operasi terkontaminasi – kotor berisiko 4,48 kali terjadi infeksi daerah operasi (IDO) dibandingkan dengan luka bersih – bersih terkontaminasi (OR= 4,48; 95% CI=1,93-10,42). Hasil penelitian ini dapat juga menjadi masukan bagi Rumah SakitFatmawati untuk dapat lebih meningkatkan kepatuhan penerapan bundle dalam upaya pencegahan infeksi daerah operasi (IDO)

 

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Surgical Site Infection (SSI) is one of the health care Associated infections that can occur in patients undergoing surgery. One effort to prevent surgical site infections (SSI) is to implement surgical site infection care bundle. The implementation of care bundle is considered compliant if the care bundle elements are carried out thoroughly. This study aims to determine the relationship between the implementation of SSI bundle care and the incidence of surgical site infections (SSI) at Fatmawati Hospital in 2023. This research design uses a case control study where data is collected retrospectively using a sample of 388 from Healthcare Associated Infections (HAIs) infection surveillance data, and audit data on the implementation of the SSI care bundle of the Fatmawati Hospital Infection Prevention and Control Committee, consisting of a group of 97 cases where SSI occurred and a control group of 291 where SSI did not occur. Data analysis was carried out using logistic regression. The results of this study found that implementing non-compliant care bundle had a 1.66 times risk of surgical site infection (SSI) compared to implementing compliant care bundle with an (OR=1,66; 95% CI: 1,007-2,735)  and was proven to be statistically significant with a p-value 0.046 (<0.05) after being controlled by age variables and wound classification variables. Covariate variables that are also related to the incidence of surgical site infection (SSI) at Fatmawati Hospital are age ≥ 60 years having a 2.05 times risk of surgical site infection (SSI) compared to age < 60 years (OR= 2,05; 95% CI=1,08-3,89) and The classification variable for contaminated - dirty surgical wounds has a 4.48 times risk of surgical site infection (SSI) compared to clean - clean contaminated wounds (OR= 4,48; 95% CI=1,93-10,42). The results of this research can also be input for Fatmawati Hospital to further improve compliance with bundle implementation in efforts to prevent surgical site infections (SSI).

 

 

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"Latar Belakang: Komplikasi pascaoperasi rentan terjadi pada populasi berisiko tinggi salah satunya adalah populasi yang menjalani operasi mayor. Infeksi daerah operasi (IDO) adalah salah satu komplikasi pascaoperasi yang sering ditemukan pada prosedur laparotomi. Pasien yang menjalani operasi akan mengalami respons stres pascaoperasi berupa peningkatan proses inflamasi yang berdampak pada peningkatan proteolisis protein otot. Sangat penting memerhatikan asupan protein praoperasi untuk meningkatkan cadangan protein otot, mendukung penyembuhan luka pascaoperasi dan imunitas. Penelitian terdahulu menjelaskan bahwa peningkatan asupan protein praoperasi sebesar 10% (> 1,2 g/kg BB/hari) dari kebutuhan dapat mengurangi risiko komplikasi (infeksi, non-infeksi dan dekubitus) sebesar 10%.Metode: Studi kohort prospektif dilakukan pada 93 pasien dengan kelompok cukup protein sebanyak 48 subjek dan kelompok tidak cukup protein sebanyak 45 subjek yang akan menjalani laparotomi elektif di RSUPN Dr. Cipto Mangunkusumo, Jakarta. Analisis kecukupan protein dilakukan dengan metode wawancara selama 7 hari praoperasi. Pemantauan pasien dilakukan selama 30 hari pascaoperasi untuk menilai adanya komplikasi berupa IDO. Analisis hubungan keduanya dilakuan menggunakan uji Chi-Square dan dilakukan analisis multivariat untuk menilai faktor-faktor yang paling berhubungan dengan kejadian IDO pascalaparotomi elektif.Hasil: Terdapat hubungan antara kecukupan protein praoperasi dengan kejadian infeksi daerah operasi pascalaparotomi elektif (RR 3,413; IK 95%, 1,363-8,549; p = 0,004). Hasil analisis multivariat menunjukan kecukupan protein praoperasi dan kadar albumin praoperasi berhubungan kuat untuk memprediksi terjadinya infeksi daerah operasi pascalaparotomi elektif.Kesimpulan: Kecukupan protein dan kadar albumin praoperasi dapat memprediksi kejadian infeksi daerah operasi pascalaparotomi elektif.

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Background: Postoperative complications are prone to occur in high-risk populations, one of which is the population undergoing major surgery. Surgical site infection (SSI) is one of the most common postoperative complications in laparotomy procedures. Patients who undergo surgery will experience a postoperative stress response in the form of an increase in the inflammatory process which results in an increase in muscle protein proteolysis. It is very important to focus on preoperative protein intake to increase muscle protein reserves, support postoperative wound healing and immunity. Previous research explained that the increment of preoperative protein by 10% (> 1.2 g/kg BW/day) can reduce the risk of complications (infectious, non-infectious and decubitus) by 10%.

Methods: A prospective cohort study was conducted on 93 patients with sufficient protein group of 48 subjects and protein insufficient group of 45 subjects undergoing elective laparotomy at Dr. Cipto Mangunkusumo Hospital, Jakarta. Analysis of protein adequacy was carried out by interview method for 7 days preoperatively. Patient monitoring was carried out for 30 days postoperatively to assess complications in the form of SSI. Analysis of association between protein adequacy and SSI was carried out by using the Chi-Square test and multivariate analysis was performed to assess the most associated factors with post elective laparotomy SSI.

Results: There is a association between preoperative protein adequacy and the incidence of post elective laparotomy SSI (RR 3,413; 95% CI, 1,363-8,549; p = 0,004). The multivariate analysis showed that preoperative protein adequacy and preoperative albumin levels were strongly related to predict the occurrence of post elective laparotomy SSI.

Conclusion: Preoperative protein adequacy and albumin levels were strongly related to predict post elective laparotomy SSI."

"Tujuan penelitian ini ialah untuk membandingkan penggunaan antibiotik sebelum dan sesudah penerapan Formularium Rumah sakit (FRS) di Rumah Sakit MMC (RS MMC). Seluruh penggunaan antibiotik yang termasuk dalam klasifikasi J01 Anatomical Therapeutic Chemical (ATC) dicatat dari data pelayanan farmasi rawat-inap dan rawat-jalan. Paramater kuantitatif penggunaan antibiotik pasien rawat inap adalah Defined Daily Doses/100 hari rawat (DDDs/shr) dan DDDs/1000 pasien/hari (DDDs/rph) untuk pasien rawat-jalan. Parameter kualitas penggunaan obat adalah jumlah nama obat yg berdasarkan urutan DDDs membentuk segmen 90% dari total penggunaan obat (DU90%) dan kepatuhan peresepan antibiotik terhadap formularium dalam segmen DU90% berdasarkan nama dagang dan nama generik. Kuantitas dan kualitas penggunaan antibiotik dibandingkan sebelum dan sesudah penerapan FRS (tahun 2000 terhadap tahun 1999). Analisa perbandingan kuantitas penggunaan antibiotik dilakukan dengan. uji peringkat tanda Wilcoxon. Penggunaan antibiotik untuk pasien rawat-inap menurun nyata sebesar 23,1%, dari 124,96 DDDs/shr di tahun 1999 menjadi 96,13 DDDs/shr (p= 0,03). Penurunan penggunaan antibiotik di rawat-jalan 4,9%, dari 3,49 DDDs/rph di tahun 1999 menjadi 3,32 DDDs/rph di tahun 2000 (p=0,58). Siprofloksasin adalah antibiotik yang terbanyak diresepkan di rawat-inap pada tahun 1999 dan 2000, sedangkan di rawat-jalan amoksisilin pada tahun 1999 dan siprofloksasin pada tahun 2000. Kepatuhan peresepan antibiotik terhadap FRS untuk pasien rawat-inap dan rawat-jalan berturut-turut berdasarkan nama generik 100% dan 100%, berdasarkan nama dagang 90,5% dan 94,3%. Profil penggunaan antibiotik dalam segmen DU90% untuk pasien rawat-inap dan rawat-jalan dapat dikatakan tidak menunjukkan perbaikan baik berdasarkan nama dagang maupun nama generik. Sebagai kesimpulan ialah bahwa penerapan FRS di RS MMC hanya menunjukkan penurunan bermakna pada penggunaan antibiotik untuk pasien rawat-inap. (Med J Indones 2004; 13: 173-9)

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The objective of this study is to compare the use of antibiotics at the Metropolitan Medical Center Hospital in Jakarta, Indonesia (MMCH), before and after the implementation of a hospital formulary. All antibiotic data under J01 Anatomical Therapeutic Chemical (ATC) classification were collected from pharmacy inpatient and outpatient records. Quantitative antibiotic use was expressed in Defined Daily Doses/100 bed-days (DDDs/hbd) for inpatients and DDDs/1000 patients/day (DDDs/tpd) for outpatients. The general quality of drug use was assessed in number of drugs that account for 90% of the use (DU90%) and the adherence to hospital formulary by substance and brand name within the DU90% segment. Quantitative and qualitative antibiotic use were compared before and after implementation of the formulary (1999 to 2000). The Wilcoxon rank sign test was used to compare overall antibiotic use. Inpatient antibiotic usage decreased significantly by 23.1%, 124.96 DDDs/hbd in 1999 to 96.13 DDDs/hbd during 2000 (p= 0.03) and outpatient antibiotic usage decreased insignificantly by 4.9%, 3.49 DDDs/tpd during 1999 to 3.32 DDDs/tpd during 2000 (p=0.58).The most commonly antibiotic use was ciprofloxacin in inpatient setting during the study and in out-patient setting was amoxicillin in 1999 and ciprofloxacin in 2000. The adherence to the formulary by substance and by brand name in inpatient department was 100% and 90.5% and in outpatient department was 100% and 94.3% during the study. DU 90% by substance name and by brand name was considerably not improved in both settings. The conclusion is that the effectiveness of one year formulary implementation at MMCH was only revealed in inpatient setting. (Med J Indones 2004; 13: 173-9) "

"Ibu hamil menjadisalah satu kelompok masyarakat yang rentan terinfeksi COVID-19 akibat adanya perubahan fisiologis tubuh. Beberapa penelitian menunjukkan pandemi COVID-19 memengaruhi perawatan selama kehamilan, meningkatkan angka kehamilan risiko tinggi, dan meningkatkan mortalitas padaibu dan bayinya. Menurut WHO, peningkatan jumlah persalinan dengan metode Sectio Caesaria (SC) berbanding lurus dengan peningkatan kejadian infeksi daerah operasi (IDO). Tujuan penelitian ini yaitu menganalisis faktor-faktor intrinsik (umur pasien, status gizi, anemia, kejadian perdarahan)dan faktor ekstrinsik ( pengetahuan tenaga kesehatan tentang pengendalian infeksi rumah sakit, kepatuah kebersihan tangan tenaga kesehatan, kepatuhan penggunaan alat pelindung diri tenaga kesehatan, lama waktu operasi dan penggunaan antibiotika profilaksis) yang menyebabkan kejadian IDO pada pasien pasca-SC selama pandemi COVID-19 di RSUD Bali Mandara. Penelitian menggunakan desain kuantitatif analitik korelasional cross-sectional. Sampel penelitian 183 tenaga kesehatan yang bertugas di ruang perawatan pasca- SC dengan menggunakan rule of thumb dan instrumen penelitiannya berupa kuisioner dan lembar observasi. Data faktor intrinsik diambil dari rekam medis (umur pasien, status gizi, anemia, serta kejadian perdarahan) kemudian dianalisis secara univariat dan bivariat. Dari variabel umur pasien rata-rata berusia 28,19 tahun (26,2–30,15) dengan pasien yang mengalami IDO cenderung lebih muda. Mayoritas subjek mengalami anemia, baik pada kelompok pasien yang mengalami maupun yang tidak mengalami IDO. OR pasien anemia yang mengalami IDO adalah 0,652 sehingga menunjukkan sifat protektif.Dari faktor ekstrinsik diperoleh nilai median pengetahuan nakes tentang pengendalian infeksi sangat baik dengan rata-rata 90 (85,89–90,36). Selain itu, nilai mean kepatuhan kebersihan tangan nakes adalah 3,35 (3,23–3,47) yang berarti sangat baik. sementara nilai median dari faktor kepatuhan penggunaan APD nakes adalah 16 (14,66-15,59) dengan nilai maksimum 16. Pada lama operasi, dengan median yang didapat 42 (41,88–45,18) menit masih serupa dengan standar rerata lama SC (45 menit). Analisis Mann-Whitney menunjukkan bahwa terdapat perbedaan peringkat lama waktu operasi pasien yang tidak signifikan pada pasien yang mengalami IDO pasca-SC dan yang tidak mengalami IDO.Pada penggunaan antibiotika profilaksis, sebagian besar pasien penelitian menggunakannya (RR = 0,16), menunjukkan faktor umur pasien menjadi faktor intrinsik dan kepatuhan pengunaan APD menjadi faktor ekstrinsik yang memengaruhi kejadian IDO pasien COVID-19 pasca SC tahun 2020 di RSUD Bali Mandara. Asuhan antenatal yang terfokus bekerja sama dengan fasilitas kesehatan primer,serta pemangku kebijakan dalam menyiapkan fasilitas kesehatan yang memadai bagi pasien dan tenaga kesehatan serta membangkitkan kesadaran untuk menjaga kesehatan ibu dan bayi oleh pasien dan keluarga merupakan salah satu upaya menurunkan angka IDO.

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Pregnant women are one of the groups of people who are vulnerable to being infected with COVID-19 due to physiological changes in the body. Several studies have shown that the COVID-19 pandemic is affecting care during pregnancy, increasing the rate of high-risk pregnancies, and increasing mortality for both mother and baby. According to WHO, the increase in the number of deliveries using the C-Section (CS) method is directly proportional to the increase in the incidence of surgical site infections (SSI). The purpose of this study was to analyze intrinsic factors (patient age, nutritional status, anemia, bleeding incidence) and extrinsic factors (knowledge of health care workers in hospital infection control, hand hygiene compliance, compliance with the use of personal protective equipment, duration of surgery and use of prophylactic antibiotics). which caused the incidence of SSI in post-CS patients during the COVID-19 pandemic at the Bali Mandara Hospital. This study uses a cross-sectional correlational analytic quantitative design. The research sample was 183 health workers who served in the post-CS treatment room using the rule of thumb and research instruments are form of questionnaires and observation sheets. Intrinsic factor data were taken from medical records (patient age, nutritional status, anemia, and bleeding incidence) and then analyzed by univariate and bivariate. From the age variable, the average patient was 28.19 years (26.2–30.15) with patients experiencing SSI which tended to be younger. The majority of subjects in this study were anemic, both in the group of patients with and without SSI. The OR of anemic patients with SSI was 0.652, indicating protective properties.

From extrinsic factors, the median knowledge of health workers about infection control was very good with an average of 90 (85.89–90.36). In addition, the mean hand hygiene compliance of health workers was 3.35 (3.23–3.47) which means very good. while the median value of the compliance factor for the use of PPE for health workers is 16 (14.66- 15.59) with a maximum value of 16. In the length of operation, the median obtained is 42 (41.88-45.18) minutes, which is still similar to the standard length of time CS(45 minutes). The Mann-Whitney analysis showed that there was a non-significant difference in the ratings for the duration of surgery for patients with post-CS SSI and those without SSI. In the use of prophylactic antibiotics, most of the study patients used them (RR = 0.16), indicating a factor The patient's age is an intrinsic factor and compliance with the use of PPE is an extrinsic factor that affects the incidence of SSI in post-CS COVID-19 patients in 2020 at the Bali Mandara Hospital. Antenatal care that focuses on collaborating with primary health facilities, as well as policy makers in preparing adequate health facilities for patients and health workers as well as raising awareness to maintain maternal and infant health by patients and families is one of the efforts to reduce SSI rates."

"ABSTRAKLaringektomi total merupakan prosedur yang umum dilakukan pada karsinoma sel skuamosa laring. Infeksi luka operasi merupakan salah satu komplikasi yang sering dan dapat memberikan dampak yang besar terhadap kualitas hidup pasien. Penggunaan antibiotika profilaksis merupakan salah satu cara pencegahan ILO namun belum ada literatur pasti yang menyebutkan penggunaan antibiotika profilaksis pada laringektomi total sebaiknya digunakan selama berapa lama. Penelitian ini merupakan suatu studi eksperimental kuasi dengan kontrol yang diambil secara retrospektif untuk melihat kejadian infeksi pasca operatif pada penggunaan Sefazolin sebagai antibiotika profilaksis perioperatif selama 5 hari pada kelompok eksperimen dibandingkan dengan kelompok kontrol statik dari data retrospektif yang menggunakan Sefazolin 30 menit sebelum insisi dan diteruskan dengan antibiotika yang berbeda selama lebih dari 12 hari di Divisi Laring Faring Departemen THT-KL FKUI-RSCM. Tiga dari 12 subyek mengalami infeksi pada kelompok eksperimen dan 2 dari 24 subyek mengalami infeksi pada kelompok kontrol. Tidak terdapat perbedaan yang bermakna proporsi angka kejadian ILO pada kedua kelompok. Analisis univariat dan bivariat dilakukan untuk menilai beberapa faktor risiko dan studi ini menunjukkan adanya hubungan yang bermakna antara penyakit ginjal dan penyakit komorbid >1 dengan angka kejadian ILO.

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ABSTRACT

Total laryngectomy is a common procedure in laryngeal squamous cell carcinoma. Surgical site infection is one frequent complication and it can have a major impact on patient rsquo s quality of life. The use of prophylactic antibiotics is one of the prevention of surgical site infections but there is no definite literature mentioning the use and how long should the prophylactic antibiotics be used in total laryngectomy. This study was a quasi experimental study with retrospective controls to look at the incidence of postoperative infection on the use of Cefazolin as the perioperative prophylactic antibiotics for 5 days on the experimental group compared to the static control group from retrospective data using Cefazolin 30 minutes before incisions and continued with different antibiotics for more than 12 days in Larynx Pharynx Division of ORL HNS Department of Medical Faculty of Universitas Indonesia. Three of 12 subjects had an infection in the experimental group and 2 of 24 subjects had an infection in the control group. There was no significant difference in the proportion of incidence of surgical site infections in both groups. Univariate and bivariate analyzes were performed to assess several risk factors and this study showed a significant association between renal disease and comorbid disease 1 with the incidence rate of surgical site infections."

"Latar belakang: Operasi sesar merupakan salah satu tindakan yang paling seringdilakukan dibidang obstetrik bahkan hingga dalam satu rumah sakit. Angka kejadianinfeksi daerah operasi sesar sangat bervariasi pada seluruh dunia berkisar pada 3-15%.Proses terjadinya IDO merupakan suatu proses multifaktorial yang meliputi mulai daripersiapan perioperatif, kondisi pasien, jenis operasi, jenis kuman dan lain-lain.Tujuan: Mengetahui karakteristik pasien, pola kuman, dan faktor risiko kejadianinfeksi daerah operasi (IDO) di RSCM tahun 2016-2018.Metode: Penelitian ini merupakan penelitian observasional dengan metode cohortretrospective. Subyek penelitian ini merupakan pasien yang menjalani operasi sesar diRSCM pada tahun 2016-2018 yang direkrut menggunakan metode consecutivesampling. Dari data yang didapatkan dilakukan analisis bivariat dan multivariat untukmenentukan faktor risiko terjadinya IDO pasca operasi sesarHasil: Didapatkan sebanyak 2.052 kasus yang memenuhi kriteria inklusi penelitian.Sebanyak 85 kasus infeksi daerah operasi (IDO) didapatkan dari 2.052 tindakan yangdilakukan (4,14%). Sebanyak 85 kelompok kasus IDO dan 1.967 kelompok kasuskontrol diikutsertakan dalam analisis faktor risiko. Kuman paling sering didapatkanpada kultur kasus infeksi daerah operasi pasca operasi sesar adalah Staphylococcusaureus (16,5%), Klebsiella pneumoniae (12,9%), Escherischia coli (9,4%),Enterococcus faecalis (9,4%), dan lainnya (21,2%). Variabel yang berpengaruhterhadap kejadian IDO pasca secar adalah gawat janin (p=0,002 ;AOR = 2,265 IK95% 1,350-3,801) dan IMT ≥30 kg/m2 (p=0,028; AOR 1,824 IK95% 1,066-3,121).Kesimpulan: Faktor yang berpengaruh terhadap kejadian IDO pasca SC adalah gawatjanin (p=0,002 ;AOR = 2,265 IK95 % 1,350-3,801) dan IMT ≥30 kg/m2 (p=0,028;AOR 1,824 IK95% 1,066-3,121).

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Background: Caesarean section is one of the most performed operations in the fieldof obstetrics and even in hospital. The incidence of infections in cesarean section variesgreatly around the world at 3-15%. Surgical site infection is a multifactorial processthat starts from the perioperative preparation, the patient, the type of surgery, the typeof germ and other factors.Objective: To determine the characteristics of patients, bacterial patterns, and riskfactors for the incidence of surgical site infection (SSI) in Cipto MangunkusumoNational General Hospital in 2016-2018.Method: This study was an observational study using a retrospective cohort method.The subject of this study were patients undergoing cesarean section in CiptoMangunkusumo National General Hospital in 2016-2018 recruited using consecutivesampling method. Based on the data obtained, bivariate and multivariate analysis wereconducted to determine the factors affecting after caesarean section SSIResult: A total of 2.052 subjects were included in the study. There were 85 cases ofsurgical site infection (SSI) out of 2.052 operations (4.14 %). A total of 85 SSI casegroups and 1.967 control groups were included in the risk factor analysis. Bacteriamost commonly found in surgical site infection culture were Staphylococcus aureus(16,5%), Klebsiella pneumoniae (12,9%), Escherischia coli (9,4%), Enterococcusfaecalis (9,4%), and others (21,2%). Variable associated with SSI in this study is fetaldistress (p=0,002 ;AOR = 2,265 CI 95 % 1,350-3,801) and BMI ≥30 kg/m2 (p=0,028;AOR 1,824 CI 95% 1,066-3,121).Conclusion: Factors influencing the incidence of SSI after SC was fetal distress(p=0,002 ;AOR = 2,265 CI 95 % 1,350-3,801) and BMI ≥30 kg/m2 (p=0,028; AOR1,824 CI 95% 1,066-3,121)."