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"Latar Belakang MasalahPerdarahan peri-intraventrikular pada bayi baru lahir merupakan salah sau penyebab kematian pada neonatus. Keadaan ini juga dapat menimbulkan gejala sisa berupa kelainan neurologis di kemudian hari.Perdarahan dimulai dari jaringan pembuluh darah yang terdapat pada matriks germinal di lapisan subependimal (Volpe, 1981-1; Volpe, 1981-2; Allan dan Volpe, 1986). Matriks germinal merupakan tempat berproliferasi neuron dan glia yang kelak akan bermigrasi ke lapisan-lapisan korteks otak. Hal ini terjadi pada bulan ketiga dan bulan kelima masa janin.Matriks germinal ini berangsur-angsur berkurang dan menghilang setelah janin cukup bulan (Kirks dan Bowie, 1986; Volpe, 1981-2). Dengan demikian semakin muda usia janin, semakin besar kemungkinan timbul perdarahan peri-intraventrikular pada bayi.Neonatus dengan masa gestasi kurang dari 32 minggu dan berat lahir kurang dari 1500 gram, 40 sampai 45% akan menderita perdarahan peri-intraventrikular (Papile dkk., 1978; Ahmann dkk., 1980). Baerts di Belanda (1984) yang meneliti neonatus kurang dari 37 minggu mendapatkan angka 40% .Perdarahan dapat timbul pada usia 12 jam sampai 7 hari setelah lahir, terbanyak pada hari kedua dan ketiga dengan rata-rata pada usia 38 jam (Tsiantos dkk., 1978).Di Indonesia belum diketahui dengan jelas berapakah frekuensi .perdarahan peri-intraventrikular pada neonatus kurang bulan. Belum Pula diketahui bagaimana karakteristik bayi-bayi tersebut. Padahal angka prematuritas di Indonesia cukup tinggi, yaitu berkisar antara 13,9% - 25% (Sarwono, 1977; Alisyahbana, 1977; Monintja, 1979; Kosim dkk., 1984; Ramelari, 1989).Fasilitas untuk mendeteksi adanya perdarahan peri-intraventrikular yaitu ultrasonografi, telah ada di sebagian besar Rumah-rumah Sakit di Indonesia. Ketepatan diagnostik alat ini mencapai 85 - 97% (Szymonowicz dkk., 1984).Rumusan MasalahBerapakah kekerapan perdarahan peri-intraventrikular pada neonatus kurang bulan di RSCM Jakarta dan bagaimana karakteristik bayi-bayi tersebut?Tujuan PenelitianUmum :mendapatkan angka proporsi perdarahan peri-intraventrikular pada neonatus kurang bulan di RSCM Jakarta dan mengetahui karakteristik bayi-bayi tersebut (dibandingkan dengan bayi tanpa perdarahan)?"

"Neonatus kurang bulan (NKB) merupakan kelompok risiko tinggi yang rentan terhadap masalah perkembangan. Selama beberapa dekade terakhir, kemajuan teknologi di Neonatal Intensive Care Unit (NICU) telah meningkatkan kelangsungan hidup NKB. Perawatan NKB adalah tidak hanya untuk menurunkan angka kematian tetapi juga untuk meningkatkan kualitas hidup bagi neonatus yang hidup. Penelitian ini bertujuan untuk melihat luaran perkembangan dan faktor risiko gangguan dari neonatus kurang bulan pascarawat di RSCM. Ini merupakan suatu studi analitik dengan metode potong lintang terhadap NKB pascarawat di RSCM selama periode April-Agustus 2023. Penilaian perkembangan menggunakan instrumen Bayley Scales of Infant and Toddler Development edisi III. Hubungan antara usia kehamilan, kecil masa kehamilan, status gizi, brain injury, sepsis neonatal dengan luaran perkembangan dianalisis dengan uji Fisher exact. Dari 75 subjek, sebesar 29,3% neonatus kurang bulan mengalami gangguan perkembangan. Gangguan motor merupakan gangguan perkembangan yang paling banyak ditemukan, yaitu sebesar 21,3%, diikuti gangguan bahasa, kognitif, dan sosial-emosional, yaitu 18,7%, 10,7% dan 1,3%, secara berurutan. Status gizi berhubungan signifikan dengan luaran perkembangan bahasa ekspresif (p=0,004; OR 8,04, CI=1,64-42,63).

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Preterm neonates are a high-risk group of developmental problems. Preterm neonates care is not only to reduce mortality but also to improve the quality of life. Cipto Mangunkusumo Hospital is a tertiary neonatal referral hospital with the best neonatal services in Indonesia. This study was aimed to analyze the risk factors of developmental delay and developmental outcomes of preterm neonates after hospitalization at RSCM. An analytic study with cross-sectional design involves premature neonate post-hospitalization at RSCM during April-August 2023. Developmental assessment using of Bayley Scales of Infant and Toddler Development-Third edition. Association between gestational age, small gestational age, nutritional status, brain injury, neonatal sepsis and developmental outcomes were analyzed using Fisher exact test. Out of the 75 subjects, 29.3% of preterm neonates experienced developmental disorders. Motor disorders were the most commonly identified developmental issue, accounting for 21.3%, followed by language, cognitive, and social-emotional disorders. Nutritional status was significantly associated with the outcomes of expressive language development (p=0.004; OR 8.04, CI=1.64-42.63)."

"Latar belakang: Anemia defisiensi besi (ADB) merupakan salah satu masalah utama kesehatan dunia, terutama di negara berkembang, dan defisiensi besi (DB) adalah salah satu penyebab tersering anemia pada bayi dan anak. Bayi berat lahir rendah (BBLR) berisiko tinggi mengalami ADB dan dampak kesehatan seperti gangguan pertumbuhan, kekebalan tubuh, kognitif, psikomotor, dan tingkah laku.Tujuan: Mengetahui status besi dan menganalisis berdasarkan asupan nutrisi pada bayi usia kronologis 4 bulan dengan riwayat berat lahir kurang dari 2.500 gram.Metode: Penelitian ini dengan desain potong lintang yang dilakukan pada bayi usia kronologis 4 bulan dengan riwayat berat lahir rendah yang kontrol di poli tumbuh kembang dan pediatri sosial Kiara RSCM, pada bulan April 2020 hingga Juni 2021.Hasil: Sebanyak 67 subyek yang diikutsertakan dalam penelitian, rerata berat lahir 1.723 g, rerata usia gestasi 33,6 minggu, bayi yang medapatkan ASI eksklusif sebanyak 23,9%, ASI predominan 16,4% dan susu formula predominan sebanyak 59,7%. Kadar feritin pada subyek yang mendapatkan ASI eksklusif dan predominan lebih rendah dibandingkan yang mendapatkan susu formula predominan yaitu 46 (2,82-221) µg/L dibandingkan 58,8 (8-488) µg/L dengan nilai p = 0,199. Rasio prevalens bayi yang mendapatkan ASI eksklusif dan predominan mengalami DB dan ADB dibandingkan susu formula adalah 2,286 (IK 95% 1,13-4,621) p = 0,035.              Kesimpulan: Pada penelitian ini prevalens anemia 50,7%, DB 14,9%, dan ADB 13,4%. Subyek yang mendapatkan asupan ASI eksklusif dan predominan memiliki kadar feritin yang cenderung lebih rendah dibandingkan dengan susu formula predominan.

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Background: Iron deficiency anemia (IDA) is one of the main health problems in the world, especially in developing countries, and iron deficiency (ID) is one of the most common causes of anemia in infants and children. Low birth weight (LBW) infants are at high risk of developing IDA and health impacts such as impaired growth, immunity, cognitive, psychomotor, and behavioral.

Methods: This study was a cross-sectional design conducted on infants of chronological age 4 months with a history of low birth weight who was controlled in the growth and development clinic, Kiara Cipto Mangunkusumo Hospital from April 2020 to June 2021.

Result:  A total of 67 subjects were included in the study, the average birth weight was 1.723 g, the mean gestational age was 33.6 weeks, infants who received exclusive breastfeeding were 23.9%, predominantly breastfed 16.4% and predominantly formula milk was 59.7%. Feritin levels in subjects who received exclusive and predominantly breast  milk were lower than those who received predominant formula milk, was 46 (2.82-221) compared to 58.8 (8-488) with p value = 0.199. The prevalence ratio of infants who were exclusively breastfed and predominantly had ID and IDA compared to formula milk was 2.28 (95% CI 1.13-4.621) p = 0.035.

>Conclusion: Prevalence of anemia in this study was 50.7%, ID 14.9%, and IDA 13.4%. Subjects who received exclusive and predominant breast milk tend to have lower ferritin levels compared to predominant formula milk."

"Latar Belakang. Sepsis neonatal awitan dini SNAD masih merupakan masalah di Indonesia. Vitamin D memiliki efek pada fungsi imunitas. Neonatus kurang bulan NKB berisiko mengalami defisiensi kadar vitamin D. Hubungan kadar vitamin D dengan kejadian SNAD pada NKB belum jelas.Tujuan. Menganalisis hubungan kadar vitamin D dengan kejadian SNAD pada NKB.Metode. Duapuluh NKB dengan klinis dan pemeriksaan laboratorium menyokong SNAD kelompok kasus dan 20 NKB tanpa hasil laboratorium SNAD kelompok kontrol ikut dalam penelitian ini. Subjek penelitian adalah NKB usia gestasi ge; 28 sampai dengan < 37 minggu dirawat di RSUPN Cipto Mangunkusumo selama bulan Juli - September 2017. Pemeriksaaan kadar vitamin D 25 OH D dengan metode competitive chemiluminescense immunoassay CLIA direk dengan alat Diasorin Liaison.Hasil. Median kadar vitamin D pada NKB dengan SNAD 8,95 4,10 - 16,30 ng/mL dengan rerata usia gestasi 33,25 1,71 minggu dan rerata berat lahir 1863,75 415,06 gram. Median kadar vitamin D tanpa SNAD 11,75 5,80 - 42,80 ng/mL dengan rerata usia gestasi 34,67 1,53 minggu dan rerata berat lahir 2125,0 340,55 gram. Median kadar vitamin D NKB SNAD lebih rendah secara bermakna dibandingkan NKB tanpa SNAD.

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Background. Early onset neonatal sepsis EONS is still a problem in Indonesia. Vitamin D has effect on immune function. Preterm infants have a risk of deficiency of vitamin D levels. The association between vitamin D levels with EONS were unclear.Objective. To determine the association between vitamin D levels with EONS in preterm infants.Methods. Twenty preterm infants with clinical and laboratory finding of EONS study group and 20 preterm infants with no signs of laboratory infection control group were enrolled this study. The subjects were preterm infants of gestational age ge 28 37 weeks in Cipto Mangunkusumo Hospital during July September 2017. Vitamin D 25 OH D levels were measured using Diasorin Liason with competitive chemilunescence immunoassay CLIA technique.Results. Median vitamin D levels with EONS was 8,95 4,10 16,30 ng mL, mean of gestational age and birth weight were 33,25 1,71 weeks and 1863,75 415,06 g, respectively. Median vitamin D levels without EONS was 11,75 5,80 42,80 ng mL, mean of gestational age and birth weight were 34,67 1,53 weeks and 2125,0 340,55 g, respectively. Median vitamin D levels of preterm infants with EONS was significantly lower than without EONS.Conclusion. Vitamin D levels are associated with EONS in preterm infants."

"Latar Belakang: Neonatus kurang bulan berisiko mengalami hiperbilirubinemia 12,5 kali lipat lebih besar dibandingkan neonatus cukup bulan, 54% membutuhkan fototerapi. Hiperbilirubinemia dapat menyebabkan neurotoksisitas hingga kematian, sedangkan fototerapi dapat menyebabkan beberapa komplikasi. Terapi ajuvan seperti asam ursodeoksikolat diperlukan untuk meningkatkan klirens bilirubin sehingga mengurangi durasi fototerapi. Saat ini belum ada data yang tersedia mengenai pengaruh penambahan asam ursodeoksikolat terhadap durasi fototerapi pada neonatus kurang bulan dengan hiperbilirubinemia.Tujuan: Penelitian ini bertujuan untuk menentukan durasi fototerapi dan penurunan kadar bilirubin pada neonatus kurang bulan yang mendapat fototerapi dan tambahan asam ursodeoksikolat.Metode: Penelitian ini merupakan uji klinis, terandomisasi, tersamar ganda, dengan kontrol plasebo, mencakup neonatus usia gestasi <37 minggu, mengalami hiperbilirubinemia yang terindikasi fototerapi, dirawat di unit perinatologi Rumah Sakit Dr. Cipto Mangunkusumo sejak bulan Februari-Mei 2024, sudah mendapat minum per oral sebanyak ≥10 mL/kgBB/hari. Grafik American Academy of Pediatrics (AAP) tahun 2022 dan The Royal Women’s Hospital (RWH) tahun 2020 digunakan untuk menentukan batas fototerapi. Total 40 subjek yang dibagi menjadi 2 kelompok. Kelompok intervensi (n=20) mendapat asam ursodeoksikolat 10 mg/kgBB/hari (puyer) dibagi 2 dosis sebagai terapi tambahan fototerapi, sedangkan kelompok kontrol (n=20) hanya mendapat fototerapi. Kadar bilirubin total diukur setiap 24 jam dengan serum dan/atau Bilistick. Hasil: Rerata durasi fototerapi adalah 24 jam pada kelompok intervensi, 36 jam pada kelompok kontrol (p=0,289). Di kelompok intervensi, penurunan kadar bilirubin setelah 24 jam fototerapi 4,15 ± 5,50 mg/dL (p=0,758), setelah 48 jam fototerapi 4,99 ± 7,66 mg/dL (p=0,664). Kadar bilirubin setelah 48 jam fototerapi lebih rendah bermakna pada neonatus yang mendapat asam ursodeoksikolat (p=0,020).Kesimpulan: Penambahan asam ursodeoksikolat tidak mengurangi durasi fototerapi maupun mempercepat penurunan kadar bilirubin pada neonatus kurang bulan dengan hiperbilirubinemia yang mendapat fototerapi setelah 24 jam dan 48 jam. Penelitian lanjutan perlu dilakukan sampai jumlah sampel terpenuhi.

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Background: Preterm neonates have a 12.5 times higher risk of developing hyperbilirubinemia compared to full-term neonates, with 54% requiring phototherapy. Hyperbilirubinemia can lead to neurotoxicity and even death, while phototherapy can cause several complications. Adjuvant therapy, such as ursodeoxycholic acid, is needed to increase bilirubin clearance and reduce the duration of phototherapy. Currently, there is no available data on the effect of adding ursodeoxycholic acid on the duration of phototherapy in preterm neonates with hyperbilirubinemia.

Objective: This study aims to determine the duration of phototherapy and the reduction of bilirubin levels in preterm neonates who receive phototherapy and additional ursodeoxycholic acid.

Method: This study is a randomized, double-blind, placebo-controlled clinical trial, involving neonates with a gestational age of less than 37 weeks who have hyperbilirubinemia requiring phototherapy, treated in the perinatology unit of Dr. Cipto Mangunkusumo Hospital from February to May 2024, and who have been fed orally at least 10 mL/kgBW/day. The 2022 American Academy of Pediatrics (AAP) and 2020 The Royal Women’s Hospital (RWH) charts were used to determine the phototherapy threshold. A total of 40 subjects were divided into 2 groups. The intervention group (n=20) received 10 mg/kgBW/day of ursodeoxycholic acid (powder) divided into 2 doses as an additional phototherapy treatment, while the control group (n=20) received only phototherapy. Total bilirubin levels were measured every 24 hours using serum and/or Bilistick.

Results: The average duration of phototherapy was 24 hours in the intervention group and 36 hours in the control group (p=0.289). In the intervention group, the reduction in bilirubin levels after 24 hours of phototherapy was 4.15 ± 5.50 mg/dL (p=0.758), and after 48 hours of phototherapy was 4.99 ± 7.66 mg/dL (p=0.664). Bilirubin levels were significantly lower after 48 hours of phototherapy in neonates who received ursodeoxycholic acid (p=0.020).

Conclusion: The addition of ursodeoxycholic acid did not reduce the duration of phototherapy nor accelerate the decrease of bilirubin levels in preterm neonates with hyperbilirubinemia who received phototherapy after 24 and 48 hours. Further research needs to be conducted until the sample size is sufficient."

"Latar belakang. Enterokolitis nekrotikan (EKN) merupakan penyakit inflamasi akut pada saluran cerna neonatus, terutama neonatus kurang bulan (NKB). Penyebab terjadinya EKN hingga saat ini belum diketahui tetapi terdapat beberapa faktor risiko yang berhubungan dengan kelainan tersebut.Tujuan. Mengetahui rerata usia dan faktor risiko terjadinya EKN pada NKB.Metode. Penelitian ini merupakan penelitian kohort retrospektif berdasarkan data rekam medis NKB yang dirawat selama periode Januari 2017-Desember 2019 di Divisi Neonatologi Rumah Sakit Cipto Mangunkusumo (RSCM). Analisis faktor risiko menggunakan analisis bivariat dan multivariat.Hasil. Sampel yang didapatkan sebanyak 160 subyek. Rerata usia terjadinya EKN adalah 11,38 hari. Analisis bivariat didapatkan faktor risiko berat lahir <1500 gr (p=0,006, RR 2,623, IK 95% 1,302-5,282), usia gestasi <32 minggu (p=0,009, RR 2,531, IK 95% 1,246-5,141), dan pemberian antibiotik ≥5 hari (p=0,007, RR 4,831, IK 95% 1,391-16,780) meningkatkan risiko terjadinya EKN. Hasil analisis multivariat pada faktor risiko berat lahir, usia gestasi, pemberian antibiotik, dan jenis nutrisi enteral tehadap terjadinya EKN, tidak didapatkan hasil yang bermakna secara statistik. Faktor prenatal dan intrapartum tidak dapat diketahui karena keterbatasan data.Kesimpulan. Rerata usia terjadinya EKN adalah usia 2 minggu pertama kehidupan neonatus. Faktor risiko terjadinya EKN bersifat multifaktorial dan terdapat kecenderungan dipengaruhi oleh berat lahir rendah, usia gestasi yang muda, serta pemberian antibiotik ≥5 hari.

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Background. Necrotizing enterocolitis (NEC) is an acute inflammatory disease of gastrointestinal tract that commonly occurs in newborns, particularly with preterm birth. To date, the cause of NEC is not known, however several risk factors contribute to the occurrence of this disease.

Objective. To investigate mean age and risk factors of NEC in premature newborns.

Methods. A retrospective cohort study was conducted using secondary data from medical records of premature infants hospitalised since January 2017 until December 2019 in Neonatology Division, Cipto Mangunkusumo Hospital, Jakarta. Risk factors was analysed using bivariate and multivariate analysis.

Results. A total of 160 subjects were obtained and analysed. Mean age of NEC occurrance is 11,38 days. Bivariate analysis showed birth weight <1500 gram (p=0,006, RR 2,623, 95% CI 1,302-5,282), gestational age <32 weeks (p=0,009, RR 2,531, 95% CI 1,246-5,141), and antibiotics administration ≥5 days (p=0,007, RR 4,831, 95% CI 1,391-16,780) were associated with increased risk of NEC. However multivariate analysis revealed birth weight, gestational age, antibiotics administration, and enteral nutrition type showed no association with NEC occurrence. Prenatal and intrapartum factors were not studied due to lack of data.

Conclusion. Mean age of occurrence is within the first 2 weeks of life. Risk factors of NEC are multifactorial and tend to be related with smaller gestational age, low birth weight, and antibiotic use ≥5 days."

"Latar belakang: Komplikasi neurologis dan tumbuh-kembang sering diteliti pada neonatus cukup bulan (NKB), tetapi masalah pada ginjal masih jarang diperhatikan. Mayoritas NKB lahir ketika ginjal masih berkembang, sehingga lebih rentan mengalami gangguan fungsi ginjal. Profil fungsi ginjal dan faktor yang memengaruhinya penting untuk diketahui. Tujuan: Penelitian ini bertujuan untuk mengetahui profil fungsi ginjal, prevalens gangguan fungsi ginjal, dan faktor yang memengaruhi fungsi ginjal pada NKB. Metode: Penelitian ini merupakan studi deskriptif analitik dengan rancangan penelitian kohort retrospektif observasional di Rumah Sakit Cipto Mangunkusumo menggunakan data rekam medik dari Oktober 2022-Oktober 2023. Partisipan penelitian adalah seluruh NKB yang dirawat dan melakukan pemeriksaan kreatinin darah dengan kriteria eksklusi meninggal sebelum usia 48 jam. Faktor risiko yang diteliti adalah nutrisi maternal, diabetes gestasional, hipertensi pada kehamilan, anemia pada kehamilan, steroid antenatal, berat lahir, pertumbuhan janin terhambat, sepsis neonatorum, asfiksia neonatorum, anemia prematuritas, steroid pascanatal, dan gentamisin. Hasil: Kreatinin serum diperiksa pada 26,1% (192/737) NKB. Terdapat 169 subyek yang diinklusi. Median usia gestasi subyek adalah 31 (24–36) minggu dan berat lahir (BL) 1.335 (500–2.815) gram. Gangguan fungsi ginjal ditemukan pada 66,3% (112/169) subyek. Gangguan fungsi ginjal yang ditemukan berupa penurunan LFG 6(3,6%), hipertensi 91(53,8%), proteinuria 1(0,6%), dan campuran dari ketiganya 71(42,0%) subyek. Neonatus yang mengalami gangguan fungsi ginjal terbanyak pada usia gestasi 28–31 minggu (45,5%). Berdasar berat lahir terbanyak < 1000 g (81,6%), 1000–1499 (67,2%), 1500–2499 (59,6%). Variabel yang secara bersama-sama memengaruhi gangguan fungsi ginjal pada pasien neonatus kurang bulan adalah BL < 1.000 gram (OR 8,38; IK 95% 1,14–61,34; p=0,036), sepsis berat (OR 2,20; IK 95% 1,06–4,54; p=0,034) dan adanya anemia prematuritas (OR 2,86; IK 95% 1,15–7,12; p=0,024). Simpulan: Faktor risiko terjadinya gangguan fungsi ginjal pada NKB adalah BL < 1.000 gram, sepsis berat, dan anemia prematuritas.

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Background: Neurodevelopmental complication is often studied in preterm neonates (PTNs), but nephrological problem is usually overlooked. The majority of PTNs are born when the kidneys are still developing. Therefore, PTN is more susceptible to impaired kidney function (IKF) and is important to know the risk factors. Objective: his study aims to determine the prevalence of IKF and identify risk factors in PTN. Methods: This research is an analytical descriptive study with an observational cohort retrospective study methods at Cipto Mangunkusumo Hospital using medical record data from October 2022-October 2023. Subjects studied were all treated PTN who had creatinine evaluated during treatment and criteria exclusion of death within 48 hours was applied. The risk factors studied were maternal nutrition, gestational diabetes, hypertension in pregnancy, anemia in pregnancy, antenatal steroids, birth weight, fetal growth restriction, neonatal sepsis, neonatal asphyxia, anemia of prematurity, postnatal steroids, and gentamycin use. Results: Serum creatinine was assessed in 26,1% (192/737) PTN. One-hundred-and-sixtynine subjects were included. The median gestational age (GA) was 31 (24–36) weeks and birth weight (BW) 1,335 (500–2,815) grams. Impaired kidney function was found in 112/169 (66,33%) subjects. Abnormalities found were decreased in GFR 6(3.6%), hypertension 91(53.8%), proteinuria 1(0.6%), and mixture of the aboves 71(42.0%) subjects. Neonates with IKF mostly found with GA 28–31 weeks (45,5%). Based on birth weight, IKF was found in < 1000 g (81.6%), 1000–1499 (67.2%), 1500–2499 (59.6%). Variables that influence IKF in PTN are BW < 1,000 grams (OR 8.38; 95% CI 1.14 – 61.34; p=0.036), severe sepsis (OR 2.20; CI 95% 1.06–4.54; p=0.034), and the presence of anemia of prematurity (OR 2.86; 95% CI 1.15 – 7.12; p=0.024). Conclusion: Risk factors for IKF in PTN were BW < 1,000 grams, severe sepsis and anemia of prematurity."

"Pemantauan Terapi Obat pada Neonatus Kurang Bulan, Bayi Berat Lahir Rendah, dan Sepsis di Ruang Neonatus Intensive Care Unit (NICU) RSUP Fatmawati Bulan September 2020.

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Neonates, especially preterm infants have weak physical defenses and immature immune function, making them susceptible to bacterial invasion. One of the efforts to achieve the Sustainable Development Goals (SDGs), which is to reduce the incidence of neonatal mortality to 12 per 1,000 live births, it is necessary to collaborate between health workers in treating patients. Pharmacists in hospitals need to carry out their roles, one of which is by monitoring the therapy given. Data were collected directly by looking at the cardex and patient's medical records with the following criteria: less-month neonatal patients, receiving polypharmacy, patients with antibiotic therapy, and length of stay in the hospital ≥5 days. The data obtained were analyzed using the SOAP method and identified problems related to drugs. From the Monitoring of Drug Therapy (PTO), it was found that drug-related problems that occurred were dose mismatches and frequency mismatches, and analysis of the evaluation of antibiotic administration (EPA) with the Gyssens method found that the use of antibiotics was found in category IIIa, namely giving meropenem too long and category IIa, which was not the right dosage."

"Latar belakang: Acinetobacter baumannii Acb merupakan salah satu organisme penyebab infeksi neonatal di ruang rawat perinatologi. Kemampuan Acb menyebabkan resistensi antibiotik dan mampu mempertahankan diri dari desikasi serta desinfeksi berpotensi mengakibatkan kejadian luar biasa infeksi rumah sakit. Infeksi Acb terutama galur resisten dapat memengaruhi keberhasilan terapi, meningkatkan waktu dan biaya perawatan, serta angka mortalitas. Informasi mengenai Acb di Indonesia sangat terbatas.Tujuan: 1 Mengetahui prevalens infeksi Acb. 2 Mengetahui karakteristik neonatus terinfeksi Acb. 3 Mengetahui pola sensitivitas dan resistensi Acb terhadap antibiotik 4 Mengetahui proporsi luaran neonatus terinfeksi Acb. 5 Mengetahui faktor risiko infeksi Acb pada neonatus di perawatan Unit Perinatologi Rumah Sakit Cipto Mangunkusumo RSCM.Metode: Penelitian kohort retrospektif dengan pengambilan data rekam medis pasien neonatus yang dirawat di Unit Perinatologi RSCM sejak 1 Januari 2012 hingga 30 Juni 2016 dengan diagnosis sepsis neonatal awitan lambat. Faktor- faktor yang dianggap berpengaruh dianalisis secara multivariat.Hasil: Pada periode 1 Januari 2012-30 Juni 2016, didapatkan 540 subyek dengan diagnosis sepsis neonatal awitan lambat. Hampir seluruh subyek merupakan bayi prematur. Prevalens infeksi Acb didapatkan sebanyak 35,4 dengan infeksi Acb galur resisten sebanyak 94,8. Mortalitas akibat Acb adalah 65,4. Sensitivitas antibiotik paling baik yaitu polimiksin dan kolistin sebanyak 26,1 dan 20,6. Resistensi antibiotik paling tinggi ditemukan pada golongan sefalosporin 93 dan karbapenem 82 . Pada analisis multivariat didapatkan faktor risiko yang bermakna yaitu penggunaan karbapenem sebelum terinfeksi Acb p

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Background Acinetobacter baumannii Acb attributes as pathogen for serious nosocomial infections in Neonatal units. The way it accumulates mechanisms of antimicrobial and desiccation resistance may cause nosocomial outbreaks. It represents a challenge as therapeutic options are limited and associated with an increased length of hospital stay and high mortality. Informations about Acb are not well established in Indonesia.Aim 1 To determine the prevalence of Acb infection. 2 To described the clinical characteristics of acb infections. 3 To identify antimicrobial susceptibility of Acb. 4 To determine the mortality rate of Acb infection. 5 To determine the risk factors associated with Acb infection in Perinatology Unit of Cipto Mangunkusumo Hospital.Method A retrospective, cohort study was conducted in Neonatal Unit of Cipto Mangunkusumo Hospital by reviewing medical records of neonates diagnosed as late onset sepsis from 1st January 2012 to 30th June 2016. Risk factors of infection were compared in multivariable analysis.Result From 1st January 2012 to 30th June 2016, 540 cases of late onset sepsis were indentified. Preterm was noted in most cases. The prevalence of Acb infection were 35.4. Antibiotic resistant Acb was the most predominant strain accounting for 94.8 of cases of Acb infection. Overall mortality was 65.4. Isolates were resistant to cephalosporins 93 and carbapenems 82 , while susceptible to polymyxins 26.1 and colistin 20.6. Statistically significant risk factors were neonates exposed to carbapenems before infection odds ratio OR 1.989 p"