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Abstrak :
A 46-year-old man was admitted to ICU with a diagnosis at the time of admission of Guillain Barre Syndrome (GBS) and sepsis due to suspected Ventilator-Associated Pneumoniae (VAP). Specimens for the following laboratory workup were inquired, i.e. complete blood count, culture and resistance workup using specimens obtained from the tip of suction pipe, urinalysis and urine culture, blood culture and resistance, procalcitonin and lactate levels. Neutrophilia was found along with increased procalcitonin and lactate levels, which supported the sepsis diagnosis. Moreover, the result of culture from suction pipe demonstrated colonies of Pseudomonas luteola MDRO, which might be originated from the oropharyngeal colonization of the patients due to poor oral hygiene and ineffective oral hygiene nursing; therefore, the colonies of the microorganism were swabbed away when obtaining the specimens. Ineffective oral hygiene nursing may have a potency to cause VAP and recurrent VAP.

Abstrak :
ABSTRACT
A 31-year-old patient came to visit the outpatient clinic at the hospital for his routine twice-weekly hemodialyis (HD) session. During HD, the patient suddenly developed a fever with shivering. At that time, a diagnosis of catheter-related blood stream infection (CR-BSI) was developed, HD catheter or the catheter double lumen (CDL) was uninstalled and the patient was hospitalized. Results of culture withdrawn through the tip of catheter lumen and peripheral blood revealed identical microorganism, i.e. the Enterobacter cloacae. Diagnosis of CR-BSI in the present case was made based on the 2009 Infectious Disease Society of America (IDSA) criteria. In general, prevention measures for CR-BSI should be taken into account including education for patient, awareness of the health care providers who install the CDL, implementation of procedure for appropriate skin aseptic technique and best practice for HD catheter care, particularly on the exit site of the CDL to prevent the development of CR-BSI.