[ABSTRAK Latar Belakang: Saat ini insidens infeksi jamur invasif yang disebabkan olehCandida semakin meningkat. Candida merupakan genus jamur yang paling seringmenyebabkan infeksi jamur invasif. Kandidiasis invasif berdampak padameningkatnya angka mortalitas dan meningkatnya masa rawat dan biayaperawatan. Sampai saat ini di Indonesia belum ada studi yang meneliti tentangprevalensi, karakteristik klinis pasien dan pola sebaran spesies jamur pada pasienkandidiasis invasif dewasa.Tujuan: Mengetahui prevalensi dan karakteristik klinis pasien kandidiasis invasifdewasa di RSCM serta mengetahui pola penyebabnya.Metodologi: Penelitian ini bersifat retrospektif, menggunakan desain potonglintang, berdasarkan data sekunder (rekam medis) pasien sepsis yang dirawat diRSCM sejak bulan Januari 2012 sampai bulan Juni 2014. Dari rekam medik, dicaripasien kandidiasis invasif (KI) berdasarkan kriteria EORTC/MSG tahun 2008. Padapasien kandidiasis invasif, selanjutnya dilakukan pencatatan data demografis, dataklinis dan penunjang, diagnosis, spesies penyebab, jenis obat antifungal danantibiotik yang diberikan, luaran klinik serta masa rawat.Hasil: Prevalensi pasien kandidiasis invasif di RSCM adalah 12,3%, yakni 91pasien KI dari 738 pasien sepsis yang rekam mediknya dapat diteliti. Dari 91 pasienKI yang memenuhi kriteria diagnosis EORTC/MSG tahun 2008, didapatkan 35pasien dengan kategori proven, 31 pasien probable dan 25 pasien possible.Manifestasi klinik KI yang paling sering ditemukan adalah kandidemia denganpenyebab utama Candida albicans. Rerata usia pasien adalah 47,9 tahun yangdidominasi oleh pasien medis, dirawat di ruang rawat biasa, non-neutropenia danmenderita syok sepsis. Kebanyakan pasien menderita keganasan, yang seringkalidisertai infeksi paru, sedangkan piranti medik yang paling sering digunakan adalahkateter urin. Umumnya pasien mendapat antibiotik cefalosporin generasi tiga,sementara antifungal yang paling sering digunakan adalah flukonazol. Sebagianpasien KI (44%) tidak mendapatkan pengobatan antifungal sistemik. Mortalitasnyasebesar 68,4% dan median masa rawat total adalah 27 hari.Kesimpulan: Prevalensi kandidiasis invasif sebesar 12,3%. Mortalitas akibatkandidiasis invasif cukup tinggi dan C. albicans merupakan spesies yang palingsering ditemukan. ABSTRACT Background: Recently, incidence of invasive fungal infection is rising. Candida isthe most common cause of invasive fungal infection. Invasive candidiasiscontribute to high mortality, prolonged hospitalization and high cost. Until now inIndonesia, there is no study about the prevalence, clinical characteristic andetiologic pathogen of invasive candidiasis in adults.Objective: To study the prevalence, clinical characteristic and etiologic pathogenin adult patients with invasive candidiasis at RSCM.Methods: Retrospective, cross sectional, based on the medical record sepsispatients which hospitalized in January 2012 until June 2014. We traced candidiasisinvasive (IC) patients which fulfill EORTC/MSG 2008 diagnostic criteria for IC.We recorded demographic data, clinical and supporting data, diagnosis, etiologicpathogen, antibiotic, antifungal, outcome and length of stay.Results: IC prevalence at RSCM was 12,3%. We have found 91 IC patients from738 sepsis patients which has complete medical record. The proportion is 35 provenpatients, 31 probable patients and 25 possible patients. Candidemia was the mostcommon form of IC and C. albicans was the most common etiologic pathogen.Mean age were 47,9 years, dominated with medical patient, non-neutropenic andseptic shock. Most patients had malignancy with lung infection. The most commonmedical intervention was application of urinary catheter. Most patient was givencephalosporin 3rd generation and the most common antifungal used wasfluconazole. Most patient (44%) didn?t get systemic antifungal treatment. Mortalitywas 68,4% and median length of stay were 27 days.Conclusions: IC prevalence was 12,3%. Mortality because of IC is high and C.albicans is most common etiologic pathogen, Background: Recently, incidence of invasive fungal infection is rising. Candida isthe most common cause of invasive fungal infection. Invasive candidiasiscontribute to high mortality, prolonged hospitalization and high cost. Until now inIndonesia, there is no study about the prevalence, clinical characteristic andetiologic pathogen of invasive candidiasis in adults.Objective: To study the prevalence, clinical characteristic and etiologic pathogenin adult patients with invasive candidiasis at RSCM.Methods: Retrospective, cross sectional, based on the medical record sepsispatients which hospitalized in January 2012 until June 2014. We traced candidiasisinvasive (IC) patients which fulfill EORTC/MSG 2008 diagnostic criteria for IC.We recorded demographic data, clinical and supporting data, diagnosis, etiologicpathogen, antibiotic, antifungal, outcome and length of stay.Results: IC prevalence at RSCM was 12,3%. We have found 91 IC patients from738 sepsis patients which has complete medical record. The proportion is 35 provenpatients, 31 probable patients and 25 possible patients. Candidemia was the mostcommon form of IC and C. albicans was the most common etiologic pathogen.Mean age were 47,9 years, dominated with medical patient, non-neutropenic andseptic shock. Most patients had malignancy with lung infection. The most commonmedical intervention was application of urinary catheter. Most patient was givencephalosporin 3rd generation and the most common antifungal used wasfluconazole. Most patient (44%) didn’t get systemic antifungal treatment. Mortalitywas 68,4% and median length of stay were 27 days.Conclusions: IC prevalence was 12,3%. Mortality because of IC is high and C.albicans is most common etiologic pathogen] |