Latar Belakang : Pasien kanker paru sering mengalami pneumonia, hal ini terjadikarena penurunan daya tahan tubuh. Pneumonia menyulitkan penanganan,memperburuk kualitas hidup, mengurangi survival dan seringkali merupakanpenyebab langsung kematian pasien kanker paru. Penangananan pneumonia padapasien NSCLC(non small cell lung cancer) dengan antimikroba yang terus menerustanpa memperhatikan kultur sensisitivitas akan menyebabkan resistensi dari kumanpenyebab pneumonia tersebut.Tujuan : Penelitian ini bertujuan untuk mengetahui, pola kuman penyebabpneumonia pada pasien NSCLC, dan membandingkan kesintasan pasien NSCLCyang menderita pneumonia yang disebabkan oleh bakteri MDR (multidrugresistance) dengan yang disebabkan oleh bakteri non-MDR.Metode : Penelitian ini merupakan kohort retrospektif dengan subjek penelitianadalah pasien NSCLC dengan pneumonia yang disebabkan oleh bakteri MDR dannon-MDR yang dirawat di Rumah Sakit Dr Cipto Mangunkusumo bulan Januari2013-Desember 2017. Analisis dilakukan dengan analisis multivariat regressi cox.Hasil: Setelah dilakukan pemeriksaan kultur BAL(Bronchoalveolar lavage), cairanpleura dan sputum, diperoleh 32 subjek hasil kulturnya hanya bakteri MDR, 14subjek tumbuh bakteri MDR dan non-MDR, dan 23 subjek hanya tumbuh bakterinon-MDR. Bakteri non-MDR terbanyak penyebab pneumonia pada pasienNSCLC adalah Klebsiella pneumoniae sebanyak 37,3%, sedangkan bakteri MDRyang terbanyak menyebabkan pneumonia pada pasien NSCLC adalahAcinetobacter baumannii sebanyak 23,2%. Median survival Pasien NSCLCdengan pneumonia yang disebabkan oleh bakteri MDR adalah 57 hari(43,707-70,293) sedangkan yang oleh bakteri non-MDR 92 hari(58,772-125,228).Simpulan : kesintasan pasien NSCLC dengan pneumonia yang disebabkan olehbakteri MDR lebih singkat daripada yang disebabkan oleh bakteri non-MDR.
Back Ground: Lung cancer patients often experience pneumonia. This is due tothe decrease in body endurance of the patients. Pneumonia complicatestreatment, worsens the quality of life, reduces survival and is often a direct causeof death for lung cancer patients. Dealing with pneumonia in non-small cell lungcancer (NSCLC) patients with continuous antimicrobials treatment withoutregard to culture sensitivity will cause resistance of germs that cause pneumonia.Objectives: This study aims to study the pattern of germs that cause pneumoniain NSCLC patients, and to compare the survival of NSCLC patients sufferingfrom pneumonia caused by MDR (multidrug resistance) bacteria with thosecaused by non-MDR bacteria.Methods: This study was a retrospective cohort with research subjects wasNSCLC patients with pneumonia caused by MDR and non-MDR bacteria whowere treated at Dr. Cipto Mangunkusumo Hospital from January 2013 toDecember 2017. Analysis was performed with multivariate cox regressionanalysis.Results: The results of the culture examination of BAL(Bronchoalveolar lavage),pleural fluid and sputum showed that 32 subjects were infected only from MDRbacteria, 14 subjects infected by both MDR and non MDR bacteria, and 23subjects were infected by only non MDR bacteria. The most non-MDR bacteriathat cause pneumonia in NSCLC patients was Klebsiella pneumoniae as much as37,3%, while the most MDR bacteria that cause pneumonia in NSCLC patientswas Acinetobacter baumannii as much as 23,2%. Median survival of NSCLCpatients with pneumonia caused by MDR bacteria was 57 days(43,707-70,293)while those by non-MDR bacteria was 92 days (58,772-125,228).Conclusions: The survival of NSCLC patients with pneumonia caused by MDRbacteria is shorter than that caused by non-MDR bacteria. |
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