Perbandingan Pola Kuman dan Kadar Biomarker Inflamasi Penderita Severe Pneumonia dengan Penderita Non-severe Pneumonia
[Bacterial Pattern and Inflammatory Biomarker in Severe Pneumonia Compared to Non-Severe Pneumonia Patient]
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Background: Severe pneumonia is still a serious problem with high mortality rate. The cause of severe pneumonia due to high inflammation or different microbial pattern compared to non-severe pneumonia is still unknown. Methods: An analytic observational study with cross-sectional design was performed in patients with severe pneumonia and non-severe pneumonia treated in intensive care unit (ICU), intensive observation room (ROI), and all inpatient wards of Dr. Soetomo General Hospital Surabaya for a period of 1 year from September 2017 to September 2018. Patients with pneumonia accompanied by active pulmonary tuberculosis (TB), lung tumors, and acute infections other than pulmonary organs were excluded from this study. All study subjects were taken for sputum samples for aerobic sputum culture and blood samples for biomarker examination of C-reactive protein (CRP) and procalcitonin (PCT). Results: The total subjects were 64. Mean value of CRP and PCT levels severe pneumonia was 143.8 mg/L and PCT levels 23.1 ng/ml, respectively. Mean value of CRP and PCT levels non-severe pneumonia was 75.0 mg/L and PCT level 8.08 ng/ml, respectively. There was a significant difference in CRP and PCT levels of severe pneumonia and non-severe pneumonia patients (p < 0.05), whereas no meaningful difference in microbial patterns in both groups. Conclusion: Since inflammation responses of severe pneumonia were more massive than nonsevere patients, it will produce higher CRP and PCT levels.
Walte T. Diagnosis and treatment of community acquired pneumonia – the German perspective. Birkhäuser Verlag Basel. Switzerland. 2007; 1-15.
Soedarsono. Pneumonia. Buku Ajar Paru.Departemen Ilmu Penyakit Paru FK Unair-RSUD dr. Soetomo. Surabaya. 2010; 149-179.
Perhimpunan Dokter Paru Indonesia. Pneumonia komunitas: pedoman diagnosis dan penatalaksanaan di Indonesia. Edisi II. Badan Penerbit FKUI. Jakarta. 2014; 3-26.
Tan YK, Khoo KL, Chin SP, Ong YY. Aetiology and outcome of severe community-acquired pneumonia in Singapore. Eur Respir J. 1998; 12: 113–115.
Hirani NA, Macfarlane JT. Impact of management guidelines on the outcome of severe community acquired pneumonia. Thorax. 1997;52:17–21.
Niederman MS, Mandell LA, Anzueto A. American Thoracic Society: Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med . 2001, 163:1730–1754.
Mandell LA, Wunderink RG, Anzueto A. Infectious diseases society of America/American thoracic society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007; 44 (Suppl 2) :S27–S72.
Torres A. Corticosteroid for severe CAP: the pros. Rev Bras Ter Intensiva. 2015;27(3):202-204
Khawaja A, Zubairi A, Durrani FK, Zafar A. Etiology and outcome of severe community acquired pneumonia in immunocompetent adults. BMC Infect Dis. 2013; 13: 1-6.
Rello J, Bodi M, Mariscal D. Microbiological testing and outcome of patients with severe community-acquired pneumonia. Chest 2003; 123:174–180.
Self WH, Grijalva CG, Williams DJ. Procalcitonin as an early marker of the need for invasive respiratory or vasopressor support in adults with Community-Acquired Pneumonia. Chest.2016; 440: 1-15.
Buchori, Prihatini. Diagnosis sepsis menggunakan prokalsitonin. Ind J Path Med Lab. 2006; 12:131-7.
Almirall J, Bol´ıbar I, Toran P. Contribution of Creactive protein to the diagnosis and assessment of severity of community-acquired pneumonia.Chest. 2004; 4 : 1335-1342.
Widyaningsih PD, Soedarsono. Hubungan pemberian terapi empiris dengan luaran pada pasien pneumonia rawat inap di RSUD dr. Soetomo. Karya Akhir. Department Pulmonologi dan Ilmu Kedokteran Respirasi Universitas Airlangga-RSUD dr. Soetomo . Surabaya. 2018.
Biring EK, Wulandari L. Hubungan derajat keparahan klinis CAP dan Pola kuman. Karya Akhir. Department Pulmonologi dan Ilmu Kedokteran Respirasi Universitas Airlangga-RSUD dr. Soetomo . Surabaya. 2016.
Agus S, Ikaningsih, Sudiro TM. Profil etiologi bakteremi dan resistensinya terhadap antibiotika di rumah sakit Cipto Mangunkusumo, Jakarta tahun 1999 – 2002. Majalah Kedokteran Indonesia. 2004;54(7):260–5.
Kurniawan J, Erly, Semiarty R. Pola Kepekaan Bakteri Penyebab Pneumonia terhadap Antibiotika di Laboratorium Mikrobiologi RSUP Dr. M. Djamil Padang Periode Januari sampai Desember 2011 . Jurnal Kesehatan Andalas 2015; 4(2): 562-66
Warnida I, Soedarsono. Perbedaan kadar prokalsitonin antara pneumonia komuniti kelas IV dan kelas V menurut pneumonia severity indeks. Karya Akhir Department Pulmonologi dan Ilmu Kedokteran Respirasi Universitas Airlangga-RSUD dr. Soetomo . Surabaya. 2016.
Nwose EU. Quality in diagnostic microbiology: experiential note to emphasize value of internal control program. N Am J Med Sci 2013;5(2):82– 7
Ruiz M, Ewig S, Torres A. Community-acquired pneumonia. Risk factors and follow-up epidemiology. Am J Respir Crit Care Med. 1999; 160:923–929.
Ramirez P, Ferrer M, Marti V. Inflammatory biomarkers and prediction for intensive care unit admission in severe community-acquired pneumonia. Crit Care Med.2011; 39: 2211-2217.
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