Browsing by Author "Endriani, Rita"

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    BAKTERIURIA PADA PASIEN DENGAN KETETERISASI SEBAGAI PENYEBAB INFEKSI SALURAN KEMIH (ISK) NOSOKOMIAL DI RSUD ARIFIN ACHMAD PEKANBARU
    (2013-03-05) Endriani, Rita
    Bakteriuria merupakan suatu keadaan ditemukannya bakteri di dalam urin. Dalam keadaan normal, urin tidak mengandung bakteri, virus ataupun mikroorganisme lain, sehingga urin di dalam sistem saluran kemih biasanya steril. Adanya bakteriuria yang jumlahnya bermakna dapat didiagnosis dengan Infeksi Saluran Kemih (ISK) ISK juga merupakan penyebab terbanyak infeksi nosokomial. Berdasarkan data survey, 36,3%-42,7% dari infeksi nosokomial disebabkan oleh ISK. ISK nosokomial adalah jika infeksi tersebut diperoleh di institusi kesehatan atau akibat dari tindakan medis, salah satunya dengan tindakan kateterisasi ISK dijumpai pada paling sedikit 10-15% pasien rawat inap dengan kateter uretra yang terus terpasang. Resiko infeksi adalah sebesar 3% - 5% per hari kateterisasi . Infeksi saluran kemih atas secara rutin terjadi pada pasien dengan kateter indwelling yaitu sebesar 50% setelah 4-5 hari, 75% setelah 7-9 hari, dan 100% setelah 2 minggu, walaupun dilakukan perawatan optimal dan sistem drainase tertutup. Walaupun demikian sempumanya cara pemasangan kateter, infeksi masih saja teijadi sebesar 2% pada kateterisasi tunggal, 10% pada kateterisasi berulang dan 95% - 100% pada kateterisasi menetap Insiden ISK pada bayi dan anak sekolah berkisar 1-2%, pada wanita muda yang tidak hamil 1-3%, sedangkan pada wanita yang hamil 4-7%. Wanita lebih sering menderita ISK dibanding pria, kira - kira 50% dari seluruh wanita pemah menderita ISK selama hidupnya. ISK nosokomial atau ISK pada pasien dengan kateter ini sering disebabkan oleh bakteri yang hidup di lingkungan lembab di rumah sakit terutama Proteus, Pseudomonas, E. coli, Klebsiella, dan Serratia Penataiaksanaan ISK nosokomial lebih sulit dibandingkan dengan ISK biasa. Hal ini disebabkan karena ISK nosokomial lebih sering disebabkan oleh bakteri yang sudah multi resisten antibiotik terutama Proteus dan Pseudomonas sehingga sering menjadi masalah di rumah sakit. Untuk itu penelitian kali ini bertujuan untuk mengetahui bagaimana pola bakteri pada urin pasien dengan kateterisasi sebagai penyebab ISK nosokomial di Pekanbaru. Hasil penelitian yang dilakukan didapatkan 55 sampel urin kateter pasien dengan sampel yang ditemukan pertumbuhan bakteri sebanyak 33 sampel (60%) dan hasil biakan bakteriuria bermakna atau ISK sebanyak 26 sampel (47,2%). Sampel sisanya berupa hasil biakan tidak bermakna sebanyak 7 sampel (12,8%), tidak ditemukan pertumbuhan bakteri sebanyak 19 sampel (34,5%) dan Candida albicans sebanyak 3 sampel (5,5%). Frekuensi ISK lebih banyak didq>atkan pada wanita sebanyak 62,5%. ISK terbanyak ditemukan pada pemakaian kateter urin yang lebih dari 2 minggu sebanyak 100%. Bakteri penyebab ISK kateter terbanyak adalah bakteri Gram negatif berupa Pseudomonas sp dan Escherichia coli masing-masing (35,1%). Bakteri terbanyak ditemukan pada laki-laki adalah Escherichia coli (47,62%) dan pada wanita Pseudomonas sp dan Enterobacter sp masing-masing (30,%). Bakteri terbanyak ditemukan pada pemakaian kateter urin yang lama adalah Psedomonas sp Sebaiknya pemakaian kateter uretra pada pasien hams dirawat dengan baik dan diganti setelah 5-7 hari serta dilakukan pemeriksaan mikrobiologi dan uji sensitivity antibotik
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    GAMBARAN INDEKS BARTHEL PADA PASIEN STROKE DENGAN LEUKOSITOSIS DI RSUD ARIFIN ACHMAD PROVINSI
    (2014-02-25) Hadisaputra, Alvin; Sukiandra, Riki; Endriani, Rita
    The Barthel Index currently being used by general practices, neurologists, and other medical division to assess progress and prospect of rehabilitation for patients with disability. Stroke patients especially with apparent neurological deficit post stroke were taken to rehabilitation phase supervised by medical rehab practice as soon as they declared stable by authorized doctor. The definition of stable itself are vary, from appropriate scores of Glasgow Coma Scale (GCS), cooperativeness, or sometimes by clinical judgement by authorized doctor. The clinical judgement includes consideration of the general state of patients, like, as in this research focusing, inflamation. Inflamation as a natural response for threat inside the human body e.g bacteria & viral infection, foreign bodies, etc. often occured in stroke patients, characterized by high body temperatures and elevated white blood cell/ leukocyte count, defined as leukocytosis. Some study has been assigned to analyzed that state, since stroke patients with leukocytosis at onset often had a worse prognosis than others; mostly death. It has been suspected that leukocyte activities as phagocyte are responsible to broke tissues around them, as in stroke particularly hemoragic stroke the blood clot that sits around brain tissue worsening the injury; evident by CT Scan in some study that lession volume are wider in stroke patients with leukocytosis. The purpose of this research is to measures whether leukocytosis did worsening the brain injury suffered by all stroke survivors thus resulting in poorer neurological deficit, affecting their activity of daily living (ADL). ADL in this research measured by Barthel Index, consisting of ten simple tasks that represents basic activity of daily living e.g independency of bathing, grooming, feeding and other motoric activity. The results are from 35 qualified patients whose dominantly characterized by men, aged above 50 years old and leukocytes above 10.000/uL, 13 patients (37,15 %) were in total dependency (Barthel index 0-20), 8 (22,86 %) were in severe dependency (Barthel index 25-40), 4 (11,42 %) in mild dependency (Barthel index 45-55), 9 (25,71 %) in light dependency (Barthel index 60-95) and only 1 patient declared independent. Conclusion more than half of subjects are categorized as poor impairment in terms of ADL and only one survivor are declared independent after hospitalized. Keywords: Stroke, Leukocytosis, Activity of Daily Living, ADL, Barthel Index
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    Penentuan Genotipe dan Subtipe Virus Hepatitis B pada Penderita Hepatitis B Kronis, Sirosis dan Hepatoma di Pekanbara
    (2012-12-03) Zainal, Andi; Endriani, Rita; Andrini, Fauzia; M.Biomed, Arfianti
    Hepatitis B virus (HBV) infection can lead to diverse clinical spectrum of liver disease including fulminant hepatitis, chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC). HBV is currently classified into 8 genotypes (A to H) and 4 HbsAg-subtypes which are adw, ayw, adr, and ayr. Previous studies showed that HBV genotypes and subtypes showed a distinct geographic and ethnic distribution. Additionally, HBV genotypes may influence the clinical manifestation of chronic hepatitis B infection, development of HCC and response to antiviral treatment The aim of the present study was to investigate the differentiation of HBV genotypes and subtypes distribution among different clinical status of chronic hepatitis B in Pekanbaru. The design of present study was analytical cross sectional. HBV genotype was examined based on homology of S gene firom this study with that of GenBank Database. Gene S was generated by amplification using polymerase chain reaction (PCR) method, followed by DNA sequencing using dye-labelled terminator method. A total of 52 of chronic hepatitis B sera was examined in this study, vMch was obtained fiwm 10 of HBsAg-positive blood donors, 12 of chronic hepatitis B active patients, 10 of liver cirrhosis patients and 20 of HCC patients. The results showed that genotype C (59.6%) was the major genotype identified, followed by genotype B (40.4%). Based on clinical status, genotype C was predominantly found in blood donor (70%) dan liver cirrhosis patients (70%). While in chronic hepatitis B active and HCC, genotype B and C were comparable. Adr (59.6%) was the major HBsAg-subtype found in all subjects, followed by adw subtype (38.5%) dan ayw subtype (1.9%). Based on statistical analysis, there was no significant difference in the distribution of HBV genotypes and subtypes among blood donor, chronic hepatitis B active patients, liver ciniiosis patiraits and HCC. HOWCVCT, the distribution of HBV graiotype was significantly different between ciiriiotic-HCC patients and non cirrhotic-HCC patients. Genotype C (88.9%) was predominantly detected among cirriiotic-HCC patients, wliile genotype B (72.7%) was mostly idoitified among non cirrhotic-HCC patients (p=0.01).
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    POLA RESISTENSI BAKTERI PENYEBAB INFEKSI SALURAN KEMIH (ISK) TERHADAP ANTIBAKTERI DI PEKANBARU PERIODE JANUARI 2005 – DESEMBER 2006
    (2013-03-05) Endriani, Rita
    Urinary Tract Infection (UTI) is caused by a variety of microorganism, but bacteries are more often. Because of that, antimicrobial is the empiric treatment for UTI The antimicrobial resistance pattern of bacterial UTI can be changed in different place and time. Urine culture test and resistency test will help us to choose the effective treatment. The purpose of this research is to know the antimicrobial resistance pattern of bacte, lal UTI in Peknbaru. A descriptive retrospective research had been done by using medical record in Laboratory microbiology Faculty of Medicine on Riau University from January 2005 to December 2006. Results of this research show that Gram-negative is the most commonly isolated organism (80%). Eschericia coli is the most UTI's caused in all group of age, both male and female. The highest level of antimicrobial resislency among the isolates is amoxiciUn (82.3%)