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INFEKSI NOSOKOMIAL
Setio Harsono
Dept. Mikrobiologi Kedokteran FK Unair
SMF Mikrobiologi Klinik RSUD.Dr.Soetomo
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Infeksi Nosokomial :
Infeksi yang didapat seorang penderita yang
sedang menjalani perawatan di rumah sakit.
Infeksi Nosokomial dapat berasal dari :
- Dokter / Perawat Sakit / Carrier
- Penderita lain Sakit / Carrier
- Penderita sendiri Flora normal tubuh
- Lingkungan Alat / Bahan tercemar,
Ruangan.
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Cara penularan sering terjadi
melalui :
- Pembedahan
- Catheter intravenous
- Catheter kandung kemih
- Cairan intravenous
- Endotracheal tube
- Respirator/Ventilator
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Infeksi Nosokomial dapat terjadi dengan
cara :
- Infeksi silang ( Cross infection ): Dokter /
Perawat / Penderita lain
- Infeksi endogen ( Autoinfection / Self
infection) : Penderita sendiri
- Infeksi lingkungan ( Environment infection ) :
Alat tercemar / Ruangan
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Faktor-faktor yang menentukan
terjadinya Infeksi Nosokomial :
- Susceptibility penderita terhadap infeksi
- Besarnya paparan mikroba
- Cara pemaparan mikroba
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Risiko terjadi Infeksi Nosokomial
meningkat karena :
- Pemakaian obat imunosupresan
- Tindakan bedah yang extensif
- Prosedur diagnostik dan terapeutik yang
intensif
- Penggunaan cairan intravenous
- Penggunaan antimikroba berspektrum
luas dan tidak rasional
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Kelompok mikroba penyebab
Infeksi Nosokomial :
- Mikroba patogen konvensional
- Mikroba patogen kondisional
- Mikroba patogen oportunistik
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Jenis mikroba penyebab Infeksi
Nosokomial :
- Bakteri Gram negatif yang sering :
- Pseudomonas aeruginosa
- Acinetobacter baumanni
- Klebsiella pneumoniae ESBL
- Escherichia coli ESBL
- Enterobacter spp.
- Proteus spp.
- Serratia spp.
- Legionella pneumophila
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- Bakteri Gram positif yang sering :
- Methicillin Resistant Staphylococcus
aureus (MRSA)
- Methicillin Resistant Staphylococcus
epidermidis (MRSE)
- Vancomycin Resistant Enterococcus
(VRE)
- Virus : Hepatitis B, Hepatitis C, HIV
- Jamur : Candida spp. , Aspergillus spp.
- Parasit : Malaria
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Pemeriksaan untuk studi
epidemiologi (surveillance) Infeksi
Nosokomial dapat dengan cara :
- Biotyping
- Serotyping
- Bacteriophage typing
- Molecular / DNA typing
- Antibiogram dan Resistogram
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Extensive Surgery
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Extensive surgery
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Abdominal Drain
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Tracheostomy
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Urethral Catheter
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Intravenous Catheter
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Intravenous Catheter
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