Perbandingan Pola Resistensi Antimikroba Bakteri Gram Positif dan Bakteri Gram Negatif pada Pasien HIV yang Mengalami Infeksi Saluran Nafas bagian Bawah dengan CD4 <100 Cell/μL dan CD4 ≥100 Cell/μL

Abstract

Objective: This observational study conducted at the HIV Services Department (Posyansus) of Internal Medicine of H. Adam Malik General Hospital in Medan examines the pattern of antimicrobial resistance Gram-positive and Gram-negative bacteria isolated from the sputum of patients with human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS) who experienced lower respiratory tract infections (BTA negative). Method: Cross sectional data collection was done to determine the types of Gram-positive bacteria and Gramnegative bacteria by using Gram & Cutan stain and then an antimicrobial resistance test was performed. Analysis: Fisher exact test analysis with significance (p<0.05) was conducted. Results: It was found that the most bacteria isolated from 16/28 patients’s sputum were Gramnegative bacteria (52.8%). Among the isolated Gram-negative bacteria , Klebsiella pneumoniae ssp pneumoniae (25%) was the most predominant, followed by Staphyloccocus epidermis (13%). 23 antimicrobials were used and the pattern of antimicrobial resistance in Gram-positive bacteria was 69%, intermediet was 2% and sensitive was 29%. The antimicrobial resistance of Gramnegative bacteria was 61%, intermediet was 3% and sensitive was 35%. Conclusion: The statistics showed that there was difference in the types of bacteria based on CD4 counts as the cause of lower respiratory tract infections in HIV/AIDS patients (p<0,05).

Tujuan: Penelitian observasional ini mendeskripsikan pola resistensi antimikroba terhadap bakteri Gram positif dan bakteri Gram negatif penyebab infeksi saluran nafas bagian bawah (BTA negatif) dan perbedaan jenis bakteri berdasarkan kadar CD4 yang diisolasi dari sputum pasien human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS) di Poli Pelayanan Khusus (Posyansus) Penyakit Dalam RSUP H. Adam Malik Medan. Metode: pengumpulan data secara cross sectional, untuk menentukan jenis bakteri Gram positif dan bakteri Gram negatif dengan pewarnaan gram dan kutur kemudian dilakukan test resistensi antimikroba. Analisis uji Fisher exact dengan kemaknaan (p<0,05). Hasil: Bakteri terisolasi yang paling banyak ditemukan adalah bakteri Gram-negatif (52,8%) dari 16/28 sputum pasien. Spesies terbanyak Klebsiella pneumoniae ssp pneumoniae (25%) dan Staphilococcus epidermis (13%). Antimikroba yang digunakan sebanyak 23, pola resistensi antmikroba pada bakteri Gram positif sebesar 69%, intermediet 2% dan sensitif 29%. Pola resistensi antimikroba bakteri Gram negatif 61%, intermediet 3%, sensitif 35%. Kesimpulan : Hasil statistik menunjukkan terdapat perbedaan jenis bakteri berdasarkan kadar CD4 pada pasien HIV/AIDS dengan Infeksi saluran nafas bawah (p<0,05).