Bakteri Non Fermenter sebagai Patogen: Fokus pada Spektrum Infeksi Stenotrophomonas maltophilia di Kota Mataram
DOI:
https://doi.org/10.29303/jku.v5i2.185Keywords:
Stenotrophomonas maltophilia, spektrum infeksi, kondisi imunokompromaisAbstract
Latar belakang: Bakteri non fermenter dahulu dikenal sebagai kontaminan pada pemeriksaan mikrobi- ologi, saat ini bakteri non fermenter juga dikenal sebagai pathogen dengan status resisten terhadap banya antibtiotika, diantaranya kelompok Carbapenem dan Penisilin. Stenotrophomonas maltophilia sebagai salah satu bakteri non fermenter, basil Gram negative aerob, sering terisolasi bersama-sama dengan Pseudomonas spp. dari pasien imunokompromais. Penelitian ini bertujuan mendeskripsikan spektrum infeksi S. maltophilia di Mataram. Metode: Isolate S. maltophilia yang didapat dari data laboratorium dikumpulkan, data rekam medis dianalisa periode Juni 2014 – September 2015 Hasil: Terdapat 12 isolate S. maltophilia. Spektrum infeksi: pneumonia (6), infeksi jaringan ikat (4), dan infeksi saluran kencing (2). Rasio laki-laki: perempuan = 8:4. Kondisi imunokompromais: usia lanjut/muda (7), terapi Carbapenem (7), penggunaan ventilator (3), dan pasien ICU (4). Marker infeksi: SIRS (12), sepsis (6). Pola kepekaan antimikroba (sensitive): ceftazidime (8), ciprofloxacin (7), cefoperazone (5), cefepime (4), gentamicin (3), meropenem (2), amikacin (2), fosfomycin, linezolid dan, trimethoprim/sulfamethoxazole (1), penicillin dan cefadroxil (0). Kesimpulan: Pneumonia merupakan kasus dominan. Mayoritas faktor resiko infeksi Stenotropho- monas maltophilia merupakan kondisi imunokompromais. Semua isolat resisten terhadap cefadroxil dan penicillin. Kepekaan tertinggi-terendah: ceftazidime, ciprofloxacine, cefoperazone, cefepime, gentamicin, meropenem, fosfomycin, linezolid dan amikacin. Trimethoprim/sulfamethoxazole bukan merupakan obat pilihan terhadap infeksi Stenotrophomonas maltophilia di Mataram.
References
2. NordCE,Sj¨obergL,Wadstr¨omT,WretlindB. Characterization of three Aeromonas and nine Pseudomonas species by extracellular enzymes and haemolysins. Medical microbiology and immunology. 1975;161(2):79–87.
3. Denton M, Kerr KG. Microbiological and clinical aspects of infection associated with Stenotrophomonas maltophilia. Clinical microbiology reviews. 1998;11(1):57–80.
4. Elting LS, Bodey GP. Septicemia due to Xanthomonas species and non-aeruginosa Pseudomonas species: increasing incidence of catheter-related infections. Medicine. 1990;69(5):296–306.
5. O’Brien TF, Stelling JM. WHONET: an information system for monitoring antimicrobial resistance. Emerging infectious diseases. 1995;1(2):66.
6. Araoka H, Baba M, Yoneyama A. Risk factors for mortality among patients with Stenotrophomonas maltophiliabacteremiainTokyo,Japan,1996–2009. European journal of clinical microbiology & infectious diseases. 2010;29(5):605–608.
7. Marshall WF, Keating MR, Anhalt JP, Steckelberg JM. Xanthomonas maltophilia: an emerging nosocomial pathogen. In: Mayo Clinic Proceedings. vol. 64. Elsevier; 1989. p. 1097–1104.
8. Gopalakrishnan R, Hawley HB, Czachor JS, MarkertRJ,BernsteinJM. Stenotrophomonasmaltophilia infection and colonization in the intensive care units of two community hospitals: a study of 143 patients. Heart & Lung: The Journal of Acute and Critical Care. 1999;28(2):134–141.
9. DentonM. Stenotrophomonasmaltophilia: anemerging problem in cystic ï¬brosis patients. Reviews in Medical Microbiology. 1997;8(1):15–20.
10. Hadjiliadis D, Steele MP, Chaparro C, Singer LG, Waddell TK, Hutcheon MA, et al. Survival of lung transplant patients with cystic ï¬brosis harboring panresistant bacteria other than Burkholderia cepacia, compared with patients harboring sensitive bacteria. The Journal of heart and lung transplantation. 2007;26(8):834–838.
11. LeclercqR,CantonR,GiskeC,HeisigP,Livermore D, et al. Expert rules in antimicrobial susceptibility testing. European Committee on Antimicrobial Susceptibility Testing. 2008;.
12. Falagas ME, Valkimadi PE, Huang YT, Matthaiou DK, Hsueh PR. Therapeutic options for Stenotrophomonas maltophilia infections beyond cotrimoxazole: a systematic review. Journal of Antimicrobial Chemotherapy. 2008;62(5):889–894.
13. Zhang L, Li XZ, Poole K. Fluoroquinolone susceptibilities of efflux-mediated multidrug-resistant Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Burkholderia cepacia. Journal of Antimicrobial Chemotherapy. 2001;48(4):549–552.
