Nilai Diagnostik Italian Score untuk Memprediksi Infeksi Bakteri Extended Spectrum Beta-Lactamase (ESBL) pada Pasien Sepsis di RSUP Dr. M. Djamil Padang

Authors

Fadrian Fadrian, Divisi Penyakit Tropik dan Infeksi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Andalas, PadangFollow
Armen Ahmad, Divisi Penyakit Tropik dan Infeksi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Andalas, PadangFollow
Khairat Khairat, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Andalas, PadangFollow

Abstract

Introduction. Infections caused by Extended-Spectrum Beta-Lactamase (ESBL) bacteria, especially in septic patients, require adequate management. Giving definitive antibiotics according to culture results takes a long time. Therefore, a clinical scoring system is needed to predict ESBL bacterial infection, one of which is the Italian score.

Methods. This research used a cross-sectional design and was conducted in the inpatient room of RSUP Dr. M. Djamil Padang for 6 months. The samples in this study were septic patients who underwent culture examination at RSUP Dr. M. Djamil Padang who met the research inclusion and exclusion criteria. Sampling was carried out using consecutive sampling, and the total sample obtained was 34 samples. Selected samples will have an Italian score calculated, and specimens will be taken for clinical culture examination. Data analysis and processing will involve 2x2 tables and ROC curves.

Results. Among a total of 34 participants with an equal distribution of male and female subjects (50% each), the average age was 59 years (standard deviation [SD] 14.15). Microbiological culture results revealed that 26 subjects (76.47%) were identified as positive for ESBL, while 8 subjects (23.53%) were classified as non-ESBL. Based on the Italian score, 22 patients were found to be ESBL-positive, and 12 were non-ESBL. The diagnostic performance of the Italian score yielded a sensitivity of 80.77%, specificity of 87.5%, positive predictive value (PPV) of 95.45%, and negative predictive value (NPV) of 58.33%. The accuracy of the Italian score in predicting ESBL bacterial infections among septic patients at RSUP Dr. M. Djamil Padang was demonstrated by an area under the curve (AUC) of 0.820 (95% confidence interval [CI] 0.75-1.00; p=0.002).

Conclusion. The Italian score demonstrated significant performance as a tool in predicting the risk of ESBL bacterial infection.

Bahasa Abstract

Pendahuluan. Infeksi akibat bakteri Extended Spectrum Beta-Lactamase (ESBL) terutama pada pasien sepsis memerlukan tata laksana yang adekuat. Pemberian antibiotik definitif sesuai hasil kultur membutuhkan waktu yang lama sehingga diperlukan sistem skoring klinis dalam memprediksi infeksi bakteri ESBL, salah satunya adalah Italian score.

Metode. Penelitian ini menggunakan desain potong lintang dan dilakukan di ruang rawat inap RSUP Dr. M. Djamil Padang selama 6 bulan. Sampel pada penelitian ini adalah pasien sepsis yang menjalani pemeriksaan kultur di RSUP Dr. M. Djamil Padang yang memenuhi kriteria inklusi dan eksklusi penelitian. Pengambilan sampel dilakukan dengan cara consecutive sampling dan didapatkan total sampel adalah 34 sampel. Sampel yang terpilih akan dilakukan penghitungan Italian score dan pengambilan spesimen untuk pemeriksaan kultur sesuai klinis, selanjutnya dilakukan analisis dan pengolahan data dengan tabel 2x2 dan kurva ROC.

Hasil. Dari 34 subjek penelitian dengan proporsi subjek berjenis kelamin laki-laki dan perempuan sama, yaitu 50% memiliki rerata usia 59 (SB 14,15) tahun. Berdasarkan hasil kultur, didapatkan pasien ESBL sebanyak 26 (76,47%) dan non-ESBL sebesar 8 (23,59%). Sementara berdasarkan Italian score, didapatkan 22 pasien ESBL dan 12 pasien non-ESBL. Uji diagnostik Italian score didapatkan sensitivitas 80,77%, spesifisitas 87,5%, nilai duga positif (NDP) 95,45%, nilai duga negatif (NDN) 58,33%. Akurasi Italian score dalam memprediksi infeksi bakteri ESBL pada pasien sepsis di RSUP Dr. M. Djamil Padang yang berdasarkan nilai AUC yaitu 0,820 (IK95% 0,75-1,00; p=0,002).

Kesimpulan. Italian score memiliki performa yang baik untuk dijadikan alat bantu dalam memprediksi risiko infeksi bakteri ESBL.

Kata Kunci: ESBL, nilai diagnostik, Italian score, sepsis

Recommended Citation

Fadrian, Fadrian; Ahmad, Armen; and Khairat, Khairat (2024) "Nilai Diagnostik Italian Score untuk Memprediksi Infeksi Bakteri Extended Spectrum Beta-Lactamase (ESBL) pada Pasien Sepsis di RSUP Dr. M. Djamil Padang," Jurnal Penyakit Dalam Indonesia: Vol. 11: Iss. 3, Article 3.
DOI: 10.7454/jpdi.v11i3.1649
Available at: https://scholarhub.ui.ac.id/jpdi/vol11/iss3/3