EVALUASI BAKTERI PATOGEN SPESIFIK PADA PERMUKAAN LINGKUNGAN RUANG ICU DAN OPERASI SEBELUM DAN SETELAH TINDAKAN PEMBERSIHAN DI RSUD ANUTAPURA PALU
Abstract
Permukaan lingkungan merupakan salah satu sumber infeksi karena dapat bertindak sebagai reservoir patogen HAIs. Permukaan rumah sakit dapat terkontaminasi bakteri patogen HAIs, seperti Methicillin Resistant-Staphylococcus aureus (MRSA), Vancomycin Resistant Enterococcus (VRE), Carbapenem Resistant Enterobacteriaceae (CRE), Multi Drug Resistant-basil gram negatif nonfermenter (Pseudomonas spp., dll), dan lainnya. Ketika HAIs meningkat akan berdampak ke peningkatan morbiditas, mortalitas, rawat inap yang lama, pemeriksaan tambahan, intervensi bedah dan pengobatan antibiotik yang berdampak pada lonjakan biaya perawatan kesehatan, serta masa pemulihan pasien tertunda atau bahkan dapat berakibat fatal ke kematian. Penelitian ini bertujuan untuk mengevaluasi bakteri patogen spesifik yang berpotensi sebagai penyebab HAIs. Penelitian ini merupakan penelitian observasional dengan desain Cross Sectional Study. Sampel swab dari permukaan lingkungan diambil dengan menggunakan swab steril yang dibasahi NaCl steril lalu diinokulasi ke media kultur bakteri aerob, dan uji biokimia untuk identifikasi, serta dilakukan uji AST untuk bakteri yang ditemukan. Sebanyak 100 sampel swab permukaan diperoleh dari 4 Kamar di Ruang Operasi dan 6 Kamar di Ruang ICU RSUD Anutapura Palu sebelum dan setelah tindakan pembersihan rutin. Dmana ditemukan MRSA (6,7%) yakni pada gagang laci Ruang ICU 1 dan gagang pintu Ruang ICU 2 serta ditemukan MDR Pseudomonas aeruginosa (3,3%) yakni pada gagang laci Ruang ICU 4 sebelum tindakan pembersihan rutin. Namun, setelah tindakan pembersihan rutin di ICU, tidak lagi ditemukan MDR Pseudomonas aeruginosa, tetapi masih ditemukan MRSA (6,7%) di Ruang ICU 4 dan 6. MRSA (6,7%) juga ditemukan yaitu pada laci anestesi dan tiang infus Ruang OK 2 sebelum tindakan pembersihan rutin, namun setelah tindakan pembersihan rutin tidak lagi ditemukan MRSA di Ruang OK RSUD Anutapura Palu. Tindakan pembersihan rutin yang efektif di Ruang ICU maupun Ruang OK sangat diperlukan dalam mengeliminasi bakteri patogen spesifik yang berpotensi menyebabkan HAIs.
ABSTRACT
Environmental surfaces are one source of infection because they can act as reservoirs of HAIs pathogens. Hospital surfaces can be contaminated with HAIs pathogenic bacteria, such as Methicillin Resistant-Staphylococcus aureus (MRSA), Vancomycin Resistant Enterococcus (VRE), Carbapenem Resistant Enterobacteriaceae (CRE), Multi Drug Resistant-nonfermenter gram-negative bacilli (Pseudomonas spp., etc.), and others. When HAIs increase, it will have an impact on increased morbidity, mortality, prolonged hospitalization, additional examinations, surgical interventions and antibiotic treatment which have an impact on the spike in health care costs, as well as delayed patient recovery or can even be fatal to death. This study aims to evaluate specific pathogenic bacteria that have the potential to cause HAIs. This study is an observational study with a Cross Sectional Study design. Swab samples from environmental surfaces were taken using sterile swabs moistened with sterile NaCl and then inoculated into aerobic bacterial culture media, and biochemical tests for identification, and AST tests were carried out for the bacteria found. A total of 100 surface swab samples were obtained from 4 Operating Rooms and 6 ICU Rooms of Anutapura Hospital Palu before and after routine cleaning. Where MRSA (6.7%) was found on the drawer handle of ICU Room 1 and the door handle of ICU Room 2 and MDR Pseudomonas aeruginosa (3.3%) was found on the drawer handle of ICU Room 4 before routine cleaning. However, after routine cleaning in the ICU, MDR Pseudomonas aeruginosa was no longer found, but MRSA (6.7%) was still found in ICU Rooms 4 and 6. MRSA (6.7%) was also found on the anesthesia drawer and infusion pole of OK Room 2 before routine cleaning, but after routine cleaning, MRSA was no longer found in the OK Room of Anutapura Hospital Palu. Effective routine cleaning in the ICU and OK Rooms is essential in eliminating specific pathogenic bacteria that have the potential to cause HAIs.
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