pola kuman rsud dr. moewardi periode...

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Pola kuman RSUD Dr. Moewardi periode 2016

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POLA KUMAN DAN POLA KEPEKAAN KUMAN RSUD Dr. MOEWARDI

PERIODE 2016

KOMITE PENGENDALIAN RESISTENSI ANTIMIKROBA

LABORATORIUM MIKROBIOLOGI KLINIK

RSUD Dr. MOEWARDI

2017

3


KATA PENGANTAR

Puji syukur kami panjatkan ke hadirat Allah SWT karena dengan ijin-Nya kami dapat menyelesaikan penyusunan buku Pola Kuman

dan Pola Kepekaan Kuman di RSUD Dr. Moewardi periode 2016 ini. Buku ini kami susun 1 tahun sekali sebagai salah satu upaya

untuk mengendalikan kejadian resistensi antibiotik serta meningkatkan penggunaan antibiotik secara bijak dan rasional. Data yang

kami sajikan berupa informasi mengenai trend MDRO (Multidrug Resistance Organism) di RSDM khususnya ESBL dan MRSA,

data kepekaan antibiotik di RSDM secara umum dan data kepekaan antibiotik di beberapa uit perawatan di RSDM. Unit perawatan

lain yang datanya tidak kami analisis secara khusus oleh karena jumlah sampel sedikit dapat mengacu pada data RSDM secara

umum.

Kami menyadari masih banyak kekurangan dalam penyusunan buku ini. Oleh karena itu kami sangat mengharapkan kritik dan

saran yang membangun supaya kami dapat melakukan perbaikan pada edisi berikutnya. Semoga apa yang kami sampaikan dalam

buku ini dapat memberikan manfaat untuk meningkatan kualitas pelayanan dan patient safety di RSDM dan lingkungan sekitarnya.

Surakarta, Mei 2017 Tim Penyusun

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POLA KEPEKAAN KUMAN RSDM PERIODE 2016

(Bakteri Gram Negatif)

Organisme Jml isolat

Am

ikas

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Ce

fozo

pra

n %

S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Do

rie

ne

m %

S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Me

rop

en

em

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Escherichia coli 792 99.1 58.9 8.7 27.7 30.2 13.2 30.4 85.5 25.9 27.8 27.7 35.4 99.5 28 97.9 66.1 99 29.2 98.8 80.4 100 62.6 38.6

Klebsiella pneumoniae 701 99.6 53.1 0 46.2 48.7 19.4 48.6 92.1 44.7 46.9 46.7 61.6 98.7 52 99 59.6 98 63.2 99.1 72.5 91.6 49.2 59.9

Pseudomonas aeruginosa 682 85 1 0.5 1.1 45 0 78.4 71.9 1 72.5 1.2 63.2 76.1 1.4 67.7 72.7 61.4 79.9 66.5 1.6 67.9 1.9

Acinetobacter baumannii 584 73.9 0 0 62.6 0 0 34.7 63.4 12.8 31.1 8.2 39.4 63.7 52.4 39.1 54.2 30 58.2 35.8 82.2 50.9 81.8

Proteus mirabilis 115 88.1 76.1 41.6 58.2 60 27.5 60 95.7 65.2 62.4 61.4 43.6 0 94.5 57.4 46.7 56.5 95 95 0 67.4 25.5

Stenotrophomonas maltophilia 58 81.5 90

Enterobacter aerogenes 38 100 0 0 0 77.8 0 88.9 100 96.4 91.9 91.9 100 100 25 100 100 85.7 28.6 100 91.9 100 100 100

Morganella morganii 34 96.4 0 0 6.7 86.7 0 100 76.9 53.8 78.6 71.4 73.3 0 100 71.4 76.9 66.7 92.6 85.2 0 75 66.7

Serratia marcescens 33 97 0 0 0 57.1 0 57.1 63.2 26.3 42.4 39.4 85.7 100 52.6 92.9 54.5 73.7 89.5 97 87.9 78.6 42.1 78.6

<40% isolat sensitif 40 - <70% isolat sensitif >70% isolat sensitif

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POLA KEPEKAAN KUMAN RSDM PERIODE 2016

(Bakteri Gram Positif)

Organisme Jml isolatA

mo

ksis

ilin

%S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Sefe

pim

%S

Sefo

taks

im %

S

Seft

asid

im %

S

Sefo

taks

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

dam

isin

%S

Do

rip

en

em

%S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Oks

asil

in %

S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Rif

amp

isin

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Staphylococcus aureus 237 8.9 60.8 60.8 60.8 60.8 60.8 60.8 60.8 58.6 75.4 60.8 60.8 75.9 56 60.8 59.7 98.4 60.8 67.5 60.5 8.9 60.8 73.3 29.8 100 88.5 84.7

Enterococcus faecalis 127 70.1 70.1 70.1 70.1 23.4 0 4.7 70.1 23.4 94.4 23.4 70.1 70.1 10.3 100 99.1

Enterococcus faecium 29 6.2 6.2 6.2 6.2 18.8 0 6.2 12.5 68.8 12.5 6.2 6.2 31.2 100 75

Streptococcus pneumoniae 26 0 100 100 100 100 100 100 100 0 100


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KEJADIAN MRSA DI RSDM

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KEJADIAN ESBL DI RSDM

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KEJADIAN MRSA POSITIF DI BEBERAPA UNIT PERAWATAN DI RSDM TAHUN 2016

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KEJADIAN ESBL POSITIF DI BEBERAPA UNIT PERAWATAN DI RSDM TAHUN 2016

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SENSITIVITAS S. aureus TERHADAP OXACILLIN DI RSDM

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SENSITIVITAS E. coli TERHADAP GOL. FLUOROQUINOLONE DAN SULFA DI RSDM

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SENSITIVITAS E. coli DARI SPESIMEN URIN

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PILIHAN ANTIBIOTIK EMPIRIK

Secara umum, saran pilihan antibiotik empirik adalah sebagai berikut :

A. Apabila diduga penyebab infeksi adalah bakteri adalah Gram positif :

- Lini I : Amoksisilin, ampisilin, eritromisin, trimetoprin/sulfametoxazole

- Lini II : Amoksisilin/asam klavulanat, ampisilin/sulbaktam, levofloksasin, moksifloksasin

- Lini III : Vankomisin

B. Apabila diduga penyebab infeksi adalah bakteri Gram negatif :

- Lini I : Amoksisilin/asam klavulanat, ampisilin/sulbaktam, sefoperazone/sulbaktam

- Lini II : Ciprofloksasin, levofloksasin, moksifloksasin

- Lini III : Meropenem, imipenem

Antibiotik golongan sefalosporin generasi III (misal cefotaksim, ceftasidim, ceftiakson) TIDAK direkomendasikan untuk digunakan

sebagai anibiotik empirik

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POLA KEPEKAAN KUMAN ICU RSDM PERIODE 2016



Am

ikas

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Ce

fazo

lin

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Do

rie

ne

m %

S

Do

xycy

clin

%S

Erta

pe

ne

m %

S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Me

rop

en

em

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S


Escherichia coli 38 100 63.6 5.4 20 40 0 40 90.9 9.1 16.2 16.2 20 100 36.4 100 70.3 100 27.3 100 89.2 100 72.7 53.3


Klebsiella pneumoniae 26 100 20 0 14.3 21.4 8.3 21.4 90.9 9.1 16 16 35.7 100 18.2 100 44 90.9 27.3 100 60 85.7 20 35.7


Pseudomonas aeruginosa 25 79.2 0 0 0 27.3 0 45.5 84.6 0 62.5 0 36.4 76.9 0 62.5 76.9 69.2 83.3 69.6 0 61.5 0 Kuman di ICU Kuman di RSDM


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POLA KEPEKAAN KUMAN HCU RSDM PERIODE 2016



Am

ikas

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Ce

fazo

lin

e %

S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Do

rie

ne

m %

S

Do

xycy

clin

%S

Erta

pe

ne

m %

S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Me

rop

en

em

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S


Escherichia coli 49 100 57.9 8.3 20.7 17.2 7.4 17.2 78.9 15.8 16.7 16.7 31 100 15.8 100 62.5 94.7 26.3 97.9 79.2 100 68.4 31


Klebsiella pneumoniae 21 100 37.5 0 33.3 33.3 11.1 33.3 87.5 12.5 25 25 41.7 100 37.5 100 70 100 37.5 100 60 91.7 25 50


Pseudomonas aeruginosa 20 65 0 0 0 46.2 0 71.4 83.3 0 70 0 57.1 83.3 0 65 83.3 83.3 65 61.1 7.1 83.3 7.1 Kuman di HCU Kuman di RSDM


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POLA KEPEKAAN KUMAN PICU NICU RSDM PERIODE 2016



Am

ikas

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

eo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Do

rie

ne

m %

S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Me

rop

en

em

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Acinetobacter baumannii 584 73.9 0 0 62.6 0 34.7 63.4 12.8 31.1 8.2 39.4 63.7 52.4 39.1 54.2 30 58.2 35.8 82.2 50.9 81.8

Acinetobacter baumannii 56 75 0 0 60.9 0 17.4 36.4 6.1 10.7 0 39.1 50 33.3 16.1 36.4 6.1 46.4 12.5 78.3 30.3 73.9

Pseudomonas aeruginosa 682 85 1 0.5 1.1 45 78.4 71.9 1 72.5 1.2 63.2 76.1 1.4 67.7 72.7 61.4 79.9 66.5 1.6 67.9 1.9

Pseudomonas aeruginosa 28 92 0 0 0 61.1 78.9 100 0 80 0 77.8 87.5 0 80 87.5 87.5 68 75 0 75 0

Escherichia coli 792 99.1 58.9 8.7 27.7 30.2 30.4 85.5 25.9 27.8 27.7 35.4 99.5 28 97.9 66.1 99 29.2 98.8 80.4 100 62.6 38.6

Escherichia coli 24 100 77.8 8.3 40 20 20 100 44.4 29.2 29.2 66.7 100 33.3 100 62.5 100 66.7 100 83.3 100 66.7 46.7

Klebsiella pneumoniae 701 99.6 53.1 0 46.2 48.7 48.6 92.1 44.7 46.9 46.7 61.6 98.7 52 99 59.6 98 63.2 99.1 72.5 91.6 49.2 59.9

Klebsiella pneumoniae 18 100 16.7 0 0 0 0 100 0 0 0 41.7 100 83.3 100 11.1 100 33.3 100 27.8 100 0 58.3 Kuman di PICU NICU Kuman di RSDM


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POLA KEPEKAAN KUMAN BANGSAL PEDIATRI RSDM PERIODE 2016

Organism Jml isolat

Am

ikas

in %

S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Ce

fazo

lin

e %

S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Fosf

om

isin

%S

Seft

asid

im %

S

Ce

ftri

akso

n %

S

Sefu

roks

im %

S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Flu

con

azo

le %

S

Ge

nta

mis

n %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Oks

asil

in %

S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Escherichia coli 130 97.7 53.1 14.1 26.2 29.7 2.1 29.7 85.9 39.1 65.6 34.4 34.4 60.9 100 37.5 96.9 55 100 59.4 98.4 74.4 100 57.8 43.8

Pseudomonas aeruginosa 58 85.7 0 0 0 54.1 0 78.9 70 0 0 71.4 0 81.1 60 0 71.4 60 55 62.5 62.3 0 45 0

Klebsiella pneumoniae 48 97.9 60 0 39.1 40.9 0 43.5 84 36 92 38.3 37.5 82.6 92 56 95.7 55.3 92 96 95.7 78.7 100 52 63.6

Acinetobacter baumannii 46 84.8 0 0 55 0 0 40 38.5 19.2 0 28.3 4.3 40 53.3 34.6 32.6 30.8 23.1 39.1 37 70 42.3 85

Staphylococcus hominis 40 5.9 14.7 14.7 14.7 14.7 14.7 14.7 14.7 63.9 50 14.7 14.7 36.1 91.7 14.7 63.9 94.3 14.7 72.2 13.9 5.6 14.7 55.6 100 16.7 88.9

Staphylococcus haemolyticus 32 0 0 0 0 0 0 0 0 6.2 25 0 0 12.5 12.5 0 9.4 96.9 0 28.1 0 0 0 81.2 100 46.9 90.6 Kuman di Gram positif Kuman Gram negatif


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POLA KEPEKAAN KUMAN BANGSAL NEONATUS RSDM PERIODE 2016

Organism Jml isolat

Am

ikas

in %

S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

AM

B %

S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefa

dro

ksil

%S

Sefe

pim

%S

Sefp

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imp

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Klebsiella pneumoniae 69 100 16.7 0 0 0 0 80 3.3 1.4 1.4 23.1 96.7 76.7 100 4.3 96.7 70 98.6 17.4 94.9 6.7 43.6

Acinetobacter baumannii 54 63 0 0 82.1 0 0 65.4 0 1.9 0 35.7 58.3 53.8 5.6 53.8 11.5 68.5 1.9 92.9 26.9 60.7

Staphylococcus haemolyticus 29 3.6 7.1 7.1 0 7.1 7.1 7.1 7.1 10.3 10.3 7.1 7.1 10.3 17.2 7.1 10.3 100 7.1 44.8 3.4 7.1 86.2 100 79.3 89.7

Staphylococcus epidermidis 28 4 8 8 0 8 8 8 8 36 4 8 8 8 20 8 36 100 8 44 4.2 8 92 100 44 95.8

Kuman di Gram positif Kuman Gram negatif


19


POLA KEPEKAAN KUMAN BANGSAL NEONATUS RSDM PERIODE 2016

(SPESIMEN DARAH)

Organism Jml isolat

Am

ikas

in %

S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

ztre

on

am %

S

Ce

fazo

lin

e %

S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Klebsiella pneumoniae 62 100 20.8 0 0 0 0 0 87.5 4.2 1.6 1.6 21.1 100 87.5 100 4.8 100 70.8 100 14.5 94.7 8.3 42.1

Acinetobacter baumannii 48 62.5 0 0 88.5 0 0 0 68.2 0 2.1 0 38.5 57.1 54.5 6.2 54.5 13.6 72.9 2.1 96.2 27.3 61.5

Staphylococcus epidermidis 28 4 8 8 8 8 8 8 36 4 8 8 8 20 8 36 100 8 44 4.2 8 92 100 44 95.8

Staphylococcus haemolyticus 28 3.7 7.4 7.4 7.4 7.4 7.4 7.4 10.7 10.7 7.4 7.4 10.7 17.9 7.4 10.7 100 7.4 42.9 3.6 7.4 85.7 100 78.6 89.3

Kuman di Gram positif Kuman Gram negatif


20


POLA KEPEKAAN KUMAN BANGSAL BEDAH RSDM PERIODE 2016

Organism Jml isolat

Am

ikas

in %

S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Sefo

ksit

in %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Escherichia coli 188 100 67.5 8 27.4 30.5 30.5 90 26.2 71.2 28.6 28.6 22.1 100 27.8 98.9 68.6 100 26.2 99.4 83.7 100 68.8 34.7

Pseudomonas aeruginosa 84 73.6 0 0 0 36.1 58.3 55.6 0 0 50 0 55.6 50 0 58.3 47.2 50 62 52.1 0 52.8 0

Staphylococcus aureus 70 0 27.5 27.5 27.5 27.5 27.5 27.5 24.4 70.7 27.5 27.5 70.7 26.8 27.5 24.4 97.6 27.5 31.7 0 27.5 17.1 100 78 85.4

Klebsiella pneumoniae 60 96.4 38.7 0 44 48 48 93.5 41.9 74.2 44.6 44.6 56 96.8 25.8 96 58.9 96.8 29 96.4 60 88 41.9 60

Acinetobacter baumannii 53 43.8 0 0 21.7 0 13 48 0 0 10.4 0 13 31.6 28 16.7 24 4 22.9 14.6 47.8 40 73.9

Proteus mirabilis 42 83.3 70 16.7 45 35 35 100 60 80 43.3 40 15 0 95 36.7 50 50 96.7 96.7 0 70 0

Providencia stuartii 27 28.6 0 0 12.5 37.5 50 100 40 40 23.8 23.8 25 0 93.8 0 40 20 95.2 90.5 6.2 0 25

Kuman Gram positif Kuman Gram negatif


21



(SPESIMEN PUS)

Organism Jml isolatA

mik

asin

%S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

$S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Sefo

ksit

in %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

rpim

/su

lfam

eto

ksas

ol %

S

Van

kom

isin

%S

Escherichia coli 88 100 85.3 2.7 22 19.5 19.5 100 8.8 85.3 14.7 14.7 22 100 38.2 100 64 100 32.4 100 87.8 100 79.4 31.7

Pseudomonas aeruginosa 64 67.3 0 0 0 30.4 43.5 44.8 0 0 42.3 0 47.8 48.3 0 50 44.8 44.8 56.9 44.2 0 48.3 0

Staphylococcus aureus 59 0 36.7 36.7 36.7 36.7 36.7 36.7 32.3 64.5 36.7 36.7 61.3 35.5 36.7 32.3 100 36.7 41.9 0 36.7 12.9 100 83.9 90.3

Acinetobacter baumannii 38 27.3 0 0 5.9 0 0 43.8 0 0 0 0 0 10 25 3 6.2 0 6.1 3 41.2 37.5 76.5

Proteus mirabilis 30 75 60 5 26.7 13.3 13.3 100 40 60 20 15 20 0 93.3 20 60 20 95 95 0 60 0

Klebsiella pneumoniae 24 95 30 0 60 60 60 80 20 80 40 40 70 90 40 90 50 90 40 90 60 100 40 70



22



(SPESIMEN URIN)


mik

asin

%S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pn

em

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Me

rop

en

em

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

rpim

/su

lfam

eto

ksas

ol %

S

Escherichia coli 75 100 52.9 13.3 29.3 43.9 43.9 79.4 44.1 44 44 19.5 100 18.2 97.6 74.7 100 20.6 98.6 80.8 100 64.7 31.7

Klebsiella pneumoniae 21 95.2 42.9 0 28.6 42.9 42.9 100 57.1 52.4 52.4 42.9 100 14.3 100 71.4 100 21.4 100 55 71.4 50 42.9

Kuman Gram negatif


23


POLA KEPEKAAN KUMAN PENYAKIT DALAM RSDM PERIODE 2016


mik

asi

n %

S

Am

ok

sisi

lin

%S

Am

ok

sisi

lin

/asa

m k

lav

ula

na

t %

S

Am

pis

ilin

%S

Am

pis

ilin

/su

lba

kta

m %

S

Azt

reo

na

m %

S

Se

fep

im %

S

Se

fop

era

son

/su

lba

kta

m %

S

Se

fota

ksi

m %

S

Se

fta

sid

im %

S

Ce

ftiz

ox

ime

%S

Se

ftri

ak

son

%S

Se

furo

ksi

m %

S

Sip

rofl

ok

sasi

n %

S

Kli

nd

am

isin

%S

Do

rip

en

em

%S

Do

xy

cyci

n %

S

Ert

ap

en

em

%S

Eri

tro

mis

in %

S

Ge

nta

mis

in %

S

Imip

en

em

%S

Lev

ofl

ok

sasi

n %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksi

flo

ksa

sin

%S

Ok

sasi

lin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

ba

kta

m %

S

Te

tra

sik

lin

%S

Tig

esi

kli

n %

S

To

bra

mis

in %

S

Tri

me

top

rim

/su

lfa

me

tok

saso

l %

S

Va

nk

om

isin

%S

Escherichia coli 226 98.7 52.5 6.2 24.3 29.1 29.1 80.3 26.2 27.6 27.6 34 99.2 25.4 98.1 69.5 97.5 26.2 98.7 76.2 100 66.1 28.2

Pseudomonas aeruginosa 108 82.1 0 0 2 36.2 67.3 73.7 0 56.6 0 53.1 70.2 0 62.3 71.9 61.4 70.9 51 4.2 73.7 4.2

Acinetobacter baumannii 99 67.7 0 0 50.9 0 15.1 54.3 0 8.1 3 15.1 45.9 37 18.2 39.1 2.2 45.5 13.1 86.8 34.8 71.7

Klebsiella pneumoniae 72 100 51.7 0 34.1 39 39 79.3 34.5 37.1 37.1 56.1 100 37.9 97.6 60 100 58.6 98.6 70 85.4 44.8 46.3

Staphylococcus aureus 67 10 64.4 64.4 64.4 64.4 64.4 64.4 64.4 64.4 58.3 75 64.4 64.4 75 56.7 64.4 60 96.7 64.4 71.7 64.4 10 64.4 23.3 100 85 81.7

Enterococcus faecalis 54 73.5 73.5 73.5 73.5 24.5 0 4.1 73.5 24.5 93.9 24.5 73.5 73.5 8.2 100 98

Staphylococcus haemolyticus 53 0 2 2 2 2 2 2 2 2 5.9 21.6 2 2 11.8 31.4 2 5.9 96.1 2 35.3 2 0 2 51 100 47.1 90.2

Proteus mirabilis 41 92.7 78.9 56.1 77.3 81.8 81.8 94.7 63.2 73.2 73.2 59.1 0 95.5 70.7 52.6 63.2 95.1 95 0 73.7 40.9



24



(SPESIMEN DARAH)


mik

asi

n %

S

Am

ok

sisi

lin

%S

Am

ok

sisi

lin

/asa

m k

lav

ula

na

t %

S

Am

pis

ilin

/su

lba

kta

m %

S

Azt

reo

na

m %

S

Se

fep

im %

S

Se

fop

era

son

/su

lba

kta

m %

S

Se

fota

ksi

m %

S

Se

fta

sid

im %

S

Se

ftiz

ok

sim

%S

Se

ftri

ak

son

%S

Sip

rofl

ok

sasi

n %

S

Kli

nd

am

isin

%S

Do

rip

en

em

%S

Do

ksi

sik

lin

%S

Ert

ap

en

em

%S

Eri

tro

mis

in %

S

Ge

nta

mis

in %

S

Imip

en

em

%S

Lev

ofl

ok

sasi

n %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksi

flo

ksa

sin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

ba

kta

m %

S

Te

tra

sik

lin

%S

Tig

esi

kli

n %

S

To

bra

mis

in %

S

Tri

me

tro

pim

/su

lfa

me

tok

saso

l %

S

Va

nk

om

isin

%S

Staphylococcus haemolyticus 17 0 0 0 0 0 0 0 0 11.8 17.6 0 0 5.9 41.2 0 11.8 94.1 0 41.2 0 0 70.6 100 47.1 82.4

Staphylococcus hominis 15 0 22.2 22.2 22.2 22.2 22.2 22.2 22.2 50 50 22.2 22.2 21.4 71.4 22.2 50 90 22.2 71.4 0 22.2 28.6 100 35.7 57.1

Escherichia coli 13 100 75 37.5 12.5 12.5 75 25 16.7 16.7 12.5 100 25 100 66.7 100 25 100 91.7 100 75 0

Staphylococcus aureus 12 9.1 63.6 63.6 63.6 63.6 63.6 63.6 63.6 63.6 72.7 63.6 63.6 72.7 72.7 63.6 63.6 90.9 63.6 81.8 9.1 63.6 27.3 100 90.9 81.8

Staphylococcus epidermidis 10 11.1 22.2 22.2 22.2 22.2 22.2 22.2 22.2 55.6 66.7 22.2 22.2 33.3 44.4 22.2 55.6 100 22.2 66.7 11.1 22.2 66.7 100 55.6 100



25



(SPESIMEN URIN)

Organism Jml isolat

Am

ikas

in %

S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Escherichia coli 87 97.7 49 9.2 18.4 31.6 31.6 77.6 34.7 33.3 33.3 31.6 100 26.5 97.4 71.8 100 28.6 98.8 72.9 100 60.4 23.7


Klebsiella pneumoniae 17 100 28.6 0 30 30 30 85.7 0 17.6 17.6 40 100 0 100 47.1 100 57.1 100 64.7 80 14.3 50

Acinetobacter baumannii 16 87.5 0 0 83.3 0 0 80 0 0 0 0 70 50 6.2 80 0 81.2 12.5 100 20 50



26



(SPESIMEN PUS)

Organism Jml isolat

Am

ikas

in %

S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

izo

ksim

%S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

iskl

in %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

S

Me

rop

en

em

%S

Mo

ksif

loks

asai

n %

S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

am %

S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Escherichia coli 226 98.7 52.5 6.2 24.3 29.1 29.1 80.3 26.2 27.6 27.6 34 99.2 25.4 98.1 69.5 97.5 26.2 98.7 76.2 100 66.1 28.2

Pseudomonas aeruginosa 108 82.1 0 0 2 36.2 67.3 73.7 0 56.6 0 53.1 70.2 0 62.3 71.9 61.4 70.9 51 4.2 73.7 4.2

Acinetobacter baumannii 99 67.7 0 0 50.9 0 15.1 54.3 0 8.1 3 15.1 45.9 37 18.2 39.1 2.2 45.5 13.1 86.8 34.8 71.7

Klebsiella pneumoniae 72 100 51.7 0 34.1 39 39 79.3 34.5 37.1 37.1 56.1 100 37.9 97.6 60 100 58.6 98.6 70 85.4 44.8 46.3

Staphylococcus aureus 67 10 64.4 64.4 64.4 64.4 64.4 64.4 64.4 58.3 75 64.4 64.4 75 56.7 64.4 60 96.7 64.4 71.7 10 64.4 23.3 100 85 81.7


Staphylococcus haemolyticus 53 0 2 2 2 2 2 2 2 5.9 21.6 2 2 11.8 31.4 2 5.9 96.1 2 35.3 0 2 51 100 47.1 90.2

Proteus mirabilis 41 92.7 78.9 56.1 77.3 81.8 81.8 94.7 63.2 73.2 73.2 59.1 0 95.5 70.7 52.6 63.2 95.1 95 0 73.7 40.9



27


POLA KEPEKAAN KUMAN KSM PARU RSDM PERIODE 2016

Organism Jml isolat

Am

ikas

in %

S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Mo

ksif

loks

asin

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tetr

asik

lin

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Klebsiella pneumoniae 396 100 64 0 58.7 61 60.4 98.1 59 60.2 59.7 69.6 100 59.6 99.6 71.5 99.4 67.7 100 84.7 92.6 60.9 67.5

Acinetobacter baumannii 262 85.9 0 0 75 0 57.4 81.7 24.2 55.5 15.6 59.6 84.9 72.5 66.8 79.2 57.5 76.2 61.3 86.8 72.5 90.4

Pseudomonas aeruginosa 230 92.5 3 1.3 2.4 53.2 89 84.2 2 81.1 3.4 78 83 4 85 75.8 73.3 85.3 76.3 3.1 85 3.9

Enterobacter cloacae 117 100 0 2.6 6.1 83.3 87.9 100 90 89.7 83.6 95.5 98 90 97 93.1 94 100 98.3 97.4 97 98 87.9

Escherichia coli 103 100 57.9 5.8 34.8 19.6 21.7 87.7 15.8 18.4 17.5 26.1 100 26.3 97.8 69.9 100 7 100 83.5 100 52.6 41.3

Streptococcus mitis 103

Staphylococcus haemolyticus 101 2.4 3.6 3.6 3.6 3.6 3.6 3.6 9.5 44 3.6 3.6 11.9 28.6 3.6 9.5 96.4 3.6 31 2.4 3.6 69 100 50 84.5

Enterobacter aerogenes 32 100 0 0 0 100 100 100 100 100 100 100 100 26.9 100 100 88.5 26.9 100 100 100 100 100

Staphylococcus hominis 31 4 16 16 16 16 16 16 44.4 57.7 16 16 33.3 92.6 16 44.4 92.3 16 48.1 3.8 16 29.6 100 26.9 88.5



28


POLA KEPEKAAN KUMAN KSM PARU RSDM PERIODE 2016

(SPESIMEN SPUTUM)


mik

asin

%S

Am

oks

isil

in %

S

Am

oks

isil

in/a

sam

kla

vula

nat

%S

Am

pis

ilin

%S

Am

pis

ilin

/su

lbak

tam

%S

Azt

reo

nam

%S

Sefe

pim

%S

Sefo

pe

raso

n/s

ulb

akta

m %

S

Sefo

taks

im %

S

Seft

asid

im %

S

Seft

riak

son

%S

Sip

rofl

oks

asin

%S

Kli

nd

amis

in %

S

Do

rip

en

em

%S

Do

ksis

ikli

n %

S

Erta

pe

ne

m %

S

Erit

rom

isin

%S

Ge

nta

mis

in %

S

Imip

en

em

%S

Levo

flo

ksas

in %

S

Lin

eso

lid

%S

Me

rop

en

em

%S

Pe

nis

ilin

%S

Pip

era

sili

n/t

aso

bak

tam

%S

Tige

sikl

in %

S

Tob

ram

isin

%S

Trim

eto

pri

m/s

ulf

ame

toks

aso

l %S

Van

kom

isin

%S

Klebsiella pneumoniae 343 100 64.8 0 55.6 58.2 57.7 98.6 59.3 58.7 58.2 67.9 100 60 99.5 70.8 99.3 68.3 100 85 91.3 60.7 64.4

Acinetobacter baumannii 252 86.6 0 0 75.4 0 57.5 82.1 25.9 55.7 16.3 59.7 85 73.2 67.1 79.5 58.9 76.4 61.8 86.6 72.3 90.3

Pseudomonas aeruginosa 205 93.1 3.3 1.5 2.7 53.6 88.5 88.9 2.2 83.2 3.8 80.5 84.3 4.5 87.1 78.4 75.6 85.9 78.9 3.5 86.5 4.4

Streptococcus sp. 114

Enterobacter cloacae 103 100 0 1.9 5.6 81.5 87 100 89.8 89.3 82.5 94.4 98 89.8 96.3 92.2 93.9 100 98.1 97.1 96.3 98 87

Streptococcus mitis 98

Escherichia coli 90 100 57.1 6.7 34.1 22 24.4 87.8 14.3 18.9 17.8 24.4 100 26.5 97.6 70 100 4.1 100 83.3 100 49 41.5

Staphylococcus haemolyticus 81 1.6 1.6 1.6 1.6 1.6 1.6 1.6 7.8 42.2 1.6 1.6 10.9 26.6 1.6 7.8 98.4 1.6 1.6 1.6 100 46.9 89.1



29


pola kuman rsud dr. moewardi periode...

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