Faktor Risiko yang Memengaruhi Kolonisasi Mikroflora Saluran Cerna Neonatus Kurang Bulan dengan Enterokolitis Nekrotikans
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Latar belakang. Insiden enterokolitis nekrotikans (necrotizing enterocolitis,NEC) sekitar 1 per 1000 kelahiran hidup, dan 90% terjadi pada neonatus kurang bulan (NKB). Patofisiologi NEC belum jelas, salah satu penyebabnya diduga akibat kolonisasi mikroflora yang abnormal. Faktor risiko yang dapat memengaruhi kolonisasi mikroflora saluran cerna, yaitu cara persalinan, lama pemakaian antibiotik, dan tipe nutrisi.
Tujuan. Mengetahui proporsi mikroflora pada NKB dengan dan tanpa NEC serta faktor risiko yang memengaruhi kolonisasi mikroflora saluran cerna NKB dengan NEC.
Metode. Penelitian potong lintang dilakukan pada NKB dengan NEC derajat II selama periode Maret-Oktober 2012. Dilakukan pemeriksaan tinja dengan quantitative realtime PCR untuk mendeteksi kolonisasi mikroflora B. lactis, L. acidophilus, Bifidobacterium sp., Lactobacillus sp., E. coli, C. difficile, dan K. pneumoniae.
Hasil. Tigapuluh subjek NKB dengan NEC dan 10 subjek NKB tanpa NEC diikutsertakan dalam penelitian. Pada subjek NEC, K. pneumoniae terdeteksi dengan median proporsi 15,2%, Bifidobacterium sp. 13,4%, E. coli 1,0%, Lactobacillus sp. 0,1%, B. lactis 0,0%, C. difficile 0,0%, dan L. acidophilus 0,00% (0,0-1,8%). Pada subjek tanpa NEC, Bifidobacterium sp. terdeteksi dengan proporsi 29,5%, K. pneumoniae 0,9%, E. coli 0,3%, Lactobacillus sp. 2,3%, B. lactis 0,0%, C. difficile 0,0%, sedang L. acidophilus tidak terdeteksi. Tidak ditemukan perbedaan proporsi ketujuh mikroflora yang bermakna secara statistik pada NKB dengan NEC berdasarkan cara persalinan, lama mendapat antibiotik, dan tipe nutrisi (p>0,05).
Kesimpulan. K.pneumoniae memiliki proporsi terbesar pada subjek NEC, sedangkan Bifidobacterium sp. pada subjek tanpa NEC. Cara persalinan, lama pemakaian antibiotik, dan tipe nutrisi tidak memengaruhi proporsi kolonisasi mikroflora saluran cerna subjek NEC.
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DOI: http://dx.doi.org/10.14238/sp15.6.2014.353-60
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