Hubungan Kadar Prokalsitonin dan Kultur Bakteri dengan Tingkat Keparahan Pneumonia pada Anak
Sari
Latar belakang. Di negara berkembang, pneumonia merupakan penyebab utama kesakitan dan kematian pada bayi dan balita.
Penelitian sebelumnya menemukan prokalsitonin dapat menggambarkan keparahan pneumonia pada anak. Dilaporkan juga kultur
bakteri positif lebih sering ditemukan pada pneumonia berat dengan komplikasi.
Tujuan.Menentukan hubungan kadar prokalsitonin dan kultur bakteri dengan tingkat keparahan pneumonia.
Metode. Penelitian potong lintang yang dilaksanakan dari bulan September 2014 hingga Januari 2015 di RSUP Dr. Hasan
Sadikin Bandung. Dilibatkan 61 anak berusia 1 bulan hingga 5 tahun. Subjek terdiri atas 30 anak pneumonia berat dan 31 anak
pneumonia. Pemeriksaan prokalsitonin dilakukan dengan Elecsys BRAHMS PCT. Kultur darah diperiksa dengan mesin BACTEC
9050, jika hasilnya positif bakteri kemudian dibiakkan dalam media agar McConkey atau agar darah. Data hasil penelitian diuji
dengan Mann Whitney dan chi-square.
Hasil.Nilai median PCT pneumonia berat 0,69 ng/mL dan pneumonia 0,075 ng/mL, dengan nilai p<0,001. Hasil kultur positif
ditemukan 5 dari 30 pada pneumonia berat dan 10 dari 31 pada pneumonia, dengan nilai p=0,157.
Kesimpulan. Keparahan pneumonia berhubungan dengan kadar prokalsitonin dan tidak berhubungan dengan hasil kultur bakteri.
Sari Pediatri2015;17(4):261-6.
Kata Kunci
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PDFReferensi
Rudan I, Tomaskovic L, Boschi-Pinto C, Campbell H.
Global estimate of the incidence of clinical pneumonia
among children under five years of age. Bull WHO
;82:895-903.
Muller F, Christ-Crain M, Bregenzer T, Krause M,
Zimmerli W, Mueller B, dkk. Procalcitonin levels
predict bacteremia in patients with communityacquired pneumonia: a prospective cohort trial. Chest
;138:121-9.
Assicot M, Gendrel D, Carsin H, Raymond J,
Guilbaud J, Bohuon C. High serum procalcitonin
concentrations in patients with sepsis and infection.
Lancet 1993;341:515-8.
Don M, Valent F, Korppi M, Falleti E, De Candia
A, Fasoli L, dkk. Efficacy of serum procalcitonin in
evaluating severity of community-acquired pneumonia
in childhood. Scand J Infect Dis 2007;39:129-37.
Boussekey N, Leroy O, Georges H, Devos P, d’Escrivan T,
Guery B. Diagnostic and prognostic values of admission
procalcitonin levels in community-acquired pneumonia
in an intensive care unit. Infection 2005;33:257-63.
Tseng JS, Chan MC, Hsu JY, Kuo BI, Wu CL.
Procalcitonin is a valuable prognostic marker in ARDS
caused by community-acquired pneumonia. Respirology
;13:505-9.
Shah SS, Dugan MH, Bell LM, Grundmeier RW, Florin
TA, Hines EM, dkk. Blood cultures in the emergency
department evaluation of childhood pneumonia. Pediatr
Infect Dis J 2011;30:475-9.
Williams DJ. Do all children hospitalized with
community-acquired pneumonia require blood cultures? Hosp Pediatr 2013;3:177-9.
Cham G, Yan S, Heng BH, Seow E. Predicting positive
blood cultures in patients presenting with pneumonia
at an Emergency Department in Singapore. Ann Acad
Med Singapore 2009;38:508-7.
Myers AL, Hall M, Williams DJ, Auger K, Tieder JS,
Statile A, dkk. Prevalence of bacteremia in hospitalized
pediatric patients with community-acquired pneumonia.
Pediatr Infect Dis J 2013;32:736-40.
Cilloniz C, Ewig S, Polverino E, Marcos MA, Esquinas
C, Gabarrus A, dkk. Microbial aetiology of communityacquired pneumonia and its relation to severity. Thorax
;66:340-6.
Paganin F, Lilienthal F, Bourdin A, Lugagne N, Tixier F,
Genin R, dkk. Severe community-acquired pneumonia:
assessment of microbial aetiology as mortality factor. Eur
Respir J 2004;24:779-85.
World Health Organization. Pocket book of hospital care
for children : guidelines for the management of common
childhood illnesses. Edisi ke-2. WHO;2013.
Okimoto N, Hayashi Y, Ishiga M, Nanba F, Kishimoto
M, Yagi S, dkk. Procalcitonin and severity of community-acquired pneumonia. J Infect Chemother
;15:426-7
Nagase N, Sasaki A, Yamashita K, Shimizu A, Wakita
Y, Kitai S, dkk. Isolation and species distribution of
staphylococci from animal and human skin. J Vet Med
Sci 2002;64:245-50.
de Allori MC, Jure MA, Romero C, de Castillo ME.
Antimicrobial resistance and production of biofilms in
clinical isolates of coagulase-negative Staphylococcus
strains. Biol Pharm Bull 2006;29:1592-6.
Ryan KJ, Ray CG, Sherris JC, penyunting. Sherris
medical microbiology: an introduction to infectious
diseases. Edisi ke-4. New York: McGraw-Hill; 2004.
Portero JL, Porcel JM, Ruiz A, Rubio-Caballero M.
Community-acquired pneumonia caused by Enterococcus faecium. Med Clin (Barc) 1994;102:316-7.
Hess B, Burchett A, Huntington MK. Leclercia
adecarboxylata in an immunocompetent patient. J Med
Microbiol 2008;57:896-8.
Eiland EH, 3rd, Siddiqui H, Goode AM, Leeth
SD. Pneumonia due to multidrug-resistant Leclercia
adecarboxylata. Am J Health Syst Pharm 2013;
:940-1.
Theodosia R, Siadi PP, Naning R. Validity of bacterial
pneumonia score for predicting bacteremia in children
with pneumonia. Paed Ind 2011;51:322-6
DOI: http://dx.doi.org/10.14238/sp17.4.2015.261-6
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