Leukositosis pada Ibu Sebagai Salah Satu Faktor Risiko Infeksi Neonatal Awitan Dini: Telaah Klinis di RSAB Harapan Kita
Sari
Latar belakang. Infeksi awitan dini neonatal masih menjadi masalah karena tingginya angka kesakitan,
kematian, biaya perawatan, dan akan menimbulkan komplikasi tumbuh kembang di kemudian hari
khususnya bayi prematur. Di sisi lain diagnosis cepat sangat diperlukan terutama untuk menentukan saat
pemberian antibiotik.
Tujuan. Mengetahui hubungan faktor risiko maternal sebagai prediktor terjadinya infeksi neonatal awitan
dini (INAD).
Metode. Studi kasus kontrol, retrospektif terhadap pasien neonatus yang dirawat di Unit Perawatan Intensif
Neonatal, Rumah Sakit Anak dan Bunda â€Harapan Kita†sejak Desember 2008 sampai dengan November
2010. Data dianalisis secara multivariat regresi logistik dengan menggunakan program SPSS 16.0.
Hasil. Subyek penelitian 566 bayi baru lahir dari 5094 kelahiran selama periode dua tahun; ditemukan
179 neonatus (35,17 per 1000 kelahiran) didiagnosis tersangka INAD, 12 (6,7%) terbukti berdasarkan
pemeriksaan biakan darah. Jenis kuman adalah Staphylococcus epidermidis (6), candida sp (2), Staphylococcus
aureus (1), Streptococcus B hemoliticus (1), Streptococcus maltophilia (1), serratia sp (1). Faktor risiko
leukositosis (􀂕15.000 sel/mm3) pada ibu dan adanya leukosit (􀂕5/LPB) dalam cairan lambung bayi yang
diaspirasi segera setelah lahir memiliki probabilitas sebagai prediktor kemungkinan neonatus menderita
infeksi awitan dini sebesar 67.7%.
Kesimpulan. Peningkatan jumlah leukosit darah ibu dan peningkatan jumlah leukosit dalam cairan lambung
bayi yang diaspirasi segera setelah lahir merupakan prediktor kemungkinan neonatus menderita infeksi
awitan dini
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Watson RS, Carcillo JA, Linde-Zwirble WT. The
epidemiology of severe sepsis in children in the United
States. Am J Respir Crit Care Med 2003; 167:695–
Stoll BJ, Hansen NI, Adams-Chapman I. For the NICHD
Neonatal Research Network. Neurodevelopmental
and growth impairment among extremely lowbirthweight
infants with neonatal infection. JAMA
;292:2357.
Goldstein B, Giroir B, Randolph A. International
Pediatric Sepsis Consensus Conference: Definitions for
sepsis and organ dysfunction in pediatrics Pediatr Crit
Care Med 2005; 6:1-8.
Laugel V, Kuhn P, Beladdale J, Donato L, Escande B,
Astruc D, Messer J. Effects of antenatal antibiotics on
the incidence and bacteriological profile of early-onset
neonatal sepsis: a retrospective study over five years. Biol
Neonate 2003;84:24-30.
Selimovic A, Skokic F, Bazardzanovic M, Selimovic Z.
The predictive score for early-onset neonatal sepsis. Turk
J Pediatr 2010; 52: 139-144.
Monintja HE. Infeksi sistemik pada neonatus. Dalam:
Monintja HE, Victor YHYu, penyunting. Beberapa
masalah perawatan intensif neonatus. Edisi pertama.
Jakarta: Balai Penerbit Fakultas Kedokteran Universitas
Indonesia; 1990.h.217-29.
Alisjahbana A, Soeroto-Hamzah E, Peeters R. Perinatal
mortality and morbidity in rural West-Java, Indonesia,
part II: the results of a longitudinal survey on pregnant
women. Paediatr Indones 1990;30:179 –90.
Durrane T, Anita KMZ. Burden of neonatal infections
in developing countries a review of evidence from
community-based studies. Pediatr Infect Dis J 2009;28:S3–S9.
Müller B, Becker KL, Schächinger H. Calcitonin
precursors are reliable markers of sepsis in a medical
intensive care unit. Crit Care Med 2000;28:977–83.
Kumar A, Roberts D, Wood KE, Light B, Parrillo
JE, Sharma S, dkk. Duration of hypotension before
initiation of effective antimicrobial therapy is the critical
determinant of survival in human septic shock. Crit Care
Med 2006;34:1589-96.
Zambon M, Ceola M, Almeida-de-Castro R, Gullo
A, Vincent JL: Implementation of the surviving sepsis
campaign guidelines for severe sepsis and septic shock:
we could go faster. J Crit Care 2008;23:455-60.
Mishra UK, Jacobs SE, Doyle LW, Garland SM. Newer
approaches to the diagnosis of early onset neonatal sepsis.
Arch Dis Child Fetal Neonatal 2006;91:F208–12.
Diana A, Arief IS, Ina ST. The use of immatane to total
neutrophil (IT) ratio to detect bacteriemia in neonatal
sepsis. J Lab Med & Quality Assuarance 2003;25ô€€237-
Arinder M, Charles PSH, Ross AP, HK. Beyond the
complete blood cell count and C-reactive protein: a
systematic review of modern diagnostic tests for neonatal
sepsis. Arch Pediatr Adolesc Med 2003;157:511-6
Philipp SP, Christ-Crain M, Müller BB. Procalcitonin and
other biomarkers for the assessment of disease severity and
guidance of treatment in bacterial infections. Adv Sepsis
;6:82–9.
Gerdes JS. Diagnosis and management of bacterial
infections in the neonate. Pediatr Clin North Am
;51:939-59.
Bhandari V, Wang C, Rinder C, Rinder H. Hematologic
profile of sepsis in neonates: neutrophil CD64 as a
diagnostic marker. Pediatrics 2008;121:129-34.
Brown L, Shaw T, Wittlake WA. Does leucocytosis
identify bacterial infections in febrile neonates
presenting to the emergency department? Emerg Med
J 2005;22:256-9.
Manroe BL, Weinberg AG, Rosenfeld CR, Browne R. The
neonatal blood count in health and disease. I. Reference
values for neutrophilic cells. J Pediatr 1979;95:89-98.
Hofer N, Mueller W, Resch B. Correlation of c-reactive
protein values with the clinical diagnosis of early
onset sepsis of the newborn. Arch Dis in Childhood
;93:230.
Campos DP, Silva MV, Machado JR, Castellano LR,
Rodrigues V, Barata CHC. Early-onset neonatal sepsis:
cord blood cytokine levels at diagnosis and during
treatment. J Pediatr 2010;86:509-14.
Nupponen I, Andersson S, Jarvenpaa AL. Neutrophil
CD11b expression and circulating interleukin-8 as
diagnostic markers for early-onset neonatal sepsis.
Pediatrics 2001;108:E12.
Chiesa C, Pellegrini G, Panero A. C-reactive protein,
interleukin-6, and procalcitonin in the immediate
postnatal period: influence of illness severity, risk status,
antenatal and perinatal complications, and infection. Clin
Chem 2003;49:60–8.
Buttery JP. Blood cultures in newborns and children:
optimising an everyday test. Arch Dis Child Fetal
Neonatal Ed 2002;87:F25–8.
Chaaban H, Kultar Singh, Huang J, Siryaporn E,
Lim YP, Padbury JF. The role of inter-alpha inhibitor
proteins in the diagnosis of neonatal sepsis. J Pediatr
;154:620-2
Vieira RC, Procianov RS, Mule LD, Prado CH. The
influence of intrapartum antibiotic therapy on the
diagnosis of early-onset neonatal sepsis. J Pediatr 1997;
:171-5.
Schuetz P, Mueller B, Trampuz A. Serum procalcitonin for
discrimination of blood contamination from bloodstream
infection due to coagulase-negative staphylococci.
Infection 2007;35:352–5.
Marshall JC. Sepsis: rethinking the approach to clinical
research. J Leukoc Biol 2008;83:471–82.
Hofer N, Miiller W, Resch B. Systemic inflammatory
response syndrome (SIRS) definition and correlation with
early-onset bacterial infection of the newborn. Arch Dis
Child Fetal Neonatal Ed 2010;95:F151.
Smulian JC, Bhandari V, Vintzileos AM. Intrapartum fever
at term: serum and histologic markers of inflammation.
Am J Obstet Gynecol 2003;188:269–74.
Pacora P, Chaiworapongsa T, Maymon E. Funisitis and
chorionic vasculitis: the histological counterpart of the
fetal inflammatory response syndrome. J Matern Fetal
Neonatal Med 2002;11:18–25.
Shah GS, Budhathoki S, Das BK, Mandal RN. Risk
factors in early neonatal sepsis Kathmandu University
Med J 2006;4:187-91.
Chen KT, Ringer S, Cohen AP, Lieberman E. The role
of intrapartum fever in identifying asymptomatic term
neonates with early-onset neonatal sepsis. J Perinatol
;22:653–7.
Wong NACS, Hunt LP, Marlow N. Risk factors for
developing neonatal septicaemia at a Malaysian hospital.
J Trop Pediatr 1997;43:54-58.
Oddie S, Embleton ND. Risk factors for early onset
neonatal group b streptococcal sepsis: case control study.
BMJ 2002; 308-325.
Kuhn P, Céline DC, Bolender C, Chognot D, Keller L,
Demil H, dkk. Incidence and distribution of pathogens
in early-onset neonatal sepsis in the era of antenatal
antibiotics. Paed and Perinal Epid 2010;24:479–87.
Betty C, Sohil. Early onset neonatal sepsis. Indian J
Pediatr 2005;72:23-6.
Soman M, Green B, Daling J. Risk factors for early
neonatal sepsis. Am J Epidemiol 1985;121:712-9.
Bhutta ZA, Yusuf K. Early- onset neonatal sepsis in
Pakistan: a case control study of risk factors in a birth
cohort. Am J Perinatol 1997;14:577-81.
DOI: http://dx.doi.org/10.14238/sp13.1.2011.33-40
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