Faktor Risiko Sekuele Meningitis Bakterial pada Anak

Muriana Novariani, Elisabeth Siti Herini, Suryono Yudha Patria

Sari


Latar belakang. Mortalitas akibat meningitis bakterial menurun dengan ditemukan antibotik yang poten
dan penanganan yang baik pada saat pasien kritis. Walaupun demikian, sekuele akibat meningitis bakterial
masih tinggi, sekitar 50%-65% di negara berkembang.
Tujuan. Mengetahui faktor risiko yang terkait dengan sekuele pada pasien meningitis bakterial yang
bertahan hidup.
Metode. Penelitian kasus kontrol dilakukan di RSUP Dr. Sardjito, RSUD Banyumas dan RSU Suradji
Tirtonegoro Klaten. Kasus adalah pasien yang terdiagnosis meningitis bakterial pada tahun 2003 – 2006
yang hidup dengan sekuele. Kontrol adalah pasien meningitis bakterial yang hidup tanpa sekuele. Data
diambil dari catatan medis, luaran ditetapkan setelah 6 bulan.
Hasil. Terdapat 78 pasien yang memenuhi kriteria inklusi. Hasil analisis multivariat menunjukkan bahwa
faktor risiko yang terkait dengan meningitis bakterial adalah kejang >30 menit saat masuk rumah sakit
(OR 4,29; IK 95% 1,38–12,99), PCS (Pediatrics Coma Scale) <8 (OR 3,76 ; IK 95% 1,15-12,28), dan
kejang yang tidak terkontrol >72 jam (OR 5,24 ; IK 95% 1,49–18,43). Onset - gejala >48 jam mempunyai
OR 2,43 (IK 95% 0,73 – 8,13).
Kesimpulan. Kejang >30 menit saat masuk rumah sakit, PCS <8, dan kejang yang tidak terkontrol >72 jam
merupakan faktor risiko yang indipenden untuk menimbulkan sekuele.


Kata Kunci


meningitis bakterial; sekuele, anak; kasus kontrol

Teks Lengkap:

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Referensi


Chong HT, Tan CT. Epidemiology of central nervous

system infections in Asia, recent trends. Neurology Asia

; 10:7-11.

Farag HF, Abdel-Fattah MM, Youssri AM. Epidemiological,

clinical and prognostic profile of acute bacterial

meningitis among children in Alexandria, Egypt. Indian

J Clin. Microbiol 2005; 23:95-101.

Swartz MN. Bacterial meningitis – a view of the past 90

years, N Engl J Med 2004; 351:1826-8.

Bedford H, Louvois J, Halket S, Peckham C, Hurley

R, Harvey D. Meningitis in infancy in England and

Wales: Follow up at age 5 years, Be Med J, 2001; 323:1-

Urowayino OE, Afolabi LF, Chinyere EK,

Olufunmilayo GA. Neurological sequelae in childrem

with pyogenic meningitis in a tertiary centre in Lagos

(Nigeria), African J Neurol Sci, 2004; 23:31-8

Weil ML and Levin M. Infections of the nervous system

Dalam: Textbook of Child Neurology, Menkes, J.H,

penyunting. Edisi ke-7. Baltimore Maryland: Wiliam

& Wilkins; 2005. h. 433-7.

Mehta N, Pollard AJ. Speciate feature meningitisbacterial

meningitis, Hosp Pharmacist, 1999;6:256-62.

Liorens XS, Ramilo O, Mustafa M, Mertsola J,

McCracken G. Molecular patophysiology of bacterial

meningitis: current concepsts and therapeutic implications.

Pediatrics 1990; 116:671-81.

Chin RF, Neville BG, Scott RC. Meningitis is a common

cause of convulsive status epilepticus with fever. Archs

Dis Child 2005; 90:66-9.

Kilpi T. Length of prediagnostic history related to the

course and sequelae of childhood bacterial meningitis.

Pediatr Inf Dis J 1993; 12:184-8.

Kirimi E, Tuncer O, Arslan S, Atas B, Husyein C, Uner

A. Prognostic factor in children with purulent meningitis

in Turkey. Acta Med Okayama, 2003; 57:39-44.

Baraff LJ, Lee SI, Schriger DL. Outcomes for bacterial

meningitis in children: a metaanalysis. Pediatr Infect Dis

J 1993; 12:389-94.

Riviello JJ, Ashwal S, Hirtz D, Glauser T, Ballaban-Gil

K, Kelley dkk. Practice parameter: Diagnostic assessment

of the child with status epilepticus (an evidence-based

review): Report of the Quality Standards Subcommittee

of American Academy of Neurology and the Practice

Committee of the Child the Neurology Society.

Neurology 2006; 67:1542-50

Rosman NP, Peterson DB, Kaye EM, Colton T. Seizure

in bacterial meningitis, prevalence, patterns, pathogenesis

and prognosis, Pediatr Neurol 1985;1:278-85.

Bashir HE, Laundy M, Booy R. Diagnosis and

treatment of bacterial meningitis, Archs Dis Child

; 88:615-20.

Communicable Disease Surveillance. Communicable

disease profile for tsunami affected areas: Indonesia,

WHO, CDS, 2005.

Schutte C-M, van der Meyden CH. A prospective study

of Glasgow Coma Scale (GCS), age, CSF-neutrophil

count, and CSF-protein and glucose levels as prognostic

indicators in 100 adult patients with meningitis. J Infect

; 37:112-5

Aronin J. Meningitis, hypotension, altered mental status

and seizure at admission increased the risk of dying in

hospital. Ann Intern Med 1998; 129:829-69.

Takayanagi M, Yamamoto K, Nakagawa H, Inuma

K. Factors associated with the prognosis of bacterial

meningitis in children. No To Hattatsu. 1997;

:291-7.

Akapede GO, Jalo I, Dawodo SO. A revised clinical

methods for assesment of severity acute bacterial

meningitis. Ann Trop Pediatr 2002; 22:33-44.

Anderson V, Catroppa C, Morse S, Haritou F, Rosenfeld.

Functional plasticity or vulnerability after early brain

injury? J Pediatr 2005; 116:1374–82.

Kanegaye JT, Seliemanzaden P, Bradley JS. Lumbar

puncture in pediatric bacterial meningitis : defining the

time interval of recovery of cerebrospinal; fluid

pathogenesis after parenteral antibiotic pretreatment.

Pediatr 2001; 108:1169-74.

Kaplan SL. Clinical presentations, diagnosis, and

prognostic factors of bacterial meningitis. Infect Dis Clin

North Am 1999; 13:579-94.

Coant PN, Kornberg AE, Duffy LC, Dryja DM, Hassan

SM. Blood culture results as determinants in the

organism identification of bacterial meningitis. Pediatr

Emerg Care 1992; 8:200-5.




DOI: http://dx.doi.org/10.14238/sp9.5.2008.342-7

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