Gambaran Kadar Profil Neutrofil Lymphocyte Ratio dan Pola Kuman pada Urine Pasien Infeksi Saluran Kemih di RSUP Haji Adam Malik

Abstract

Introduction: Urinary tract infection (UTI) is one of the most common infections found in healthcare facilities and is a leading cause of nosocomial infections in Indonesia. The Neutrophil-Lymphocyte Ratio (NLR) is a simple laboratory indicator that can be used to assess inflammatory response and the severity of UTI. However, local data on the association between NLR profiles and the bacterial patterns causing UTI in Indonesia, particularly at RSUP Haji Adam Malik Medan, remain limited. Objective: This study aims to analyze the NLR profile and the distribution of bacterial patterns in urine samples from UTI patients, as well as assess the relationship between NLR levels and the bacterial patterns causing UTI at RSUP Haji Adam Malik Medan. Methods: This was an analytic observational study with a cross-sectional design, involving 97 UTI patients hospitalized at RSUP Haji Adam Malik Medan during April–May 2025. Data were collected through consecutive sampling and included demographic characteristics, NLR values from laboratory tests, and urine culture results for bacterial identification. The relationship between NLR profiles and bacterial patterns was analyzed using chi-square or Fisher exact test, with significance set at p<0.05. Results: Most UTI patients had a normal NLR (68.0%), with 27.8% showing high NLR and 4.1% low NLR. Escherichia coli was the most common isolated bacterium (71.1%), followed by Klebsiella spp. (10.3%), Staphylococcus saprophyticus (7.2%), Proteus spp. (4.1%), Enterococcus spp. (4.1%), and Pseudomonas aeruginosa (3.1%). Statistical analysis showed no significant association between NLR and the bacterial patterns causing UTI (p=0.08). However, there was a trend of higher NLR being more frequently found in infections caused by Proteus and Enterococcus. Conclusion: The majority of UTI patients showed a normal NLR profile, with Escherichia coli as the predominant pathogen. No significant relationship was found between NLR levels and the bacterial pattern. This study highlights the need for further research with larger samples and additional inflammatory biomarkers to optimize the role of NLR in risk stratification and management of UTI.