Pseudomonas Aeruginosa pada Penyakit Paru Obstruktif Kronik (PPOK) Eksaserbasi Akut dan Hubungannya dengan Derajat Keparahan PPOK

Abstract

Pseudomonas aeruginosa plays an important role in acute exacerbation of chronic obstructive pulmonary disease (COPD). Since exacerbation caused by this bacteria results in worsening lung function, and high rate of morbidity and mortality, it is necessary to manage Pseudomonas aeruginosa course adequately and efficiently. Then, obtaining the role of Pseudomonas aeruginosa during exacerbation is important to guide the appropriate antibiotic treatment and find out the association between this bacteria and severity of copd is another benefit in treating patients with acute exacerbation of COPD. A cross sectional study was conducted on 50 patients who were hospitalized due to exacerbation of COPD in Internal Medicine ward of H. Adam Malik General Hospital since August 2009 –June 2010. History of illness, physical examination, chest radiograph, spirometry and sputum culture were obtained from the patients. Statistical analysis was done using chi-square test and Anova test. Pseudomonas aeruginosa counted as the fourth most common bacteria in this study. Bacterial pattern during exacerbation were consist of 4 most common bacteria including Klebsiella pneumonia (20.37%) , Staphylococcus aureus (18.52%), Klebsiella ozaenae (11.11%) dan, Pseudomonas aeruginosa (9.26%). Pseudomonas aeruginosa was found related to severe degree of COPD (FEV1 < 50%pred) significantly (p=0,05). All of the bacteria has very high sensitivity to meropenem (100%), followed by amikacin (96,88%), gentamycin (93,75%), kanamycin (84,38%), cefotaxim (78,12%), and levofloxacin (75%). Meanwhile, the most common found resistant antibiotics are tetracyclin dan amoxycillin (84,38), followed by ampicilin (81,25%). In conclusion, Pseudomonas aeruginosa was found as the fourth most common bacteria in this study and was related to severe degree of COPD.

Pseudomonas aeruginosa memegang peranan penting pada eksaserbasi Penyakit Paru Obstruktif Kronik (PPOK). Eksesarbasi oleh kuman ini menyebabkan perburukan fungsi paru, morbiditas dan mortalitas yang tinggi, sehingga diperlukan penanganan yang adekwat dan efisien. Maka perlu diketahui peranan kuman ini saat eksaserbasi sebagai panduan terapi antibiotik yang tepat dan informasi mengenai hubungannya dengan derajat keparahan PPOK memberi manfaat tambahan dalam penanganan pasien-pasien dengan eksaserbasi akut. Sebuah penelitian potong lintang dilakukan terhadap 50 orang pasien yang dirawat karena eksaserbasi PPOK di ruang rawat inap Penyakit Dalam RSUP H. Adam Malik Medan mullai Agustus 2009- Juni 2010. Dilakukan anamnesis, pemeriksaan fisik, foto toraks, spirometri dan kultur sputum. Analisa statistik menggunakan uji chi-square dan Anova. Pseudomonas aeruginosa menempati urutan ke-4 kuman terbanyak pada penelitian ini. Pola kuman pada saat eksaserbasi meliputi Klebsiella pneumonia (20.37%) , Staphylococcus aureus (18.52%), Klebsiella ozaenae (11.11%) dan, Pseudomonas aeruginosa (9.26%). Pseudomonas aeruginosa ditemukan berhubungan dengan PPOK derajat berat (FEV1 <50% prediksi, p=0,05). Semua bakteri memiliki sensitivitas yang sangat tinggi terhadap meropenem (100%), diikuti amikasin (96,88%), gentamisin (93,75%), kanamisin (84,38%), sefotaksim (78,12%), and levofloksasin (75%). Sementara itu, antibiotik yang paling banyak resisten adalah tetrasiklin dan amoksisilin (84,38), diikuti ampisilin (81,25%). Pseudomonas aeruginosa menempati urutan ke-4 kuman terbanyak pada penelitian ini dan berhubungan dengan PPOK derajat berat.