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BACTERIAL NOSOCOMIAL INFECTION

NOSOCOMIAL INFECTIONS
BLOODSTREAM INFECTIONS, 28% VENTILATOR-ASSOCIATED PNEUMONIA, 21% URINARY TRACT INFECTION (UTI), 15% LOWER RESPIRATORY INFECTION, 12%

GASTROINTESTINAL, SKIN, SOFT TISSUE, AND CARDIOVASCULAR INFECTIONS, 10%


SURGICAL-SITE INFECTIONS, 7% EAR, NOSE, AND THROAT INFECTIONS 7%

4 MAJOR TYPE
URINARY TRACT INFECTION
SURGICAL WOUND INFECTION

NOSOCOMIAL PNEUMONIA
NOSOCOMIAL BLOODSTEAM INFECTION

URINARY TRACT INFECTION

URINARY TRACT INFECTION

INSIDENSI
MOST COMMON DEVICE RELATED INFECTION PROSEDUR KATETER :

80%
20%

OTHER UROLOGIC INSTRUMENTATION

UTI KARENA PEMASANGAN KATETER

25% DARI TOTAL PASIEN YANG DIPASANG KATETER

URINARY TRACT INFECTION

BAKTERI TERSERING:

Eschericia colli

Enterococcus Spp
P. Aeruginosa

URINARY TRACT INFECTION

Endogenous source
Exogenous source

Flora normal GIT Flora normal kulit

Tangan petugas medis Peralatan yang terkontaminasi

URINARY TRACT INFECTION


BAKTERI MASUK KE SALURAN KEMIH BERASAL DARI FLORA REKTAL DI AREA PERIURETA BAKTERI TERTENTU : PROTEUS DAN PSEUDOMONAS DAPAT MEMBENTUK BIOFILM DI KATETER

URINARY TRACT INFECTION


FAKTOR RESIKO
JENIS KELAMIN DURASI PEMASANGAN KATETER PEMBERIAN ANTIBIOTIKA

KEBERSIHAN PERALATAN DAN PROSEDUR PEMASANGAN

URINARY TRACT INFECTION


PENCEGAHAN
SEPTIC DAN ASEPTIC MANAGEMENT PEMELIHARAAN URINE KATETER YANG TERPASANG

MENGURANGI DURASI / LAMANYA PENGGUNAAN KATETER URINE PEMBERIAN ANTIBIOTIKA PROFILAKSIS

SURGICAL WOUND INFECTION

SURGICAL WOUND INFECTION


INSIDENSI
MERUPAKAN 25% DARI TOTAL NOSOCOMIAL INFEKSI SAAT INSISI / PERLUKAAN PADA KULIT 60% 80%

SURGICAL WOUND INFECTION

FAKTOR RESIKO
TINGKAT KONTAMINASI LUKA AWAL OPERASI PROSEDUR OPERASI / PENANGANAN LUKA
RESISTENSI / DAYA TAHAN TUBUH

SURGICAL WOUND INFECTION


S AUREUS, 20% PSEUDOMONAS, 16% COAGULASE-NEGATIVE STAPHYLOCOCCI, 15% ENTEROCOCCI, FUNGI, ENTEROBACTER SPECIES, AND ESCHERICHIA COLI, LESS THAN 10% EACH

SURGICAL WOUND INFECTION


KONTROL
RAWAT INAP PRE OPERASI PROSEDUR / METODA OPERASI MINIMAL AND OPTIMAL SURGICAL TIME

PROCESSING, WRAPPING, STORING SURGICAL EQUIPMENT


ANTIBIOTIK PROFILAKSIS

PNEUMONIA NOSOCOMIAL INFECTION

PNEUMONIA NOSOCOMIAL INFECTION


INSIDENSI
13%-18% DARI TOTAL INFEKSI NOSOCOMIAL CASE FATALITY RATE PALING TINGGI SURVEY : 60% DARI HOSPITAL DEATH RELATED TO INFECTION, DISERTAI NOSOCOMIAL PNEUMOMNIA DI ICU : PASIEN DENGAN PENUMONIA NOSOCOMIAL INFECTION MEMILIKI FATALITY RATE 50% PATOGEN PALING SERING : BAKTERI AEROB GRAM NEGATIVE , PSEUDOMONAS AEUROGINOSA, ENTEROBACTERIA, KLEBSIELA PNEUMONIA

PNEUMONIA NOSOCOMIAL INFECTION

ENDOGENOUS
Aspirasi secret Upper Respiratory Tract Flora normal GIT

EXOGENOUS
Alat bantu pernafasan: intubasi, ventilator circuits Petugas medis Cairan dan obat obatan

PNEUMONIA NOSOCOMIAL INFECTION


FAKTOR RESIKO
USIA LANJUT > 70 PENYAKIT PENYERTA : CHRONIC LUNG DISEASE, PENURUNAN KESADARAN, OPERASI THORAX, PASIEN DENGAN INTUBASI, VENTILATOR

PNEUMONIA NOSOCOMIAL INFECTION


PENCEGAHAN
PERNATALAKSANAAN SEBELUM DAN SESUDAH PROSEDUR OPERASI

PENATALAKSANAAN SAAT TERAPI YANG BERHUBUNGAN DENGAN ORGAN RESPIRASI (RESPIRATORY THERAPY)
PENANGANAN ALAT ANESTHESIA

PROSEDUR CUCI TANGAN: TERUTAMA SEBELUM DAN SESUDAH PROSEDUR SUCTIONING, PENANGANAN PASIEN TRACHEOSTOMY PENINGKATAN DAYA TAHAN TUBUH PASIEN : VAKSINASI, STOP

PNEUMONIA NOSOCOMIAL INFECTION


MOST IMPORTANT
EFFECTIVE SURVEILLANCE PROGRAM IDENTIFICATION OF HIGH-RISK PATIENTS, COMPLIANCE WITH INFECTION CONTROL PROSEDURE

NOSOCOMIAL BLOOD STREAM INFECTION


INSIDENSI SEKITAR 28 % DARI INFEKSI NOSOCOMIAL

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