Sepsis Enterobacterial

WISNUARDHY . H
 Enterobacterial

Definition
Enterobacterial infections are disorders of the
digestive tract and other organ systems produced by
a group of gram-negative, rod-shaped bacteria called
Enterobacteriaceae
 Enterobacterial

Caused
Enterobacterial infections in the digestive tract
typically start when the organisms invade the
mucous tissues that line the digestive tract. They
may be bacteria that are already present in the
stomach and intestines, or they may be transmitted
by contaminated food and water. It is also possible
for enterobacterial infections to spread by person-to-
person contact. The usual incubation period is 12-72
hours.
 Enterobacterial

The organisms are categorized according to whether

they are invasive or noninvasive
1. Non Invasive
- Enteropathogenic E.coli(EPEC)
- Enteropathogenic E.coli (ETEC)
2. Invasive
- Enterohemorrhagi E.coli (EHEC)
- Enteroinvasive E. coli (EIEC)
 Sepsis

Definisi
Sepsis adalah suatu sindroma klinik yang terjadi
oleh karena adanya respon tubuh yang berlebihan
terhadap rangsangan produk mikroorganisme.
Ditandai dengan panas, takikardia, takipnea,
hipotensi dan disfungsi organ berhubungan
dengan gangguan sirkulasi darah.
 Sepsis

Derajat Sepsis
1. Systemic Inflammatory Response
Syndrome (SIRS), ditandai dengan ≥2 gejala
sebagai berikut
- Hyperthermia/hypothermia (>38,3°C; <35,6°C)
- Tachypneu (resp >20/menit)
- Tachycardia (pulse >100/menit)
- Leukocytosis >12.000/mm atau Leukopenia
<4.000/mm
-10% >cell imature
 Sepsis

2. Sepsis
Infeksi disertai SIRS
3. Sepsis Berat
Sepsis yang disertai MODS/MOF, hipotensi, oligouri
bahkan anuria.
Sepsis dengan hipotensi (tekanan sistolik <90
mmHg atau penurunan tekanan sistolik >40
mmHg).
 Sepsis

4. Syok septik
Syok septik adalah subset dari sepsis berat, yang
didefinisikan sebagai hipotensi yang diinduksi sepsis dan
menetap kendati telah mendapat resusitasi cairan, dan
disertai hipoperfusi jaringan.
- Ketidakseimbangan: DO2 (oxygen delivery) dan VO2
(oxygen consumption).
- USA → 400.000 kasus sepsis; 200.000 kasus syok
septik; 100.000 kematian.
- Pasien mendapatkan obat vasoaktif → syok septik jika
mengalami hipoperfusi jaringan
 Therapy Across the Sepsis Continuum

Infectio SIRS Sepsis Severe Sepsis Septic Shock

n

Microorganism  A clinical SIRS with a Sepsis with Refractory

invading response arising presumed organ failure hypotension
sterile tissue from a nonspecific or confirmed Vascular collapse
insult, with 2 of infectious
Renal
the following: process
Hemostasis
 T >38oC or
<36oC Lung
 HR >90 LA
beats/min
 RR >20/min
 WBC
>12,000/mm3
or <4,000/mm3
or >10% bands

Chest 1992;101:1644
TERIMA KASIH