Tesis

Prevalensi infeksi cytomegalovirus kongenital pada neonatus di RS Cipto Mangunkusumo = Prevalence of congenital cytomegalovirus infection among neonates in Cipto Mangunkusumo Hospital .

Infeksi CMV merupakan penyebab infeksi kongenital tersering di dunia yang menyebabkan kematian maupun kecacatan permanen misalnya keterlambatan perkembangan, gangguan pendengaran dan penglihatan. Prevalensi CMV dipengaruhi oleh letak geografis, status sosial ekonomi dan etnis. Prevalensi CMV kongenital di Amerika berkisar 0,5-1%, sementara di Negara berkembang 0,6-6,1%. Di Indonesia belum terdapat data prevalensi CMV kongenital. Penelitian ini adalah penelitan potong lintang untuk mengetahui prevalensi infeksi CMV pada neonatus yang lahir di RSCM. Penelitian dilakukan dari bulan Oktober 2016 sampai April 2017. Pemilihan subjek penelitian dilakukan dengan teknik consecutive sampling tanpa randomisasi, mengikutsertakan semua neonatus berusia kurang dari 21 hari. Sampel urin dilakukan polymerase chain reaction (PCR) dan sequencing. Neonatus yang terinfeksi akan menjalani skrining kelainan fungsi pendengaran, penglihatan dan USG kepala serta pemantauan selama 6 bulan. Sebanyak 12 dari 205 (5,9%) subjek penelitian, terinfeksi CMV atas dasar pemeriksaan PCR dan sequencing CMV urin. Sebanyak 5 dari 12 bayi yang terinfeksi CMV menjalani perawatan dengan diagnosis sepsis dan prematuritas. Satu orang bayi yang terinfeksi CMV meninggal. Prevalensi infeksi CMV pada neonatus di RS Cipto Mangunkusumo adalah 5,9%. Sebanyak 2 subjek merupakan infeksi simtomatik, sementara 10 subjek asimtomatik. Manifestasi klinis yang terlihat adalah gejala sistemik berupa viral-like sepsis, kolestasis, trombositopenia, dan gejala neurologis berupa ventrikulomegali.
Kata kunci: CMV kongenital; PCR urin; prevalensi


CMV infection is the commonest cause of congenital infection, causing death or permanent disability such as delayed growth, hearing and sight problems. Prevalence of CMV infection is influenced by geographical location, socio-economic status, and ethnicity. Prevalence of CMV infection in the US is around 0.5-1%, while in the developing countries varies from 0.6-6.1%. In Indonesia the prevalence of congenital CMV infection is unknown. This study is a cross-sectional study to determine the prevalence of congenital CMV infection among neonates in Cipto Mangunkusumo hospital, held from October 2016 to April 2017. Subjects were recruited through consecutive sampling without randomization, from all neonates below 21 days old. Urine sample are collected for polymerase chain reaction (PCR) and sequencing of CMV. Infected neonates were screened for hearing and sight problems, brain ultrasound, and given a follow up program for 6 months. Twelve out of 205 subjects (5.9%) were infected with CMV according to urine PCR and sequencing results. Five of them underwent hospitalization in the NICU due to sepsis and prematurity. One died during follow up. Prevalence of congenital CMV infection in Cipto Mangunkusumo hospital is 5.9%. Two subjects were considered as symptomatic infection, while the other ten asymptomatic. Clinical manifestation were systemic symptoms such as viral-like sepsis, cholestasis, thrombocytopenia, and ventriculomegaly.
Keywords: congenital CMV; urine PCR; prevalence