Skripsi

Angka Kejadian Infeksi Aliran Darah Terkait Akses Sentral dan FaktorFaktor yang Memengaruhi di Unit Neonatologi RSCM = Incidence of Central Line Associated Bloodstream Infections and Influencing Factors in the RSCM Neonatology Unit.

Latar Belakang Akses sentral merupakan elemen penting dalam perawatan neonatus di Neonatal Intensive Care Unit (NICU), tetapi dapat menyebabkan komplikasi serius seperti Infeksi aliran darah terkait kateter sentral (central line-associated bloodstream infection [CLABSI]). Penelitian terkait CLABSI pada neonatus di rumah sakit di Indonesia masih terbatas. CLABSI memiliki angka mortalitas yang relatif tinggi, meningkatkan morbiditas dan biaya perawatan, serta dapat berujung pada sepsis. Penelitian ini bertujuan memberikan data terbaru mengenai angka kejadian dan faktor risiko CLABSI. Metode Penelitian kohort retrospektif ini dilakukan pada neonatus yang menggunakan akses sentral di Unit Neonatologi RSCM pada Desember 2018-2023. Pengambilan sampel menggunakan total sampling. Data sekunder berupa rekam medis dianalisis secara deskriptif untuk menghitung angka kejadian CLABSI. Analisis bivariat dan multivariat dilakukan untuk melihat hubungan antara faktor risiko dengan kejadian CLABSI. Hasil Sebanyak 1.289 neonatus yang memenuhi kriteria penelitian diikutsertakan. Angka kejadian CLABSI pada populasi ini adalah 10,6%. Analisis menunjukkan faktor risiko yang signifikan meliputi bayi berat lahir rendah (adjusted odds ratio [aOR] 2,80, 95% confidence interval [CI]: 1,67–4,72), central venous catheter (CVC) (aOR 2,02, 95% CI: 1,03–3,96), umbilical venous catheter (UVC) (aOR 0,10, 95% CI: 0,01 –0,71), nutrisi parenteral (aOR 3,84, 95% CI: 1,18–12,48), pembedahan abdomen (aOR 1 ,93, 95% CI: 1,16–3,19), patologi intra-abdomen (aOR 2,95, 95% CI: 1,95–4,46). Kesimpulan CLABSI memiliki proporsi tinggi (10,6%) pada populasi ini. Faktor risiko yang meningkatkan peluang terjadinya CLABSI adalah bayi berat lahir rendah, penggunaan CVC, nutrisi parenteral, pembedahan abdomen, dan patologi intra-abdomen. Sebaliknya, penggunaan UVC secara signifikan menurunkan peluang terjadinya CLABSI.
Kata Kunci: Central line-associated bloodstream infection, central venous catheter, faktor risiko, neonatus, peripherally inserted central catheter, umbilical venous catheter.


Introduction Central access is a crucial element in the care of neonates in the Neonatal Intensive Care Unit (NICU), but it can lead to serious complications such as central line-associated bloodstream infection (CLABSI). Research on CLABSI in neonates in hospitals in Indonesia remains limited. CLABSI has a relatively high mortality rate, increases morbidity and healthcare costs, and can lead to sepsis. This study aims to provide updated data on the incidence and risk factors of CLABSI. Method This retrospective cohort study was conducted on neonates who used central access in the RSCM Neonatology Unit from December 2018 to 2023. Sampling was done using total sampling. Secondary data from medical records were analyzed descriptively to calculate the incidence of CLABSI. Bivariate and multivariate analyses were performed to assess the relationship between risk factors and CLABSI incidence. Results A total of 1 .289 neonates who met the study criteria are included. The incidence of CLABSI was found to be 10,6%. The analysis showed significant risk factors, including low birth weight (adjusted odds ratio [aOR] 2,80, 95% confidence interval [CI]: 1,67– 4,72), central venous catheter (CVC) (aOR 2,02, 95% CI: 1,03–3,96), umbilical venous catheter (UVC) (aOR 0,10, 95% CI: 0,01 –0,71), parenteral nutrition (aOR 3,84, 95% CI: 1,18–12,48), abdominal surgery (aOR 1,93, 95% CI: 1,16–3,19), and intra-abdominal pathology (aOR 2,95, 95% CI: 1,95–4,46). Conclusion CLABSI has a high proportion (10,6%) in this population. Risk factors that increase the likelihood of CLABSI include low birth weight, use of CVC, parenteral nutrition, abdominal surgery, and intra-abdominal pathology. In contrast, the use of UVC significantly reduced the likelihood of CLABSI.
Keywords: Central line-associated bloodstream infection, central venous catheter, neonates, peripherally inserted central catheter, risk factors, umbilical venous catheter