Skripsi

Candida krusei: Profil Pasien, Bahan Klinis, dan Kepekaannya terhadap Antijamur di Laboratorium Parasitologi FKUI Periode 2009–2023 = Candida krusei: Patient Profile, Clinical Specimens, and Antifungal Susceptibility at the Parasitology Laboratory, Faculty of Medicine, Universitas Indonesia, 2009–2023.

Latar Belakang Candida krusei merupakan penyebab kandidemia dengan mortalitas tinggi dan resistensi intrinsik terhadap flukonazol. Data epidemiologi dan pola kepekaannya di Indonesia masih terbatas. Penelitian ini bertujuan menganalisis insidensi, distribusi demografis, sumber isolat, dan profil resistensi C. krusei di Laboratorium Parasitologi FKUI selama 15 tahun. Metode Studi retrospektif analitik menggunakan data 2009–2023. Identifikasi jamur dilakukan melalui KOH 10%, kultur, serta uji kepekaan dengan difusi cakram dan Vitek2. Analisis deskriptif mencakup insidensi, usia, jenis kelamin, bahan klinis, dan pola resistensi. Hasil Terdapat 600 isolat C. krusei dari 12.419 kultur (4,8%). Insidensi fluktuatif, tertinggi pada 2016 (9,79%). Infeksi lebih banyak pada laki-laki (58,5%) dan usia dewasa (58,6%). Isolat terbanyak berasal dari feses (42,5%) dan sputum (30,0%), sedangkan isolat darah menandakan infeksi invasif dengan signifikansi klinis tinggi. Uji kepekaan menunjukkan resistensi tinggi terhadap flukonazol (44,4%) dan itrakonazol (56,4%), sementara vorikonazol, ketokonazol, amfoterisin B, dan mikafungin masih efektif. Kesimpulan Candida krusei menunjukkan insidensi fluktuatif, lebih sering pada laki-laki dewasa, dan banyak diisolasi dari saluran cerna serta pernapasan. Resistensi terhadap azol menekankan pentingnya uji sensitivitas sebelum terapi. Studi prospektif multicenter dibutuhkan untuk memperkuat temuan ini.
Kata Kunci: Candida krusei, resistensi antijamur, kandidemia, epidemiologi


Introduction Candida krusei is a non-albicans Candida species known for its intrinsic resistance to fluconazole and its potential to cause candidemia with high mortality. Epidemiological data and antifungal susceptibility profiles of C. krusei in Indonesia remain limited. This study aims to elucidate the incidence trends, demographic distribution, specimen sources, and antifungal susceptibility patterns of C. krusei isolates at the Parasitology Laboratory, Faculty of Medicine, University of Indonesia, over 15 years. Method A retrospective analytic study was conducted using data from 2009 to 2023. Identification of fungal isolates was performed via 10% KOH preparation and culture, followed by antifungal susceptibility testing using disk diffusion and Vitek2 methods. Descriptive analyses included incidence by year, patient age and sex distribution, specimen types, and susceptibility profiles to various antifungals. Results Out of 12,419 fungal cultures, 600 C. krusei isolates (4.8 %) were identified. Incidence fluctuated over time, peaking in 2016 (9.79 %). Infections occurred more frequently in males (58.5 %) and in adults (58.6 %). The most common specimen sources were stool (42.5 %) and sputum (30.0 %), while bloodstream isolates—though fewer—indicated clinically significant candidemia. Antifungal susceptibility testing revealed high resistance to fluconazole (44.4 %) and itraconazole (56.4 %), whereas voriconazole, ketoconazole, amphotericin B, and micafungin maintained good activity. Conclusion Candida krusei infections in this cohort exhibited a fluctuating incidence, predominance in adult males, and frequent isolation from gastrointestinal and respiratory specimens. Resistance to azole antifungals underscores the necessity of susceptibility testing prior to therapy. Prospective multicenter studies are warranted to validate and expand upon these findings.
Keywords: Candida krusei, antifungal resistance, candidemia, epidemiology, retrospective