Skripsi

Gambaran Demografis, Klinis, dan Mikroorganisme pada Permukaan Okular Pasien Sindrom Stevensjohnson dengan Keterlibatan Okular = Demographic, Clinical, and Microorganisms on The Ocular Surface Of Stevens-Johnson Syndrome Patients With Ocular Involvement.

Latar Belakang Sindrom Stevens-Johnson (SSJ) merupakan reaksi hipersensitivitas berat yang melibatkan kulit dan mukosa, termasuk permukaan okular, yang dapat menyebabkan gangguan penglihatan permanen. Informasi mengenai karakteristik demografis, klinis, serta mikroorganisme permukaan okular pada pasien SSJ di Indonesia masih terbatas. Metode Penelitian ini merupakan studi deskriptif retrospektif menggunakan data rekam medis pasien SSJ dengan keterlibatan okular di Rumah Sakit Cipto Mangunkusumo (RSCM) periode 2020–2024. Data yang dikumpulkan meliputi karakteristik demografis, klinis, hasil kultur mikroorganisme, serta pola resistensi antibiotik. Hasil Dari 131 kasus SSJ okular, 6 kasus termasuk fase akut dan 125 kasus fase kronik. Median usia pasien adalah 34 tahun (rentang 5–85 tahun) dan mayoritas berjenis kelamin perempuan. Obat penyebab terbanyak adalah antibiotik golongan penisilin, diikuti analgesik/antipiretik. Manifestasi klinis fase akut didominasi oleh konjungtiva hiperemis, disfungsi kelenjar meibom, neovaskularisasi, dan superficial punctate keratitis, sedangkan fase kronik menunjukkan trikiasis, konjungtival hiperemis, dan neovaskularisasi kornea. Dari 66 sampel mata yang dikultur, sebagian besar menunjukkan hasil positif. Staphylococcus epidermidis dan Staphylococcus aureus merupakan mikroorganisme Gram-positif terbanyak, sementara Pseudomonas aeruginosa dan Acinetobacter sp. mendominasi kelompok Gram-negatif. Kesimpulan Pasien Sindrom Stevens-Johnson dengan keterlibatan okular di RSCM didominasi oleh kasus fase kronik. Sebagian besar pasien berusia dewasa muda dan berjenis kelamin perempuan. Penyebab tersering adalah antibiotik golongan penisilin, dengan manifestasi klinis yang dominan berbeda antara fase akut dan kronik. Mikroorganisme yang paling banyak ditemukan adalah Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, dan Acinetobacter sp., dengan pola resistensi tertinggi terhadap beberapa antibiotik.
Kata Kunci: antibiotik, karakteristik klinis, mikroorganisme, resistensi, Sindrom Stevens-Johnson


Introduction Stevens-Johnson syndrome (SJS) is a severe hypersensitivity reaction involving the skin and mucosa, including the ocular surface, which can cause permanent visual impairment. Information regarding the demographic, clinical, and ocular surface microorganism characteristics of SJS patients in Indonesia is still limited. Method This study is a retrospective descriptive study using medical record data of SSJ patients with ocular involvement at Cipto Mangunkusumo Hospital (RSCM) from 2020 to 2024. The data collected included demographic and clinical characteristics, microorganism culture results, and antibiotic resistance patterns. Results Among 131 SJS ocular cases, 6 were in the acute phase and 125 in the chronic phase. The median patient age was 34 years (range 5–85 years), with a predominance of females. The most common causative drugs were penicillin-class antibiotics, followed by analgesics/antipyretics. Acute phase manifestations were mainly conjunctival hyperemia, meibomian gland dysfunction, neovascularization, and superficial punctate keratitis, while chronic phase cases showed trichiasis, conjunctival hyperemia, and corneal neovascularization. Of 66 cultured ocular samples, most showed positive growth. Staphylococcus epidermidis and Staphylococcus aureus were the most frequent Grampositive organisms, while Pseudomonas aeruginosa and Acinetobacter sp. dominated the Gram-negative group. Conclusion SJS patients with ocular involvement at RSCM were predominantly in the chronic phase. Most patients were young adults and female. The most common cause was penicillin antibiotics, with dominant clinical manifestations differing between the acute and chronic phases. The most commonly found microorganisms were Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter sp., with the highest resistance patterns to several antibiotics.
Keywords: antibiotics, clinical characteristics, microorganisms, resistance, StevensJohnson Syndrome