Skripsi

Profil Jamur Udara dan Kaitannya dengan Kondisi Klinis Pasien di Unit Perawatan Intensif Pediatrik (Pediatric Intensive Care Unit/PICU) = Profile of Airborne Fungi and Their Association with Clinical Condition of Patients in the Pediatric Intensive Care Unit (PICU).

Penelitian ini bertujuan untuk menggambarkan profil spesies jamur udara, distribusi dan konsentrasi beban jamur di berbagai area, angka kejadian penyakit jamur, serta kaitannya dengan kondisi pasien di ruang Pediatric Intensive Care Unit (PICU) Rumah Sakit Persahabatan. Rancangan penelitian observasional ini dilakukan dengan pengambilan sampel udara pasif menggunakan media Sabouraud Dextrose Agar pada enam titik tempat tidur pasien dan dua titik nurse station. Data klinis pasien diperoleh melalui rekam medis satu bulan sebelum pengambilan sampel. Hasil menunjukkan adanya variasi spasial yang nyata dengan hotspot pada Bed 6, Bed 4, dan Bed 2, masing-masing mencapai >20.000 CFU/m³. Uji PERMANOVA menunjukkan perbedaan komposisi spesies antar-lokasi yang signifikan (p=0,003), dengan dominasi Candida albicans, C. parapsilosis, dan Penicillium sp. Insidensi infeksi jamur sebesar 15,62 per 1.000 patientdays, tanpa perbedaan bermakna antara kelompok beban rendah dan tinggi (IRR=0,578; p=0,548). Kadar CRP tinggi, penggunaan ventilator, dan paparan sefotaksim berhubungan dengan peningkatan risiko infeksi dan mortalitas. Hasil ini menegaskan bahwa pola beban jamur di PICU bersifat heterogen dan dipengaruhi oleh kelembapan ruang serta praktik klinis, sementara luaran pasien lebih banyak ditentukan oleh faktor host dan paparan antibiotik. Diperlukan pemantauan lingkungan dan kebijakan antimikroba yang terintegrasi untuk menekan risiko paparan dan infeksi jamur di ruang intensif pediatrik.
Kata Kunci: jamur udara, PICU, infeksi jamur, beban koloni, antimikroba


This study aimed to characterize airborne fungal species profiles, spatial distribution and concentration patterns, incidence of fungal infections, and their association with patient conditions in the Pediatric Intensive Care Unit (PICU) of Persahabatan Hospital. An observational design was employed using passive air sampling with Sabouraud Dextrose Agar plates at six patient-bed sites and two nurse stations. Clinical data were collected from medical records within one month prior to sampling. Results demonstrated marked spatial heterogeneity, with contamination hotspots identified at Beds 6, 4, and 2, each exceeding 20,000 CFU/m³. PERMANOVA revealed significant inter-site variation in fungal composition (p=0.003), dominated by Candida albicans, C. parapsilosis, and Penicillium species. The incidence of fungal infection was 15.62 per 1,000 patient-days, with no significant difference between high and low exposure groups (IRR=0.578; p=0.548). Elevated C-reactive protein, ventilator use, and cefotaxime exposure were associated with increased infection and mortality risk. These findings highlight that fungal burden in the PICU is highly heterogeneous, influenced by humidity and environmental conditions, while patient outcomes are primarily driven by host vulnerability and antimicrobial pressure. Integrated environmental monitoring and antimicrobial stewardship are essential to mitigate fungal contamination and infection risk in pediatric intensive care settings.
Keywords: airborne fungi, PICU, fungal infection, colony load, antimicrobial