Chateter Blood Stream Infection akibat Staphylococcus Epidermidis

Abstract

Latar belakang: Infeksi aliran darah terkait kateter (CRBSI) didefinisikan sebagai adanya bakteremia yang berasal dari kateter intravena. Faktor risiko potensial untuk CRBSI meliputi penyakit yang mendasari, metode pemasangan kateter, lokasi pemasangan dan durasi kateter, serta tujuan kateterisasi.Deskripsi kasus : Pasien wanita usia 50 tahun dengan keluhan demam disertai menggigil sejak 7 hari sebelum masuk rumah sakit dan demam. Pasien juga mengeluhkan keluar nanah sekitar akses kateter double lumen pada leher kanan. Pasien menjalani hemodialisis selama 10 bulan. Pasien juga menderita dan hipertensi. Pemeriksaan hiperemis pada status lokalis. Pemeriksaan laboratorium selama rawatan hemoglobin 7 mg/dL dan leukosit 12540. Diagnosis selama rawatan adalah Chateter Blood Stream Infection, penyakit ginjal kronis stadium 5HD, anemia dan hipertensi. ⁠ Pasien mendapat terapi Levofloxacin 1 kali 500 mg. Hasil kultur terdapat Staphylococcus Epidermidis selanjutnya mendapat Vancomisin dan klinis perbaikan. Diskusi : Kateter double lumen (CDL) akan membentuk biofilm di permukaan bagian dalam dalam waktu 24 jam. Penyebab CRBSI umumnya adalah gram positif dengan antibiotic pilihan adalah Vancomisin. Perburukan infeksi menyebabkan CDK tidak dapat dipertahankan. Simpulan: Pemakaian CDL membutuhkan pemantauan dan kultur berkala.

Background: Catheter-associated bloodstream infection (CRBSI) is defined as the presence of bacteremia originating from an intravenous catheter. Potential risk factors for CRBSI include the underlying disease, the method of catheter insertion, the location and duration of the catheter, and the purpose of the catheterization.

Case Description:  A 50-year-old female patient presented with fever complaints, chills, and pus discharge from the right neck for seven days prior to hospitalization. The patient had been undergoing dialysis for ten months and was also diagnosed with hypertension. A localist examination was conducted to assess the patient’s condition. Laboratory tests revealed a hemoglobin level of 7 mg/dL and a leukocyte count of 12,540. Diagnosis during treatment is Chateter Blood Stream Infection, chronic kidney disease stage 5HD, anemia and hypertension. As a result, the patient received Levofloxacin therapy once, administered at a dosage of 500 mg. The culture results indicated the presence of Staphylococcus Epidermidis, which was subsequently treated with Vancomisin. This treatment led to a clinical improvement in the patient’s condition.  Discussion: A double-lumen catheter will form a biofilm on the inner surface within 24 hours. The causative agent of catheter-related bloodstream infection (CRBSI) is typically gram-positive bacteria, and the antibiotic of choice is vancomycin. The progression of the infection leads to removal of CDL.  Conclusion: The use of CDL requires periodic monitoring and culture.