Introduction: Installation service system at the Emergency Department (ED) Soetomo Hospital is a coordinated and integrated system under one roof. Include emergency medical and emergency surgery in a very important component of health services at each hospital. The information published on the patient profile and the usefulness of emergency care services indeveloping countries and developed countries is still very rare. This study aimed to describe the characteristic of patients attending the ED at Soetomo hospital Surabaya.Method: This study was a retrospective study. The profile of patients visiting the ED for 1 year were recorded and presented descriptively.Result: The total number of patients visiting the hospital was 5,835, with a monthly average of 486 patients. The children at the age of 1–5 years presented the largest age group (33.6%). The main diagnosis was respiratory tract infection (31%), diarrhea (17.%), followed by seizure (12.4%). The overall mortality rate was 1.7%.Discussion: Respiratory tract infection in children at the age of 1–5 years still count as a major problem at Soetomo Hospital Surabaya.

Background Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in the pediatric intensive care unit (PICU), with mortality rates of up to 50%. Post-mortem pulmonary examination is considered to be the gold standard for diagnosis of VAP, but is impossible for routine application. The sensitivity and specificity of Clinical Pulmonary Infection Score (CPIS) are considered to be similar to the those of the gold standard, but the Centers for Disease Control and Prevention PNU-1 (CDC PNU-1) is simpler and not invasive, compared to the CPIS. Objective To evaluate the level of agreement between CDC PNU-1 and CPIS criteria in diagnosing VAP. Methods This cross-sectional study was conducted in the PICU at Dr. Soetomo Hospital, Surabaya from June to October 2018. Subjects were children aged 1 month–18 years who had been intubated for more than 48 hours. The VAP diagnoses were made by CDC PNU-1 and CPIS criteria. The level of agreement between the two methods was evaluated by Cohen’s Kappa test using SPSS Statistics Base 21.0 software. Results hirty-six subjects were evaluated using CDC PNU-1 and CPIS criteria. Subjects’ mean age was 3.5 (SD 4.7) years. Amongst 19 patients with VAP, 14 were diagnosed by CPIS criteria and 17 were diagnosed by CDC PNU-1 criteria. The level of agreement between the CDC PNU-1 and CPIS criteria was good (Kappa 0.61; 95%CI 0.31 to 0.83). The CDC PNU-1 had sensitivity 0.85, specificity 0.77, positive predictive value (PPV) 0.70, and negative predictive value (NPV) 0.89. Conclusion The CDC PNU-1 criteria has a good level of agreement with CPIS criteria in diagnosing VAP.

Gram-negative bacterial are known as common pathogen caused infection in Pediatric Intensive Care Unit (PICU). Microbial Pattern and Antibiotic Susceptibility are needed as clinical data for selected appropriate antibiotic therapy. In PICU Dr. Soetomo hospital until now still lacking of Microbial Pattern and Antibiotic Susceptibility data. This descriptive study is to recognized Microbial Pattern and Antibiotic Susceptibility in PICU patients from blood, urine, sputum, stool, cerebrospinal fluid, endotracheal tube, pus swab and pleural fluid culture specimens. Patients whose admitted into PICU without signs of infections were excluded from the study. The inclusion criteria are patients with sign infection as follows: fever < 36,5°C or > 37.5°C, leukocyte < 4000/mm 3 or > 10000/mm 3 , marker infections CRP >10 mg/L or PCT >0,3 ng/mL, bradycardia or tachycardia, tachypnea, infiltrates on chest X-ray, turbid urine, dysuria, thrombophlebitis, abdominal pain or tenderness, and mucous or skin lesion. Medical record data from 2011 to 2016, revealed 1138 patients had positive microbial culture result, wherein positive result came from blood 44.46%, urine 19.15%, sputum 11.59%, stool 8.96%, cerebrospinal fluid 7.50%, endotracheal tube 4.04%, pus swab 2.89%, and pleural fluid 1.41%. The microorganisms found in PICU Dr. Soetomo was dominated with gram negative bacteria. Commonest bacterial that recognized from blood was B. cepacea, urine was E. coli, sputum was P. aeruginosa, Stool was E. coli, Cerebrospinal fluid was S. cohnii, endotracheal tube was K. pneumoniae ESBL, pus swab was S. aureus, and pleural fluid was S. maltophilia. Both gram-negative bacteria and gram-positive bacteria isolates revealed multiple drug resistance to commonly used antibiotic, but still had good susceptibility for antibiotic such as; amikacin, cefoperazone-sulbactam, linezolid, vancomycin and carbapenem group. ABSTRAKBakteri gram negatif merupakan patogen tersering penyebab infeksi di ruang rawat intensif anak. Pola bakteri dan kepekaan antibiotik diperlukan sebagai data klinis dalam pemilihan terapi antibiotik yang sesuai. Di ruang rawat intensif anak RS.Dr. Soetomo hingga saat ini masih sangat kekurangan data mengenai pola bakteri dan kepekaan antibiotik. Penelitian deskriptif ini bertujuan untuk membuat pola bakteri dan kepekaan antibiotika pada pasien yang dirawat di ruang rawat intensif anak dari spesimen darah, urin, sputum, feces, cairan serebrospinal,tabung endotrakeal (ETT), pus luka dan cairan pleura. Pasien yang masuk ke PICU yang tidak menunjukkan tanda dan gejala infeksi di eklusi dari penelitian. Kriteria inklusi pada penelitian ini adalah ditemukannya tanda dan gejala infeksi, antara lain ;demam < 36,5°C or > 37.5°C, kadar leukosit darah < 4000/mm3 or > 10000/mm3, marker infeksi CRP >10 mg/L or PCT >0,3 ng/mL, bradikardi atau takikardi, takipneu, gambaran infiltrate pada radiologi paru,urine yang keruh, nyeri berkemih, tromboplebitis, nyeri perut, dan lesi pada mukosa atau kulit. Dari data rekam medis dari tahun 2011 sampai...

Introduction: Pneumonia causes morbidity and mortality in children worldwide. Pediatric patients with complicated pneumonia have a poor prognosis and are more at risk of death. Objective To identify risk factors for complications in pediatric patients with pneumonia. Method: This research was a case-control study, involving children with pneumonia aged 1-59 months in Dr. Soetomo in 2016-2020. The sample was divided into two groups. Patients who had complications at first admission were classified as a case group. Whereas patients without complications at first admission were classified as a control group. Samples for the case group were obtained by using total sampling method, while the control group employed random sampling technique. Data were collected from medical records and analyzed by chi-square test. Result: A total of 44 case group samples and 53 control group samples were involved during this study. Among investigated variables, male gender (OR=2,842; 95% CI, 1,24-6,49) and anemia (OR=3,283; 95% CI, 1,26-8,49) might increase the risk of complicated pneumonia. Meanwhile other variables, namely age, comorbidities, birth weight, malnutrition, and immunization status did not have a significant relationship with the incidence of complications in pneumonia patients. Conclusion: Male gender and anemia are risk of complicated pneumonia.