Hubungan Kadar Prokalsitonin dan Kultur Bakteri dengan Tingkat Keparahan Pneumonia pada Anak

Abstract

Latar belakang. Di negara berkembang, pneumonia merupakan penyebab utama kesakitan dan kematian pada bayi dan balita. Penelitian sebelumnya menemukan prokalsitonin dapat menggambarkan keparahan pneumonia pada anak. Dilaporkan juga kultur bakteri positif lebih sering ditemukan pada pneumonia berat dengan komplikasi. Tujuan.Menentukan hubungan kadar prokalsitonin dan kultur bakteri dengan tingkat keparahan pneumonia.Metode. Penelitian potong lintang yang dilaksanakan dari bulan September 2014 hingga Januari 2015 di RSUP Dr. Hasan Sadikin Bandung. Dilibatkan 61 anak berusia 1 bulan hingga 5 tahun. Subjek terdiri atas 30 anak pneumonia berat dan 31 anak pneumonia. Pemeriksaan prokalsitonin dilakukan dengan Elecsys BRAHMS PCT. Kultur darah diperiksa dengan mesin BACTEC 9050, jika hasilnya positif bakteri kemudian dibiakkan dalam media agar McConkey atau agar darah. Data hasil penelitian diuji dengan Mann Whitney dan chi-square. Hasil.Nilai median PCT pneumonia berat 0,69 ng/mL dan pneumonia 0,075 ng/mL, dengan nilai p<0,001. Hasil kultur positif ditemukan 5 dari 30 pada pneumonia berat dan 10 dari 31 pada pneumonia, dengan nilai p=0,157.Kesimpulan. Keparahan pneumonia berhubungan dengan kadar prokalsitonin dan tidak berhubungan dengan hasil kultur bakteri. Sari Pediatri2015;17(4):261-6.

Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia

“…Most of the children in the case group were >1 year old. Nonetheless, this finding is consistent with those reported by Suwarto et al [ 15 ] which also revealed no relationship between the age and the incidence of pneumonia in children under 5 years ( P =0.642). Muhe et al [ 19 ] and Greenberg et al [ 20 ] came to similar conclusions.…”

“…Nonetheless, this finding is consistent with those reported by Suwarto et al which also revealed no relationship between the age and the incidence of pneumonia in children under five years (p = 0.642). 15) Muhe et al and Greenberg et al came to similar conclusions. We also found no relationship between sex and the incidence of pneumonia among children in our cohort, an observation that may relate to different proportions of males and females enrolled in the study 19), 20) .…”

“…Similar research featuring a cohort from Brazil found that children who were not breastfed were 17-times more likely to be hospitalized with pneumonia than were breastfed children; as such, the study concluded that breastfeeding could protect children from the most severe forms of pneumonia, especially in the first month of life. 15) Most of the participants in our study have received complete basic immunization (60%), although this number also does not meet the national target. We found here that children with incomplete basic immunization were nearly 5-times more likely to contract pneumonia than children whose basic immunizations were complete.…”

“…Breast milk contains colostrum, which is ~16% protein and contains immunoglobulin A, lactoferrin, and white blood cells that contribute to the prevention of infections [ 14 ]. Similar research featuring a cohort from Brazil found that children who were not breastfed were 17 times more likely to be hospitalized with pneumonia than were breastfed children; as such, the study concluded that breastfeeding could protect children from the most severe forms of pneumonia, especially in the first month of life [ 15 ].…”