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All Journal Jurnal Respirologi Indonesia
Harsini Harsini
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret
Health Professions Medicine & Pharmacology

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Correlation of Antibiotic Resistance with Sepsis Incidence, Hospital Mortality, and Time of Sepsis Onset in Community Acquired Bacterial Pneumonia Kresentia Anita Raniputri; Harsini Harsini; Reviono Reviono; Leli Saptawati
Jurnal Respirologi Indonesia Vol 42, No 3 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v40i3.359

Abstract

Background: Community acquired pneumonia is associated with high morbidity and mortality. Treatment of multidrug-resistant organisms (MDRO) infection in pneumonia is a challenge. Antibiotic resistance is a major factor determining clinical treatment unresponsiveness and rapid progression to sepsis. Septic patients with MDRO have a higher hospital mortality. The correlation of antibiotic resistance with the incidence of sepsis and hospital mortality is yet to be known. This study analyzed the correlation of antibiotic resistance with sepsis incidence, hospital mortality, and time of sepsis onset.Methods: Retrospective cohort study of patients with community acquired bacterial pneumonia from July-December 2019 at RSUD Dr. Moewardi. The correlation between antibiotic resistance and incidence of sepsis, hospital mortality was tested by using Chi Square and Fisher's exact test correction. Association between two variables with relative risk. Survival analysis and log rank test were used to examine the time differences of sepsis onset.Results: There was a correlation between antibiotic resistance and incidence of sepsis in community acquired bacterial pneumonia (r = 0.417, p = 0.000) with RR = 4,294 (95% CI 2,886-6,390). The median time of sepsis onset was day 0 in the MDRO group and day 4 in non-MDRO group (p = 0.000).Conclusion: There is a correlation between antibiotic resistance and incidence of sepsis in community acquired bacterial pneumonia with a fairly strong and significant correlation value. The presence of antibiotic resistance increases the incidence of sepsis fourfold. Antibiotic resistance also affects the time of sepsis onset.
Comparison of NEWS, SIRS, and qSOFA Score as Predictors of Mortality and Length of Stay in Patients Pneumonia with Sepsis Harsini Harsini; Aditya Alfarizi; Jatu Aphridasari; A Farih Raharjo; Reviono Reviono
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i1.505

Abstract

Background: Pneumonia is a major health problem in all age groups and often related with sepsis. In 2021, Surviving Sepsis Campaign Guidelines mentioned several clinical scoring systems to identify patients with potentials of developing sepsis, such as systemic inflammatory response syndrome (SIRS), national early warning score (NEWS), quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA). The guideline stated that there is no gold standard for diagnosing sepsis, contradicting The Sepsis-3 Guideline in 2016 that mentioned SOFA score as a gold standard for diagnosing sepsis.Methods: Subjects were all patients with pneumonia and sepsis who were treated in Dr.Moewardi Hospital within 1 January to 31 December 2022. Data from subjects’ medical records were collected to assess their NEWS, SIRS, qSOFA, and SOFA score on the day of admission. Since evaluation of SOFA score needs a number of components requiring laboratory results and takes longer time so they made a simpler tool called qSOFA to avoid delayed treatment of the patients.Results: NEWS is more consistent with SOFA compared to SIRS and qSOFA (Kappa value = 0.726 vs 0.320 vs 0.22; respectively). NEWS, SIRS, and qSOFA were all significantly correlated with mortality (P<0.001) with NEWS having the strongest correlation (r=0.482 vs 0.216 vs 0.175; respectively). Only NEWS showed significant correlation with the length of stay (r=0.129; P<0.001).Conclusion: NEWS was the most consistent score to SOFA compared to SIRS and qSOFA. NEWS was also the best predictor for mortality and was the only score correlated with length of hospital stay.
Co-Authors A Farih Raharjo Aditya Alfarizi Jatu Aphridasari Kresentia Anita Raniputri Leli Saptawati Reviono Reviono Reviono Reviono