Extended-Spectrum Beta Laktamasi (ESBL)
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Transcript of Extended-Spectrum Beta Laktamasi (ESBL)
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8/17/2019 Extended-Spectrum Beta Laktamasi (ESBL)
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R E F E R A T
N A M A : M I K H A E L R O B E R T M A R A M P E
N I M : 0 9 6 1 0 5 0 1 4 4
EXTENDED-SPECTRUM BETA LAKTAMASI(ESBL)
PEMBIMBING : !" E#$%&%! P$!'%% S*"A
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PENDAHULUAN
• A+,,.+,/ *$!+%'% ,+$'/% .#$ S,! A#$2%$! F#$',3*%% +% 19 % ,%'%/% *$,,#, 7%3'$!*%/% $+% #%/+%' 7%3 '$'*7%, $'*%+ 8,8,$+% #%/+%' +,3% 8,8, /%!. % %+ ,+!.3$"
• S%#% %+ $+/ *$!#%%% %/+$!, +$!%%* /$!;% %!,%+,,.+,/ $+% #%/+%' ,, %/+$!, '$3%,#/% $&,'7%3 ,$+ $3% $+% #%/+%'%$
• E&,' %*%+ '$!%/ 8,8, $+% #%/+%' %!, *$,,#,$3% ,!.#,, % +%*% 8,8, $+% #%/+%' *$,,#,
'$;%, +,%/ $
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MEKANISME RESISTENSI TERHADAP BETA LAKTAM" DIKUTIP DARI: =OHN
>ILE? @ SONS INC BACTERIAL DRUG RESISTANCE, 004"
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DEFINISI
• ESBL %%#% $&,'-$&,' 7%3 '$7$%/% !$,+$,+$!%%* $2+$$-*$8+!' (3$$!%, /$+,3%) $
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ETIOLOGI
• ESBL *%#,3 %7%/ ,%,#/% .#$E+$!.%8+$!,%8$%$ (+$!+%'%E8$!,8,% 8.#,) % K#$,$##% *$'.,%$"
•
G$ *$3/.$ ESBL *%% %/+$!, *%#,3 %7%/$!%% , *#%', "
• U''7% ESBL $!%%# %!, 3$ TEM-1 TEM-%+% SH-1 7%3 '$3%#%', '+%, %
'$3% /.3!%, %%' %',. , $/,+%!#./%, %/+,< %!, -#%8+%'%$" K$%%%,, '$'%+ *$/+!' %+,,.+,/ -#%8+%'!$+% +$!%%* ,!.#,, .#$ $&,' ,,"
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KLASIFIKASI
• A33.+%
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=ENIS ESBL ?ANG SERING DITEMUKAN ADALAHSEBAGAI BERIKUT :
• SH -#%8+%'%$ (8#% A)
• TEM -#%8+%'%$ (8#% A)
• CTX-M -#%8+%'%$ (8#% A)
• OXA -#%8+%'%$ (8#% D)• ESBL *$! +,*$
• ESBL #%,
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EPIDEMIOLOGI
• S+!%, %/+$!, ESBL ,, +$!$%! #% , $#!,% #$, $!,3 ,%*%+, *%% *$,'$ 7%3$!%%# %!, !'% %/,+ +$+%*, ;3% %*%+
,;'*%, , '%7%!%/%+"• D, USA National Nosocomial Infection
Surveillance (NNIS) '$$'/% $;%/ =%%!,199 %'*%, =, 00 ,%*%+, 61 %!, 6"101,.#%+ Klebsiella neumonia %!, 110 !%3 !%%+,%* ,+$,< !$,+$ +$!%%* $
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• E!.*% *$$#,+,% !eroenem "earl# Suscetibilit#Test Information Collection (M7+,8 S+7) +%00 '$#,%+/% 1 $3%!% ,*$!.#$ /$;%,%
ESBL 56 %!, +.+%# *.*#%,"• A,% $,!, *%% +% 19 ,.#%+ Klebsiella neumonia %!, C,% 7%3 '$3%3 ESBL+/ *$!+%'% /%#, ,#%*.!/%,.#%+ %!, +%199 % 1999 0 ,.#%+ Klebsiella
neumonia % 45 ,.#%+ Esc$ericia coli,/$+%, '$3%,#/% ESBL"
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STRUKTUR DAN MEKANISME KERJA
ESBL
• S$'% ESBL '$',#,/, $!,$ 7%3 +$!#$+%/ , %8+,$,+$ /$8%#, $%3,% /$8,# 8#% B G!* M$+%##. -#%8+%'%$"
• -#%8+%'%$%/% '$7$!%3 ,/%+% %',% , 8,8, -#%8+%' *$,8,##, %8$*%#.*.!, $!+%'$3%,#/% *$,8,##,.,8 %8, % 8$*%#.*.!,8 %8, "
• P#%', 7%3'$',#,/, /!% J 0 K % $!+%333 ;%% +$!%%* *$'%% 3$ ESBL"
•
P%% .!3%,'$ *$3%,# ESBL ;3% $!,3 !$,+$+$!%%* %+,,.+,/ 3.#.3% %',.3#78.,$.!.,.#. +$+!%878#,$ 8#.!%'*$,8.# %#
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• ESBL ;%!%3 +$!;%, , P!.+$ ',!%,#, ,3%*$7$%7% /%!$% *$,$ ,, '$',#,/,/%3% *#%', 7%3 !$%"
•
H%# ,, '$'*$!/%+ +$.!, %% +!%',,ESBL %+%!% %+ .!3%,'$ /$ .!3%,'$ 7%3#%, ,%%7% +$!;%, , *#%',"
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ESBL
T$!/%7%+!%+ B-
L%8+%'
S+,+,%%'%',.
K.3!%,$&,'
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FAKTOR RESIKO INFEKSI
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PENATALAKSANAAN ESBL
• SCREENING
• INFECTION MANAGEMENT
• DRUG OF CHOICE
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SCREENING
• MELALUI PENILAIAN ATAU SCORING
ITALIAN SCORE DAN DUKE MODEL SCORE
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MANA=EMEN INFEKSI
• A%7% ,+$' /.!,3 %/% %3%+ '$'%+ /#,,, %#%''$3%%*, ,
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• U+/ '$'$%/% %+ ,
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PENDEKATAN NON FARMAKOLOGIS
• P$$/%+% +%*% %+,,.+,/ %#%' '%%;$'$,
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PENDEKATAN FARMAKOLOGIS
• P,#,% %+,,.+,/ *%% *%,$ $3% ,
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