Infeksi Komunitas (Ik)/infeksi Luar Rumah Sakit (Ilrs) (Community Acquired Infection) di Rumah Sakit Khusus Penyakit Menular, Jakarta

A one year prospective study was conducted at the Infectious Diseases Hospital (IDH) of Jakarta in 1982-1983 to survey the rate of community acquired infection (CAI). Blood culture, rectal swab, urine culture and in some patients cerebro spinal fluid culture were obtained randomly from hospitalized patient at the time of admission. From 723 patients with age 2 months-70 years, who were examined and fulfilled the study criteria, 504 (69,7%) patients were positive for CAI resulted in total of 611 CAIs. Based on anatomical location, this number consists of 53.5% CAI of GI Tract, 20.9% CAI of Urinary Tract, 9.5% CAI bacteremia and 0.6% CAI involving central nervous system. Incidence rate was significantly higher in female (74.1%) compared to male (65.7%) (p12 years patients (73.9%) compared to children <12 years (p<0,01). Diarrhea patients had significantly higher CAI (77.4%) compared to febrile patients (55.2%) (p<0,01). Patients who had not received antibiotic prior to admission had higher rate of CAI (70.9%) compared to who received it prior to admission (67.1%) Etiologic agents most commonly recovered were gram negative bacterias (94.9%) with Vibrio cholerae (48.6%) as the leading cause, and only 5.1% were gram positive. Some of bacteria found as the etiologic agent of CAI, were Salmonella group D, Salmonella group E4, Proteus vulgaris and ruttgerii, Klebsiella pneumoniae, Mima polymorpha, Alkaligenes sp showed high rate of resistancy to commonly used antibiotics. (Ampicillin, Tetracycline, Chloramphenicol and Trimethoprim + Sulfamethoxazole). Average duration of hospitalization for CAI cases (6,4 days) was longer than in cases without CAI (4,3 days). There were 11 deaths (2.2%) in cases with CAI and 2 deaths (1.4%) in patients without CAI, with death rate was higher in males (2.4%) compared to female (1.9%), and highest was in less than 1 year old age group patient (13.6%), also significantly higher in febrile patients compared to diarrhea patients (7.2% vs 0.3%, p< 0.001). The higher mortality rate in CAI is due to more severe condition of underlying disease of patients who had CAI