Hasil Pencarian  ::  Simpan CSV :: Kembali

"LATAR BELAKANG : Sirosis hati merupakan salah satu masalah kesehatan di Indonesia. Penyakit ini merupakan penyakit hati yang sering dijumpai selain hepatitis virus akut dan kanker hati. Komplikasi sirosis hati yang tersering adalah asites. Adanya asites merupakan prognosis yang buruk karena hanya sekitar 50% penderita sirosis hati dengan asites dapat bertahan hidup dalarn waktu 2 tahun. Asites juga merupakan faktor predisposisi terjadinya komplikasi berbahaya seperti Peritonitis Bakteri Spontan (PBS).BAHAN DAN METODE : 74 subyek penelitian penderita sirosis hati dengan asites. Pada cairan asites dilakukan biakan aerob-anaerob, pemeriksaan hitung leukosit dengan alat hitung sel otomatis Sysmex XT2000i®, hitung jenis leukosit dengan mikroskop dan uji leukosit esterase carik celup urin sedangkan pemeriksaan albumin, protein dan LDH dilakukan untuk serum dan cairan asites.HASIL : Pada penelitian ini didapatkan penderita PBS sebanyak 14 orang (18.92%). Pada kelompok PBS didapatkan netrositik asites sebanyak 12 orang (85.71%). Dari hasil biakan yang positif pads kelompok penderita PBS berhasil diisolasi dua jenis kuman golongan Enterobacteriaceae yaitu Escherichia call dan Enterobacter aerogenes. Kedua kuman ini diduga menghasilkan Extended Spectrum Beta Lactamase (ESBL). Dengan menggunakan cara perhitungan stastistik menurut Bland-Altman didapatkan bahwa hasil hitung jumlah leukosit pada cairan asites dengan menggunakan alat otomatis Sysmex XT2000P tidak berbeda bermakna dengan cara manual. Untuk memperkirakan jumlah PMN cairan asites ? 250 sellpL maka cut off point untuk MuitistixlOSG® adaiah pada skala trace sedangkan untuk Comburl4M® adalah pada skala positif-2. Sebagian besar cairan asites pada penderita PBS termasuk transudat berdasarkan kriteria Light (85.71 %). Pada 92.86 % penderita PBS mempunyai SAAG > 1.1 g/dL.KESIMPULAN : Pada penelitian ini diperoleh proporsi PBS sebesar 18.92 % dan proporsi netrositik asites sebesar 85.71%. Kedua jenis kuman batang Gram negatif diduga menghasilkan ESBL sehingga resisten terhadap Sefotaksim. Hitung leukosit cairan asites dapat dilakukan dengan alat penghitung sel otomatis Sysmex XT2000i. Leukosit esterase carik celup urin Multistixi OSG® dan Comburl0M@ dapat digunakan untuk memperkirakan jumlah PMN cairan asites > 250 sellpL. Cairan asites pada penderita PBS temasuk transudat menurut modifikasi kriteria Light. PBS tidak mempengaruhi SAAG.SARAN : Parasentesis diagnostik harus dilakukan sebelum pemberian antibiotik empirik. Leukosit esterase carik celup urin dapat digunakan sebagai salah satu cara untuk memdiagnosis PBS secara "bedside". Penelitian lanjutan untuk mendapatkan pola dan kepekaan antibiotika kuman penyebab PBS.

---

Cirrhosis is identified as one of major health problems in Indonesia. It is found to be the most prevalent liver disease in addition to acute viral hepatitis and liver cancer. Ascites is the most common complication associated with cirrhosis. About 50% of patients with cirrhosis who develop ascites die within 2 years of diagnosis. Ascites also predisposes life-threatening complication such as Spontaneous Bacterial Peritonitis (SBP).

Materials and Methods. 74 cirrhosis patients who develop ascites were included in the study. The ascitic fluid was cultured in aerobic and anaerobic media. Leukocytes were evaluated for leukocytes count using Sysmex XT2000iT"" automatic cell counter, leukocytes differential count was observed under the microscope, and dip stick urine of leukocyte esterase test. Moreover, albumin, protein, and LDH level were assessed for both serum and ascitic fluid.

Results. Spontaneous Bacterial Peritonitis was diagnosed in 14 subjects (18.92%). Twelve subjects (85.71%) within this group developed neutrocytic ascites. Enterobacteriaceae pathogens, i.e. Eschericiiia coil and Enterobacter aerogerles, had been isolated from the ascitic fluid culture. These pathogens were suspected for producing Extended Spectrum Beta Lactamase (ESBL). Using Bland-Altman test, it was discovered that there were no significant differences in leukocytes count of ascitic fluid either measured with Sysmex XT2000iT"' automatic cell counter or conventional method. The cut-off point for MultistixlOSGTm was set on trace scale, whereas the ComburlOMTM was set on scale positive-2 to obtain a number of PMN leukocytes count of more than 250 cellslpL. Based on Light criteria, 85.71% of ascitic fluid from the SBP patients were considered as transudates. Meanwhile, 92.86% of SBP group showed an SHAG ? 1.lg/dL.

Conclusions. The study reveals that the proportion of SBP is 18.92% and neutrocytic ascites is 85.71%. Both of the Gram-negative bacteria are considered producing ESBL that induce resistance to Cefotaxime. Leukocytes count of ascitic fluid can be measured using Sysmex XT2000iTM automatic cell counter. To predict PMN leukocyte count of more than 250 cells/pL, the dip stick urine leukocytes esterase test using MultistixlOSGT"^ and ComburlOMTM are available. The ascitic fluid in SBP patients are classified as transudates, based on Light criteria. SBP has no effect against SAAG.

Suggestions. A diagnostic paracentesis should be performed prior to empirical antibiotics therapy. The dip stick urine leukocytes esterase test can be use as an alternative method to diagnose SBP along with the other bedside techniques. Further study is required to attain pattern and sensitivity of SBP pathogens."

"Spontaneous bacterial peritonitis (SBP) is one of serious complication of liver cirrhosis. Most of the patient with SBP have severe reduced liver function that clasified as Child Plugh class C. There are other risk factors for SBP such as poor nutritional status, GI bleeding, intravascular catheter insertion, ascites fluid protein concentration of less than I g/L, large volume paracentesis, urinary tract infection and respiratory tract infection. The management of SBP is mainly the administration of proper antibiotics. The antibiotic of choice for the emperial treatment is cefotaxim."

"[Salah satu komplikasi berat akibat kolestasis kronik adalah peritonitis bakteri spontan (PBS). Kondisi ini dapat meningkatkan angka mortalitas pada anak dengan kolestasis. Penelitian ini bertujuan untuk mengetahui faktor risiko dan spektrum klinis PBS pada anak dengan kolestasis di RSCM. Penelitian ini dilakukan pada bulan Agustus sampai Oktober 2015 dengan metode kohort retrospektif terhadap pasien anak dengan kolestasis usia 0-5 tahun yang diikuti selama 6 bulan melalui rekam medis pasien. Dari 97 pasien, didapatkan prevalensi PBS sebanyak 13,4%. Dari analisis multivariat didapatkan rasio odds untuk sirosis sebesar 10,21 (IK 95%=1,83-56,84). Manifestasi klinis yang sering ditemukan adalah infeksi di tempat lain (n=12, 92,3%), sirosis (n=11, 84,6%), hepatomegali (n=9, 69,2%), splenomegali (n=8, 61,5%), dan perdarahan saluran cerna (n=8, 61,5%). Mikroorganisme patogen dari hasil kultur cairan asites adalah Streptococcus epidermidis (n=1) dan Klebsiella pneumoniae(n=1). Sirosis merupakan faktor risiko independen terhadap kejadian PBS pada anak dengan kolestasis, Spontaneous bacterial peritonitis (SBP) is a serious complication of chronic cholestasis. This condition may increase mortality rate among the children with cholestasis. The aim of this research is to identify risk factors and clinical spectrums of SBP in children with cholestasis admitted to RSCM. This research was conducted from August to October 2015 by using retrospective cohort study toward cholestatic children age 0-5 years old who were followed-up for 6 months through medical record. From 97 patients, prevalence of SBP is 13.4%. In multivariate analysis, odds ratio for cirrhosis is 10.21 (95% CI=1.83-56.84). The most common clinical manifestations in children with SBP are other source of infections (n=12, 92.3%), cirrhosis (n=11, 84.6%), hepatomegaly (n=9, 69.2%), splenomegaly (n=8, 61.5%), and gastrointestinal bleeding (n=8, 61.5%). Microorganism pathogens from ascitic fluid cultures are Streptococcus epidermidis (n=1) and Klebsiella pneumoniae (n=1). Cirrhosis is an independent risk factor of SBP in children with cholestasis.]"

"lnfected ascites is one of the complication happened in liver cirrhotic patient in ascites. There are 5 infected ascites classifications i. e. Spontaneous Ascites Infection Consist of Spontaneous Bacterial Peritonitis, Monomicrobial Non Neurocytic Bacteriascites, Culture Negative Neurovytic Ascites, Secondary Bacterial Peritonitis and Iantrogenic Polimicrobial Bacterascites. Spontaneous Bacterial Peritonitis (SBP) is the infection in ascites without unrecognized intra abdominal infection source. The normal floras in the gastrointestinal, respiratory or urinal tract are the important infection source in SBP. As we know that normal ascites has ability to kill micro organism through phagocitosis function, opsonization, but when infected occurs; phagocitosis function, opsanization, and MPS could be worst so that the possibility of being SBP increased. The commoon frequently sign and symtom of SBP are fever, abdominal pain, consciousness assault,tenderness, diarrhea, paralytic ileus, hypotension and hypothermia. Some of the invasive actions like endoscopy, variceal sclerothrerapy and ligation may cause intestine flora translocation to mesenteric gland bacterimia and infected ascites also made transmural passage intestine micro organism to ascites may cause infected ascites. Cefotaxime is the antibiotic that more frequently studied to SBP patient. The close of cefotaxirne to SBP patient show that 2 grant/6 hours and 2 grain/I2 hours injected produce SBP resolution and the same survival, besides that 2 gram/8 hours injected for 5 and 10 days also show the same effectively. The antibiotic prophylaxis such as quinolon group show the effective result in liver cirrhotic with the gastroentestinal tract bleeding and lout total protein (<1 graim/dl ) or has the SBP experience patients."

"Spontaneous Bacterial Peritonitis (SBP) adalah salah satu komplikasi yang sering terjadi pada pasien sirosis hepatis. Tiga populasi pasien yang berisiko tinggi terinfeksi SBP adalah pasien dengan perdarahan gastrointestinal bagian atas, pasien dengan kadar protein rendah dalam cairan asites, dan pasien yang memiliki riwayat episode SBP sebelumnya. Antibiotik sefalosporin merupakan terapi empiris awal yang dapat digunakan untuk penanganan SBP. Penelitian ini bertujuan untuk menganalisis secara deskriptif efektivitas dan biaya antibiotik sefalosporin yang digunakan pada pasien sirosis hepatis dengan risiko Spontaneous Bacterial Peritonitis. Desain penelitian ini adalah non eksperimental dengan desain studi perbandingan dan pengambilan data secara retrospektif menggunakan data sekunder dari rekam medis dan tagihan biaya pasien di RSUP Fatmawati. Pengambilan sampel secara total sampling. Sampel yang diikutkan dalam penelitian berjumlah 12 pasien, yaitu 9 pasien dengan sefotaksim dan 3 pasien dengan seftriakson. Efektivitas sefotaksim sebesar 8 hari, sedangkan efektivitas seftriakson adalah sebesar 9 hari. Total biaya medis langsung sefotaksim adalah sebesar Rp 4.695.577,00, sedangkan pada seftriakson adalah sebesar Rp 5.181.533,00.

---

Spontaneous Bacterial Peritonitis (SBP) is one of the complications that often occur in patients with liver cirrhosis. Three high risk infected patient populations are patients with upper gastrointestinal bleeding, patients with low levels of protein in the ascites fluid, and patients who had a history of previous episodes of SBP. Cephalosporin is the the initial empirical therapy that could be used for SBP treatment. This study aimed to analyze descriptively the effectiveness and cost cephalosporin used in liver cirrhosis patients with Spontaneous Bacterial Peritonitis risk.

Design of this study was non-experimental with comparative studies and retrospective data collection which was using secondary data from medical records and patient bills in Fatmawati Hospital. Samples were taken by using total sampling method. Samples were included in the study amounted to 12 patients, 9 patients with cefotaxime and 3 patients with ceftriaxone. Effectiveness of cefotaxime was 8 days, while the effectiveness of ceftriaxone was 9 days. The total direct medical cost of cefotaxime was Rp 4,695,577.00, while ceftriaxone was Rp 5,181,533.00."

"Latar Belakang: Pasien sirosis hati berisiko mengalami infeksi bakteri cairan asites melalui jalur translokasi patogen di dalam saluran cerna. Kategori infeksi bakteri cairan asites netrositik meliputi PBS dan ANKN. Baku emas pemeriksaan meliputi jumlah PMN, kultur bakteri dan DNA ribosomal RNA 16S untuk mengkaji adanya patogen bakteri pada cairan asites sirosis hati. Data populasi sel alat analisa hematologi otomatis belum optimal digunakan dan perlu dikaji dalam hal kemampuan mendeteksi infeksi bakteri cairan asites.Tujuan: Mengetahui proporsi, pola patogen, kepekaan terhadap antibiotik pada infeksi bakteri cairan asites sirosis hati dan kemampuan diagnostik 5 parameter hematologi dalam data populasi sel alat analisa hematologi otomatis dengan baku emas jumlah PMN, kultur bakteri dan atau identifikasi adanya materi genetik bakteri dengan DNA ribosomal RNA 16S pada cairan asites.Metode: Penelitian potong lintang pada subjek asites sirosis hati oleh sebab apapun berusia ≥ 18 tahun di 3 rumah sakit rujukan tersier di Jakarta selama 4 Januari - 30 April 2021. Variabel independen terdiri dari HFLC, IG, ANC, NESFL, Delta Ret-Hb, parameter tambahan RNL dengan baku emas jumlah PMN ≥ 250, kultur bakteri positif & atau rt- PCR DNA ribosomal RNA 16S positif dengan nilai CT ≤ 31.1 pada cairan asites netrositik.Hasil: 93% subjek adalah sirosis hati dekompensata CPS ≥ 8. Proporsi infeksi bakteri cairan asites dengan baku emas kultur: PBS 4.1%, ANKN 10.3%, bakterasites 7.1%; kultur dan DNA ribosomal RNA 16S bakteri: PBS 7.1%, ANKN 7.1%, bakterasites 45.9%. Kultur bakteri yang tumbuh 11.2% : gram negatif 54.5%, gram positif 45.4%, tidak ditemukan bakteri anaerob & E. coli. ESBL ditemukan pada E. aerogenes & P. aeruginosa. Nilai diagnostik tunggal diperoleh pada parameter IG (sensitivitas 64.3%, spesifitas 75%), ANC (64.2%, 70.2%) dan RNL (71.4%, 71.4%). Nilai diagnostik gabungan memberikan hasil terbaik pada IG, HFLC, NESFL dengan AUC 0.80 IK 95% 0.68 – 0.92 p <0.001, sensitivitas 66%, spesifitas 84%, yang berasosiasi negatif dengan infeksi bakteri cairan asites netrositik dan menghasilkan sistem skor dengan nilai AUC, sensitivitas dan spesifitas yang sama.Simpulan: Hasil kultur & DNA bakteri memberikan proporsi infeksi bakteri cairan asites (PBS, ANKN, bakterasites) 60.1% dengan bakteri gram positif & negatif yang hampir seimbang. Ditemukan resistensi ESBL. IG, ANC & RNL memiliki nilai diagnostik tunggal. IG, HFLC dan NESFL memiliki nilai diagnostik gabungan serta menghasilkan sistem skor untuk infeksi bakteri cairan asites netrositik (PBS, ANKN).

---

ackground: Liver cirrhosis posseses risks to sustain ascitic bacterial infection in peritoneal cavity through GI tract pathogen translocation. Neutrocytic ascites bacterial infection includes SBP & CNNA. Diagnostic gold standards for them are ascitic fluid PMN count, bacterial culture and 16S RNA Ribosomal DNA. Cell population data of automated hematology analyzer is not widely used nor evaluated as part of diagnostic process in ascitic bacterial infection.

Objective: To determine proportion, microbial pattern, antibiotic susceptibility, diagnostic values of 5 hematological parameters in cell population data of automated hematology analyzer toward gold standard of ascitic fluid bacterial infection : PMN count, bacterial culture positivity and or positivity identification of 16S RNA ribosomal DNA in liver cirrhosis ascitic fluid .

Methods: Cross sectional study of ascitic liver cirrhosis due to any cause in ≥ 18 years old subject conducted in 3 tertiary referral hospitals in Jakarta during 4 January to 30 April 2021. Independent variables consist of HFLC, IG, ANC, NESFL, Delta Ret-Hb with gold standard ascitic fluid of PMN count ≥ 250, bacterial culture positivity and or rt-PCR 16S RNA Ribosomal DNA positivity with CT value ≤ 31.1 in neutrocytic ascitic fluid.

Results: There are 93% decompensated liver cirrhosis whose CP ≥ 8. Proportion according to culture: SBP 4.1%, CNNA 10.3%, bacterascites 7.1%, while culture and or 16S ribosomal DNA : SBP 7.1%, CNNA 7.1%, bacterascites 45.9%. Proportion of 11.2% positive bacterial culture consists of gram negative 54.5%, gram positive 45.4% & none of anaerobic bacteria nor E. coli. ESBL is detected in E. aerogenes & P. aeruginosa. Individual diagnostic value includes IG (sensitivity 64.3%, specifity 75%), ANC (64.2%, 70.2%) and additional parameter of LNR (71.4%, 71.4%) . The best combination diagnostic value is found in IG, HFLC, NESFL with AUC 0.80, 95% CI 0.68 – 0.92 p <0.001, sensitivity 66%, spesifity 84% which contains negative association to neutrocytic ascites bacterial infection. It produces a score system with similar AUC, sensitivity and specifity.

Conclusions: Culture and bacterial DNA results in ascitic bacterial infection (SBP, CNNA, bacterascites) 60.1% with almost equal proportion of gram positive & negative bacterial culture with ESBL resistance. IG, ANC & LNR have individual diagnostic value in neutrocytic ascitic bacterial infection, otherwise IG, HFLC and NESFL are combined cell population data parameters and yield a score system for neutrocytic ascites bacterial infection (SBP,CNNA)."

"Latar Belakang: Kondisi dekompensata tanpa infeksi bakteri pada pasien sirosis hati dapat meningkatkan kadar prokalsitonin (PCT). Belum ada penelitian yang secara khusus membandingkan kadar PCT berdasarkan kompensasi hati dan ada tidaknya infeksi bakteri. Tujuan: Mengetahui peran PCT dalam membantu menegakkan diagnosis infeksi bakteri pada pasien sirosis hati. Metode: Studi potong lintang dilakukan terhadap pasien sirosis hati yang berobat jalan dan dirawat inap di RSUPNCM Jakarta dari April sampai Mei 2016. Pada pasien dilakukan pemeriksaan PCT dan penentuan ada tidaknya infeksi bakteri berdasarkan pemeriksaan standar sesuai jenis infeksi yang dicurigai. Dilakukan analisis untuk mengetahui perbedaan rerata kadar PCT pada pasien sirosis hati yang tidak terinfeksi bakteri dan yang terinfeksi bakteri, serta pencarian nilai titik potong PCT untuk mendiagnosis infeksi bakteri pada sirosis hati dekompensata dengan menggunakan receiver operating curve (ROC). Hasil: Didapatkan 55 pasien sirosis hati, pria sebanyak 65,5%, dengan rerata usia 55,34±1,308 tahun. Sebanyak 38 (69,1%) pasien sirosis hati dekompensata yang 22 (57,9%) diantaranya tidak terinfeksi bakteri dan 16 (42,1%) terinfeksi bakteri. Pada pasien yang tidak terinfeksi bakteri terdapat perbedaan rerata kadar PCT yang bermakna antara pasien dekompensata (0,738ng/mL±1,185) dibandingkan dengan 17 pasien kompensata (0,065ng/mL±0,022). Rerata kadar PCT pasien dekompensata yang terinfeksi bakteri (3,607ng/mL±0,643) lebih tinggi bermakna dibandingkan dengan yang tidak terinfeksi bakteri(0,738ng/mL±1,185). Dari kurva ROC, kadar PCT pada pasien sirosis hati dekompensata didapatkan area under curve (AUC) 0,933 (IK 0,853-1,014) untuk diagnosis infeksi bakteri. Nilai titik potong kadar PCT untuk mendiagnosis infeksi bakteri pada pasien sirosis hati dekompensata adalah 2,79ng/mL dengan sensitivitas 87,5% dan spesifisitas 86,4%. Kesimpulan: Pada pasien sirosis hati yang tidak terinfeksi bakteri, kadar PCT pasien dekompensata lebih tinggi dibandingkan dengan yang kompensata. Kadar PCT pasien sirosis hati dekompensata yang terinfeksi bakteri lebih tinggi dibandingkan dengan yang tidak terinfeksi bakteri. Sementara nilai titik potong kadar PCT untuk mendiagnosis infeksi bakteri pada pasien sirosis hati dekompensata adalah 2,79ng/mL.

---

Background: Liver decompensated without bacterial infection may increase procalcitonin (PCT) level in liver cirrhosis patients. Previous studies did not provide conclusive results about the differences of PCT level due to specific liver compensation and bacterial infection.

Objective: To examine the role of PCT in assisting the diagnosis of bacterial infection in liver cirrhosis patients.

Methods: A cross sectional study was conducted in liver cirrhosis patients who were outpatients and admitted to Cipto Mangunkusumo Hospital, Jakarta between April and May 2016. Procalcitonin were examined and bacterial infection were identified using standard criteria for each type of infection being suspected. Analysis were performed to determine differences in the level of PCT among liver cirrhosis patients without bacterial infection and with bacterial infection, also to get cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients using receiver operating curve (ROC).

Results: There were 55 patients with liver cirrhosis, 65,5% male, with mean of age 55,34±1,308 years. A total of 38 (69,1%) patients had decompensated liver cirrhosis, while 22 (57,9%) of them without bacterial infection and 16 (42,1%) with bacterial infection. In the absence of bacterial infection, there was significant difference between PCT level in decompensated patients (0,738ng/mL±1,185) and 17 compensated patients(0,065ng/mL±0,022). Decompensated patients with bacterial infection (3,607ng/mL±0,643) had significantly higher PCT levels than those without bacterial infection(0,738ng/mL±1,185). From ROC, level of PCT for bacterial infection in decompensated liver cirrhosis was area under curve (AUC) 0,933 (IK 0,853-1,014). Cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients was 2,79ng/mL with a sensitivity of 87.5% and specificity of 86,4%.

Conclusion: In the absence of bacterial infection, PCT levels of decompensated patients was higher than compensated ones. Procalcitonin levels of decompensated liver cirrhosis patients with bacterial infection was higher than those without bacterial infection.Cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients was 2,79ng/mL."

"Saat ini data peritonitis rate dan angka kematian pasien penyakit ginjal kronik (PGK) stadium akhir pengguna terapi Continuous Ambulatory Peritoneal Dialysis (CAPD) di Asian Tenggara masih terbatas. Angka peritonitis rate dan angka kematian pasien CAPD merupakan key performance indicator (KPI) yang diperlukan untuk melakukan evaluasi dan perbaikan mutu pelayanan secara berkelanjutan/continuous quality improvement (CQI) terhadap pelayanan terapi CAPD di rumah sakit. Peritonitis dapat menyebabkan kegagalan terapi CAPD sehingga pasien beralih ke metode hemodialisis atau berujung kematian. Metode CAPD memiliki keunggulan dibandingkan hemodialisis karena lebih hemat biaya, memberikan kualitas hidup lebih baik dan tidak memerlukan perawatan khusus di pusat hemodialisis. Metode ini cocok diterapkan di negara Asia Tenggara yang mengalami peningkatan jumlah penderita PGK tahap akhir yang membutuhkan biaya terapi sangat besar namun memiliki dana serta sumber daya terbatas. Tujuan utama systematic review ini untuk mengetahui peritonitis rate dan angka kematian pasien CAPD di Asia Tenggara. Systematic review menggunakan data renal registry serta basis data PubMed dan ProQuest khusus berbahasa Inggris dan Indonesia sejak tanggal 1 Januari 1992 sampai dengan 1 November 2022. Semua jenis studi yang memberikan informasi terkait peritonitis rate dan angka kematian pasien CAPD diambil dalam penelusuran systematic review. Penulis menyaring, memilih dan mengekstrak data sesuai skema systematic review PRISMA 2020. Artikel terpilih diberikan tinjauan kritis dan dilakukan sintesis data. Hasil sintesis data dilaporkan secara secara naratif serta diperjelas dengan tabel dan diagram. Dalam melakukan systematic review penulis menggunakan aplikasi Mendeley dan Microsoft Exel 2010 sebagai alat bantu. Hasil: Dari pencarian database Pubmed (1397) dan Proquest (422) serta laporan renal registry total terjaring 1819 artikel dan 5 laporan renal registry. Setelah proses penyaringan dan tinjauan kritis diperoleh 34 artikel dan 3 laporan renal registry. Hasil analisis menunjukkan telah terjadi penurunan tingkat peritonitis rate di Asia Tenggara dalam kurun waktu 1993-2022. Terdapat 4 negara yaitu Indonesia (0,25 episode per pasien-tahun),Vietnam (0,19 episode per pasien-tahun), Singapura (0,31-0,339 episode per pasien-tahun) dan Malaysia (0,13-0,33 episode per pasien-tahun) secara umum mencapai target International Society for Peritoneal Dialysis (ISPD)2022 yaitu tingkat peritonitis dibawah 0,4 episode episode per pasien-tahun. Adapun Thailand (0,39-0,864 episode per pasien-tahun) dan Brunei Darussalam (0,38-0,49 episode per pasien-tahun) belum mencapai target yang telah ditetapkan oleh International Society for Peritoneal Dialysis (ISPD) 2022. Sebagian besar angka kematian di bawah 20%. Angka kematian akibat peritonitis berkisar 3,2-5,5%. Mikroorganisme penyebab peritonitis yang paling sering ditemukan adalah Staphylococcus aureus dan Coagulase-negative Staphylococcus. Faktor risiko peritonitis yang ditemukan yaitu faktor usia tua (60 tahun keatas); diabetes milletus; sosial ekonomi rendah; tidak adanya sumber air bersih; hipoalbuminemia; kemampuan pasien CAPD dalam menerapkan tindakan aseptik saat pertukaran cairan dialisat yang buruk; rasio pasien-perawat lebih dari (50:1); jarak rumah yang jauh dari pusat dialisis; letak geografis dan penggunaan mupirocin topikal pada exit-site CAPD. Penggunaan cairan dialisat Dextrosa 4,2% yang sering dan terus menerus meningkatkan risiko kematian pada pasien CAPD sebanyak 2 kali lipat. Kesimpulan: Sebagian besar Negara di Asia Tenggara memiliki kualitas pelayanan yang baik terhadap pasien penyakit ginjal kronik stadium akhir pengguna terapi CAPD. Untuk mencapai kualitas pelayanan CAPD yang baik diperlukan bagi rumah sakit untuk memperhatikan faktor risiko peritonitis dan faktor risiko kematian dalam melakukan seleksi terhadap pasien CAPD serta melakukan pelatihan terhadap pasien CAPD sesuai rekomendasi International Society for Peritoneal Dialysis (ISPD).

---

Currently data on the peritonitis rate and mortality rate of end-stage chronic kidney disease (CKD) patients using Continuous Ambulatory Peritoneal Dialysis (CAPD) therapy in Southeast Asia are still limited. The peritonitis rate and mortality rate of CAPD patients are key performance indicators (KPI) needed to evaluate and improve continuous quality improvement (CQI) for CAPD therapy services in hospitals. Peritonitis can lead to failure of CAPD therapy so that patients switch to hemodialysis methods or lead to death. The CAPD method has advantages over hemodialysis because it is more cost-effective, provides a better quality of life and does not require special treatment at a hemodialysis center. This method is suitable for use in Southeast Asian countries where there is an increasing number of end-stage CKD patients who require very large therapeutic costs but have limited funds and resources. The main aim of this systematic review is to determine the peritonitis rate and mortality rate of CAPD patients in Southeast Asia. The systematic review used renal registry data and the English and Indonesian PubMed and ProQuest databases from January 1 1992 to November 1 2022. All types of studies that provided information regarding the peritonitis rate and mortality rate of CAPD patients were included in a systematic review search. The author filters, selects and extracts data according to the PRISMA 2020 systematic review scheme. Selected articles are given a critical review and data synthesis is carried out. The results of data synthesis are reported in a narrative manner and clarified by tables and diagrams. In carrying out a systematic review, the author uses the Mendeley application and Microsoft Exel 2010 as a tool. Results: From a search of the Pubmed (1397) and Proquest (422) databases and renal registry reports, a total of 1819 articles and 5 renal registry reports were captured. After screening and critical review, 34 articles and 3 renal registry reports were obtained. The results of the analysis show that there has been a decrease in the peritonitis rate in Southeast Asia in the period 1993-2022. There are 4 countries namely Indonesia (0.25 episodes per patient-year), Vietnam (0.19 episodes per patient-year), Singapore (0.31-0.339 episodes per patient-year) and Malaysia (0.13-0, 33 episodes per patient-year) generally achieves the International Society for Peritoneal Dialysis (ISPD) 2022 target of a peritonitis rate below 0.4 episodes per patient-year. Meanwhile, Thailand (0.39-0.864 episodes per patient-year) and Brunei Darussalam (0.38-0.49 episodes per patient-year) have not yet reached the target set by the International Society for Peritoneal Dialysis (ISPD) 2022. Most of them mortality rate below 20%. The mortality rate from peritonitis ranges from 3.2-5.5%. The most common microorganisms that cause peritonitis are Staphylococcus aureus and Coagulase-negative Staphylococcus. The risk factors for peritonitis found were old age (60 years and over); milletus diabetes; low socioeconomic; lack of clean water sources; hypoalbuminemia; poor ability of CAPD patients to apply aseptic measures during dialysate fluid exchange; patient-nurse ratio more than (50:1); the distance from the house to the dialysis center; geographic location and use of topical mupirocin in CAPD exit-sites. Frequent and continuous use of Dextrose 4.2% dialysate fluid increases the risk of death in CAPD patients by 2 times. Conclusion: Most countries in Southeast Asia have good quality of care for patients with end-stage chronic kidney disease using CAPD therapy. To achieve good quality CAPD services, it is necessary for hospitals to pay attention to risk factors for peritonitis and risk factors for death in selecting CAPD patients and conducting training for CAPD patients according to the recommendations of the International Society for Peritoneal Dialysis (ISPD)."