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THE EFFORT TO CONTROL FOR REDUCTION THE INCIDENCE OF NOSOCOMIAL INFECTION IN NEONATE WARD, IN DR. SOETOMO HOSPITAL SURABAYA AS A TOP REFERRAL HOSPITAL FOR EAST PART OF INDONESIA

Damanik S., Indarso F., Harianto A., Etika R., Nugroho W.A.

Child Health Department of Dr. Soetomo Hospital Surabaya, Indonesia

Nosocomial infection is if the patient that hospitalized get the infection from the hospital. Nosocomial infection in neonate different to children and adult from the aspect of epidemiology, pathogen profile and places that infection happened. The rate of morbidity and mortality among neonate with nosocomial infection depends on the presence or absence of high risk neonate, environment hygiene, availability of facilities, aseptic and antiseptic procedures and invasive procedures for diagnostic and treatment.

The incidence of nosocomial infection in the world 5,9 – 30%, in Indonesia (limited report) 7 – 8,5% and in Dr. Soetomo Hospital (1998 – 2000) 7,6% with the mortality of 2,2%.

Based on the observation in NICU and Intermediate ward between 1998 to 2000. It was found that the highest incidence diarrhea (36,02%) and septicemia (33,8%) with highest specific fatality rate was cellulitis (18,5%). Positive culture were found on Salmonella spp, Salmonella w., Pseudomonas a., which were sensitive to meropenem and chloramphenicol.

Various procedures have been taken to control these incidence, such as changing the apparatus in the ward with the aseptic ones, sampling test for baby’s drink, the use of antibiotics in accordance with the results of antibiotic sensitivity test, etc. However, weakness was still found in the factors of man, material, method, machine, and environment that needed to be overcome. Even though there was a decrease in the rate of incidence, nosocomial infection should continuously be a precaution which should be prevented by performing surveillance, finding resistant germs and sources of infection, as well as intensifying training and improvement to prevent the increase of nosocomial infection incidence in the future.

Key words: nosocomial infection, effort to control