Etiologi Infeksi Saluran Pernapasan Bawah (ISPB)

Oleh :

dr.Nailla Fariq Alfiani

Etiologi infeksi saluran pernapasan bawah (ISPB) melibatkan berbagai patogen, termasuk virus respiratory syncytial virus (RSV) dan influenza, bakteri Streptococcus pneumoniae dan Haemophilus influenzae, serta infeksi jamur pada populasi imunokompromais. Faktor risiko meliputi usia balita dan lansia, paparan polusi, kebiasaan merokok, serta penggunaan ventilator. Malnutrisi, anemia, dan penyakit kronis juga merupakan faktor risiko.[1–3,5–7,11,12,14–16].

Virus

Virus merupakan penyebab utama ISPB pada anak dan dewasa muda. Virus yang paling banyak dikaitkan dengan ISPB adalah RSV, influenza, parainfluenza, dan adenovirus. Virus lainnya mencakup COVID-19. Infeksi virus sering menyebabkan inflamasi difus pada saluran pernapasan bawah, mengganggu pertukaran gas, dan meningkatkan risiko infeksi sekunder oleh bakteri.[1–3,5,12–15]

Referensi

1. Malakounidou E, Tsiri P, Theochari E, Koulousousa E, Karampitsakos T, Tzouvelekis A. Lower respiratory tract infections treatment recommendations: An overview. Pneumon, 36(3), 17. 2023. https://doi.org/10.18332/pne/163184
2. Hussain SM, Rumaisa N, Keshav J. Understanding Lower Respiratory Tract Infection: A Comprehensive Review of Associated Risk Factors. Ann Pulm Res Med. 2024; 2(1): 1006. 2024. https://www.remedypublications.com/open-access/understanding-lower-respiratory-tract-infection-a-comprehensive-review-of-associated-10135.pdf
3. Gan Y, Hu Y, Dong H, Wu L, Niu Y. Causes of Lower Respiratory Tract Infections and the Use of Diagnostic Biomarkers in Blood Samples from Children in Hohhot, Inner Mongolia, China, Between July 2019 and June 2020. Medical science monitor : international medical journal of experimental and clinical research, 28, e934889. 2022. https://doi.org/10.12659/MSM.934889
5. Ulsamer A, Bonilla S, Pérez-Fernández X, Rello J, Sabater-Riera J. The pathogenesis of ventilator-associated pneumonia: old and new mechanisms. Expert Review of Respiratory Medicine, 19(7), 655–671. 2025. https://doi.org/10.1080/17476348.2025.2493366
6. Duyu M, Karakaya Z. Viral etiology and outcome of severe lower respiratory tract infections among critically ill children admitted to the PICU. Med Intensiva. 2021;45(8):447–458. doi:10.1016/j.medine.2020.04.011. 2021. https://www.medintensiva.org/en-viral-etiology-outcome-severe-lower-articulo-S2173572721001259
7. Scaglione G, Canuti M, Offer M, et al. Burden and Outcomes of Severe Lower Respiratory Tract Infections with Unknown Etiology: A Retrospective Observational Study on Epidemiological Trends Over an 8-Year Period (2016–2024). Infect Dis Ther 14, 1075–1087. 2025. https://doi.org/10.1007/s40121-025-01148-9
8. Byungsun Y, Ilha Y, Eu SK, et al. Etiology of Community Acquired Lower Respiratory Tract Infection (LRTI) in Children, Open Forum Infectious Diseases, Volume 10, Issue Supplement_2, 2023, ofad500.2219. 2023. https://doi.org/10.1093/ofid/ofad500.2219
9. Martin-Loeches I, Torres A, Nagavci B, et al. ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia. Intensive Care Med. 2023 Jun;49(6):615-632. doi: 10.1007/s00134-023-07033-8
11. Sürücü Kara I, Aydın Peker N, Arslan YK, Topal İ. Risk Factors for Lower Respiratory Tract Infection and Recurrent Lower Respiratory Tract Infection in Children. Van Med J. 2024;31(1):53-59. doi:10.5505/vmj.2024.97105. 2024. https://jag.journalagent.com/vmj/pdfs/VMJ_31_1_53_59.pdf
12. Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics (2014) 134 (5): e1474–e1502.
13. Yoo B, Yune I, Kang D, Cho Y, Lim SY, Yoo S, Kim M, Kim JS, Kim D, Lee HY, Baek RM, Jung SY, Kim ES, Lee H. Etiology and Clinical Prediction of Community-Acquired Lower Respiratory Tract Infection in Children. J Korean Med Sci. 2025 Jan;40(2):e5. doi:10.3346/jkms.2025.40.e5. 2025.
14. Kalgo ZM, Amin BM, Muhammed B, Saka HK. Prevalence and risk factors for lower respiratory tract infection: a multicenter study at Kebbi State, Nigeria. Int J Adv Health Sci Technol. 2023;3(1):60-67. doi:10.35882/ijahst.v3i1.170. 2023. https://ijahst.org/index.php/ijahst/article/view/170
15. Thaver L, Zar HJ. Determining the aetiology of lower respiratory tract illness in children. African journal of thoracic and critical care medicine, 30(2), e2378. 2024. https://doi.org/10.7196/AJTCCM.2024.v30i2.2378
16. Tailor D, Bamnawat S, Sareen D, Jain S. Association of anemia with acute lower respiratory tract infection in children aged 2 months to 5 years. International Journal of Contemporary Pediatrics, 10(7), 1053–1056. 2023. https://doi.org/10.18203/2349-3291.ijcp20231841

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