193 ORIGINAL ARTICLE Acta Medica Indonesiana - Te Indonesian Journal of Internal Medicine Risk Factors and Scoring Systems for Patients with Candidemia at a Tertiary Hospital in Jakarta, Indonesia Mursinah, Fera Ibrahim, Mardiastuti H. Wahid Department of Microbiology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Corresponding Author: Fera Ibrahim, MD, MSc, PhD. Department of Microbiology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital. Jl. Pegangsaan Timur 16, Jakarta 10320, Indonesia. email: feraib@yahoo.fr. ABSTRAK Tujuan: untuk mengidentifkasi faktor risiko kandidemia dan mengembangkan sistem skoring kandidemia yang dapat digunakan di Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta, Indonesia. Metode: studi retrospektif dengan kasus kontrol dilakukan dengan menggunakan rekam medik pasien tahun 2011-2014. Semua pasien sepsis yang dirawat di RSCM dengan hasil kultur darah positif Candida dimasukkan sebagai kelompok kasus. Kelompok kontrol yaitu semua pasien sepsis tanpa kandidemia. Perbandingan kelompok kasus dengan kontrol adalah sama (1:1). Hasil: dari 234 pasien yang dianalisis, faktor risiko yang bermakna pada penelitian ini yaitu lama perawatan 8-14 hari (OR 3,464; 95% CI 1,458-7,800), lama perawatan lebih dari 14 hari (OR 6,844; CI 3,0-15,330), sepsis berat (OR 16,407; 95% CI 1,458-7,800) dan pembedahan (OR 3,03; 95% CI 1,492- 6,152). Prediktor kandidemia di RSCM yaitu lama perawatan 8-14 hari (nilai 1), lama perawatan lebih dari 14 hari (nilai 2), sepsis berat (nilai 3) dan pembedahan (nilai 1) dengan nilai cut off 3,5. Kesimpulan: hasil studi ini mengindikasikan bahwa sistem skoring sebagai panduan terapi empirik kandidemia dapat dikembangkan dengan menggunakan faktor risiko kandidemia dari pasien yang diidentifkasi sebagai pasien berisiko di RSCM. Kata kunci: kandidemia, faktor risiko, sistem skoring. ABSTRACT Aim: to identify the risk factors of candidemia and to develop a scoring system that could be implemented in Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia. Methods: this study was a retrospective study with case control design using the medical records of patients since 2011 to 2014. All sepsis patients hospitalized in the RSCM with a positive blood culture for Candida were included in this study as a case group. The control group was all of the sepsis patients without candidemia. The ratio for case and control groups was equal (1:1). Results: from 234 patients who were analyzed, the risk factors that infuenced the study were length of stay of 8-14 days (OR 3.464; 95% CI 1.458-7.800), length of stay of more than 14 days (OR 6.844; 95% CI 3.0- 15.330), severe sepsis (OR 16.407; 95% CI 1.458-7.800), and surgery (OR 3.03; 95% CI 1.492-6.152). The predictors for candidemia in RSCM were length of stay in hospital for 8-14 days (score 1), a length of stay ≥14 days (score 2), severe sepsis (score 3), and surgery (score 1), with a cut off score of 3.5. Conclusion: the results of this study have indicated that a scoring system in order to guide an empirical treatment for candidemia can be developed by using the risk factors for candidemia from patients who have been identifed as patients with risk at Cipto Mangunkusumo Hospital. Keywords: candidemia, risk factor, scoring system.