Tingginya Prevalensi MRSA pada Isolat Klinik Periode 2010- 2014 di RSUD Dr. Saiful Anwar Malang, Indonesia
DOI:
https://doi.org/10.21776/ub.jkb.2016.029.02.9Abstract
Methicillin Resistant Staphylococcus aureus (MRSA) merupakan bakteri patogen terpenting penyebab infeksi terkait perawatan di rumah sakit di dunia. Penelitian ini bertujuan untuk membandingkan prevalensi dan pola resistensi antibiotik dari isolat MRSA di RSUD Dr. Saiful Anwar Malang, Jawa Timur, Indonesia selama kurun waktu 2010-2014. Isolat MRSA didapatkan dari berbagai spesimen klinik, seperti darah, pus, sputum, dan urin. Kami mendeteksi isolat MRSA secara fenotipik, selanjutnya melakukan uji kepekaan antibiotik sesuai standar dari Clinical and Laboratory Standards Institute (CLSI) 2014. Secara keseluruhan, didapatkan 772 isolat Staphylococcus aureus, 38,2% diantaranya merupakan isolat MRSA. Prevalensi MRSA tertinggi didapatkan pada tahun 2012 (45,3%), sedangkan prevalensi terendah pada tahun 2013 (33,5%). Kasus MRSA paling sering ditemukan dari pus (49%). Ditemukan penurunan resistensi isolat MRSA dari darah terhadap chloramphenicol (p<0,05), dari pus terhadap tetracycline, dari sputum terhadap erythromycin dan trimethoprim-sulfamethoxazole. Sementara itu didapatkan peningkatan resistensi terhadap chloramphenicol (p<0,05). Dapat disimpulkan bahwa prevalensi MRSA di RSUD dr. Saiful Anwar Malang, Indonesia cukup tinggi dan terjadi perubahan pola sensitifitas terhadap beberapa antibiotik.
Kata Kunci: MRSA, resistensi antibiotik, rumah sakit
Downloads
References
Gordon RJ and Lowy FD. Pathogenesis of Methicillin-Resistant Staphylococcus aureus Infection. Clinical Infectious Disease. 2008; 46(5): S350–S359.
Brooks GF, Caroll KC, and Butel JS, Morse SA, and Mietzer TA. Jawetz, Melnick & Adelberg's Medical Microbiology International Edition. Edisi 25. New York: McGraw-Hill Companies; 2010: hal. 185-190.
DeLeo FR, Otto M, Kreiswirth BN, and Chambers HF. Community-Associated Methicillin Resistant Staphylococcus aureus. Lancet. 2010; 375(9725): 1557-1568.
Ray P, Gautam V, and Singh R. Methicillin-Resistant Staphylococcus aureus (MRSA) in Developing and Developed Countries: Implications and Solutions. Proceeding Regional Health Forum. 2011; 15(1): 74-82.
Moellering Jr RC. MRSA: The First Half Century. Journal of Antimicrobial Chemotherapy. 2012; 67(1): 4-11.
Fey PD, Said-Salim B, Rupp ME, et al. Comparative Molecular Analysis of Community- or Hospital-Acquired Methicillin-Resistant Staphylococcus aureus. Antimicrobial Agents Chemotherapy. 2003; 47(1): 196–203.
Mejfa C, Zurita J, and Guzman-Blanco M. Epidemiology and Surveillance of Methicillin-Resistant Staphylococcus aureus in Latin America. The Brazilian Journal Infectious Disease. 2010; 14(2): S79-S86.
Santoso S, Santosaningsih D, Erikawati D, et al. Panduan Praktik Klinis Prosedur Tindakan. Edisi 1. Malang: Instalasi Mikrobiologi Klinik RSUD Dr. Saiful Anwar; 2013; hal. 2-50.
Forbes BA, Sahm DF, and Weissfeld AS. Overview of Bacterial Identification Method and Strategies. In: Forbes BA, Sahm DF, and Weissfeld AS (Eds). Bailey & Scott's Diagnostic Microbiology 12th edition. St. Louis Missouri: Mosby Elsevier; 2007: p. 221.
Forbes BA, Sahm DF, Weissfeld AS. Laboratory Method and Strategies for Antimicrobial Susceptibility Testing. In: Forbes BA, Sahm DF, and Weissfeld AS (Eds). Bailey & Scott's Diagnostic Microbiology 12th edition. St. Louis Missouri: Mosby Elsevier; 2007: pp. 194-198.
Patel JB, Cockerill III FR, Alder J, et al. Zone Diameter and Minimum Inhibitory Concentration (MIC) Interpretive Standards for Staphylococcus spp. In: Performance Standards for Antimicrobial Susceptibility Testing Twenty Fourth Informational Supplement Vol 34 No 1. Pennsylvania: Clinical and Laboratory Standards Institute; 2014: p. 68-75.
Chen CJ and Huang YC. New Epidemiology of Staphylococcus aureus in Asia. Clinical Microbiology and Infection. 2014; 20(7): 605-623.
Cookson B, Bonten MJ, MacKenzie FM, et al. Methicillin-Resistant Staphylococcus aureus (MRSA): Screening and Decolonization. International Journal of Antimicrobial Agents. 2011; 37(3): 195-201.
Buehlmann M, Frei R, Fenner L, Dangel M, Fluckiger U, and Widmer AF. Highly Effective Regimen for Decolonization of Methicillin-Resistant Staphylococcus aureus Carriers. Infectious Control Hospital Epidemiology. 2008; 29(6): 510-516.
Graffunder EM and Venezia RA. Risk Factors Associated with Nosocomial Methicillin-Resistant Staphylococcus aureus (MRSA) Infection including Previous Use of Antimicrobials. Journal of Antimicrobial Chemotherapy. 2002; 49(6): 999-1005.
Evan RP. The Silent Epidemic: CA-MRSA and HA-MRSA, Recommendations for Prevention, Identification, and Treatment. (Online) 2008. http://www.aaos.org/news/aaosnow/may08/research1.asp [diakses 10 Januari 2015].
Hadi U, Doerink DO, Lestari ES, et al. Survey of Antibiotic Use of Individual Visiting Public Healthcare Facilities in Indonesia. International Journal of Infectious Diseases. 2008; 12(6): 622—629.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).