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Antibiogram and biofilm formation among extended-spectrum ?-lactamase-producing Klebsiella pneumoniae clinical isolates in Sanglah General Hospital, Bali, Indonesia Ichlazul Ma’ruf; Made Agus Hendrayana; I Dewa Made Sukrama; Ni Nengah Dwi fatmawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (357.341 KB) | DOI: 10.15562/ism.v12i1.909

Abstract

Background: Klebsiella pneumoniae is a common cause of healthcare-associated infections (HAIs), and has a high level of resistance to antibiotics first, second, extended-spectrum cephalosporins, and monobactam which are a serious threat to public health worldwide. Besides, it is known that this bacterium can form biofilms as virulence factors that contribute to drug resistance. This study aims to determine the antibiotics susceptibility patterns and the capacity of K. pneumoniae to form biofilms.Methods: K. pneumoniae was isolated from clinical specimens (urine, sputum, pus, blood, and others) for the period 2018-2019. Bacterial identification and antibiotic susceptibility testing were performed using the Vitek Compact 2 (bioMérieux®) test in the Clinical Microbiology Laboratory of Sanglah General Hospital. Biofilm formation was checked using the tissue culture plate method (TCP). Data were analyzed using SPSS version 20 for Windows.Results: Most of Extended Spectrum ?-Lactamase (ESBL)-producing K. pneumoniae showed resistance to antibiotics. The susceptible profiles were only towards ertapenem (97.50%), meropenem (97.50%), amikacin (95.00%), and tigecycline (87.50%). The TCP method detected 72 (90.00%) as biofilm producers among 80 clinical isolates, while 8 (10.0%) as non-biofilm producers. Among the biofilm-producer bacteria, there were 6 (7.50%) as strong, 37 (46.25%) moderate, and 29 (36.25%) weak biofilm-producer isolates.Conclusions: Most ESBL-producing K.pneumoniae clinical isolates in Sanglah General Hospital demonstrate multiple resistance to antibiotics and as biofilm producers. However, further research is needed to be conducted using a molecular approach to see the ESBL- and biofilm-encoded genes.
Kesesuaian pewarnaan gram dengan kultur darah sebagai prediktor nilai kritis kasus bakteremia di Rumah Sakit Umum Pusat Sanglah, Denpasar Putu Yoska Arya Harindana; Ida Sri Iswari; Indramawan Setyojatmiko; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (481.58 KB) | DOI: 10.15562/ism.v12i2.1038

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Background: One of the considerations for giving empiric antibiotics in bacteremia cases is gram staining (GS) results. Accurate and fast results are required in distinguishing infection-caused bacteria. However, the data on how much the corresponding gram stain results with bacterial growth in blood cultures are still insufficient.Aim: The study aims to compare Gram stain results with bacterial growth in positive blood cultures.Methods: A cross-sectional analytic study obtained data from the VITEK® 2 Compact (bioMérieux) results for six months (January - June 2020). Data involved all blood cultures examined as many as 509.Results: Of the 509 blood samples, 46 were reported as critical values for bacteremia. Gram-negative bacillus bacteria were identified in 39.13% of the gram staining (GS) and 45.65% of the blood culture (BC) samples. Gram-positive bacteria appeared in 56.52% of GS and 52.17% of BC. MBRO (multidrug-resistant organisms) bacteria were identified in the proportion of 11%, then 13% from ESBL (extended-spectrum beta-lactamase) bacteria, and they remain as 4% MRSA (methicillin-resistant Staphylococcus aureus) bacteria. The higher result, 76% of the data was confirmed from the non-ICU patients.Conclusion: GS can be used as a reference for empiric antibiotic therapy due to its effectiveness, and it has a high degree of similarity with positive blood culture results.  Latar belakang: Salah satu pertimbangan pemberian antibiotika empiris pada kasus bakteremia adalah berdasarkan hasil pewarnaan gram. Dibutuhkan hasil yang akurat dan cepat dalam membedakan bakteri penyebab infeksi. Namun sedikit data tentang berapa besar kesesuaian hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah. Untuk membandingkan hasil pewarnaan gram dengan pertumbuhan bakteri pada kultur darah yang positif.Metode: Penelitian ini merupakan penelitian analitik cross-sectional. Data diperoleh dari hasil VITEK® 2 Compact (bioMérieux) selama enam bulan (Januari – Juni 2020). Sampel penelitian adalah semua kultur darah yang diperiksa pada periode penelitian berjumlah 509.Hasil: Dari 509 sampel spesimen darah, 46 sampel dilaporkan sebagai nilai kritis prediktor bakteremia. Bakteri batang gram negatif teridentifikasi pada 39,13% sampel pewarnaan gram dan 45,65% sampel hasil kultur darah. Bakteri gram positif muncul pada 56,52% sampel pewarnaan gram dan 52,17% sampel hasil kultur darah. Bakteri MDRO (multidrug resistant organisms) teridentifikasi sebanyak 11%, 13% bakteri ESBL (extended spectrum beta lactamase), dan 4% bakteri MRSA (methicillin-resistant Staphylococcus aureus). Proporsi 76% sampel berasal dari pasien non-ICU.Simpulan: Hasil pewarnaan gram dapat digunakan sebagai acuan terapi antibiotika empiris karena memiliki tingkat kesesuaian yang tinggi dengan hasil kultur darah positif.
Prevalence of SCCmec Types I, II, III, and pvl gene among Methicillin-Resistant Staphylococcus aureus (MRSA) isolated from clinical specimens in Sanglah General Hospital I Gede Sathya Agastya; Agus Eka Darwinata; Komang Januartha Putra Pinatih; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.598 KB) | DOI: 10.15562/ism.v13i1.1215

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Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is a big challenge for health services worldwide which causes infections both in healthcare and community. Healthcare-associated MRSA (HA-MRSA) strains are shown to be resistant to beta-lactam antibiotics and several non-beta lactam antibiotics. At the same time, the community-associated MRSA (CA-MRSA) tends to be resistant to beta-lactam antibiotics. MRSA carried staphylococcal cassette chromosome (SCCmec) types I, II, III, IV, and V. SCCmec types I, II, and III were predominantly found in  HA-MRSA strain while SCCmec types IV and V predominantly found in CA-MRSA strains. Furthermore, the panton valentine leukocidine (pvl) gene is commonly found in CA-MRSA strains. Therefore, this study aimed to determine the prevalence of SCCmec types I, II, III, and pvl gene in MRSA isolated from clinical specimens in Sanglah General Hospital. Methods: This study was a cross-sectional descriptive study. MRSA was isolated from clinical specimens (sputum, wounds, tissue, blood, etc.) from January 2020 to July 2021 and identified by the Vitek 2 Compact (Biomerieux, France) at the Clinical Microbiology Laboratory of Sanglah Hospital. Prevalence of SCCmec and pvl gene using PCR. Data were analyzed using Microsoft Excel version 2010 for Windows. Results: Most of the specimens (69.56%) were wound. Seventeen (73.91%) out of 23 MRSA isolates were positive for the SCCmec III and pvl gene, while none was positive for the SCCmec I and SCCmec II. About 19 (82.60%) isolates were resistant to two or more non-beta-lactam antibiotics. Conclusions: The isolates of MRSA in this study were predominantly isolated from wound specimens, with the most prevalent genetic element being SCCmec III. In this study, although most MRSA isolates carried SCCmec III that suggested as HA-MRSA, however, most of the strains harbored the pvl gene. This interesting phenomenon needs to be further elucidated.
Contamination of Escherichia coli, Salmonella sp. and Vibrio sp. on ice cubes at food stalls in Karangasem Regency, Bali Province in 2021 I Gede Wikania Wira Wiguna; Agus Eka Darwinata; Komang Januartha Putra Pinatih; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (289.082 KB) | DOI: 10.15562/ism.v13i1.1218

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Background: Waterborne diseases spread through drinking water and food products made from drinking water, including cooking utensils that are washed using contaminated water. Ice cube is widely used by the people in Indonesia. There was no study regarding bacteria contamination on an ice cube in Karangasem Regency. This study aimed to determine the contamination of Escherichia coli, Salmonella sp., and Vibrio sp. on ice cubes at food stalls in Karangasem Regency in 2021. Methods: This study used a cross-sectional research design and simple purposive sampling as the sampling technique. Ice cubes were taken from 42 food stalls from eight sub-districts. Samples were cultured on Lactose Broth (LB) media for the Most Probable Number (MPN) test procedures and Eosin Methylene Blue Agar (EMBA) to identify the presence of E. coli, Salmonella Shigella Agar (SSA) for Salmonella sp., and Thiosulfate Citrate Bile Sucrose (TCBS) for Vibrio sp. and followed by gram staining. Data processing was carried out descriptively to determine the percentage of samples with positive contamination. Data were analyzed using Microsoft Excel version 2010 for Windows. Results: Based on the study results, it was found that all samples contained coliform bacteria through the MPN test (100.0%). In addition, 5 samples (11.9%) were found positive for E. coli. While the identification of Salmonella sp. and Vibrio sp was found no positive results. Conclusions: There was coliform bacteria contamination in the tested ice cube samples. In addition, E. coli was found in the sample; however, there were no Salmonella sp. and Vibrio sp. on ice cube samples.
Colonization of Citrobacter koseri and Streptococcus agalactiae in a case of cellulitis cruris dextra et sinistra Luh Gede Melia Puspita Sari; Ni Nengah Dwi Fatmawati; I Gusti Ayu Agung Praharsini; Marvin Giantoro
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (515.511 KB) | DOI: 10.15562/ism.v13i2.1326

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Background: Cellulitis is a skin infection involving the deep dermis and subcutaneous tissue, characterized by localized pain, swelling, tenderness, erythema, and warmth. The most common causes of cellulitis are group A streptococci and Staphylococcus aureus. Streptococcus agalactiae or the so-called group B Streptococcus can also cause cellulitis. This case report aims to evaluate the colonization of Citrobacter koseri and Streptococcus agalactiae in a case of cellulitis cruris dextra et sinistra. Case Presentation: A 53-year-old married woman presented to the outpatient clinic complaining of swelling and redness in her left and right legs since five days ago. At first, there was only a little redness around the calf, but it became wider and pain in that area. On examination, there were multiple erythematous macules, patches, and multiple erosional lesions, warm palpable and tender to palpation, and the diascopy test disappeared with pressure. Based on the wound culture results, isolated Citrobacter koseri and Streptococcus agalactiae bacteria were considered colonization. Both of these bacteria were less virulent. The patient was treated with systemic and topical antibiotics, analgesics, wound care management and elevated lower limbs. Conclusion: The diagnosis of cellulitis is based on history and physical examination. On examination of the wound culture of this case, Citrobacter koseri and Streptococcus agalactiae were found, considered as colonization. The patient showed clinical improvement at each observation after administration of antibiotics and wound care management. The patient's prognosis is dubious ad bonam.
Prevalensi cemaran patogen Salmonella pada daging babi yang dijual di Pasar Tradisional di Kota Denpasar I Gusti Agung Istri Gladys Elsyaningrat; Komang Januartha Putra Pinatih; Ni Nengah Dwi Fatmawati; Agus Eka Darwinata
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (511.833 KB) | DOI: 10.15562/ism.v13i2.1381

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Background: Food contamination is a serious problem. Salmonella sp is one of the main bacteria causing gastrointestinal disease, especially in raw pork, due to the production and distribution process. Traditional markets have high risk of pathogenic microbial contamination. The purpose of this study was to detect contamination of Salmonella sp. on pork sold in traditional markets, particularly in Denpasar, Bali. Method: This research is a cross-sectional descriptive, with the samples coming from the porks sold by traditional market traders in every sub-district in Denpasar, Bali. The sampling technique used is the cluster purposive sampling. The procedure for identification of Salmonella sp. using culture and subculture examination on Salmonella Shigella Agar (SSA), simmon citrate agar media, and identification of the microscope. Results: Based on SSA culture results from 38 samples, 26 samples of pork showed colony growth, but only 10 samples with typical morphology of Salmonella sp. The 16 samples with atypical morphology were examined for SSA subculture, with 9 samples having clear black colonies. In 19 research samples that showed the results were suspected to be contaminated with Salmonella sp. continued to the Simmons citrate test, but only 8 samples were positive. The 19 samples were also examined under a microscope and all samples showed a rod image and red color indicating that the colonies in the sample were gram-negative bacilli which are typical of the morphology of Salmonella sp. Conclusion: Contamination of Salmonella was found in pork sold at Traditional Markets in Denpasar with a prevalence of 21%.   Latar belakang: Kontaminasi makanan merupakan suatu masalah serius. Salmonella sp merupakan salah satu bakteri penyebab utama penyakit gastrointestinal, terutama pada daging babi mentah, dikarenakan pada proses produksi dan distribusi. Pasar tradisional merupakan tempat yang sangat rawan dan beresiko cukup tinggi terhadap cemaran mikroba patogen. Tujuan penelitian ini adalah mendeteksi ada tidaknya cemaran bakteri Salmonella sp. pada daging babi yang dijual di Pasar Tradisional, khususnya di Denpasar, Bali. Metode: Penelitian ini merupakan deskriptif potong lintang, dengan sampel penelitian berupa daging babi yang dijual oleh pedagang pasar tradisional di setiap kecamatan di Kota Denpasar, Bali. Teknik penentuan sampel yang digunakan yaitu teknik cluster purposive sampling. Prosedur identifikasi kontaminasi Salmonella sp. menggunakan pemeriksaan kultur serta subkultur pada Salmonella Shigella Agar (SSA), Kultur pada media simmon citrate agar, dan identifikasi mikroskop. Hasil: Berdasarkan hasil kultur SSA dari 38 sampel daging babi, 26 sampel daging babi menunjukan adanya pertumbuhan koloni, namun hanya 10 sampel dengan morfologi khas Salmonella sp. Pada 16 sampel dengan morfologi tidak khas dilakukan pemeriksaan subkultur SSA, dengan 9 sampel memiliki warna koloni hitam bening. Pada 19 sampel penelitian yang menunjukan hasil terduga terkontaminasi Salmonella sp. dilanjutkan ke uji Simmons citrate, namun hanya 8 sampel dengan hasil positif. Pada 19 sampel juga dilakukan pemeriksaan mikroskop dan seluruh sampel menunjukkan gambaran batang serta berwarna merah yang menandakan bahwa koloni pada sampel adalah basil gram negatif yang khas pada morfologi bakteri Salmonella sp. Kesimpulan: Terdapat cemaran patogen Salmonella sp. pada daging babi yang dijual di Pasar Tradisional di Denpasar dengan prevalensi sebesar 21%.
Hubungan Pengetahuan Menjaga Kebersihan Gigi Tiruan Lepasan terhadap Gambaran Rongga Mulut pada Lansia di Desa Penatahan, Tabanan I Gusti Ayu Janadewi; I Gst. A. Dyah Ambarawati; Ni Nengah Dwi Fatmawati
Bali Dental Journal Vol. 6 No. 1 (2022): January 2022
Publisher : School of Dentistry Faculty of Medicine Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/bdj.v6i1.216

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Background : Tooth loss is a problem in the elderly in Indonesia with a high prevalence. Loss of tooth that are not replaced will cause a decrease in the level of self-confidence because the function of mastication is disrupted and can also affect the temporomandibular joints thereby reducing a person’s quality of life. This research was held to determine the level of knowledge in Maintaining removable denture to stay clean, the description of the oral cavity in the elderly in Penatahan Village, Tabanan and its relationship. Method: The design of this study was an observational descriptive design using a cross-sectional study method with a sample of 39 elderly people who actively participated in elderly gymnastics in Penatahan Village, Tabanan Regency, Bali. This research was conducted by giving questionnaire covering questions about knowledge and intra oral examinations. Result: The results obtained that the level of knowledge to maintaining removable denture to stay clean an with the highest percentage is good as much as 56.4% without any oral lesions, moderate level of knowledge as much as 23.1% without any oral lesions and as much as 23.1% with less knowledge level accompanied by traumatic ulcers as much as 37.5%, and experiencing denture stomatitis 12.5%. Conclusion: There is relationship between between the level of knowledge in maintaining removable denture to stay clean and the oral cavity on Elderly in Penatahan Village, Tabanan. (P-value <0.05). Latar Belakang : Kehilangan gigi merupakan masalah pada lansia di Indonesia dengan prevalensi yang tinggi. Kehilangan gigi yang tidak digantikan maka akan menyebabkan turunnya tingkat kepercayaan diri seseorang karena fungsi pengunyahan yang terganggu dan juga dapat berpengaruh terhadap sendi temporomandibular sehingga menurunkan kualitas hidup seseorang. Diadakannya penelitian ini untuk mendapatkan tingkat pengetahuan menjaga kebersihan gigi tiruan lepasan lansia, gambaran rongga mulut lansia di Desa Penatahan, Tabanan serta hubungan antara keduanya. Metode: Desain penelitian ini dengan rancangan deskriptif observational menggunakan metode cross-sectional study dengan jumlah sampel 39 orang lansia yang aktif mengikuti senam lansia di Desa Penatahan, kabupaten Tabanan, Bali. Penelitian dilakukan dengan memberi pertanyaan meliputi pengetahuan dalam bentuk kuisioner secara langsung dan pemeriksaan intra oral. Hasil: Didapatkan hasil bahwa tingkat pengetahuan menjaga kebersihan gigi tiruan lepasan dengan persentase tertinggi adalah baik yaitu sebanyak 56,4% tanpa adanya lesi rongga mulut, tingkat pengetahuan sedang sebanyak 23,1% tanpa adanya lesi rongga mulut dan sebanyak 23,1% dengan tingkat pengetahuan kurang disertai traumatic ulcer sebanyak 37.5%, dan mengalami denture stomatitis 12.5%. Simpulan: Terdapat hubungan antara pengetahuan menjaga kebersihan gigi tiruan lepasan terhadap gambaran rongga mulut pada lansia di Desa Penatahan, Tabanan. ( P-value < 0,05).
PREVALENSI KONTAMINASI BAKTERI Salmonella sp. DAN Shigella sp. PADA DAGING AYAM POTONG YANG DIJUAL OLEH PEDAGANG PASAR TRADISIONAL DI KOTA DENPASAR Surya Putra, I Gusti Agung Utama; Darwinata, Agus Eka; Putra Pinatih, Komang Januartha; Fatmawati, Ni Nengah Dwi
E-Jurnal Medika Udayana Vol 11 No 6 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i06.P11

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Salmonella sp. and Shigella sp. are bacterias that have become the most frequent cause of foodborne illness in developing countries. One of its contamination is chicken meat which is a daily staple food. The contamination occurs if the processing, storage, and distribution of chicken meat are improper. The aim of this study was to find the prevalence of contamination by Salmonella sp. and Shigella sp. on chicken meat sold by traditional market traders in Denpasar City. The type of research is cross-sectional research with descriptive observational. This study used the cluster sampling method. The total of samples is 24 samples and were taken from six traditional markets in each district of Denpasar City. Identification of Salmonella sp. and Shigella sp.Bacteria was done at the Integrated Biomedical Laboratory of Medical Faculty of Udayana with the culture method on Salmonella-Shigella agar media and Simmons Citrate culture. The total percentage contamination of Salmonella sp. was 58.33% (14/24), while Shigella sp. 20.83% (5/24). This bacterial contamination is caused by the lack of attention to hygiene in every chicken meat processing, storage, and distribution. The researcher suggests that further similar research be carried out using advanced identification methods to distinguish bacterial colonies in more detail and conduct a quantitative assessment of environmental contamination where chicken traders live.
PERBANDINGAN EFEKTIVITAS MENCUCI TANGAN DENGAN AIR, SABUN ANTISEPTIK, HAND SANITIZER GEL, DAN ALKOHOL 70% TERHADAP JUMLAH BAKTERI PADA TANGAN Dhyana Ratmaja, I Gusti Agung Ngurah; Darwinata, Agus Eka; Pinatih, Komang Januartha Putra; Fatmawati, Ni Nengah Dwi
E-Jurnal Medika Udayana Vol 12 No 8 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i08.P09

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Background: Hand washing is an activity that has to be achieved by everyone, by washing hands with excellent and correct techniques, able to make hands clean and of course can kill germs on the hands, good and proper hand washing can be done using soap and also running water or handwashing can also be done using alcohol or alcohol-based hand rubs. Methods: This research is an experimental study, One Group Pretest-posttest Design, taking primary data by taking samples from palms before and after washing using water, antiseptic soap, hand sanitizer gel, and alcohol 70%. Results: This study found that the effectiveness of washing hands with alcohol at 70% showed a decrease in bacterial number by 99%. In antiseptic soaps, there was a decrease in bacterial number by 86%. The use of hand sanitizer gel decreased bacterial number by 96%, and in water use, there was a decrease in bacterial number by 61%. Conclusion: alcohol 70% has the most significant effect in decreasing the number of bacterial colonies among other hand washing materials.
DETEKSI KEBERADAAN GEN hla SEBAGAI GEN PENYANDI ?-TOXIN HEMOLYSIN PADA ISOLAT METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) TERISOLASI DI LABORATORIUM MIKROBIOLOGI KLINIK RSUP PROF. DR. I.G.N.G. NGOERAH Saraswati, I Gusti Ayu Agung Putri Indria; Fatmawati, Ni Nengah Dwi; Darwinata, Agus Eka; Pinatih, Komang Januartha Putra
E-Jurnal Medika Udayana Vol 12 No 9 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i09.P18

Abstract

Latar Belakang : MDROs adalah mikrooganisme yang resisten terhadap beberapa antibiotic. Methicillin-resistant Staphylococcus aureus (MRSA) termasuk ke dalam MDROs, dimana dapat menyebabkan beberapa penyakit pada manusia seperti misalnya keracunan makanan dan infeksi kulit. Alfa-hemolysin merupakan salah satu faktor virulensi yang dimiliki oleh bakteri S. aureus termasuk MRSA. Faktor virulensi ini banyak berkontribusi dalam patogenesis beberapa penyakit dan infeksi pada tubuh manusia, beberapa diantaranya adalah pneumonia, abses otak, sepsis, infeksi kornea, sepsis artritis, bakteremia, trombositopenia. Oleh karena itu, sangat penting untuk dilakukan deteksi secara genotif terhadap keberadaan faktor virulensi ini dengan mendeteksi gen hla sebagai penyandi protein ?-hemolysin. Tujuan : Penelitian ini bertujuan untuk mengetahui keberadaan gen hla sebagai gen penyandi ?-hemolysin pada isolat MRSA di Laboratorium Mikrobiologi Klinik RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali. Metode : Penelitian ini merupakan penelitian potong lintang (cross-sectional) deskriptif. Sampel penelitian ini berjumlah 29 buah dan diambil dari stok gliserol MRSA di Laboratorium Mikrobiologi Klinik RSUP Prof. dr. I.G.N.G. Ngoerah, kemudian MRSA ditumbuhkan pada media agar darah. Selanjutnya, dilakukan isolasi DNA dengan menggunakan metode boiling. PCR dan elektroforesis dilakukan di Unit Laboratorium Biomedik Terpadu FK Unud divisi Bakteriologi dan Virologi. Setelah didapatkan hasil secara genotif, dilakukan inokulasi 2 sampel yang positif gen hla dan 2 sampel yang negative gen hla untuk konfirmasi secara fenotif keberadaan faktor virulensi ?-hemolysin. Hasil : Sebanyak 29 sampel yang diteliti, ditemukan sejumlah 7 sampel (24.14%) yang memiliki gen hla. Sejumlah 2 sampel (6.90%) berasal dari isolat darah, dan 5 sampel (14.24%) berasal dari isolat jaringan luka. Hasil inokulasi menunjukkan dari 4 sampel, sejumlah 3 sampel menunjukkan hasil positif ?-hemolysis dan 1 sampel tidak terdapat zona hemolysis. Simpulan : Berdasarkan penelitian yang dilakukan pada isolat MRSA yang terisolasi dari spesimen klinis di RSUP Prof. dr. I.G.N.G. Ngoerah pada tahun 2021, terdeteksi gen penyandi ?-toxin hemolysin (hla) dengan persentase sebesar 24.14%. Namun demikian terdapat perbedaan hasil antara deteksi genotif dan fenotif, mengindikasikan bahwa terdapat faktor virulensi lain yang dimiliki oleh MRSA untuk menimbulkan hemolisis.
Co-Authors Adhy Candra, I Kadek Bayu Agus Eka Darwinata Andi Yasmon Anggita Ratri Pusporini Aviana, Felicia Bagus Ngurah Putu Arhana Bryan Setiawan Budiman Bela Cynthia Dewi Sinardja Dave Gerald Oenarta Dea Antariksa Dharmika, Ida Ayu Gde Wahyudevi Dhyana Ratmaja, I Gusti Agung Ngurah Dwijastuti, Ni Made Sri F. S. Wignall Fera Ibrahim Gema Zakharian GNR Suwardana I Dewa Agung Gede Meisha Dhanam I Dewa Ayu Made Dian Lestari I Dewa Made Sukrama I G. A. Ngurah Aswin Panji Sanjaya I G. R. M. TEMAJA I Gede Agus Darsana Palgunadi I Gede Gita Sastrawan I Gede Pradnya Wisnu Murthi I Gede Raka Adhyatma I Gede Sathya Agastya I Gede Wikania Wira Wiguna I Gusti Agung Dyah Ambarawati I Gusti Agung Istri Gladys Elsyaningrat I Gusti Ayu Agung Praharsini I Gusti Ayu Janadewi I Gusti Ngurah Kade Mahardika I Gusti Ngurah Krishna Priyaka I Kadek Jaya Santika I Made Sathya Vijayananda I Made Sutha Saskara I Nengah Sujaya I Putu Bayu Mayura I Putu Bayu Mayura I Wayan Agus Gede Manik Saputra I Wayan Aryabiantara, I Wayan I Wayan Gustawan I Wayan Muda Suta Arta I Wayan Suranadi I. B. P. Dwija I.D.P.K. Pratiwi Ichlazul Ma’ruf Ida Ayu Andhira Dewi Suarisavitra Ida Bagus Gede Adiguna Wibawa Ida Sri Iswari Indramawan Setyojatmiko K. Subrata K. Wirasandhi Kadek Anggie Wigundwipayana Kadek Tresna Yuwana Ketut Tuti Parwati Komang Aditya Arya Prayoga KOMANG AYU NOCIANITRI Komang Januartha Putra Pinatih Luh Gede Melia Puspita Sari Made Agus Hendrayana Made Gede Dwi Lingga Utama Made Widianantara Marvin Giantoro N. K. Susilarini N.W.A. Utami Ni Kadek Seri Mahayanti Ni Luh Made Rasmawati Ni Made Adi Tarini Ni Made Mertaniasih Ni Made Susilawathi Ni Nyoman Sri Budayanti Ni Putu Wirantari Ni Wayan Eka Putri Gayatri Kastawa NMRP Dewi Prisela Zharaswati Prisillia Brigitta Putu Agung Satvika Pradnyadevi Putu Ayu Utami Prajawaty Putu Yoska Arya Harindana Rachmy Hamdiyati Raka-Sudewi A. A. Reny Rosalina Rian Ka Praja Saputra, Darmawan Jaya Saputra, I Wayan Agus Gede Manik Saraswati, I Gusti Ayu Agung Putri Indria Sonia Elvira Salim Surya Putra, I Gusti Agung Utama Wahyu Hidayati Wahyu Hidayati Wahyu Hidayati Yan Ramona