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All Journal Majalah Kedokteran Bandung Althea Medical Journal
Sunarjati Sudigdoadi
Department of Microbiology and Parasitology, Faculty of Medicine Universitas Padjadjaran
Medicine & Pharmacology

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Analisis Tipe Staphylococcal Cassette Chromosome mec (SCCmec) Isolat Methicillin Resistant Staphylococcus aureus (MRSA) Sudigdoadi, Sunarjati
Majalah Kedokteran Bandung Vol 42, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Resistensi methicillin resistant Staphylococcus aureus (MRSA) terhadap berbagai antimikrob terutama didasari adanya insersi mobile genetic elements yang disebut Staphylococcal cassette chromosome mec (SCCmec) pada kromosom Staphylococcus aureus. SCCmec tersusun atas gen rekombinase (ccr), gen kompleks mec, gen resisten tambahan, dan insertion sequences. Struktur gen rekombinase memungkinkan SCCmec dapat berpindah dari satu bakteri ke bakteri lainnya. Identifikasi dan analisis SCCmec sangat diperlukan untuk mengetahui dasar genetik resistensi dan memperkirakan penyebaran bakteri ini. Penelitian ini bertujuan menganalisis tipe SCCmec dan hubungannya dengan pola kepekaan MRSA terhadap berbagai antimikrob. Penelitian ini adalah penelitian observasional analitik dengan pendekatan molekuler berupa typing SCCmec dan uji kepekaan terhadap antimikrob, periode Juli–Desember 2007. Pembiakan dan identifikasi 45 isolat MRSA dilakukan di Departemen Mikrobiologi Fakultas Kedokteran Unpad, sedangkan penentuan gen mecA dan PCR multipleks SCCmec dilakukan di Fakultas Kedokteran Universitas Sriwijaya, Palembang. Seluruh 45 isolat MRSA yang diteliti, dipastikan memiliki gen mecA. Analisis PCR multipleks menunjukkan 40 isolat memiliki SCCmec tipe III dan 5 isolat memiliki tipe IV. Semua isolat dengan SCCmec tipe III bersifat multiresisten, sedangkan tipe IV tidak bersifat multiresisten. Dapat disimpulkan bahwa MRSA dengan genotip SCCmec tipe III berhubungan, sedangkan tipe IV tidak berhubungan dengan sifat multiresisten. [MKB. 2010;42(4):149–54].Kata kunci: Methicillin resistant Staphylococcus aureus(MRSA) , pola kepekaan, tipe SCCmecStaphylococcal Casette Chromosome mec (SCCmec) Type Analysis of Methicillin Resistant Staphylococcus aureus (MRSA) IsolatesResistance of methicillin resistant Staphylococcus aureus (MRSA) were based mainly on insertion of mobile genetic elements namely Staphylococcal cassette chromosome mec (SCCmec) in the chromosome of Staphylococcus aureus. SCCmec consists of recombinase genes (ccr), mec genes complex, additional resistance genes, and insertion sequences. Recombinase genes structure mediates transfer of SCCmec from one bacteria to another. Identification of SCCmec is very important to know basic genetic resistance and to predict spreading of MRSA. The aim of this research was to analyze SCCmec type and antimicrobial susceptibility patterns. The design of this study was observational analytic study by typing SCCmec and antimicrobial susceptibility testing on July– December 2007. Isolation and identification of 45 MRSA isolates was performed in the Department of Microbiology, Faculty of Medicine, University of Padjadjaran, whereas identification of mecA gene and typing of SCCmec by multiplex PCR was performed in the Department of Microbiology, Faculty of Medicine, Sriwijaya University, Palembang. The result showed that all isolates contained mecA gene. Multiplex PCR revealed that 40 MRSA isolates had SCCmec type III and 5 isolates with type IV. All SCCmec type III isolates were multiresistant and all of the type IV were not multiresistant. In conclusion, MRSA isolates with SCCmec type III was associated with multiresistant whereas type IV was not. [MKB. 2010;42(4):149–54].Key words: Methicillin resistant Staphylococcus aureus (MRSA), susceptibility patterns, type of SCCmec DOI: http://dx.doi.org/10.15395/mkb.v42n4.28
Isolasi Bacillus thuringiensis Lokal dari Tanah Kota Bandung Berdasarkan Ketinggian Sudigdoadi, Sunarjati; Sukandar, Hadyana; Faridah, Lia
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n2.1055

Abstract

Demam dengue (DD) merupakan penyakit endemis di negara berkembang termasuk Indonesia. Kasus DD di Kota Bandung mencapai angka tertinggi di antara kota lain di Jawa Barat, yaitu sebesar 1.180 kasus. Belum ditemukan obat yang tepat dalam menangani infeksi ini. Walaupun sudah ditemukan vaksin, namun penggunaan vaksin ini masih terbatas pada usia dan kalangan tertentu. Dengan demikian, pengendalian vektor baik secara kimiawi maupun biologis, masih menjadi prioritas. Salah satu agen biologis untuk mengendalikan populasi larva nyamuk adalah Bacillus thuringiensis (Bt). Penelitian dilakukan selama bulan Januari–Desember 2015. Penelitian ini merupakan suatu eksperimen dengan rancangan faktorial yang bertujuan mendapatkan isolat Bt dari tanah di berbagai ketinggian di Kota Bandung. Sampel tanah diambil dari ketinggian 600 m, 800 m, serta 1000 m dan setiap ketinggian diambil 3 lokasi dengan metode acak. Bt diisolasi dengan medium selektif. Isolat bakteri yang diperoleh kemudian diidentifikasi dengan pewarnaan gram, pengamatan endospora subterminal, uji fermentasi glukosa, sitrat, indol, dan manitol. Kelimpahan Bt di tiap ketinggian dihitung menggunakan Bt index. Hasil identifikasi mendeteksi terdapat 3 isolat yang menunjukkan kemiripan dengan Bt, yaitu isolat STBD.2.02, CBRM.3.01, dan KOPO.3.02. Nilai Bt index menunjukkan kelimpahan Bt di ketinggian 800 m lebih tinggi dibanding dengan ketinggian yang lain. [MKB. 2017;49(2):110–4]   Kata kunci: Bacillus thuringiensis lokal, Bandung, ketinggian, tanah     Local Bacillus thuringiensis Isolation from Bandung Soil by Altitude Dengue fever (DF) is an endemic disease in developing countries including Indonesia. Bandung has the highest number of Dengue Fever in West Java Province with 1,180 cases. There  is currently  no drugs or vaccines that can prevent dengue fever and dengue hemorrhagic fever, making vector control, both chemically and biologically, the primary prevention approach. One biological agent that has been used to control the larval population is Bacillus thuringiensis (Bt). This study is an experimental study with factorial design aimed to obtain Bt isolates from soil of various altitude around Bandung city area period January to December 2015. Soil samples were acquired from 600 m, 800 m and 1,000 m above sea level. Sampling was conducted randomly from 3 points at every altitude. Bt were isolated with a selective medium. The acquired bacteria samples were then identified using gram stain, subterminal endospore observation, as well as glucose fermentation, citrate, indole, and manitol tests. Bt abundance for each altitude was calculated using Bt index. Three isolates with similarity with Bt were identified, i.e. STBD 2.02, CBRM 3.01 and KOPO 3.02 isolates. Bt index value indicates that the abundance of Bt at 800 m altitude is the highest compared to others. [MKB. 2017;49(2):110–4]   Key words: Altitude, Bandung, local Bacillus thuringiensis, soil
Gambaran Partisipasi Masyarakat terhadap Pengendalian Vektor Melalui Kajian Tempat Perkembangbiakan Aedes aegypti di Kota Bandung Faridah, Lia; Respati, Titik; Sudigdoadi, Sunarjati; Sukandar, Hadyana
Majalah Kedokteran Bandung Vol 49, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (184.081 KB) | DOI: 10.15395/mkb.v49n1.986

Abstract

Pada tahun 2014, Bandung memiliki angka kasus demam dengue (DD) tertinggi dari 27 kabupaten/kota di Jawa Barat. Upaya pengendalian DD telah dilaksanakan sejak beberapa dekade yang lalu. Salah satu upaya adalah dengan mengeliminasi tempat perkembangbiakan nyamuk melalui peran serta masyarakat. Penelitian ini bertujuan menilai partisipasi masyarakat Kota Bandung dengan mengetahui tempat-tempat perkembangbiakan Aedes aegypti baik di dalam maupun di luar rumah. Sampling dilakukan di 16 kelurahan di Kota Bandung yang telah dipilih berdasar atas angka kejadian DD, kepadatan penduduk, ketinggian permukaan, dan status sosial-ekonomi periode 2015. Populasi penelitian adalah rumah-rumah yang terdapat di 16 kelurahan tersebut. Jumlah sampel penelitian ini adalah 1.983 rumah yang merupakan perwakilan dari tiap kelurahan. Sampling jentik dilakukan pada berbagai tempat penampungan air, baik penampungan alami maupun buatan di sekitar pemukiman penduduk. Jentik yang ditemukan dimasukkan ke dalam wadah dan dibawa ke laboratorium untuk diidentifikasi dan dihitung jumlahnya. Hasil menunjukkan tempat perkembangbiakan nyamuk yang paling dominan adalah bak mandi (50%), talang air (24%), dan dispenser (15%). Data entomologi diperoleh hasil House index (HI) 24%, Container index (CI) 12%, dan Breteau index (BI) 36%. Hasil tersebut menunjukkan masih kurangnya peran serta masyarakat untuk mencegah DD dengan membasmi tempat perkembangbiakannya dan Kota Bandung masih berpotensi untuk terjadi penyebaran penyakit DD. [MKB. 2016;49(1):42–7]Kata kunci: Aedes aegypti, Bandung, demam dengue, tempat perkembangbiakan, partisipasi masyarakat Community Participation on Vector Control Based on Aedes aegypti’s Breeding Sites in BandungIn 2014, Bandung has the highest number of Dengue Fever cases of 27 districts and cities in West Java. Dengue Fever control efforts have been implemented for several decades. One of the efforts is the eradication of the vector breeding site with community participation. The aim of this study was to assess community participation by identifying Aedes aegypti’s breeding sites, both indoor and outdoor, in Bandung area. Sampling was conducted on houses in 16 villages throughout Bandung area. The sampling points were selected according to the Dengue Fever event number, population density, height, and socio-economic status. The total sample points were 1983 houses. Larvae from sample points were collected from various water containments, both natural and manmade, around the settlement. The larvae samples were then brought to the laboratory to be identified and counted. Results indicated the dominant breeding sites were bathtub (50%), gutter (24%), and dispenser (15%). Entomological survey resulted in 24% HI, 12% CI, and 36% BI. This indicates the lack of community participation in preventing DF by eradicating vector’s breeding sites and Bandung is still potential for DF outbreak. [MKB. 2016;49(1):42–7]Key words: Aedes aegypti, Bandung, breeding site, dengue fever, community pasticipation
Pengaruh Ekstrak Etanol Propolis Terhadap Aktivitas dan Kapasitas Fagositosis pada Kultur Makrofag yang Diinfeksi Enteropathogenic Escherichia coli (EPEC) Herawati, Iis; Husin, Usep A.; Sudigdoadi, Sunarjati
Majalah Kedokteran Bandung Vol 47, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penanganan penyakit infeksi diperlukan suatu imunostimulator. Propolis adalah campuran resin yang dikumpulkan lebah dari tumbuh-tumbuhan, digunakan sebagai material isolasi sarang lebah, merupakan bahan yang berpotensi sebagai imunostimulator. Penelitian dilakukan di Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada, pada Januari–Maret 2013. Penelitian ini bertujuan menganalisis peningkatan aktivitas dan kapasitas fagositosis kultur makrofag yang diberi ekstrak etanol propolis terhadap Enteropathogenic Escherichia coli (EPEC). Desain penelitian eskperimen. Ke dalam kultur makrofag yang diperoleh dari tiga orang subjek, masing-masing diberi ekstrak etanol propolis 6,25, 12,5, 25, 50, dan 100 µg/mL serta kontrol tanpa ekstrak etanol propolis. Inkubasi dilakukan satu hari. Kultur diinfeksikan EPEC selama 30 menit, diwarnai dengan Giemsa dan diamati dengan mikroskop. Persentase aktivitas fagositosis diperoleh dengan menghitung jumlah makrofag yang aktif dalam 100 makrofag. Nilai kapasitas fagositosis diperoleh dengan menghitung jumlah bakteri yang difagosit oleh 50 makrofag. Uji analysis of variance (ANOVA) menunjukkan perbedaan signifikan aktivitas maupun kapasitas fagositosis kultur makrofag yang diberi ekstrak etanol propolis dibanding dengan kontrol (p=0,000). Uji Tukey HSD pada aktivitas fagositosis menunjukkan hasil signifikan antara kontrol dan konsentrasi 6,25 µg/mL (p=0,008), sedangkan pada kapasitas fagositosis terlihat antara kontrol dan konsentrasi 12,5 µg/mL (p=0,001). Simpulan, ekstrak etanol propolis meningkatkan aktivitas dan kapasitas fagositosis kultur makrofag terhadap EPEC dengan konsentrasi minimum 12,5 µg/mL. [MKB. 2015;47(2):102–8]Kata kunci: Aktivitas fagositosis, Enteropathogenic Escherichia coli (EPEC), kapasitas fagositosis, makrofag, propolis.    The Effect of Ethanolic Extract Propolis on Phagocytosis Activity and Capacity Macrophages Culture which Infected by Enteropathogenic Escherichia coli (EPEC)AbstractThe use of immunostimulant for treatment infectious diseases is needed. Propolis is mixture of resin collected from plants by bees, used as an insulating material in beehives, which has potential as immunostimulant. The research was performed at Laboratory of research and integrated testing Gadjah Mada University in January−March 2013. This experimental research is amied to analyze the increase of phagocytosis activity and capacity on macrophages culture which added by propolis ethanolic extract againts Enteropathogenic Escherichia coli (EPEC). The design research is experimental. Macrophage culture obtained from three subjects, individually culture supplemented with the propolis ethanolic extract 6.25, 12.5, 25, 50, and 100 µg/mL as well as control without the addition of propolis ethanolic extract. The cultures were incubated for one day. Macrophage cultures infected by EPEC for 30 minutes, stained by Giemsa and observed by microscope. Percentage of phagocytosis activity is determined by the number of active macrophages per 100 macrophages. Phagocytosis capacity value determined by counting the number of bacteria that phagocytized by 50 macrophages.  Analysis of variance (ANOVA) showed significantly different phagocytosis activity and capacity between macrophage cultures that added by propolis ethanolic extract and control (p=0.000). Tukey HSD analysis showed significantly different phagocytosis activity between control and subject with concentration 6.25 µg/mL (p=0.008) whereas on phagocytosis capacity appears between control and subject with concentration 12,5 µg/mL (p=0.001). In conclusion, propolis ethanolic extract is able to increase the phagocytosis activity and capacity of macrophages againts EPEC with minimum concentration 12.5µg/mL. [MKB. 2015;47(2):102–8] Key words: Enteropathogenic Escherichia coli (EPEC), macrophage, phagocytosis activity, phagocytosiscapacity, propolis DOI: 10.15395/mkb.v47n2.460
Methicillin-Resistant Staphylococcus aureus pada Penderita Dermatitis Atopik dan Sensitivitasnya terhadap Mupirosin Dibandingkan dengan Gentamisin Istasaputri M., Keni; Sutedja, Endang; Suwarsa, Oki; Sudigdoadi, Sunarjati
Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) mulai dijumpai pada penderita dermatitis atopik (DA) derajat sedang hingga berat dan bersifat multiresisten terhadap antibiotik topikal. Gentamisin telah digunakan secara luas, sedangkan mupirosin merupakan pilihan utama eradikasi MRSA. Penelitian ini bertujuan untuk mengetahui kolonisasi MRSA pada penderita DA dan sensitivitasnya terhadap mupirosin dibandingkan dengan gentamisin di Poliklinik Departemen Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Survei potong lintang analitik dilakukan selama 19 September–31 Oktober 2011 terhadap 22 penderita DA derajat sedang hingga berat sesuai dengan Scoring Atopic Dermatitis objektif dan 22 individu sehat. Seluruh subjek dilakukan pemeriksaan apusan kulit untuk deteksi MRSA dan uji sensitivitas terhadap mupirosin dan gentamisin. Pada kedua kelompok masing-masing didapatkan 10 laki-laki dan 12 perempuan. Pada kelompok penderita DA didapatkan DA derajat sedang (10/22) dan berat (12/22), dengan lesi akut (14/22) dan kronik (8/22). Pertumbuhan S. aureus didapatkan pada 17/22 penderita DA dengan sensitivitas terhadap mupirosin 14/17 dan gentamisin 11/17 penderita. Pada individu sehat tidak didapatkan pertumbuhan koloni S. aureus. Galur MRSA ditemukan pada 3/17 penderita DA dan dianggap berbeda secara bermakna bila dibandingkan dengan individu sehat (p<0,01), galur ini bersifat sensitif terhadap mupirosin pada 2/3 penderita dan seluruhnya resisten terhadap gentamisin. Simpulan, kolonisasi MRSA perlu dicurigai pada penderita DA derajat sedang hingga berat, sehingga perlu pengobatan tambahan antibiotik topikal mupirosin. [MKB. 2013;45(1):36–44]Kata kunci: Dermatitis atopik, gentamisin, MRSA, mupirosinMethicillin-Resistant Staphylococcus aureus in Atopic Dermatitis Patients and Its Sensitivity to Mupirocin Compared to GentamycinMethicillin-resistant Staphylococcus aureus (MRSA) is found in moderate to severe atopic dermatitis (AD) and is multiresistant against topical antibiotic. Gentamycin is widely used while mupirocin is the first line therapy to eliminate MRSA. This research is intended to observe the colonization of MSRA case in AD patients and its sensitivity to mupirocin compared to gentamycin in Dermato-venereology Clinic Dr. Hasan Sadikin General Hospital Bandung. An analytical cross sectional survey was intended from 19th September–31st October 2011 in 22 moderate to severe AD patients based on objective Scoring Atopic Dermatitis and 22 healthy persons. All subjects went through skin-scraping, MSRA was detected and sensitivity test was done for mupirocin and gentamycin. The subjects consisted of 10 boys and 12 girls in both group. Based on severity, 10/22 of AD subjects were in moderate AD and 12/22 were severe AD, 14/22 of AD subjects presented with acute lesions and 8/22 subjects had chronic lesions. In the group of AD patients, 17/22 growth of S. aureus were found with sensitivity against mupirocin 14/17 and gentamycin 11/17. In healthy individual group, no  S. aureus growth was found. Methicillin-resistant Staphylococcus aureus strain in AD patients was observed on 3/17 patients, and this was declared significantly different compared to healthy individuals (p <0.01). The isolates in 2/3 patients were sensitive to mupirocin and all patients were resistant to gentamycin. In conclusion, the patients of moderate to severe AD are prone to MRSA colonization and therefore requires mupirocin topical antibiotic treatment.  [MKB. 2013;45(1):35–43]Key words: Atopic dermatitis, gentamycin, MRSA, mupirocin DOI: http://dx.doi.org/10.15395/mkb.v45n1.203
Co-Authors Abdullah Firmansyah W., Abdullah Andri Rezano Andriana Purnama, Andriana Aris Primadi, Aris Bayu A. P. Wilopo, Bayu A. P. bin Mohd Rafee, Mohd Hafeez Dewanto, Julius B Edhyana Sahiratmadja Endang Sutedja Gaga Irawan Nugraha Gowre Govindasamy Hadyana Sukandar Hardisiswo Soedjana Huthamaputiran, Theruna IIS HERAWATI Intan M. W. Dewi, Intan M. W. Iswandari, Nadya Jeevanisha Patmanathan, Jeevanisha Kavita Arumugam, Kavita Keni Istasaputri M. Lia Faridah Oki Suwarsa Ricky Adriansjah Syamsul Arifin Syed Anwar Husain, Syed Anwar Titik Respati Usep A. Husin, Usep A. Usep Abdullah Husin Yanti Mulyana Yodya Evila, Yodya Yoni Fuadah Syukriani