Antibiotic Susceptibility Assay of Methicillin-resistant Staphylococcus aureus (MRSA) against Co-trimoxazole

ARSTIPUTRI NINDYA P, dr. Abu Tholib Aman, M.Sc., Ph. D., Sp. MK (K); dr. Titik Nuryastuti, M. Si., Ph. D, Sp. MK ; Dr. dr. Hera Nirwati, M. Kes, Sp. MK

2017 | Skripsi | S1 PENDIDIKAN DOKTER

INTISARI Uji Kepekaan Bakteri Methicillin-resistant Staphylococcus aureus (MRSA) Terhadap Co-trimoxazole Latar Belakang Methicillin-resistant Staphylococcus aureus (MRSA) adalah Staphylococcus aureus yang resisten terhadap antibiotik ß-lactam. Kemunculan MRSA adalah sebuah masalah klinis berkelanjutan karena akibat yang ditimbulkannya mempersulit kontrol dan pengobatan infeksi. Saat ini, Vancomycin masih merupakan pengobatan pilihan untuk MRSA tetapi kemunculan resistensi terhadap Vancomycin, mengharuskan pemakaian rasional obat ini dan menjadi krusial untuk menemukan opsi obat lain yang sensitif terhadap MRSA. Co-trimoxazole, senyawa yang terdiri dari Trimethoprim dan Sulfamethoxazole menyerang bakteria melalui mekanisme yang berbeda dari ß-lactam, dengan mekanisme yang menyerang metabolisme folate pada jalur replikasi DNA bakteri, Co-trimoxazole memiliki potensi sebagai alternatif pengobatan MRSA. Dalam penelitian ini, kepekaan MRSA terhadap Co-trimoxazole diuji. Mengetahui presentasi isolat Methicillin-resistant Staphylococcus aureus (MRSA) yang sensitif terhadap Co-trimoxazole akan memberikan gambaran apakah obat Co-trimoxazole dapat menjadi obat yang potensial sebagai alternatif pengobatan MRSA. Tujuan Mengetahui proporsi isolat Methicillin-resistant Staphylococcus aureus (MRSA) sensitif terhadap Co-trimoxazole. Metode Penelitian ini menggunakan metode observasi laboratorium. Subyek penelitian adalah isolat Methicillin-resistant Staphylococcus aureus (MRSA) yang disediaakan oleh Departemen Mikrobiologi Universitas Gadjah Mada dengan isolat yang telah terbukti membawa gen MecA. Variable bebas adalah Co-trimoxazole. Metode uji kepekaan bakteri adalah Kirby-Bauer disk difusi, hasil penelitian dikategorikan menjadi sensitive, intermediate, dan atau resisten. Hasil Proporsi isolat Methicillin-resistant Staphylococcus aureus (MRSA) Departemen Mikrobiologi, Fakultas Kedokteran, Universitas Gadjah Mada yang terbukti sensitif terhadap Co-trimoxazole adalah 100%, total lima dari 5 isolat adalah sensitif. Conclusion Proporsi isolat Methicillin-resistant Staphylococcus aureus (MRSA) Departemen Mikrobiologi, Fakultas Kedokteran, Universitas Gadjah Mada yang terbukti sensitif terhadap Co-trimoxazole adalah 100%, total lima dari 5 isolat adalah sensitif, hasil tersebut mengindikasikan potensi Co-trimoxazole sebagai alternatif pengobatan MRSA.

ABSTRACT Antibiotic Susceptibility Assay of Methicillin-resistant Staphylococcus aureus (MRSA) against Co-trimoxazole Background Methicillin-resistant Staphylococcus aureus (MRSA) is Staphylococcus aureus strain that gains resistance to antibiotics, mostly ß-lactams and several other non ß-lactams. Emergence of MRSA has been a continuous problem in clinical setting as this complicates infection control and treatment choices. As for now, Vancomycin still remains to be the treatment of choice for MRSA but resistance to Vancomycin has also been reported and the need for rational use of this agent makes it crucial for clinicians to find other option available that is susceptible for MRSA with non-inferiority in clinical efficacy and cost effectiveness. Co-trimoxazole, a compound consists of Trimethoprim and Sulfamethoxazole acts on bacteria through different pathways from ß-lactam, by inhibiting two sites of folic acid pathway, it just might be an alternative treatment choice to treat MRSA. It is though important to notice whether Staphylococcus aureus has been resistant to Co-trimoxazole and through this research the susceptibility of MRSA isolates to Co-trimoxazole is tested. Knowing the percentage of Methicillin-resistant Staphylococcus aureus (MRSA) isolates susceptible to Co-trimoxazole will give a small picture whether or not the antimicrobial agent Co-trimoxazole can be used as alternative for treating Methicillin-resistant Staphylococcus aureus (MRSA) in clinical setting. This research will benefit for further study regarding this issue. Objectives The objective of this research is to know the proportion of Methicillin-resistant Staphylococcus aureus (MRSA) susceptible to Co-trimoxazole. Method This research uses Observational laboratory method. The subject of this research is Methicillin-resistant Staphylococcus aureus (MRSA) isolates owned by Department of Microbiology Universitas Gadjah Mada retrieved from previous international study. The independent variable is antimicrobial agent Co-trimoxazole. MRSA isolates is tested with Kirby-Bauer antibiotic susceptibility assay against Co-trimoxazole with outcome of susceptible, intermediate, or resistant. Results The proportion of Methicillin-resistant Staphylococcus aureus (MRSA) isolates from Departement of Microbiology, Faculty of Medicine, Universitas Gadjah Mada observed to be susceptible to Co-trimoxazole is 100%, a total five out of 5 isolates are classified as susceptible. Conclusion Susceptibility indicates a potentiality of Co-trimoxazole use as an alternative drug choice for MRSA.

Kata Kunci : Antibiotic susceptibility assay, Co-trimoxazole, MRSA, Methicillin-resistant Staphylococcus aureus, 2017, disk diffusion, susceptibility, resistance