KEMAMPUAN PEMBENTUKAN BIOFILM DAN PERBEDAAN POLA KEPEKAAN ANTIFUNGAL ANTARA ISOLAT KLINIS CANDIDA SP PLANKTONIK DAN ISOLAT KLINIS CANDIDA SP BIOFILM

INAYATI, dr. Much. Mustafa, SU, SpMK(K)

2014 | Tesis | Mikrobiologi Klinik

Jamur Candida sp sering menjadi penyebab infeksi di seluruh dunia , selain sebagai flora normal pada manusia. Manifestasi infeksi Candida sp dihubungkan dengan kemampuan membentuk biofilm yang berimplikasi klinis negatif. Sel yang tertutup biofilm terhindar dari respon imun hospes dan efek antifungal sehingga infeksi sulit disembuhkan dengan terapi konvensional. Biofilm Candida sp menunjukkan resistensi terhadap antifungal spektrum luas. Tujuan penelitian adalah mengetahui pola kepekaan antifungal Ketokonazol, Itrakonazol dan Flukonazol terhadap isolat klinis Candida sp yang mampu membentuk biofilm dan melihat perbedaan pola kepekaan antifungal antara isolat Candida sp dalam bentuk Biofilm dengan isolat Candida sp dalam bentuk Planktonik Metode penelitian deskriptif laboratorik dengan rancangan Cross sectional pada isolat klinis Candida sp koleksi Laboratorium Mikrobiologi FK UGM Yogyakarta. Kemampuan membentuk biofilm diuji pada microplate 96-wheel, dihirung intensitas biofilm dengan pengecatan Crystal Violet. Pemeriksaan Uji Kepekaan Antifungal isolat Candida sp dalam bentuk Planktonik dan Biofilm dengan metode dilusi cair pada microplate 96-wheel. Hasil penelitian terdapat 24 sampel isolat klinis Candida sp, 70,8% intensitas kemampuan membentuk biofilm kuat dan 29,2% menunjukkan intensitas sedang. Pola kepekaan isolat klinis Candida sp planktonik terhadap Flukonazol 100% sensitif , terhadap. Ketokonazol 78,9 % sensitif dan terhadap Itrakonazol 57,9 % sensitif. Pola kepekaan isolat klinis Candida sp biofilm terhadap Ketokonazol 31,6 % sensitif , terhadap Itrakonazol sebanyak 21,1 % sensitif dan terhadap Flukonazol 31,6% sensitif, menunjukkan terjadi penurunan persentase sensitif dan peningkatan persentase resisten isolat klinis Candida sp. Nilai MIC isolat klinis Candida sp biofilm 2 sampai ≥ 33 kali nilai MIC isolat klinis Candida sp planktonik. Kesimpulan terdapat perbedaan Pola kepekaan antara isolat klinik Candida sp planktonik dengan isolat klinik Candida sp biofilm terhadap antifungal yaitu penurunan persentase sensitif dengan peningkatan nilai MIC isolat klinis Candida sp biofilm 2 sampai ≥ 33 kali dibandingkan nilai MIC isolat klinis Candida sp planktonik

Although Candida sp is known as a normal flora in humans’ body, this fungus has frequently become a cause of infection worldwide.Manifestations of Candida sp infection are associated with the ability to form biofilms that has negative clinical implications. Cell covered by biofilm is unreachable by host immune response to infection and the effects of antifungal, thus the infection is difficult to be treated with conventional therapy. Biofilms of Candida sp show resistance to broad-spectrum antifungal. The objective of this study were to determine the antifungal susceptibilty pattern of Ketoconazole, Itraconazole and Fluconazole against Candida sp clinical isolates which form biofilms and to identify the difference of antifungal susceptibility pattern between clinical isolates of biofilm Candida sp and planctonic Candida sp This research used laboratory descriptive methode with cross sectional design using clincal isolates of Candida sp which were collected from the Laboratory of Microbiology Faculty of Medicine Gadjah Mada University Yogyakarta. The ability to form biofilm was tested on 96- wheel microplate and the intensity of biofilm formation was determined by staining with Crystal Violet. The atifungal susceptibility test of clinical isolates both planktonic and biofilm Candida sp was done by using liquid dilution methode on 96-wheel microplate Result showed that among 24 clinical isolates of Candida sp, 70.8% has strong intensity on the ability to form biofilm and 29.2% showed moderate intensity. Susceptibility pattern of clinical isolates of planktonic Candida sp against Fluconazole, Ketokonazole and Itraconazole are 100%, 78.9% and 57.9% respectively. Meanwhile susceptibilty pattern of clinical isolates of biofilm Candida sp against Ketoconazole, Itraconazole and Fluconazole are 31.6%, 21.1% and 31.6% respectively. This study indicates a decline on percentage of sensitive and an increase on percentage of resistant among clinical isolates of Candida sp. The MIC values of clinicalisolates of biofilm Candida sp was 2 to ≥ 33 times more than the MIC values of clincal isolates of planktonic Candida sp. The study concludes that the difference on the antifungal susceptibility between clinical isolates of planktonic Candida sp and clinical isolates of biofilms Candida sp were decline pattern of the sensitivity percentage and an increase pattern of resistance percentage. MIC values of clinical isolates of biofilm Candida sp were 2 to ≥ 33 times higher than the MIC clinical isolates of planktonic Candida sp

Kata Kunci : Biofilm Candida sp, Pola Kepekaan Antifungal, Nilai MIC