UJI RESISTENSI BAKTERI Salmonella typhi TERHADAP ...repository.upnvj.ac.id/2048/1/AWAL.pdf ·...
Transcript of UJI RESISTENSI BAKTERI Salmonella typhi TERHADAP ...repository.upnvj.ac.id/2048/1/AWAL.pdf ·...
UJI RESISTENSI BAKTERI Salmonella typhi TERHADAP
ANTIBIOTIK AMOKSISILIN, KLORAMFENIKOL,
KOTRIMOKSAZOL, SEFTRIAKSON, DAN
SIPROFLOKSASIN SECARA IN VITRO
SKRIPSI
IRVINA WANDA NOVIASTRI
1210211178
UNIVERSITAS PEMBANGUNAN NASIONAL “VETERAN” JAKARTA
FAKULTAS KEDOKTERAN
PROGRAM STUDI KEDOKTERAN
2016
UJI RESISTENSI BAKTERI Salmonella typhi TERHADAP
ANTIBIOTIK AMOKSISILIN, KLORAMFENIKOL,
KOTRIMOKSAZOL, SEFTRIAKSON, DAN
SIPROFLOKSASIN SECARA IN VITRO
SKRIPSI
Diajukan Sebagai Salah Satu Syarat Untuk Memperoleh
Gelar Sarjana Kedokteran
IRVINA WANDA NOVIASTRI
1210211178
UNIVERSITAS PEMBANGUNAN NASIONAL “VETERAN” JAKARTA
FAKULTAS KEDOKTERAN
PROGRAM STUDI KEDOKTERAN
2016
ii
iii
iv
v
UJI RESISTENSI BAKTERI Salmonella typhi TERHADAP
ANTIBIOTIK AMOKSISILIN, KLORAMFENIKOL,
KOTRIMOKSAZOL, SEFTRIAKSON, SIPRFLOKSASIN
SECARA IN VITRO
Irvina Wanda Noviastri
Abstrak
Salmonella typhi adalah bakteri penyebab penyakit demam tifoid. Kasus demam tifoid
meningkat dari tahun ke tahun dengan angka mortalitas 500/100.00 penduduk.
Penelitian bertujuan untuk menguji resistensi bakteri S. typhi terhadap antibiotik
Amoksisilin, Kloramfenikol, Kotrimoksazol, Seftriakson, dan Siprofloksasin.
Penelitian dilakukan secara eksperimental, menggunakan metode dilusi pengenceran
bakteri dengan konsentrasi 10-3, 10-4, 10-5 dan difusi Kirby-Bauer dengan Mueller
Hinton Agar dan disk antibiotik. Diameter zona hambat diukur dengan jangka sorong.
Zona hambat dinilai menurut sifatnya, yaitu resisten, intermediet dan sensitif. Hasil
yang didapatkan diolah dengan uji Kruskal-Wallis dan menunjukkan rata-rata diameter
zona hambat amoksisilin pada konsentrasi bakteri 10-3 bersifat intermediet, amoksisilin
pada konsentrasi bakteri 10-4 dan 10-5 bersifat resisten. kloramfenikol pada konsentrasi
bakteri 10-3 dan 10-4 bersifat sensitif, kloramfenikol pada konsentrasi bakteri 10-5
bersifat resisten, kotrimoksazol pada konsentrasi bakteri 10-3 dan 10-4 bersifat resisten,
kotrimoksazol pada konsentrasi bakteri 10-5 bersifat sensitif, seftriakson pada
konsentrasi bakteri 10-3, 10-4 dan 10-5 bersifat sensitif, siprofloksasin pada konsentrasi
bakteri 10-3, 10-4 dan 10-5 bersifat sensitif. Hasil penelitian menunjukkan bahwa S. typhi
bersifat resisten terhadap antibiotik amoksisilin, kloramfenikol dan kotrimoksazol.
Resistensi dapat terjadi karena bakteri menghasilkan inaktivator yang dapat
melemahkan kerja antibiotik dan mengubah binding site. Bakteri S. typhi menunjukkan
sifat sensitif terhadap antibiotik seftriakson dan siprofloksasin.
Kata Kunci : Salmonella typhi, Resistensi, Antibiotik
vi
RESISTANCE TEST OF Salmonella typhi BACTERIUM TO
AMOXICILLIN, CHLORAMPHENICOL, COTRIMOXAZOLE,
CEFTRIAXONE, AND CIPROFLOXACIN BACTERIUM BY IN
VITRO
Irvina Wanda Noviastri
Abstract
Salmonella typhi is a bacterium which can cause typhoid fever. The purpose of this
research is to test the resistance of S. typhi bacterium to Amoxicillin, Chloramphenicol,
Cotrimoxazol, Ceftriaxone, and Ciprofloxacin antibiotic. This research was done by
experimental methode and used dilution method to dilute the bacterium with 10-3, 10-
4, 10-5 concentration and Kirby-Bauer difution with Mueller Hinton Agar and disc
antibiotic. The inhibition zone diameter was measured by using a caliper. The
inhibition zone was rated based on that characters such as resistance, intermediate, and
sensitive. The result was treated with Kruskal-Wallis test and showed that the average
of Amoxicillin inhibition zone on 10-3 bacterium concentration was intermediate,
Amoxicillin on 10-4 and 10-5 was resistance. Chloramphenicol was sensitive on 10-3
and 10-4 bacterium concentration, Chloramphenicol was resistance on 10-5 bacterium
concentration. Cotrimoxazole was resistance on 10-3 and 10-4 bacterium concentration
but it was sensitive on 10-5 bacterium concentration. Ceftriaxone was sensitive on 10-
3, 10-4, 10-5 bacterium concentration and Ciprofloxacin was sensitive on 10-3, 10-4, 10-5
bacterium concentration. The results showed that S. typhi are resistant to the antibiotic
amoxicillin, chloramphenicol and cotrimoxazole. Resistance may occur because
bacteria produce inactivator which can weaken the antibiotics and changing the binding
site. Bacteria S. typhi sensitive to the antibiotics ceftriaxone and ciprofloxacin.
Key words : Salmonella typhi, Resistance, Antibiotics
vii
KATA PENGANTAR
Puji dan syukur penulis panjatkan kehadirat Allah SWT atas segala karunia-
Nya sehingga skripsi ini berhasil diselesaikan. Judul yang dipilih dalam penelitian
ini yang dilaksanakan sejak November 2015 ini adalah “Uji Resistensi Bakteri
Salmonella typhi Terhadap Antibiotik Amoksisilin, Kloramfenikol, Kotrimoksazol,
Seftriakson dan Siprofloksasin Secara In Vitro”. Terima kasih saya ucapkan kepada
dr. Mariono Reskoprododjo, Sp.OG, Sp.KP (K), selaku dekan Fakultas Kedokteran
UPN “Veteran” Jakarta, Ibu Meiskha Bahar, S.Si, M.Si dan dr. Leli Hesti Indriyati,
M.Kk, selaku dosen pembimbing skripsi yang telah memberikan banyak saran dan
dukungan yang sangat bermanfaat, dr. Winda Lestari, selaku koordinator skripsi
tingkat IV dan Ibu Titi selaku laboran Mikrobiologi UPN “Veteran” Jakarta.
Disamping itu, ucapan terima kasih juga kepada Eko Putranto, SH (Ayah),
Mutia Nofarida, B.Sc (Ibu), Febri Sastiviani Putri Cantika, SP., Joelanda Priesmalita
Deviani, SH, M.Kn (Kakak), dan Arkashadan Mahesakha AZ serta seluruh keluarga
yang tidak henti-hentinya memberikan penulis semangat dan do’a. Penulis juga
mengucapkan terima kasih kepada Herlianti Rizkia, Astrid Putri, Hafidha Nur,
Alif Perwira, Salsabila Pratiwi, Eka Sulistyowati, Vina Devi, Gresilva
Sevyanti, Najibah Zulfa, Lucky Resa, Hasna Ibadurrahmi, Paramita, Marlin,
Jonathan, Ikhsan Pratama, serta seluruh keluarga NRP 178 , serta seluruh
teman- teman angkatan 2012 yang tidak bisa saya sebutkan satu per satu.
Jakarta, 21 Maret 2016
Irvina Wanda Noviastri
viii
DAFTAR ISI
HALAMAN JUDUL ...................................................................................................... i
PERNYATAAN ORISINALITAS ............................................................................... ii PERNYATAAN PERSETUJUAN PUBLIKASI ........................................................ iii PENGESAHAN ........................................................................................................... iv
ABSTRAK .................................................................................................................... v ABSTRACT ................................................................................................................. vi KATA PENGANTAR ................................................................................................ vii DAFTAR ISI .............................................................................................................. viii
DAFTAR TABEL ......................................................................................................... x DAFTAR BAGAN ...................................................................................................... xi
DAFTAR GAMBAR .................................................................................................. xii
DAFTAR LAMPIRAN .............................................................................................. xiii
BAB I PENDAHULUAN ............................................................................................. 1
I.1 Latar Belakang ..................................................................................................... 1
I.2 Rumusan Masalah ................................................................................................ 3 I.3 Tujuan Penelitian ................................................................................................. 3 I.4 Manfaat Penelitian ............................................................................................... 4
BAB II LANDASAN TEORI ....................................................................................... 5
II.1 Tinjauan Pustaka .................................................................................................. 5 II.2 Kerangka Teori................................................................................................... 18
II.3 Kerangka Konsep ............................................................................................... 19 II.4 Hipotesis ............................................................................................................. 19
II.5 Penelitian Yang Relevan .................................................................................... 20
BAB III METODE PENELITIAN.............................................................................. 21
III.1 Jenis Penelitian ................................................................................................... 21 III.2 Lokasi dan Waktu Penelitian ............................................................................. 21
III.3 Subyek Penelitian ............................................................................................... 21 III.4 Teknik Pengambilan Sampel.............................................................................. 21 III.5 Besar Sampel ...................................................................................................... 22
III.6 Rancangan Penelitian ......................................................................................... 22 III.7 Identifikasi Variabel Penelitian .......................................................................... 22 III.8 Definisi Operasional........................................................................................... 23 III.9 Jenis Dan Cara Pengumpulan Data .................................................................... 23
III.10 Instrumen Penelitian.......................................................................................... 24 III.11 Alur Penelitian ................................................................................................... 25 III.12 Protokol Penelitian ............................................................................................ 26 III.13 Analisis Data ..................................................................................................... 29
ix
BAB IV HASIL DAN PEMBAHASAN .................................................................... 30 IV.1 Hasil Analisis Penelitian .................................................................................... 30 IV.2 Pembahasan ........................................................................................................ 40 IV.3 Keterbatasan Peneliti .......................................................................................... 45
BAB V KESIMPULAN DAN SARAN ...................................................................... 46 V.1 Kesimpulan ........................................................................................................ 46
V.2 Saran ................................................................................................................... 46
DAFTAR PUSTAKA ................................................................................................. 48 RIWAYAT HIDUP
LAMPIRAN
x
DAFTAR TABEL
Tabel 1 Penelitian Yang Relevan ................................................................................ 20
Tabel 2 Definisi Operasional ...................................................................................... 23
Tabel 3 Komposisi MHA ............................................................................................ 27
Tabel 4 Dosis dan Interpretasi Hasil Uji Resistensi .................................................... 29
Tabel 5 Rata-rata Diameter Zona Hambat .................................................................. 30
Tabel 6 Normalisasi Data ............................................................................................ 32
Tabel 7 Tabel Transformasi yang Dianjurkan ............................................................ 33
Tabel 8 Nilai Slope dan Power ................................................................................... 33
Tabel 9 Hasil Transformasi Data ................................................................................ 34
Tabel 10 Uji Varians Data .......................................................................................... 35
Tabel 11 Hasil Uji Kruskal-Wallis .............................................................................. 36
Tabel 12 Uji Post Hoc Mann-Whitney ....................................................................... 37
xi
DAFTAR BAGAN
Bagan 1 Kerangka Teori ............................................................................................. 18 Bagan 2 Kerangka Konsep .......................................................................................... 19 Bagan 3 Alur Penelitian .............................................................................................. 25
xii
DAFTAR GAMBAR
Gambar 1 Pewarnaan Gram Salmonella typhi .............................................................. 6
Gambar 2 Biakan S. typhi Pada Salmonella Shigella Agar ........................................... 7
xiii
DAFTAR LAMPIRAN
Lampiran 1 Surat Izin Penelitian
Lampiran 2 Surat Persetujuan Pra Proposal Penelitian
Lampiran 3 Surat Persetujuan Etik
Lampiran 4 Hasil Data Output SPSS
Lampiran 5 Diagram Hasil
Lampiran 6 Dokumentasi Peneliti