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Antibiogram bakteri aerob pada otitis media supuratif kronik di RSUP Sanglah Denpasar tahun 2015-2017

Abstract

Antibiotic used in chronic suppurative otitis media (CSOM) should be based on pathogens and their antibiotic susceptibility test results. This examination takes few days to give a result thus empirical therapy based on bacterial antibiogram become important. The increasing of prevalence of multi resistant bacteria, as well as changes in the sensitivity among the same strains, indicate the need for bacteriological surveys of CSOM to be carried out continuously and periodically. This study aimed to describe the sensitivity pattern of aerobic bacteria in CSOM in the ENT outpatient clinic of Sanglah General Hospital in 2015-2017 as an empirical therapy. This study was a descriptive study using a cross sectional design. The research sample was all CSOM patients who carried out bacterial culture and sensitivity tests at Sanglah General Hospital Denpasar in 2015 to 2017. Of the total 37 samples, 45.9% were male while 54.1% were female. The age range ranged from 1-74 years with the commonest age group being 31-40 years (29.6%). Aerobic bacteria that could be isolated and identified included Pseudomonas aeruginosa as much as 54.1% (20), Staphylococcus aureus, Klebsiella pneumonia, Achromobacter xylosoxidans, Acinetobacter baumanii, Morganella morganii, and Staphylococcus haemolyticus, each of 2.7% (1). Whereas in 5.4% (2) was Candida sp and 24.3% (9) obtained regional normal flora. Pseudomonas aeruginosa was sensitive to meropenem (100%), amikacin (95%), gentamycin (95%), ceftazidime (90%), cefepime (95%), aztreonam (80%), and ciprofloxacin (75%). Isolated Staphylococcus aureus was identified as Methicillin Resistant Staphylococcus aureus (MRSA) and sensitive to quinupristin-dalfopristin, linezolid, vancomycin, doxicyclin, minocycline, tetracyclin, and rifampicin. Staphylococcus haemolyticus was sensitive to quinupristin-dalfopristin, linezolid, vancomycin, doxicyclin, tetracyclin, and rifampicin. Klebsiella pneumonia, Achromobacter xylosoxidans, Acinetobacter baumanii, and Morganella morganii are sensitive to ceftazidime, meropenem, amikasin, and cefepime. In this study, aerob bacterium of CSOM was dominated by Pseudomonas aeruginosa, which were sensitive to meropenem, amikacin, gentamycin, ceftazidime, cefepime, aztreonam, and ciprofloxacin.

 

Pemilihan antibiotik pada kasus otitis media supuratif kronik (OMSK) sebaiknya berdasarkan jenis bakteri penyebab penyakit serta data uji kepekaan antibiotik. Mengingat hasil pemeriksaan penunjang tersebut memerlukan waktu beberapa hari, maka pengobatan secara empirik berdasarkan antibiogram bakteri penyebab penyakit menjadi sangat penting. Pemetaan bakteri tersebut perlu dilakukan secara kontinyu dan periodik karena pada beberapa penelitian didapatkan prevalensi bakteri multiresisten yang meningkat dan perubahan sensitivitas bakteri dengan strain yang sama. Penelitian ini bertujun untuk mengetahui gambaran pola kepekaan bakteri aerob pada OMSK di Poliklinik THT-KL RSUP Sanglah tahun 2015-2017 yang dapat digunakan sebagai terapi empirik. Penelitian ini bersifat deskriptif dengan menggunakan potong lintang. Sampel penelitian adalah semua pasien OMSK yang dilakukan kultur bakteri dan uji sensitivitas di RSUP Sanglah Denpasar pada tahun 2015 sampai 2017. Pada penelitian ini dari total 37 sampel, 45,9% adalah lelaki sedangkan 54,1% adalah perempuan. Rentang umur berkisar antara 1-74 tahun dengan kelompok umur terbanyak adalah 31-40 tahun (29,6%). Bakteri aerob yang teridentifikasi antara lain Pseudomonas aeruginosa sebanyak 54,1% (20), Staphylococcus aureus, Klebsiella pneumoniae, Achromobacter xylosoxidans, Acinetobacter baumanii, Morganella morganii, serta Staphylococcus haemolyticus yang masing-masing 2,7% (1). Selain itu, 5,4% (2) ditemukan Candida sp dan 24,3% (9) didapatkan flora normal regional. Pseudomonas aeruginosa sensitif terhadap meropenem (100%), amikacin (95%), gentamycin (95%), ceftazidime (90%), cefepime (95%), aztreonam (80%), dan ciprofloxacin (75%). Staphylococcus aureus yang terisolasi merupakan suatu Methicillin Resistant Staphylococcus aureus (MRSA) yang sensitif terhadap quinupristin-dalfopristin, linezolid, vancomycin, doxicyclin, minocycline, tetracyclin, dan rifampicin. Staphylococcus haemolyticus sensitif terhadap quinupristin-dalfopristin, linezolid, vancomycin, doxicyclin, tetracyclin, dan rifampicin. Klebsiella pneumoniae, Achromobacter xylosoxidans, Acinetobacter baumanii, dan Morganella morganii sensitif terhadap ceftazidime, meropenem, amikasin, dan cefepime. Pasien OMSK pada penelitian ini lebih didominasi Pseudomonas aeruginosa yang sensitif terhadap meropenem, amikacin, gentamycin, ceftazidime, cefepime, aztreonam, dan ciprofloxacin.

References

  1. Hafizah, Qamariah N, Budiarti LY. Perbandingan Sensitivitas bakteri aerob penyebab otitis media supuratif kronik tipe benigna aktif tahun 2008 dan 2012. Berkala Kedokteran. 2013;9(1):75-83. http://dx.doi.org/10.20527/jbk.v9i1.920
  2. Yeo GS, Park DC, Hong MS, Cha IC, Kim MG. Bacteriology of chronic suppurative otitis media - a multicenter study. Acta Oto-Laryngologica. 2007;127:1062-7. https://dx.doi.org/ 10.1080/00016480601126978
  3. Shyamala R, Reddy PS. The study of bacteriological agents of chronic suppurative otitis media – Aerobic culture and evaluation. J Microbiol Biotechnol Res 2012;2(1):152-62. https://www.jmbronline.com/index.php/JMBR/article/view/461
  4. Afolabi OA, Salaudeen AG, Ologe FE, Nwabuisi C, Nwawolo CC. Pattern of bacterial isolates in the middle ear discharge of patients with chronic suppurative otitis media in a tertiary hospital in North central Nigeria. Afr Health Sci. 2012;12(3): 362-7. https://www.ncbi.nlm.nih.gov/pubmed/23382753
  5. Madana J, Yolmo D, Kalairasi R, Gopalakrishnan S, Sujatha S. Microbiological profile with antibiotic sensitivity pattern of cholesteatomatous chronic suppurative otitis media among children. International Journal of Pediatric Otorhinolaryngology. 2011;75:1104-8. https://dx.doi.org/10.1016/j.ijporl.2011.05.025
  6. Malkappa SK, Kondapaneni S, Surpam RB, Chakraverti TK. Study of aerobic bacterial isolates and their antibiotic susceptibility pattern in chronic suppurative otitis media. Indian Journal of Otology. 2012;18(3):136-9. http://dx.doi.org/ 10.4103/0971-7749.103440.
  7. Rumipunu A, Kountul C, Buntuan V. Pola Bakteri Aerob dan Uji Kepekaan Terhadap Antibiotik pada Pasien Otitis Media di Poliklinik THT-KL BLU RSUP Prof. Dr. R. D. Kandou Manado Periode Desember 2012-Januari2013. e-Biomedik. 2014;2(1):11-18. https://ejournal.unsrat.ac.id/index.php/ebiomedik/article/view/3860/3375
  8. Prakash R, Juyal D, Negi V, Shekhar P, Adekhandi S, Sharma M, Sharma N. Microbiology of chronic suppurative otitis media in a tertiary care setup of Uttarakhand State, India. N Am J Med Sci. 2013;5(4):282-7. https://dx.doi.org/ 10.4103/1947-2714.110436
  9. Juyal D, Negi V, Sharma M, Adekhandi S, Prakash R, Sharma N. Significance of fungal flora in chronic suppurative otitis media. Ann Trop Med Public Health. 2014;7:120-3. http://dx.doi.org/10.4103/1755-6783.146400
  10. Mittal R, Lisi CV, Gerring R, et al. Current concept in pathogenesis and treatment of chronic suppurative otitis media. J Med Microbiol. 2017;64:1103-16. https:// dx.doi.org/10.1099/jmm.0.000155

How to Cite

Vedayanti, P. D., Saputra, K. A. D., & Fatmawati, N. N. D. (2021). Antibiogram bakteri aerob pada otitis media supuratif kronik di RSUP Sanglah Denpasar tahun 2015-2017. Medicina, 52(2), 143–147. https://doi.org/10.15562/medicina.v52i2.710

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Putu Diah Vedayanti
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Komang Andi Dwi Saputra
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Ni Nengah Dwi Fatmawati
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