Spoligotyping, Resistensi Mycobacterium tuberculosis terhadap obat TB dan Faktor Risiko Penularan Tuberkulosis Paru di Kota Jayapura
Abstract
Identification of the Mycobacterium tuberculosis strain found in pulmonary tuberculosis patients in Jayapura using Spolygotyping was carried out Patients with pulmonary tuberculosis are taken as an index case. Sputum samples were taken to be diagnosed with Acid Fast Staining and to culture M. tuberculosis bacteria using Lowensten Jansen solid media, Ogawa solid media and Mycobacterium Growth Indicator Tube liquid media. The patient's home visit was conducted to determine the environmental conditions of the patient's residence, interview the close contacts and test the bacterial infection M. tuberculosis in close contact cases using the Mantoux test. A thorax radiology of close contacts was carried out in the hospital's radiology unit. The results of spolygotyping showed 8%sputum samples M. tuberculosis of Beijing strain, while the rest are M. tuberculosis non Beijing strains. Among the 46 of Non-Beijing strains, the type U (likely S) is most transmitted by tuberculosis patients to their close contacts, which is as much as 6%. This study confirms the factors that influence tuberculosis transmission are the sleeping location of close contacts with the patients, the frequency of meetings that occur at least once or more in a day, density of house occupants and the presence of clinical symptoms of TB. Drugs Resistance Susceptibility test results showed that 12 patients were resistance to TB drugs and one of them was MDR TB from strain LAMP.
Key words : tuberculosis transmission, Spolygotyping, tuberculosis, Jayapura, drugs resistance
Abstrak
Identifikasi galur Mycobacterium tuberculosis yang ditemukan pada penderita tuberculosis paru di Jayapura telah dilakukan dengan menggunakan Spoligotyping Penderita tuberkulosis paru diambil sebagai kasus indeks. Sampel sputum juga diambil untuk didiagnosis dengan pengecatan Basil Tahan Asam dan kultur bakteri M.tuberculosis yang dilakukan pada media padat Lowensten Jansen, media padat Ogawa serta media cair Mycobacterium Growth Indicator Tube. Ekstraksi DNA dilakukan pada koloni Mycobacterium tuberculosis untuk dilakukan analisis spoligotyping. Kunjungan rumah pasien dilakukan untuk mengetahui kondisi lingkungan tempat tinggal pasien, mewawancara kontak kasus dan melakukan skrining infeksi bakteri M.tuberkulosis pada kasus kontak menggunakan tes Mantoux. Foto dada pada kontak kasus selanjutnya dilakukan di unit radiologi rumah sakit. Hasil spoligotyping menunjukkan 8% (4/50) sampel sputum penderita tuberkulosis adalah M.tuberculosis galur Beijing, sedangkan sisanya adalah M.tuberculosis galur Non Beijing. Dari 46 galur Non-Beijing, tipe U (likely S) paling banyak ditransmisikan oleh penderita tuberculosis pada kontaknya yaitu sebanyak 6% (3/50). Penelitian ini mengkonfirmasi faktor-faktor yang mempengaruhi transmisi tuberkulosis meliputi lokasi tidur kontak kasus yang serumah dengan penderita, frekuensi pertemuan yang terjadi sedikitnya sekali atau lebih dalam sehari, kondisi rumah padat penghuni dan adanya gejala klinis TB. Hasil uji resistensi menunjukkan 12 pasien mengalami resistensi terhadap OAT dan 1 diantaranya adalah MDR TB dari strain LAMP.
Kata kunci : Transmisi, Splygotyping, Mycobacterium tuberculosis, tuberkulosis, Jayapura, resistensi
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