PENGGUNAAN ENRICHMENT-SELECTIVE MEDIUM UNTUK MENINGKATKAN SENSITIFITAS PEMERIKSAAN LABORATORIUM DIFTERI
Abstract
Konfirmasi laboratorium kasus difteri dilakukan dengan isolasi dan tes toksigenisitas bakteri penyebab difteri menggunakan metode konvensional berbasis kultur. Metode konvensional memiliki keterbatasan dalam hal sensitivitas pemeriksaan. Penelitian ini bertujuan untuk menguji penggunaan darah domba + telurit sebagai enrichment-selective medium untuk meningkatkan sensitivitas pemeriksaan laboratorium difteri dengan metode konvensional. Sebanyak 18 spesimen klinis (swab tenggorok) penderita difteri digunakan sebagai sampel penelitian. Swab tenggorok tersebut sebelumnya telah digunakan untuk pemeriksaan Polymerase Chain Reaction (PCR) sehingga proses ekstraksi DNA menyebabkan jumlah sel bakteri yang tertinggal menjadi sangat terbatas. Sel bakteri tersebut ditumbuhkan menggunakan 2 cara yang berbeda, yaitu inokulasi langsung dan inokulasi yang didahului dengan penggunaan enrichment-selective medium. Hasil identifikasi bakteri penyebab difteri dibandingkan antara keduanya. Hasil penelitian menunjukkan bahwa inokulasi secara langsung hanya berhasil mengisolasi dan mengidentifikasi bakteri penyebab difteri (Corynebacterium diphtheriae) pada 3 dari 18 sampel yang diperiksa. Sebaliknya dengan penggunaan enrichment-selective medium, bakteri penyebab difteri berhasil diisolasi dan diidentifikasi pada 9 dari 18 sampel yang diperiksa. Oleh karena itu, disimpulkan bahwa enrichment-selective medium (darah domba + telurit) dapat digunakan untuk meningkatkan sensitivitas pemeriksaan laboratorium difteri.
Laboratory confirmation for diphtheria cases are performed by using conventional culture-based method for isolation/identification and toxigenicity of the bacteria causing diphtheria. This method has limitation in its sensitivity. This study aimed to examine the sensitivity of sheep blood + tellurite as the enrichment selective medium to improve the sensitivity of the conventional method. The samples were 18 clinical specimens (throat swabs) obtained from diphtheria patient, which had been used for Polymerase Chain Reaction (PCR) assay, therefore the DNA extraction process caused the number of bacteria cells to be very limited. The samples were cultured by two different methods, directly on the agar medium and indirectly through enrichment selective medium previously. The result showed that the directly inoculation could isolate C. diphtheriae as many as 3 out of 18 samples, whereas indirectly method by using enrichment selective medium could isolate and identify 9 out of 18 samples. In conclusion, enrichment selective medium (sheep blood + tellurite) may improve the examination sensitivity of bacteria causing diphtheria identification in the laboratory.
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