DETEKSI GEN SHV PADA ISOLAT KLINIK Escherichia coli PENGHASIL EXTENDED SPECTRUM BETA−LACTAMASES (ESBLs) DENGAN METODE POLYMERASE CHAIN REACTION (PCR) DARI URIN PASIEN DI RSUD Dr. SOETOMO SURABAYA
Authors: Prasetya Yulianto Ade 
Published: October 2018

AbstrakEscherichia coli penghasil Extended Spectrum Beta Lactmases (ESBLs) bertanggungjawab terhadap terjadinya wabah infeksi nosokomial, peningkatan morbiditas dan mortalitas, serta peningkatan biaya kesehatan. Enzim yang diproduksi oleh gen SHV dari bakteri mampu menghidrolisis antibiotik sefotaksim dan seftazidim. Tujuan penelitian ini adalah untuk mengetahui prevalensi gen SHV pada isolat klinik E. coli penghasil ESBLs dari urin pasien yang merupakan koleksi Laboratorium Mikrobiologi Klinik RSUD Dr. Soetomo Surabaya pada bulan Januari-Februari 2014. Jenis penelitian yang digunakan adalah observasional deskriptif dengan pendekatan molekuler. Deteksi gen SHV menggunakan metode Polymerase Chain Reaction (PCR) yang kemudian dilakukan elektroforesis dan divisualisasikan pada gel agarose 1,5%. Isolat E. coli yang positif membawa gen SHV ditunjukkan dengan adanya amplikon sebesar 867 bp. Hasil penelitian menunjukkan bahwa dari 30 isolat, sebanyak 12 isolat (40%) positif mengandung gen SHV, dengan prevalensi tertinggi berada di Ruang Instalasi Rawat Jalan. Meropenem dan fosfomisin masih dapat digunakan untuk terapi penyakit yang disebabkan oleh E. coli penghasil ESBLs. Deteksi ESBLs secara genotipik penting dilakukan karena beberapa gen ESBLs menunjukkan resistensi yang berbeda terhadap antibiotik golongan beta laktam. Hasil tersebut memberi informasi kepada pihak rumah sakit manapun untuk mewaspadai prevalensi E. coli penghasil ESBLs melalui pengawasan yang ketat pelaksanaan pemberian antibiotika sesuai tata laksananya.Abstract Extended Spectrum Beta Lactmases (ESBLs) producing−Escherichia coli strains are responsible for the occurrence of nosocomial infection outbreaks, increase of morbidity and mortality, as well as increased healthcare costs. The enzyme produced by the SHV gene from bacteria are able to hydrolyze antibiotics of cefotaxime and cefazazim. The purpose of this study was to detect the presence of SHV gene in clinical ESBLs−producing E. coli isolates from patients’ urines which are collections of Clinical Microbiology Laboratory in Dr. Soetomo Hospital of Surabaya within period of January−February 2014. The research used descriptive observasional design with molecular approach. The SHV gene was detected by using Polymerase Chain Reaction (PCR) method, then the products was performed by electrophoresis and visualized on 1.5% agarose gel. E. coli isolates that positively carrying the SHV gene were demonstrated in the presence of amplicons of 867 bp. The results showed that of 30 isolates, 12 isolates (40%) positively contained the SHV gene, with the highest prevalence being in the Outpatient Installation Room. Meropenem and fosfomycin can still be used for disease therapy caused by ESBLs−producing E. coli. Genotypic detection of ESBLs is important because some ESBLs genes exhibit different resistance to beta−lactam antibiotics. The result provides information to any hospital to be aware of the prevalence of ESBLs−producing E.coli through strict supervision of the implementation of antibiotics according to their administration.