Biofilm bakteri pada penderita rinosinusitis kronis: laporan seri kasus berbasis bukti
Authors: Silvia S , Munir Delfitri , Rambe Andrina Yunita Murni , Simanjuntak Amran , Chrestella Jessy , Ashar Taufik 
Published: September 2018

Latar belakang: Rinosinusitis kronis merupakan penyakit yang sering dijumpai pada bagian telinga hidung tenggorok kepala dan leher. Melalui berbagai macam teknik pencitraan, biofilm dijumpai pada mukosa sinonasal dari pasien rinosinusitis kronis. Beberapa peneliti mengemukakan bahwa biofilm adalah penyebab yang umum dari infeksi persisten kronis. Peranan biofilm pada penderita rinosinusitis kronis dapat membantu menjelaskan manifestasi klinis pada penyakit tersebut. Ketersediaan pewarnaan hematoksilin-eosin yang luas dalam laboratorium patologi klinik membuatnya menjadi metode yang sangat praktis untuk mendeteksi biofilm dalam praktik klinis. Tujuan: Mempresentasikan ekspresi biofilm bakteri pada penderita rinosinusitis kronis yang menjalani tindakan bedah sinus endoskopi fungsional. Kasus: Sebanyak 33 pasien rinosinusitis kronis menjalani tindakan bedah sinus endoskopi fungsional di beberapa rumah sakit di Sumatera Utara selama bulan Januari-Desember 2016. Prevalensi biofilm didapati pada 22 pasien (66,7%) penderita rinosinusitis kronis. Pada penderita rinosinusitis kronis dengan biofilm positif dijumpai jenis kelamin pria lebih banyak, umur lebih tua, lama gejala lebih singkat, keberadaan polip lebih sering, dan keluhan hidung tersumbat lebih sering. Metode: Pencarian literatur melalui Pubmed dengan kata kunci: chronic rhinosinusitis and biofilm. Setelah melalui proses skrining didapati 2 literatur yang dianalisis. Hasil: Penatalaksanaan rinosinusitis kronis dengan medikamentosa, meliputi pemberian antibiotik, dekongestan, kortikosteroid dan mukolitik disertai terapi tambahan irigasi hidung, serta pembedahan. Bila dijumpai biofilm, maka regimen pemberian antibiotik memakai protocol Marshall. Kesimpulan: Prevalensi biofilm pada penderita rinosinusitis kronis cukup tinggi, pemeriksaan biofilm dapat dipertimbangkan pada pasien rinosinusitis kronis yang menjalani tindakan bedah sinus endoskopi fungsional. Kata kunci: Biofilm, rinosinusitis kronis, hematoksilin-eosin, bedah sinus endoskopi fungsional ABSTRACT Background: Chronic rhinosinusitis is a disease that often found in otorhinolaryngology. Its pathogenesis is not fully understood. Using variety techniques, biofilms have been found in the mucosa of chronic rhinosinusitis patients. Some researchers have suggested that biofilm is a common cause of chronic persistent infection. The role of biofilms in patients with chronic rhinosinusitis can help explain the clinical manifestations of the disease. The extensive availability of hematoxylin-eosin staining in clinical pathology laboratories makes it a very practical method for detecting biofilms in clinical practice. Purpose: To present bacterial biofilm expression in chronic rhinosinusitis patients who had underwent functional endoscopic sinus surgery. Cases:About 33 chronic rhinosinusitis patients who had underwent functional endoscopic sinus surgery in several hospitals in North Sumatera during January-December 2016.Biofilms were found in 22 (66.7%) patients with chronic rhinosinusitis. Chronic rhinosinusitis patients with positive biofilms found mostly male, older in age, shorter duration of symptoms, more frequent polyps, and more frequent nasal congestion complaints. Method: Literature study was conducted through Pubmed with keywords chronic rhinosinusitis and biofilm. After screening process, we obtained two articles that were analyzed based on the critical appraisal. Result: Management of chronic rhinosinusitiswas medical treatment with antibiotic, decongestant, corticosteroid and mucolytic, accompanied by additional nasal irrigation therapy, and surgery. If biofilm was found, antibiotic regimen given using Marshal protocol. Conclusion: The prevalence of biofilms in patients with chronic rhinosinusitis was quite high. Biofilm examination should be considered in patients with chronic rhinosinusitis who undergo functional endoscopic sinus surgery. Keywords: Biofilm, chronic rhinosinusitis, hematoxylin-eosin, fungsional endoscopic sinus surgery