Hubungan Kuantitas Penggunaan Antibiotik dengan Dinamika Profil Gen Resistensi Antibiotik pada Limbah Cair Inlet RSUD Dr. Saiful Anwar Malang dengan Metode Smartchip qPCR

Fadriyana, Aulia Putri and dr. Dewi Santosaningsih, Sp.MK, M.Kes, PhD and Dr. dr. Irene Ratridewi, Sp.A(K), M.Kes (2023) Hubungan Kuantitas Penggunaan Antibiotik dengan Dinamika Profil Gen Resistensi Antibiotik pada Limbah Cair Inlet RSUD Dr. Saiful Anwar Malang dengan Metode Smartchip qPCR. Magister thesis, Universitas Brawijaya.

Abstract

Resistensi antibiotik merupakan salah satu ancaman terbesar bagi kesehatan global saat ini. Perkembangan resistensi bakteri terhadap antibiotik berkaitan erat dengan tingkat keberhasilan terapi penyakit infeksi. Hal ini secara signifikan meningkatkan angka morbiditas dan mortalitas. Salah satu tempat berkembangnya dan penyebaran bakteri resisten antibiotik dan gen resisten antibiotik akibat tingginya penggunaan antibiotik adalah rumah sakit. Air limbah rumah sakit merupakan reservoir penting resistensi antibiotik yang berpotensi mengakumulasi gen resistensi antibiotik. Penelitian ini bertujuan untuk mengukur jumlah copy number gen resistensi antibiotik dalam air limbah rumah sakit dan mengkorelasikannya dengan antibiotik yang digunakan di RSUD Dr. Saiful Anwar Malang. Sampel limbah cair inlet rumah sakit sejumlah 1 L diambil secara grab sampling 2 kali setiap minggu selama 6 minggu pemantauan menggunakan teknik random sampling. Sampel air limbah kemudian difiltrasi menggunakan PES hydrophilic serta dilakukan ekstraksi DNA dengan DNeasy PowerWater Kit. Empat puluh satu gen resistensi antibiotik (18 gen resistensi beta-lactam, 14 gen resistensi aminoglikosida, 7 gen resistensi kuinolon, dan 2 gen resistensi vancomycin) dikuantifikasi menggunakan Smartchip qPCR di Resistomap, Finlandia. Hasil kuantifikasi dianalisis dan divisualisasikan menggunakan platform ResistApp. Data kuantitas penggunaan antibiotik diperoleh dari Departemen Farmasi selama periode pengambilan sampel limbah cair inlet. Sejumlah 29-37 gen dari 41 gen resistensi antibiotik terdeteksi dari waktu ke waktu dalam sampel air limbah rumah sakit inlet dengan rentang antara 84 - 1.586.180 copy number. Berdasarkan analisis korelasi Pearson, terdapat korelasi positif antara jumlah semua antibiotik yang digunakan di rumah sakit dan copy number gen antibiotik relevan yang terdeteksi di air limbah inlet (p=0,012). Pemantauan jumlah penggunaan antibiotik dalam pengaturan klinis dapat dilakukan melalui sampel air limbah rumah sakit, namun penelitian lebih lanjut dengan lebih banyak sampel diperlukan untuk mengevaluasi korelasi masing-masing golongan antibiotik.

English Abstract

Antibiotic resistance is one of the biggest threats to global health nowadays. The development of bacterial resistance to antibiotics is closely related to the success rate of infectious disease therapy. This significantly increases morbidity and mortality rates. One of the places for the development and spread of antibiotic resistant bacteria and antibiotic resistant genes due to the high use of antibiotics is the hospital. Hospital wastewater is an important reservoir of antibiotic resistance which has the potential to accumulate antibiotic resistance genes. This study aims to measure the copy number of antibiotic resistance genes in hospital wastewater and correlate them with the antibiotics used in RSUD Dr. Saiful Anwar Malang. One liter inlet hospital wastewater samples were taken by grab sampling twice each week for 6 weeks of monitoring using a random sampling technique. The wastewater samples were filtered using hydrophilic PES membrane followed by DNA extraction using DNeasy PowerWater Kit. Forty-one antibiotic resistance genes (18 beta-lactam resistance genes, 14 aminoglycoside resistance genes, 7 quinolone resistance genes, and 2 vancomycin resistance genes) were quantified using Smartchip qPCR in Resistomap, Finland. Quantification results are analyzed and visualized using the ResistApp platform. Data on antibiotic use in the clinical setting was obtained from the Department of Pharmacy during the inlet wastewater sampling period. 29-37 genes out of 41 antibiotic resistance genes were detected over time in inlet hospital wastewater samples with abundances between 84 -1.586.180 copy numbers. Based on Pearson correlation analysis, there is a positive correlation between the amount of all antibiotics used in the hospital and the abundance of relevant antibiotic genes detected in wastewater (p=0.012). It is possible to monitor the amount of antibiotic use in the clinical setting through hospital wastewater samples, however further study with more samples is required to evaluate the correlation of each antibiotic group.

Item Type:	Thesis (Magister)
Identification Number:	0423060023
Subjects:	600 Technology (Applied sciences) > 616 Diseases > 616.02 Special topics of disease > 616.025 Medical emergencies / Emergency medicine / Emergency nursing / Triage (Medicine)
Divisions:	S2/S3 > Magister Ilmu Biomedis, Fakultas Kedokteran
Depositing User:	Endang Susworini
Date Deposited:	03 Nov 2023 07:34
Last Modified:	03 Nov 2023 07:34
URI:	http://repository.ub.ac.id/id/eprint/204324

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