Staphylococcal cassette chromosome mec (SCCmec) is one of the mobile genetic elements of Methicillin-Resistant Staphylococcus aureus (MRSA) that carries many resistance genes and allows SCCmec to move from one bacterium to another. Twelve types of SCCmec have been identified throughout the world. Identification of SCCmec type is needed to determine the pattern of MRSA resistance in a particular region. This study aimed to identify the type of SCCmec MRSA from clinical samples. Specifically, this study was conducted at the Biomolecular Laboratory of the Faculty of Medicine and Health Sciences of Jambi University in June 2018-February 2019. Culture was carried out on 100 clinical specimens of festering wound swabs from inpatients at hopitals in Jambi City. A total of 32 samples of Staphytect plus test positive were tested using Cefoxitin disc diffusion method and MecA Polymerase Chain Reaction (PCR). There were 14 samples identified as MRSA isolates, namely twelve samples (85.72%) of SCCmec type III, one sample (7.14%) of SCCmec type II, and one sample (7.14%) of SCCmec type IVb. The results were different from previous studies where all MRSA isolates (100%) in Indonesia were SCCmec type III, although most SCCmec types were still dominated by SCCmec type III. This study concludes that there has been a shift in the content of SCCmec in MRSA isolate originating from hospitals in Jambi city.
ABSTRACT Plasmodium is a parasite causing malaria, the most important infection disease in the world. Gold standard of malaria diagnosis was founded Plasmodium by Giemsa staining method. Fundamental difference between Giemsa and Polymerase Chain Reaction (PCR) is the ability to detect parasite. Giemsa can detect minimal 50-100 parasit/μl whereas PCR detect parasite DNA in lower parasitemia. The purpose of this study was to determine the sensitivity and specificity of the PCR compared to blood slide with Giemsa in detecting of malaria infection. A diagnostic test has been conducted in Laboratorium Biomedik Fakultas Kedokteran Universitas Jambi and Laboratorium Biomolekuler Fakultas Kedokteran Universitas Sriwijaya. There were 87 subjects who fulfilled the criteria inclusion and drawn by consecutive sampling. Blood samples were taken from venous blood. Detection of Plasmodium used Giemsa and PCR method. Detection of Plasmodium from 87 subjects, Giemsa and PCR method founded 1 subject (1.1%) P. falciparum and 4 subjects (4.6%) P. vivax. 82 subjects (94.3%) were negative. The sensitivity and specificity of PCR was 100%, positive predictive value and negative predictive value was 100%.Conclusion is higher sensitivity and spesificity PCR methode in the malaria diagnosis was proven and PCR methode able to identified Plasmodium species accuratly. Keywords: Plasmodium, Malaria, Giemsa, PCR, Diagnostic Test ABSTRAK Plasmodium merupakan parasit penyebab malaria, suatu penyakit infeksi paling penting di dunia. Baku emas diagnosa malaria adalah menemukan Plasmodium melalui pemeriksaan mikroskopis dengan pengecatan Giemsa. Perbedaan mendasar antara metode Giemsa dengan metode Polymerase Chain Reaction (PCR) terletak pada kemampuan mendeteksi parasit. Metode Giemsa hanya mampu mendeteksi Plasmodium dengan ambang batas antara 50-100 parasit/μl sedangkan metode PCR dapat mendeteksi DNA parasit pada parasitemia yang lebih rendah. Tujuan penelitian ini adalah untuk mengetahui sensitivitas dan spesifisitas metode PCR dibandingkan dengan pengecatan Giemsa dalam menegakkan diagnosis infeksi malaria. Penelitian ini merupakan uji diagnostik yang dilakukan di Laboratorium Biomedik Fakultas Kedokteran dan Ilmu Kesehatan Universitas Jambi dan Laboratorium Biomolekuler Fakultas Kedokteran Universitas Sriwijaya. Penelitian dilakukan mulai bulan Januari sampai April 2017. Subjek penelitian berjumlah 87 orang yang diambil secara consecutive sampling dari laboratorium RS Theresia Jambi. Semua subjek diambil sampel darah venanya, kemudian dilakukan pengecatan Giemsa dan pemeriksaan PCR. Hasil pemeriksaan PCR nested menggunakan primer genus dan primer spesies Plasmodium ditemukan P.falciparum positif sebanyak 1 sampel (1,1%). Sedangkan P.vivax positif sebanyak 4 sampel (4,6%). Sebanyak 82 sampel (94,3%) negatif. Hal ini sesuai dengan hasil pemeriksaan mikroskopis dengan pengecatan Giemsa. Metode PCR dibandingkan dengan metode pengecatan Giemsa sensitivitas dan spesifisitasnya 100%, nilai prediksi positif dan nilai prediksi negatifnya 100%. Dapat disimpulkan bahwa metode PCR sangat sensitif dan spesifik dalam penegakan diagnosis malaria dan mampu mengidentifikasi spesies parasit secara akurat. Kata Kunci: Plasmodium, Malaria, Giemsa, PCR, Uji Diagnostik.
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