No 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.

Diarrheal diseases are the second cause of the high morbidity and mortality in children under five years old. According to the Basic Health Survey 2018 conducted by the Ministry of Health, the prevalence of diarrheal diseases among children under five years old that were diagnosed by healthcare workers was 11.0%. The aim of this study was to describe the enteric pathogen isolated from children with diarrhea. The study was conducted in five cities in Indonesia: Jakarta, Serang, Denpasar, Makassar, and Mataram. The Inclusion criteria were children aged one month to five years old, with diarrhea that was diagnosed by a healthcare worker. The rectal swabs were sent to the Centre for Research and Development for Biomedical and Basic Health Technology, National Institute of Health Research and Development, Ministry of Health in Jakarta. Virus and Enterotoxigenic Escherichia coli (ETEC) identification by using multiplex PCR from Seegene, meanwhile bacteria identified by conventional method. As many as 2626 children under five years old participated in this study. The highest viral pathogen that causes diarrhea is viral 1.807 (68,81%) and 486 (18,56%). The virus etiology was Rotavirus 982 (54,34%) cases, followed by Adenovirus 916 (50.69) cases, Norovirus II 444 (24,57%) cases, meanwhile the bacteria pathogen were Enterotoxigenic Escherichia coli detected in 262 (9,98%) followed by Campylobacter jejuni and Shigella spp. This study described Rotavirus is the prevalence etiology of diarrhea among children under five years old followed by Adenovirus and Norovirus, some other cases reported the cause of diarrhea were bacteria ETEC E. coli followed Campylobacter jejuni, Shigella spp, etc.

Indonesia is one of the five countries with highest diphtheria cases in the world. Laboratory confirmation by culture method as a gold standard requires bacterial survival. Indonesia’s geographical condition as an archipelagic country and difficulties in transporting clinical samples are often obstacles in maintaining bacterial survival. This study aims to evaluate the ability of several transport mediums to maintain the survival of Corynebacterium diphtheriae. A total of 90 isolates were divided into nine groups of transport mediums. Samples were divided into 2 treatment groups, namely room temperature and temperature 2-8 ºC. On day 2, 4, 8, 16, and 32, 1 isolate from each group with 2 different incubation temperatures was cultured on blood agar medium and incubated for 24 hours at 37 ºC. Bacterial survival was indicated by the growth of suspect colonies which were identified by microscopic and biochemical tests. Results show serum with tellurite can be used with viability lower than silica gel, but higher than other media. Meanwhile at a temperature of 2-8 ºC, there are 2 types of the best transport medium, namely serum with tellurite and open silica gel in aluminum foil. Newborn Calf Serum supplemented with Tellurite can be used as an alternative transport medium for Corynebacterium diphtheriae, both at room temperature and at 2-8 ºC.

One of the microbes that causes acute diarrhea is bacteria. Vibrio cholerae is one that causes diarrhea called cholera diarrhea. Cholera diarrhea is caused by enterotoxins produced by these bacterial colonies in the small intestine. Giving antibiotics is still the main choice in the treatment and treatment of diarrhea because it is expected to kill bacteria and will usually stop diarrhea. Irrational use and the existence of abuse and excessive use of antibiotics can be a factor that causes bacterial resistance to antibiotics. Tests carried out to determine the sensitivity of bacteria to an antibiotic. Vibrio cholerae isolate was regrowed in alkaline peptone (APW) water medium and incubated at 37ºC for 18-24 hours, then planted in the thiosulfate-citrate-bile-sucrose (TCBS) medium. The sensitivity test was carried out on V. cholerae bacterial colonies growing on TCBS agar medium with the Disk Diffusion Method from Kirby Bauer. Data were analyzed descriptively. The results showed that most V. cholerae isolates were still sensitive to all types of antibiotics used in the test. Vibrio cholerae has shown resistance to Colistin antibiotics that is equal to 88.2%, Ampicillin at 23.5% and Ceftazidime at 5.9%. The level of resistance to antibiotics that are still low indicates that the antibacterial group can still be used as an alternative in the treatment of cholera diarrhea.