DETEKSI GEN blaSHV, blaCTX?M, blaTEM, DAN blaCMY PADA Escherichia coli ISOLAT KLINIK RESISTEN SEFTRIAKSON SEBAGAI DASAR KONSELING

• Main Author: Dwi Putranto, Galih
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/45108
• Institution: Institut Teknologi Bandung

Background and purpose: Escherichia coli infection is causing variety of ilnesses, ranging from diarrhea to peritonitis. In general, the treatment of E. coli infection is with beta lactam antibiotics. Ceftriaxone, a third generation cephalosporin, is a beta lactam antibiotic and also the next line drugs in the treatment of E. coli infection. However, there are E. coli resistance cases to ceftriaxone. The purpose of this study was to determine the presence of beta lactamase in ceftriaxone?resistant E. coli, to determine the presence of blaSHV, blaCTX?M, blaTEM, dan blaCMY genes on ceftriaxone?resistant E. coli producing beta lactamase, and to suggest therapeutical recommendation in ceftriaxone?resistant E. coli infection based on research data. Methods: The presence of beta lactamase was identified from ceftriaxone?resistant E. coli samples originated from one hospital in Bandung. Then, PCR annealing temperature optimization was performed using ceftriaxone?resistant E. coli DNA templates. PCR optimization was carried out using 4 pairs of primer. The optimal annealing temperature was then used for the detection of blaSHV, blaCTX?M, blaTEM, dan blaCMY genes. Results: From 66 ceftriaxone?resistant E. coli samples, 46 was found producing beta lactamase. The optimal annealing temperature for the detection of gene blaSHV, blaCTX?M, blaTEM, dan blaCMY were 53° C, 55° C, 55° C and 58 °C, respectively. 15 of 46 samples have been tested by PCR and there were 1 sample with blaSHV gene, 6 samples with blaCTX?M gene, 4 samples with blaTEM gene, and 1 sample with blaCMY gene. Conclusion: There were 66,7% of samples which produce beta lactamase from 66 samples. The presence of blaSHV, blaCTX?M, blaTEM, and blaCMY in ceftriaxone?resistant E. coli producing beta lactamase were 6,67% for blaSHV, 40% for blaCTX?M, 26,67% for blaTEM, and 6,67% for blaCMY from 15 samples tested. There were indication that the use of penicillins and cephalosporins were no longer right. Carbapenems or piperacillin? tazobactam might be proper when the existence of four genes mentioned are confirmed.