Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Kesesuaian antara Metode Microscopic Observation Drug Susceptibility Assay dan Ogawa pada Biakan Mycobacterium tuberculosis

Tuberkulosis (TB) merupakan masalah kesehatan masyarakat di berbagai negara di dunia. Diagnosis pasti TB ditegakkan berdasarkan penemuan kuman M. tuberculosis pada pemeriksaan mikroskopik atau biakan sputum. Biakan merupakan baku emas, namun metode yang digunakan saat ini membutuhkan waktu minimal 8 minggu. Microscopic observation drug susceptibility assay (MODS) merupakan metode biakan untuk M. tuberculosis menggunakan media cair yang dapat sekaligus menguji kepekaan obat TB secara mikroskopik. Tujuan penelitian mi adalah untuk mengetahui kesesuaian metode MODS dengan metode Ogawa (media padat) untuk biakan M. tuberculosis pada penderita TB paru. Penelitian cross sectional telah dilakukan di Departemen Patologi Klinik RSUP Dr. Hasan Sadikin Bandung dan pemeriksaan spesimen dilakukan di Balai Pengembangan Laboratorium Kesehatan (BPLK) Provinsi Jawa Barat periode April—Agustus 2010. Subjek penelitian sebanyak 133 penderita yang didiagnosis tersangka TB paru. Setiap spesimen ditanam pada dua media, media cair MODS dan media padat Ogawa. Analisis statistik kesesuaian metode MODS dengan Ogawa menggunakan uji koefisien Kappa. Terdapat 172 spesimen dari 133 subjek. Kesesuaian antara hasil biakan M. tuberculosis metode MODS dan Ogawa didapatkan nilai Kappa 0,91 yang berarti terdapat kesesuaian yang tinggi antara metode MODS dan Ogawa. Perbandingan waktu pertumbuhan M. tuberculosis secara bermakna Iebih cepat (p = 0.000) pada metode MODS, yaitu 10,1 han (rentang 4-21 han), dibandingkan dengan metode Ogawa. yaitu 24.8 han (rentang 14-35 hari). Simpulan. metode MODS dan Ogawa mempunyai angka keberhasilan diagnostik yang relatif sama. keunggulan metode MODS adalah pertumbuhan M. tuberculosis lebih cepat dibandingkan dengan metode Ogawa.

Tuberculosis (TB) is a problem of public health that causing high morbidity and mortality rates in various countries in the world. The diagnosis of pulmonary tuberculosis in adults can be established based on the discovery of M. tuberculosis on smear or culture of sputum. Culture is the gold standard but the availlable method is time consuming, it is need minimal eight weeks. Microscopic observation drug susceptibility assay (MODS) is one of methods for M. tuberculosis culture using liquid medium that can be a simultaneously test for Al. tuberculosis drug sensitivity. The purpose of this study was to determine the conformity of the MODS method compared with Ogawa method for cultivation of M. tuberculosis in pulmonary TB patients. The cross sectional research has been conducted at Clinical Pathology Department of Dr. Hasan Sadikin Hospital. Bandung and examination of the specimen done at Health Laboratory Development Unit (BPLK). West Java Province between April to August 2010. The subjects were patients who diagnosed as pulmonary TB suspect. Each collected specimen was cultured in liquid media MODS and solid media Ogawa. To analyze the conformity of MODS and Ogawa method, Kappa coefficient of agreement was used. There were 172 specimens collected from 133 subjects. The conformity between culture results of M. tuberculosis in MODS method and in Ogawa’s method using Kappa coefficient, was high (Kappa index 0.91). The difference of growth time of M. tuberculosis significant (p0.000), in MODS was 10.1 days (range 4-21 days) and in Ogawa method was 24.8 days (range 14-35 days). Conclusion. MODS and Ogawa’s method have the relatively similar diagnostic success rate, the advantage of MODS method is. the growth of M. tuberculosis is faster than in Ogawa method.