Tesis

Perbedaan Berbagai Larutan Dekontaminan Sputum dalam Mencegah Kontaminasi pada Kultur Mycobacterium tuberculosis = The Differences of several decontaminant solutions for sputum in inhibiting contamination of Mycobacterium tuberculosis culture.

Indonesia termasuk ke dalam kriteria negara “high-burden” dengan insidensi TB yang masih tinggi. Indonesia masuk kedalam kriteria ini karena tingginya data epidemiologis kasus TB-HIV dan TB-MDR. Spesimen klinis terbanyak yang diolah untuk kultur TB adalah sputum, yang mengandung banyak kontaminan dari flora normal tenggorok. Salah satu metode kultur TB yang ideal adalah dengan mengembangkan larutan yang mudah didapat serta efektif tanpa banyak membunuh basil TB. Bleach adalah larutan yang murah dan diketahui secara luas sebagai disinfektan yang baik sehingga dapat dijadikan alternatif. Penelitian dilaksanakan di laboratorium TB LMK FK UI RSCM menggunakan 35 sampel dengan BTA positif. Setiap sampel dibagi dalam 4 kelompok dengan metode dekontaminasi yang berbeda. Keempat metode tersebut menggunakan 4%NaOH, 2%NALC-NaOH, 5% asam oksalat dan 1% bleach. Larutan 1% bleach disiapkan dari larutan pemutih komersial yang ada di pasaran. Setiap kelompok perlakuan dihitung proprsi kontaminasi dan kultur positif. Kultur positif divalidasi menggunakan MPT 64. Hasil penelitian menunjukkan subyek dengan BTA (+1) sebanyak 46%, BTA(+2) 37% dan BTA (+3) sebanyak 17%. Bleach merupakan kelompok dengan proporsi kontaminasi terbaik sebesar 2.8% dibanding 4% NaOH sebesar 5.7%, dengan perbedaan proporsi kontaminasi yang signifikan (p=0.000). Terdapat perbedaan signifikan antar kelompok dalam proporsi kultur positif (p=0.006), tetapi pada uji post hoc tidak ada perbedaan bermakna antara 1% bleach, 4% NaOH dan 2% NALC-NaOH. Kesimpulan penelitian ini, 1% bleach dapat digunakan untuk dekontaminan pada kultur TB dengan harga yang lebih murah, terutama pada sampel BTA (+2) keatas serta terkontaminasi berat.
Keyword : bleach, dekontaminasi, kontaminasi, kultur TB


Indonesia remains one of 22 high-burden countries with highly tuberculosis (TB) incidence according to WHO. There are a lot of numbers of TB-HIV and TB– MDR in Indonesia. As most processed clinical specimen for TB culture, sputum is contaminated by normal flora from oropharyngeal tract. The best method to establish appropriate culture from sputum is establishing a safe solution for the laboratory worker without kills numerous TB bacilli, preferred economic and easy prepared solution. Bleach is well known as cheap and good disinfectant that could use as an alternative. The research was aimed to compare the capability as bleach as decontaminat solution to other solution. The study was conducted at TB laboratory of FMUI, by using 35 samples sputum with positive AFS, 3-5 ml. Each sample was divided into 4 groups which was decontaminated by different methods. The methods are 4%NaOH, 2%NALC-NaOH, 5% oxalic acid and 1% bleach. 1% Bleach was prepared from commercially bleach. Each group was assessed for contamination and culture positive rate. The positive culture was validated using MPT 64. The number of positive AFS were (+1) 46%, (+2) 37% and (+3) 17%. Bleach had the best contamination rate which was 2.8% compared to 4% NaOH 5.7%, and significant difference among 4 groups (p=0.000). There was also significant difference among 4 groups in positive culture proportion (p=0.006), but there wasn’t signficant different between 1% bleach, 4% NaOH and 2% NALC-NaOH. Conclusion of this study is, 1% bleach can be used as an alternative solution for decontamination of TB culture from highly contaminated sputum with AFB higher than (+2)
Keyword : bleach, decontamination, contamination, TB culture