Electronic Theses and Dissertation

Penggunaan antibiotik secara berlebihan dan tidak tepat sasaran dapat menginisiasi terjadinya resistensi antibiotik pada bakteri. Instalasi Pengolahan Air Limbah (IPAL) diyakini sebagai reservoir bagi bakteri resisten antibiotik, termasuk Escherichia coli. Penelitian ini bertujuan untuk melakukan enumerasi, isolasi, karakterisasi dan evaluasi sifat resistensi serta gen pengkode resistensi antibiotik yang tersandikan oleh plasmid E. coli asal limbah cair IPAL Rumah Sakit Umum Daerah dr. Zainoel Abidin (RSUDZA). Penelitian ini dilaksanakan dengan beberapa tahapan, yaitu isolasi dan kuantifikasi E. coli, uji resistensi antibiotik, uji konfirmasi isolat ESBL-E. coli, isolasi DNA plasmid, dan amplifikasi gen TEM, SHV dan CTX-M. Hasil penelitian menunjukkan bahwa air limbah pada bak sum pit, bak aerasi dan bak akhir IPAL secara berturut-turut mengandung 7,5x104 CFU/mL, 3x102 CFU/mL dan 1x102 CFU/mL E. coli. Hasil isolasi didapatkan total 22 isolat dengan rincian sebanyak sepuluh isolat E. coli dari bak sum pit, tujuh isolat dari bak aerasi, dan lima isolat dari bak akhir. Isolat E. coli memiliki resistensi terhadap delapan jenis antibiotik pada bak aerasi dan tujuh jenis antibiotik di bak akhir dibandingkan dengan bak sum pit IPAL. Sebanyak 59% isolat termasuk ke dalam multi drug resistance (MDR) dan 32% isolat termasuk ke dalam Extended Spectrum β-Lactamase E. coli (ESBL-EC). Sebanyak 63,6% dari total isolat memeiliki gen TEM, 27% isolat memiliki gen SHV, dan 95,5% isolat memiliki gen CTX-M. Proses pengolahan limbah cair rumah sakit harus ditingkatkan untuk menurunkan keberadaan bakteri resisten antibiotik dan penyebaran gen resistensi antibiotik.

Kata kunci: Antibiotik, Escherichia coli, Plasmid, Resistensi, Rumah sakit, IPAL

Excessive and improper use of antibiotics can initiate the emergence of antibiotic resistance in bacteria. Wastewater Treatment Plant (WWTP) are believed to be a reservoir for antibiotic-resistant bacteria, including Escherichia coli. This study aims to perform the enumeration, isolation, characterization, and evaluation of resistance properties and antibiotic resistance-coding genes encoded by plasmid E. coli from WWTP of the dr. Zainoel Abidin General Hospital (RSUDZA). The study was conducted through several stages, including the isolation and quantification of E. coli, antibiotic resistance testing, confirmation testing of ESBL-E. coli isolates, isolation of plasmid DNA, and amplification of TEM, SHV, and CTX-M genes. The results showed that the wastewater in the sum pit tank, aeration tank, and final tank of the WWTP contained 7.5x104 CFU/mL, 3x102 CFU/mL, and 1x102 CFU/mL of E. coli, respectively. A total of 22 isolates were obtained, with ten isolates from the sum pit tank, seven from the aeration tank, and five from the final tank. E. coli isolates had resistance to eight types of antibiotics in the aeration tank and seven types in the final tank, compared to the sum pit tank of the WWTP. A total of 59% of the isolates were classified as Multi-Drug Resistant (MDR) and 32% were classified as Extended Spectrum β-Lactamase E. coli (ESBL-EC). 63,6% of the total isolates had the TEM gene, 27% had the SHV gene, and 95,5% had the CTX-M gene. The wastewater treatment process of the hospital must be improved to reduce the presence of antibiotic-resistant bacteria and the spread of antibiotic resistance genes Keywords: Antibiotics, Escherichia coli, Hospital, Plasmid, Resistance, WWTP