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Endang Sutedja
Departemen Ilmu Kesehatan Kulit dan Kelamin Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung
Medicine & Pharmacology

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Efek Penggunaan Probiotik Topikal Terhadap Ekspresi MMP-13 dan Kolagen III pada Lapisan Dermis Tikus yang Dipapar Sinar Ultraviolet-B Tarawan, Vita M.; Anissa, Anissa; Sutedja, Endang; Lesmana, Ronny
Indonesian Journal of Clinical Pharmacy Vol 5, No 2 (2016)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (952.26 KB) | DOI: 10.15416/ijcp.2016.5.2.138

Abstract

Proses penuaan kulit terjadi karena kombinasi penurunan kapasitas proliferasi sel-sel kulit, berkurangnya sintesis matriks dermis, dan peningkatan ekspresi enzim yang mendegradasi matriks kolagen. Penelitian ini merupakan eksperimental laboratorik, menggunakan 24 ekor tikus jantan galur Sprague-Dawley sebagai objek penelitian. Pada kelompok perakuan, kulit dorsal kedua kelompok dicukur, kemudian diberikan paparan sinar UVB seminggu tiga kali selama 4 minggu dengan dosis total penyinaran 840 mJ/ cm2. Kulit kelompok perlakuan diolesi krim Lactobacillus plantarum FNCC 0020 yang tidak bereplikasi, sehari 2 kali dengan komposisi aplikasi topikal koloni 247,27x107, sedangkan kelompok kontrol tidak diolesi apapun. Hasil penelitian diperoleh, baik intensitas, distribusi, maupun histoskor MMP-13 antara kelompok perlakuan dan kelompok kontrol tidak menunjukkan ada perbedaan yang bermakna (p>0,05). Intensitas kolagen III baik pada kelompok perlakuan maupun kontrol semua mempunyai derajat kuat, sedangkan distribusi kepadatan kolagennya paling rendah 20–50% dan tertingginya di atas 80%. Perbandingan distribusi kepadatan kolagen III secara statistik sangat bermakna (p<0,01). Pemberian krim topikal L. plantarum FNCC 0020 meningkatkan ekspresi distribusi kepadatan kolagen III namun tidak menurunkan ekspresi MMP-13. Kata kunci: Lactobacillus plantarum, kolagen, (matrix metalloproteinases) MMP13 Effect of Topical Probiotic on MMP-13 and Collagen III Expression in The Dermis Layer of Male Rats Irradiated with Ultraviolet-B Abstract Nowadays, there is a big interest in the use of topical probiotic preparations for skin health. One of the probiotics therurapeutic benefits is used as anti-aging. During aging, there is stimulation of activator protein-1 (AP-1) which is a transcription factor that inhibits the production of collagen and AP-1 supports the breakdown of collagen by enzymes called matrix metalloproteinases (MMPs). As administration of oral Lactobacillus plantarum could inhibit skin aging by lowering the activity of MMP, so the collagen degradation can be derived so probably topical use of Lactobacillus plantarum may give more prominent effects. We used 24 male rats Sprague-Dawley strain as research objects. This study was divided into two groups, the treatment and control groups. The shaved dorsal skin of rats were irradiated with UVB three times a week for 4 weeks with total irradiation dose of 840 mJ/cm2. Skin cream, containing 247.27x107 CFU non-replicating Lactobacillus plantarum FNCC 0020, was smeared on the treatment group, two times daily, whereas the control group did not receive any treatment. Skin biopsies were done at the end of the study for examination of MMP-13 and collagen III expressions. Intensity, distribution, and histoscore of MMP-13 between the treatment and the control group showed no significant difference (p>0.05). The treatment group showed a significant different in the intensity of collagen III with the density distribution of 20–50% and the highest density was 80% (p<0.01). Administration of topical cream L. plantarum FNCC 0020 increased the expression of collagen III density distribution, but not the MMP-13 expression.Keywords: Collagen, Lactobacillus plantarum, (matrix metalloproteinases) MMP13
Etiology of Allergic Contact Dermatitis based on Patch Test Anggraini, Dita Maulida; Sutedja, Endang; Achadiyani, Achadiyani
Althea Medical Journal Vol 4, No 4 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (574.12 KB) | DOI: 10.15850/amj.v49n4.1265

Abstract

Background: Allergic contact dermatitis is a type of contact dermatitis, whose  prevalence tends to increase every year. Patch test is an important diagnostic test to confirm the disease. The result of patch test can help doctors to perform appropriate treatment.  The aim of the study was to identify  the most frequent allergen causing allergic contact dermatitis based on patch test results.Methods: This was a descriptive retrospective study among patients who underwent patch test at the Dermatology and Venereology Clinic in Dr.Hasan Sadikin General Hospital Bandung, Indonesia from August 1st, 2014 to August 31st, 2015. The patch test result was obtained from the patient’s medical record and recapitulation data. The patient’s medical record would be collected based on inclusion and exclusion criteria. This study also collected demographic data of the patients, including age, sex, and occupation.The collected data were presented using tables.Results: Out of 45 patient’s medical records, 19 patients were male (42.2%) and 26 patients were female (57.8%). Nickel sulphate was the most frequent allergen with 17 sensitization. Thirteen out of 17 patients who were sensitized by nickel sulphate were females. A great majority of the patients were in the age group of 15–44 years. Most of the patients were students (42.2%). Allergic contact dermatitis (64.4%) was the main clinical diagnosis among the patients.Conclusions: The most frequent allergen causes allergic contact dermatitis is nickel sulphate.
CINICO-EPIDEMIOLOGICAL PROFILE OF VITILIGO PATIENTS IN DR. HASAN SADIKIN GENERAL HOSPITAL BANDUNG Dwiyana, Reiva Farah; Marindani, Vani; Agustina, Rohana; Setiawan, Setiawan; Idjradinata, Ponpon S.; Sutedja, Endang
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.63 KB) | DOI: 10.15395/mkb.v49n2.1056

Abstract

Vitiligo is the most common hypopigmentation disorder; however, until now there iss no comprehensive epidemiological-clinical study of vitiligo in Indonesia. A descriptive study  using a questionnaire among vitiligo patients in Dr. Hasan Sadikin General Hospital Bandung was conducted to determine the clinical findings, socio-demographic factors, coexisting autoimmune disorders, and severity of disease. All vitiligo patients were recruited during the period of February 2012 to April 2014 from the Dermatology Outpatient Clinic of Dr. Hasan Sadikin General Hospital Bandung, as well as from the Endocrinology and Rheumatology Clinic Department of Internal Medicine; Endocrinology and Allergy and Immunology Clinics Department of Child Health; and Department  of Nuclear Medicine the same hospital. We collected data on socio-demographic profiles, clinical profile, and severity of vitiligo based on Vitiligo European Task Force (VETF). Out of 242 patients, female patients made up the majority of the patients (66.12%). In addition, most patients  wereunder 20 years (33.47%) and experienced onset of vitiligo highest in the first decade of life (29.34%). About 19.42% had positive family history of vitiligo and only 6.2% had history of autoimmune diseases. The majority of patients (77.27%) had vulgaris type of vitiligo with  head-neck (35.36%) asthe most frequent initial site of onset. Based on VETF,  the skin affected was mostly below 10% of body surface area (82.23%), i.e. staging score of between 0?5 (57.44%), and spreading score of between >0?(+5) or 68.18%. It is concluded that vitiligo most commonly occurs in females with the highest onset of under 10-years old and strong relationship with genetic predisposition.T he affected area was relatively small, despite the high spreading score. [MKB. 2017;49(2):132?8]   Key words: Clinical profile, epidemiology, vitiligo  Profil Kliniko-Epidemiologi pada Pasien Vitiligo di RSUP Dr. Hasan Sadikin Bandung   Vitiligo merupakan kelainan hipopigmentasi tersering, tetapi hingga kini belum ada penelitian epidemiologi-klinik yang komprehensif di Indonesia. Penelitian deskriptif menggunakan kuesioner dilakukan pada pasien vitiligo di Rumah Sakit Dr. Hasan Sadikin Bandung untuk mengetahui gambaran klinis, faktor sosio-demografik, kelainan autoimun yang menyertai, dan keparahan penyakit. Seluruh pasien vitiligo dari periode Februari 2012 hingga April 2014 yang berkunjung ke poliklinik Kulit dan Kelamin Rumah Sakit Dr. Hasan Sadikin Bandung, serta poliklinik: Endokrinologi dan Rematologi, Ilmu Penyakit Dalam; Endokrinologi dan Alergi-imunologi, Ilmu Kesehatan Anak; serta Kedokteran Nuklir, diikutsertakan dalam penelitian. Data yang dihimpun mencakup keadaan sosiodemografi, klinik, dan keparahan vitiligo berdasar atas Vitiligo European Task Force (VETF). Dari 242 pasien, perempuan merupakan jenis kelamin terbanyak (66,12%), usia di bawah 20 tahun (33,47%), dan awitan vitiligo terjadi pada dekade pertama kehidupan (29,34%). Sekitar 19,42% memiliki riwayat vitiligo pada keluarga dan hanya 6,2% yang memiliki penyakit autoimun. Umumnya tipe vitiligo vulgaris (77,27%) dengan predileksi pertama pada kepala-leher (35,36%). Area kulit yang terkena berdasarkan VETF ialah di bawah 10% dari body surface area (82,23%), staging score 0?5 (57,44%), dan spreading score antara >0?(+5) atau 68,18%. Simpulan penelitian ini ialah vitiligo banyak mengenai perempuan, awitan tersering pada usia di bawah 10 tahun dengan predisposisi genetik yang tinggi, serta daerah yang terkena vitiligo relatif kecil meskipun spreading score-nya tinggi. [MKB. 2017;49(2):132?8]   Kata kunci: Epidemiologi, gambaran klinik, vitiligo
Kadar Interleukin-18 pada Kultur Limfosit Penderita Dermatitis Atopik yang Distimulasi Staphylococcal Enterotoxin B (SEB) Suwarsa, Oki; Sudigdoadi, -; Sutedja, Endang; Idjradinata, Ponpon
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Staphylococcus aureus (S. aureus) mempunyai peranan penting pada patogenesis dermatitis atopik (DA). Peran S. aureus tersebut tidak hanya sebagai pencetus DA, tetapi juga menyebabkan inflamasi kronik. Peran tersebut berhubungan dengan dihasilkannya protein antara lain toksin poten oleh S. aureus, yaitu Staphylococcal enterotoxin B (SEB). Interleukin-18 (IL-18) merupakan regulator penting dari produksi sitokin Th-1 yaitu interferon-γ (IFN-γ).  Tujuan penelitian ini adalah mengetahui kadar IL-18 pada kultur limfosit pasien DA yang distimulus dengan SEB. Penelitian ini dilakukan pada 20 orang penderita DA (7 laki-laki dan 13 perempuan) dan 20 orang sehat (9 laki-laki dan 11 perempuan) di Rumah Sakit Dr. Hasan Sadikin Bandung, merupakan penelitian eksperimental secara in vitro pada kultur ilmfosit yang distimulus dengan SEB di Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. Terjadi peningkatan kadar IL-18 rata-rata pada kultur limfosit antara sebelum dipapar dan setelah dipapar SEB, baik pada kelompok DA maupun kelompok kontrol. Setelah dilakukan uji statistik perbandingan antara kadar IL-18 rata-rata sebelum dan sesudah dipapar SEB antara kelompok DA dan kontrol, didapatkan hasil kadar IL-18 kelompok DA lebih tinggi bermakna dibanding  dengan kelompok kontrol (p<0,05) sehingga dapat disimpulkan kadar IL-18 meningkat tinggi pada kelompok DA yang dipapar SEB. [MKB. 2015;47(4):249–54]Kata kunci: Dermatitis atopik, interleukin-18 (IL-18), Staphylococcus enterotoxin BInterleukin-18 Levels in Lymphocytes Cultures from Atopic Dermatitis Patients Stimulated by Staphylococcal Enterotoxin BAbstractStaphylococcus aureus (S. aureus) has an important role in the pathogenesis of atopic dermatitis (AD). S. aureus acts as a triggering factor for AD and also causes chronic inflammation. These roles of S. aureus are related to various proteins such as Staphylococcal enterotoxin B (SEB) as a potent toxin. Interleukin-18 (IL-18) is an important regulator of cytokine production of Th-1, which is interferon-γ (IFN-γ). The aim of this study was to reveal the levels of IL-18 in cultured lymphocytes from AD patients exposed by SEB. This study was conducted on 20 people with DA (7 men and 13 women) and 20 healthy volunteers (9 men and 11 women) in dr. Hasan Sadikin General Hospital. The in vitro experimental study on cultured lympocytes exposed with SEB was performed at the Integrated Research and Testing Laboratory of Gadjah Mada University. The average levels of IL-18 in cultured lymphocytes before and after being exposed to SEB increased both in AD group and control group. After the statistical tests was performed on the ratio of the average levels of IL-18 before and after being exposed to SEB between AD and control groups, it was shown that the levels of IL-18 AD group was significantly higher than the control group (p <0.05). Therefore, it can be concluded that the levels of IL-18 increased higher in AD group exposed by SEB. [MKB. 2015;47(4):249–54]Key words: Atopic dermatitis , interleukin-18, Staphylococcal enterotoxin BDOI: 10.15395/mkb.v47n4.620
Keberhasilan Terapi Kombinasi Menggunakan Metotreksat Injeksi dan Siklosporin pada Psoriasis Pustulosa Generalisata Suwarsa, Oki; Devi Nursjamsi, Nadilla Carissa; Pangastuti, Miranti; Sutedja, Endang; Dharmadji, Hartati Purbo
Majalah Kedokteran Bandung Vol 49, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1846.617 KB) | DOI: 10.15395/mkb.v49n3.1123

Abstract

Psoriasis pustulosa generalisata (PPG) adalah bentuk khusus dari psoriasis yang bersifat akut dan berat. Etiologi yang belum diketahui secara pasti menyebabkan pengobatan PPG masih menjadi suatu tantangan. Terapi kombinasi dapat diberikan pada PPG yang berat maupun yang tidak memberikan respons terhadap terapi sistemik tunggal, selain itu terapi kombinasi juga dapat meningkatkan efektivitas dari obat tunggal. Dilaporkan satu kasus PPG pada seorang wanita yang diterapi dengan menggunakan kombinasi metotreksat (MTX)  injeksi dan siklosporin. Dari anamnesis dan pemeriksaan fisis didapatkan pustula berkelompok pada dasar makula eritem yang bergabung membentuk lake of pus, disertai gejala sistemik demam dan leukositosis. Keluhan tersebut sudah berulang sejak 13 tahun yang lalu. Pasien diberikan terapi kombinasi injeksi MTX dan siklosporin. Pustula pada pasien menghilang setelah tujuh hari pemberian obat. Terapi kombinasi dengan MTX injeksi dan siklosporin ini baru pertama kali dilakukan 19 Mei–26 Mei 2017 di Departemen Ilmu Kesehatan Kulit dan Kelamin Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dan memberikan hasil yang baik. [MKB. 2017;49(3):208–12]Kata kunci: Metotreksat, metotreksat injeksi, psoriasis pustulosa generalisata, siklosporin Succesful Treatment of Generalized Pustular Psoriasis with a Combination of Methotrexate Injection and CyclosporineGeneralized pustular psoriasis (GPP) is a special form of acute and severe psoriasis. The definite etiology of GPP remains a challenge. Combination therapy may be given to severe GPP or GPP that does not respond to a single systemic therapy sincecombination therapy may also improve the effectiveness of a monotherapy drug. A GPP case was reported in a woman treated with a combination of methotrexate (MTX) and cyclosporine. From anamnesis and physical examination it was revealed that there were clustered  pustules on the base of erythematous macules that form a lake of pus accompanied by systemic symptoms of fever and leukocytosis. This was a recurrent complaint since 13 years ago. Patients were given combination therapy of MTX injection and cyclosporine. Pustules disappeared after seven days of drug administration. This case was the first combination therapy with MTX injection and cyclosporine used during the period of 19 May to 26 May 2017 at the Department of Dermatology and Venereology Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, resulting in good results. [MKB. 2017;49(3):208–12]Key words: Cyclosporine, generalized pustular psoriasis, methotrexate, methotrexate injection
Penurunan Aktivitas Tirosinase dan Jumlah Melanin oleh Fraksi Etil Asetat Buah Malaka (Phyllantus emblica) pada Mouse Melanoma B16 Cell-Line Hindritiani, Reti; Dhianawaty, Diah; Sujatno, Muchtan; Sutedja, Endang; Setiawan, -
Majalah Kedokteran Bandung Vol 45, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (458.747 KB)

Abstract

Akumulasi melanin menyebabkan hiperpigmentasi dan bila terdapat pada wajah dapat menimbulkan masalah psikososial. Bahan depigmentasi dari tanaman semakin banyak digunakan. Bahan yang dikembangkan harus efektif menghambat sintesis melanin serta tidak toksik terhadap melanosit. Penelitian ini bertujuan menguji efek fraksi etil asetat buah Phyllanthus emblica (P. emblica) atau buah malaka, terhadap sintesis melanin dengan mengukur jumlah melanin dan aktivitas tirosinase, yang merupakan enzim utama sintesis melanin, secara spektrofotometrik pada kultur sel melanosit mouse melanoma B16 cell-line. Sitotoksisitas diukur dengan metode 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay. Penelitian dilakukan pada November–Desember 2009 di Department of Biochemistry and Diabetes Research Centre, Chonbuk National University Medical School, Korea Selatan. Hasil penelitian menunjukkan aktivitas tirosinase dan jumlah melanin menurun bergantung pada dosis perlakuan berbagai konsentrasi fraksi etil asetat buah P. emblica dengan inhibition concentration (IC) 50 berturutturut 95,63 dan 16,90 μg/mL, serta lethal dose (LD) 50 pada konsentrasi 106,64 μg/mL. Simpulan, fraksi etil asetat buah P. emblica mempunyai potensi sebagai bahan depigmentasi, karena mampu menurunkan sintesis melanin melalui inhibisi aktivitas tirosinase. [MKB. 2013;45(2):118–24]Kata kunci: Aktivitas tirosinase, etil asetat, melanin, Phyllanthus emblicaReduction of Tyrosinase Activity and Melanin Amount by Ethyl Acetate Fraction from Malaka (Phyllanthus emblica) Fruit in Mouse Melanoma B16 Cell-LineMelanin accumulation can lead to hyperpigmentation, and if it occurs on the face can cause psychosocial problem. Depigmenting agents derived from plants are increasingly utilized. Agents being developed have to be effective in inhibiting melanin synthesis and should not be toxic to melanocyte. This study aimed was to examine the effect of ethyl acetate fraction from Phyllanthus emblica (P. emblica) fruit, also known as malaka fruit, towards melanine synthesis, which was measured from the melanin amount and tyrosinase activity, the key regulatory enzyme in melanin synthesis, spectrophotometrically towards melanocytes of mouse melanoma B16 cell-line. The cytotoxic effect towards melanocytes was measured with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay. This study was conducted on November−December 2009 in Department of Biochemistry and Diabetes Research Centre, Chonbuk National University Medical School, South Korea. The result of this study showed that tyrosinase activity and melanin amount decreased in a dose-dependent manner towards various concentrations of ethyl acetate fraction of P. emblica fruit with inhibition concentration (IC) 50=95.63 and 16.90 μg/mL, respectively and lethal dose (LD) 50 concentration 106.64 μg/mL. In conclusion, ethyl acetate fraction of P. emblica fruit is a potential depigmenting agent, since it can reduce melanin synthesis by inhibition of tyrosinase activity. [MKB. 2013;45(2):119–24]Key words: Ethyl acetate, melanin, Phyllanthus emblica, tyrosinase activity DOI: http://dx.doi.org/10.15395/mkb.v45n2.115
Efikasi Terapi Kombinasi Salep Kalsipotriol 0,005% dan Klobetasol Propionat 0,05% Dibanding Klobetasol Propionat 0,05% pada Psoriasis Vulgaris Indriyani, Dian; Sutedja, Endang; Suwarsa, Oki
Majalah Kedokteran Bandung Vol 42, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Psoriasis adalah penyakit eritropapuloskuamosa kronik residif. Obat yang paling sering digunakan untuk terapi penyakit ini adalah kortikosteroid topikal, tetapi penggunaan jangka panjang dapat menyebabkan berbagai efek samping. Kalsipotriol merupakan obat topikal selain kortikosteroid yang memiliki efek samping yang lebih ringan. Tujuan penelitian ini adalah untuk membandingkan skor psoriasis area and severity index (PASI) sebelum dan sesudah pengobatan dengan kombinasi salep kalsipotriol 0,005% dengan salep klobetasol propionat 0,05% dan monoterapi salep klobetasol propionat 0,05% pada penderita psoriasis vulgaris. Skor psoriasis area severity index (PASI), digunakan untuk mengukur berat ringannya psoriasis dan mengevaluasi perbaikan lesi. Desain penelitian adalah uji klinik dengan rancangan acak secara double blind. Uji Mann-Whitney dan Wilcoxon digunakan untuk menganalisis data skor PASI sebelum dan sesudah pengobatan. Penelitian dilakukan di poliklinik I.K. Kulit danKelamin RS. Hasan Sadikin Bandung dari bulan November 2007- Januari 2008 dengan subjek penelitian sebanyak 44 orang yang dibagi dalam dua kelompok. Derajat keparahan penyakit dinilai dengan skor PASI yang dinilai sebelum, satu minggu, dan dua minggu setelah pengobatan. Kesimpulan: Penggunaan terapi kombinasi salep kalsipotriol 0,005% dan klobetasol propionat 0,05% selama dua minggu memiliki efikasi yang lebih baik dibandingkan monoterapi salep klobetasol propionat 0,05%, secara statistik sangat bermakna (p<0,001).Efficacy Combination Therapy of 0.005% Calcipotriol and 0.05% Clobetasol Propionat Compared to 0.05% Clobetasol Propionat Ointment in Psoriasis VulgarisPsoriasis is a chronic relapsing erythropapulosquamous skin disease. Topical corticosteroid is the most common treatment for psoriasis, but it can cause many side effect on longterm used. Calcipotriol ointment is the other topical treatment for psoriasis and has minimal side effect. The study was a double blind randomized clinical trial, compared psoriasis area and severity index score before and after treatment combination therapy of 0.005% calcipotriol ointment 0.05% and clobetasol propionat ointment with 0.05% clobetasol propionat alone. Psoriasis area severity index (PASI) score was used to evaluate severity degree and imprvoment of psoriasis. Mann-Whitney and Wilcoxon test were used for statistical analysis of PASI score before and after treatment. Study was conducted at Dermatology and Venereology outpatient Department of Hasan Sadikin Hospital Bandung period November 2007 to January 2008 with fourty four psoriasis vulgaris patients were enrolled in this study, divided into two groups. The assesment of the severity of skin lesions psoriasis area and severity index was performed at baseline, after one week and two weeks treatment. Conclusion: the use of daily 0.005% calcipotriol ointment combined with 0.05% clobetasol propionate. DOI: http://dx.doi.org/10.15395/mkb.v42n1.4
Methicillin-Resistant Staphylococcus aureus pada Penderita Dermatitis Atopik dan Sensitivitasnya terhadap Mupirosin Dibandingkan dengan Gentamisin Istasaputri M., Keni; Sutedja, Endang; Suwarsa, Oki; Sudigdoadi, Sunarjati
Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) mulai dijumpai pada penderita dermatitis atopik (DA) derajat sedang hingga berat dan bersifat multiresisten terhadap antibiotik topikal. Gentamisin telah digunakan secara luas, sedangkan mupirosin merupakan pilihan utama eradikasi MRSA. Penelitian ini bertujuan untuk mengetahui kolonisasi MRSA pada penderita DA dan sensitivitasnya terhadap mupirosin dibandingkan dengan gentamisin di Poliklinik Departemen Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Survei potong lintang analitik dilakukan selama 19 September–31 Oktober 2011 terhadap 22 penderita DA derajat sedang hingga berat sesuai dengan Scoring Atopic Dermatitis objektif dan 22 individu sehat. Seluruh subjek dilakukan pemeriksaan apusan kulit untuk deteksi MRSA dan uji sensitivitas terhadap mupirosin dan gentamisin. Pada kedua kelompok masing-masing didapatkan 10 laki-laki dan 12 perempuan. Pada kelompok penderita DA didapatkan DA derajat sedang (10/22) dan berat (12/22), dengan lesi akut (14/22) dan kronik (8/22). Pertumbuhan S. aureus didapatkan pada 17/22 penderita DA dengan sensitivitas terhadap mupirosin 14/17 dan gentamisin 11/17 penderita. Pada individu sehat tidak didapatkan pertumbuhan koloni S. aureus. Galur MRSA ditemukan pada 3/17 penderita DA dan dianggap berbeda secara bermakna bila dibandingkan dengan individu sehat (p<0,01), galur ini bersifat sensitif terhadap mupirosin pada 2/3 penderita dan seluruhnya resisten terhadap gentamisin. Simpulan, kolonisasi MRSA perlu dicurigai pada penderita DA derajat sedang hingga berat, sehingga perlu pengobatan tambahan antibiotik topikal mupirosin. [MKB. 2013;45(1):36–44]Kata kunci: Dermatitis atopik, gentamisin, MRSA, mupirosinMethicillin-Resistant Staphylococcus aureus in Atopic Dermatitis Patients and Its Sensitivity to Mupirocin Compared to GentamycinMethicillin-resistant Staphylococcus aureus (MRSA) is found in moderate to severe atopic dermatitis (AD) and is multiresistant against topical antibiotic. Gentamycin is widely used while mupirocin is the first line therapy to eliminate MRSA. This research is intended to observe the colonization of MSRA case in AD patients and its sensitivity to mupirocin compared to gentamycin in Dermato-venereology Clinic Dr. Hasan Sadikin General Hospital Bandung. An analytical cross sectional survey was intended from 19th September–31st October 2011 in 22 moderate to severe AD patients based on objective Scoring Atopic Dermatitis and 22 healthy persons. All subjects went through skin-scraping, MSRA was detected and sensitivity test was done for mupirocin and gentamycin. The subjects consisted of 10 boys and 12 girls in both group. Based on severity, 10/22 of AD subjects were in moderate AD and 12/22 were severe AD, 14/22 of AD subjects presented with acute lesions and 8/22 subjects had chronic lesions. In the group of AD patients, 17/22 growth of S. aureus were found with sensitivity against mupirocin 14/17 and gentamycin 11/17. In healthy individual group, no  S. aureus growth was found. Methicillin-resistant Staphylococcus aureus strain in AD patients was observed on 3/17 patients, and this was declared significantly different compared to healthy individuals (p <0.01). The isolates in 2/3 patients were sensitive to mupirocin and all patients were resistant to gentamycin. In conclusion, the patients of moderate to severe AD are prone to MRSA colonization and therefore requires mupirocin topical antibiotic treatment.  [MKB. 2013;45(1):35–43]Key words: Atopic dermatitis, gentamycin, MRSA, mupirocin DOI: http://dx.doi.org/10.15395/mkb.v45n1.203
Co-Authors - Setiawan, - - Sudigdoadi, - Achadiyani Agustina, Rohana Anggraini, Dita Maulida Anissa, Anissa Devi Nursjamsi, Nadilla Carissa Diah Dhianawaty Dian Indriyani Hartati Purbo Dharmadji, Hartati Purbo Keni Istasaputri M. Marindani, Vani MUCHTAN SUJATNO Oki Suwarsa Pangastuti, Miranti Ponpon Idjradinata Ponpon S. Idjradinata Reiva Farah Dwiyana Reti Hindritiani Ronny Lesmana Setiawan Setiawan Sunarjati Sudigdoadi Tarawan, Vita M.