Karakteristik Klinis dan Profil Kepekaan Antibiotik dari Isolat Klinis Pasien dengan Infeksi  Methicillin Resistant Staphylococcus aureus (MRSA) di Rumah Sakit Daerah (RSD) Gunung Jati Kota Cirebon

Moh Erwin Indrakusuma

Authors

Moh Erwin Indrakusuma Departemen Parasitologi, Imunologi dan Mikrobiologi FK UGJ, Indonesia

Keywords:

Keywords: MRSA, antibiogram, antibiotic resistance, Staphylococcus aureus

Abstract

Abstrak

Latar Belakang : Methicillin-Resistant Staphylococcus aureus (MRSA) merupakan patogen prioritas global yang berkontribusi terhadap peningkatan mortalitas, lama rawat inap, serta biaya perawatan akibat terbatasnya pilihan terapi antibiotik efektif. Data epidemiologi dan pola kepekaan antibiotik MRSA lokal masih terbatas di wilayah Cirebon. Tujuan penelitian adalah menganalisis karakteristik klinis infeksi MRSA serta profil kepekaan antibiotik pada isolat klinis di Rumah Sakit Daerah Gunung Jati Kota Cirebon. Metode : Desain penelitian deskriptif potong lintang dengan data sekunder hasil identifikasi bakteri dan uji kepekaan antibiotik pada isolat Staphylococcus aureus periode Januari 2022–Oktober 2025. Identifikasi patogen dan pengujian minimum inhibitory concentration (MIC) dilakukan menggunakan sistem otomatisasi VITEK-2 Compact dengan metode broth microdilution sesuai standar Clinical and Laboratory Standards Institute (CLSI) 2025. Analisis antibiogram dilakukan menggunakan perangkat lunak WHONET 2025 dengan pendekatan first isolate only. Hasil dan Pembahasan : Dari 282 isolat S. aureus, sebanyak 56 isolat (19,86%) merupakan MRSA. Isolat MRSA paling sering ditemukan pada spesimen darah, pus, dan jaringan, dengan diagnosis klinis terbanyak berupa sepsis (32,14%) dan infeksi kulit serta jaringan lunak (21,43%). Antibiotik dengan tingkat sensitivitas tertinggi adalah nitrofurantoin (100%), linezolid (96,6%), vancomycin (96,6%), tigecycline (94,8%), rifampicin (89,8%), dan quinupristin/dalfopristin (89,7%). Beberapa antibiotik lain menunjukkan sensitivitas <70%, termasuk gentamicin, trimethoprim–sulfamethoxazole, dan tetracycline. Analisis overall antibiotic susceptibility menunjukkan kombinasi gentamicin dan trimethoprim–sulfamethoxazole memiliki probabilitas sensitivitas tertinggi (89,48%) sebagai alternatif terapi ketika antibiotik anti-MRSA utama tidak tersedia. Simpulan : Antibiotik pilihan pada infeksi MRSA adalah Nitrofurantoin (spesifik urine), Linezolid, Vancomycin, Tigecyclin, Rifampicin dan Quinpristin/dalfopristin dg alternatif kombinasi adalah Gentamycin + Trimetoprim sulfametoxazole.

Kata kunci: MRSA, antibiogram, resistensi antibiotik, Staphylococcus aureus

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a global priority pathogen associated with increased mortality, prolonged hospitalization, and higher healthcare costs due to limited effective antimicrobial therapy. Local epidemiological data and antibiotic susceptibility patterns of MRSA remain limited in the Cirebon region. This study aimed to analyze the clinical characteristics of MRSA infections and the antibiotic susceptibility profile of clinical isolates at Gunung Jati Regional Hospital, Cirebon. Methods: A descriptive cross-sectional study was conducted using secondary data from bacterial identification and antimicrobial susceptibility testing of Staphylococcus aureus isolates collected between January 2022 and October 2025. Pathogen identification and minimum inhibitory concentration (MIC) testing were performed using the VITEK-2 Compact automated system with the broth microdilution method in accordance with the Clinical and Laboratory Standards Institute (CLSI) 2025 guidelines. Antibiogram analysis was performed using WHONET 2025 software applying the first isolate only approach. Results and Discussion: Among 282 S. aureus isolates, 56 (19.86%) were identified as MRSA. MRSA isolates were most frequently obtained from blood, pus, and tissue specimens. The most common clinical diagnoses were sepsis (32.14%) and skin and soft tissue infections (21.43%). Antibiotics demonstrating the highest susceptibility rates included nitrofurantoin (100%), linezolid (96.6%), vancomycin (96.6%), tigecycline (94.8%), rifampicin (89.8%), and quinupristin/dalfopristin (89.7%). Several antibiotics showed lower susceptibility (<70%), including gentamicin, trimethoprim–sulfamethoxazole, and tetracycline. Analysis of overall antibiotic susceptibility indicated that the combination of gentamicin and trimethoprim–sulfamethoxazole provided the highest predicted sensitivity (89.48%) as an alternative therapeutic option when standard anti-MRSA agents are unavailable. Conclusion: The preferred antibiotics for MRSA infections include nitrofurantoin (for urinary infections), linezolid, vancomycin, tigecycline, rifampicin, and quinupristin/dalfopristin, while the combination of gentamicin and trimethoprim–sulfamethoxazole may serve as a potential alternative regimen.

Keywords: MRSA, antibiogram, antibiotic resistance, Staphylococcus aureus

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