Praktikum Modul Infeksi &

Imunologi
Interpretasi Pemeriksaan
Mikrobiologi
 Antimicrobial susceptibility tests

Minimum inhibitory concentration [MIC]

The smallest concentration of antibiotic
that inhibits the growth of organism
Liquid media (dilution) allows MIC
estimation
Solid media (diffusion)
Disk diffusion (Kirby-Bauer)
E-tests
Allows MIC estimation
Dilution in liquid broth
Tubes containing increasing antibiotic
concentrations

MIC
Bacterial growth Inhibition

0 (Control) 0,25 0,50 1 2 4 8 mg/l

Kirby-Bauer disc testing
Clear zone of inhibition around disc reflects susceptibility
Based on size of zone organism can be described as susceptible or
resistant
Uji Kepekaan Antibiotik
E-test
Plastic strips with a
predefined gradient of
One antibiotic
One antifungal
Only one manufacturer
One strip per antibiotic
Wide range of antibiotics
Easy to use
Storage at -20C
Short shelf life, expensive
Reading E-tests Ciprofloxacin for
Yersinia pestis

Resistant > 4 ug/ml

Intermediate 1-4 ug/ml

Susceptible < 1

Upper reading
Different standards

Use standardized reference

National Committee for Clinical
Laboratory Standards (USA)
Clinical Laboratory Standard Institute
(CLSI)
Other norms
Canadian
Europe
British
Do not confuse the different tables
Critical points in quality assurance

1. Culture media: Muller-Hinton

2. Reagents: disks
3. Size of the inoculums
4. Incubation condition
5. Control with reference strains
6. Reading inhibition diameters (accurate
measurement)
7. Knowledge of staff
Cara pengambilan,
penyimpanan dan
pengiriman bahan
Petunjuk Umum
Pemeriksaan diambil
sebelum diberikan
antibiotik
Bahasn pemeriksaan
diambil saat & lokasi yang
tepat( untuk dapat kuman)
Tindakan aseptik
Jumlah cukup
Formulir diisi
lengkap(riwayat penyakit,
pengobatan,diagnosis
Pelabelan yang jelas
Petunjuk
Air seni Khusus
penampungan pagi
hari-steril-midstream/
kateter-segera kirim.
( Urin diambil < 3 hari
MRS)
Darah : diambil sesuai
perjalan penyakit
Dengan media
bactec
Ukuran sesuai dengan
aturan
 Lanjt.....

Tinja LCS

Pengambilan pada
pagi hari atau tinja
yang baru Pengambilan dengan
pungsi
Hapusan rektum
kurang dianjurkan Pengiriman segera
mungkin
Jumlah 10 gramn
Segera kirim
Laboratorium Mikrobiologi
Pemeriksaan Kultur Darah