Hubungan Kepatuhan Pasien Tuberkulosis Paru Mengkonsumsi Isoniazid Selama Pengobatan Obat Anti Tuberkulosis dengan Mutasi Gen katG Ser315thr (G944c) Mycobacterium Tuberculosis

Mara Imam Taufiq Siregar

Abstract


Abstrak:  Mutasi pada gen Mycobacterim tuberculosis merupakan penyebab utama terjadinya resistensi terhadap  obat anti tuberkulosis (OAT) oleh karena kadar terapi yang inadekuat akibat ketidakpatuhan selama mengkonsumsi obat. Mutasi pada gen katG Ser315Thr (G944C) merupakan salah mutasi yang terjadi akibat ketidakadekuatan dosis isoniazid (INH) . Penelitian kohort dilakukan terhadap 100 pasien TB paru BTA positif yang akan mulai mengkonsumsi INH di Rumah Sakit Umum dr. Pirngadi Medan, yang belum mengalami mutasi gen katG Ser315Thr (G944C) M tuberculosis. Penelitian ini bertujuan untuk mengetahui hubungan antara kepatuhan pasien TB paru mengkonsumsi INH selama pengobatan OAT dengan terjadinya mutasi gen katG Ser315Thr (G944C). Kepatuhan dinilai dengan pemeriksaan metabolit INH urin metode Arkansas menggunakan Taxo urine test stripÒ, sedangkan mutasi gen dengan metode PCR-RFLP. Turut dinilai karakteristik sosiodemografi penderita TB paru pada penelitian ini serta hubungannya dengan kepatuhan dalam mengkonsumsi INH selama pengobatan OAT. Hasil penelitian tidak dijumpai adanya mutasi gen katG Ser315Thr (G944C) M tuberculosis, baik pada kelompok penderita TB paru yang patuh (84%) maupun tidak patuh (16%) mengkonsumsi INH (100% wild type). Berdasarkan karakteristik sosiodemografi, tidak dijumpai hubungan antara umur, suku, tingkat pendidikan  dan jenis kelamin penderita TB paru dengan tingkat kepatuhan mengkonsumsi INH selama pengobatan OAT. Simpulan, INH masih sangat sensitif untuk digunakan sebagai obat lini pertama bagi penderita TB paru yang akan mulai mendapat pengobatan OAT sampai pada bulan pertama penggunaan INH.

Kata kunci: Mycobacterium tuberculosis, mutasi gen katG Ser315Thr, PCR-RFLP, Taxo urine test stripÒ metode Arkansas, kepatuhan


DOI:

https://doi.org/10.30596/bf.v3i3.2066


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