Karakteristik, Faktor Risiko, Pola Kuman dan Uji Sensitifitas Antibiotika pada Penyakit Otitis Media Supuratif Kronis (Omsk) di Rsup. Haji Adam Malik Medan

Abstract

Introduction: Chronic suppurative otitis media (CSOM) is a notorious infection and a major health problem in developing countries which can cause many complications.Data is needed to make new policy of treatment and preventive strategy. Method: This descriptive study was carried out from December 2014 to September 2015 at ENT Department and Microbiology Department of Haji Adam Malik General Hospital, Medan. This study was conducted with 30 ears of 26 CSOM patients with active aural discharge, either unilateral or bilateral. The exudates from tympanic cavity were collected in sterile conditions via 18 gauge needle covered with an intravenous plastic cateter connected to 1 ml disposable syringe under microscope guidance. Result: From 26 patients, 65,39% were men, 26,92% were at the age between 11-20 years old and 46,15% were at the right ears. Benign type was 76,66% and 83,33% with main complaint of active ear discharge with 56,6% duration of 6-10 years. In Schuller projection, chronic mastoiditis were found 70% of all images. 80,77% patients were live in densely populated environment, 76,92% patients were with low income level, and 69,23% patients have history of recurrent otitis media. Microbiology culture found 73,33% aerobic bacteria, 41,93% were Pseudomonas aeruginosa with high sensitivity rates to ceftazidime 100% and to amicasin 8,62%, 3,33% anaerobic bacteriaand 13,33% mixed bacteria.

Latar belakang: Otitis media supuratif kronis (OMSK) merupakan penyakit telinga yang sulit diobati dan masalah besar bagi kesehatan negara berkembang karena dapat menimbulkan banyak komplikasi. Untuk itu diperlukan strategi pencegahan dan pola tatalaksana yang sesuai dengan karakteristik, pola kuman dan uji sensitiitas antibiotika pada penderita OMSK. Metode: Penelitian bersifat deskriptif yang dilakukan dari bulan Desember 2014-September 2015 di Departemen THT dan Departemen Mikrobiologi di RSUP. H. Adam Malik Medan. Total sampel sebanyak 30 telinga dari 26 penderita OMSK dengan sekret aktif baik unilateral maupun bilateral. Sekret yang berasal dari kavum timpani diambil secara steril, menggunakan plastik intravenous cateter nomor 18 yang dihubungkan dengan spuit 1cc dan dilakukan dibawah mikroskop. Hasil: Dari 26 penderita diperoleh laki-laki 65,39% terjadi pada usia 11-20 tahun 26,92% pada telinga kanan 46,15%. Jenis OMSK benigna ditemukan terbanyak 76,66% dengan keluhan utama telinga berair 83,33% dengan lama keluhan 6-10 tahun 56,67% dengan gambaran mastoiditis kronis 70% pada foto polos proyeksi Schuller. 80,77% penderita OMSK tinggal ditempat yang padat dengan tingkat pendapatan rendah 76,92% dan riwayat otitis media berulang 69,23%. Hasil kultur dijumpai aerob 73,33% terbanyak Pseudomonas aeruginosa 41,93% sensitif pada ceftazidime 100% dan amicasin 8,62%, anaerob 3,33% dan kuman campuran 13,33%.