Identifikasi Penyebab Diare di Kabupaten Karangasem, Bali

Abstract

In February to March 2008, Bali was shocked by the outbreak of diarrhea in Karangasem District, Bali. It was recorded that 600 people were having diarrhea and 5 people were died due to the disease. This outbreak was the first time happened in Bali and the causing pathogen was not yet identified. The aim of this study was to identify the causing pathogen of diarrhea in the outbreak case in Karangasem, as well as to identify the possible transmitting pathway. The tracking of outbreak cause was carried out by analyzing water sample taken from communal clean water source, private clean water reservoir, food sample, as well as rectal swab of the patient with the combination of pathogen enrichment technique and specific PCR with Escherichia coli as the target of toxin forming agent. Based on the culture growth from food samples, it was found that 11 from 21 samples were E. coli positive. From samples that E. coli positive, 2 samples that were taken from patient’s house were detected a shiga like toxic forming gene, type I and II on the E. coli. The similar shiga like toxin forming gene type I was also detected on samples from patient and samples from water of private family cubang. This shows that E. coli that forms shiga like toxin type I was the diarrhea causing pathogen in this particular outbreak in Karangasem. Furthermore, it was found out that the ribbon formed by shiga like toxin type I and II differ from the strain of EHEC. Thus, it is possible that the strain found in Karangasem was a new strain of E. coli pathogen due to genetic transformation on shiga like toxin forming E. coli that was found in Bali. Key words : Diarrhea, Escherichia coli, shiga like toxin