KARYA TULIS AKHIR

UJI EFEK ANTIMIKROBA EKSTRAK ETANOL BUAH LADA HITAM

(Piper nigrum) TERHADAP PERTUMBUHAN Salmonella typhi

SECARA IN VITRO

Oleh :

Mudrika Amaliah

201510330311192

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

KATA PENGANTAR

Assalamu’alaikum wa rahmatullahi wa barakatuh

Puji syukur saya panjatkan kepada Tuhan Yang Maha Esa, karena atas

rahmat dan hidayah-Nya, penulis telah berhasil menyelesaikan usulan penelitian

yang berjudul “Uji Efek Antimikroba Ekstrak Etanol Buah Lada Hitam (Piper

nigrum) terhadap Pertumbuhan Salmonella typhi Secara In Vitro”.

Penulisan usulan penelitian ini dilakukan dalam rangka memenuhi salah

satu persyaratan dalam program sarjana Fakultas Kedokteran Universitas

Muhammadiyah Malang.

Penulis menyadari bahwa penyusunan usulan penelitian ini jauh dari

sempurna, walaupun demikian penulis telah berusaha semaksimal mungkin serta

mendapatkan bantuan dan bimbingan dari Dosen Pembimbing dalam rangka

penyusunan. Tanpa bantuan dan dorongan dari berbagai pihak, tidaklah mudah

menjalani masa perkuliahan hingga pada penyusunan tugas akhir ini.

Akhir kata, penulis mengucapkan terima kasih kepada semua pihak yang

telah membantu dan memberikan dukungannya, semoga amal kebaikan tersebut

dilipat gandakan Allah .

Wassalamu’alaikum wa rahmatullahi wa barakatuh

Malang, 09 Agustus 2019

Penulis

vi

UCAPAN TERIMAKASIH

Pada penulisan karya tulis ini, penulis banyak mendapat bimbingan dan bantuan

dari berbagai pihak. Oleh karena itu dalam kesempatan ini penulis mengucapkan

terima kasih yang tak terhingga kepada:

1. Dr. dr. Meddy Setiawan, Sp. PD, selaku Dekan Fakultas Kedokteran

Universitas Muhammadiyah Malang atas bimbingannya selama di

Fakultas Kedokteran Universitas Muhammadiyah Malang.

2. dr. Moch. Ma’roef, Sp. OG, selaku Wakil Dekan 1 Fakultas Kedokteran

Universitas Muhammadiyah Malang atas bimbingannya selama di

Fakultas Kedokteran Universitas Muhammadiyah Malang.

3. dr. Sri Ardila Nurainiwati, Sp. KK, Selaku Wakil Dekan II Fakultas

Kedokteran Universitas Muhammadiyah Malang atas bimbingannya

selama di Fakultas Kedokteran Universitas Muhammadiyah Malang.

4. dr. Indra Setiawan, Sp. THT-KL, Selaku Wakil Dekan III Fakultas

Kedokteran Universitas Muhammadiyah Malang atas bimbingannya

selama di Fakultas Kedokteran Universitas Muhammadiyah Malang.

5. dr. Irma Suswati, M. Kes selaku dosen pembimbing I, atas kebaikan hati,

kesediaan dalam meluangkan waktu, telah membantu membimbing dan

mengarahkan penulis dalam menyelesaikan karya tulis ini.

6. dr. Diah Hermayanti, Sp. PK selaku dosen pembimbing II, atas kebaikan

hati, kesediaan dalam meluangkan waktu, telah membantu membimbing

dan mengarahkan penulis dalam menyelesaikan karya tulis ini.

vii

7. dr. Isbandiyah, Sp. PD selaku dosen penguji yang telah membantu,

memberikan arahan serta saran yang bermanfaat kepada penulis dalam

penyelesaian karya tulis ini.

8. Seluruh Staff dan Tata Usaha serta Laboran Laboratorium Biomedik

Fakultas Kedokteran Universitas Muhammadiyah Malang atas

bimbingannya selama di Fakultas Kedokteran Universitas Muhammadiyah

Malang.

9. Kedua orangtua penulis, Ayahanda Ambo Lala Rauf dan Ibunda Siti

Barisah yang selalu mendukung penulis dalam setiap keadaan. Saya

berdoa agar Allah selalu menyayangi beliau berdua sebagaimana beliau

menyayangi penulis sewaktu kecil.

10. Saudara penulis yang terkasih, Syahid Kamal Firdaus, Maula Arfawie,

Hilal Fithrawie serta Arizka Choirun Nisa. Terima kasih atas doa,

dukungan serta motivasi yang tiada henti.

11. Tim Kuliner yang terkasih, Zakiyatul Amaliyah, Ruru Indrawati, Balqis

Hanifatul, Safira Putri, Anggraeni Saputri, Bayu Destiawan, Hilman

Fachriansyah, Indra Ardiansyah, Azmy Abdah, Arfan Umar, Uwais Al

Qarany.

12. Tim Mikro yang sudah banyak membantu, Siti Sofiatul Aini, Putri

Mumpuni, Shaskia Rafsanjani, Inggit Ndaru, Mbak Siti Qomariyah, Nadia

Wahyuning

13. Segenap keluarga Obscura Medico dan Saman FK UMM

14. Sejawatku Metacarpal15 FK UMM yang telah berjuang bersama ,

terimakasih atas dukungan, bantuan dan semangat kalian. Semoga kelak

viii

dapat menjadi dokter-dokter yang professional, amanah, erakhlakul

karimah, serta selalu diliputi keberkahan Allah dalam pengabdiannya.

15. Saudara A4/9 terkasih, Mbak Resa, Adella Juanita, Mbak Favi, Mbak

Anggi, Mbak Chandra, Mbak Irene Tiara, Mbak Intan, Mbak Tir.

16. Temanku terkasih No OMDO, Odin, Pauline, Lutfi, Ika, Adit, Bashir,

Ridwan, Edwin.

17. Sahabatku Husnul Hatimah yang telah berkenan dengan kebaikan hati

serta keikhlasannya dalam membantu penulis selama pengerjaan karya

tulis ini.

ix

DAFTAR ISI

HALAMAN JUDUL ....................................................................................... i

HASIL PENELITIAN ................................................................................... ii

LEMBAR PENGESAHAN ............................................................................ iii

HALAMAN PERNYATAAN ORISINALITAS ........................................... iv

LEMBAR PENGUJIAN ................................................................................. v

KATA PENGANTAR .................................................................................... vi

UCAPAN TERIMA KASIH ..........................................................................vii

ABSTRAK ....................................................................................................... x

ABSTRACT..................................................................................................... xi

DAFTAR ISI ..................................................................................................xii

DAFTAR TABEL ..........................................................................................xii

DAFTAR GAMBAR ..................................................................................... xvi

DAFTAR SINGKATAN ...............................................................................xvii

DAFTAR LAMPIRAN ................................................................................ xviii

BAB 1 PENDAHULUAN................................................................................ 1

1.1 Latar Belakang ..................................................................................... 1

1.2 Rumusan Masalah ................................................................................ 4

1.3 Tujuan Penelitian ................................................................................. 4

1.3.1 Tujuan Umum ............................................................................ 4

1.3.2 Tujuan Khusus............................................................................ 4

1.4 Manfaat Penelitian ............................................................................... 4

1.4.1 Manfaat Akademik ..................................................................... 4

1.4.2 Manfaat Masyarakat ................................................................... 4

BAB 2 TINJAUAN PUSTAKA ...................................................................... 5

2.1 Tinjauan tentang lada hitam (Piper nigrum) ......................................... 5

2.1.1 Taksonomi lada hitam (Piper nigrum) ........................................ 5

2.1.2 Morfologi tumbuhan ................................................................... 5

2.1.3 Habitat dan Distribusi Geografi ........................................................... 7

2.1.4 Kandungan buah lada hitam (Piper nigrum)................................ 7

xii

2.1.5 Manfaat lada hitam (Piper nigrum) ............................................. 9

2.1.6 Mekanisme lada hitam (Piper nigrum) sebagai antibakteri .......... 9

2.2 Tinjauan tentang Salmonella typhi ....................................................... 12

2.2.1 Taksonomi ................................................................................. 12

2.2.2 Struktur ..................................................................................... 12

2.2.3 Struktur Antigen ........................................................................ 18

2.2.4 Metabolisme Bakteri .................................................................. 19

2.2.5 Pertumbuhan S. typhi ................................................................. 20

2.2.6 Identifikasi Bakteri S. typhi ........................................................ 21

2.2.7 Daya Tahan ............................................................................... 23

2.2.8 Patogenitas S. typhi .................................................................... 23

2.2.9 Patogenesis S. typhi ................................................................... 23

2.2.10 Diagnosis Laboratorium........................................................... 25

2.2.11 Pengobatan .............................................................................. 28

BAB 3 KERANGKA KONSEP ..................................................................... 39

3.1 Kerangka Konsep Penelitian ................................................................ 39

3.2 Hipotesis Penelitian ............................................................................. 40

BAB 4 METODOLOGI PENELITIAN ........................................................ 41

4.1 Jenis Penelitian .................................................................................... 41

4.2 Lokasi dan Waktu Penelitian ............................................................... 41

4.3 Populasi dan Sampel ........................................................................... 41

4.3.1 Populasi ..................................................................................... 41

4.3.2 Sampel ...................................................................................... 41

4.3.3 Estimasi Jumlah Pengulangan .................................................... 41

4.4 Jenis Variabel ...................................................................................... 42

4.4.1 Variabel Bebas .......................................................................... 42

4.4.2 Variabel Terikat ......................................................................... 43

4.5 Definisi Operasional ............................................................................ 43

4.6 Instrumen Penelitian ............................................................................ 44

4.6.1 Alat dan Bahan Pembuatan Ekstrak Buah Lada Hitam ............... 45

4.6.2 Alat dan Bahan Uji Kepekaan Esktrak Buah Lada Hitam ........... 45

xiii

4.7 Prosedur Penelitian .............................................................................. 45

4.7.1 Sterilisasi Alat ........................................................................... 45

4.7.2 Pembuatan Medium SS Agar ..................................................... 46

4.7.3 Pembuatan Ekstrak Buah Lada Hitam ........................................ 46

4.7.4 Pembuatan Perbenihan Cair Bakteri ........................................... 47

4.7.5 Uji Kepekaan Ekstrak Buah Lada Hitam .................................... 48

4.8 Skema Alur Penelitian ......................................................................... 51

4.9 Analisis Data ....................................................................................... 51

BAB 5 HASIL PENELITIAN DAN ANALISIS DATA ............................... 53

5.1 Efek Ekstrak Buah Lada Hitam (Piper nigrum) terhadap S. typhi ........ 53

5.2 KBM Ekstrak Buah Lada Hitam (Piper nigrum) terhadap S. typhi ....... 53

5.3 Pengaruh Perlakuan Konsentrasi Ekstrak Buah Lada Hitam (Piper

nigrum) terhadap S. typhi .......................................................................... 54

5.3.1 Uji Normalitas Shapiro-Wilk...................................................... 54

5.3.2 Uji Homogenitas Levene’s test ................................................... 54

5.3.3 Uji One way ANOVA ................................................................. 55

5.3.4 Uji Post Hoc Bonferroni ............................................................ 55

5.3.5 Uji Regresi Linier ...................................................................... 55

BAB 6 PEMBAHASAN ................................................................................. 59

BAB 7 KESIMPULAN DAN SARAN ........................................................... 64

7.1 Kesimpulan ......................................................................................... 64

7.2 Saran ................................................................................................... 64

DAFTAR PUSTAKA ..................................................................................... 65

LAMPIRAN ................................................................................................... 71

xiv

DAFTAR TABEL

Tabel Halaman

Tabel 2.1 Deksripsi Bagian Tumbuhan Lada Hitam .......................................... 6

Tabel 4.1 Definisi Operasional ......................................................................... 39

Tabel 5.1 Rerata Jumlah Koloni S. typhi Per Cawan ......................................... 50

Tabel 5.2 Uji Normalitas Data.......................................................................... 51

Tabel 5.3 Uji Homogenitas Data ...................................................................... 51

Tabel 5.4 Uji Statistik One Way ANOVA .......................................................... 52

Tabel 5.5 Hasil Uji Post Hoc Bonferroni .......................................................... 53

Tabel 5.6 Hasil Uji Regresi Linier .................................................................... 54

xv

DAFTAR GAMBAR

Gambar Halaman

Gambar 2.1 Tanaman lada hitam (Piper nigrum) .................................................. 5

Gambar 2.2 Flagela peritrichous Salmonella ........................................................ 7

Gambar 2.3 Flagela S. typhi yang membawa antigen H ...................................... 19

Gambar 2.4 Gambaran kultur Salmonella typhi .................................................. 20

Gambar 2.5 Pewarnaan gram Salmonella typhi dari kultur darah positif ............. 21

Gambar 2.6 Gambaran bakteri gram negatif produksi S ................................. 26

Gambar 3.1 Kerangka Konsep...............................................................................35

Gambar 4.1 Skema Alur Penelitian.......................................................................48

Gambar 5.1 Gambar Grafik Scatter Plot.......................................................... ..56

xvi

DAFTAR SINGKATAN

ANOVA : Analysis of Variance

CFU : Coloni Forming Unit

DNA : Deoxyribonucleid Acid

EMB : Eosin Methylen Blue

KBM : Kadar Bunuh Minimal

LPS : Lipoposakarida

KHM : Kadar Hambat Minimal

MCA : Mac Conkey Agar

MDR : Multi Drug Resistance

mRNA : Messenger Ribonucleid Acid

MR-VP : Methyl Red – Vogas Proskauer

NCCLS : National Committee on Clinical Laboratory Standards

PABA : Para-aminobenzoic acid

RNA : Ribonucleid Acid

SSA : Salmonella Shigella Agar

tRNA : Transfer Ribonucleid Acid

TSA : Trypticase Soy Agar

TSIA : Triple Sugar Iron Agar

XLD : Xylose Lysine Deoxycholate

xvii

DAFTAR LAMPIRAN

Lampiran Halaman

Lampiran 1: Hasil analisis data SPSS ............................................................... 71

Lampiran 2: Hasil Pengamatan KBM dan Dokumentasi Penelitian .................. 72

Lampiran 3: Surat Telah Selesai Penelitian ...................................................... 77

Lampiran 4: Surat Lolos Kaji Ilmiah ................................................................ 78

Lanpiran 5: Surat Keterangan Bimbingan Metodologi Penelitian ..................... 79

Lampiran 6: Surat Keterangan Laporan Hasil Uji Isolat Bakteri ....................... 80

Lampiran 7: Surat Determinasi Tanaman Lada Hitam ...................................... 81

Lampiran 8: Hasil Deteksi Plagiasi .................................................................. 82

Lampiran 9: Kartu Konsultasi Tugas Akhir ...................................................... 83

xviii

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