Upaya Pengendalian dan Pencegahan Infeksi Patogen Multi-Drug Resistant Organism (MDRO) Klon Methicillin-Resistant Staphylococcus Aureus (MRSA) dengan Inovasi Produk Hand Rub Berbasis Alkohol

Abstract

The pandemic that is occurring caused both by COVID-19 (currently occurring) as well as the clone of the methicillin-resistant staphylococcus aureus (MRSA) in the previous period has really threatened human life. This condition requires materials that can break the chain of transmission from human to human and from the environment to human. An alcohol-based antiseptic (hand rub/hand sanitizer) often contains ethanol, isopropanol or n-propanol, or a combination of two of these types. Alcohol has an excellent germicidal activity in vitro against gram-positive and gram-negative vegetative bacteria (including multidrug-resistant pathogens such as MRSA and VRE) as well as viruses. Hand rub/hand sanitizer products are declared good if they have formulation stability, no irritation effect when they are used and are able to kill pathogens more than 90%. This study aimed to evaluate the quality of alcohol-based hand rub with WHO-based-standard formulation based on the stability of the formulation, the risk of irritation and the ability to kill bacteria. Hand rub/hand sanitizer was made by modifying the levels of the WHO formula with a hygiene procedure for 500 ml/bottle with the composition: Ethanol 96%; H2O2 3%; Glycerol 98%; and Aqua Sterile ad 500ml. Assessment on the presence of rancidity, clarity, discoloration, final alcohol content and skin irritation risk was done to know the quality of product formulation. A bacterial Methicillin-resistant staphylococcus aureus (MRSA) was used to assess the percentage of bacterial killing power. The selected bacteria were bacteria commonly found in the hospital environment. The results of formulation stability from four variants of level modification showed that MD.4 has good stability compared to other formulation modifications. The results of the percentage kill test against MRSA showed that the percentage kill is 99.90% at 1st, 2nd, and 5th minute. The selected manufacturer's product also showed the same percentage kill value at 1st, 2nd, and 5th minute. The results of percentage kill test showed that the effective value for each contact time is ≥ 90%. The SEM observations showed that MD.4 hand rub effect in the form of MRSA cell lysis. The LC50 test, it is known that MD.4 hand rub value is 620 ppm while softaman (control) is 114 ppm. In terms of irritation risk, twenty-three selected subjects were generally well tolerated in use.