HASIL PENELITIAN
PENGARUH CUKA APEL (Malus domestica) TERHADAP
PERTUMBUHAN Candida albicans SECARA IN VITRO
Oleh:
ELI ARDIANI
201610330311008
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2020
i
Pengaruh Cuka Apel (Malus domestica) Terhadap Pertumbuhan Candida
albicans Secara In Vitro
HASIL PENELITIAN
Ditujukan Kepada
Universitas Muhammadiyah Malang
Untuk Memenuhi Salah Satu Persyaratan
Dalam Menyelesaikan Program Sarjana
Fakultas Kedokteran
Oleh:
ELI ARDIANI
201610330311008
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2020
ii
iii
iv
v
KATA PENGANTAR
Assalamualaikum Wr. Wb.
Puji syukur kepada Allah SWT karena atas rahmat dan hidayah-Nya,
penulisan hasil penelitian ini dapat diselesaikan dengan baik. Sholawat serta salam
semoga selalu tercurahkan kepada Rasulullah SAW, keluarga, para sahabat dan
pengikut Beliau hingga akhir zaman.
Penelitian ini yang berjudul “Pengaruh Cuka Apel (Malus domestica)
Terhadap Pertumbuhan Candida albicans Secara In Vitro”. Hasil penelitian ini
diajukan untuk memenuhi persyaratan Pendidikan Sarjana Fakultas Kedokteran
Universitas Muhammadiyah Malang.
Pada kesempatan ini, penulis ingin menyampaikan ucapan terima kasih
yang tak terhingga kepada:
1. Dr. dr. Meddy Setiawan, Sp.PD, selaku Dekan Fakultas Kedokteran
Universitas Muhammadiyah Malang atas dukungannya selama di FK UMM.
2. dr. Moch. Ma’roef, Sp.OG, selaku Wakil Dekan I Fakultas Kedokteran
Universitas Muhammadiyah Malang sekaligus selaku dosen pembimbing I
yang selalu memberikan arahan, membimbing dengan sabar, memberi
dorongan motivasi, dan selalu menyediakan waktu membimbing penulis,
sehingga penulis dapat menyelesaikan tugas akhir ini dengan baik.
3. dr. Sri Adila Nurainiwati, Sp.KK, selaku Wakil Dekan II Fakultas
Kedokteran Universitas Muhammadiyah Malang sekaligus selaku penguji
yang senantiasa memberikan masukan dan saran yang sangat bermanfaat
untuk penulis.
4. dr. Indra Setiawan, Sp.THT-KL, selaku Wakil Dekan III Fakultas
Kedokteran Universitas Muhammadiyah Malang atas dukungannya selama di
FK UMM.
5. dr. Irma Suswati, M.Kes, selaku dosen pembimbing II yang selalu
memberikan arahan, membimbing dengan sabar, memberi dorongan motivasi,
dan selalu menyediakan waktu membimbing penulis, sehingga penulis dapat
menyelesaikan tugas akhir ini dengan baik.
vi
6. Kedua orangtua penulis, Bapak Budiono dan Ibu Marti, serta kakak satu-
satunya Mas Aris, terimakasih sudah menjadi motivasi terbesar penulis
selama menempuh pendidikan ini dan mengerjakan tugas akhir ini.
Terimakasih atas doa, dukungan, dan semangat yang selalu diberikan kepada
penulis. Tugas akhir ini penulis persembahkan untuk kalian.
7. Adhan Karisma, selaku teman sekaligus kekasih yang selalu memberikan doa,
dukungan, dan semangat sehingga penulis dapat menyelesaikan tugas akhir
ini.
8. Teman-teman di FK UMM Nadya, Tansa, Puteri, Sarah, Savira, dan Dian
yang selalu membantu dan memberikan dukungan serta semangat pada
penulis selama menempuh pendidikan dan mengerjakan tugas akhir ini.
9. Staf TU dan Laboran Laboratorium Biomedik Fakultas Kedokteran
Universitas Muhammadiyah Malang, atas bantuannya selama di FK UMM.
10. Semua pihak yang terlibat langsung maupun tidak langsung yang tidak
mampu penulis sebutkan satu per satu, terima kasih atas dukungan dan
doanya.
Dengan segala kerendahan hati, penulis mohon maaf sebesar-besarnya bila
hasil penelitian ini masih jauh dari kata sempurna. Oleh karena itu penulis
membuka diri untuk segala saran dan kritik yang bersifat membangun guna
kesempuranaan dari hasil penelitian ini. Semoga hasil penelitian ini dapat
memberikan manfaat bagi penulis, pembaca, dan menjadi sumbangan yang berarti
bagi perkembangan ilmu pengetahuan kedepan.
Wassalamualaikum Wr.Wb.
Malang, 20 Januari 2020
Penulis
vii
ABSTRAK
Ardiani, Eli. 2020. Pengaruh Cuka Apel (Malus domestica) Terhadap
Pertumbuhan Candida albicans Secara In Vitro. Tugas Akhir, Fakultas
Kedokteran Universitas Muhammadiyah Malang. Pembimbing: (1) Moch.
Ma’roef (2) Irma Suswati
Latar belakang: Candida albicans merupakan satu dari tiga penyebab terbanyak
vulvovaginal candidiasis di Indonesia. Fluconazole sebagai pengobatan lini
pertama vulvovaginal candidiasis juga dilaporkan mengalami resistensi sebesar
7% terhadap Candida spp. Cuka apel merupakan salah satu jenis olahan apel yang
memiliki banyak manfaat, termasuk sebagai antifungi. Hal tersebut disebabkan
karena kandungan asam asetat, flavonoid, dan pektin.
Tujuan: Untuk mengetahui pengaruh cuka apel (Malus domestica) terhadap
pertumbuhan Candida albicans secara in vitro.
Metode penelitian: True experiment dengan posttest-only control group design,
menggunakan dilusi tabung dengan konsentrasi cuka apel 100%, 50%, 25%,
12,5%, 6,25%, 3,125%, 1,56%, 0,78%, 0,39%, 0%. Analisis data menggunakan
uji One Way Anova, uji Post Hoc Games-Howell, dan uji Regresi Linear.
Hasil: KHM 6,25% dan KBM 12,5%. Hasil uji One Way Anova didapatkan nilai
signifikansi sebesar 0,000, menunjukkan terdapat perbedaan antara perlakuan
yang diuji. Hasil uji Post Hoc Games-Howell didapatkan hasil p<0,05 pada
konsentrasi 0,78% hingga 50%, menunjukkan besar penurunan yang signifikan
mulai konsentrasi 0,78% hingga 50%. Hasil uji Regresi Linear didapatkan R
Square sebesar 90,5%, menunjukkan dosis cuka apel berpengaruh terhadap
jumlah koloni C. albicans sebesar 90,5%.
Kesimpulan: Cuka apel (Malus domestica) memiliki pengaruh terhadap
pertumbuhan Candida albicans secara in vitro.
Kata Kunci: Cuka Apel, Candida albicans, KHM, KBM
viii
ABSTRACT
Ardiani, Eli. 2020. The Effect of Apple Cider Vinegar (Malus domestica) on the
Growth of Candida albicans In Vitro. Final Assignment, Medicine Faculty
of Muhammadiyah Malang University. Advisors: (1) Moch. Ma’roef (2)
Irma Suswati
Background: Candida albicans is one of three most common causes of
vulvovaginal candidiasis in Indonesia. Fluconazole as the first-line treatment for
vulvovaginal candidiasis also has reported resistance of 7% against Candida spp.
Apple vinegar is one type of processed apple that has many benefits, including as
an antifungal. This is caused by the content of acetic acid, flavonoids, and pectin
Purpose: To know the effect of apple cider vinegar (Malus domestica) on the
growth of Candida albicans in vitro.
Research Methods: True experiment with posttest-only control group design,
using dilution tube with apple cider vinegar concentration 100%, 50%, 25%,
12,5%, 6,25%, 3,125%, 1,56%, 0,78%, 0,39%, 0%. Data was analyzed using One
Way Anova, Post Hoc Games-Howell, and Regresi Linear.
Results: The MIC was 6,25% and the MFC was 12,5%. One Way Anova test
results obtained a significance value of 0,000, indicating there is a difference
between the treatments tested. The results of the Post Hoc Games-Howell test
showed p <0.05 at 0.78% to 50% concentration, indicating a significant decrease
from 0.78% to 50% concentration. The Linear Regression test results obtained R
Square of 90.5%, showing the dose of apple cider vinegar affects the number of C.
albicans colonies of 90.5%.
Conclusion: Apple cider vinegar (Malus domestica) had effect on the growth of
Candida albicans in vitro.
Keywords: Apple cider vinegar, Candida albicans, MIC, MFC
ix
DAFTAR ISI
HALAMAN JUDUL .............................................................................................. i
LEMBAR PENGESAHAN .................................................................................. ii
LEMBAR PENGUJIAN ...................................................................................... iii
PERNYATAAN ORISINALITAS ...................................................................... iv
KATA PENGANTAR .......................................................................................... iv
ABSTRAK .......................................................................................................... viii
ABSTRACT ....................................................................................................... viiii
DAFTAR ISI ......................................................................................................... ix
DAFTAR GAMBAR .......................................................................................... xiii
DAFTAR TABEL............................................................................................... xiv
DAFTAR SINGKATAN ..................................................................................... xv
DAFTAR LAMPIRAN ...................................................................................... xvi
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 .................................................................................... 5
1.4.1 Bidang akademis ............................................................................... 5
1.4.2 Bidang klinis ..................................................................................... 5
1.4.3 Bidang masyarakat. ........................................................................... 5
BAB II .................................................................................................................... 6
TINJAUAN PUSTAKA ........................................................................................ 6
2.1. Apel .......................................................................................................... 6
2.1.1. Taksonomi ......................................................................................... 6
2.1.2. Deskripsi ........................................................................................... 6
2.1.3. Kandungan Apel................................................................................ 8
2.2. Cuka Apel ............................................................................................... 10
2.2.1. Deskripsi ......................................................................................... 10
x
2.2.2. Proses Pembuatan Cuka Apel ......................................................... 11
2.2.3. Kandungan Cuka Apel .................................................................... 13
2.3. Candida albicans .................................................................................... 16
2.3.1. Taksonomi ....................................................................................... 16
2.3.2. Deskripsi ......................................................................................... 16
2.4. Kandidiasis ............................................................................................. 19
2.4.1. Definisi ............................................................................................ 19
2.4.2. Epidemiologi ................................................................................... 19
2.4.3. Faktor Predisposisi .......................................................................... 20
2.4.4. Patogenesis ...................................................................................... 21
2.4.5. Jenis Kandidiasis ............................................................................. 22
2.5. Antifungi................................................................................................. 25
2.5.1. Obat Sistemik untuk Infeksi Sistemik ............................................. 25
2.5.2. Obat Sistemik untuk Infeksi Mukokutis ......................................... 27
2.5.3. Obat Topikal untuk Infeksi Mukokutis ........................................... 27
2.6. Uji Kepekaan terhadap Antifungi ........................................................... 28
2.6.1. Metode Dilusi .................................................................................. 28
2.6.2. Metode Difusi Cakram .................................................................... 29
2.7. Penelitian Penunjang .............................................................................. 30
BAB III ................................................................................................................. 31
KERANGKA KONSEP DAN HIPOTESIS PENELITIAN ............................ 31
3.1. Kerangka Konsep ................................................................................... 31
3.2. Hipotesis Penelitian ................................................................................ 33
BAB IV ................................................................................................................. 34
METODE PENELITIAN ................................................................................... 34
4.1. Jenis Penelitian ....................................................................................... 34
4.2. Lokasi dan Waktu Penelitian .................................................................. 34
4.3. Subjek Penelitian .................................................................................... 34
4.3.1. Populasi dan Sampel ....................................................................... 34
4.3.2. Estimasi Besar Sampel .................................................................... 35
4.4. Variabel Penelitian ................................................................................. 35
4.4.1. Variabel bebas. ................................................................................ 35
xi
4.4.2. Variabel terikat ................................................................................ 35
4.4.3. Variabel kontrol .............................................................................. 35
4.5. Definisi Operasional ............................................................................... 36
4.6. Alat dan Bahan Penelitian ...................................................................... 37
4.6.1. Alat-alat dalam penelitian ............................................................... 37
4.6.2. Bahan-bahan dalam penelitian ........................................................ 38
4.7. Prosedur Penelitian ................................................................................. 38
4.7.1. Sterilisasi Alat ................................................................................. 38
4.7.2. Pembuatan Medium Sabouraud Dextrose Agar (SDA) .................. 38
4.7.3. Pembuatan Medium Sabouraud Dextrose Broth (SDB) ................. 39
4.7.4. Identifikasi C. albicans ................................................................... 39
4.7.5. Pembuatan Perbenihan Cair Jamur ................................................. 40
4.7.6. Uji Kepekaan Cuka Apel Terhadap C. albicans ............................. 40
4.8. Alur Penelitian ........................................................................................ 42
4.9. Analisis Data .......................................................................................... 43
BAB V ................................................................................................................... 45
HASIL PENELITIAN ........................................................................................ 45
5.1. Kadar Hambat Minimum Cuka Apel (Malus domestica) terhadap C.
albicans.............................................................................................................. 45
5.2. Kadar Bunuh Minimum Cuka Apel (Malus domestica) terhadap C.
albicans.............................................................................................................. 46
5.3. Analisis Data Kadar Bunuh Minimum Cuka Apel (Malus domestica)
terhadap Pertumbuhan C. albicans .................................................................... 47
5.4.1. Uji Normalitas (Shapiro Wilk Test)................................................. 47
5.4.2. Uji Homogenitas (Levene Test) ....................................................... 48
5.4.3. Uji One Way Anova ......................................................................... 49
5.4.4. Uji Post Hoc Games-Howell ........................................................... 50
5.4.5. Uji Regresi Linier ............................................................................ 50
BAB VI ................................................................................................................. 54
PEMBAHASAN .................................................................................................. 54
BAB VII................................................................................................................ 57
KESIMPULAN DAN SARAN ........................................................................... 57
7.1. Kesimpulan ............................................................................................. 57
xii
7.2. Saran ....................................................................................................... 57
DAFTAR PUSTAKA .......................................................................................... 58
LAMPIRAN ......................................................................................................... 63
xiii
DAFTAR GAMBAR
2.1 Tanaman apel…………………………………………………………...…7
2.2 Persamaan kimia pada proses fermentasi cuka apel…………………..…12
2.3 Struktur dinding C. albicans…………………………...………………...17
2.4 C.albicans secara mikroskopis………………………………………...…18
3.1 Kerangka konsep…………………………………………………………31
5.1 Grafik Uji Regresi Linier……………………………………………...…55
xiv
DAFTAR TABEL
2.1 Kandungan Apel………………………………………………………...…8
2.2 Kandungan Cuka Apel…………………………………………………...13
5.1 Tingkat Kejernihan Tabung Dilusi……………………………………….45
5.2 Pertumbuhan Koloni Jamur C. albicans…………………………...…….46
5.3 Hasil Uji Normalitas Shapiro Wilk Test…………….……………………48
5.4 Hasil Uji Homogenitas Levene Test………………………….…………..48
5.5 Hasil Uji One Way Anova……………………….……………………….49
5.6 Hasil Uji Post Hoc Games-Howell………………………………………50
5.7 Hasil Regresi Linier……………………………………………………...51
xv
DAFTAR SINGKATAN
C. albicans : Candida albicans
CDC : Centers for Disease Control and Prevention
KHM : Kadar Hambat Minimum
KBM : Kadar Bunuh Minimum
ROS : Reactive Oxygen Species
RNA : Ribonucleic Acid
DNA : Deoxyribonucleic Acid
NCCLS : National Committee for Clinical Laboratory Standart
MIC : Minimum Inhibitory Concentration
MFC : Minimum Fungicidal Concentration
S. typhi : Salmonella typhi
SDA : Sebouraud Dextrose Agar
SDB : Sebouraud Dextrose Broth
xvi
DAFTAR LAMPIRAN
1. Penelitian Pendahuluan…………………………………………………….63
2. Penelitian (Pengulangan 1)………………………………………………...70
3. Penelitian (Pengulangan 2)………………………………………………...77
4. Penelitian (Pengulangan 3)………………………………………………...84
5. Analisis Data……………………………………………………………….91
6. Surat Keterangan Lolos Kaji Ilmiah……………………………………….95
7. Keterangan Layak Etik…………………………………………………….96
8. Surat Keterangan Penuntasan Penelitian…………………………………..97
9. Dokumentasi Penelitian……………………………………………………98
10. Hasil Deteksi Plagiasi…………………………………………………….100
11. Kartu Konsultasi Tugas Akhir……………………………………………101
58
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