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한 대학병원의 혈액배양 결과 분석: 균종 분포와 누적 항생제 내성 양상(2016–2020)

Analysis of blood culture data at a university hospital: bacterial distribution and cumulative antimicrobial resistance (2016–2020)

김대원|안정열|박필환|이환태|서자영|서일혜
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2023.12|Annals of Clinical Microbiology|제26권 제4호|pp. 147-157|DOI 10.5145/ACM.2023.26.4.147

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SusceptibilityBloodstream infectionBlood culture

초록

배경: 혈류 감염에서 흔히 분리되는 균종 분포와 누적 항생제 감수성 양상은 초기 치료로써 경험적 항생제를 선택하는 근거가 된다. 따라서 개별 환자들의 혈액 배양 결과를 일관성 있게 수집하고 정확하게 분석하는 것이 중요하다. 방법: 2016년부터 2020년까지 한 대학병원 환자의 혈액 배양 결과를 후향적으로 분석하여 의미있는 병원균 분포 및 항생제 내성 양상을 파악하고자 하였다. 한 환자에서 같은 균종이 반복 분리되면 첫 번째 분리균만 포함하여 중복균을 제거하였다. 항생제 감수성 결과는 최소억제농도 값을이용하였으며 Clinical and Laboratory Standards Institute (CLSI) M100 ED30: 2020을 기준으로 해석하였다. 결과: 5년 동안 혈액 배양에서 가장 흔히 분리된 균은 Escherichia coli (27.1%)였고, Klebsiellapneumoniae (10.1%), Staphylococcus aureus (8.6%) 순이었다. S. aureus의 methicillin 내성률은 49.2%,E. faecium의 vancomycin 내성률은 39.5%였고 5년간 의미 있는 추세변화는 없었다. E. coli의cefotaxime, ciprofloxacin, ertapenem 내성률은 각각 35.0%, 46.8%, 0.7%였으며 총 17주의 carbapenem내성 E. coli가 분리되었고 이 중 11주가 carbapenemase 생성균이었다. K. pneumoniae의 cefotaxime,ciprofloxacin, ertapenem 내성률은 각각 29.5%, 31.7%, 5.4%였으며 총 48주의 carbapenem 내성 K. pneumoniae가 분리되었고 이 중 37주가 carbapenemase 생성균이었다. A. baumannii의 imipenem 내성률은 72.3%, P. aeruginosa의 imipenem 내성률은 23.4%로 5년간 추세변화는 없었다. 결론: 2016-2020년까지 혈액 배양에서 E. coli, K. pneumoniae, E. faecium 분리율은 증가추세였고S. aureus는 큰 변화가 없었다. 5년간 E. coli와 P. aeruginosa의 ciprofloxacin 내성률, A. baumannii의ampicillin/sulbactam 내성률이 증가추세를 나타냈다.

Abstract

Background: The distribution of bacteria isolated from bloodstream infections andcumulative antimicrobial susceptibility data are the basis for empirical decisions regardingantibiotics as an initial treatment. Therefore, it is important to consistently collect bloodculture results of individual patients and analyze them correctly. Methods: The blood culture results of patients at a university hospital from 2016 to 2020 wereanalyzed retrospectively to determine the bacterial distributions and antibiotic resistancepatterns. Duplicates were eliminated by including only the first isolate of each species perpatient. Results: Escherichia coli (27.1%) was the most commonly isolated bacterium from bloodcultures, followed by Klebsiella pneumoniae (10.1%) and Staphylococcus aureus (8.6%). Themethicillin resistance rate of S. aureus was 49.2%, and the vancomycin resistance rate ofEnterococcus faecium was 39.5%; with no significant changes over the study period. Thecefotaxime, ciprofloxacin, and ertapenem resistance rates of E. coli were 35.0%, 46.8%, and0.7%, respectively. Seventeen carbapenem-resistant E. coli strains were isolated, of which 11produced carbapenemase. The cefotaxime, ciprofloxacin, and ertapenem resistance rates ofK. pneumoniae were 29.5%, 31.7%, and 5.4%, respectively. Forty-eight carbapenem-resistantK. pneumoniae strains were isolated, of which 37 produced carbapenemase. The imipenemresistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa were 72.3% and23.4%, respectively. Conclusion: In the blood culture results from 2016 to 2020, the isolation frequency of E. coli, K. pneumoniae, and E. faecium showed an increasing trend, whereas that of S. aureuswas stable. Over the 5 year study period, the ciprofloxacin resistance rate of E. coli and P. aeruginosa and ampicillin/sulbactam resistance rate of A. baumannii significantly increased.

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관련 논문AI추천

한 3차 대학병원의 혈액배양 분석(2006년-2015년)권우재, 김경희, 박필환, 서일혜, 서자영, 안정열, 이환태, 정지훈대한임상미생물학회 · Annals of Clinical Microbiology2017 · 제20권 제2호13년간 한 대학병원 혈액배양에서 분리된 균의 분포 및 항생제 감수성 변화 양상김낙현, 김남중, 김의석, 김의종, 김홍빈, 박상원, 박완범, 송경호, 오명돈, 최평균, 황정환대한감염학회 · Infection and Chemotherapy2012 · 제44권 제4호1994-2003년 한 대학병원 혈액배양에서 분리된 미생물의 분포 및세균의 항균제 감수성 양상고은미, 김동수, 김명숙, 김준명, 김창기, 용동은, 이경원, 이상국, 정윤섭대한진단검사의학회 · Annals of Laboratory Medicine2007 · 제27권 제4호Trends in Bloodstream Infections and Antimicrobial Susceptibilities at a University Hospital in Korea Between 2007 and 2016권민정, 박효순, 염준섭, 우희연, 이경훈, 임상은, 정혜숙, 주은정대한진단검사의학회 · Laboratory Medicine Online2019 · 제9권 제2호Characteristics of Microorganisms Isolated from Blood Cultures at a University Hospital Located in an Island Region During 2003∼2007강성하, 김영리대한임상미생물학회 · Annals of Clinical Microbiology2008 · 제11권 제1호환자의 혈액배양에서 분리된 균종과 항균제 감수성의 변화추이문대수, 박영진, 안균열, 이성현, 장숙진, 정옥연대한임상미생물학회 · Annals of Clinical Microbiology2006 · 제9권 제1호

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