2012년도 우리나라 급성설사질환 유발 원인 세균의 분리현황 및 특성
The Prevalence and Characteristics of Bacteria Causing Acute Diarrhea in Korea, 2012
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배경: 기후 변화에 따라 병원성 세균에 의한 설사증이 다발하고 있으며, 생활환경변화에 따라 설사를 유발하는 원인체의분리 양상 또한 변화하고 있다. 국내에서 발생하는 세균성 급성설사질환 유발 원인 병원체의 종류, 지역적 특성, 연령분포, 계절적 발생특성 및 분리균의 특성 등을 조사 분석하여 국내 발생 설사질환을 감소시키기 위한 기초 자료로 활용하고 국내 설사환자 병원체의 특성을 파악하고자 하였다. 방법: 2012년 1월부터 12월까지 엔터넷을 통해 접수된 설사환자 검체 21,180건을 대상으로 설사질환을 유발하는 것으로알려진 각 균 속의 주요 분리지역 및 환자의 나이, 성별에 따라 분석하였으며, 각 균 속에 대한 병원체 동정은 국립보건연구원에서 발간한 감염병 실험실진단(2005년)에 준하여 실험을 수행하였다. 결과: 전체 21,180건의 검체 중 감시 대상 원인 병원체의 분리율은 2,444건으로 전체 검체의 11.5%를 차지하였으며, 하절기인 6월부터 9월에 집중적으로 발생하였으나 Pathogenic E. coli와 Staphylococcus aureus, 그리고 Clostridium perfringens의경우 연중 지속적으로 분리되는 경향을 보였다. 연령별 분리율은 감염 취약계층인 10세 이하의 어린이 연령층에서 전체발생률의 절반이 넘는 분리율을 보였다. 결론: 다른 연령층에 비해 감염 취약계층인 10세 이하의 연령층과 50대, 그리고 70대 이상의 노약계층에 대한 위생교육및 지속적인 모니터링이 필요할 것으로 보인다. 그리고 대상 병원체에 대한 감염 예방을 위해 감시사업을 실시하여 지속적으로 자료를 축적하여 급성설사질환의 예방에 활용해야 할 것으로 생각한다.
Abstract
Background: Through change in the climate and living environment, bacterial pathogens that cause diarrhea also change. This study sought to determine the characteristics of pathogens according to species,isolated region, and patient age/sex using National Surveillance Data for diarrhea, and to provide basic data for the prevention of diarrheal disease. Methods: From January to December 2012, stool specimens were collected from 21,180 diarrheal patients in Korea to identify the pathogenic bacteria involved. Pathogenic bacteria were analyzed according to isolated region and patient age/sex. Identification and analysis of the pathogens were conducted based on the Guidelines of the National Institute of Health Diagnostic Laboratory: Disease-specific protocol (2005). Results: Among the 21,180 stool specimens, pathogenic bacteria known to cause diarrhea were isolated from 2,444 stool specimens (11.5%). The isolation rate was highest in the summer (from June to September)for most pathogenic bacteria, except Escherichia coli, Staphylococcus aureus, and Clostridium perfringens. The isolation rate of pathogenic bacteria based on patient age was highest in children under the age of 10. Conclusion: Hygiene education should be addressed in diarrheal disease-susceptible groups, such as children under 10, people in their 50s, and those greater than 70 years old, and ongoing monitoring for pathogens is needed. In addition, an efficient information system and surveillance program should be continued for infection prevention.
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