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2011년 국내 12개 병원에서 분리된 효모균과 균사형 진균의 분포

Distribution of Yeast and Mold Species Isolated from Clinical Specimens at 12 Hospitals in Korea during 2011

김신영|김수현|이경원|김미나|이미경|박연준|이혜수|이원길|어영|신종희|이위교|원은정|구선회
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2013.06|Annals of Clinical Microbiology|제16권 제2호|pp. 92-100|DOI http://dx.doi.org/10.5145/ACM.2013.16.2.92

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참고문헌

키워드

Species distributionFungiYeastsMolds

초록

배경: 진균 감염증의 빈도 및 분포는 병원 및 분석시기에 따라 다를 수 있다. 본 연구에서는 국내 다기관의 임상 검체에서 최근 분리된 효모균 및 균사형 진균의 분포에 대하여 조사하였다. 방법: 2011년 1월부터 12월까지 국내 12개 대학병원의 임상 검체에서 분리된 효모균 및 균사형 진균을 균종별, 병원별및 검체별로 분석하였다. 결과: 1년 동안 효모균 37,847주, 균사형 진균 1,686주 등 총 39,533주의 진균이 분리되었다. 전체 임상 검체에서 분리된효모균에서 C. albicans (49.4%)가 가장 흔하였고 C. glabrata (7.2%) 및 C. tropicalis (6.5%) 순이었다. 무균 체액 검체에서5,248주의 효모균이 분리되었는데, 71.1%가 혈액에서 분리되었고, 복수액(9.4%)이 그 다음 순이었다. 무균 체액에서 분리된 효모균 중 2개 병원을 제외한 10개 병원에서 C. albicans (41.7%)가 가장 흔하였으나 non-albicans 칸디다 균종의 비율은 71.2%에서 40.1%로 병원마다 상당히 다양하였다. 전체적으로 무균 검체에서는 C. albicans (41.7%), C. parapsilosis (17.8%), 및 C. glabrata (14.4%) 순으로, 비 무균 검체에서는 C. albicans (50.7%), C. glabrata (6.0%) 및 C. tropicalis (5.5%) 순으로 분리되었다. 균사형 진균 중에는 아스페르길루스(62.3%)가 가장 흔히 분리되었고 그 다음은 Trichophyton spp. (15.4%)이었다. 균사형 진균은 호흡기 검체에서 전체 균주의 39.6%가 분리되었고 농 검체(28.4%)와 조직 검체(17.5%)의순이었다. 결론: 임상 검체에서 분리된 효모균 및 균사형 진균의 균종 분포는 검체 종류 및 병원마다 다소 상이하였다. 따라서 추후검체에 따른 진균 균종의 분포에 대한 주기적인 조사가 필요할 것으로 생각한다.

Abstract

Background: The incidence of fungal infections varies among hospitals and between different time periods. We performed a nationwide survey in Korea to investigate the distribution of yeast and mold species recovered from clinical specimens. Methods: The distributions of clinical isolates of yeast and mold species obtained from 12 university hospitals between January and December 2011 were evaluated relative to the hospital and specimen type. Results: A total of 39,533 fungal isolates (37,847 yeast and 1,686 mold isolates) were obtained. C. albicans was the predominant species (49.4%) among the yeast isolates from all clinical specimens, followed by C. glabrata (7.2%) and C. tropicalis (6.5%). For 5,248 yeast isolates from sterile body fluids, blood was the most common source of yeasts (71.1%), followed by peritoneal fluid (9.4%). Although C. albicans was the predominant species at all but two hospitals, the rate of non-albicans Candida species varied from 71.2% to 40.1%, depending on the hospital. The yeast species recovered most frequently from the sterile body fluids was C. albicans (41.7%), followed by C. parapsilosis (17.8%) and C. glabrata (14.4%), while that from non-sterile sites was C. albicans (50.7%), followed by C. glabrata (6.0%) and C. tropicalis (5.5%). For mold-forming fungi, Aspergillus species (62.3%) were most common, followed by Trichophyton species (15.4%). Respiratory specimens were the most common source of molds (39.6%), followed by abscesses/wounds (28.4%) and tissues (17.5%). Conclusion: The rank order of distribution for different fungal species varied among hospitals and specimen types. Continual national surveillance programs are essential for identifying possible changes in fungal infection patterns.

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