Multilocus Sequence Typing of Clonal Changes of Methicillin-resistant Staphylococcus aureus Isolated from Intensive Care Unit Patients: 1996 versus 2004
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배경：한국의 3차 진료기관에서 분리되는 황색포도구균의 70% 이상은 methicillin 내성으로 보고 된 바 있다. 최근 multilocus sequence typing (MLST) 기법은 환자에서 분리되는 methicillin-resistant Staphylococcus aureus (MRSA)에 대해 지역 및 국가간의 역학분석을 위해 흔히 사용되고 있다. 저자들은 동일한 병동에서 일정한 기간을 두고 분리된 MRSA 균주들을 대상으로 유전적 배경을 비교해보고자 하였다. 방법：한국의 1개 3차 진료기관의 중환자실에서 분리된 MRSA를 대상으로 하였다. 1996년에 분리된 16주, 2004년에 분리된 17주를 수집하여 8년간 중환자실에서 분리된 MRSA의 균형의 변화를 알아보고자 하였다. 디스크 확산법으로 항균제 감수성 검사를 시행하였고, MLST를 시행해 각각의 sequence type을 결정하였다. 결과：1996년 분리주 중 ST5(n=11, 68.7%)가 가장 흔한 형이었고, ST254 (n=3, 18.8%), ST1(n=2, 12.5%)의 형들이 분리되었다. 2004년에는 ST5은 6균주에서만 확인되었고 ST239(n=10, 58.8%)로 가장 흔한 형이 바뀌었다. 결론：중환자실에서 분리된 MRSA의 sequence type은 1996년에는 ST5가 가장 우세하였으나, 2004 년에는 ST239로 변화하였다.
Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) accounts for more than 70% of S. aureus isolates from tertiary-care hospitals in Korea. Recently, a multilocus sequence typing (MLST) scheme has been used to study the local and global epidemiologies of MRSA. The aim of this study is to compare the genetic background of MRSA strains isolated in the same ward during two different periods. Methods: To investigate clonal changes of endemic MRSA isolates between 1996 and 2004, we studied a total of 33 MRSA strains (16 from 1996 and 17 from 2004) isolated in the intensive care units of a tertiary-care hospital in Korea. The isolates were analyzed for their sequence types by MLST and for their antimicrobial susceptibilities by the disk diffusion method. Results: ST5 was the most frequent type (n=11, 68.7%) in 1996, followed by ST254 (n=3, 18.8%) and ST1 (n=2, 12.5%). In 2004, ST239 was the most frequent type (n=10, 58.8%), followed by ST5 (n=6, 35.3%). Conclusion: The major clone type of MRSA isolates from intensive care unit patients changed from ST5 in 1996 to ST239 in 2004.
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