2004년도 국내 12개 병원에서 분리된 주요 세균의 항균제 내성율
Antimicrobial Resistance of Clinically Important Bacteria Isolated from 12 Hospitals in Korea in 2004
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배경：새로운 내성균이 출현하고 흔해짐에 따라, 전국 규모의 내성율을 조사하는 것은 매우 중요하다. 본 연구에서는 2004년 상반기 전국 12개 대학병원 및 종합병원에 내원한 환자에서 분리된 주요 세균의 항균제 내성율을 분석하였다. 방법：전국 주요 대학병원 및 종합병원 총 12개 기관에서 분리된 주요 세균의 항균제 내성율을 조사하였다. 2004년 4월부터 11월 사이에 임상검체에서 분리된 주요 세균의 항균제 감수성 양상을 각 기관별로 종합하여 환자의 입원 형태에 따라 분석하였다. 결과：주요 원내감염균인 MRSA는 전체적으로 67%, 중환자실 환자에서는 86%에서 분리되었다. Vancomycin 내성 장구균(VRE)은 Enterococcus faecalis에서는 1%, Enterococcus faecium에서는 20%였다. Penicillin 내성 Streptococcus pneumoniae의 비율은 70%로 높았다. Haemophilus influenzae의 ampicillin 내성율은 40-63%로 평균 54%이었고 β-lactamase 생성율은 내성율과 비슷하였다. 제 3세대 cephalosporin제에 대한 내성율은 Escherichia coli에서 7-10%, Klebsiella pneumoniae에서 26-31%이었고, 주요 원내감염균인 Citrobacter freundii, Enterobacter cloacae 및 Serratia marcescens에서는 각각 22-30%, 35-44% 및 15-22%이었다. Pseudomonas aeruginosa의 imipenem과 meropenem에 대한 내성율은 평균 26% 및 21%이었다. Acinetobacter baumannii의 imipenem 내성율은 17%, meropenem 내성율은 32%로 다른 그람음성 간균에 비하여 높았다. Stenotrophomonas maltophilia의 cotrimoxazole 및 levofloxacin에 대한 내성율은 각각 46% 및 44%로 높았다. 결론：결론적으로 국내 환자의 임상검체에서 분리되는 주요 병원균의 항균제 내성율은 여전히 높았으며 외래 환자보다 항균제 선택압력이 높은 병동, 중환자실 환자에서 더욱 많은 내성 균주가 분리되었다. 내성 세균의 전파를 막기 위한 감염관리 대책 수립과 함께 전국적인 항균제 내성율 조사가 정기적으로 시행되어야 할 것으로 판단되었다.
Abstract
Background: A rapid increase in antimicrobial-resistant bacteria has become a serious problem in many countries including Korea, but the rate and pattern of antimicrobial resistance may vary significantly depending on countries and even on hospitals. The aim of this study was to determine the nationwide prevalence of resistance among frequently isolated bacterial pathogens in Korea. Methods: Routine susceptibility data for medically important bacterial pathogens from 12 university hospital and general hospital laboratories in Korea were analysed by patient group. These pathogens had been isolated during the period from April to November in 2004. Results: The proportion of methicillin-resistant Staphylococcus aureus (MRSA) was 67%. Vancomycin-resistance rate of Enterococcus faecalis was 1% and that of E. faecium was 20%. The resistance rates of Streptococcus pneumoniae to penicillin and Haemophilus influenzae to ampicillin were 70% and 54%, respectively. The resistant rates of Escherichia coli and Klebsiella pneumoniaewere 7-10% and 26-31% to the 3rd generation cephalosporin, respectively. The resistance rates to 3rd generation cephalosporin were 22-30% in Citrobacter freundii, 35-44% in Enterobacter cloacaeand 15-22 % in Serratia marcescens. Imipenem resistance rates of Pseudomonas aeruginosaand Acinetobacter baumannii were 26% and 17%. Cotrimoxazole and levofloxacin resistance rates of Stenotrophomonas maltophiliawere 46% and 44%, respectively. Conclusion: Antimicrobial resistance rates of clinically important pathogens in Korea were still high and were generally higher among the bacteria isolated from the intensive care unit patients. Strict infection control and continuous nationwide surveillance program will be required to manage the antimicrobial resistance problem.
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- "73 2004년도 국내 12개 병원에서 분리된 주요 세균의 항균제 내성율Antimicrobial Resistance of Clinically Important Bacteria Isolated from 12Hospitals in Korea in 2004Hyukmin Lee1"