부산지역 설사환자에서 분리한 Campylobacter jejuni의 항균제 감수성과 유전자형 분석
Antimicrobial Susceptibility and Genetic Analysis of Campylobacter jejuni Isolated from Diarrhea Patients in Busan
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부산지역 설사환자에서 분리한 Campylobacter jejuni 의항균제 감수성과 유전자형 분석부산광역시 보건환경연구원 감염병연구부 미생물팀박선희, 김병준, 권영희, 황인영, 성경혜, 박은희, 진성현배경: Campylobacter는 식품매개질환의 중요한 원인균으로, 본 연구에서는 부산지역 설사환자에서 분리한 Campylobacterjejuni의 분리경향, 항균제 내성률, 유전자형 분석에 대해 조사하였다. 방법: 2014년부터 2017년 9월까지 급성설사질환 감시사업 및 5건의 식중독 사례에서 97주의 Campylobacter jejuni를 분리하였다. 항균제 감수성 검사는 9종류의 항균제(ciprofloxacin (CIP), nalidixic acid (NAL), tetracycline (TET), chloramphenicol,azithromycin (AZI), erythromycin (ERY), streptomycin (STR), gentamicin, telithromycin)에 대하여 액체배지미량희석법으로 실시하였고, 유전자형은 pulsed-field gel electrophoresis (PFGE)로 분석하였다. 결과: Campylobacter jejuni의 4년간 평균 분리율은 2.0%였으며 해마다 분리율은 증가하였다. 항균제 내성률은 NAL90.9%, CIP 89.4%, TET 13.6%, AZI와 ERY 각 3.0%, STR 1.5% 순이었고, 다제내성률은 18.2%였으며 다제내성균주 모두quinolone계 항균제(CIP-NAL)를 포함하고 있었다. SmaI 제한효소로 처리한 PFGE 패턴은 모두 17개 cluster로 분류되었으며 이 중 cluster 11이 부산지역에서 분리되는 Campylobacter의 주요 유전자형 패턴이었다. 결론: 본 연구는 적절한 항균제 사용과 항균제 내성 관리를 위한 유용한 자료를 제시하며, 향후 증가가 예상되는Campylobacter로 인한 식중독의 역학 조사를 위한 자료 축적에 도움이 될 것이다.
Abstract
Background: Campylobacter jejuni is an importantfood-borne pathogen that causes human gastroenteritis. This study was conducted to investigate theincidence of isolation, antimicrobial susceptibility pattern,and C. jejuni genotype from diarrhea patients inBusan, Korea. Methods: A total of 97 C. jejuni were isolated fromdiarrhea patients during five food-borne outbreaksfrom 2014 to September 2017. Antimicrobial susceptibilitytests were carried out by the broth microdilutionmethod for ciprofloxacin (CIP), nalidixic acid(NAL), tetracycline (TET), chloramphenicol, azithromycin(AZI), erythromycin (ERY), streptomycin(STR), gentamicin, and telithromycin. To investigateC. jejuni genotypes, pulsed-field gel electrophoresis(PFGE) profile analysis was performed. Results: The isolation rate of C. jejuni was 2.0% forthe last 4 years and increased annually. Antimicrobialresistance rates of C. jejuni were shown to be in theorder of NAL (90.9%), CIP (89.4%), TET (13.6%),AZI (3.0%), ERY (3.0%), and STR (1.5%). The proportionof multidrug-resistance was 18.2%, and theycommonly contained quinolones (CIP-NAL). Analysisof PFGE patterns of SmaI-restricted DNA of C. jejuniisolates showed 17 clusters; cluster 11 was the majorgenotype pattern. Conclusion: This study will provide useful data forthe proper use of antimicrobials and the managementof resistant C. jejuni. Also it will help to providedata for the epidemiological investigation of foodbornediseases caused by C. jejuni, which is expectedto increase in the future.
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