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감염관리를 위한 신속 검출법을 이용한 다제내성 세균의 적극적 감염감시

Active Surveillance of Multidrug-Resistant Organisms with Rapid Detection Methods for Infection Control

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초록

여러 항균제에 대해 내성을 보이는 다제내성 세균은 한국에서 점점 심각한 문제가 되고 있고, 메티실린내성 황색 포도알균(MRSA), 반코마이신내성 장알균(VRE), 다제내성 녹농균 및 다제내성 Acinetobacter baumannii 등이 점점 증가하고 있다. 더욱이 최근에는 카바페넴 약제도 내성을 보이는 장세균군이 출현하여 전세계적으로 퍼지고 있어 보건에 긴급한 위협이 되고 있다. 무증상의 보균자에게서 다제내성 세균을 검출하는 적극적 감염감시(active surveillance)는 MRSA와 VRE의 감염 관리의 중요한 방법으로 사용되고 있으며, 다제내성 그람음성 막대균에 대해서도 효과적인 전략이 될 수 있다. 분자유적학적 방법 등을 이용한 신속한 다제내성 세균의 보균자 검출과 이를 통한 적절한 병원감염 정책은 의료관련 감염의 전파를 막을 수 있는 핵심 요소이다. [Ann Clin Microbiol 2015;18:103-110]

Abstract

Antibiotic-resistant bacteria have become an increasingly serious problem in Korea, and multidrug-resistant organisms (MDROs) such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii have increased over the recent years. More seriously, the recent emergence of carbapenem resistance among Enterobacteriaceae is thought to be an urgent worldwide threat. Active surveillance have been identified as an important tool as an intensified infection control intervention for the control of MRSA and VRE and may be also an effective strategy for multidrug-resistant Gram-negative bacilli. Rapid detection using molecular methods could aid in the timely detection of MDRO carriers, and adequate application of infection control strategy could reduce the transmission of MDROs within hospital settings. (Ann Clin Microbiol 2015;18:-110)

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