결핵균 검사에 관한 전국 다기관 실태조사
A Nationwide Multicenter Survey for Mycobacterial Testing in Korea
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배경: 결핵균 진단방법은 꾸준한 변화와 개선이 이루어지고 있어 국내 현황을 파악하기 위해서는 주기적인 실태조사가 필요하다. 본 연구는 전국적인 다기관 조사를 통하여 결핵균의 주요 검사방법 및 정도관리의 실태를 조사하고자 하였다. 방법: 저자들은 4개의 소주제에 대하여 42개 문항으로 이루어진 설문지를 만든 후 2014년 4월부터 9월까지 대한임상미생물학회 회원들에게 전자메일로 설문지를 배포 및 회신하여 응답결과를 분석하였다. 결과: 총 65개의 병원검사실과 5개의 전문수탁기관으로부터 설문결과가 회신되었다. 항산성 염색은 참여한 모든 70 기관에서 검사하였고, 형광 염색을 시행하는 기관은 59기관(84.3%)이었다. 고체 및 액체배양은 각각 62기관(88.6%)과 59기관(84.3%)에서 시행하고 있었다. 배양기관 중 57기관(90.5%)에서 신속항원검사 또는 분자진단법 등을 이용하여 배양된 균주로 결핵균 동정을 시행하였다. 배양 양성률과 오염률 평균은 고체배양에서 8.2% (3.7-19.9%), 4.0% (0.4-8.4%)였으며 액체배양에서 11.5%(4.8-22.3%), 6.8%(0.3-18.7%)였다. 결론: 형광염색법, 액체배양, 배양된 균주의 결핵균의 동정을 시행하는 기관수가 증가하는 등 전반적인 결핵균 검사법에 의의 있는 변화 및 개선이 있었다. [Ann Clin Microbiol 2015;18:69-75]
Abstract
Background: There have been steady changes and improvements in diagnostic tests for Mycobacterium tuberculosis, so it is necessary to carry out periodic surveys to understand the current situation. The aims of this study were to investigate the changes in principal practices and quality control for M. tuberculosis using a nationwide survey in the Republic of Korea. Methods: We constructed a questionnaire composed of four subseries with 42 items. We e-mailed this survey to members of the Korean Society of Clinical Microbiology from April to September 2014 and analyzed the replies. Results: Employees at a total of 65 hospital laboratories and 5 commercial laboratories participated in the survey. AFB staining was reportedly performed in all 70 institutions, and fluorescent staining was used as the primary detection method in 59 (84.3%) laboratories. Solid and liquid culture methods for Mycobacterium were performed at 62 (88.6%) and 59 (84.3%) laboratories, respectively. There were 57 laboratories (90.5%) that identified strains growing on primary culture media using a rapid antigen kit or molecular method. The mean values of positive and contamination rates for solid culture media were 8.2% (range 3.7-19.9%) and 4.0% (0.4-8.4%), respectively. In liquid culture, the mean values of positive and contamination rates were 11.5% (4.8-22.3%) and 6.8% (0.3-18.7%), respectively. Conclusion: There have been significant changes and improvements in overall mycobacterial testing, especially in the numbers of laboratories using fluorescent staining, liquid culture, and identification of M. tuberculosis cultured media compared with previous surveys in Korea. (Ann Clin Microbiol 2015;18:-75)
참고문헌 (11)
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