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다제내성균의 표본감시 및 분자역학 특성

Sentinel Surveillance and Molecular Epidemiology of Multidrug Resistance Bacteria

김화수|정영희|유재일|유정식|이영선
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2012.06|Annals of Clinical Microbiology|제15권 제2호|pp. 43-48|DOI http://dx.doi.org/

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참고문헌

키워드

Multidrug resistanceSentinel surveillanceMolecular epidemiology

초록

전세계적으로 다제내성균 감염이 지역사회 및 병원에서 증가하면서 공중보건 문제로 대두되고 있다. 그람양성구균에서 vancomycin 내성과 그람음성막대균에서는 cefotaxime과 carbapenem 내성이 지속적으로 증가하고 있어 다제내성의 발생규모와 추이를 파악하기 위해서는 항생제내성 감시가 중요하다. 따라서 보다 효율적인 관리를 위해 의료관련감염균인 반코마이신내성황색포도알균, 반코마이신내성장알균, 메티실린내성황색포도알균, 다제내성녹농균, 다제내성아시네토박터바우마니균, 카바페넴내성장내세균속균종 6종을 2011년에 법정감염병으로 지정하였다. VRSA/VISA는 2002년부터 carbapenemase 생성 장내세균은 2010년부터 실험실 감시를 수행하고 있다. 본 고에서는 다제내성균의 국가감시 프로그램과 분자역학 특성에 대해 고찰하였다.

Abstract

The global emergence and spread of multidrug resistant bacterial infections in communities and hospitals has become an important issue in public health. The resistance rate of gram-positive cocci to vancomycin and the resistance rate of several gram-negative bacilli against cefotaxime and carbapenem have been continuously increasing. Surveillance of antimicrobial resistance is essential for providing information on the magnitude of and trend in multidrug resistance. Therefore, beginning 2011, more robust and effective management is to be legally required for six multidrug-resistant bacteria that have been linked to healthcare-related infections: vancomycin-resistant Staphylococcus aureus (VRSA), vancomycinresistant enterococci (VRE), methicillin- resistant S. aureus (MRSA), multidrug-resistant Pseudomonas aeruginosa (MRPA), multidrug-resistant Acinetobacter baumannii (MRAB), and carbapenem-resistant Enterobactericeae (CRE). We have also performed laboratory-based sentinel surveillance for VRSA/VISA since 2002 and carbapenemase-producing Enterobacteriaceae since November, 2010. This article reviews the national surveillance programs, and molecular epidemiology of multidrug-resistant bacteria.

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