최근 10년 동안 일개 상급종합병원의 칸디다혈증 환자에서 분리된 칸디다 균종의 빈도
Frequency of Candida Strains Isolated from Candidiasis Patients at A Tertiary Hospital over the Last 10 Years
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초록
칸디다혈증(candidemia)은 이환율과 사망률을 높이는 주요 원인으로 입원 환자에서 심각한 위험으로 남아 있으며 의료비용을 증가시킨다. 2009년부터 2018년까지 S병원의 혈액 배양 검사에서 분리된 칸디다 균주 3,533건을 대상으로 시기별 분리빈도, 연도, 성별, 나이, 병동 등에 따라 분석하였다. 전체 기간 중 혈액 배양 의뢰 건수 717,996 중에 54,739건이 배양 양성으로 7.6%의 양성율을 보였으며 칸디다 분리률은 1,036명의 환자에서 3,533건으로 6.4%였다. 균종의 분포는 C. albicans (33.8%), C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), C. krusei (4.0%) 이다. 전기/후기 분리에서는 C. tropicalis가 3.8% 감소하고 C. glabrata 는 3.4% 증가하였다. 50세 이후 연령이 증가할수록 분리 빈도가 높았으며, 1∼10대에서는 C. parapsilosis (31.3%), 41∼50 대에서는 C. tropicalis (30.3%), C. glabrata (27.6%) 순으로, 80대에서는 C. tropicalis (28.6%)가 상대적으로 자주 분리되었다. C. krusei 는 여성(60.9%)에서 상대적으로 높은 비율로 분리되었다. 따라서 Candida 균종의 분포를 지속적으로 감시하고 신속한 동정 결과를 제공하여 적절한 치료 및 항진균제 치료 지침을 위한 체계적이고 지속적인 병원감염관리 시스템이 이루어져야 할 것이다.
Abstract
Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009∼2013)/late (2014∼2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1∼10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41∼50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.
참고문헌 (29)
- López Dupla M, "Clinical characterization of breakthrough bacteraemia : a survey of 392 episodes", J Intern Med, 258, pp.172~180 (2005)[DOI]
- Balk RA, "Severe sepsis and septic shock. Definitions, epidemiology, and clinical manifestations", Crit Care Clinics, 16, pp.179~192 (2000)[DOI]
- Goto M, "Overall burden of bloodstream infection and nosocomial bloodstream infection in North America and Europe", Clin Microbiol Infect, 19, pp.501~509 (2013)[DOI]
- Antinori S, "Candidemia and invasive candidiasis in adults : A narrative review", Eur J Intern Med, 34, pp.21~28 (2016)[DOI]
- Pappas PG, "Clinical practice guideline for the management of candidiasis : 2016 update by the Infectious Diseases Society of America", Clin Infect Dis, 62, pp.e1~e50 (2016)[DOI]
- Marchetti O, "Epidemiology of candidemia in Swiss tertiary care hospitals : secular trends, 1991-2000", Clin Infect Dis, 38, pp.311~320 (2004)[DOI]
- Horn DL, "Presentation of the PATH Alliance registry for prospective data collection and analysis of the epidemiology, therapy, and outcomes of invasive fungal infections", Diagn Microbiol Infect Dis, 59, pp.407~414 (2007)[DOI]
- Falagas ME, "Relative frequency of albicans and the various non-albicans Candida spp among candidemia isolates from inpatients in various parts of the world : a systematic review", Int J Infect Dis, 14, pp.e954~e966 (2010)[DOI]
- 김재수, "최근 8년간 혈액배양에서 분리된 미생물의 항균제 감수성 양상: 2010∼2017", 대한임상검사과학회지, 51(2), pp.155~163 (2019), 대한임상검사과학회[DOI]
- Kett DH, "Candida bloodstream infections in intensive care units : analysis of the extended prevalence of infection in intensive care unit study", Crit Care Med, 39, pp.665~670 (2011)[DOI]
- Colombo AL, "Prognostic factors and historical trends in the epidemiology of candidemia in critically ill patients : an analysis of five multicenter studies sequentially conducted over a 9-year period", Intensive Care Med, 40, pp.1489~1498 (2014)[DOI]
- Falagas ME, "Attributable mortality of candidemia : a systematic review of matched cohort and case–control studies", Eur J Clin Microbiol Infect Dis, 25, pp.419~425 (2006)[DOI]
- Taei M, "An alarming rise of non-albicans Candida species and uncommon yeasts in the clinical samples; a combination of various molecular techniques for identification of etiologic agents", BMC Res Notes, 12, pp.779~ (2019)[DOI]
- Diekema D, "The changing epidemiology of healthcare-associated candidemia over three decades", Diagn Microbiol Infect Dis, 73, pp.45~48 (2012)[DOI]
- Arendrup MC, "Diagnostic issues, clinical characteristics, and outcomes for patients with fungemia", J Clin Microbiol, 49, pp.3300~3308 (2011)[DOI]
- Ding X, "Epidemiology and risk factors for nosocomial non-Candida albicans candidemia in adult patients at a tertiary care hospital in North China", Med Mycol, 53, pp.684~690 (2015)[DOI]
- Cleveland AA, "Declining incidence of candidemia and the shifting epidemiology of Candida resistance in two US metropolitan areas, 2008-2013 : results from population-based surveillance", PLoS One, 10, pp.e0120452~ (2015)[DOI]
- Hesstvedt L, "Twenty-two years of candidaemia surveillance : results from a Norwegian national study", Clin Microbiol Infect, 21, pp.938~945 (2015)[DOI]
- Kumar S, "Frequency, clinical presentation and microbiological spectrum of candidemia in a tertiary care center in Karachi, Pakistan", J Pak Med Assoc, 64, pp.281~285 (2014)
- Tang JL, "High incidences of invasive fungal infections in acute myeloid leukemia patients receiving induction chemotherapy without systemic antifungal prophylaxis : a prospective observational study in Taiwan", PLoS One, 10, pp.e0128410~ (2015)[DOI]
- Lamoth F, "Changes in the epidemiological landscape of invasive candidiasis", J Antimicrob Chemother, 73, pp.i4~i13 (2018)[DOI]
- 원은정, "2011년 국내 12개 병원에서 분리된 효모균과 균사형 진균의 분포", Annals of Clinical Microbiology, 16(2), pp.92~100 (2013), 대한임상미생물학회[DOI]
- 김동균, "최근 20년 동안 단일 3차 의료기관의 칸디다혈증 환자에서 분리된 Candida 균종별 분리 빈도와 항진균제 내성률의 변화 추이", Annals of Clinical Microbiology, 20(3), pp.53~62 (2017), 대한임상미생물학회
- Won EJ, "Fluconazoleresistant Candida glabrata bloodstream isolates, South Korea, 2008-2018", Emerg Infect Dis, 27, pp.779~788 (2021)[DOI]
- Chamilos G, "Delaying amphotericin B-based frontline therapy significantly increases mortality among patients with hematologic malignancy who have zygomycosis", Clin Infect Dis, 47, pp.503~509 (2008)[DOI]
- Gilgado F, "Antifungal susceptibilities of the species of the Pseudallescheria boydii complex", Antimicrob Agents Chemother, 50, pp.4211~4213 (2006)[DOI]
- Chowdhary A, "A multicentre study of antifungal susceptibility patterns among 350 Candida auris isolates(2009-17)in India : role of the ERG11 and FKS1 genes in azole and echinocandin resistance", J Antimicrob Chemother, 73, pp.891~899 (2018)[DOI]
- "Antimicrobial resistance global report on surveillance 2014"[URL]
- Kwon YJ, "Candida auris clinical isolates from South Korea: Identification, antifungal susceptibility, and genotyping", J Clin Microbiol, 57, pp.e01624~e01618 (2019)[DOI]