일개 고등학교 환경에서 메치실린 내성 포도알균의 오염도 조사
Study on the Contamination of Methicillin-Resistant Staphylococcus (MRS) in a High School Environment
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메치실린 내성 포도알균(methicillin resistant Staphylococci, MRS)는 인체 여러 부위에서 집락화 될 수 있으며 의료기관과 연관된 사람에서 흔히 분리된다. 이 연구는 밀접한 단체생활을 하는 일개 고등학교 한 개 반의 학생들 손과 그들이 사용하는 책상에서 MRS 균의 오염 정도를 평가하고자 하였다. Staphylococcus aureus가 28명의 학생의 손 중에서 2 균주가 분리되었으며 모두 메치실린에 감수성이었다. 응고인자 음성 포도알균(coagulase negative Staphylococci, CoNS)는 26 균주가(26/28, 92.9%) 분리되었으며 이들 균주 중 14 균주는 메치실린 내성균(MRCoNS) 이었다. 14 MRCoNS 중 S. warneri가 가장 흔하였으며(8/14, 57%), 이들은 대부분의 non-β-lactam 항생제에 감수성 이었다. 31개의 책상에서는 S. aureus는 분리되지 않았으나 26 CoNS (26/31, 83.9%)가 분리되었다. 손과 책상에서 분리된 포도알균 이외의 균은 Micrococcus와 Bacillus spp.이었다. 결론적으로 MRSA는 이번 연구에서 분리되지 않았으나 mecA 유전자를 갖고 있는 MRCoNS는 학생들의 손에서 높은 비율로 분리되었다. 손씻기와 같은 예방 교육을 강화할 뿐만 아니라 이들 균의 오염 및 보균율 등의 조사와 같은 능동적 감시 등이 이들 균의감염예방과 전파 차단을 위해 필요할 것으로 사료된다.
Abstract
Methicillin-resistant Staphylococcus (MRS) can be colonized in various body sites and is more frequently isolated in healthcare associated persons. This study aimed to evaluate the contamination rate of MRS in a high school environment, those living with closed life style. Staphylococcus aureus was isolated from only the hands of 2 students among a sample of 28 students, and S. aureus were susceptible to methicillin antibiotics. Coagulase negative Staphylococci (CoNS) were isolated from the hands of 26 students (26/28, 92.9%), and among them, 14 (53.8%) isolates were methicillin-resistant CoNS (MRCoNS). Among the 14 MRCoNS, S. warneri was the most common (8/14, 57%) and susceptible to most non-β-lactam antibiotics, such as clindamycin, erythromycin, ciprofloxacin, tetracycline, gentamicin, and vancomycin. In a culture of 31 desks, S.aureus was not isolated but CoNS were isolated from 26 desks (26/31, 83.6%), which did not harbor the mecA gene. The other bacteria isolated from the hands and desks were Micrococcus and Bacillus spp. In conclusion, methicillin-resistant S. aureus was not isolated from the hands and desks of high school students. However, the frequency of MRCoNS harboring mecA gene were high in the hands of high school students. Therefore, to prevent and to control the transfer of infection, intensifying preventive education, such as hand washing, and active surveillance systems, such as an investigation of contamination or carrier rate of resistant bacteria are necessary.
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