최근 10년 동안 일개 대학병원 상처 배양에서 분리된 포도알균의 항생제 내성 변화 연구
A Study on Changes in Antimicrobial Resistant Staphylococcus aureus from Wound Isolates in a South Korean University Hospital for the Past 10 Years (2006, 2016)
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초록
일반적으로 지역사회 관련 경로로 감염되기 쉬운 S. aureus는대부분이 MSSA로 알려져 있었으나 최근 CA-MRSA가 증가하고 있다. 항생제와 glycopeptides의 지속적인 남용은 VISA, VRSA가 더욱 증가할 가능성이 있다. 본 연구는 최근 10년간 일개 대학병원의상처에서 분리한 황색 포도상 구균의 항생제 감수성 패턴과 항생제내성의 유병률의 변화를 조사하기 위하여 실시 하였다. 본 연구에서는 남성이 여성보다 항생제 내성이 높게 나타났다. 그리고 연령에 따라 항생제 내성률이 증가하였다. 2006년 항생제 내성률은penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin에서 각각 97.7%, 60.5%, 57.4%, 48.8%, 41.1%, 44.2%, 44.2%, 14.7%, 13.2%, 3.9% 나타났으며, 2016년 항생제 내성률은 penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin 에서 각각 95.9%, 62.6%, 55.7%, 28.6%, 50.3%, 34.7%, 38.8%, 34.0%, 2.7%, 8.2%로 나타났다. Vancomycin, linezolid, quinupristin/dalfopristin, teicoplanin 는 항생제 감수성에서 100%를나타내었다. 특히, fusidic acid는 2006년에 비하여 2016년에 내성이 19.3% 증가하였고, 감수성이 12.4% 감소하였으며, 통계적으로 유의하였다. 따라서, 미생물 및 항생제 변화의 주기적인 검토와이해를 통해 적절한 항생제 감수성을 지속적으로 연구해야 할 것으로 사료된다.
Abstract
Staphylococcus aureus, which is generally susceptible to the involvement route in community, is mostly MSSA. However, CA-MRSA is recently increased. Abuse of antibiotics and glycopeptides may increase VISA and VRSA. This study was conducted to investigate the changes on the antibiotic resistance prevalence and antibiotic susceptibility patterns of Staphylococcus aureus isolated from the wound of patients in a university hospital for the past 10 years. This study showed that antibiotic resistance was higher in males than in females; moreover, the antibiotic resistance rates increased with age. The resistance rate for penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, and rifam-picin was, respectively, 97.7%, 60.5%, 57.4%, 48.8%, 41.1%, 44.2%, 44.2%, 14.7%, 13.2% and 3.9% in 2006. The resistance rate for penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, fusidic acid, clindamycin, and rifampicin was, respectively 95.9%, 62.6%, 55.7%, 28.6%, 50.3%, 34.7%, 38.8%, 34.0%, 2.7% and 8.2% in 2016. Vancomycin, linezolid, quinupristin/dalfopristin, and teicoplanin exhibited 100% in antibiotic susceptibility. In particular, fusidic acid resistance was increased by 19.3% in 2016. Compared with 2006, the decreased point, 12.4% was susceptible and was statistically significant. Therefore, this study suggests that periodic review and understanding of microbial and antibiotic changes should continue to investigate appropriate antibiotic susceptibility.
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