일개 도서지역의 요로감염 원인균과 항균제 감수성의 최근 양상
Patterns of Antimicrobial Susceptibility of the Causative Bacteria of Urinary Tract Infections in Recent Years in an Island Region
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배경: 지역에 맞는 요로감염의 경험적 치료 지침을 마련하기 위해 연구자들은 일개 도서지역에서 요로감염의 원인균의 분포와 항균제 감수성 양상을 알아보았다 . 방법: 2002년 1월부터 2005년 12월까지 제주대학병원에 내원한 입원 및 외래 환자 중 요 1 mL당 105개 이상의 집락이 배양된 3,064예를 대상으로 원인균 및 항균제 감수성 결과를 분석하고 병록지 조사를 통해 연령별 , 성별 차이 등을 알아 보았다. 결과: Escherichia coli 1,376예(44.9%), Klebsiella spp. 247예(8.1%), Pseudomonas spp. 215예(7.0%) 순으로 분리되었다. E. coli에 대한 항균제 감수성은 ampicillin, trimethoprim-sulfamethoxazole, ciprofloxacin에 대한 4년 평균 내성률이 각각 69.0%, 32.5%, 24.7%였다. 결론: 요로감염의 주요 원인균인 장내세균에서 도서지역인 제주도 내에서 1차 치료제로 사용되어 왔던 ampicillin, trimethoprim-sulfamethoxazole에 대한 내성률이 높고, ciprofloxacin에 대한 내성이 증가하고 있어 앞으로 합리적인 항균제 사용 지침이 마련되어야 할 것으로 생각한다.
Abstract
Background: In order to provide a guideline for empirical treatment of urinary tract infections, we studied a change in causative organisms and antimicrobial susceptibility in our region of an island. Methods: We reviewed the results of antimicrobial susceptibility and the hospital charts of 3,064 patients with a significant bacteriuria (more than 105 colony forming unit/mL in urine cultures); the patients had been admitted to or seen at the out-patient clinic of Cheju University Hospital during the period from January 2002 to December 2005. Results: The most common pathogens were Escherichia coli (44.9%), Klebsiella spp. (8.1%), and Pseudomonas spp. (7.0%). In E. coli, the mean percent resistance to ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin during the 4-year period was 69.0%, 32.5%, and 24.7%, respectively. Conclusion: An increasing resistance of common urinary pathogens to known empirical agents such as ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin caused a need for a more updated guideline in our region of an island.
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