국내 환자의 혈액에서 분리된 Panton-Valentine 독소 양성인Staphylococcus aureus
Panton-Valentine Leukocidin Positive Staphylococcus aureus Isolated from Blood in Korea
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배경 : Panton-Valentine leukocidin (PVL)은 Staphylococ-cus aureus가 분비하는 세포용해독소로서, 피부연조직 감염과 관련이 있다고 알려졌다. PVL 양성인 S. aureus 균주는 최근 미국과 유럽에서 메티실린 내성 S. aureus (methicillin-resistant S.aureus, MRSA) 균주에 의한 집단발병을 일으키거나, 정상 성인에서 괴사성 폐렴을 일으킨 균주와 역학적인 관련이 있다. 이 연구는 국내에서 PVL 양성인S. aureus의 존재유무와, 이 균주에의한 심각한 감염이 있는지를 알아보기 위해 시행하였다.방법 : 2002년에서 2005년까지 한 대학병원에 입원한 환자의혈액에서 분리된 S. aureus 573균주를 대상으로 하였다. PVL독소 검출은 PCR로 시행하였다. PVL 양성 균주에 대해 12가지의 추가적인 포도구균 독소를 검출하였고, MRSA 균주에 대해staphylococcal cassette chromosome mec (SCCmec) 유전형분석을 실시하였다.결과 : 전체 573균주 중 PVL 양성인 균주는 5개(0.9%)였으며,MRSA가 1균주 MSSA가 4 균주였다. MRSA 1균주는 SCC mecIV형이었으며, 이 균주에서 다른 포도구균 독소는 검출되지 않았다. PVL 양성 S. aureus 감염환자들에서 나이의 중앙값은 36세였으며, 총 5명 중 3명의 환자는 균혈증 이전에 피부연조직 감염이선행된 경우였다.
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