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반코마이신 저항 장구균의 자발적 집락 소실 기간에 대한 영향 인자

Influence Factors for Duration of Vancomycin Resistant Enterococci's Spontaneous Decolonization

김동수|김기환|이제선
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)|2015.04|Pediatric Infection and Vaccine|제22권 제1호|pp. 16-22

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키워드

ChildrenVancomycin Resistant EnterococcusSpontaneous decolonization

초록

목적: 소아에서 VRE의 자발적 소실 기간에 대한 영향인자들을 밝히는 것이다. 방법: 2005년 1월부터 2010년 11월까지 VRE 양성인 환자의 의무기록을 후향적으로 분석하였다. 집락소실 기간의 평균 325일을 기준으로 하여 조기소실군과 만기소실군을 나누어 임상특징을 비교하였다. 결과: VRE가 확인된 환자 중 관찰기간이 1년 이상이 되었거나 VRE 집락 소실이 확인된 수는 151명이었다. 조기소실군(41명)에서 처음 VRE 집락이 되었을 때 나이는 만기소실군(110명)에 비하여 많았다(44.9개월 vs 40.9개월, P =0.040). 그리고 조기소실군보다 만기소실군에서 VRE 집락 후 반코마이신치료를 한 경우가 더 많았다(7% vs 27.2%, P =0.008). 결론: VRE 집락기간에 있어, 처음 VRE를 획득하였을 당시의 나이와 항생제의 사용여부가 중요하다. 감염질환을 치료하고 항생제 저항성 세균의 집락을 억제하기 위하여 적절하고 신중한 항생제 사용이필요하다.

Abstract

Purpose: The aim of this study was to identify the factors influencing the spontaneous decolonization period of vancomycin resistant enterococcus (VRE) species in pediatric patients. Methods: The medical records of patients presenting positive VRE cultures between January 2005 and November 2010 at a tertiary hospital in Seoul, Korea, were reviewed retrospectively. The subjects were divided into two groups according to the average number of days for decolonization (325 days). Clinical characteristics were compared between shorter VRE colonization patients (<325 days, n=41) and prolonged VRE colonization patients (>325 days, n=110). Results: There were 151 patients who had more than 1 year of follow up period or confirmed of VRE decolonization among patients who were identified with VRE. The average age at the time of initial VRE colonization was significantly younger in shorter decolonization group than in prolonged decolonization group (44.9 months vs 40.9 months, P =0.040). The prolonged decolonization group received more vancomycin treatments after VRE colonization in comparison with patients in shorter decolonization group (7.0% vs 27.2%, P =0.008). Conclusions: For the duration of VRE colonization, it was found that the initial age of acquiring VRE and use of antibiotics were important factors. Antibiotics should be used properly and precisely in order to treat infectious diseases and to control the colonization of antibiotic resistant bacteria.

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