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비뇨생식기 감염 유증상군과 무증상군에서 Mycoplasma homins, Ureaplasma urealyticum, Ureaplasma parvum의 양성률 및 항균제감수성 양상 분석

Prevalence and Antimicrobial Susceptibility of Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum in Individuals With or Without Symptoms of Genitourinary Infections

이미경|김태형|이승주|조용현|오세민|최현섭|임용관|권오주
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2016.04|Laboratory Medicine Online|제6권 제2호|pp. 79-87

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키워드

PrevalenceUreaplasma urealyticumUreaplasma parvumAntimicrobial susceptibilityMycoplasma hominisGenitourinary

초록

배경: 저자들은 비뇨생식기 증상을 가진 환자 및 무증상 지원자들에서 Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), 그리고 Ureaplasma parvum (UP)에 대한 국내 유병률 및 항균제감수성 양상을 분석하였다. 방법: 897명의 참여자(유증상군 365명, 무증상군 532명)에서 얻은 검체를 multiplex real-time PCR (AnyplexTM II, Seegene, Korea), multiplex PCR (Seeplex®, Seegene), 그리고 Mycoplasma IST 2 Kit (bioMerieux, France)를 사용하여 분석하였다. 결과: 유증상군에서 MH, UU, UP의 양성률은 각각 9.9%, 12.3%, 36.4%였고 무증상군에서는 각각 5.5%, 9.0%, 30.8%였다. 증상을 일으킬 수 있는 다른 원인균에 중복감염된 사례를 제외시킨 후, MH는 유증상군과 무증상군 간 의미 있는 차이를 보였으나(9.1% vs. 5.2%, P<0.05) UU와 UP는 그렇지 않았다. 항균제감수성검사 결과 세 균주의 tetracycline, doxycycline, josamycin, pristamycin에 대한 감수성률은 95.5% 이상이었으며, 78.9% 이상의 Ureaplasma spp.가 azithromycin, erythromycin, 그리고 clarithromycin에 감수성을 보였으나 MH는 감수성률이 4.2% 미만이었다. Ofloxacin과 ciprofloxacin의 감수성률은 각각 40.9-58.9%, 9.1-25.0%였다. 결론: 본 연구결과 M. hominis는 비뇨생식기 감염질환의 병원균으로 작용한다 판단할 수 있겠으나, Ureaplasma spp.의 병원성에 대해서는 의문이 든다. 항균제감수성 양상 분석 결과 MH와 Ureaplasma spp.가 서로 다른 항균제감수성 양상을 보이므로 정확한 동정과 항균제감수성검사가 적절한 치료 약제 선택에 필수적이라 사료된다.

Abstract

Background: The aim of this study was to determine the prevalence and antimicrobial susceptibility of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum among patients displaying symptoms of genitourinary infections and asymptomatic volunteers. Methods: Genitourinary samples were collected from 897 participants (365 symptomatic patients and 532 asymptomatic volunteers). The samples were analyzed using multiplex real-time PCR (AnyplexTM II, Seegene, Korea), multiplex PCR (Seeplex®, Seegene), and Mycoplasma IST 2 Kit (bioMerieux, France). Results: The prevalence of M. hominis, U. urealyticum, and U. parvum in the genitourinary samples of symptomatic patients compared with asymptomatic volunteers was 9.9% vs. 5.5%, 12.3% vs. 9.0%, and 36.4% vs. 30.8%, respectively. After eliminating cases of co-infections with other pathogens, there was a significant difference in the prevalence of M. hominis between symptomatic patients and asymptomatic volunteers (9.1% vs. 5.2%, P<0.05), but not in the prevalence of U. urealyticum and U. parvum organisms. When tested for antimicrobial susceptibility, more than 95.5% of each species were susceptible to tetracycline, doxycycline, josamycin, and pristamycin. More than 78.9% of Ureaplasma spp. were susceptible to azithromycin, erythromycin, and clarithromycin; however less than 4.2% of M. hominis were susceptible to these antibiotics. When tested with ofloxacin and ciprofloxacin, 40.9-58.9% and 9.1-25.0% of the three species were susceptible to these drugs, respectively. Conclusions: M. hominis is the leading causative pathogen for genitourinary infection; however the involvement of Ureaplasma spp. is debatable. For optimal antimicrobial therapy, the accurate detection of these organisms and determination of antimicrobial susceptibility is crucial considering their diverse antimicrobial susceptibility patterns.

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