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최근 8년간 혈액배양에서 분리된 미생물의 항균제 감수성 양상: 2010~2017

Antimicrobial Susceptibility Patterns of Microorganisms Isolated from Blood Culture during the Last 8 Years: 2010~2017

  • 김재수 (단국대학교병원 진단검사의학과) ;
  • 공소영 (단국대학교 대학원 보건학과) ;
  • 김종완 (단국대학교 의과대학 진단검사의학과) ;
  • 임인수 (단국대학교 의과대학 진단검사의학과) ;
  • 김가연 (단국대학교 대학원 보건학과)
  • Kim, Jae Soo (Department of Laboratory Medicine, Dankook University Hospital) ;
  • Gong, So Young (Department of Public Health, Dankook University Graduate School) ;
  • Kim, Jong Wan (Department of Laboratory Medicine, Dankook University College of Medicine) ;
  • Rheem, Insoo (Department of Laboratory Medicine, Dankook University College of Medicine) ;
  • Kim, Ga Yeon (Department of Public Health, Dankook University Graduate School)
  • 투고 : 2019.04.19
  • 심사 : 2019.06.03
  • 발행 : 2019.06.30

초록

검사는 2010년부터 2017년까지 162,551 검체중 11,233 검체(6.9%)가 배양 양성이었으며, 이중 11,865 균주가 배양되었다. 배양된 균종 중 그람양성구균이 47.8%, 그람음성간균 38.8%, 그람양성간균 4.2%, 진균 6.8%, 혐기성균이 2.3%를 나타냈다. 배양결과를 성별로 비교하면 남성에서 분리된 균이 55.0% (2,732/4,969)로 여성에서 분리된 45.0% (2,237/4,969) 보다 많았다. 또한 연령별로는 70대가 28.7% (1,426/4,969)로 가장 많이 분리되었으며, 10대의 1.2% (62/4,969)와 많은 차이를 보였다. MRSA에 대한 내성률은 2016년 66.7%에서 2017년에는 46.8%로 많은 감소를 보였으며, E. faecium의 vancomycin 내성률은 35.0% (48/137)로 나타났다. 한편 장내세균에서 E. coli의 ESBL 양성률은 2010년 17.2%에서 2017년 28.8%로 증가하였으나, K. pneumoniae에서는 오히려 양성률이 감소하였다. P. aeruginosa의 MRPA는 11.8% (14/119), A. baumannii에서의 MRAB는 64.3% (161/252)로 높은 내성을 나타내었다. 혈액 검체에서 분리되는 미생물의 균종과 항균제 감수성 양상은 시기, 지역 및 대상환자 등에 따라 다르므로 병원균을 주기적으로 분석하고 이에 대한 항균제 감수성 정도의 변화양상을 파악하는 것이 병원에서 내성균의 감독과 조절에 큰 도움이 될 것으로 판단된다.

During the time period from 2010 to 2017, out of 162,551 blood specimens, 11,233 (6.9%) specimens were positive for culture and 11,865 strains were cultured. Among the isolates, 47.8% were Gram positive cocci, 38.8% were Gram negative rods, 4.2% were Gram positive bacilli, 6.8% were fungi and 2.3% were anaerobes. When the culture results were compared according to gender, 55.0% (2,732/4,969) of the isolates were found in males and 45.0% (2,237/4,969) were isolated in females. In addition, when categorized according to age group, people in their 70s were the most separated by 28.7% (1,426/4,969) and this showed a great difference from 1.2% (62/4,969) of people in their teens. MRSA decreased significantly from 66.7% in 2016 to 46.8% in 2017. The vancomycin resistance rate of E. faecium was 35.0% (48/137). The ESBL positive rate of E. coli in intestinal bacteria was increased from 17.2% in 2010 to 28.8% in 2017, but the positive rate decreased for K. pneumoniae. 11.8% (14/119) of multidrug-resistant P. aeruginosa (MDRPA) of P. aeruginosa and 64.3% (161/252) of MDRAB of A. baumannii showed high resistance. Because the microbial susceptibility and antimicrobial susceptibility patterns of the blood specimens isolated from all the blood specimens differ according to the time period, region and patients, periodic analyses of different pathogens and understanding the changes in the degree of susceptibility to antimicrobial susceptibility have been conducted in hospitals.

키워드

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