Abstract
Objectives and Methods: This study was performed to investigate the etiologic bacterial, viral and protozoal organisms for the diarrhea from hospitals in Chungnam area from January to December in 2004. Total of 787 fecal samples were collected and examined. Results and Conclusions: In test for enteropathogenic bacteria, total of 79 cases out of 787 samples from hospitals showed positive isolation. Among 79 positive samples, 27 cases were confirmed as Salmonella spp.. 20 cases as pathogenic E. coli, 18 cases as Clostridium perfringens, 6 cases as Staphylococcus aureus, 4 cases as Shigella spp. and 4 cases as Vibrio parahaemolyticus. In test for enteropathogenic virus, 190 cases out of 787 samples from hospitals showed positive reaction. Among 190 samples, 115 cases were confirmed as rotavirus, 55 cases as norovirus, 5 case as astrovirus, 4 case as rotavirus & norovirus, 3 cases as adenovirus, 2 case as rotavirus & astrovirus. In test for enteropathogenic protozoa, 6 cases out of 787 samples from hospitals showed positive result. Among 6 samples, 5 cases were confirmed as Entamoeba histolytica and 1 cases as Giardia lamblia. When we classified the positive results by the age of the patients, the highest isolation rate was noted in a group of age under 10 and over 60 for bacterial, viral and protozoal pathogens. Especially, patient below age of 5 showed high positive rate. When we classified the positive results by the time, pageathogenic bacteria were isolated throughout the year, and the highest frequency was noted in August. On the other hand, pathogenic viruses were detected more frequently during the colder season from December to April. Antimicrobial susceptibility test for the isolated bacteria resulted as follows; Salmonella strains showed high drug resistance rates against ampicillin, chloramphenicol, tetracycline, nalidixic acid, ticarcillin. Shigella strains showed high drug resistance rates against ampicillin, trimethoprim/sulfamethoxazole, chloramphenicol, tetracycline, ampicillin/sulbactam, ticarcillin. Pathogenic E. coli strains showed high drug resistance rates against ampicillin, cephalothin, gentamicin, tetracycline, nalidixic acid, ampicillin/sulbactam, ticarcillin.
2004년 1월부터 12월까지 충남지역 5개 지정 협력병원에서 수거한 설사환자의 대변가검물 787건에 대한 병원성세균, 설사바이러스 및 원충에 대한 검사를 실시하여 다음과 같은 결론을 얻었다. 병원성 세균 10종에 대한 검사결과 Salmonella spp. 27건, 병원성대장균 20건(EHEC 3건, EPEC 9건, ETEC 8건), Clostridium perfringens 18건, Staphy-lococcus aureus 6건, Vibrio parahaem-olyticus 4건과 Shigella spp. 4건 등 79건이 분리되었다. 병원성 바이러스 4종에 대한 검사결과 rotavirus 115건, norovirus 55건, astro-virus 5건, rotavirus 4건, norovirus 4건의 혼합감염, adenovirus 3건, rotavi-rus 2건과 astrovirus 2건의 혼합감염으로 총 190건이 검출되었다. 원충 3종에 대한 검사결과 Entam-oeba histolytica 5건, Giardia lamblia 1건으로 6건이 검출되었다. 병원성세균은 10세 이하에서 26.8%, 61세 이상에서 45.6%, 바이러스는 10세 이하에서 65.8%, 61세 이상에서 17.4% 그리고 원충은 10세 이하에서 83.3%, 61세 이상에서 16.7%로 모두 10세 이하와 61세 이상에서 높은 검출을 보였다. 특히, 5세 이하의 어린이 경우 세균은 20.3%, 바이러스는 63.7% 그리고 원충은 83.3%로 높은 검출을 보였다. 병원성세균은 월별, 계절별로 분리율 차이가 미미하나 1월과 3월에 각각 2.5%로 가장 적게 분리되었고 8월에 16.7%로 가장 많이 분리되었다. 병원성 바이러스는 9월에 1.6%로 가장 적게 4월에 14.7%로 가장 많이 검출 되었다. Salmonella spp.는 ampicillin, chloramphenicol, tetracycline, nalidixic acid, ticarcillin에 비교적 높은 내성을 나타냈고, Shigella spp.는 ampicillin, trimethoprim/sulfamethoxazole, chloram-phenicol, tetracycline, ampicillin/sulbactam, ticarcillin에 비교적 높은 내성을 나타냈으며, 병원성대장균은 ampicillin, ceph-alothin, gentamicin, tetracycline, nalidi-xic acid, ampicllin/sulbactam, ticarcillin에 비교적 높은 내성을 나타내었다.