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부산지역 설사환자에서 분리한 MRSA 균주의 다양성 분석

Analysis of the Diversity of Methicillin Resistant Staphylococcus aureus (MRSA) Strains Isolated from Diarrhea Patients in Busan Area

  • 최성화 (부산광역시보건환경연구원) ;
  • 박은희 (부산광역시보건환경연구원) ;
  • 박연경 (부산광역시보건환경연구원) ;
  • 김정아 (부산광역시보건환경연구원) ;
  • 김남호 (부산광역시보건환경연구원) ;
  • 이영숙 (부산광역시보건환경연구원) ;
  • 빈재훈 (부산광역시보건환경연구원) ;
  • 박호국 (부산광역시보건환경연구원)
  • Choi, Seong-Hwa (Busan Metropolitan City Institute of Health & Environment) ;
  • Park, Eun-Hee (Busan Metropolitan City Institute of Health & Environment) ;
  • Park, Yon-Koung (Busan Metropolitan City Institute of Health & Environment) ;
  • Kim, Joung-A (Busan Metropolitan City Institute of Health & Environment) ;
  • Kim, Nam-Ho (Busan Metropolitan City Institute of Health & Environment) ;
  • Lee, Young-Suk (Busan Metropolitan City Institute of Health & Environment) ;
  • Bin, Jae-Hun (Busan Metropolitan City Institute of Health & Environment) ;
  • Park, Ho-Kuk (Busan Metropolitan City Institute of Health & Environment)
  • 발행 : 2008.08.30

초록

부산 지역 5개 2차 종합병원 설사환자 변에서 유래한 메치실린 내성 황색포도상구균(MRSA)에 대한 연구 결과, 분리된 황색포도상구균 142주 중 총 49주(34.5%)가 MRSA인 것으로 확인되었으며, 황색포도상구균 중 MRSA 분리율이 '04, '05, '06년에 걸쳐 각각 30.0%, 32.7%, 46.7%인 것으로 나타나, 지속적으로 증가하고 있음을 알 수 있었다. MRSA 균주의 항균제 내성 양상은 75.5%가 10종 이상의 항균제에 내성을 나타내었으며, 특히 11종 항균제에 대한 다제 내성균이 가장 많은 것으로 확인되었다. MRSA주의 장독소 유전자 시험을 실시한 결과 51%가 장독소 유전자를 가지고 있지 않았고, 30.6%가 독소유전자 A를 가지고 있었으며 그 밖에 C (8.3%), B (4.1%) 순이었다. MRSA 총 49주에 대해 PFGE를 수행하여 dendrogram을 작성한 결과, 크게 7개의 그룹으로 구분되었으며, 부산지역 전체에 뚜렷하게 동일한 균주의 유행은 확인 할 수 없었으나, 종합병원 내에 소규모의 MRSA 유행은 있을 것으로 사료되었다.

We investigated the molecular epidemiological characteristic of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from stool samples in Busan from 2004 to 2006. Among 142 isolates of S. aureus, 49 isolates (34.5%) were confirmed as MRSA. With the antimicrobial susceptibility tests, 37 isolates (75.5%) showed multiple resistance to more than 10 antibiotics, but all isolates were sensitive to vancomycin. All of MRSA had enterotoxin A in 30.6%, B 4.1%, C 8.3%, D, C/G, A 2.0% and None 51%. PFGE of SmaI-digested chromosomal DNA was performed on 49 sporadic MRSA isolates. Restriction fragment patterns consisted of 8 to 14 fragments ranged in size from 48.5 to 630.5 kbp. We could divided the isolates into 7 groups ($I{\sim}VII$) by analyzing PFGE patterns. Group I subdivided as 2 subgroups and 17 (34.7%) strains belong to the group I. Dendrogram of PFGE patterns showed that MRSA strains in Busan were heterogeneous but we could find out minor homogeneity in hospital.

키워드

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