Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
권호 표지
DOI QR코드

DOI QR Code

A Study on Changes in Antimicrobial Resistant Staphylococcus aureus from Wound Isolates in a South Korean University Hospital for the Past 10 Years (2006, 2016)

최근 10년 동안 일개 대학병원 상처 배양에서 분리된 포도알균의 항생제 내성 변화 연구

  • Hong, Seong-No (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Kim, Joon (Department of Laboratory Medicine, Ajou University Hospital) ;
  • Sung, Hyun-Ho (Department of Clinical Laboratory Science, Dongnam Health University)
  • 홍성노 (동남보건대학교 임상병리과) ;
  • 김준 (아주대학교병원 진단검사의학과) ;
  • 성현호 (동남보건대학교 임상병리과)
  • Received : 2016.08.16
  • Accepted : 2016.10.24
  • Published : 2016.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Staphylococcus aureus, which is generally susceptible to the involvement route in community, is mostly MSSA. However, CA-MRSA is recently increased. Abuse of antibiotics and glycopeptides may increase VISA and VRSA. This study was conducted to investigate the changes on the antibiotic resistance prevalence and antibiotic susceptibility patterns of Staphylococcus aureus isolated from the wound of patients in a university hospital for the past 10 years. This study showed that antibiotic resistance was higher in males than in females; moreover, the antibiotic resistance rates increased with age. The resistance rate for penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, and rifampicin was, respectively, 97.7%, 60.5%, 57.4%, 48.8%, 41.1%, 44.2%, 44.2%, 14.7%, 13.2% and 3.9% in 2006. The resistance rate for penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, fusidic acid, clindamycin, and rifampicin was, respectively 95.9%, 62.6%, 55.7%, 28.6%, 50.3%, 34.7%, 38.8%, 34.0%, 2.7% and 8.2% in 2016. Vancomycin, linezolid, quinupristin/dalfopristin, and teicoplanin exhibited 100% in antibiotic susceptibility. In particular, fusidic acid resistance was increased by 19.3% in 2016. Compared with 2006, the decreased point, 12.4% was susceptible and was statistically significant. Therefore, this study suggests that periodic review and understanding of microbial and antibiotic changes should continue to investigate appropriate antibiotic susceptibility.

일반적으로 지역사회 관련 경로로 감염되기 쉬운 S. aureus는 대부분이 MSSA로 알려져 있었으나 최근 CA-MRSA가 증가하고 있다. 항생제와 glycopeptides의 지속적인 남용은 VISA, VRSA가 더욱 증가할 가능성이 있다. 본 연구는 최근 10년간 일개 대학병원의 상처에서 분리한 황색 포도상 구균의 항생제 감수성 패턴과 항생제 내성의 유병률의 변화를 조사하기 위하여 실시 하였다. 본 연구에서는 남성이 여성보다 항생제 내성이 높게 나타났다. 그리고 연령에 따라 항생제 내성률이 증가하였다. 2006년 항생제 내성률은 penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin에서 각각 97.7%, 60.5%, 57.4%, 48.8%, 41.1%, 44.2%, 44.2%, 14.7%, 13.2%, 3.9% 나타났으며, 2016년 항생제 내성률은 penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, rifampicin에서 각각 95.9%, 62.6%, 55.7%, 28.6%, 50.3%, 34.7%, 38.8%, 34.0%, 2.7%, 8.2%로 나타났다. Vancomycin, linezolid, quinupristin/dalfopristin, teicoplanin 는 항생제 감수성에서 100%를 나타내었다. 특히, fusidic acid는 2006년에 비하여 2016년에 내성이 19.3% 증가하였고, 감수성이 12.4% 감소하였으며, 통계적으로 유의하였다. 따라서, 미생물 및 항생제 변화의 주기적인 검토와 이해를 통해 적절한 항생제 감수성을 지속적으로 연구해야 할 것으로 사료된다.

Keywords

References

  1. Ogston A. On abscesses. Rev Infect Dis, 1984;6(1):122-128. https://doi.org/10.1093/clinids/6.1.122
  2. Chambers HF, Deleo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol. 2009;7(9):629-641. https://doi.org/10.1038/nrmicro2200
  3. Jevons MP, Coe AW, Parker MT. Methicillin resistance in staphylococci. Lancet. 1963;1(7287):904-907.
  4. Newsom SW. MRSA-past, present, future. J R Soc Med. 2004;97(11):509-510.
  5. Finberg RW, Moellering RC, Tally FP, Craig WA, Pankey GA, Dellinger EP, et al. The importance of bactericidal drugs: Future directions in infectious disease. Clin Infect Dis. 2004;39(9): 1314-20. https://doi.org/10.1086/425009
  6. Wilkinson JD. Fusidic acid in dermatology. Br J Dermatol. 1998;139(53):37-40. https://doi.org/10.1046/j.1365-2133.1998.1390s3037.x
  7. Weisblum, B. Erythromycin resistance by ribosome modification. Antimicrob Agents Chemother. 1995;39(3): 577-585. https://doi.org/10.1128/AAC.39.3.577
  8. Wormser, GP, Keusch, GT, Heel RC. Co-trimoxazole (trimethoprim-sulfamethoxazole). Drugs. 1982;24(6):459-518. https://doi.org/10.2165/00003495-198224060-00002
  9. Chambers HF, Deleo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol. 2009;7(9):629-641. https://doi.org/10.1038/nrmicro2200
  10. Miller LS, Cho JS. Immunity against Staphylococcus aureus cutaneous infections. Nat Rev Immunol. 2011;11(8):505-518. https://doi.org/10.1038/nri3010
  11. Ruef C. Epidemiology and clinical impact of glycopeptide resistance in Staphylococcus aureus. Infection. 2004;32:315-327. https://doi.org/10.1007/s15010-004-4124-7
  12. Fridkin SK, Hageman JC, Morrison M, Sanza LT, Como-Sabetti K, Jernigan JA, et al. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med. 2005;352(14):1436-1444. https://doi.org/10.1056/NEJMoa043252
  13. Joo EJ, Chung DR, Ha YE, Park SY, Kang SJ, Kim SH, et al. Community-associated Panton-Valentine leukocidin-negative meticillin-resistant Staphylococcus aureus clone (ST72-MRSA-IV) causing healthcare-associated pneumonia and surgical site infection in Korea. J Hosp Infect. 2012;81(3):149-55. https://doi.org/10.1016/j.jhin.2012.04.018
  14. Park SH, Park C, Yoo JH, Choi SM, Choi JH, Shin HH, et al. Emergence of community-associated methicillin-resistant Staphylococcus aureus strains as a cause of healthcare-associated bloodstream infections in Korea. Infect Control Hosp Epidemiol. 2009;30(2):146-155. https://doi.org/10.1086/593953
  15. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 19th ed, CLSI document M100-S19. Wayne, PA: CLSI; 2009.
  16. Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis. 2005;5:751-762. https://doi.org/10.1016/S1473-3099(05)70295-4
  17. Kitara L, Anywar A, Acullu D, Odongo-Aginya E, Aloyo J, Fendu M. Antibiotic susceptibility of Staphylococcus aureus in suppurative lesions in Lacor hospital, Uganda. African Health Sciences. 2011;11(3):34-39.
  18. Lee K, Lee MA, Lee CH, Lee J, Roh KH, Kim S, et al. Increase of ceftazidime and fluoroquinolone-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter spp. in Korea: Analysis of KONSAR study data from 2005 and 2007. Yonsei Med J. 2010;51:901-911. https://doi.org/10.3349/ymj.2010.51.6.901
  19. Lee K, Lee MA, Lee CH, Lee J, Roh KH, Kim S, et al. Increase of ceftazidime and fluoroquinolone-resistant Klebsiella pneumoniae and imipenem-resistant Acinetobacter spp. in Korea: Analysis of KONSAR study data from 2005 and 2007. Yonsei Med J. 2010;51:901-911. https://doi.org/10.3349/ymj.2010.51.6.901
  20. Kim HJ, Lee NY, Kim S, Shin JH, Kim MN, Kim EC, Koo SH, et al. Characteristics of microorganisms isolated from blood cultures at nine university hospitals in Korea during 2009. Korean J Clin Microbiol. 2011;14:48-54. https://doi.org/10.5145/KJCM.2011.14.2.48
  21. Lee JY, Wang HJ, Shin DB, Cho YS. Antibiotic resistance and bacterial biofilm formation by Staphylococcus aureus strains isolated from various foods. Korean J. Microbiol Biotechnol. 2013;41(1):96-104. https://doi.org/10.4014/kjmb.1208.08012
  22. Farrell DJ, Mendes RE, Castanheira M, Jones RN. Activity of fusidic acid tested against Staphylococci isolated from patients in U.S. medical centers in 2014. Antimicrob Agents Chemother. 2016;60(6):3827-3831. https://doi.org/10.1128/AAC.00238-16
  23. Shinde RV, Pawar SK, Mohite RV, Shinde AR, Duggu P. Study of nasal carriage of staphylococcus aureus with special reference to methicillin resistance among nursing staff. Arch Clin Microbiol. 2016;7:1-6.
  24. Coombs GW, Daley DA, Thin Lee Y, Pearson JC, Robinson JO, Nimmo GR, et al. Australian group on antimicrobial resistance australian Staphylococcus aureus sepsis outcome programme annual report, 2014. Commun Dis Intell Q Rep. 2016;40(2):244-254.
  25. Kim BN. Overview of antibiotic use in Korea. Infection & Chemotherapy. 2012;44(4):250-262. https://doi.org/10.3947/ic.2012.44.4.250

Cited by

  1. 항 Methicillin Resistant Staphylococcus aureus 활성을 가지는 해양미생물 Pseudomonas sp. YJ-1의 분리와 특성 vol.35, pp.4, 2016, https://doi.org/10.11626/kjeb.2017.35.4.694
  2. Differences in the Antibiotic Resistance Pattern of Staphylococcus aureus Isolated by Clinical Specimens in a University Hospital in South Korea vol.50, pp.2, 2016, https://doi.org/10.15324/kjcls.2018.50.2.85
  3. Efficacy of Antibiotic-Loaded Cement Augmentation for Correcting Low Grade Pedicle Screw Loosening vol.17, pp.1, 2016, https://doi.org/10.13004/kjnt.2021.17.e2