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Antimicrobial resistance rates changes according to the amount of the antimicrobial agent in clinically important strain isolated from blood cultures

혈액배양에서 분리된 임상적 주요 균주의 항균제사용량에 따른 내성률 변화

  • Kim, Jae-Jung (Department of Laboratory Medicine, St. Mary's Hospital, Daejeon Catholic university)
  • 김재중 (가톨릭대학교 대전성모병원 진단검사의학과)
  • Received : 2016.02.29
  • Accepted : 2016.05.12
  • Published : 2016.05.31

Abstract

The purpose of the study is to investigate the correlation between the amount of antimicrobial agent (Defined Daily Dose, DDD) and antimicrobial resistance rate (%). The treatment of infectious diseases is becoming increasingly difficult, due to the increase in the number of multi-drug resistant bacteria, making it a clinically significant problem. Among the various factors, antimicrobial abuse is a major cause of antimicrobial resistance. The study was conducted on inpatients in a secondary university hospital in the central region utilizing the hospital's computerized statistical data and microbiological program of laboratory medicine from January 2010 to December 2014 pertaining to the dose of antimicrobial drugs for Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli strains isolated from blood culture. We analyzed the antimicrobial resistance rate per dose with the Pearson correlation coefficient. A significant (positive?) correlation was detected between the cefepime dose and the resistance of E. coli (P<0.033; r=0.907), while a significant negative correlation was found between the tobramycin dose and the resistance of E.coli. (P<0.028; r=-0.917). The aminoglycoside resistance of A. baumannii showed a significant negative correlation (P<0.048; r=-0.881), and the aminoglycoside resistance of E. coli showed a significant negative correlation as well (P<0.001; r=-0.992). In conclusion, the amount of antimicrobial agent (Defined Daily Dose, DDD) (is partly related to) the bacterial strain and its antimicrobial resistance rate (%).

본 논문의 목적은 항균제 사용량(Defined Daily Dose. DDD)과 세균의 내성률(%)과의 상관성을 보고자 하였다. 항균제 내성은 최근 다제 내성균들의 증가로 인하여 감염증의 치료가 점점 더 어려워져 임상적으로 중대한 문제가 되고 있다. 그리고, 여러 요인들 중에서 항균제 오남용은 항균제 내성의 주요 원인이 되고 있다. 중부권지역의 일개 2차 대학병원의 입원환자를 대상으로 병원전산통계 자료와 진단검사의학과의 미생물 프로그램을 이용하여 2010년 1월부터 2014년 12월 까지 혈액배양에서 분리 동정된 Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli 균주에 대하여 항균제 사용량에 따른 균주의 내성률과의 상관성을 분석하기 위하여 균주 내성률과 항균제 사용량을 각각 조사하였다. 사용량에 따른 항균제 내성률은 pearson상관분석을 실시하였다. 그 결과 cefepime사용량과 cefepime 내성 E. coli에서 유의한 상관관계가 있었고(P<0.033;r=0.907), tobramycin사용량과 tobramycin 내성 E.coli에서도 유의한 음의 상관관계가 있었다(P<0.028;r=-0.917). Aminoglycoside계열 내성 A.baumannii가 유의한 음의 상관관계를 나타냈고(P<0.048;r=-0.881), aminoglycoside계열 내성 E. coli도 유의한 음의 상관관계를 나타냈다(P<0.001;r=-0.992). 결론적으로 항균제 사용량은 일부 세균에서 내성률과 상관성이 있었다.

Keywords

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