Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Molecular Genetic Characteristics of Methicillin-Resistant Staphylococcus aureus Isolated from Patients and Environment of General Hospital Intensive Care Unit in a Chungnam Province, Korea

충남지역 종합병원 중환자실 환경과 환자로부터 분리한 메티실린 내성 황색포도알균(MRSA)의 분자유전학적 특성

  • Kim, Hye-Suk (Department of Laboratory Medicine, Hongsung Medical Center) ;
  • Park, Sung-Bae (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Sang-Ha (Department of Laboratory Medicine, Konyang University Hospital) ;
  • Kim, Sunghyun (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Hyun, Sung-Hee (Department of Biomedical Laboratory Science, School of Medicine, Eulji University) ;
  • Kim, Young-Kwon (Department of Biomedical Laboratory Science, College of Medical Sciences, Konyang University)
  • 김혜숙 (홍성의료원 진단검사의학과) ;
  • 박성배 (부산가톨릭대학교 보건과학대학 임상병리학과) ;
  • 김상하 (건양대학교병원 진단검사의학과) ;
  • 김성현 (부산가톨릭대학교 보건과학대학 임상병리학과) ;
  • 현성희 (을지대학교 의과대학 임상병리학과) ;
  • 김영권 (건양대학교 의과학대학 임상병리학과)
  • Received : 2018.02.20
  • Accepted : 2018.05.22
  • Published : 2018.06.30
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Abstract

In the present study, mec complex typing and SCCmec typing were performed to analyze the molecular genetic characteristics of 20 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from clinical specimens and 4 strains isolated from the ICU environments of secondary medical institutions in a Chungnam province, Korea, from June to July of 2017. Among a total of 20 MRSA strains isolated from clinical specimens, 8 cases (40%) were SCCmec type II, one case (5%) was SCCmec type IVa, and 11 cases (55%) were not-typeable in SCCmec type analysis. Among 4 MRSA isolates from the ICU environment, one strain did not have the mecA gene and 3 strains were typed as SCCmec types II, III, and IVa, respectively. Data from the present study showed that the origin of MRSA isolated from the clinical specimens was different from those from the ICU environment in most cases but the origin was concordant in one case. In this case, MRSA might be transmitted by healthcare workers to the ICU environment. Further study with a large number of cases and other hospital infection-related microorganisms will be needed. This continuous follow-up study might provide useful information on infection control in medical institutions.

본 연구에서는 2017년 6월부터 7월까지 국내 충남 소재 2차 의료기관의 임상검체에서 분리 된 20개 균주와 ICU환경으로부터 분리 한 4개를 포함해 총 24개의 MRSA 균주에 대한 분자유전학적 특성을 분석하기 위해 SCCmec typing과 mec complex typing을 수행하였다. 임상검체에서 분리된 MRSA 20균주의 SCCmec typing 분석 결과 SCCmec type II가 8건, type IVa가 1건, Not-typeable이 11건으로 나타났다. 의료기관 중환자실 환경에서 분리 된 MRSA 중 한 균주는 mecA 유전자를 가지고 있지 않은 것으로 확인되었으며, 나머지 세 균주는 SCCmec type II, III, IVa가 각각 한 건으로 나타났다. 임상검체와 중환자실 환경검체에서 분리된 MRSA는 SCCmec typing 결과 그 기원이 서로 다른 것으로 나타났으나, 의료기관 환경에서 분리된 1건의 경우 그 기원이 서로 일치하여 의료종사자의 손, 가운 등을 매개체로 하여 환경내의 MRSA가 환자에게 전파되었을 가능성이 있는 것으로 사료된다. 이후 추가적인 연구를 통해 좀 더 많은 수의 병원감염 관련 균주를 대상으로 추적조사를 실시 한다면 임상 현장에 감염관리와 관련한 더욱 유용한 정보를 제공할 수 있을 것으로 사료된다.

Keywords

References

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