[논문]2015~2020년 동안 인천 지역 단일기관에서의 비결핵항산균 분포 및 항균제 내성률

김지우; 주효진; 구제현; 이혜영; 박현환; 송경철; 김자영

doi:10.15324/kjcls.2021.53.3.225

2015~2020년 동안 인천 지역 단일기관에서의 비결핵항산균 분포 및 항균제 내성률
Distribution and Antimicrobial Resistance of Non-Tuberculous Mycobacteria during 2015~2020: A Single-Center Study in Incheon, South Korea 원문보기

Korean journal of clinical laboratory science : KJCLS = 대한임상검사과학회지, v.53 no.3, 2021년, pp.225 - 232

김지우 (가톨릭관동대학교 국제성모병원 진단검사의학과) , 주효진 (가톨릭관동대학교 의과대학 인문학교실) , 구제현 (가톨릭관동대학교 국제성모병원 진단검사의학과) , 이혜영 (가톨릭관동대학교 국제성모병원 진단검사의학과) , 박현환 (가톨릭관동대학교 보건의료융합연구소) , 송경철 (가톨릭관동대학교 국제성모병원 진단검사의학과) , 김자영 (가톨릭관동대학교 국제성모병원 진단검사의학과)

초록
AI-Helper

본 연구는 인천지역에 위치한 단일기관의 비결핵항산균의 분포 및 항균제 내성률과 동반 세균 빈도를 조사한 것으로, 2015년부터 2020년까지 TB/NTM real-time PCR 검사가 의뢰된 8,258건의 환자 데이터를 후향적으로 검토하였다. 총 296건의 검체가 NTM 양성이었고, 발생률은 2015년 2.5% (30/1,209)에서 2020년 3.8% (66/1,740)로 증가하였다. NTM으로 확인된 296건 중, 54.7% (162/296)는 M. avium complex (MAC)에 속하는 균종으로 확인되었고, 그다음으로 M. abscessus complex (MABC) 20.9% (62/296), M. fortuitum 6.4%(19/296) 및 M. flavescens 3.4% (10/296) 순이었다. NTM 양성 검체 중, 약제내성검사가 의뢰된 검체는 76.7% (227/296)였다. 다제내성 NTM은 40.1% (91/227)였고, 광범위 내성 NTM은 59.9% (136/227)였다. NTM과 동시 감염은 43.4% (63/145)이었고 가장 흔한 균종은 Klebsiella pneumonia (23.8%, 15/63)였다. 본 연구는 인천지역의 NTM 분포 및 항균제 내성률과 동반 세균 빈도에 관한 최초 보고이다. NTM 감염의 비율은 점차적으로 증가하는 추세이며 효과적인 관리를 위해 적극적인 진료와 철저한 감염관리가 필요할 것이다.

Abstract ▼ AI-Helper

This study sought to investigate the distribution, antimicrobial resistance rate, and bacterial co-infection frequency of non-tuberculous mycobacteria (NTM) in a single center in Incheon, South Korea. A total of 8,258 specimens submitted for tuberculosis (TB)/NTM real-time PCR tests during the years 2015 to 2020 were retrospectively reviewed. In total, 296 specimens (3.6%) were NTM positive, and the positivity increased from 2.5% (30/1,209) in 2015 to 3.8% (66/1,740) in 2020. Of 296 NTM specimens, 54.7% (162/296) were identified as the Mycobacterium avium complex (MAC) followed by the Mycobacterium abscessus complex (MABC) 20.9% (62/296), M. fortuitum 6.4% (19/296) and M. flavescens 3.4% (10/296). Of the NTM-positive specimens, 76.7% (227/296) were tested for drug resistance. The results showed multidrug-resistant NTM in 40.1% (91/227) and extensively drug-resistant NTM in 59.9% (136/227) of these specimens. Of the 145 isolates taken for bacterial culture, bacteria/fungi co-infection with NTM accounted for 43.4% (63/145), in which the most common bacterial species was Klebsiella pneumonia (23.8%, 15/63). This study is the first report on the distribution and antimicrobial resistance of NTM in Incheon. As the proportion of NTM infections increases, active treatment and thorough infection control are required for effective management.

주제어

표/그림 (4)

그림 Figure 1. The isolation rate of NTM in MTB/NTM real-time PCR systems increased from 2.5% (30/1,209) in 2015 to 3.8% (66/1,740) in 2020, while the isolation rate of MTB decreased from 8.2% (99/1,209) to 3.8% (66/1,740) during the studied period. Among the 768 positive samples in TB/NTM realtime PCR results, the proportion of MTB and NTM was 61.5% (472/768), and 38.5% (296/768), respectively. The the proportion of MTB decreased from 76.7% (99/129) in 2015 to 50.0% 66/132) in 2020, while the proportion of NTM increased from 23.3% (30/129) to 50.0% (66/132) during the same period.
표 Table 1. Distrubution of NTM species in a single center in Incheon
표 Table 2. Antimicrobial resistant rates of NTM (N=227)
그림 Figure 2. Among the 66 samples (66/145, 45.5%) of bacteria/fungi coinfection with NTM, the most common bacterial species was Klebsiella pneumonia accounted for 23.8% (15/63), followed by Candida albicans 19.0% (12/63), Psuedomonas aeruginosa 15.9% (10/63), non-Candida albicans 11.1% (7/63) and Staphylococcus haemolyticus 6.3% (4/63).

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표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

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