2018-2020년 한 전문검사센터 요 배양에서 분리된 세균 균종 및 항균제 감수성 (Microorganisms Isolated from Urine Cultures and Their Antimicrobial Susceptibility Patterns at a Commercial Laboratory during 2018-2020)

서지정보

· 발행기관 : 대한의료관련감염관리학회
· 수록지 정보 : 의료관련감염관리 / 27권 / 1호 / 51 ~ 58페이지
· 저자명 : 곽병학, 홍정미, 배혜경, 박윤수, 이미경, 이경원, 이경률

초록

Background: Antimicrobial resistance of bacterial pathogens that cause urinary tract infections is a leading concern in Korea. This study analyzed the urine culture results and antimicrobial susceptibility trend in different types of healthcare facilities including long-term care hospitals. The aim of the study was to derive relevant information for the empirical treatment of patients with antibiotics.
Methods: We analyzed the species and antimicrobial susceptibility of the isolates from urine cultures received at the Seoul Clinical Laboratories from 2018 to 2020. Organisms were identified using Microflex MALDI Biotyper (Bruker Daltonik GmbH, Germany). Antimicrobial susceptibility was tested using the Vitek 2 automated system (bioMérieux, France).
Results: The most frequently isolated organism was Escherichia coli. In general and small and medium sized hospitals, Enterococcus faecalis was the next most frequently isolated organism. In long term care hospitals (LTCH), Proteus mirabilis was the next most frequently isolated organism. A total of 37-70% of E. Coli, 51-76% of Klebsiella pneumoniae, and 52- 85% of P. mirabilis strains were cefotaxime resistant. The incidence of fluoroquinolone-resistant isolates for the aforementioned strains was 48-86%, 51-83%, and 60-95% respectively. A total of 8-22% of isolates of K. pneumoniae were carbapenem-resistant. The incidence of carbapenem resistant K. pneumoniae in LTCH increased sharply from 8% in 2018 to 38-40% in 2020. The incidence of glycopeptide-resistant E. faecalis was 27-80%.
Conclusion: This study demonstrated that the use of fluroquinolones and b-lactam antibiotics recommended for empirical antibiotic therapy was limited considering the high prevalence of antibiotic resistant organism. Antimicrobial stewardship programs and infection control programs may also play an important role considering the high prevalence of antimicrobialresistant organisms especially in LTCH.

영어초록

Background: Antimicrobial resistance of bacterial pathogens that cause urinary tract infections is a leading concern in Korea. This study analyzed the urine culture results and antimicrobial susceptibility trend in different types of healthcare facilities including long-term care hospitals. The aim of the study was to derive relevant information for the empirical treatment of patients with antibiotics.
Methods: We analyzed the species and antimicrobial susceptibility of the isolates from urine cultures received at the Seoul Clinical Laboratories from 2018 to 2020. Organisms were identified using Microflex MALDI Biotyper (Bruker Daltonik GmbH, Germany). Antimicrobial susceptibility was tested using the Vitek 2 automated system (bioMérieux, France).
Results: The most frequently isolated organism was Escherichia coli. In general and small and medium sized hospitals, Enterococcus faecalis was the next most frequently isolated organism. In long term care hospitals (LTCH), Proteus mirabilis was the next most frequently isolated organism. A total of 37-70% of E. Coli, 51-76% of Klebsiella pneumoniae, and 52- 85% of P. mirabilis strains were cefotaxime resistant. The incidence of fluoroquinolone-resistant isolates for the aforementioned strains was 48-86%, 51-83%, and 60-95% respectively. A total of 8-22% of isolates of K. pneumoniae were carbapenem-resistant. The incidence of carbapenem resistant K. pneumoniae in LTCH increased sharply from 8% in 2018 to 38-40% in 2020. The incidence of glycopeptide-resistant E. faecalis was 27-80%.
Conclusion: This study demonstrated that the use of fluroquinolones and b-lactam antibiotics recommended for empirical antibiotic therapy was limited considering the high prevalence of antibiotic resistant organism. Antimicrobial stewardship programs and infection control programs may also play an important role considering the high prevalence of antimicrobialresistant organisms especially in LTCH.

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