Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Changes in Causative Organisms and Antimicrobial Susceptibility of the Urinary Tract Infection

요로감염의 주요 원인균과 항생제 감수성의 변화에 관한 고찰

  • Ha, Tae Uk (Department of Emergency Medicine, Wonkwang Unicersity School of Medicine) ;
  • Hwang, Yong (Department of Emergency Medicine, Wonkwang Unicersity School of Medicine) ;
  • Park, Seung Chol (Department of Urology Medicine, Wonkwang Unicersity School of Medicine) ;
  • Lee, Jea Whan (Department of Urology Medicine, Wonkwang Unicersity School of Medicine)
  • 하태욱 (원광대학교의과대학 응급의학교실) ;
  • 황용 (원광대학교의과대학 응급의학교실) ;
  • 박승철 (원광대학교의과대학 비뇨기과학교실) ;
  • 이재환 (원광대학교의과대학 비뇨기과학교실)
  • Received : 2017.01.31
  • Accepted : 2017.03.10
  • Published : 2017.03.31
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Abstract

The urinary tract infection (UTI) is one of the most important infections in hospital. The overuse and misuse of antimicrobial agents and the resulting emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. This study examined the changes in the antibiotic susceptibility to the causative organisms of urinary tract infections to provide useful information on the choice of adequate drugs in the treatment of urinary tract infections. The medical records of 2,707 patients with more than $10^5/ml$ microorganism in urine culture between January 2010 and December 2015 were reviewed retrospectively. The most common pathogenic organism was E. coli (28.1%). In the case of E.coli, there were no differences in frequency from 2010 to 2015 in men, but since 2014, the frequency decreased gradually since 2014 in women. For E. coli, the resistance rates to antibiotics were 72.2% in ampicillin, 44.9% in trimethoprim/sulfamethoxazole (TMP/SMX), and 41.3% in ciprofloxacin, but the 2nd, 3rd, and 4th cephalosporin (5%) had low antibiotic resistance rates. The pathogens of urinary tract infection are becoming diverse and their frequencies are also changing over time. These results suggest that the recommended drugs for UTI should be selected more carefully for in-patients and out-patients.

요로감염은 병원 내 감염의 주요한 부분이며 최근 항생제의 남용 등으로 인해 요로감염에서의 효과적인 항생제의 선택이 제한받고 있다. 연구자들은 본 병원을 방문하여 시행한 요배양검사에서 의미있는 균이 동정된 외래 및 입원 환자의 요로감염의 주요 원인균과 항생제 감수성을 조사하여 요로감염의 치료에 도움을 주고자 하였다. 2010년 1월 1일부터 2015년 12월 31일까지 6년간 본 병원에서 시행한 요배양검사에서 의미 있는 원인균이 동정된 외래 및 입원환자를 대상으로 하였으며 균집락 단위(colony forming unit: CFU)가 $10^5/ml$이상인 환자를 대상으로 하였다. 배양된 동정균주에서 가장 흔한 원인균은 E.coli로 28.1%의 비율이었다. E.coli의 경우 남성에서는 2010년부터 2015년까지 빈도의 차이는 없었으나 여성의 경우 2014년 이후 그 빈도가 점차 감소하였다. 항생제 감수성 결과 가장 흔한 균주인 E.coli의 감수성 검사에서는 ampicillin 72.2%, TMP/SMX (trimethoprim/sulfamethoxazole) 44.9%, ciprofloxacin 41.3%의 내성율을 보였으며, cefazolin 12.4%, 2,3,4세대 cephalosporin에는 5% 이하의 낮은 내성율을 보였다. 요로감염의 원인균은 시간이 지날수록 다양해지고 빈도 또한 변화를 보인다. 따라서 TMP/SMX와 ciprofloxacin 등 기존 항생제에 대한 내성도 또한 비교적 높은 것으로 나타나 향후 요로감염에 대한 경험적인 항생제의 사용에 대해 더욱 신중한 선택을 해야 할 것으로 생각한다.

Keywords

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