지난 11년간 5년 간격으로 살펴본 피부과 외래 환자의 피부 세균 감염의 변화 추세

Trends of the Bacterial Skin Infections of Dermatology Outpatients in 1996, 2001 and 2006

박지혜;변지연;이동윤;이주흥;양준모;이일수
Park, Ji-Hye;Byun, Ji-Yeon;Lee, Dong-Youn;Lee, Joo-Heung;Yang, Jun-Mo;Lee, Eil-Soo

  • 발행 : 20090600

초록

Background: Bacterial infections of the skin are treatable and reversible, so clinicians should be alert for the cutaneous signs of the skin infection. However, there have been only a few reports about the epidemiology of skin infections. Objective: This study was done to evaluate the trend of the clinical features, the results of cultures and the prevalence of MRSA in the dermatology outpatients who had suspected bacterial skin infection in 1996, 2001 and 2006 and we wanted to compare the trends of bacterial skin infection over the last eleven years. Methods: The survey was conducted via the medical records of 24 patients in 1996, 77 patients in 2001 and 88 patients in 2006 who visited the our dermatology department and who underwent Gram-stain and bacterial culture. Results: Of the 347 samples, bacteria were cultured in 197 samples. Among them, 77 samples had coagulase negative Staphylococci, which were excluded as normal skin flora. Among 120 samples, the number of cases of secondary pyoderma, folliculitis, furuncle or carbuncle and cellulitis were 63, 17, 17 and 15, respectively. There was no change in the type of diagnosis during eleven years. The most common pathogen of skin infection was S. aureus (42.7%) and there was no trend to increase for ten years. However, the prevalence of methicillin resistant S. aureus (MRSA) increased for eleven years. Conclusion: The most common pathogen in pyogenic skin infections of the dermatology outpatients was S. aureus, which was sensitive to $\beta$-lactamase resistant $\beta$-lactam antibiotics, but there was an increase of the prevalence of MRSA for eleven years, and the first therapeutic choice for MRSA is vancomycin or teicoplanin.

키워드

참고문헌

  1. Jung MH. Recent changes in infectious diseases. J Korean Acad Fam Med 1996;17:1340-1357
  2. Kim YJ. A study of prevalence and antibiotic susceptibilities of Staphylococcus aureus in the bacterial skin infection of dermatology outpatients. Korean J Dermatol 2001;39:866-871
  3. Roh JY, Park SD, Lee JH, Park CJ, Kim HU, Kwon KS, et al. Infectious skin diseases, In: Korean Dermatological Association. Dermatology. 5th ed. Seoul: Ryo Moon Gak, 2008:293-298
  4. Mark WB, Paul MB, Willian DJ. Topical antibiotics, In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick's dermatology in general medicine. 7th ed. New York: McGraw-Hill, 2008:2113-2116
  5. Rammelkamp CH, Maxon T. Resistant of Staphylococcus aureus to the action of penicillin. Proc So Exp Bio Med 1942;51:386
  6. Panlilio AL, Culver DH, Gaynes RP, Banerjee S, Henderson TS, Tolson JS, et al. Methicillin- resistant Staphylococcus aureus in US hospitals, 1975-1991. Infect Control Hosp Epidermiol 1992;13:582-586 https://doi.org/10.1086/646432
  7. National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004;32:470-485 https://doi.org/10.1016/j.ajic.2004.10.001
  8. Kim WJ. Nosocomial infection: change in the epidemiology. Korean J Med 1999;57:562-571
  9. Park SJ, Chong YS, Lee SY. Antibiotic susceptibility of clinical isolates of bacteria. Korean J Clin Pathol 1977;11:119-125
  10. Lee MK, Choi YS, Chong YS, Lee SY. Prevalence of methicillin-resistant Staphylococcus aureus and comparison of susceptibility test method for its detection. Korean J Clin Pathol 1987;7:265-272
  11. Shin SH, Chang JS, Lim Y. Antimicrobial resistant of Staphylococcus aureus isolated in Gwangju. Med J Chosun Univ 2000;25:52-59
  12. Saravolatz LD, Makowitz N, Arking L, Pohlod D, Fisher E. Methicillin-resistant Staphylococcus aureus: epidemiologic observations during a community-acquired outbreak. Ann Intern Med 1982;96:11-16 https://doi.org/10.7326/0003-4819-96-1-11