Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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Carriage Rates of Methicillin-resistant Staphylococcus aureus in Neonates with Neonatal Jaundice

신생아황달 환아에서의 메티실린내성 황색포도알균 보균율에 관한 연구

  • Na, Dong Cheon (Department of Pediatrics, Sungae General Hospital) ;
  • Seo, Jae Min (Department of Pediatrics, Gwangmyeong Sungae General Hospital) ;
  • Lee, Jung Hyun (Department of Pediatrics, Gwangmyeong Sungae General Hospital) ;
  • Lee, Won Uk (Department of Pediatrics, Gwangmyeong Sungae General Hospital) ;
  • Kim, Eun Ryoung (Department of Pediatrics, Sungae General Hospital)
  • 나동천 (성애병원 소아청소년과) ;
  • 서재민 (광명성애병원 소아청소년과) ;
  • 이정현 (광명성애병원 소아청소년과) ;
  • 이원욱 (광명성애병원 소아청소년과) ;
  • 김은령 (성애병원 소아청소년과)
  • Received : 2011.06.04
  • Accepted : 2011.09.09
  • Published : 2011.12.25
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Abstract

Purpose : It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. Methods : We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillinresistance. Results : Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. Conclusion : Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.

목 적 : 황색포도알균의 보균율은 신생아에서 가장 높다고 알려져 있고, 황색포도알균의 보균은 곧 그 균주에 의한 감염증으로 이어질 위험이 높아진다. 본 연구에서는 신생아황달로 입원한 환아에서의 황색포도알균과 MRSA의 보균율을 조사하였고, 신생아황달의 대부분이 모유황달이나 생리적황달임을 감안하여 이를 통해 간접적으로 건강한 신생아의 황색포도알균 및 MRSA 보균율을 추정하고자 하였다. 방 법: 2006년 1월부터 2010년 12월까지 성애병원과 광명성애병원 신생아집중치료실에 황달로 입원한 환아 545명을 대상으로 하였다. 입원 첫날 멸균된 면봉으로 비강과 서혜부를 도찰하여 얻은 검체를 세균배양을 통해 황색포도알균을 동정하고 다시 항생제감수성 검사를 통해 메티실린내성 여부를 판정한 결과를 후향적으로 조사하였다. 결 과:총 545명의 환아가 본 연구에 포함되었고, 이중 318명의 비강과 서혜부에서 황색포도알균이 분리되어 보균율은 58.3%였고 214명의 환아에서는 MRSA가 분리되어 MRSA 보균율은39.3%였다. 또한 분리된 MRSA를 항생제 감수성 결과를 토대로 분석하였을 때, CA-MRSA로 추정되는 균주는 65.7% (142/216), HA-MRSA로 추정되는 균주는 34.3% (74/216)였다. 결 론: 39.3%의 MRSA 보균율로 미루어볼 때, 외부에서 전원되는 신생아를 대상으로 한 MRSA 감시배양검사는 필요하다고 생각된다. 또한, MRSA 균주 중 CA-MRSA 가능성 균주가 65.7%로 높게 나와 이미 지역내산부인과 및 분만실 등에 CA-MRSA 균주가 정착해 있을 가능성이 높다고 생각되며 이에 대한 지속적이고도 정기적인 MRSA 감시배양검사도 필요할 것으로 생각된다.

Keywords

References

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