DOI QR코드

DOI QR Code

Differences in the Antibiotic Resistance Pattern of Staphylococcus aureus Isolated by Clinical Specimens in a University Hospital in South Korea

일개 대학병원의 임상 검체에서 분리한 포도알균 항생제 내성 경향 차이

  • Hong, Seong-No (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Kim, Joon (Department of Laboratory Medicine, Ajou University Hospital) ;
  • Sung, Hyun-Ho (Department of Clinical Laboratory Science, Dongnam Health University)
  • 홍성노 (동남보건대학교 임상병리과) ;
  • 김준 (아주대학교병원 진단검사의학과) ;
  • 성현호 (동남보건대학교 임상병리과)
  • Received : 2018.05.09
  • Accepted : 2018.05.31
  • Published : 2018.06.30

Abstract

Information on the prevalence of S. aureus and the current antimicrobial resistance profile is necessary in selecting the appropriate treatment of S. aureus infections in any part of the world. This study examined the frequency and antibiotic resistance list of S. aureus isolates obtained from clinical specimens at one hospital in Korea. A total of 1,746 gram positive cocci collected were identified as S. aureus. S. aureus isolates were obtained from different samples including sputum (N=565; 32.4%), endotracheal aspirate (358; 20.5%), wounds (329; 18.8%), blood (137; 7.8%), urine (67; 3.8%), and pus (59; 3.4%). All 1,545 S. aureus (100%) strains screened from sputum (565; 36.6%), endotracheal aspirate (388; 25.1%), wounds (329; 21.3%), blood (137; 8.9%), urine (67; 4.3%), and pus (59; 3.8%) were sensitive to glycopeptide (vancomycin, teicoplanin), oxazolidinone (linezolid) and stretogramin (quinupristin/dalfopristin). The prevalence of resistant S. aureus was significantly (P<0.01) lower in urine, blood, pus, wounds, and sputum than in endotracheal aspirates. As a result, there was a significant difference in the antibiotic resistance of S. aureus according to the clinical specimens.

황색포도상구균의 유병률에 대한 정보와 항생제 내성 리스트는 전 세계 어느 곳에서나 황색포도상구균 감염의 적절한 치료 방법을 선택하는 데 필요하다. 이 연구는 한국의 어느 병원 임상 검체에서 얻은 황색포도상구균 균주의 빈도와 항생제 저항성을 조사하기 위하여 수행하였다. 그람 양성구균 1,746 개의 균은 S. aureus으로 확인되었다. S. aureus은 객담(N=565, 32.4%), 기관내 흡인(358, 20.5%), 상처(329, 18.8%), 혈액(137명, 7.8 %), 고름(59 %, 3.4 %)이었다. 객담, 기관 내 흡인, 상처, 혈액, 소변 및 고름에서 스크리닝 된 1,282개의 S. aureus 균주 모두 글리코 펩타이드 옥시 졸리 디논(리네 졸리드) 및 스트렙토그라민(퀴뉴프리스틴/달포프리스틴)에서 모두 민감성이 나타났다. 황색 포도상 구균은 기관 내 흡인과 비교하면 소변, 혈액, 고름, 상처 및 객담에서 내성이 유의하게 낮았으며(P<0.01), 기관내 흡인 검체에서 분리 된 황색포도상 구균의 경우 특히 내성의 빈도가 높았다. 결과적으로, 임상 표본에 따라 황색 포도상 구균의 항생제 저항성에는 상당한 차이가 있었다.

Keywords

References

  1. Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998;339:520-532. https://doi.org/10.1056/NEJM199808203390806
  2. Hardy KJ, Hawkey PM, Gao F, Oppenheim BA. Methicillin resistant Staphylococcus aureus in the critically ill. Br J Anaesth. 2004;92:121-130. https://doi.org/10.1093/bja/aeh008
  3. Brown DF, Edwards DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, et al. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). J Antimicrob Chemother. 2005;56:1000-1018. https://doi.org/10.1093/jac/dki372
  4. Palavecino E. Clinical, epidemiological, and laboratory aspects of methicillin-resistant Staphylococcus aureus (MRSA) infections. Methods Mol Biol. 2007;391:1-19.
  5. Chambers HF, Deleo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol. 2009;7:629-641. https://doi.org/10.1038/nrmicro2200
  6. Brown DF, Edwards DI, Hawkey PM, Morrison D, Ridgway GL, Towner KJ, et al. Guidelines for the laboratory diagnosis and susceptibility testing of methicillin-resistant Staphylococcus aureus (MRSA). J Antimicrob Chemother. 2005;56:1000-1018. https://doi.org/10.1093/jac/dki372
  7. Joo EJ, Chung DR, Ha YE, Park SY, Kang SJ, Kim SH, et al. Community-associated panton-valentine leukocidin-negative meticillin-resistant Staphylococcus aureus clone (ST72-MRSAIV) causing healthcare-associated pneumonia and surgical site infection in Korea. J Hosp Infect. 2012;81:149-155. https://doi.org/10.1016/j.jhin.2012.04.018
  8. Hong SN, Kim J, Sung HH. A study on changes in antimicrobial resistant Staphylococcus aureus from wound isolates in a South Korean university hospital for the past 10 years (2006, 2016). Korean J Clin Lab Sci. 2016;48:335-342. https://doi.org/10.15324/kjcls.2016.48.4.335
  9. Ubukata K, Nonoguchi R, Matsuhashi M, Konno M. Expression and inducibility in Staphylococcus aureus of the mecA gene, which encodes a methicillin-resistant S. aureus-specific penicillin-binding protein. J Bacteriol. 1989;171:2882-2885. https://doi.org/10.1128/jb.171.5.2882-2885.1989
  10. Chambers HF. Methicillin resistance in staphylococci: molecular and biochemical basis and clinical implications. Clin Microbiol Rev. 1997;10:781-791. https://doi.org/10.1128/CMR.10.4.781
  11. Mediavilla JR, Chen L, Mathema B, Kreiswirth BN. Global epidemiology of community-associated methicillin resistant Staphylococcus aureus (CA-MRSA). Curr Opin Microbiol. 2012;15:588-595. https://doi.org/10.1016/j.mib.2012.08.003
  12. Al-Zoubi MS, Al-Tayyar IA, Hussein E, Al Jabali A, Khudairat S. Antimicrobial susceptibility pattern of Staphylococcus aureus isolated from clinical specimens in Northern area of Jordan. Iranian journal of microbiology. 2015;7:265-272.
  13. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; 28th ed, CLSI document M100. Wayne, PA: Clinical and Laboratory Standards Institute; 2017.
  14. Akcam FZ, Tinaz GB, Kaya O, Tigli A, Ture E, Hosoglu S. Evaluation of methicillin resistance by cefoxitin disk diffusion and PBP2a latex agglutination test in mecA-positive Staphylococcus aureus, and comparison of mecA with femA, femB, femX positivities. Microbiol Res. 2009;164:400-403. https://doi.org/10.1016/j.micres.2007.02.012
  15. Park C, Seong CN. The correlation between toxin genotype and antibiotic resistance in methicillin resistant Staphylococcus aureus isolated from clinical specimen of intensive care unit. Korean J Clin Lab Sci. 2016;48:202-209. https://doi.org/10.15324/kjcls.2016.48.3.202
  16. Tamma PD, Robinson GL, Gerber JS, Newland JG, DeLisle CM, Zaoutis TE, et al. Pediatric antimicrobial susceptibility trends across the United States. Infect Control Hosp Epidemiol. 2013;34:1244-1251. https://doi.org/10.1086/673974
  17. Ray GT, Suaya JA, Baxter R. Microbiology of skin and soft tissue infections in the age of community-acquired methicillin-resistant Staphylococcus aureus. Diagn Microbiol Infect Dis. 2013;76:24-30. https://doi.org/10.1016/j.diagmicrobio.2013.02.020
  18. Belbase A, Pant ND, Nepal K, Neupane B, Baidhya R, Baidya R, et al. Antibiotic resistance and biofilm production among the strains of Staphylococcus aureus isolated from pus/wound swab samples in a tertiary care hospital in Nepal. Ann Clin Microbiol Antimicrob. 2017;16:15. doi: 10.1186/s12941-017-0194-0.
  19. Begum R, Towhid ST, Moniruzzaman M, Mia Z, Islam MA. Study of Staphylococcus aureus from clinical samples in Savar, Bangladesh. Res J Microbiol. 2011;6:884-890. https://doi.org/10.3923/jm.2011.884.890
  20. Choo EJ. Antimicrobial therapy for methicillin-resistant Staphylococcus aureus. J Korean Med Assoc. 2018;61:207-213. https://doi.org/10.5124/jkma.2018.61.3.207
  21. Charles MP, Kali A, Easow JM, Joseph NM, Ravishankar M, Srinivasan S, et al. Ventilator-associated pneumonia. Australas Med J. 2014;7:334-344.
  22. Jung YH, Kim HB. Multidrug-resistant Gram-positive bacterial infections. Korean J Intern Med. 2015;88:487-501. https://doi.org/10.3904/kjm.2015.88.5.487
  23. Kelesidis T, Osman S, Trayner E, Worthington M, Celli B. Tracheobronchitis caused by methicillin-resistant Staphylococcus aureus as a cause of chronic wheezing in a non-ventilated adult patient with tracheobronchomalacia. Respiration. 2010;80:148-156. https://doi.org/10.1159/000273268
  24. Jarraud S, Mougel C, Thioulouse J, Lina G, Meugnier H, Forey F, et al. Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. Infect Immun. 2002;70:631-641. https://doi.org/10.1128/IAI.70.2.631-641.2002
  25. Parker D, Prince A. Immunopathogenesis of Staphylococcus aureus pulmonary infection. Semin Immunopathol. 2012;34:281-297. https://doi.org/10.1007/s00281-011-0291-7
  26. Malekzadegan Y. Motamedifar M. Trends of antibiotic resistance in Staphylococcus aureus isolates obtained from clinical specimens. Jkimsu. 2017;6:19-30.

Cited by

  1. Resistance profiling and molecular characterization of Staphylococcus aureus isolated from goats in Korea vol.336, pp.None, 2021, https://doi.org/10.1016/j.ijfoodmicro.2020.108901