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病院內 病原性 葡萄球菌 分布에 關한 硏究

Studies On The Pathogenic Syaphylococci In Hospital

경북의대잡지 1964년 5권 1호 p.135 ~ 152
김병태 (  ) - 경북대학교 의과대학 소아과학교실

Abstract


In order to know the carrier rate of staphylococci in the hospital, stapiiyloc:oc;ci were isolated from nasal cavity and throat from a total of 577 individuals, including 233 doctors, 202 nurses, and 122 laboratory technicians and clerks, during the periods from January to ivlay of 1962 and from February of 1963 to January oP 19E4. The biological character, phage type and antibiotic-resistance of isolated strains were siudied and evaluated according to the origins, and the following results were obtained.
1) Staphylococci were isolated from 387(G9.5 ~) cases of nasal cavity and 3~6(e5.7%) of throat. -
The isolation rate of staphylococci from nasal cavity was slightly higher than that from thr~-at. No marked seasonal differcnce was noted in the rare. Among the strains isolated, 92.1 % of nasal origin and 86.9% of throat origin were coagulase positive.
2) The laboratory technicians showed the highest carrier rate with 77.8% both in nasal cavity and in throat and was followed by doctors (72.1%), nurses (65.8,0 and clerks (45.5%) in nasal cavity, and nurses (59.4%), doctors (55.8 %) and. clerks (42.9%) in throat.
3) Considering the isolation rate of staphylococci from nasal cavity and throat of doctors and nurses i:n each department, surgical field was higherthan ;Internal medicine field, and the laboratory (93.3%} occupied the highest carrier rate.
4) coagulase positive staphylococci were isola-ted from nasal cavity and throat of the same persons in 53, 7% of individuals tested, and 9.3% in nasal cavity only and 3.4% in throat only.
5) Almost all strains of coagulase positive staphylococci isolated from nasal cavity and tlu--oat fermented mannitol and produced golden yellow pigment.
6) Among coagulase positive staphylococci, 84.1% of strains isolated from nasal cavity, and 79.6% of strains from throat were typable with basic set of typing phages.
7) The Mixed Group was the most predominant occupying 29.3% and 29.8% of strains from nasal cavity and throat; respectively. The distribution of each phage group among strains from nasal cavity and throat were as follows:
Strains
Phage groups from nasal from
cavity throat
I 23, 9% 18.2%

I 8.0 % 7.9
1I 20.8% 22.3%
N o 0
Miscellaneous 2.0% 1, 3%
Mixed 29, 3% 29.8%
Non-typable 10.0% 20.5%
8) The strains belonging to Mixed Group was 29.2% and 28.3% among strains isolated from throat of doctors and nurses, and followed by non-typable, ~ , I , I , and Miscellaneous Group in the decresing order. The Mixed Group was the most predominant with 27.7 and 27.8% amon~ strains from nasal cavity of doctors and nurses and followed by I , II , non-typable, I and Miscellaneous Group.
9) Among 142 strains belonging to Group I , phage patterns 80 and 52/52A/80 `vere 27 and 24 strains respectively and the others were less than 10. In the Group I , of 53 strains, phage patterns 3A/3B, and 3A/3B/55 were 12 strains respectively, Phage patterns 53/54/75/77, 7/47/ 54, and 7/47/53/54 were 29, 23 and 21 strains respectively among 144 strains belonging to Group II. Phage pattern 81 in Miscellanous Group was 11 strains. Phage pattern 80/81 was 35 strains (5.2%) among 198 strains belonging to M-fixed Group.
10) Among the 299 cases which canied staphylococci both in nasal cavity and throat, and number of persons who carry strains of the same phafie patterns in both localities occupied a large majority. And, only 51 persons carried the stra~.ins of different phage patterns.
11) 139 strains (20.8%) out of 669 strains of coagulase positive staphylococci isolated from nasal cs.vity and throat were classified into epidemic phage group, Among the epidemic strains, phage p,3ttern 80/81 occupied about one-fourth and the next: was phage patterns 52/52A/80. Although there aie no marked seasonal difference in the isolation rate and the frequency of isolation of epidemic: strains were slightly higher in summer. The distribution of the epidemic strains in each department showed some differences by seasons.
12) Among the antibiotics tested, strains resistant to penicillin and tetracycline derivates w-ere from 93.6% to 66.2% among total strains tested. :itrains resistant to erythromycin, albamycin, kanamycin and neomycin were from 19.7% to 35.7%. However, in chloromycetin, it was 56.1 %.
13) Tlie relationship between the antibiotic-resistance and the phage pattern indicated that strains .resistant to erythromycin, albamycin, neomyci~i and kanamycin were found frequently in GrouF~ I and Miscellaneous Group, and strains sensitive to above antibiotics were frequently found in Group I , Group II and Non-typable. Strains resistant to penicillin, reverin, achromycin, ter:ramycin, aureomycin, sigmamycin were frequently found in Group I , I and Miscella~leous Group. Strains resistant to chloromycetin was found in Group I and I/liscellaneous Group and strains sensitive to this drug was found in Group I
14) Comparing the antibiotic-resistance rate between epidemic and nonepidemic strains, the former showed higher rate than the latter.
15) About 22.3%29.5% of epidemic strains were multiple resistant to 67 antibiotics, and 22.5%18.1% of non-epidemics strains were multiply resistant to 46 kinds of antibiotics.

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