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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.153 ~ 167
김병태 (  ) - 경북대학교 의과대학 소아과학교실

Abstract


Staphylococci were isolated from hospital air (1, 109 places) during the time from January to May of 1962 and from February of 19"03 to January 1904. The biological character, phage type and antibiotic resistance of isolated strains were studied and the results were as follows:
1) The isolation rate of staphylococci in hospital air was 56.5% among the total 1,109 places and there was no difference in each season. 523 ctrains(83.4%)among 627 were coagulase positive.
2) The isolation rate of the coagulase positive Qtrains was highest in ward (68.9;0) and followed by out-patient clinic (48.2%), corridor(39.0%) and other places (30.5%).
In the ward and out-patient clinics, surgical field was higher than internal medicine field. Out-patient corridor (50.0%) was more predominant than the surgical, internal and ward corridors.
In miscellaneous spaces, administration dept, , (47.0%) was prominent, and followed by labor atory (49.1%), nursing quarter, nursery, pharmacy, operating room and the blood bank in the decreasing order.
Operating room (13.6%) and nursery (21.4%) had lower rate than others.
3) The number of organisms on media exposed to air for 2 hours was 41.5 in average in each plate. It was estimated that the number in each plate was 38.750.9 in average in main entrance and exit of outpatient clinics, corridors, wards, laboratory, administration department and nursing quarter. T.he operating room and nursery was clear than the above places.
4) Allmost all of coagulase positive staphylococci fermented mannitoal and produced golden yellow pigment.
5) 62.3% of the isolated strains was typable at RTD of phage s, and 17.4% was typable at 1, OOCRTD. Non-typable strains occupied 20.3%.
6) Strains belonging to the Mixed Group occupied the most predominant distribution (28.5%). Strains belonging to Group 1Q and Non-typable were next predominant with the sane level (20. 3%), and followed by Group I (17.2%), Group j (9.9%), and Miscellaneous Group (3.8%).
7) The Mixed Group occupied the highest distri bution in every places and the Miscellaneous Group showed lowest. While, in out-patient clinics and wards, the internal medicine field occupied a slightly higher rate in Group j[ than in Group I , and the surgical field showed slightly higher in Group I than in Group j[. Group I , j , 1Q and Miscellaneous Groups were evenly distributed in every places.
Therefore, the significant relationship was not observed between the isolated places and phage group. Non-typable group occupied 49 strains in ward and prominent than ether places.
8) Phage pattern 80 was 37 strains (7. 1%) and phage pattern 52/52A/80 were 12 among 9J belonging to phage Group I .
Strains showing phage pattern 71 were 11 among 52 strains belonging to phage Group j .
Strains showing phage patterns 53,53/77, and 47/53/77 were 18,16,12 strains respectively among 106 strains belonging to Group j[, and strains of phage pattern 81 were 21(3.8%).
In the Mixed Group strains of phage pattern 80/81 were 19 strains (3.6%) among 149.
9) The distribution of the epidemic strains was19(18.8%), 17(16.8%), and 13(12.8%) in out-patient corridor, surgical out-patient and surgical ward. Aiid the surgical field including out-patient, ward anti corridor was two times higher in isolation rate than internal medicine field. Isolation rates in miscellaneous places except laboratory (8.9%) were 12%.
10) Among the antibiotics tested, strains resistant to tetracycline derivatives and penicillin were 83.295.8% and 84.3% among total strains tested. Strains resistant to erythromycin, albamycin, neomycin and kanamycin were from 16. E% to 213.1 jo. However, in chloromycetin, it was 51.6 %.
11) The relationship between the antibiotic-resistance: and the phage pattern indicated that strains resistant to erythromycin, aabamycin, neomycin and kanamycin were frequently found in miscellaneous Group (45.0%60. C%) and were gracivally decreased in Group j[ and I , and Mixed Group. Strains sensitive to above antibiotics were found predominantly in Group j , and 1\fon-typable.
The high rate of resistant strains to penicillin, reverin, :ichromycin, terramycin, auieomycin were found in each Group but Group I was prominent among them. The strains resistant to chloromycetin and streptomycin were found equally in each Group, and was higher in Miscellaneous Group.
12) Comparing the antibiotic-resistance rate between the epidemic and non-epidemic strains, the former showed higher rate than the latter and espec;i,ally some prominent difference was found in e~~ch season between chloromycetin (73. 2%) and steptomycin (90.1,0).
13) About 23.829.7% of the epidemic strains were multiply resistant to 56 antibiotics, and 23.028.ORo of non-epidemics strains were multiply resistant to 34 kinds of the antibiotics.

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