초록 열기/닫기 버튼
배경: Mycoplasma IST2 kit (bioMérieux, France)로 검출된 생식기 mycoplasma 중 Ureaplasma urealyticum은 7.6% 관찰된 반면 대부분이 Ureaplasma parvum으로 동정되었다(80.3%). U. parvum과 U. urealyticum을 감별한 것은 본 연구가 처음으로 저자들은 한국인 여성의 ureaplasma 분리율과 항생제 내성을 알아보고자 하였다. 방법: 2014년 10월에서 11월까지 서울성모병원에서 Mycoplasma IST2 kit (bioMérieux)를 사용하여 배양된 150검체를 대상으로 하였다. Mycoplasma IST2 kit로 배양과 항균제 감수성검사를 하였고 Ureaplasma spp. 동정을 위하여 PCR 검사를, 내성유전자변이를 보기 위하여 PCR과 sequencing을 시행하였다. 결과: 생식기 mycoplasma의 양성률은 44.0% (66/150)였고 그 중 53 (80.4%) 검체가 U. parvum으로 동정되었으며 5 (7.6%) 검체는 U. urealyticum, 2 (3.0%) 검체는 Mycoplasma hominis, 6 (9.0%) 검체는 복합감염을 보였다. Ureaplasma spp.에 대한 항균제감수성률은 erythromycin, azithromycin, clarithromycin과 doxycycline에서 각각 86.0%, 80.7%, 98.2%, 94.7%였고 ofloxacin, ciprofloxacin에서는 각각 47.4%, 17.5%였다. Ofloxacin 내성 균주와(5/7, 71.4%), ciprofloxacin 내성 균주에서(7/14, 50.0%) ParC 부위의 S83L 아미노산변이가 각각 관찰되었다. 한 균주의 M. hominis는 erythromycin, azithromycin, clarithromycin에는 내성을, josamycin, pristinamycin, quinolone, tetracycline에는 감수성을 각각 보였다. 결론: 한국인 여성의 생식기 mycoplasma의 분리율은 44.0%였고 대부분은 U. parvum이었다. Ureaplasma spp.의 erythromycin과 azithromycin의 비감수성률이 10% 이상 보이므로(15.5%, 20.7%) 이들 약제를 사용하기 전 항균제감수성검사가 필요할 수 있다. U. urealyticum과 U. parvum 감염으로 인한 임상적 양상차이와 내성기전에 대한 추후 연구가 필요하겠다.
Background: While 7.6% of cultured genital Mycoplasmataceae was identified as Ureaplasma urealyticum, most of them were Ureaplasma parvum (80.3%). This is the first study differentiating between these two species. We investigated the prevalence and antimicrobial resistance of genital Mycoplasmataceae in Korean women. Methods: A total of 150 specimens submitted to the laboratory for culture of M. hominis and Ureaplasma spp. were included. Detection and antimicrobial susceptibility tests were performed with the Mycoplasma IST2 kit (bioMérieux, France). The identification of Ureaplasma spp. was performed by PCR, and mutations in drug resistance genes were investigated by PCR and sequencing. Results: In total, 66 specimens (44.0%) were positive for genital Mycoplasmatacea: U. parvum, 53 (80.3%); U. urealyticum, 5 (7.6%); M. hominis, 2 (3.0%); mixed infection, 6 (9.1%). Susceptibilities of Ureaplasma spp. to erythromycin, azithromycin, clarithromycin, and doxycycline were 86.0%, 80.7%, 98.2%, and 94.7%, respectively. The susceptibility of Ureaplasma spp. to ofloxacin and ciprofloxacin was 47.4% and 17.5%, respectively. The S83L mutation was found in the ParC subunit of the ofloxacin-resistant (5/7, 71.4%) and the ciprofloxacin-resistant isolates (7/14, 50.0%). One M. hominis isolate showed resistance to erythromycin, azithromycin, and clarithromycin but susceptibility to josamycin, pristinamycin, fluoroquinolones, and tetracyclines. Conclusion: The prevalence of genital Mycoplasmataceae in Korean women was 44.0%; most of them were identified as U. parvum. As more than 10% of Ureaplasma spp. showed non-susceptibility to erythromycin and azithromycin (15.5%, 20.7%), a susceptibility test is needed prior to use of these antibiotics. Further study is needed about the clinical features of infections caused by U. urealyticum vs. U. parvum and their associated resistance mechanisms.
