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      • SCOPUSKCI등재

        Valuation of ecosystem services in the organic carbon of the Pinus densiflora forest at Mt. Namsan, Seoul Metropolitan City

        Lee, Eung-Pill,Lee, Soo-In,Jeong, Heon-Mo,Han, Young-Sub,Lee, Seung-Yeon,Park, Jae-Hoon,Jang, Rae-Ha,Hong, Youg-Sik,Jung, Young-Ho,Kim, Eui-Joo,Lee, Sang-Hun,You, Young-Han The Ecological Society of Korea 2019 Journal of Ecology and Environment Vol.43 No.4

        Background: Standing biomass, litter production, rate of litter decomposition, amount of litter on forest floor, and amount of soil organic carbon distribution were investigated from March 2016 to November 2018 in order to evaluate the ecosystem value through organic carbon distribution in the Pinus densiflora forest at Namsan, Seoul Metropolitan City. Results: The amount of organic carbon in the Pinus densiflora forest was 261.09 ton C ha<sup>-1</sup> during the research period, and fixed organic carbon in plant through net photosynthesis was 3.2 ton C ha<sup>-1</sup> year<sup>-1</sup>. The organic carbon in plant was 62.77 ton C ha<sup>-1</sup> (24.04%), in litter on the forest floor was 3.65 ton C ha<sup>-1</sup> (1.40%), and in soil was 194.67 ton C ha<sup>-1</sup> (74.56%). The value of plant, litter on forest floor, and soil organic carbon distribution were each 6,277,000 won ha<sup>-1</sup>, 365, 000 won ha<sup>-1</sup>, and 19,467,000 won ha<sup>-1</sup>. The value per ton of fixed organic carbon in plant through net photosynthesis was 320,000 won ha<sup>-1</sup> year<sup>-1</sup> and the value of ecosystem services stored in carbon in the Namsan forest ecosystem was about 26.1 million won ha<sup>-1</sup> for 3 years. Conclusions: The results of this study suggest that the pine forests of Namsan rapidly decompose leaves due to the high atmospheric temperature and accumulate a large amount of organic carbon in the soil to provide climate control regulatory service function.

      • KCI등재

        Bloodstream Infections and Clinical Significance of Healthcare-associated Bacteremia: A Multicenter Surveillance Study in Korean Hospitals

        Son, Jun Seong,Song, Jae-Hoon,Ko, Kwan Soo,Yeom, Joon Sup,Ki, Hyun Kyun,Kim, Shin-Woo,Chang, Hyun-Ha,Ryu, Seong Yeol,Kim, Yeon-Sook,Jung, Sook-In,Shin, Sang Yop,Oh, Hee Bok,Lee, Yeong Seon,Chung, Doo The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.7

        <P>Recent changes in healthcare systems have changed the epidemiologic paradigms in many infectious fields including bloodstream infection (BSI). We compared clinical characteristics of community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA) BSI. We performed a prospective nationwide multicenter surveillance study from 9 university hospitals in Korea. Total 1,605 blood isolates were collected from 2006 to 2007, and 1,144 isolates were considered true pathogens. HA-BSI accounted for 48.8%, CA-BSI for 33.2%, and HCA-BSI for 18.0%. HA-BSI and HCA-BSI were more likely to have severe comorbidities. <I>Escherichia coli</I> was the most common isolate in CA-BSI (47.1%) and HCA-BSI (27.2%). In contrast, <I>Staphylococcus aureus</I> (15.2%), coagulase-negative <I>Staphylococcus</I> (15.1%) were the common isolates in HA-BSI. The rate of appropriate empiric antimicrobial therapy was the highest in CA-BSI (89.0%) followed by HCA-BSI (76.4%), and HA-BSI (75.0%). The 30-day mortality rate was the highest in HA-BSI (23.0%) followed by HCA-BSI (18.4%), and CA-BSI (10.2%). High Pitt score and inappropriate empirical antibiotic therapy were the independent risk factors for mortality by multivariate analysis. In conclusion, the present data suggest that clinical features, outcome, and microbiologic features of causative pathogens vary by origin of BSI. Especially, HCA-BSI shows unique clinical characteristics, which should be considered a distinct category for more appropriate antibiotic treatment.</P>

      • KCI등재

        Survey of Cultivation and Status of Gerbera Smart Farms

        Oh Keun Kwon,Jae Ah Jung,Myung Suk Ahn,Hyun Young Song,Manjulatha Mekapogu,Dan Hye Kim,Doo Jong Ha 한국화훼학회 2021 화훼연구 Vol.29 No.4

        본 연구는 거베라 주산지인 경북과 경남 지역의 농가 재배 및 스마트팜 현황을 조사하고 분석하고자 수행하였다. 조사방법은 2020년 81 농가를 대상으로 대면 설문조사를 실시하였다. 거베라 경영주 연령은 50∼60대가 71.6%로 가장 많았고, 30∼ 40대가 16%, 70세 이상이 9.9%, 30세 이하는 2.5% 순이었다. 거베라 재배 경력은 5년 이하가 37%였으며, 6∼10년 25.9%, 11∼20년 29.6%, 21년 이상 농가가 7.4%였다. 재배 면적은 0.3 ∼0.6ha가 61.7%로 가장 많았고, 0.3ha 미만이 30.9%, 0.6ha 이상이 7.4%였으며, 전체 평균재배 면적은 0.37ha였다. 거베라 재배 농가당 평균 인력은 자가 노동력 2.1명, 고용 노동력 0.8명 이었다. 재배 방식에서 토경 88.9%, 양액재배 농가는 11.1%였다. 국산품종을 전체 또는 일부라도 재배하고 있는 농가는 61.7%였고 외국산 거베라 품종만 재배하고 있는 농가는 38.3% 였다. 거베라 병해충 발생조사에서 병 발생이 많았다고 응답한 농가는 91.4%였으며, 충 발생이 많았다고 응답한 농가는 98.8% 였다. 스마트팜 시스템을 설치한 농가는 12.3%였으며, 설치하지 않은 농가에서 향후 설치할 의향이 있다고 응답한 농가는 76.9% 였다. 향후 경영계획을 묻는 질문에서 현상유지 80.2%, 축소 8.6%, 경영확대 11.1%였으며, 경영 확대를 대답한 농가는 경북 지역이 8농가로 경남지역 1농가 보다 많았다. This study was conducted to investigate and analyze gerbera cultivation and the status of smart farms in Korea. The survey was conducted in person for 81 farms, in 2020. About 71.6% managers of the gerbera farms were in their 50s and 60s, 16% in their 30s and 40s, 9.9% were over 70, and 2.5% under 30. About 37% of the farmers have cultivation experience of less than five years; 25.9%, 6–10 years; 29.6%, 11–20 years; and 7.4%, over 21 years. Around 61.7% of the area under gerbera cultivation was 0.3–0.6 ha, 30.9% was less than 0.3 ha, and 7.4% was over 0.6 ha; and the average area under cultivation was 0.37 ha. The average family labor of the gerbera farms was 2.1 people and the employed labor was 0.8 people. The cultivation methods included about 88.9% soil and 11.1% nutrient cultivation farms. However, 61.7% of the farmers cultivated all or part of the domestic gerbera varieties, whereas 38.3% only cultivated foreign varieties. In the pest survey, around 91.4% of the farm managers responded to have observed different diseases, and around 98.8% farms exhibited various pests. The smart farm system has been installed by 12.3% of the farming households. However, 76.9% of farming households with no prior smart farms are planning to install them in the future. Future plans include the status quo of 80.2%, reduction in total area by 8.6% and expansion in total area by 11.1%, and around eight farms in Gyeongbuk and one farm in Gyeongnam area are planning to expand their management.

      • 폐렴구균의 용혈능 변화와 pneumolysin 유전자의 변이 양상

        오원섭,장현하,정숙인,김연숙,이혁,김신우,김성민,백경란,이남용,송재훈 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.3

        목적 : 폐렴구균은 인체에서 폐렴, 수막염 및 패혈증 등을 일으키는 중요한 병원균으로 현재 전 세계적으로 항균제 내성이 큰 문제가 되고 있다. 하지만 폐렴구균의 항균제 내성에 따라 병독성이 어떻게 변화하는지에 대해서는 구체적으로 알려져 있지 않다. 이에 기능적 및 구조적 분석을 통하여 폐렴구균의 주요 병독성 인자인 pneumolysin의 병인론적 역할을 규명하고자 하였다. 방법 : 임상 검체에서 분리된 페니실링 감수성 균주 20주와 내성 균주 20주를 대상으로 하였다. Pneumolysin의 세포 독성의 변화를 관찰하기 위하여 각각의 균주들의 용혈능을 측정하였고, pneumolysin 유전자를 중합효소 연쇄반응으로 증폭한 후 증폭 산물의 유전자 구조를 분석하였다. 결과 : 페니실린 감수성 균주와 내성 균주간의 용혈능은 유의한 차이를 보이지 않았으나, 일부 용혈능이 매우 낮은 균주에서 Lys152→Thr, Thr-172→Ile, Lys-224→Arg와 같은 변이가 관찰되었다. 결론: pneumolysin의 세포 독성의 변화는 항균제 내성 정도와는 무관하였으나, 일부 용혈능이 저하된 균주에서 발견된 pneumolysin 유전자의 변이가 pneumolysin의 세포 독성에 영향을 주는 것으로 보인다. Background : Pnumolysin (Ply) is one of the most important virulence factors of Streptococcus pneumoniae. To investigate the functional and structural variation of Ply, hemolytic activity (HA) and gene sequences of pneumolvsin were determined. Methods : A total of 40 invasive pneumococcal isolated (20 penicillin-susceptible & 20-resistant strains) were analyzed. HA of each isolate was measured in crude extracts (1×10^8 CFU/mL) hourly from the time of inoculation to 9h. Crude extracts (50㎕) and DTT buffer (100㎕) were serially diluted in 96-well plate and mixed with 1% sheep blood (50㎕). HA was represented as the reciprocal of the greatest dilution, which resulted in the complete lysis. Two sets of oligonucleotide primers were used to amplify a 1,474-bp fragment containing the coding region and a 578-bp fragment of upstream region of ply gene, respectively. Amplified products were directly sequenced. Results : HA showed a wide variation from 0 to 87,480 regardiess of penicillin MICs, serotypes or specimen sources. Two bacteremic strains showed completely no hemolytic activity. No significant differences in HA between penicillin-susceptible (Mean± SE : 15,468± 4,693) and penicillin-resistant strains (21,384± 4,087) were found (p > 0.05).Sequencing of the coding region showed unique alterations in amino acids in strains with markedly reduced hemolytic activity (≤ 40): Thr-172-Ile and Lys-224-Arg. However, upstream region of ply gene was highly conserved. Conclusions : Ply activity was not related with antibiotic resistance. Absence of HA in some strains was associated with unique alterations in amino acid sequences in ply gene. Relationnship between genomic alteration and functional changes in pneumolysin should be further investigated.

      • KCI등재

        2010 파주, 안산지역 갈대, 억새 등 야초류의 이용실태와 사료가치 평가

        서성(Sung Seo),김원호(Won Ho Kim),정민웅(Min Woong Jung),박형수(Hyung Soo Park),심재진(Jae Jin Shim),박진길(Jin Gil Park),성하균(Ha Guyn Sung),김종덕(Jong Duk Kim),이종경(Joung Kyong Lee) 한국초지조사료학회 2011 한국초지조사료학회지 Vol.31 No.2

        본 연구는 부존 조사료자원의 이용을 활성화하여 수입사료를 줄이고 가축 사료비를 절감하고자 2010년도에 경기 파주 (민통선 지역)와 경기 안산 (시화지구)에서 갈대와 억새 등 야초자생지를 탐색하고, 수확?이용실태 조사와 함께 사료가치를 분석하였다. 파주 민통선 내억새 (Miscanthus sinensis)와 갈대 (Phragmites communis) 혼합 자생지는 90~100 ㏊ 규모로, 1차 곤포작업으로 사일리지 520톤 (㏊당 6톤), 2차로 380톤 (㏊당 4톤)을 조제하여, 연 사일리지 900톤 (㏊당 10톤)을 생산하였다. 곤포의 유통가격은 롤당 52~55천 원으로 ㎏당 130~137.5원이었다. 곤포는 자가소비 50~70%, 판매유통 30~50%로, 수익성은 인건비 정도로 추정되었다. 초장 70 ㎝의 재생 억새는 조단백질 9.6%, 상대사료가치 82.4 (건초 4등급), 건물 소화율 67.7%, 초장 70 ㎝의 재생 갈대는 각각 13.8%, 84.3 (4등급), 67.9%로 사료가치는 높았으며, 수확이 늦어짐에 따라 사료가치는 크게 낮아졌다. 안산 시화지구 (3공구)의 갈대 등 야초류자생지는 100 ㏊ 정도로 2009년도에는 50 ㏊에서 사일리지 550톤 (㏊당 11톤)을 생산하여 롤당 50천 원에 유통하였으며, 2010년도는 잦은 강우와 장마로 부분 이용에 그쳤다. 고초기의 갈대는 건물률 89.8%, 조단백질 2.2%, NDF 80.6%, ADF 55.4%, 상대사료가치 52.9 (5등급), 건물 소화율 36.4%로 볏짚에 비해서도 사료가치는 크게 낮았다. 초장 80 ㎝의 재생 갈대는 조단백질 12.9%, 상대사료가치 99.8 (3등급), 건물 소화율 66.6%로 사료가치는 양호하였으며, 개화기의 초장 150 ㎝ 갈대는 조단백질 4.5%, 상대사료가치 59.9 (5등급), 건물 소화율 42.2%로 볏짚의 사료가치와 비슷하였다. 이상의 결과를 종합하여볼 때, 갈대, 억새 등 야초류는 현 상태에서 최대한 수거?이용하되, 사료가치를 유지하고 가축 기호성을 고려한 시기에 수확하는 것이 중요하며, 최소한 볏짚과 비슷하거나 그 이상의 사료가치를 기대하기 위해서는 7월 중순 이전 (늦어도 7월까지)에 수확?이용하는 것이 권장된다. 본 연구에서 조사된 대부분의 야초류는 상대사료가치가 75 이하인 건초 5등급으로 사료가치는 매우 낮았으며, 키가 작은 영양생장기에 수확한 경우에만 4등급으로 나타났다. 부존 조사료자원의 이용은 양질의 사료작물 생산과 병행하여 추진하는 것이 바람직하였다. This study was carried out in 2010 to investigate the utilization and nutritive value of native grasses, such as Phragmites communis and Miscanthus sinensis which might reduce the cost of feeding domestic cattle. The regions within the Civilian Control Line in Paju and Sihwa region in Ansan were surveyed. In Paju, the yearly silage production was 900 MT harvested from 90 ha (10 MT/㏊). About 30~50% of these were sold out at the marketing price of 52,000~55,000 Won per roll (130~137.5 Won/㎏). Regrown Miscanthus sinensis of 70 ㎝ in length contained 9.6% of crude protein (CP), 82.4 of relative feed value (RFV), and 67.7% of in vitro dry matter digestibility (IVDMD). Regrown Phragmites communis of 70 ㎝ in length contained 13.8% of CP, 84.3 of RFV, and 67.9% of IVDMD. As harvesting was delayed, the quality was decreased dramatically. In Ansan region, Phragmites communis plantation covers 100 ha. The silage production was 550 MT from the area of 50 ha (11 MT/㏊) in 2009. And the marketing price was 50,000 Won per roll. But in 2010 only a small amount of grasses could have been baled due to frequent and much rainfall from spring to summer season. However, the good forage quality was observed from regrown Phragmites communis of 80 ㎝ in length, 12.9% CP, 99.8 RFV and 66.6% IVDMD, while that of late matured grasses was very low, 2.2% CP, 52.9 RFV and 36.4% IVDMD, greatly lower than forage quality of rice straw. The quality of grasses at bloom stage of 150 ㎝ in length was similar to that of rice straw, showing 4.5% CP, 59.9 RFV and 42.2% IVDMD. In conclusion, the overall quality of most native grasses in this survey were very poor. Therefore, we recommend that Phragmites communis and Miscanthus sinensis should be harvested during June or July to obtain better forage quality which is richer in forage values than rice straw. Production of high quality forage crops was also desirable for self sufficiency of forage.

      • KCI등재

        한국인 직무 스트레스 측정도구의 개발 및 표준화

        장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

        Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

      • 부순모래 콘크리트의 특성에 미치는 잔골재 치수와 혼합조건의 영향에 관한 실험적 연구

        정영한,김재온,송하영,김을용 大田産業大學校 1999 한밭대학교 논문집 Vol.16 No.1

        Recently, the suprly of natural river sand as concrete fine aggregate has been getting worse and it is necessary to recycle the construction wastes produced on the process of stone materials production in our country. Therefore, this study was aimed to find the reuse method of crushed sand as concrete fine aggregate and to estimate the quality of crushed sand concrete. In this study, to inverstigate the influence of fine aggreate size and mixing condition on the properties of crushed sand oncrete and compare with the natural river sand concreter the 2 cases of the aggreate size and the 5 cases of mixing condition are tested. The test results presented that the properties of mixed crushed sand with natural river sand concrete was better than the prorerties of natural river sand concrete.

      • KCI등재후보

        국내 5개 3차 병원의 β-lactam계 항생제 사용 실태 및 Klebsiella pneumoniae의 항생제 내성과의 상관 관계

        정숙인,박경화,권기태,고관수,오원섭,정두련,백경란,염준섭,장현하,김신우,손준성,송재훈 대한감염학회 2007 감염과 화학요법 Vol.39 No.4

        Background : This study was performed to evaluate the prescribing pattern of β-lactam antibiotics and the relationship between antimicrobial resistance and antimicrobial use in 5 tertiary care hospitals in Korea. Materials and Methods : Data on annual patient-days and annual consumption (defined daily dose (DDD) per 100 patient-days) of β-lactam antibiotics from 2003 to 2005 in 5 tertiary hospitals were analyzed. To determine the antimicrobial resistance in K. pneumoniae, broth microdilution test and double disk synergy were performed according to the CLSI performance standards. Spearman's correlation coeffient was used to determine the relationship between antibiotic consumption and resistance. Results : The prescription of β-lactam antibiotics in 5 tertiary hospitals markedly varied. In two hospitals, increase in consumption of β-lactam antibiotics was more than 30% during recent 3 years. The higher consumption of β-lactam antibiotics significantly correlated with the higher rate of antibiotic-resistant K. pneumoniae in 5 tertiary care hospitals. Conclusion : Continuous surveillance of antibiotic use is needed to encourage appropriate prescribing of antibiotics and to reduce antibiotic resistance. 목적 : 항생제의 오남용으로 인한 내성균의 발현 및 급속한 확산이 전세계적으로 문제시 되고 있다. 특히 병원은 항생제 내성의 중심점에 있는 것으로 여겨진다. 본 연구에서는 최근 3년간 국내 5개 3차 병원의 β-lactam계 항생제의 사용량을 조사하고, 각 병원별 항생제 사용량과 K. pneumoniae의 항생제 내성률과의 상관관계를 알아보고자 하였다. 재료 및 방법 : 국내 5개 3차 병원에서 2003년 1월부터 2005년 12월까지 병원 입원 환자를 대상으로 연도별 재원연인원수와 각 β-lactam계 항생제의 총사용량을 수집하여 DDD (defined daily dose) per 100 patient-days로 환산하여 비교하였다. 2005년 6월부터 8월까지 각 병원의 임상검체에서 동정된 K. pneumoniae를 수집하여 액체배지미량희석법으로 항생제 감수성 검사를 시행하였고 ESBL(extended-spectrum β-lactamase) 생성 여부는 double disk synergy test를 시행하였다. 항생제 사용량과 내성의 상관관계는 Spearman 상관관계 분석을 시행하였다. 결과 : 5개 병원 중 3개 병원에서는 연도별 β-lactam계 항생제 사용량이 비슷하게 유지되었으나, 2개 병원에서는 2003년에 비해 2005년에 항생제 사용량이 30% 이상 증가하였다. β-lactam계 항생제 중 제제별 비율은 각 병원마다 차이가 있었으나, 3세대 cephaosporin의 사용이 가장 많았고 2세대 ceaphlosporin, β-lactam/β-lactamase inhibitor, 1세대 cephalosporin 순이었다. 경구용 β-1actam계 항생제의 사용량(r=0.900, P<0.037)과 2세대 cephalosporin의 사용량(r=0.900, P<0.037)은 각각 K. pneumoniae의 ESBL 생성과 양의 상관관계가 있었다. Ceftazidime의 사용량은 K. pneumoniae의 ceftazidime 내성률과 양의 상관관계가 있었다(r=0.900, P<0.037). 반면 imipenem의 사용량은 piperacillin/tazobactam 내성과 음의 상관관계가 있었다(r=-0.900, P<0.037). 결론 : 최근 3개년간 항생제 사용량은 병원별로 차이가 있으나 일부 병원에서는 증가하였다. β-lactam계 항생제의 사용량은 K. pneumoniae의 항생제 내성과 상관관계가 있었다. 항생제 사용을 줄임으로써 항생제 내성을 감소시킬 수 있을 것으로 기대되며, 병원별로 항생제 사용에 대한 지속적인 감시가 필요할 것이다.

      • GMAHN 환경에 적응하는 에러 복구기능을 이용한 AODV 라우팅 프로토콜

        정찬혁,오세덕,배진승,이기원,장양근,이광배,김현욱,유충렬,하재승 明知大學校 産業技術硏究所 2006 産業技術硏究所論文集 Vol.25 No.-

        Mobile nodes in ad hoc mobile networks typically communicate over wireless channels and are capable of movement. These are networks that support multihop communication and can be formed on a temporary basis. This paper proposes a solution that allows mobile nodes to access the wired Internet and to roam from base station to base station. And we also develop the efficient method that adapts in Global MANET which can be changed over time. It is observed that we can reduce not only error detection time but also network load, thus increasing the data reception rate in Global MANET Environment.

      • KCI등재후보

        아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

        정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

        목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

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