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Report of the Korean Association of External Quality Assessment Service on Clinical Bacteriology and Mycology (2016)
J Lab Med Qual Assur 2019;41:179-194
Published online December 31, 2019
© 2019 Korean Association of External Quality Assessment Service.

Jae-Seok Kim1,2 and Hyoung Sun Lee2

1Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon;
2Department of Laboratory Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
Correspondence to: Jae-Seok Kim
Department of Laboratory Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Korea
Tel: +82-2-2224-2327 Fax: +82-2-2224-2214 E-mail: jaeseok@hallym.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

Annual proficiency surveys were conducted thrice in 2016 as a part of the Clinical Microbiology Program of the Korean Association of External Quality Assessment Service. This program covers the fields of clinical bacteriology and mycology. Additionally, another assessment involved three bacterial and two yeast trials. These sets were distributed to different laboratories for the Gram staining, culture, identification, and antimicrobial susceptibility tests of bacteria, as well as for culture and identification of yeasts. In 2016, the trials I, II, and III reported responses from 293, 292, and 285 laboratories, respectively, for bacterial assessment. For yeasts, 107 and 101 laboratories responded in trials I and II, respectively. A novel proficiency testing program was applied in 2016 with the “80%” rules for every laboratory. Identification of bacteria was acceptable for all isolates with the following order of accuracy: Klebsiella pneumoniae, 99.6%; Acinetobacter baumannii, 98.0%; Enterococcus faecalis, 97.6%; E. faecium, 97.5%; Morganella morganii, 97.2%; Streptococcus agalactiae, 94.4%; Staphylococcus saprophyticus, 93.9%; S. aureus, 93.2%; and Salmonella spp. group B, 90.6%. Species-level identification of Gram-positive cocci tended to be lower than that of the Gram-negative bacilli. Although genus level identification has been reported by a few institutions in case of Salmonella, there is a requirement for precise identification of its serotypes. In antimicrobial susceptibility testing, the results were generally similar, with the most accurate results attained for methicillin-resistant S. aureus and carbapenem- resistant A. baumannii. The microbiology laboratories using disk diffusion method for susceptibility testing should improve the lists of reportable antibiotics in their laboratories where cephalosporins have been reported to be efficient against Enterococci. Compared to previous years, the commonly isolated yeasts were successfully identified up to their species levels to a greater extent. Novel external proficiency systems have been applied for clinical microbiology laboratories since 2016, causing fewer cases of misleading external quality control reporting. These novel systems may contribute to the progress of the quality control systems. Laboratories should continuously improve the quality of their analyses with the help of these external quality assurance systems.

Keywords : Quality control, Microbiology, Bacteriology, Mycology, Microbial sensitivity test
꽌 濡

2016뀈 븳엫긽寃궗젙룄愿由ы삊쉶 誘몄깮臾쇰텇빞쓽 꽭洹좉낵 吏꾧퇏 쇅遺젙룄愿由ъ궗뾽쑝濡, 꽭洹좎쓽 떊鍮숇룄議곗궗뒗 3쉶 떆뻾븯 쑝硫 珥 9媛 젙룄愿由щЪ吏덉쓣 궗슜뻽怨, 洹몃엺뿼깋, 꽭洹좊같뼇, 꽭洹좊룞젙, 빆깮젣媛먯닔꽦 寃궗瑜 떎떆븯떎. 吏꾧퇏쓽 떊鍮숇룄議곗궗뒗 2쉶 떆뻾븯쑝硫, 珥 4媛 젙룄愿由щЪ吏덉쓣 궗슜븯怨, 吏꾧퇏諛곗뼇 諛 吏꾧퇏룞젙寃궗瑜 떎떆븯떎.

2016뀈遺꽣뒗 씠쟾쓽 엫긽誘몄깮臾쇰텇怨쇱쓽 떊鍮숇룄議곗궗봽濡쒓렇옩怨쇰뒗 떎瑜 깉濡쒖슫 슫쁺諛⑹떇쓽 李⑥꽭떊鍮숇룄議곗궗궗뾽쓣 떎떆븯怨, 깉濡쒖슫 젙룄愿由 룊媛泥닿퀎媛 쟻슜릺뿀떎[1-3].

2016뀈 씠쟾뿉뒗 洹몃엺뿼깋, 꽭洹좊같뼇룞젙, 媛먯닔꽦 寃궗瑜 湲곕낯 紐⑤뱢濡 떎떆븯怨, 옄諛쒖쟻 李몄뿬떊泥湲곌쓣 긽쑝濡 떖솕꽭洹좊같뼇怨 룞젙寃궗 벑쓽 뿬윭 꽑깮 紐⑤뱢濡 씠猷⑥뼱吏 떊鍮 룄議곗궗봽濡쒓렇옩쓣 젣怨듯븯뿬 룞젙씠굹 諛곗뼇씠 돺吏 븡 꽭洹좎씠굹 삉湲곗꽦 꽭洹, 誘명샇湲곗꽦 꽭洹, 꽭怨고뙜씠瑜 벑쓣 쇅遺젙룄 愿由щ줈 룷븿븯뿬 떎떆븯떎[1-3].

삉븳 媛 寃궗떎쓽 옄泥댁쟻 뙋떒쓣 媛먯븞븯뿬 洹몃엺뿼깋 젏닔瑜 諛곗젏븯뿬 룊媛븯怨, 洹좎쥌 룞젙 醫(species)닔以源뚯 留욌뒗 寃쎌슦瑜 슦닔(good), 엫긽쟻쑝濡 냽닔以쓽 룞젙씠 쓽誘멸 엳떎硫 냽닔以源뚯 留욌뒗 寃쎌슦瑜 쟻젅(acceptable), 湲곗뿉 留욎 븡쑝硫 遺쟻젅(unacceptable)濡 뙋젙븯怨 媛곴컖 젏닔솕븯뿬 寃곌낵瑜 젣怨듯븯떎. 깉濡쒖슫 泥닿퀎媛 쟻슜맂 2016뀈遺꽣뒗 寃궗븞 궡臾몄뿉 뵲瑜 룊媛湲곗쓣 젣떆븯怨, 洹좎쥌 룞젙쓽 寃쎌슦룄 醫낆닔以쓽 寃곌낵媛믪씠 留욎쑝硫 쟻젅(acceptable), 留욎 븡쑝硫 遺쟻젅 (unacceptable)濡 蹂寃쏀븯寃 릺뿀떎.

빆깮젣媛먯닔꽦 寃궗쓽 寃쎌슦, 2016뀈 씠쟾뿉뒗 媛긽솚옄쓽 엫긽쟻 諛곌꼍쓣 젣떆븯뿬 떎뼇븳 엫긽긽솴뿉꽌 엫긽쟻쑝濡 쓽誘몄엳뒗 닔以쓽 룞젙怨 빆깮젣媛먯닔꽦떆뿕쓣 떎떆븯룄濡 슂援ы븯쑝굹, 2016뀈遺꽣뒗 Clinical and Laboratory Standards Institute (CLSI) M100-S24쓽 湲곗뿉 뵲씪 categorical data 瑜 뙋젙湲곗쑝濡 븯뿬 susceptible (S), intermediate (I), resistance (R)濡 蹂닿퀬븳 寃곌낵瑜 룊媛븯寃 릺뿀떎[4].

삉븳 2016뀈 씠쟾뿉뒗 젅媛믪쓣 젙븷 닔 엳뒗 寃쎌슦瑜 젣쇅븯怨, 85%쓽 湲곌씠 씪移섑븯뒗 寃곌낵瑜 젙떟쓽 湲곗쑝濡 븯쑝굹, 2016뀈遺꽣뒗 쟾泥 李몄뿬湲곌쓽 80%媛 씪移섎맂 寃곌낵瑜 蹂댁씤 寃쎌슦瑜 “acceptable” 뙋젙湲곗쑝濡 븯怨, 씪移섑븯吏 븡 寃쎌슦뒗 “not available”濡 븯뿬 쇅遺젙룄愿由ъ쓽 뙋젙쓣 쑀蹂댄븯怨, 湲곌 궡遺쟻쑝濡 빐寃고븯뒗 寃껋쓣 쑀룄븯떎. 삉븳 2016뀈 씠쟾뿉뒗 쟾泥 湲곌쓣 紐 媛쒖쓽 援곗쑝濡 굹늻뼱 꽌濡 떎瑜 set쓽 洹좎<瑜 諛쒖넚븿쑝濡쒖뜥 媛 湲곌留덈떎 떎瑜 洹좎쓣 寃궗븯뿬 쇅遺젙룄愿由ш궗쓽 吏덉쓣 넂씠젮뒗 끂젰쓣 븯쑝굹, 2016뀈 씠썑濡쒕뒗 媛앷꽦쓣 遺뿬븯湲 쐞븯뿬 紐⑤뱺 湲곌뿉 룞씪븳 寃泥대 諛쒖넚븯떎.

씠踰 蹂닿퀬꽌뿉뒗 2016뀈뿉 떎떆븳 엫긽誘몄깮臾쇰텇빞쓽 꽭洹, 吏꾧퇏寃궗뿉 븳 떊鍮숇룄議곗궗궗뾽 寃곌낵瑜 遺꾩꽍 蹂닿퀬븯怨좎옄 븳떎.

옱猷 諛 諛⑸쾿

1. 떊鍮숇룄議곗궗 諛⑸쾿

2016뀈 떊鍮숇룄議곗궗궗뾽 媛곴컖 뿰 3쉶 寃泥대 諛쒖넚뻽쑝硫, 寃泥대뒗 깮洹좎쓣 硫대큺쓣 쟻떊 긽깭濡 Amies 슫넚諛곗濡 諛쒖넚븯떎. 媛 李⑥닔留덈떎 꽭洹 寃泥 3媛쒖뵫쓣 諛쒖넚븯쑝硫, 吏꾧퇏쓽 寃쎌슦 꽭洹 1, 2李 諛쒖넚 떆 媛숈씠 諛쒖넚븯怨, 媛 李⑥닔留덈떎 2媛쒖뵫 諛쒖넚븯떎. 떊鍮숇룄議곗궗궗뾽쓽 떊泥怨 寃곌낵엯젰, 寃곌낵뙋젙 벑 븳엫긽寃궗젙룄愿由ы삊쉶 솃럹씠吏뿉 援ъ텞맂 떊鍮숇룄議곗궗 봽濡쒓렇옩(http://keqas.org/)쓣 씠슜븯떎.

2. 젙룄愿由щЪ吏

꽭洹좉궗뒗 洹몃엺뿼깋, 꽭洹좊같뼇, 꽭洹좊룞젙, 빆깮젣媛먯닔꽦 寃 궗瑜 떎떆븯쑝硫, 1李⑤줈 MB-16-01, MB-16-02, MB-16-03, 2李⑤줈 MB-16-04, MB-16-05, MB-16-06, 3李⑤줈 MB-16- 07, MB-16-08, MB-16-09 寃泥대 諛쒖넚븯떎. 媛 寃궗瑜 떆뻾븯뒗 寃쎌슦뒗 紐⑤뱺 寃泥댁뿉 빐 洹몃엺뿼깋, 꽭洹좊같뼇, 꽭洹좊룞젙, 빆깮젣媛먯닔꽦 寃궗 떎떆瑜 슂援ы븯떎.

吏꾧퇏寃궗뒗 洹몃엺뿼깋, 吏꾧퇏諛곗뼇, 吏꾧퇏룞젙쓣 떎떆븯쑝硫, 1李⑤줈 MF-16-01, MF-16-02, 2李⑤줈 MF-16-03, MF-16-04 寃泥대 諛쒖넚븯떎. 媛 寃궗瑜 떆뻾븯뒗 寃쎌슦뒗 紐⑤뱺 寃泥댁뿉 빐 洹몃엺뿼깋, 吏꾧퇏諛곗뼇, 吏꾧퇏룞젙 떎떆瑜 슂援ы븯떎.

紐⑤뱺 꽭洹좉낵 吏꾧퇏 媛뺣룞꽦떖蹂묒썝 吏꾨떒寃궗쓽븰怨쇱뿉꽌 諛곗뼇븳 엫긽遺꾨━洹좎<떎. 꽭洹좎 삁븸 븳泥쒕같吏뿉꽌 諛곗뼇븯怨, 吏꾧퇏 Sabouraud dextrose agar 븳泥쒕같吏 샊 삁븸 븳泥쒕같吏뿉꽌 諛곗뼇븯뿬 吏묐씫쓣 솗씤븳 썑뿉 젙룄愿由щЪ吏덉쓣 젣議고븯떎. 젙룄愿由щЪ吏덉 슫넚쓣 쐞빐 Amies 諛곗뿉 硫대큺긽깭濡 슫넚븯떎. Amies 諛곗뿉꽌 젙룄愿由щЪ吏덉씠 諛곗뼇릺吏 븡 寃쎌슦, 湲곌쓽 슂泥뿉 뵲씪 옱諛쒖넚븯떎. 諛쒖넚슜 젙룄愿由щЪ吏덉쓽 룷옣 븳엫긽寃궗젙룄愿由ы삊쉶뿉꽌 씪愿꾩쟻쑝濡 떆뻾븯떎.

3. 寃곌낵 뙋젙 諛 빐꽍

洹몃엺뿼깋 꽭洹좎쓽 쟾삎쟻씤 뙋룆寃곌낵 씪移섑븯뒗吏瑜 룊媛븯떎. 꽭洹좎쓽 룞젙寃궗뒗 湲곕낯쟻쑝濡 醫낆닔以쓣 룞젙븯뒗 寃껋쑝濡 뙋젙븯쑝硫, 쇅遺떊鍮숇룄議곗궗뿉 李몄뿬븳 湲곌쓽 옄猷뚮 醫낇빀븯뿬 80% 뙋젙湲곗쓣 쟻슜븯뿬 理쒖쥌 뙋젙븯떎. 씪遺 genus留 蹂닿퀬븳 湲곌쓽 寃쎌슦뿉룄 80% 뙋젙湲곗쓣 쟻슜븯뿬 뙋젙븯쑝硫, subspecies瑜 옒紐 蹂닿퀬븳 씪遺 湲곌쓽 寃쎌슦 biochemical test쓽 삤瑜섎줈 뙋떒븯뿬 由 寃껋쑝濡 뙋젙븯떎. 理쒖쥌 뙋젙 寃곌낵瑜 넻빀븳 썑 80% 뙋젙湲곗뿉 뵲씪 acceptable怨 unacceptable濡 뙋젙븯떎. 빆깮젣媛먯닔꽦 寃궗뒗 洹좎쥌蹂꾨줈 2016뀈 CLSI M100쓽 湲곗뿉 뵲씪 뙋젙븯쑝硫[4], 삁븸 遺꾨━洹좎<뿉 以븯뿬 寃궗븯룄濡 븞궡븯떎. 吏꾧퇏룞젙쓽 寃쎌슦뿉룄 80% 뙋젙湲곗뿉 뵲씪 acceptable怨 unacceptable濡 遺꾨쪟븯떎.

寃 怨

2016뀈 엫긽誘몄깮臾쇳븰 꽭洹좊텇빞 떊鍮숇룄議곗궗뿉뒗 1李⑥뿉꽌 293湲곌, 2李⑥뿉꽌 292湲곌, 3李⑥뿉꽌 285湲곌씠 쉶떊븯떎. 吏꾧퇏遺꾩빞쓽 떊鍮숇룄議곗궗뿉뒗 1李⑥뿉꽌 107湲곌, 2李⑥뿉꽌 101湲곌씠 쉶떊븯떎.

1. 洹몃엺뿼깋

1, 2, 3李 紐⑤몢뿉꽌 洹몃엺뿼깋 꽭洹좉낵 吏꾧퇏 紐⑤몢 95% 씠긽쓽 湲곌뱾씠 젙떟쓣 蹂닿퀬븯떎. 洹몃엺뿼깋쓽 寃쎌슦 MB-16-06 Streptococcus agalactiae瑜 G(-) cocci, G(-) coccobacilli 씪怨 蹂닿퀬븳 湲곌씠 5湲곌, 4湲곌씠 엳뿀쑝硫, MB-16-08 Enterococcus faecium쓣 G(-) cocci, G(-) diplococci濡 蹂닿퀬븳 湲곌씠 2湲곌, 6湲곌씠 엳뼱 洹몃엺뿼깋뿉꽌 씪遺 湲곌 遺젙솗븳 寃곌낵瑜 蹂닿퀬븯떎(Table 1).

Table 1 . Clinical bacteriology: performance of laboratories in Gram stain.

Survey no.OrganismsGram (+) bacilli (%)Gram (+) cocci (%)Gram (–) bacilli (%)Gram (–) cocci (%)Gram (–) coccobacilli (%)Others
MB-16-01Staphylococcus aureus292 (99.7)1 (0.3)
MB-16-02Acinetobacter baumannii3 (1.0)136 (46.4)24 (8.2)122 (41.6)G(–) Diplococci: 8 (2.7)
MB-16-03Enterococcus faecalis277 (94.5)2 (0.7)G(+) Coccobacilli: 2; G(–) Diplococci: 1
MB-16-04Morganella morganii1 (0.3)277 (95.2)12 (4.1)G(+) Yeast: 1 (0.3)
MB-16-05Klebsiella pneumoniae1 (0.3)272 (93.2)5 (1.7)9 (3.1)G(–) Diplococci: 5; others: 5
MB-16-06Streptococcus agalactiae281 (96.2)5 (1.7)4 (1.4)Others: 2
MB-16-07Salmonella spp. serogroup B277 (97.2)1 (0.4)7 (2.5)
MB-16-08Enterococcus faecium1 (0.4)275 (96.5)2 (1.1)G(–) Diplococci: 6
MB-16-09Staphylococcus saprophyticus282 (98.9)2 (0.7)G(–) Diplococci: 1

2. 꽭洹좊룞젙寃궗

1李⑥뿉꽌뒗 Staphylococcus aureus, Acinetobacter baumannii, Enterococcus faecalis 벑쓽 쇅遺젙룄愿由 洹좎<뿉 빐꽌 93.2%, 98.0%, 97.6%濡 넂 젙솗룄瑜 蹂댁떎. MB-16-01 洹좎< MB-16-03 洹좎<瑜 샎룞빐꽌 蹂닿퀬븳 湲곌쑝濡 쓽떖릺뒗 湲곌씠 2-3媛 엳뿀떎.

2李⑥뿉꽌뒗 Morganella morganii, Klebsiella pneumoniae, S. agalactiae 벑쓽 쇅遺젙룄愿由 洹좎<뿉 빐꽌 97.2%, 99.6%, 94.4%濡 鍮꾧탳쟻 넂 젙솗룄瑜 蹂댁떎. 씪遺 湲곌뿉꽌뒗 species 떊 genus level濡 蹂닿퀬븯쑝硫, 듅엳 MB-16-06 S. agalactiae쓽 寃쎌슦 洹좎쥌씠 떎瑜 寃쎌슦룄 엳뿀怨, Streptococcus, beta-hemolytic group B濡 蹂닿퀬븳 湲곌씠 씪遺 엳뿀떎.

3李⑥뿉꽌뒗 Salmonella spp. serogroup B, E. faecium, Staphylococcus saprophyticus뿉 빐 90.6%, 97.5%, 93.9%쓽 寃곌낵瑜 蹂댁떎. Salmonella spp.뿉 빐꽌뒗 serogroup쓣 蹂닿퀬븯吏 븡븯嫄곕굹, spp.濡쒕쭔 蹂닿퀬븳 湲곌뱾룄 떎닔 엳뿀떎. S. saprophyticus쓽 寃쎌슦 Staphylococcus, coagulase negative 굹 S. aureus濡 蹂닿퀬븳 湲곌룄 씪遺 엳뿀떎(Table 2).

Table 2 . Clinical bacteriology: performance of laboratories in bacterial identification.

Survey no.No. of major reported organisms (%)Lists of other reported organisms (%)
MB-16-01Staphylococcus aureus : 234 (93.2)MRSA isolated: 15 (6.0); E. faecalis : 2
MB-16-02Acinetobacter baumannii : 246 (98.0)Acinetobacter spp.: 2; Chryseomonas luteola : 1; CRE isolated: 1; Moraxella spp.: 1
MB-16-03Enterococcus faecalis : 245 (97.6)Enterococcus spp.: 2; S. aureus : 2; Staphylococcus haemolyticus: 1; VRE isolated: 1
MB-16-04Morganella morganii : 242 (97.2)Morganella spp.: 2; M. morganii ss. Sibonii: 1; Escherichia coli : 1; Pasteurella spp.: 1; NA: 1
MB-16-05Klebsiella pneumoniae : 248 (99.6)NA: 1
MB-16-06Streptococcus agalactiae : 235 (94.4)Streptococcus, beta-hemolytic group B: 8 (3.2); Enterococcus durans: 1; Enterococcus spp.: 1; Moraxella catarrhalis: 1; S. aureus : 1; Streptococcus spp.: 1; NA: 1
MB-16-07Salmonella spp. serogroup B: 221 (90.6)Salmonella spp.: 13 (5.3); Salmonella spp. not serogroup A, B, C1, C2, D, or E: 4; Salmonella spp.: 2; Salmonella spp. serogroup A: 1; Shigella spp.: 1; Salmonella spp. not S. typhi : 1
MB-16-08Enterococcus faecium : 238 (97.5)Aerococcus viridans : 2; Enterococcus spp.: 1; S. saprophyticus : 1; Enterococcus gallinarum: 1; Staphylococcus spp.: 1
MB-16-09Staphylococcus saprophyticus : 229 (93.9)Staphylococcus, coagulase negative: 5; Staphylococcus saccharolyticus: 5; S. aureus : 4; E. faecium : 1

Abbreviations: MRSA, Methicillin-resistant Staphylococcus aureus ; CRE, carbapenem-resistant Enterobacteriaceae ; VRE, vancomycin-resistant Enterococci ; NA, not available..


3. 꽭洹좎쓽 빆깮젣媛먯닔꽦 寃궗

2016뀈遺꽣뒗 빆깮젣媛먯닔꽦 寃궗 룊媛瑜 湲곕낯쟻쑝濡 CLSI 湲곗뿉 뵲瑜대룄濡 븯떎. Group A빆깮젣쓽 寃쎌슦 紐⑤뱺 湲곌뿉꽌 蹂닿퀬븯룄濡 븯怨, 怨듯넻쟻쑝濡 蹂닿퀬 媛뒫븳 빆깮젣瑜 臾띠뼱꽌 룊媛븯떎(삁: S. aureus쓽 寃쎌슦 Azithromycin怨 Erythromycin쓽 minimum inhibitory concentration (MIC) 寃궗踰뺤쓽 寃쎌슦 븯굹留 蹂닿퀬븯硫 릺怨, 媛숈 臾띠쓬쑝濡 뙋젙븿). Group B 벑쓽 蹂닿퀬 媛뒫븳 빆깮젣 寃쎌슦뒗 媛 湲곌씠 엯젰븳 빆깮젣瑜 룊媛븯떎. CLSI뿉 뙋젙湲곗씠 뾾뒗 빆깮젣瑜 엯젰븳 寃쎌슦뒗 unacceptable濡 븯떎.

1) 1李 쇅遺젙룄愿由

MB-16-1, S. aureus 洹좎<뒗 methicillin-resistant S. aureus (MRSA)瑜 諛쒖넚븯쑝硫 鍮꾧탳쟻 젙솗븳 媛믪쓣 蹂닿퀬븯떎. Gentamicin쓣 MIC踰뺤쑝濡 떆뻾븳 69媛 湲곌 以 R濡 蹂닿퀬븳 湲곌씠 41媛, I濡 蹂닿퀬븳 湲곌씠 26媛쒖떎. Disk 踰뺤쓣 떆뻾븯뒗 씪遺 湲곌 CLSI 룊媛湲곗씠 뾾뒗 떎뼇븳 cephalosporin쓣 蹂닿퀬븯떎(Table 3).

Table 3 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-01 Staphylococcus aureus.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Azithromycin21Clarithromycin1
 Erythromycin1212Erythromycin124
 Clindamycin215Clindamycin124
 Oxacillin206Oxacillin218
 Cefoxitin2Cefoxitin8
 Oxacillin (Cefoxitin)11Oxacillin (Cefoxitin)41
 Penicillin G21961Penicillin G223
 Trimethoprim/Sulfamethoxazole20711Trimethoprim/Sulfamethoxazole22
Other CLSI groups
 Chloramphenicol1Amikacin1
 Ciprofloxacin120Chloramphenicol3
 Daptomycin321Ciprofloxacin20
 Doxycycline1Doxycycline1
 Gentamicin22641Gentamicin1114
 Levofloxacin2Imipenem4
 Linezolid2031Kanamycin1
 Nitrofurantoin2Levofloxacin51
 Quinupristin/Dalfopristin4Linezolid6
 Rifampicin54Minocycline1
 Rifampin992Moxifloxacin1
 Teicoplanin30Netilmicin1
 Telithromycin6
 Tetracycline205
 Tigecycline3
 Vancomycin2246
Unacceptable
 Ampicillin21Ampicillin4
 Ampicillin/Sulbactam1Cefamandole11
 Cefazolin1Cefazolin1
 Imipenem1Cefmetazole11
 Norfloxacin1Cefoperazone11
Cefotaxime11
Ceftriaxone6
Cefuroxime axetil1
Cefuroxime sodium1
Meropenem1
Piperacillin/Tazobactam1

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


MB-16-2, A. baumanni 洹좎<뒗 carbapenem 궡꽦 洹좎<瑜 諛쒖넚븯쑝硫, carbapenem 궡꽦 寃궗뿉꽌뒗 MIC, disk踰 紐⑤몢 젙솗븳 媛믪쓣 蹂닿퀬븯떎. MIC踰뺤쓣 떎떆븯뒗 湲곌뿉꽌뒗 湲곗뿉 뾾뒗 aztreonam쓣 蹂닿퀬븯뒗 湲곌씠 14媛 엳뿀쑝硫, disk踰뺤쓣 떎떆븯뒗 湲곌뿉꽌룄 aztreonam씠굹, 湲곗뿉 뾾뒗 떎뼇븳 cephalosporin 빆깮젣瑜 蹂닿퀬븯떎(Table 4).

Table 4 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-02 Acinetobacter baumannii.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Ampicillin/Sulbactam16172Ampicillin/Sulbactam348
 Ceftazidime211Ceftazidime21
 Ciprofloxacin208Ciprofloxacin24
 Levofloxacin50Levofloxacin8
 Gentamicin214Gentamicin23
 Tobramycin38Tobramycin15
 Imipenem204Imipenem24
 Meropenem174Meropenem14
Other CLSI groups
 Amikacin110Amikacin22
 Cefepime166Cefepime8
 Cefotaxime117Cefotaxime14
 Ceftriaxone1Ceftriaxone8
 Colistin30Colistin1
 Minocycline9451Minocycline4
 Piperacillin36Piperacillin4
 Piperacillin/Tazobactam128Piperacillin/Tazobactam6
 Ticarcillin/Clavulanic acid12Ticarcillin/Clavulanic acid11
 Tigecycline6Tigecycline5
 Trimethoprim/Sulfamethoxa2129Trimethoprim/Sulfamethoxa15
Unacceptable
 Amoxicillin/Clavulanic acid1Amoxicillin/Clavulanic acid2
 Ampicillin1Ampicillin5
 Aztreonam14Aztreonam26
 Clinafloxacin3Carbenicillin1
 Tetracycline2Cefamandole1
Cefazolin2
Cefoperazone3
Cefoperazone/Sulbactam1
Cefotetan1
Ceftizoxime1
Cephalothin3
Ofloxacin1
Penicillin G2
Rifampin1
Tigecycline1

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


MB-16-3, E. faecalis 洹좎<뒗 遺遺 씪移섑븯뒗 寃곌낵瑜 蹂댁 쑝굹, linezolid쓽 寃쎌슦 MIC踰뺤쓣 떎떆븯뒗 212湲곌 以 S濡 蹂 怨좏븳 湲곌씠 197媛, I濡 蹂닿퀬븳 湲곌씠 14媛, R濡 蹂닿퀬븳 湲곌 씠 1湲곌 엳뿀쑝硫, disk踰뺤뿉꽌 vancomycin 궡꽦쑝濡 옒紐 蹂 怨좏븳 3媛 湲곌씠 엳뿀떎(Table 5).

Table 5 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-03 Enterococcus faecalis.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Ampicillin213Ampicillin2111
 Penicillin G2032Penicillin G212
Other CLSI groups
 Chloramphenicol1Chloramphenicol2
 Daptomycin48Erythromycin3112
 Erythromycin612Gentamicin-high4
 Gentamicin-high1411Linezolid311
 Linezolid197141Minocycline1
 Quinupristin/Dalfopristin36Quinupristin/Dalfopristin1
 Rifampicin3Rifampin2
 Rifampin14Streptomycin-high3
 Streptomycin-high1372Teicoplanin811
 Teicoplanin631Vancomycin2033
 Vancomycin2221
Unacceptable
 Ampicillin/Sulbactam9Amoxicillin/Clavulanic acid2
 Ciprofloxacin281Ampicillin/Sulbactam2
 Clindamycin6Bacitracin1
 Gentamicin11Cefazolin2
 Imipenem7Cefepime1
 Levofloxacin23Cefoperazone1
 Nitrofurantoin11Cefotaxime1
 Norfloxacin9Cefoxitin1
 Oxacillin2Ceftazidime11
 Streptomycin1Ceftriaxone411
 Tetracycline3617Ciprofloxacin463
 Tigecycline5Clindamycin9
 Trimethoprim/Sulfamethoxa23Gentamicin512
Imipenem21
Levofloxacin311
Meropenem1
Netilmicin1
Oxacillin4
Oxacillin (Cefoxitin)2
Tetracycline18
Tigecycline1
Trimethoprim/Sulfamethoxa11

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


2) 2李 쇅遺젙룄愿由

MB-16-04, M. morganii쓽 寃쎌슦 imipenem뿉꽌 S, I, R 寃곌낵瑜 떎뼇븯寃 蹂닿퀬븯뒗뜲, 씠 寃곌낵뒗 imipenem뿉 븳 M. morganii 洹좎<쓽 듅꽦쑝濡 蹂댁씤떎. 옣꽭洹 以 Proteus spp., Providencia spp., Morganella spp.쓽 寃쎌슦 imipenem MIC媛 넂 洹좎<뱾씠 엳쑝硫, 옄뿰궡꽦쑝濡 깮媛곹븯湲곕룄 븯誘濡 씠윴 쁽긽씠 愿李곕맂 寃껋쑝濡 뙋떒븳떎(Table 6). MB-16-05, K. pneumoniae 洹좎<뒗 鍮꾧탳쟻 씪移섑븯뒗 寃곌낵瑜 蹂댁떎(Table 7). MB-16-06, S. agalactiae 洹좎<룄 鍮꾧탳쟻 씪移섑븯뒗 寃곌낵瑜 蹂댁떎(Table 8).

Table 6 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-04 Morganella morganii.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Cefazolin159Cefazolin8
 Gentamicin212Gentamicin22
Other CLSI groups
 Amikacin181Amikacin
 Amoxicillin/Clavulanic acid107Amoxicillin/Clavulanic acid17
 Ampicillin/Sulbactam321Ampicillin/Sulbactam312
 Aztreonam221Aztreonam62
 Cefepime1741Aztreonam62
 Cefotaxime17821Cefamandole2
 Cefotetan2Cefepime5
 Cefoxitin76122Cefotaxime171
 Ceftazidime281Cefotaxime171
 Ceftriaxone1Cefotetan3
 Cefuroxime sodium1Cefoxitin32
 Ciprofloxacin177Ceftazidime122
 Ertapenem120Ceftriaxone10
 Imipenem581421Cefuroxime sodium2
 Levofloxacin30Chloramphenicol3
 Meropenem49Ciprofloxacin231
 Minocycline1Ertapenem1
 Piperacillin6Imipenem154
 Piperacillin/Tazobactam113Levofloxacin4
 Tetracycline2Meropenem101
 Ticarcillin/Clavulanic acid5Minocycline1
 Trimethoprim/Sulfamethoxa145Netilmicin2
Ofloxacin1
Piperacillin22
Piperacillin/Tazobactam51
Tetracycline1
Trimethoprim/Sulfamethoxa15
Unacceptable
 Colistin1Carbenicillin1
 Erythromycin1Cefmetazole2
 Gentamicin-high1Cefoperazone/Sulbactam
 Tigecycline2Cephalothin13
Moxifloxacin1
Rifampin1
Tigecycline
IND
 Ampicillin193Ampicillin117
 Tobramycin35Tobramycin11

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


Table 7 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-05 Klebsiella pneumoniae.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Ampicillin1201Ampicillin215
 Cefazolin1661Cefazolin53
 Gentamicin217Gentamicin22
Other CLSI groups
 Amikacin175Amikacin27
 Amoxicillin/Clavulanic acid1101Amoxicillin/Clavulanic acid9
 Ampicillin/Sulbactam23Ampicillin/Sulbactam61
 Aztreonam15Aztreonam7
 Cefepime1641Cefamandole2
 Cefotaxime182Cefepime5
 Cefotetan1Cefotaxime181
 Cefoxitin125Cefotetan3
 Ceftazidime19Cefoxitin4
 Ceftriaxone1Ceftazidime15
 Cefuroxime axetil2Ceftriaxone10
 Cefuroxime sodium2Cefuroxime sodium1
 Ciprofloxacin171Chloramphenicol3
 Ertapenem101Ciprofloxacin221
 Imipenem158Ertapenem1
 Levofloxacin23Imipenem211
 Meropenem33Levofloxacin3
 Piperacillin1Meropenem101
 Piperacillin/Tazobactam941Minocycline1
 Tetracycline2Netilmicin2
 Ticarcillin/Clavulanic acid4Ofloxacin1
 Trimethoprim/Sulfamethoxa125Piperacillin12
Piperacillin/Tazobactam6
Tetracycline2
Trimethoprim/Sulfamethoxa14
Unacceptable
 Cefprozil1Cefmetazole2
 Clinafloxacin3Cefoperazone/Sulbactam2
 Gentamicin-high1Cephalothin4
 Tigecycline3Clinafloxacin1
Moxifloxacin1
Rifampin1
Tigecycline1
IND
 Tobramycin31Tobramycin12

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


Table 8 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-6 Streptococcus agalactiae.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Ampicillin18111Ampicillin141
 Penicillin G1961Penicillin G143
 Clindamycin2062Clindamycin233
 Erythromycin1892Erythromycin222
Other CLSI groups
 Azithromycin1Cefepime2
 Cefepime24Cefotaxime14
 Cefotaxime164Ceftriaxone71
 Ceftriaxone133Chloramphenicol7
 Chloramphenicol14Levofloxacin52
 Daptomycin16Linezolid5
 Levofloxacin164Ofloxacin2
 Linezolid152Tetracycline5
 Meropenem3Vancomycin215
 Quinupristin/Dalfopristin11
 Tetracycline448
 Vancomycin214
Unacceptable
 Ceftizoxime1Bacitracin1
 Ciprofloxacin2Cefoperazone/Sulbactam1
 Imipenem2Cefoxitin1
 Norfloxacin1Ceftazidime1
 Piperacillin1Ciprofloxacin31
 Piperacillin/Tazobactam1Gentamicin11
 Teicoplanin1Minocycline1
 Trimethoprim/Sulfamethoxa10Netilmicin1
Oxacillin211
Oxacillin (Cefoxitin)1
Rifampicin1
Teicoplanin3
Trimethoprim/Sulfamethoxa11
IND
 Ofloxacin1Amoxicillin/Clavulanic acid1
Ampicillin/Sulbactam1
Cefazolin2
Cephalothin2
Imipenem2

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


3) 3李 쇅遺젙룄愿由

MB-16-07, Salmonella spp. serogroup B쓽 寃쎌슦 鍮꾧탳쟻 젙솗븳 寃곌낵瑜 蹂댁쑝굹, amikacin, cefazolin, gentamicin 벑 湲곗씠 뾾뒗 빆깮젣瑜 蹂닿퀬븯뒗 湲곌뱾씠 씪遺 엳뿀떎(Table 9). MB-16-08, E. faecium 洹좎<뒗 vancomycin 媛먯닔꽦 洹좎< 쑝硫, disk踰뺤쓣 떎떆븯뒗 23湲곌 以 2湲곌 궡꽦쑝濡 옒 紐 蹂닿퀬븯떎. 삉븳 disk踰뺤쓣 떎떆븯뒗 湲곌뿉꽌뒗 옣援ш퇏씠 cephalosporin뿉 옄뿰궡꽦엫뿉룄 蹂닿퀬븳 湲곌뱾씠 씪遺 엳뿀 떎(Table 10). MB-16-09, S. saprophyticus 洹좎<뒗 penicillin disk踰뺤뿉꽌 21湲곌 以 9媛 湲곌씠 媛먯닔꽦쑝濡 옒紐 蹂닿퀬븯 떎(Table 11).

Table 9 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-07 Salmonella species serogroup B.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Ampicillin200Ampicillin23
 Cefotaxime2041Cefotaxime17
 Ceftazidime175Ceftazidime12
 Ceftriaxone1Ceftriaxone10
 Ciprofloxacin16512Ciprofloxacin35
 Levofloxacin371Levofloxacin4
 Trimethoprim/Sulfamethoxa204Trimethoprim/Sulfamethoxa24
Other CLSI groups
 Amoxicillin/Clavulanic acid12Amoxicillin/Clavulanic acid4
 Aztreonam7Aztreonam4
 Cefepime37Cefepime5
 Chloramphenicol3Chloramphenicol5
 Clinafloxacin1Imipenem10
 Ertapenem15Meropenem6
 Imipenem23Ofloxacin1
 Meropenem11Piperacillin22
 Minocycline12Piperacillin/Tazobactam6
 Piperacillin6
 Piperacillin/Tazobactam21
 Ticarcillin/Clavulanic acid111
Unacceptable
 Amikacin8Amikacin10
 Cefazolin9Carbenicillin1
 Cefoxitin4Cefazolin4
 Gentamicin13Cefmetazole1
 Tigecycline5Cefoxitin2
 Tobramycin1Cefuroxime axetil1
Cefuroxime sodium1
Gentamicin27
Netilmicin1
Rifampin1
Tigecycline1
Tobramycin3
IND
 Ampicillin/Sulbactam27Ampicillin/Sulbactam311
 Colistin2Cefoperazone/Sulbactam1
 Nalidixic acid1Moxifloxacin1
Nalidixic acid2

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


Table 10 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-08 Enterococcus faecium.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Ampicillin212Ampicillin21
 Penicillin G205Penicillin G19
Other CLSI groups
 Chloramphenicol1Chloramphenicol22
 Daptomycin49Erythromycin114
 Erythromycin161Gentamicin-high4
 Gentamicin-high148Linezolid41
 Linezolid2111Rifampin1
 Quinupristin/Dalfopristin32Streptomycin-high3
 Rifampicin11Teicoplanin9
 Rifampin1311Vancomycin212
 Streptomycin-high1441
 Teicoplanin57
 Vancomycin215
Unacceptable
 Ciprofloxacin23Cefazolin2
 Clindamycin12Cefoperazone/Sulbactam1
 Gentamicin11Cefotaxime1
 Levofloxacin15Cefoxitin1
 Nitrofurantoin7Ceftazidime3
 Norfloxacin5Ceftriaxone3
 Oxacillin1Cephalothin2
 Streptomycin1Ciprofloxacin11
 Tetracycline24Clindamycin7
 Trimethoprim/Sulfamethoxa11Gentamicin21
Levofloxacin2
Netilmicin1
Oxacillin5
Tetracycline81
Trimethoprim/Sulfamethoxa2
IND
 Ampicillin/Sulbactam6Amoxicillin/Clavulanic acid1
 Imipenem6Ampicillin/Sulbactam3
 Telithromycin1Imipenem2
 Tigecycline5Meropenem2
Piperacillin/Tazobactam1

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


Table 11 . Performance of laboratories in antimicrobial susceptibility testing of MB-16-09 Staphylococcus saprophyticus.

AntibioticsMICAntibioticsDisk


SIRINDSIRIND
CLSI group A
 Azithromycin26Cefoxitin6
 Erythromycin18121Clarithromycin1
 Clindamycin210Erythromycin191
 Penicillin G3190Clindamycin22
 Trimethoprim/Sulfamethoxa203Penicillin G912
Trimethoprim/Sulfamethoxa18
Other CLSI groups
 Ciprofloxacin1091Amikacin1
 Daptomycin36Chloramphenicol5
 Gentamicin74Ciprofloxacin14
 Levofloxacin4Doxycycline1
 Linezolid194Gentamicin15
 Quinupristin/Dalfopristin4Levofloxacin3
 Rifampicin45Linezolid5
 Rifampin97Moxifloxacin1
 Teicoplanin27Netilmicin1
 Telithromycin5Ofloxacin1
 Tetracycline202Rifampin3
 Tigecycline1Teicoplanin5
 Vancomycin219Tetracycline11
Vancomycin13
Unacceptable
 Cefazolin1Cefazolin3
 Gentamicin-high1Cefepime1
 Nitrofurantoin2Cefmetazole1
 Streptomycin-high1Cefoperazone/Sulbactam1
Cefotaxime3
Ceftazidime11
Ceftriaxone11
Cefuroxime axetil1
Cefuroxime sodium1
Cephalothin1
IND1
 Amoxicillin/Clavulanic acid1Ampicillin3
 Ampicillin7Imipenem2
 Aztreonam1Meropenem2
 Cefoxitin5Oxacillin136
 Imipenem1Oxacillin (Cefoxitin)2
 Oxacillin16734Piperacillin/Tazobactam2
 Oxacillin (Cefoxitin)93

Abbreviations: MIC, minimum inhibitory concentration; S, susceptible; I, intermediate; R, resistance; IND, indeterminate; CLSI, Clinical and Laboratory Standards Institute..


4. 吏꾧퇏룞젙寃궗

吏꾧퇏룞젙寃궗뿉 李멸븳 湲곌 1李 107媛 湲곌, 2李 101 媛쒖씠뿀쑝硫, 젙룄愿由щЪ吏덉 MF-16-01, Candida albicans, MF-16-02, Candida parapsilosis, MF-16-03, Candida glabrata, MF-16-04, Trichosporon asahii瑜 諛쒖넚븯떎. 寃궗踰뺤 Vitek 2瑜 궗슜븯뒗 湲곌씠 빟 80媛 湲곌(74.8%-78.2%)쑝濡 媛옣 留롮븯쑝硫, MALDI-TOF 10媛 湲곌뿉꽌 궗슜븯떎. C. albicans뒗 紐⑤뱺 湲곌씠 젙떟쓣 蹂닿퀬븯怨, C. parapsilosis쓽 寃쎌슦 씪遺 湲곌뿉꽌뒗 yeast like organism, Candida spp. 벑쑝濡 蹂닿퀬븯떎. C. glabrata뒗 닔湲곕쾿쓣 궗슜븯뒗 2湲곌 쇅뿉뒗 젙떟쓣 蹂닿퀬븯떎. T. asahiiTrichosporon spp.濡 蹂닿퀬븳 湲곌씠 101媛 湲곌 以 26湲곌씠 뿀떎(Table 12).

Table 12 . Clinical mycology: performance of laboratories in yeast identification of MF-16-01 Candida albicans.

Survey no.Methods of identificationNo. (%)Lists of reported organisms (%)
MF-16-01. Candida albicansAPI9 (8.4)C. albicans : 9 (100)
MALDI-TOF (BioMérieux)3 (3.9)C. albicans : 3 (100)
MALDI-TOF (Bruker)7 (6.5)C. albicans : 7 (100)
Manual2 (1.9)C. albicans : 2 (100)
Microscan3 (2.8)C. albicans : 3 (100)
Vitek 282 (76.6)C. albicans : 82 (100)
Others
MF-16-02. Candida parapsilosisAPI12 (11.2)C. parapsilosis : 12 (100)
MALDI-TOF (BioMérieux)3 (2.8)C. parapsilosis : 3 (100)
MALDI-TOF (Bruker)7 (6.4)C. parapsilosis : 7 (100)
Manual2 (1.9)Candida spp.: 1 (50.0), yeast like organism: 1 (50.0)
Microscan3 (2.8)C. parapsilosis : 2 (66.7); Candida spp.: 1 (33.3)
Vitek 280 (74.8)C. parapsilosis : 79 (98.8); Candida famata : 1 (1.3)
Others
MF-16-03. Candida glabrataAPI7 (6.9)C. glabrata : 7 (100)
MALDI-TOF (BioMérieux)2 (2.0)C. glabrata : 2 (100)
MALDI-TOF (Bruker)8 (7.9)C. glabrata : 8 (100)
Manual2 (2.0)Candida spp.: 1 (50.0); yeast like organism: 1 (50.0)
Microscan2 (2.0)C. glabrata : 2 (100)
Vitek 279 (78.2)C. glabrata : 79 (100)
Others
MF-16-04. Trichosporon asahiiAPI7 (6.9)T. asahii : 5 (71.4); Trichosporon spp.: 2 (28.6)
MALDI-TOF (BioMérieux)2 (2.0)Trichosporon spp.: 2 (100)
MALDI-TOF (Bruker)8 (7.9)T. asahii : 5 (62.5); Trichosporon spp.: 3 (37.5)
Manual2 (2.0)Trichosporon spp.: 1 (50.0); yeast like organism: 1 (50.0)
Microscan1 (1.0)Trichosporon spp.: 1 (100)
Vitek 279 (78.2)T. asahii : 62 (78.5); Trichosporon spp.: 17 (21.5)
Others2 (2.0)T. asahii : 2 (100)

The instruments were from the following companies: BioMérieux SA (Marcy l’Etoile, France) and Bruker Corp. (Billerica, MA, USA)..


怨좎같

엫긽誘몄깮臾쇳븰 꽭洹좊텇빞 떊鍮숇룄議곗궗뿉꽌뒗 2016뀈 1李⑥뿉꽌 293湲곌, 2李⑥뿉꽌 292湲곌, 3李⑥뿉꽌 285湲곌씠 쉶떊븯떎. 吏꾧퇏遺꾩빞쓽 떊鍮숇룄議곗궗뿉뒗 1李⑥뿉꽌 107湲곌, 2李⑥뿉꽌 101湲곌씠 쉶떊븯떎.

2016뀈遺꽣 깉濡쒖슫 李⑥꽭 쇅遺떊鍮숇룄議곗궗궗뾽씠 떆옉릺硫댁꽌 꽭洹좉낵 吏꾧퇏遺꾩빞뿉꽌룄 룊媛湲곗씠 긽떦엳 蹂솕릺뿀떎. 湲곕낯쟻쑝濡 쟾泥 李몄뿬湲곌 80%媛 씪移섎맂 寃곌낵瑜 蹂댁씠硫 “acceptable” 뙋젙湲곗쑝濡 젙븯怨, 씪移섑븯吏 븡 寃쎌슦뒗 “not available”濡 븯떎. 뵲씪꽌 씠쟾뿉뒗 species level 룞젙씠 뼱젮슫 寃쎌슦굹 빆깮젣 醫낅쪟뿉꽌 떎젣쟻씤 遺遺꾩쓣 媛먯븞븯뿬 룷愿꾩쟻쑝濡 룊媛븯뜕 諛⑹떇쓣 궗슜븯吏 븡怨, 80% 湲곌씠 蹂 怨좏븳 湲곕낯쟻씠怨 怨듯넻쟻씤 寃곌낵瑜 媛 湲곌뿉 슂援ы븯뒗 諛⑹떇쑝濡 蹂寃쎈릺뿀떎. 留뚯빟 李멸븳 湲곌 以 怨듯넻맂 蹂닿퀬媛믪씠 80% 씠븯씪 寃쎌슦뒗 쇅遺젙룄愿由 뙋젙쓣 쑀蹂댄븯怨, 湲곌 궡遺쟻쑝濡 빐寃고븯뒗 寃껋쓣 쑀룄븯떎.

꽭洹좎쓽 洹몃엺뿼깋뿉꽌뒗 遺遺 쟻젅븳 寃곌낵瑜 蹂닿퀬븯쑝굹 씪遺 湲곌뿉꽌뒗 떎瑜 寃곌낵瑜 蹂닿퀬븯떎. MB-16-06, S. agalactiae쓽 寃쎌슦 G(-) cocci굹 G(-) coccobacilli濡 蹂닿퀬븳 湲곌씠 9媛 湲곌씠 엳뿀怨, MB-16-08, E. faecium쓽 寃쎌슦 룞떆뿉 諛쒖넚븳 洹좎<媛 G(-) bacilli, G(+) cocci엫뿉룄 遺덇뎄븯怨 G(-) diplococci濡 6湲곌씠 蹂닿퀬븯뿬 씪遺 湲곌뿉꽌뒗 洹몃엺뿼깋쓽 媛쒖꽑씠 슂援щ릺뿀떎.

꽭洹 룞젙뿉꽌뒗 K. pneumoniae쓽 寃쎌슦 99.6% 湲곌씠 젙떟쓣 蹂닿퀬븯뿬 媛옣 젙솗븳 寃곌낵瑜 蹂댁怨, A. baumannii 98.0%, E. faecalis 97.6%, E. faecium 97.5%, M. morganii 97.2%, S. agalactiae 94.4%, S. saprophyticus 93.9%, S. aureus 93.2%, Salmonella spp. group B 90.6% 닚꽌濡 젙떟쓣 蹂닿퀬븯떎. CoNS쓽 寃쎌슦 洹몃엺쓬꽦媛꾧퇏뿉 鍮꾪빐 젙솗룄媛 궙 렪씠뿀쑝硫, 씠 寃쎌슦 species 닔以쑝濡 蹂닿퀬븯吏 븡怨 Staphylococcus, coagulase negative濡 寃궗븯뒗 湲곌씠 엳뿀쑝硫, biochemical test뿉꽌 떎瑜 寃곌낵媛 굹삩 寃쎌슦룄 엳뒗 寃껋쑝濡 뙋떒맂떎.

빆깮젣媛먯닔꽦 寃궗뿉뒗 CLSI guideline M100뿉 뵲씪 뙋젙븯쑝硫[4], 湲곗〈뿉 媛 湲곌뿉꽌 蹂닿퀬븯뜕 빆깮젣 醫낅쪟瑜 옄泥댁쟻씤 뙋떒쑝濡 諛쏆븘뱾뜕 뜲뿉 鍮꾪빐꽌, CLSI 뙋젙몴瑜 쇅遺젙룄愿由ъ쓽 湲곗쑝濡 븯뿬 긽떦븳 蹂솕媛 엳뿀떎. 슦꽑 group A뒗 紐⑤뱺 湲곌뿉꽌 諛섎뱶떆 蹂닿퀬빐빞 븯뒗 寃껋쑝濡 븯怨, 떎瑜 빆깮젣뒗 蹂닿퀬븷 닔 엳뒗 寃껋쑝濡 遺꾨쪟븯쑝硫, CLSI 湲곗뿉 뾾뒗 빆깮젣瑜 蹂닿퀬븳 寃쎌슦 “unacceptable”濡 븯떎.

MB-16-1, S. aureus 洹좎<뿉꽌뒗 gentamicin MIC踰뺤쓣 蹂닿퀬븳 69媛 湲곌 以 R濡 蹂닿퀬븳 湲곌씠 41媛, I濡 蹂닿퀬븳 湲곌씠 26媛쒕 蹂댁뿬 꽌濡 셿쟾엳 씪移섑븯吏뒗 븡븯쑝굹, 엫긽쟻쑝濡 겙 쓽쓽뒗 뾾쓣 寃껋쑝濡 뙋떒뻽떎. S. aureus뒗 disk踰뺤뿉꽌 MRSA 뙋젙뿉 궗슜븯뒗 cefoxitin怨 떊빟씤 ceftaroline 쇅뿉뒗 寃궗븯吏 븡뒗 寃껋씠 씪諛섏쟻씠굹, 긽떦닔 湲곌뿉꽌 CLSI 룊媛湲곗씠 뾾뒗 떎뼇븳 cephalosporin쓣 蹂닿퀬븯뿬 媛쒖꽑씠 슂援 맂떎. MB-16-2, A. baumannii 洹좎<뒗 carbapenem 궡꽦 洹좎<濡쒖꽌 MIC, disk踰 紐⑤몢 imipenem, meropenem뿉꽌 궡꽦쑝濡 젙솗븳 寃궗媛믪쓣 蹂닿퀬븯뿬 씠 洹좎쥌뿉꽌 carbapenem 궡꽦 寃궗쓽 젙솗룄뒗 넂 寃껋쑝濡 뙋떒븳떎. 떎留, 옄룞솕 湲곌린瑜 씪諛섏쟻쑝濡 궗슜븯뒗 MIC 寃궗湲곌뿉꽌 湲곗씠 뾾뒗 aztreonam쓣 蹂닿퀬븯뒗 湲곌씠 14媛 엳뼱꽌 媛 湲곌蹂꾨줈 蹂닿퀬 媛뒫 빆깮젣 紐⑸줉뿉 븳 媛쒖꽑씠 븘슂븷 寃껋쑝濡 깮媛곹븳떎. MB-16-3, E. faecalis 洹좎<뒗 linezolid MIC 寃궗湲곌 以 S濡 蹂닿퀬븳 湲곌씠 197媛, I濡 蹂닿퀬븳 湲곌씠 14媛, R濡 蹂닿퀬븳 湲곌씠 1湲곌 엳뼱 異붽쟻씤 愿李곗씠 엳뼱빞 븷 寃껋쑝濡 蹂댁씤떎. 삉븳 MIC 蹂닿퀬湲곌뿉꽌뒗 옣援ш퇏씠 옄뿰궡꽦쓣 蹂댁씠 뒗 cephalosporin 빆깮젣뿉 븳 蹂닿퀬媛 1嫄대룄 뾾뿀쓬뿉 鍮꾪빐, disk 蹂닿퀬湲곌뿉꽌뒗 쟻吏 븡 湲곌씠 cephalosporin 빆깮젣 寃곌낵瑜 蹂닿퀬븯쑝誘濡 disk 寃궗湲곌뿉꽌뒗 二쇱쓽븷 븘슂媛 엳떎. 옣꽭洹 以 Proteus spp., Providencia spp., Morganella spp.쓽 寃쎌슦 imipenem MIC媛 긽듅븳 洹좎<뱾씠 엳뼱 옄뿰궡꽦쑝濡 깮媛곹븯뒗 寃쎌슦媛 긽떦닔 엳떎. MB-16-04, M. morganii뿉꽌 imipenem 寃곌낵瑜 S, I, R濡 떎뼇븯寃 蹂닿퀬븯뒗뜲, 씠뒗 M. morganii 洹좎< 듅꽦뿉 湲곗씤븳 寃껋쑝濡 蹂댁씤떎. MB-16-07, Salmonella spp. serogroup B뒗 amikacin, cefazolin, gentamicin 벑 湲곗씠 뾾뒗 빆깮젣瑜 蹂닿퀬븯뒗 湲곌뱾씠 씪遺 엳뼱 媛쒖꽑씠 슂援щ맂떎. MB-16-08, E. faecium뒗 disk踰뺤쓣 떎떆븯뒗 23湲곌 以 2湲곌 vancomycin 궡꽦쑝濡 옒紐 蹂닿퀬븯怨, 옣援ш퇏씠 cephalosporin뿉 옄뿰궡 꽦엫뿉룄 씪遺 湲곌뿉꽌 蹂닿퀬븯怨 엳뼱 媛쒖꽑씠 슂援щ맂떎. MB-16-09, S. saprophyticus 洹좎<뒗 penicillin disk踰뺤뿉꽌 21湲곌 以 9媛 湲곌씠 媛먯닔꽦쑝濡 옒紐 蹂닿퀬븳 寃곌낵瑜 蹂댁떎.

쟾諛섏쟻쑝濡 MIC踰뺤 옄룞솕 옣鍮꾨 궗슜븯뒗 怨녹씠 留롮븘꽌 蹂닿퀬븯吏 븡븘빞 븷 빆깮젣瑜 蹂닿퀬븯뒗 寃쎌슦뒗 쟻뿀쑝굹, disk踰뺤쓣 궗슜븯뒗 怨녹 媛곸옄 빆깮젣瑜 꽑깮븯뒗 寃쎌슦媛 留롮븘꽌 CLSI 湲곗뿉 쟻젅븯吏 븡 빆깮젣瑜 蹂닿퀬븯뒗 寃쎌슦媛 留롮븯怨, 씪遺 湲곌뿉꽌뒗 potency굹 빐꽍 湲곗쓽 媛쒖꽑씠 븘슂빐 蹂댁씠硫, 빆깮젣 disk 寃궗踰뺤쓽 궡遺젙룄愿由ш 蹂댁셿릺뼱빞 븷 寃껋쑝濡 깮媛곹븳떎.

吏꾧퇏寃궗湲곌 100뿬 媛쒕줈 꽭洹좉궗湲곌 290뿬 媛쒖뿉 鍮꾪빐 쟻吏留, 遺遺 옄룞솕 湲곌린濡 寃궗瑜 떆뻾븯怨 엳뼱 湲곌쓽 洹쒕え媛 鍮꾧탳쟻 겙 寃껋쑝濡 蹂댁씤떎. 2016뀈 諛쒖넚洹좎<뒗 돺寃 룞젙씠 媛뒫븳 슚紐④퇏쑝濡 꽑젙븯怨, 遺遺꾩쓽 湲곌뿉꽌 젙떟쓣 蹂닿퀬븯떎. 븯吏留 닔湲곕쾿쓣 궗슜븯뒗 湲곌씠굹 씪遺 湲곌뿉꽌뒗 species 닔以쑝濡 蹂닿퀬븯뒗 뜲 뼱젮씠 엳뼱 媛쒖꽑씠 슂援щ맂떎.

2016뀈 엫긽誘몄깮臾쇳븰 꽭洹, 吏꾧퇏쓽 쇅遺젙룄愿由 떊鍮숇룄議곗궗뒗 李⑥꽭떊鍮숇룄議곗궗 봽濡쒓렇옩씠 쟻슜맖쑝濡쒖뜥 洹좊룞젙怨 빆깮젣媛먯닔꽦 寃궗쓽 룊媛뿉꽌 긽떦븳 蹂솕媛 엳뿀떎. CLSI 뿉꽌룄 빆깮젣媛먯닔꽦 寃궗쓽 寃쎌슦 寃궗踰뺤쓽 李⑥씠뿉 뵲씪 빐꽍씠 뼱젮슫 寃쎌슦媛 議댁옱븯硫, 떎젣 빆깮젣媛먯닔꽦 寃궗寃곌낵瑜 룊媛븯湲 쐞븳 諛⑸쾿 媛쒖꽑怨 몴以솕 옉뾽쓣 넻븳 媛쒖꽑옉뾽씠 吏꾪뻾 릺怨 엳떎[5].

씠쟾쓽 떊鍮숇룄議곗궗媛 넂 닔以쓽 룞젙뒫젰 룊媛쓣 吏뼢븳 뜲 鍮꾪빐꽌, 2016뀈遺꽣뒗 떒닚븳 룊媛諛⑹떇쓣 슦꽑 쟻슜븯쑝굹, 뼢썑뿉뒗 吏덉쟻씤 뼢긽쓣 쐞빐 떎瑜 봽濡쒓렇옩쓽 쟻슜룄 怨좊젮빐빞 븷 寃껋쑝濡 蹂댁씤떎. 깉濡쒖슫 쇅遺젙룄愿由ъ궗뾽 80% 踰뺤튃쓣 쟻슜븯뿬 媛앷꽦쓣 媛뺤“븯怨, 떎瑜 寃궗떎怨 룞씪븳 吏덉쟻 鍮꾧탳寃곌낵濡 媛쒖꽑쓽 諛⑺뼢쓣 젣떆븯쑝硫, 寃궗떎뿉 鍮꾪빐 寃궗 諛 蹂닿퀬 닔以씠 궙 寃궗떎뿉꽌뒗 뼢썑뿉 80% 씠궡뿉 吏꾩엯븯湲 쐞븳 끂젰씠 엳쓣 寃껋쑝濡 삁긽븳떎. 삉븳 빆깮젣 媛먯닔꽦 寃궗쓽 뙋젙뿉 CLSI M100 湲곗쓣 쟻슜븿쑝濡쒖뜥 留ㅻ뀈 蹂寃쎈릺뒗 빆깮젣媛먯닔꽦 寃궗寃곌낵뿉 쓳븯뿬 理쒖떊 湲곗쓣 쟻슜븯뒗 끂젰씠 媛 寃궗떎쓽 젙룄愿由 뼢긽쓣 媛졇삱 寃껋쑝濡 湲곕븳떎.

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