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냉각탑물에서 분리된 Legionella pneumophila 균주에 대한 혈청살균성시험 및 항균제 감수성 시험

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 Serum bactericidal and antimicrobial susceptibility test on Legionella pneumophila isolates from cooling tower water 
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[한글] Legionella Pneumophila는 Legionella증의 주원인균으로서, ]3개의 혈청형으로 나뉜다. 최근에는 같은 혈청형 중에도 monoclonal antibody binding pattern이나 plasmid analys is 등은 통해 여러가지 subtype이 있음이 밝혀졌다. Subtype에 따라 병독성이 다르며 Leg ionella가 자연계에 널리 존재함에도 환자발생이 적은 이유가 될 수 있다. 병독성의 시험 으로 guinea pig에 대한 독성, flagella의 존재, toxin과 protease의 생성여부, 혈청의 살균활성에 대한 저항성등 여려가지가 보고되어 있다. 본 연구에서는 1983년 부터 1986년 사이에 서울시내의 냉각탑물에서 분리한 Legionella pneumophila serogroupl, 10 균주의 병독성 유무를 조사하고자 혈청살균성 시험을 하였 고. 아울러 항균제 감수성검사를 한천희석법으로 시험하였다. 시험된 10균주는 모두 혈청살균성 시험에 저항성을 보여 병독성이 있는 것으로 생각되 었다. 아직 병독성을 결정짓는 필수 인자가 정해져 있는 것은 아니므로 본 연구에서 얻은 결과만으로 병독성이 있다고 단정 할 수는 없었으며 앞으로 guniea pig 독성실험등으로 더 확인 할 필요가 있다고 생각되었다. Erythromycin, rifampin, doxycycline, ciprofloxacin의 시험균주에 대한 MIC^^90 는 각각 0.25μg/ml, 0.008μg/ml, 4μg/ml, 0.125μg/ml이었다. 즉, 시험균주들은 모두가 l egionella증의 치료제로 널리 이용되어 온 erythromycin과 rifampin에 감수성을 보였고, 최근에 개발된 새로운 quinolone 제인 ciprofloxacin도 erythromycin과 유사한 낮은 MIC 를 보였다.
[영문] Legionella pneumophila is the most common cause of legionellosis among 13 serogroups. Recently, it was reported that serogroup 1 could be subdivided into subtypes by the monoclonal antibody binding pattern and plasmid content and others. Difference of virulence of these subtypes may account for the disparity between environmental prevalence of the organism and the rarity of the infections. Various methods, such as pathogenicity to guinea pig, presence of flagella, production of toxin or protease are used to determine the virulence. Resistance to killing by serum was also reported to correlate with virulence. For the treatment of legionellosis, erythromycin and a few other drugs are recommended. Strains of L. pneumophila was isolated from water samples of cooling tower in Seoul, but the virulence or antimicrobial susceptibility has not been tested. In this study 10 isolates of L. pneumophila serogroup 1 from cooling tower during 1983-1986 were tested for their resistance to serum bactericidal test and for their antimicrobial susceptibility by the agar dilution method to drugs recommended for the treatment of legionellosis. It was found that all of the 10 isolates were resistant to bactericidal activity of normal serum indicating the isolates were virulent ones and suggesting possibility of occurrence of legionellosis in Korea. However, as there is no known single major virulence factor further study is required to definitely determine the virulence of the isolates. The minimal inhibitory concentration to 90% of the isolates (MIC^^90) of the drugs were erythromycin 0.25μg/ml rifampin 0.008μg/ml doxycycline 4μg/ml, and ciprofloxacin 0.125μg/ml. The MIC range of the drugs to the test strains were similar to those to reference strains, indicating similar susceptibility. Erythromycin and rifampin may be the drug of choice of the treatment of legionellosis in Korea, too, if it happens to occur. Ciprofloxacin was as active as erythromycin at least in vitro.
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2. Thesis / Dissertation (학위논문) > 1. College of Medicine (의과대학) > Master's Degree (석사)
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