1. 2. KPC- 3. NDM-1-β- 4. CTX-M-15ST131 CTX-M-9CTX-M-14 5. Oct. 1, 2010
1SSI 2.2008 3Acinetobacter 4
MRSA PRSP GP VRE MR-S. aureus (erm) PRGBS MR-S. pneum (mefe) MDR-TB XDR-TB 1970 GN 1980 ESBL 1990 EM-R E. coli (ere) MDR ESBLβ- MBL- β- EM-R AG MR PMQR MDRP TB PRGBSB MBL MDRP 2000 MR-M. pneumoniae AG PMQR OXA- MBL: IMP, VIM KPC GIM, SIM SPM NDM
Ø 200910 7
1. Hoffmann MS et al. Infect Control Hospital Epidemiol 2010;31:196-197. 2006K. pneumoniae KPC2006KPC A. baumannii2006 Landman D et al. J Antimicrob Chemother 2007;60:78-82.
2004) (Meropenem Yearly Susceptibility Test Information Collection [MYSTIC], Perez, F. et al. 2007. Antimicrob. Agents Chemother. 51(10):3471-3484
(JANIS) ICUVAP, CRBSI, UTI SSI NICUMRSA
2. NDM-1 1. β-ndm-1 -β- 2. CMY-4CTX-M-15β- 3. RmtB RmtC16S rrna 4. 5.
NDM-1 (Sep. 2010, ICAAC, Boston) 1. NDM-1 2. Enterobacter, Proteus, MorganellaPseudomonasAcinetobacter 3. SalmonellaNDM-1 ShigellaDr. Nordmann 4. NDM-1plasmidIncA/C 5. NDM-1CMY-4CTX-M-15ArmA, RmtB, RmtC 16S rrna
Klebsiella pneumoniae KPC-1 KPC-2 KPC-2 19981999 KPC-3 2000-2001NY Medical Center OmpK35OmpK36 KPC-3β- KPC-β-KPC-10 KPC-β-MLST ST258(USA, Fin, Nor, Pol, Swe)
KPC- Nordmann P et al. Lancet Infect Dis. 2009;9:229-36.
KPCβ-PIPC/TAZ Woodford N, et al., AAC 48, 4793-4799, 2004
Klebsiella pneumoniae 1. IMP--β- 2. KPC- 3. NDM-1-β-
4. CTX-M-β- CTX-M-β- CTX-M-β- 1. β- 2.
CTX-M-β-
CTXE. coli ST131 FQ ST38
JANIS
qnr (Lancet, 1998) (AAC, ) (Lancet, 2001) (Lancet, 2001; JAC, 2005) vana (MMWR, 2002; Lancet 2003) 16S rrna GNR*rmtA(Lancet, AAC, 2003) / (AAC, 2004) 10PlasmidFQ(QepA) (AAC, 2007) 11G(PRGBS)(AAC, 2008) 12NDM-1(AAC, 2009; Lancet 2010) (*GNR:)
WHO Aug. 20, 2010) 2011WHO <http://www.who.int/mediacentre/news/releases/2010/amr_20100820/en/>