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Han, Yang, Kang, and Son: Antimicrobial susceptibility of major bacterial pathogens in the equine genital tract

Abstract

Equine reproductive failures for many different reasons are the main contributors to economic losses in the horse industry. This paper describes major bacterial agents isolated from thoroughbred mares that had reproductive failures in the previous year as well as the antimicrobial susceptibility of these bacterial isolates. A total of 146 vaginal and uterine swab samples were submitted to Jeju Self-Governing Veterinary Research Institute by equine veterinarians from 2011 to 2015. Streptococcus equi subspecies zooepidemicus were the most frequently encountered bacteria in 29 samples (48.3%). Other identified species included 21 samples (35%) with Escherichia coli, six samples (10%) with Klebsiella pneumoniae, and four samples (6.7%) with Pseudomonas aeruginosa. All Streptococcus equi subsp. zooepidemicus isolates were sensitive to amoxicillin-clavulanic acid, cefazolin, cefuroxime, and florfenicol, while all were resistant to tetracycline and kanamycin. All E. coli were sensitive to enrofloxacin, ciprofloxacin, and sulfamethoxazole-trimethoprim, and most were susceptible to cefazolin, amoxicillin-clavulanic acid, cefuroxime, florfenicol, and gentamicin. All K. pneumoniae isolates were sensitive to amoxicillin-clavulanic acid, cefazolin, cefuroxime, florfenicol, and ciprofloxacin, while all were resistant to sulfamethoxazole-trimethoprim. P. aeruginosa exhibited sensitivity to quinolones and aminoglycosides, particularly gentamicin, while all were resistant to cefazolin and cefuroxime.

์„œ ๋ก 

๊ฐ€์ถ• ์ค‘์—์„œ ์ƒ์‚ฐํšจ์œจ์ด ๊ฐ€์žฅ ๋‚ฎ์€ ๊ฒƒ์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋Š” ๋ง์€ ๋‹ค๋ฅธ ๋™๋ฌผ์— ๋น„ํ•ด ๊ฐœ์ฒด๋ณ„ ํŠน์ด์„ฑ์ด ๋†’์œผ๋ฉฐ, ๋Œ€๋ถ€๋ถ„์˜ ๊ตญ๊ฐ€์—์„œ ์”จ์•”๋ง์˜ ์ˆ˜ํƒœ์œจ์€ ์•ฝ 85โˆผ90% ์ •๋„์ด๋‚˜ ์ˆ˜ํƒœ๋œ ํƒœ์•„๊ฐ€ ํƒœ์–ด๋‚˜๋Š” ๋น„์œจ์€ 65โˆผ79% ์ •๋„์— ๋ถˆ๊ณผํ•œ ๊ฒƒ์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค [1]. ์•”๋ง์˜ ๋ถˆ์ž„์ฆ ์›์ธ์€ ๋ฐœ์ •์ฃผ๊ธฐ์˜ ๋ถˆ๊ทœ์น™ ๋ฐ ๋ฌด๋ฐœ์ •์— ๋”ฐ๋ฅธ ๊ต๋ฐฐ์ ๊ธฐ๋ฅผ ๋†“์นœ ๊ฒฝ์šฐ, ๊ฐ์ข… ๋‚œ์†Œ ์งˆํ™˜๊ณผ ํ˜ธ๋ฅด๋ชฌ ์žฅ์• ์— ๋”ฐ๋ฅธ ๋ฌด๋ฐฐ๋ž€ ๋ฐ ๋ฐฐ๋ž€์ง€์—ฐ, ์•”๋ง์˜ ์˜์–‘๋ถ€์กฑ ๋ฐ ์ƒ์‹๊ธฐ ๊ฐ์—ผ์ฆ ๋“ฑ์ด ์žˆ๋‹ค [3]. ์ด ์ค‘์— ์ƒ์‹๊ธฐ ๊ฐ์—ผ์˜ ์›์ธ์€ ์ฒซ์งธ, ์™ธ์Œ๋ถ€์˜ ๋ถˆ๋Ÿ‰ํ•œ ํ˜•ํƒœ๋กœ ์ธํ•˜์—ฌ ๊ณต๊ธฐ ์ค‘์˜ ์ด๋ฌผ์ด๋‚˜ ์„ธ๊ท  ๋ฐ ๋ถ„๋ณ€์ด ์งˆ๊ณผ ์ž๊ถ๋‚ด๋กœ ์œ ์ž…๋˜๋ฉด์„œ ์งˆ์—ผ, ์ž๊ถ๊ฒฝ๊ด€์—ผ ๋ฐ ์ž๊ถ๋‚ด๋ง‰์—ผ์„ ์ผ์œผํ‚จ๋‹ค. ๋‘˜์งธ๋Š” ๋‚œ์‚ฐ, ์‚ฌ์‚ฐ, ํƒœ๋ฐ˜์ •์ฒด ๋ฐ ์‚ฐ๋„์˜ ์‹ฌํ•œ ์†์ƒ๊ณผ ์ˆ˜๋ณต๋ถ€์ „์— ๋”ฐ๋ฅธ ๋ถˆ์ž„์ฆ์ด ์žˆ๋‹ค. ์…‹์งธ๋Š” ๊ต๋ฐฐ ์ „ ํ›„ ์ข…๋ถ€๋งˆ์— ๋Œ€ํ•œ ์ƒ์‹๊ธฐ ์†Œ๋…์ด ์ž˜ ๋˜์ง€ ์•Š์•˜์„ ๋•Œ ์„ธ๊ท  ๊ฐ์—ผ์ด ๋˜๋Š” ๊ฒฝ์šฐ์ด๋‹ค. ๋„ท์งธ๋Š” ์ƒ์‹๊ธฐ ๊ด€๋ จ ์„ธ๊ท ์— ๊ฐ์—ผ๋œ ๋ง์— ์‚ฌ์šฉํ•œ ์งˆ๊ฒฝ์ด๋‚˜ ์ž๊ถ์„ธ์ •๊ธฐ๊ตฌ ๋“ฑ์˜ ๋ถˆ์™„์ „ํ•œ ์†Œ๋…์— ์˜ํ•œ ๊ฐ์—ผ์ด ์žˆ๋‹ค. ์ด๋Ÿฌํ•œ ์š”์ธ์— ๋”ฐ๋ฅธ ์ž๊ถ์—ผ์€ ๋ถˆ์ž„, ์กฐ๊ธฐ ํƒœ์•„์†์‹ค (early embryonic loss), ํƒœ๋ฐ˜์—ผ, ์‚ฐํ›„ ์ž๊ถ์—ผ(postpartum metritis), ๋ถ€ํŒจํƒœ์•„ ์ถœ์ƒ (septic foal) ๋“ฑ์„ ์•ผ๊ธฐํ•˜๋ฉฐ [22], ๋ฒˆ์‹์šฉ ์•”๋ง์˜ 25โˆผ40%์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์œผ๋กœ ์ถ”์ •ํ•˜๊ณ  ์žˆ๋‹ค [9]. ์ž๊ถ์—ผ์€ ์ž๊ถ ๋‚ด๋กœ ์นจ์ž…๋œ ๋ณ‘์›์„ฑ ์„ธ๊ท ์„ ์ œ๊ฑฐํ•˜๋Š” ๋ฐฉ์–ด๊ธฐ์ „ ์‹คํŒจ ์‹œ ๋ฐœ์ƒํ•œ๋‹ค [16]. ์ž๊ถ ๋‚ด ์„ธ๊ท  ์˜ค์—ผ์€ ๊ต๋ฏธ, ์ถœ์‚ฐ, ์ธ๊ณต์ˆ˜์ • ๋ฐ ์ƒ์‹๊ธฐ ๊ฒ€์‚ฌ๊ฐ€ ์ฃผ์›์ธ์ธ ๊ฒƒ์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ์œผ๋ฉฐ [10, 23, 24], ์ด๋Ÿฌํ•œ ์ž๊ถ์—ผ์€ ์ˆ˜ํƒœ์œจ ์ €ํ•˜์˜ ๊ฐ€์žฅ ํฐ ์›์ธ์˜ ํ•˜๋‚˜๋กœ ์ธ์‹๋˜๊ณ  ์žˆ๋‹ค [14]. ์ด์™€ ๊ฐ™์ด ๋ง์˜ ์ˆ˜ํƒœ์œจ ์ €ํ•˜๋Š” ์ง์ ‘์ ์œผ๋กœ ๋˜๋Š” ๊ฐ„์ ‘์ ์œผ๋กœ ๋ณ‘์›์„ฑ ์„ธ๊ท ์˜ ์นจ์ž…์— ์˜ํ•ด ๋ฐœ์ƒ๋˜๋Š” ๊ฒƒ์ด ๋Œ€๋ถ€๋ถ„์ด๋‹ค. ๊ธฐ์กด ์—ฐ๊ตฌ๊ฒฐ๊ณผ๋“ค์— ์˜ํ•˜๋ฉด, ์ƒ์‹๊ธฐ ์งˆํ™˜์ด ์žˆ๋Š” ์”จ์•”๋ง์—์„œ ๋ถ„๋ฆฌ๋œ ๋ณ‘์›์ฒด๋Š” Streptococcus (S.) equi subspecies (ssp.) zooepidemicus, Escherichia (E.) coli, Klebsiella (K.) pneumoniae, Pseudomonas (P.) aeruginosa, Taylorella (T.) equigenitalis, Equine herpes virus ๋“ฑ์ด๋ฉฐ [24], ๋ง ์œ ์‚ฐํƒœ์•„, ์‚ฌ์‚ฐํƒœ์•„, 24์‹œ๊ฐ„ ๋‚ด์— ํ์‚ฌ๋œ ๋ง์•„์ง€ ๋ฐ ํƒœ๋ฐ˜์— ๋Œ€ํ•œ ์„ธ๊ท  ๊ฒ€์‚ฌ์—์„œ๋„ S. equi ssp. zooepidemicus, E. coli, K. pneumoniae, P. aeruginosa, Leptospira spp., Enterobacter spp., ฮฑ-hemolytic Streptococci, Staphylococcus spp. ๋“ฑ์ด ๋ถ„๋ฆฌ๋˜์—ˆ๋‹ค [11]. ์ด๋Ÿฌํ•œ ์—ฐ๊ตฌ๊ฒฐ๊ณผ๋“ค์„ ์ข…ํ•ฉํ•˜์˜€์„ ๋•Œ ๋ง์˜ ์ƒ์‹๊ธฐ๊ด€์—์„œ ๊ฐ€์žฅ ๋นˆ๋ฒˆํ•˜๊ฒŒ ๋ถ„๋ฆฌ๋˜๋Š” ์„ธ๊ท ์€ S. equi ssp. zooepidemicus, E. coli, K. pneumoniae, P. aeruginosa์ด๋ฉฐ [10, 23], ์ด ๋“ค ์ค‘ K. pneumoniae, P. aeruginosa๋Š” T. equigenitalis์™€ ํ•จ๊ป˜ ๊ฐ์—ผ๋œ ์ •์•ก์„ ํ†ตํ•œ ์„ฑ์ ‘์ด‰์ด๋‚˜ ์ธ๊ณต์ˆ˜์ •์— ์˜ํ•ด ์ „์—ผ๋˜๊ธฐ ๋•Œ๋ฌธ์— ๋ง์˜ ์„ฑ๋ณ‘์œผ๋กœ ๊ฐ„์ฃผ๋˜๊ณ  ์žˆ๋‹ค [17]. ๋”ฐ๋ผ์„œ ์ด๋Ÿฌํ•œ ์„ธ๊ท ๋“ค์€ ์•”๋ง์—์„œ ํŠนํžˆ ๋ฐœ์ •๊ธฐ๋‚˜ ๋ฐฐ๋‡จํ•˜๊ธฐ ์œ„ํ•ด ์›…ํฌ๋ฆด ๋•Œ ํ™”๋†์„ฑ์˜ ์งˆ ๋ถ„๋น„๋ฌผ์„ ํŠน์ง•์œผ๋กœ ํ•˜๋Š” โ€œdirty mare syndromeโ€์„ ์ผ์œผํ‚ค๋ฉฐ, ์ž๊ถ์— ์ง€์†์ ์œผ๋กœ ์กด์žฌํ•  ๊ฒฝ์šฐ์—๋Š” ๋•Œ๋•Œ๋กœ ๊ณ ์—ด, ์‹์š•๊ฐํ‡ด, ์นจ์šธ, ์ œ์—ฝ์—ผ์„ ์ผ์œผํ‚ค๊ธฐ๋„ ํ•˜๊ณ , ๋งŒ์„ฑ ๊ฐ์—ผ์œผ๋กœ ์ด์–ด์งˆ ์‹œ์—๋Š” ์˜๊ตฌ์ ์ธ ๋ถˆ์ž„์„ ์•ผ๊ธฐํ•  ์ˆ˜๋„ ์žˆ๋‹ค [15].
๊ตญ๋‚ด ์‚ฌ์œก ์•”๋ง์„ ๋Œ€์ƒ์œผ๋กœ ํ•œ ์ƒ์‹๊ธฐ ๋‚ด ๋ณ‘์›์„ฑ ์„ธ๊ท ์— ๋Œ€ํ•œ ์—ฐ๊ตฌ๋Š” ๋ฏธ๋น„ํ•œ ์‹ค์ •์ด๋‹ค. Choi ๋“ฑ [4]์€ ๊ต๋ฐฐ ์ „ ๋”๋Ÿฌ๋ธŒ๋ › ์”จ์•”๋ง์„ ๋Œ€์ƒ์œผ๋กœ ๋ฌผ๋ฆฌโ€ง์œก์•ˆ์  ๊ฒ€์‚ฌ๋ฅผ ํ†ตํ•ด ์ƒ์‹๊ธฐ ์งˆํ™˜์ด ์˜์‹ฌ๋˜๋Š” ์•”๋ง 100๋‘ ๋Œ€์ƒ์œผ๋กœ ์„ธ๊ท ๋ถ„ํฌ ๋ฐ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ์–‘์ƒ์„ ํŒŒ์•…ํ•œ ๋ฐ” ์žˆ๋‹ค. Cho ๋“ฑ [3]์€ ํ•œ๊ตญ๋งˆ์‚ฌํšŒ ์žฅ์ˆ˜๋ชฉ์žฅ์— ์ธ๊ณต์ˆ˜์ •์„ ๋ชฉ์ ์œผ๋กœ ์ž…์›๋œ ์Šน์šฉ ์•”๋ง ์ค‘ ๋ฒˆ์‹์žฅ์• ๋ฅผ ๊ฒช๊ณ  ์žˆ๋Š” ๋ง 104๋‘ ๋Œ€์ƒ์œผ๋กœ ์ƒ์‹๊ธฐ ์œ ๋ž˜์„ธ๊ท ์˜ ๋ถ„ํฌ ๋ฐ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ์–‘์ƒ์„ ๋ณด๊ณ ํ•˜์˜€๋‹ค. ์ด๋“ค ์—ฐ๊ตฌ๋Š” ๋ชจ๋‘ ๋ง์˜ ์งˆ์ ๋ง‰์—์„œ ์„ธ๊ท ์„ ๋ถ„๋ฆฌํ•˜์˜€์œผ๋ฉฐ, ๋ง์ƒ์‹๊ธฐ ์งˆํ™˜์— ๊ด€์—ฌํ•˜๋Š” ์„ธ๊ท ์˜ ์ค‘์š”๋„๋ฅผ ๊ณ ๋ คํ•˜์ง€ ์•Š๊ณ  ๋ฌด์ž‘์œ„๋กœ ์„ ๋ฐœ ๋ถ„๋ฆฌํ•˜์˜€๋‹ค.
๋”ฐ๋ผ์„œ ๋ณธ ์—ฐ๊ตฌ๋Š” ์ œ์ฃผ์ง€์—ญ ๋ง ์‚ฌ์œก๋ชฉ์žฅ์˜ ๋”๋Ÿฌ๋ธŒ๋ › ์•”๋ง์—์„œ ๋ถˆ์ž„์„ ์•ผ๊ธฐํ•  ๊ฐ€๋Šฅ์„ฑ์ด ๋†’์€ ์ฃผ์š” ์›์ธ ์„ธ๊ท ์„ ๋ถ„๋ฆฌํ•˜๊ณ  ๋™์ •ํ•˜์—ฌ ๊ทธ ๋ถ„ํฌ๋ฅผ ํŒŒ์•…ํ•จ์€ ๋ฌผ๋ก , ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๋ฅผ ํ†ตํ•˜์—ฌ ๋ง์˜ ์ƒ์‹๊ธฐ ์งˆํ™˜์—์„œ ์›์ธ์ด ๋  ์ˆ˜ ์žˆ๋Š” ์„ธ๊ท ์„ฑ ๊ฐ์—ผ์ฆ์˜ ์˜ˆ๋ฐฉ๊ณผ ์˜ฌ๋ฐ”๋ฅธ ์น˜๋ฃŒ์ œ ์„ ํƒ์„ ์œ„ํ•œ ๊ธฐ์ดˆ ์ž๋ฃŒ๋ฅผ ์–ป๊ณ ์ž ํ•˜์˜€๋‹ค.

์žฌ๋ฃŒ ๋ฐ ๋ฐฉ๋ฒ•

๊ณต์‹œ์žฌ๋ฃŒ

๊ณต์‹œ์žฌ๋ฃŒ๋Š” 2011๋…„๋ถ€ํ„ฐ 2015๋…„ ์‚ฌ์ด์— ์ „๋…„๋„ ๊ต๋ฐฐ ํ›„ ๊ณตํƒœ๋งˆ ์ƒํƒœ๋กœ ์žˆ์—ˆ๋˜ ๋”๋Ÿฌ๋ธŒ๋ › ์”จ์•”๋ง์˜ ์งˆ ๋ฐ ์ž๊ถ ๋ฉด๋ด‰์‹œ๋ฃŒ๋กœ์„œ, ์ œ์ฃผํŠน๋ณ„์ž์น˜๋„ ๋™๋ฌผ์œ„์ƒ์‹œํ—˜์†Œ์— ๋ณ‘์„ฑ๊ฐ์ • ์˜๋ขฐ๋œ ๊ฒƒ์„ ์‚ฌ์šฉํ•˜์˜€๋‹ค. ์ฑ„์ทจ๋œ ๋ฉด๋ด‰์‹œ๋ฃŒ๋Š” ์ˆ˜์†ก๋ฐฐ์ง€์— ๋„ฃ์–ด 12์‹œ๊ฐ„ ๋‚ด ์‹คํ—˜์‹ค๋กœ ์šด๋ฐ˜๋˜์—ˆ๋‹ค. ์˜๋ขฐ๋œ ์‹œ๋ฃŒ๋Š” ๊ฐ๊ฐ 18๋‘, 35๋‘, 33๋‘, 40๋‘, 20๋‘๋กœ์„œ ์ด 146๋‘์˜€๋‹ค (Table 1).

๋ถ„๋ฆฌ ๋ฐ ๋™์ • ๊ฒ€์‚ฌ

์ฑ„์ทจํ•œ ์‹œ๋ฃŒ๋Š” blood agar plate (HANIL KOMED, Korea)์™€ MacConkey agar plate (BD Difco, USA)์— ๊ฐ๊ฐ ์ ‘์ข…ํ•˜์—ฌ 37โ„ƒ์—์„œ 18โˆผ24์‹œ๊ฐ„ ๋ฐฐ์–‘ํ•˜๊ณ , ํ˜ˆ์•ก๋ฐฐ์ง€์— ๊ณ„๋Œ€ํ•˜์—ฌ ์ˆœ์ˆ˜๋ถ„๋ฆฌํ•˜์˜€๋‹ค. ์œก์•ˆ์  ํŒ์ •๊ณผ Gram stain (BD Difco, USA)์„ ํ†ตํ•ด ์„ธ๊ท ์„ ๋ถ„๋ฅ˜ํ•œ ํ›„, Vitekโ…ก (Biomeriux, USA) ๊ธฐ๊ธฐ๋ฅผ ํ†ตํ•ด ๊ท ์„ ์ตœ์ข…์ ์œผ๋กœ ๋™์ •ํ•˜์˜€๋‹ค.

ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ

๋™์ •๋œ ์„ธ๊ท ์€ ๋Œ€์ƒ์œผ๋กœ Clinical and Laboratory Standards institute (CLSI)์˜ ๊ธฐ์ค€์— ๋”ฐ๋ผ ๋””์Šคํฌ ํ™•์‚ฐ๋ฒ•์œผ๋กœ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค. S. equi ssp. zooepidemicus ๊ท ์ฃผ์— ๋Œ€ํ•œ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๋Š”blood agar plate์—์„œ ์ˆ˜ํ–‰ํ•˜์˜€๊ณ  ๊ทธ ์ด์™ธ์—๋Š” Muller-Hinton agar (Difco, USA) ๋ฅผ ์ด์šฉํ•˜์˜€๋‹ค.
์‚ฌ์šฉํ•œ ํ•ญ์ƒ์ œ ๋””์Šคํฌ๋Š” BBL (USA)์‚ฌ์™€ Oxoid (UK)์‚ฌ์—์„œ ๊ตฌ์ž…ํ•˜์˜€์œผ๋ฉฐ, Amoxicillin-clavulanic acid (AMC, 20 ใŽ-10 ใŽ), Ampicillin (Ap, 10 ใŽ), Cefazolin (CZ, 30 ใŽ), Ceftiofur (30 ใŽ), Cefuroxime (30 ใŽ), Ciprofloxacin (5 ใŽ), Enrofloxacin (5 ใŽ), Erythromycin (15 ใŽ), Florfenicol (30 ใŽ), Gentamicin (G, 10 ใŽ), Kanamycin (K, 30 ใŽ), Neomycin (30 ใŽ), Oxytetracycline (30 ใŽ), Penicillin (P, 10 iu), Spiramycin (100 ใŽ), Streptomycin (10 ใŽ), Sulfamethoxazole-trimethoprim (23.75 ใŽ-1.25 ใŽ), Tetracycline (30 ใŽ), Tylosin (150 ใŽ)์„ ์ด์šฉํ•˜์˜€๋‹ค.

๊ฒฐ ๊ณผ

์ฃผ์š” ๋ณ‘์›์„ฑ ์„ธ๊ท ์˜ ๋ถ„๋ฆฌ์œจ

๋”๋Ÿฌ๋ธŒ๋ › ์”จ์•”๋ง 146๋‘์˜ ์งˆ ๋ฐ ์ž๊ถ swab ์‹œ๋ฃŒ์—์„œ์˜ ์ƒ์‹๊ธฐ ์งˆํ™˜๊ด€๋ จ ์ฃผ์š” ๋ณ‘์›์„ฑ ์„ธ๊ท ์„ ๋ถ„๋ฆฌํ•œ ๊ฒฐ๊ณผ, ์ด 53๋‘ (36.3%)์—์„œ 60๊ท ์ฃผ๊ฐ€ ๋ถ„๋ฆฌ๋˜์—ˆ๋‹ค. ๋ถ„๋ฆฌ๋™์ •๋œ ๋ณ‘์›์„ฑ ์„ธ๊ท ์€ 2011์—์„œ 2015๋…„ ์‚ฌ์ด์— ๊ฐ๊ฐ 7, 14, 15, 20, 4๊ท ์ฃผ์˜€๋‹ค (Table 1). ์ด๋“ค ์ค‘S. equi ssp zooepidemicus๊ฐ€ 29๊ท ์ฃผ (48.3%)๋กœ ๊ฐ€์žฅ ๋งŽ์•˜์œผ๋ฉฐ, E. coli๊ฐ€ 21๊ท ์ฃผ (35%), K. pneumoniae๋Š” 6๊ท ์ฃผ(10%), P. aeruginosa๋Š” 4๊ท ์ฃผ (6.7%)์˜€๋‹ค (Table 2). ์„ธ๊ท ์˜ ๋ถ„๋ฆฌ ์ƒํ™ฉ์„ ์—ฐ๋„๋ณ„๋กœ ๋ถ„์„ํ•œ ๊ฒฐ๊ณผ S. equi ssp zooepidemicus๋Š” ๋งค๋…„ 3๋‘ ์ด์ƒ์—์„œ ๋ถ„๋ฆฌ๋˜์—ˆ๊ณ  2014๋…„๋„์— 9๊ท ์ฃผ๊ฐ€ ๋ถ„๋ฆฌ๋˜์—ˆ๋‹ค. E. coli๋Š” ๋งค๋…„ 2๋‘ ์ด์ƒ์—์„œ ๋ถ„๋ฆฌ๋˜์—ˆ๊ณ , 2014๋…„๋„์— 8๊ท ์ฃผ๊ฐ€ ๋ถ„๋ฆฌ๋˜์—ˆ๋‹ค. ํ•œ ๊ฐœ์ฒด์—์„œ ๋‘ ๊ฐ€์ง€ ์ด์ƒ์˜ ๊ท ์ด ๊ฐ™์ด ๋ถ„๋ฆฌ๋œ ๊ฒƒ์œผ๋กœ, 2011๋…„ ๋ฐ 2013๋…„์—๋Š” S. equi ssp zooepidemicus ๋ฐ E. coli๊ฐ€, 2012๋…„์—๋Š” S. equi ssp zooepidemicus ๋ฐ K. pneumoniae๊ฐ€ ๊ฐ๊ฐ 1๋‘์—์„œ ๋™์‹œ์— ๊ฒ€์ถœ๋˜์—ˆ๋‹ค. 2014๋…„์—๋Š” S. equi ssp zooepidemicus ๋ฐ E. coli๊ฐ€ 2๋‘์—์„œ ๋™์‹œ์— ๊ฒ€์ถœ๋˜์—ˆ์œผ๋ฉฐ, ๋˜ ๋‹ค๋ฅธ 2๋‘์—์„œ๋„ S. equi ssp zooepidemicus ๋ฐ K. pneumoniae๊ฐ€ ๋™์‹œ์— ๋ถ„๋ฆฌ๋˜์—ˆ๋‹ค (Table 2).

ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ

๊ทธ๋žŒ์–‘์„ฑ ์„ธ๊ท ์ธ S. equi ssp zooepidemicus์— ๋Œ€ํ•œ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ Cephalosporin ๊ณ„์—ด ์ค‘ 1์„ธ๋Œ€์ธ cefazolin, 2์„ธ๋Œ€์ธ cefuroxime๊ณผ ฮฒ-lactamase ์–ต์ œ์ œ๊ฐ€ ํ•จ์œ ๋œ ํŽ˜๋‹ˆ์‹ค๋ฆฐ๊ณ„์ธ amoxicillin -clavulanic acid ๋ฐ florfenicol์— 29๊ท ์ฃผ ๋ชจ๋‘์—์„œ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€๊ณ , ampicillin, ceftiofur, enrofloxacin, erythromycin์—๋„ ๋น„๊ต์  ๋†’์€ ๊ฐ์ˆ˜์„ฑ (60โˆผ76%)์„ ๋ณด์˜€๋‹ค. Penicillin, oxytetracyclin, enrofloxacin์—์„œ๋Š” ๋†’์€ ์ €ํ•ญ์„ฑ(75โˆผ90%)์ด ๊ด€์ฐฐ๋˜์—ˆ์œผ๋ฉฐ, kanamycin, tetracycline์—๋Š” ๋ชจ๋“  ๊ท ์ฃผ๊ฐ€ ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค (Table 3).
๊ทธ๋žŒ์Œ์„ฑ ์„ธ๊ท ์ธ E. coli์˜ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ, quinolone ๊ณ„์—ด ๋ฐ sulfamethoxazole-trimethoprim์— ๋ชจ๋“  ๊ท ์ฃผ๊ฐ€ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€๋‹ค. S. equi ssp zooepidemicus์™€ ๋งˆ์ฐฌ๊ฐ€์ง€๋กœ cephalosporin ๊ณ„์—ด ์ค‘ 1์„ธ๋Œ€์ธ cefazolin, 2์„ธ๋Œ€์ธ cefuroxime์€ ๋ฌผ๋ก  amoxicillin-clavulanic acid, florfenicol, gentamicin์— 90% ์ด์ƒ์˜ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€๋‹ค. Ampicillin, ceftiofur, neomycin, kanamycin์—๋Š” ์ค‘๋“ฑ๋„ (47โˆผ70%)์˜ ๊ฐ์ˆ˜์„ฑ์ด ์žˆ์—ˆ์œผ๋‚˜, oxytetracycline, tetracycline, streptomycin์—๋Š” 10โˆผ15%๋กœ ๊ฐ์ˆ˜์„ฑ์ด ๋‚ฎ์•˜๋‹ค (Table 3).
๊ทธ๋žŒ์Œ์„ฑ ์„ธ๊ท ์ธ K. pneumoniae์˜ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ, cephalosporin ๊ณ„์—ด ์ค‘ 1์„ธ๋Œ€์ธ cefazolin, 2์„ธ๋Œ€์ธ cefuroxime, amoxicillin-clavulanic acid, florfenicol, ciprofloxacin์— ๋ชจ๋“  ๊ท ์ฃผ๊ฐ€ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€๊ณ , ceftiofur, enrofloxacin, gentamicin, kanamycin, neomycin, streptomycin ์—๋Š” ์ค‘์ •๋„ (50โˆผ83%)์˜ ๊ฐ์ˆ˜์„ฑ์ด, ampicillin tetracycline, oxytetracycline์—๋Š” 17โˆผ20%๊ฐ€ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€๋‹ค. ํŠนํžˆ sulfamethoxazole-trimethoprim์—๋Š” ๋ชจ๋“  ๊ท ์ฃผ๊ฐ€ ์ €ํ•ญ์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค (Table 3).
๊ทธ๋žŒ์Œ์„ฑ ์„ธ๊ท ์ธ P. aeruginosa์˜ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ, ๋ชจ๋“  ๊ท ์ฃผ๊ฐ€ cefazolin, cefuroxime, florfenicol, sulfamethoxazoletrimethoprim์— ์ €ํ•ญ์„ฑ์„ ๋ณด์˜€๊ณ , amoxicillin-clavulanic acid, ampicillin, ceftiofur, oxytetracyclin, tetracycline์—๋„ ๋น„๊ต์  ๋†’์€ ์ €ํ•ญ์„ฑ (50โˆผ75%)์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ์ „๋ฐ˜์ ์œผ๋กœ aminoglycoside ๊ณ„์—ด ๋ฐ quinolone ๊ณ„์—ด์„ ์ œ์™ธํ•˜๊ณ ๋Š” ๋†’์€ ์ €ํ•ญ์„ฑ์„ ๋ณด์˜€๊ณ , aminoglycoside ๊ณ„์—ด์€ 50โˆผ75%์˜ ๊ฐ์ˆ˜์„ฑ์ด, quinolone ๊ณ„์—ด์€ 50โˆผ67% ๊ฐ์ˆ˜์„ฑ์ด ๊ด€์ฐฐ๋˜์—ˆ์œผ๋ฉฐ ๊ทธ ์ค‘ gentamicin์— ๊ฐ€์žฅ ๋†’์€ ๊ฐ์ˆ˜์„ฑ์ด ๋ณด์˜€๋‹ค (Table 3).

๊ณ  ์ฐฐ

์•”๋ง์€ ๊ณ„์ ˆ๋ฒˆ์‹ ๋™๋ฌผ๋กœ์„œ ํ‰๊ท  21์ผ์˜ ๋ฐœ์ •์ฃผ๊ธฐ๋ฅผ ๊ฐ€์ง€๊ณ , ์šฐ๋ฆฌ๋‚˜๋ผ๋ฅผ ํฌํ•จํ•œ ๋ถ๋ฐ˜๊ตฌ์—์„œ์˜ ๋ฒˆ์‹์‹œ๊ธฐ๋Š” ๋ณดํ†ต 4์›”โˆผ10์›”์ด๋ฉฐ, ๋ฒˆ์‹๋Šฅ๋ ฅ์ด ๊ฐ€์žฅ ํ™œ๋ฐœํ•œ ์‹œ๊ธฐ๋Š” 6โˆผ8์›”์ด๋‹ค [3]. ํ˜„์žฌ ๊ตญ๋‚ด์˜ ๋”๋Ÿฌ๋ธŒ๋ ›์ข…์€ ์”จ์ˆ˜๋ง์˜ ์šฐ์ˆ˜ํ•œ ์œ ์ „ํ˜•์งˆ์„ ์ „๋‹ฌํ•˜๊ธฐ ์œ„ํ•ด ์ธ์œ„์ ์ด๊ณ  ๊ณ„ํš์ ์ธ ๊ต๋ฐฐ๊ฐ€ ์ด๋ฃจ์–ด์ง€๊ณ  ์žˆ๋‹ค [1]. ํ•˜์ง€๋งŒ ๋ณด์œ ํ•˜๊ณ  ์žˆ๋Š” ๊ณ ๋Šฅ๋ ฅ์˜ ์”จ์ˆ˜๋ง ์ˆ˜์— ๋น„ํ•ด ์ด๋“ค๊ณผ ๊ต๋ฐฐ๋ฅผ ์›ํ•˜๋Š” ์”จ์•”๋ง์˜ ์ˆ˜์— ๋ถˆ๊ท ํ˜•์ด ์žˆ์œผ๋ฉด ๊ต๋ฐฐ์œจ์˜ ์ƒ์Šน๊ณผ ๊ณผ๋„ํ•œ ๊ตฌ์•  ํ–‰๋™์— ์˜ํ•ด ์ˆ˜ํƒœ์œจ์˜ ์ €ํ•˜๊ฐ€ ์ผ์–ด๋‚  ์ˆ˜ ์žˆ๋‹ค. ๋ง ๋†์žฅ์—์„œ๋Š” ์ด๋Ÿฌํ•œ ๋ฌธ์ œ์ ์„ ๊ทน๋ณตํ•˜๊ธฐ ์œ„ํ•˜์—ฌ ์”จ์•”๋ง์˜ ์ ์ ˆํ•œ ๊ต๋ฐฐ์‹œ๊ธฐ๋ฅผ ํŒŒ์•…ํ•˜๊ณ  ์ƒ์‹๊ธฐ ๊ฐ์—ผ์ฆ์— ๋Œ€ํ•œ ์ „๋ฐ˜์ ์ธ ์ดํ•ด์™€ ์กฐ๊ธฐ ์ง„๋‹จ ๋ฐ ์ ํ•ฉํ•œ ์น˜๋ฃŒ์™€ ์งˆ๋ณ‘์˜ˆ๋ฐฉ์œผ๋กœ ๋ฒˆ์‹ ํšจ์œจ์„ ๊ทน๋Œ€ํ™”ํ•˜์—ฌ ์ƒ์‚ฐ์„ฑ์„ ํ–ฅ์ƒ์‹œ์ผœ์•ผ ํ•  ๊ฒƒ์œผ๋กœ ๋ณธ๋‹ค. ๋ง์˜ ์ƒ์‹๊ธฐ ๊ฐ์—ผ์ฆ์€ ๋ถ„๋งŒ ๋˜๋Š” ๊ต๋ฐฐ์‹œ์˜ ๋น„์œ„์ƒ์ ์ธ ํ™˜๊ฒฝ ๋ฐ ๊ฒ€์‚ฌ์žฅ๋น„์˜ ์˜ค์—ผ ๋“ฑ์œผ๋กœ ๋ฐœ์ƒ ํ•œ๋‹ค [3]. ์ผ๋ฐ˜์ ์œผ๋กœ ์”จ์ˆ˜๋ง ์™ธ๋ถ€์ƒ์‹๊ธฐ์— ์žˆ๋Š” E. coli, S. zooepidemicus, S. equisimilis, Staphylococcus aureus, Bacillus spp., Klebsiella spp. ๋ฐ Pseudomonas spp.์™€ ๊ฐ™์€ ์„ธ๊ท ๋“ค์ด ์ •์ƒ์ ์œผ๋กœ ์กด์žฌํ•˜๋ฉฐ, ์ด ๊ท ๋“ค์€ ๋ณดํ†ต ๋น„๋ณ‘์›์„ฑ ์„ธ๊ท ์œผ๋กœ ๊ฐ„์ฃผ๋œ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๊ฐ„ํ—์ ์œผ๋กœ ๋ฐœ์ƒํ•˜๋Š” ์”จ์ˆ˜๋ง์˜ ์™ธ๋ถ€์ƒ์‹๊ธฐ ์ •์ƒ ์„ธ๊ท ์ด์˜ ๋ณ€ํ™”๋Š” S. zooepidemicus, K. pneumoniae ๋ฐ P. aeruginosa ๊ฐ™์€ ๊ธฐํšŒ๊ฐ์—ผ ์„ธ๊ท ์˜ ์ฆ์‹์„ ์•ผ๊ธฐํ•œ๋‹ค. ์ด๋ ‡๊ฒŒ ์ฆ์‹๋œ ์„ธ๊ท ๋“ค์€ ๊ฐ์ˆ˜์„ฑ ์žˆ๋Š” ์•”๋ง์— ๋“ค์–ด๊ฐ€๋ฉด ๋ถˆ์ž„์„ ์•ผ๊ธฐํ•œ๋‹ค. ๋”ฐ๋ผ์„œ S. equi ssp zooepidemicus, E. coli, K. pneumoniae ๋ฐ P. aeruginosa๊ฐ€ ์•”๋ง์˜ ์ƒ์‹๊ธฐ ๊ฐ์—ผ์—์„œ ๊ฐ€์žฅ ๋นˆ๋ฒˆํ•˜๊ฒŒ ๋ถ„๋ฆฌ๋ณด๊ณ  ๋˜๊ณ  ์žˆ๋Š” ์ด์œ ์ผ ๊ฒƒ์ด๋‹ค [10, 21, 23].
S. equi ssp zooepidemicus๋Š” Lancefields C๊ตฐ์— ์†ํ•˜๋Š” beta-hemolytic streptococci์˜ ์ผ์ข…์œผ๋กœ์„œ, ๋ชจ๋“  ์•”๋ง๊ณผ ์ˆ˜๋ง์˜ ์™ธ๋ถ€ ์ƒ์‹๊ธฐ ๋ฐ ๊ตฌ๊ฐ•, ์ธ๋‘ ๊ทธ๋ฆฌ๊ณ  ํ˜ธํก๊ธฐ๊ด€ ์ ๋ง‰์— ๊ณต์ƒํ•˜๋Š” ๊ธฐํšŒ๊ฐ์—ผ ์„ธ๊ท ์œผ๋กœ์„œ, ๋ง์ด ๋ฐ”์ด๋Ÿฌ์Šค์— ๊ฐ์—ผ๋˜๊ฑฐ๋‚˜ ์—ด ์ŠคํŠธ๋ ˆ์Šค(heat stress) ๋˜๋Š” ์กฐ์ง์†์ƒ์ด ์ผ์–ด๋‚˜๋ฉด ๋น„์—ผ, ๊ธฐ๊ด€์ง€์—ผ, ํ๋ ด ๋“ฑ์˜ ํ˜ธํก๊ธฐ๊ณ„ํ†ต ์งˆํ™˜์˜ ์›์ธ์ด ๋˜๊ฑฐ๋‚˜ ์ž๊ถ๋‚ด๋ง‰์—ผ์„ ์ผ์œผํ‚ฌ ์ˆ˜ ์žˆ๋‹ค. ๋˜ํ•œ, ์ด ๊ท ์€ ๋ถ„๋งŒ ํ›„ ์ˆ˜์ผ ๋™์•ˆ ์•ฝ 90% ์ด์ƒ์˜ ์•”๋ง์˜ ์ƒ์‹๊ธฐ๋„์— ์กด์žฌํ•˜๋ฉฐ, ์ˆ˜๋ง์˜ ์ •์•ก ์ค‘์—์„œ๋„ ํฌํ”ผ๋‚ด์šฉ๋ฌผ๊ณผ ์„ž์˜€์„ ๋•Œ ํ”ํžˆ ๊ฒ€์ถœ๋˜๊ณ  ์žˆ๋‹ค [3, 21]. ๋ณ‘์›์„ฑ E. coli๋Š” ๊ฐ์—ผ์ด ์ผ์–ด๋‚˜๋Š” ํ•ด๋ถ€ํ•™์ ์ธ ์œ„์น˜์— ๋”ฐ๋ผ ์„ค์‚ฌ์œ ๋ฐœ ๋Œ€์žฅ๊ท , ๋น„๋‡จ์ƒ์‹๊ธฐ ๋ณ‘์›์„ฑ ๋Œ€์žฅ๊ท , ํŒจํ˜ˆ์ฆํ˜• ๋Œ€์žฅ๊ท  ๋“ฑ์œผ๋กœ ๋ถ„๋ฅ˜๋œ๋‹ค. ์ด๋“ค ์ค‘ ์„ค์‚ฌ์œ ๋ฐœ ๋Œ€์žฅ๊ท ์ด ๊ฐ€์žฅ ๋งŽ์ด ์•Œ๋ ค์ ธ ์žˆ์œผ๋ฉฐ heat-labile (LT) enterotoxin ๋ฐ heat-stable (ST) enterotoxin๊ณผ ๊ฐ™์€ ๋ณ‘๋…์„ฑ์ธ์ž์˜ ์ข…๋ฅ˜๋‚˜ ์ฃผ์š” ์ž„์ƒ์ฆ์ƒ์— ๋”ฐ๋ผ์„œ ์žฅ๋…์†Œํ˜• ๋Œ€์žฅ๊ท , ์žฅ๋ณ‘์›์„ฑ ๋Œ€์žฅ๊ท , ์žฅ์ถœํ˜ˆ์„ฑ ๋Œ€์žฅ๊ท , ์žฅ์นจ์ž…์„ฑ ๋Œ€์žฅ๊ท  ๋“ฑ์œผ๋กœ ๋ถ„๋ฅ˜๋œ๋‹ค [19]. ์ด๋Ÿฌํ•œ ์„ค์‚ฌ์œ ๋ฐœ ๋Œ€์žฅ๊ท ๋“ค์€ ๋™๋ฌผ์—์„œ ์„ค์‚ฌ๋ฅผ ์œ ๋ฐœํ•˜์ง€๋งŒ ๋ง์˜ ๋Œ€์žฅ ๋‚ด์— ์ƒ์žฌํ•˜๊ฑฐ๋‚˜ ์„ค์‚ฌ๋ฅผ ์œ ๋ฐœํ•˜๋Š” ๋Œ€์žฅ๊ท ์˜ ํŠน์„ฑ์€ ์•„์ง๋„ ์ž˜ ๋ฐํ˜€์ ธ ์žˆ์ง€ ์•Š๋‹ค [25]. ํ•˜์ง€๋งŒ E. coli๋Š” ๋ง์—์„œ๋„ ์žฅ๊ด€ ๋‚ด์—์„œ ๊ฐ€์žฅ ๋งŽ์ด ๊ด€์ฐฐ๋˜๋Š” ๊ท ์ด๋ฉฐ ์žฅ๋‚ด ์ƒ๋ฆฌํ™œ๋™์— ์ค‘์š”ํ•œ ์—ญํ• ์„ ํ•˜๊ณ , ์œ ์„ ์ด๋‚˜ ์š”๋กœ ๋“ฑ์—์„œ๋Š” ๊ธฐํšŒ๊ฐ์—ผ์„ ์ผ์œผํ‚จ๋‹ค [19]. K. pneumoniae๋Š” Enterobacteriaceae๊ณผ์— ์†ํ•˜๋Š” ๊ทธ๋žŒ์Œ์„ฑ์˜ ํ†ต์„ฑ ํ˜๊ธฐ์„ฑ ๊ฐ„๊ท ์œผ๋กœ ๋‹ค๋ฅธ ์žฅ๋‚ด์„ธ๊ท ๊ณผ ๋‹ฌ๋ฆฌ ์šด๋™์„ฑ์ด ์—†์œผ๋ฉฐ, ์†Œ์—์„œ ์œ ๋ฐฉ์—ผ, ์†ก์•„์ง€ ๋ฐ ๋ง์•„์ง€์—์„œ ํ๋ ด๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ๊ฐœ์—์„œ ์š”๋„๊ฐ์—ผ์˜ ์›์ธ์ด ๋œ๋‹ค [19]. ๋ง์—์„œ ์ด ๊ท ์€ ๋ถ„๋ณ€, ํ˜ธํก๊ธฐ๊ณ„ ๋ฐ ์ƒ์‹๊ธฐ๊ณ„์—์„œ ๋ถ„๋ฆฌ๋˜๋ฉฐ, ์ด 77๊ฐœ์˜ ํ˜‘๋ง‰ํ˜• (capsule type)์ด ์กด์žฌํ•˜๋Š” ๊ฒƒ์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค [21]. ์•”๋ง์˜ ์ƒ์‹๊ธฐ์— ์ฃผ๋กœ ๊ฐ์—ผ๋˜๋Š” K. pneumoniae์˜ ํ˜‘๋ง‰ํ˜•์€ K1, K2 ๋ฐ K5์ด๋ฉฐ ๊ทธ ์ค‘ K1์ด ๊ฐ€์žฅ ๋นˆ๋ฒˆํ•˜๊ฒŒ ๊ฒ€์ถœ๋œ๋‹ค [12]. P. aeruginosa๋Š” ๊ทธ๋žŒ์Œ์„ฑ ๊ฐ„๊ท ์œผ๋กœ ์—ฌ๋Ÿฌ ๋™๋ฌผ์—์„œ ๊ธฐํšŒ๊ฐ์—ผ์„ ์ผ์œผํ‚ค๋Š” ์„ธ๊ท ์ด๋ฉฐ, ํ™•์‚ฐ์„ฑ์ด ์žˆ๋Š” ์ƒ‰์†Œ๋ฅผ ์ƒ์‚ฐํ•œ๋‹ค [19]. ๋น„๋ก ๋ณธ ๊ท ์ฒด๋Š” ๋ถˆ์ž„ ์ฆ์ƒ์ด ์—†๋Š” ์ˆ˜๋ง ์ƒ์‹๊ธฐ์—์„œ๋„ ํ”ํ•˜๊ฒŒ ๋ถ„๋ฆฌ๋˜๋‚˜, ์ ๋ง‰์ด๋‚˜ ํ”ผ๋ถ€ ์†์ƒ ์‹œ, ์ „์—ผ์„ฑ์ด ์ƒ๋‹นํžˆ ๋†’๊ณ  ์น˜๋ฃŒ๊ฐ€ ์–ด๋ ต๊ธฐ ๋•Œ๋ฌธ์— ์ž„์ƒ์ ์œผ๋กœ ๋งค์šฐ ์ค‘์š”ํ•˜๋‹ค [20]. P. aeruginosa๋Š” ๋‹ค๋ฅธ Pseudomonas spp.์™€ ๋‹ค๋ฅด๊ฒŒ ์†์ƒ์„ฑ ํšจ์†Œ ๋ฐ ์šฉํ˜ˆ์†Œ๋ฅผ ์ƒ์‚ฐํ•  ์ˆ˜ ์žˆ๋Š”๋ฐ, ์ด๋Š” ์กฐ์ง์„ ๊ฐ์—ผ์‹œํ‚ค๋Š” ๋Šฅ๋ ฅ์„ ํ–ฅ์ƒ์‹œ์ผœ์ค€๋‹ค.
๊ตญ๋‚ด์—์„œ ์กฐ์‚ฌ๋œ ๋ง ์ƒ์‹๊ธฐ ๊ฐ์—ผ์ฆ์— ๊ด€๋ จ ์—ฐ๊ตฌ๋Š” ๋งŽ์ง€ ์•Š์œผ๋‚˜ ์ตœ๊ทผ Choi ๋“ฑ [4]์€ ์ƒ์‹๊ธฐ ์งˆํ™˜์ด ์˜์‹ฌ๋˜๋Š” ๋”๋Ÿฌ๋ธŒ๋ ›์ข… ์”จ์•”๋ง 100๋‘์˜ ์ƒ์‹๊ธฐ์—์„œ E. coli 93์ฃผ (82.3%), S. equi ssp zooepidemicus 8์ฃผ (7.1%) ๋ฐ P. aeruginosa 12์ฃผ (10.6%) ์ˆœ์œผ๋กœ ๊ฒ€์ถœํ•˜์˜€๋‹ค. Cho ๋“ฑ [3]์€ 3ํšŒ ์ด์ƒ ์ˆ˜ํƒœ๊ฐ€ ๋˜์ง€ ์•Š๊ฑฐ๋‚˜ ์ „๋…„๋„ ๋ถˆ์ž„์ธ ์Šน์šฉ ์”จ์•”๋ง 104๋‘์˜ ์ƒ์‹๊ธฐ์—์„œ E. coli 21์ฃผ (77.8%), S. equi ssp zooepidemicus 4์ฃผ (14.8%) ๋ฐ K. pneumoniae 2์ฃผ (7.4%) ์ˆœ์œผ๋กœ ๋ถ„๋ฆฌํ•˜์˜€๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๋ณธ ์‹คํ—˜์—์„œ๋Š” E. coli (21๊ท ์ฃผ, 35%) ๋ณด๋‹ค๋Š” S. equi ssp zooepidemicus (29๊ท ์ฃผ, 48.3%)์˜ ๋ถ„๋ฆฌ์œจ์ด ๋†’๊ฒŒ ๋‚˜ํƒ€๋‚ฌ์œผ๋ฉฐ K. pneumoniae ๋ฐ P. aeruginosa๊ท ์ด ๋ถ„๋ฆฌ๋˜์–ด ๊ท ์ฃผ์˜ ๋ถ„ํฌ๋„์— ๋‹ค์†Œ๊ฐ„์˜ ์ฐจ์ด๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ์™ธ๊ตญ์˜ ๋ณด๊ณ ์— ์˜ํ•˜๋ฉด, Albihn ๋“ฑ [1]์€ 1996๋…„๋ถ€ํ„ฐ 1997๋…„๊นŒ์ง€ ์Šค์›จ๋ด์˜ 239๋‘ ์•”๋ง์—์„œ ์ž๊ถ์‹œ๋ฃŒ๋ฅผ ์ฑ„์ทจํ•˜์—ฌ ๋ง์˜ ์ˆ˜์ •์— ์˜ํ–ฅ์„ ๋ฏธ์น  ์ˆ˜ ์žˆ๋Š” ์„ธ๊ท ์„ ๋ถ„๋ฆฌํ•˜๊ณ  ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ์„ ์กฐ์‚ฌํ•˜์˜€๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ์ ์–ด๋„ 1์ข… ์ด์ƒ์˜ ์„ธ๊ท ์ด 152๋‘์—์„œ ๋ถ„๋ฆฌ๋˜์—ˆ์œผ๋ฉฐ ์ด๋“ค ์ค‘ E. coli๊ฐ€ 104 ๊ท ์ฃผ๋กœ์„œ ๊ฐ€์žฅ ๋งŽ์•˜๊ณ , รŸ-haemolytic streptococci (31 ๊ท ์ฃผ), fungi (16 ๊ท ์ฃผ)์˜ ์ˆœ์œผ๋กœ ๋ถ„๋ฆฌ๋˜์—ˆ์œผ๋ฉฐ, ๊ทธ ์™ธ K. pneumoniae (1 ๊ท ์ฃผ)๋ฅผ ํฌํ•จํ•œ ์žฅ๋‚ด์„ธ๊ท ์ด 8๊ท ์ฃผ๊ฐ€ ๋ถ„๋ฆฌ๋˜์—ˆ๋‹ค. Davis ๋“ฑ [7]์€ ๋ฏธ๊ตญ ํ”Œ๋กœ๋ฆฌ๋‹ค ์ง€์—ญ์˜ ๋ง 7,665๋‘๋ฅผ ๋Œ€์ƒ์œผ๋กœ 2003๋…„๋ถ€ํ„ฐ 2008๋…„๊นŒ์ง€ ์ž๊ถ swab์‹œ๋ฃŒ, ์ž๊ถ์„ธ์ฒ™์•ก, ์ƒ๊ฒ€์‹œ๋ฃŒ 8,296์ ์œผ๋กœ๋ถ€ํ„ฐ ์„ธ๊ท ์„ ๋ถ„๋ฆฌํ•˜๊ณ  ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์˜€๋‹ค. ๊ฒ€์‚ฌ ๋Œ€์ƒ ๋ง์€ ๊ต๋ฐฐ ์ •๊ธฐ๊ฒ€์‚ฌ ๋Œ€์ƒ์ด๊ฑฐ๋‚˜ ๋ฒˆ์‹์žฅ์• ๊ฐ€ ์žˆ๋Š” ๋ง์ด์—ˆ๋‹ค. ์ž ์žฌ์ ์ธ ๋ณ‘์›์„ฑ ์„ธ๊ท ์ด ๋ถ„๋ฆฌ๋œ 2,576 ์‹œ๋ฃŒ (31%)์—์„œ, ฮฒ-hemolytic S. equi ssp zooepidemicus ๋ฐ E. coli๊ฐ€ ๊ฐ๊ฐ 733์ฃผ (29%) ๋ฐ 729์ฃผ (28%)๋กœ ๊ฐ€์žฅ ๋งŽ์ด ๋ถ„๋ฆฌ๋˜์—ˆ๋‹ค. Clark ๋“ฑ [7]์€ ์บ๋‚˜๋‹ค ์ง€์—ญ์˜ ๋ง 1,323๋‘๋ฅผ ๋Œ€์ƒ์œผ๋กœ 1998๋…„๋ถ€ํ„ฐ 2003๋…„๊นŒ์ง€ ๊ธฐ๊ด€ (trachea), ์ž๊ถ (uterine), ์ƒ์ฒ˜๋ถ€์œ„ (wound), ํ›„๋‚ญ (guttural pouch), ์ฒ˜์น˜ ํ›„ (postprocedural), ๋‡จ (urine), ์•ˆ๊ตฌ (eye), ๋ง์•„์ง€ ํŒจํ˜ˆ์ฆ, ๋ฐฐ๊ผฝ (umbilicus), ํ‰์ˆ˜ (pleural fluid)์—์„œ ๊ฐ๊ฐ 334, 87, 83, 49, 53, 37, 29, 22, 20, 23, 17, 15์ฃผ๋กœ์„œ ์ด 334 ๊ท ์ฃผ๋ฅผ ๋ถ„๋ฆฌํ•˜์˜€๋‹ค. ๊ทธ ์ค‘ S. equi ssp zooepidemicus 221์ฃผ, E. coli 82์ฃผ, Actinobacillus suis 69์ฃผ, alpha-hemolytic streptococci 45์ฃผ, Enterobacter spp. 42์ฃผ ์ˆœ์œผ๋กœ ๋ถ„๋ฆฌ ๋˜์—ˆ์œผ๋ฉฐ, uterine ์—์„œ๋Š” S. equi ssp zooepidemicus 31์ฃผ, E. coli 12์ฃผ๋ฅผ ๋ถ„๋ฆฌํ•˜์˜€๋‹ค.
์ด์™€ ๊ฐ™์€ ๋ง์˜ ์ž๊ถ์ด๋‚˜ ์งˆ์—์„œ ๋ถ„๋ฆฌ๋˜๋Š” ์ฃผ์š” ์ž ์žฌ์  ๋ณ‘์›์„ฑ๊ท ์€ ์—ฐ๊ตฌ๋ฅผ ์ˆ˜ํ–‰ํ•œ ๊ตญ๊ฐ€๋‚˜ ์ง€์—ญ์— ๋”ฐ๋ผ ๋‹ค์†Œ๊ฐ„์˜ ์ฐจ์ด๋Š” ์žˆ์—ˆ์œผ๋‚˜ ๋ณธ ์—ฐ๊ตฌ์—์„œ์™€ ๋น„์Šทํ•˜๊ฒŒ E. coli์™€ S. equi ssp zooepidemicus๊ฐ€ ๊ฐ€์žฅ ๋†’์€ ๋น„์ค‘์„ ์ฐจ์ง€ํ•˜์˜€๊ณ  K. pneumonia์™€ P. aeruginosa์˜ ๋ถ„๋ฆฌ์œจ์€ ๋‚ฎ๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๊ฒ€์‚ฌํ•œ ์‹œ๋ฃŒ์˜ ์ˆ˜์— ๋น„ํ•˜๋ฉด ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” K. pneumonia์™€ P. aeruginosa์˜ ๋ถ„๋ฆฌ์œจ์€ ๋†’์€ ํŽธ์œผ๋กœ ๋ณผ ์ˆ˜ ์žˆ์œผ๋ฉฐ, ์ด๋Ÿฌํ•œ ์ฐจ์ด๋Š” ๊ฒ€์‚ฌ๋Œ€์ƒ์ธ ๋ง์˜ ์ƒํƒœ ์ฆ‰, ์ƒ์‹๊ธฐ ๊ด€๋ จ ์ž„์ƒ์ฆ์ƒ ์œ ๋ฌด, ์‹œ๋ฃŒ์ฑ„์ทจ ๊ณผ์ • ๋˜๋Š” ์ฑ„์ทจ ํ›„ ์‹คํ—˜์‹ค๋กœ ์šด๋ฐ˜ํ•˜๋Š” ์‹œ๊ฐ„ ๋“ฑ์— ๊ธฐ์ธํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋œ๋‹ค. ํŠนํžˆ, Albihn ๋“ฑ [1]์˜ ๋ณด๊ณ ์— ์˜ํ•˜๋ฉด รŸ-haemolytic streptococci๋Š” ์ €์ˆ˜ํƒœ (repeat breeding) ๋ณด๋‹ค๋Š” ์ž๊ถ๋‚ด๋ง‰์—ผ์— ์ฃผ๋กœ ๊ด€์—ฌํ•˜๋ฉฐ, E. coli๋Š” ์ €์ˆ˜ํƒœ ๋ฐ ์ž๊ถ๋‚ด๋ง‰์—ผ์— ๋ชจ๋‘ ๊ด€์—ฌํ•œ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์ž„์ƒ์ ์ธ ์ž๊ถ๋‚ด๋ง‰์—ผ์— ๊ด€ํ•œ ๋ถ„์„์€ ํ•˜์ง€ ์•Š์•˜์œผ๋‚˜ รŸ-haemolytic streptococci ์ค‘์— ํ•˜๋‚˜์ธ S. equi ssp zooepidemicus๊ฐ€ ๊ฐ€์žฅ ๋งŽ์ด ๊ฒ€์ถœ๋˜์–ด ์ œ์ฃผ๋„ ๋‚ด ๋ง์˜ ๋ฒˆ์‹์žฅ์•  ํ˜น์€ ์ž๊ถ๋‚ด๋ง‰์—ผ์— ์ค‘์š”ํ•œ ์—ญํ• ์„ ํ•˜๊ณ  ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค. ๊ฒŒ๋‹ค๊ฐ€ S. equi ssp zooepidemicus๋Š” ์‚ฌ๋žŒ์„ ํฌํ•จํ•˜์—ฌ ๊ด‘๋ฒ”์œ„ํ•œ ๋™๋ฌผ์— ๊ฐ์—ผ๋  ์ˆ˜ ์žˆ๊ณ  ํŠนํžˆ ์ตœ๊ทผ์—๋Š” ๊ฐœ์™€ ๊ณ ์–‘์ด์—์„œ ๋งค์šฐ ์‹ฌ๊ฐํ•œ ํ˜ธํก๊ธฐ ์งˆํ™˜์„ ์œ ๋ฐœํ•˜๋Š” ์‹ ์ข… ์งˆ๋ณ‘์˜ ์›์ธ์ฒด์ด๋‹ค [13]. ๋‹ค์Œ์œผ๋กœ ๋งŽ์ด ๋ถ„๋ฆฌ๋œ ๋Œ€์žฅ๊ท ์˜ ๊ฒฝ์šฐ์—๋„ ๋ฐ˜๋ณต์ ์ธ ๊ต๋ฐฐ๋ฅผ ํ•˜๊ฒŒ ํ•˜๋Š” ์ฃผ์š” ๊ท ์œผ๋กœ ๋ณด๊ณ ๋˜์–ด ์žˆ๋‹ค [5]. ๋ง์˜ ์ž๊ถ์—ผ๊ณผ ๊ด€๋ จ๋œ K. pneumoniae์˜ ์ฃผ์š” ํ˜‘๋ง‰ํ˜•์˜ ๊ฒฝ์šฐ, ์ˆ˜๋ง์˜ ์™ธ๋ถ€์ƒ์‹๊ธฐ์—์„œ๋Š” K5 ๋ฐ K7์ด ๊ฐ€์žฅ ๋งŽ์ด ๊ฒ€์ถœ๋˜๊ณ  K1์€ ๊ฑฐ์˜ ์กด์žฌํ•˜์ง€ ์•Š๋Š”๋‹ค. ๋˜ํ•œ ์ž๊ถ์—ผ ๋ฐœ์ƒ ์‹œ ๋”๋Ÿฌ๋ธŒ๋ ›์ข…์—์„œ๋Š” ์ฃผ๋กœ K1์ด ๊ฒ€์ถœ๋˜๋Š” ๊ฒƒ๊ณผ ๋‹ฌ๋ฆฌ Draft์ข…์—์„œ๋Š” K39๊ฐ€ ๊ฒ€์ถœ๋˜์—ˆ๋‹ค๊ณ  ํ•˜์˜€๋‹ค [>12, 19]. ๋”ฐ๋ผ์„œ ํ–ฅํ›„ ์ œ์ฃผ๋„ ๋‚ด ๋ง์—์„œ ๋ถ„๋ฆฌ๋˜๋Š” S. equi ssp zooepidemicus๊ฐ€ ์‚ฌ๋žŒ์ด๋‚˜ ๋‹ค๋ฅธ ๋™๋ฌผ๋“ค์—๊ฒŒ ์–ด๋– ํ•œ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š”๊ฐ€์— ๊ด€ํ•œ ์ถ”๊ฐ€์ ์ธ ์—ฐ๊ตฌ๊ฐ€ ์ˆ˜ํ–‰๋˜์–ด์•ผ ํ•  ๊ฒƒ์ด๋ฉฐ, ๋ณธ ์—ฐ๊ตฌ์—์„œ ๋ถ„๋ฆฌ๋œ K. pneumoniae์˜ ํ˜‘๋ง‰ํ˜•์„ ์กฐ์‚ฌํ•˜์—ฌ ์ด ๊ท ์ด ์–ด๋””์—์„œ ์œ ๋ž˜๋˜์—ˆ์ง€๋ฅผ ์กฐ์‚ฌ ์—ฐ๊ตฌํ•  ํ•„์š”๊ฐ€ ์žˆ์„ ๊ฒƒ์ด๋‹ค.
์•”๋ง์—์„œ์˜ ํ›„์‚ฐ์ •์ฒด ๋ฐ ๋ถ„๋งŒ ํ›„ ์ž๊ถ์—ผ์€ ์‹ฌ๊ฐํ•œ ํ•ฉ๋ณ‘์ฆ์„ ์ผ์œผํ‚ค๊ธฐ ๋•Œ๋ฌธ์— ํ•ญ์ƒ๋ฌผ์งˆ ์น˜๋ฃŒ๊ฐ€ ํ•„์š”ํ•˜๋‹ค [17]. ๊ธด๋ฐ•ํ•œ ์œ ์‚ฐ์€ ๋Œ€๋ถ€๋ถ„ ์„ธ๊ท ์„ฑ ํƒœ๋ฐ˜์—ผ์ด ์›์ธ์ด๊ธฐ์— ํ•ญ์ƒ์ œ ์น˜๋ฃŒ๊ฐ€ ํ•„์š”ํ•˜๋ฉฐ, ์•”๋ง์—์„œ ์ž๊ถ๋‚ด๋ง‰์—ผ์€ ๋ถˆ์ž„์˜ ์ฃผ์š” ์›์ธ์œผ๋กœ ๊ฐ„์ฃผ๋˜์ง€๋งŒ ๋Œ€๊ฐœ๋Š” ๊ณผ์ž‰์ง„๋‹จ ๋˜๊ณ  ์น˜๋ฃŒํ•  ๊ฐ€๋Šฅ์„ฑ๋„ ์žˆ๋‹ค. ๋ง์—์„œ ์ƒ์‹๊ธฐ๊ด€์˜ ์ง•ํ›„์— ๋Œ€ํ•œ ํ•ญ์ƒ์ œ ์น˜๋ฃŒ์˜ ์ฐจ๋ณ„ํ™”์— ๊ด€ํ•œ ํšจ๊ณผ๋ฅผ ์•Œ ์ˆ˜ ์žˆ๋Š” ๊ณผํ•™์ ์ธ ์ •๋ณด๋Š” ๋ฏธํกํ•˜๊ณ  ์ข…์ข… ๋‹จ์ผ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋‚˜ ๊ฒฝํ—˜์— ์˜์กดํ•˜์—ฌ ์น˜๋ฃŒ๋ฐฉ๋ฒ•์ด ์ถ”์ฒœ๋œ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ ๋ถ„๋ฆฌํ•œ ์„ธ๊ท ๋“ค์˜ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ๋Š” ๊ตญ๋‚ด ๋ง์—์„œ ๋ฐœ์ƒ๋  ์ˆ˜ ์žˆ๋Š” ๋ง์˜ ๋ถˆ์ž„์„ ํฌํ•จํ•œ ์ƒ์‹๊ธฐ ๊ด€๋ จ ์„ธ๊ท ์„ฑ ์งˆํ™˜ ์น˜๋ฃŒ๋ฅผ ์œ„ํ•œ ๊ธฐ์ดˆ์ž๋ฃŒ๊ฐ€ ๋  ๊ฒƒ์ด๋‹ค. ๊ตญ๋‚ด์—์„œ Choi ๋“ฑ [4]๊ณผ Cho ๋“ฑ [3]์ด ๋ง์˜ ์งˆ ์ ๋ง‰์—์„œ ๋ถ„๋ฆฌํ•œ ๊ท ์„ ๋Œ€์ƒ์œผ๋กœ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์˜€์œผ๋‚˜ ๋ถ„๋ฆฌ๋œ ๊ท ์˜ ์ข…๋ฅ˜๋‹น 1๊ฐœ์˜ ๊ท ์ฃผ๋ฅผ ๋Œ€์ƒ์œผ๋กœ ํ•˜๊ฑฐ๋‚˜ ๋Œ€ํ‘œ์ ์ธ ์†Œ์ˆ˜์˜ ๊ท  ์ค‘ 1๊ท ์ฃผ์”ฉ๋งŒ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๋ฅผ ์‹ค์‹œํ•˜์—ฌ ๋ณธ ์—ฐ๊ตฌ์™€ ๋น„๊ต ๋ถ„์„ํ•˜๋Š” ๋ฐ์—๋Š” ํ•œ๊ณ„๊ฐ€ ์žˆ์—ˆ๋‹ค. ์™ธ๊ตญ์˜ ๋ณด๊ณ ์— ์˜ํ•˜๋ฉด, Albihn ๋“ฑ [1]์€ 10์ข…๋ฅ˜์˜ ํ•ญ์ƒ์ œ์— ๋Œ€ํ•œ E. coli์˜ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๋ฅผ ์‹ค์‹œํ•œ ๊ฒฐ๊ณผ enrofloxacin์— ๋‚ด์„ฑ์„ ๊ฐ€์ง€๋Š” ๊ท ์€ ์ „ํ˜€ ์—†์—ˆ๊ณ , ampicillin (86%), chloramphenicol (94%), enrofloxacin (97%), gentamicin (96%), neomycin (93%), nitrofurantoin (93%), oxytetracycline (81%), sulphamethoxazole-trimethoprim (85%)์˜ ๊ฐ์ˆ˜์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๊ณ , cephalothin (39%), streptomycin (22%), ampicillin (11%), sulphamethoxazole-trimethoprim (15%) ๋ฐ ampicillin (11%)์— ๋Œ€ํ•œ ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค๊ณ  ํ•˜์˜€๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ ๋ณธ ์—ฐ๊ตฌ์—์„œ ๋ถ„๋ฆฌํ•œ E. coli์™€ K. pneumoniae๋„ chloramphenicol, enrofloxacin, gentamicin์— ๋Œ€ํ•ด์„œ๋Š” ๋†’์€ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€์œผ๋‚˜, 1์„ธ๋Œ€ cethalosporin ๊ณ„์—ด์ธ cefazolin (95.2-100%)์— ๋Œ€ํ•œ ๊ฐ์ˆ˜์„ฑ์ด ๋†’์•˜๊ณ , neomycin (52.5, 50%), kanamycin (47.6, 66.6%), oxytetracycline (15.0, 16.7%), tetracycline (14.3, 16.7%)์— ๋Œ€ํ•ด์„œ๋Š” ๋‚ฎ์€ ๊ฐ์ˆ˜์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ๋˜ํ•œ Albihn ๋“ฑ [1]์€ รŸ-haemolytic streptococci ๊ฐ€ ampicillin, cephalothin, chloramphenicol, erythromycin, penicillin G ๋ฐ spiramycin์— 100% ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์ธ ๋ฐ˜๋ฉด, gentamicin (52%), neomycin (39%), oxytetracycline (23%)์—๋Š” ๋น„๊ต์  ๋†’์€ ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค๊ณ  ํ•˜์˜€๋‹ค. ํ•˜์ง€๋งŒ, ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” S. equi ssp zooepidemicus ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๊ฒฐ๊ณผ, ฮฒ-lactamase ์–ต์ œ์ œ๊ฐ€ ํ•จ์œ ๋œ amoxicillin-clavulanic acid์—๋Š” ๋ชจ๋‘ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€๋‹ค. ๊ทธ ์™ธ ํŽ˜๋‹ˆ์‹ค๋ฆฐ๊ณ„์ธ ampicillin (60.7%) ๋ฐ penicillin (25%)์—์„œ๋Š” ๋‚ฎ์€ ๊ฐ์ˆ˜์„ฑ์„ ๋ณด์˜€๊ณ , ํŠนํžˆ penicillin์—๋Š” 75%์˜ ๋ถ„๋ฆฌ๊ท ์ฃผ๊ฐ€ ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ์œผ๋ฉฐ, ์ „๋ฐ˜์ ์œผ๋กœ aminoglycoside ๊ณ„์—ด (gentamicin 55%, kanamycin 100%)์—์„œ๋Š” ๋†’์€ ๋‚ด์„ฑ์„ ๋ณด์—ฌ ์Šค์›จ๋ด์—์„œ ๋ถ„๋ฆฌ ๋ณด๊ณ ๋œ ๋ง ์ƒ์‹๊ธฐ๊ด€๋ จ ๋ณ‘์›์ฒด์˜ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ์˜ ๊ฒฐ๊ณผ์™€๋Š” ํฐ ์ฐจ์ด๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค.
Davis ๋“ฑ [7]์˜ ๋ณด๊ณ ์— ์˜ํ•˜๋ฉด E. coli๋Š” sulfonamide-trimethoprim ๋ฐ ampicillin์— ๊ฐ€์žฅ ๋‚ด์„ฑ์ด ๋†’์•˜๊ณ , amikacin, enrofloxacin์— ๊ฐ์ˆ˜์„ฑ์ด ๊ฐ€์žฅ ๋†’์•˜๋‹ค. ์ด ๊ฒฐ๊ณผ๋Š” ๋ณธ ์—ฐ๊ตฌ๊ฒฐ๊ณผ์™€ ๋น„๊ตํ•˜์˜€์„ ๋•Œ E. coli ๊ฐ์ˆ˜์„ฑ์€ ์ „๋ฐ˜์ ์œผ๋กœ ๋น„์Šทํ•˜์˜€์œผ๋‚˜, suflonamide-trimethoprim ๋Œ€ํ•œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ ๊ฒฐ๊ณผ๋Š” E. coli๋Š” 100% ๊ฐ์ˆ˜์„ฑ์„, K. pneumoniae๋Š” 100% ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด์–ด ๋™์ผํ•œ ๊ทธ๋žŒ์Œ์„ฑ ๊ฐ„๊ท ์ž„์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ๊ท ์ฃผ๋ณ„, ๋ถ„๋ฆฌ ๊ตญ๊ฐ€๋ณ„์—์„œ๋„ ์ƒ์ดํ•œ ๊ฒฐ๊ณผ๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. Davis ๋“ฑ [7]์€ ๋ถ„๋ฆฌํ•œ S. equi ssp zooepidemicus๊ฐ€ oxytetracycline๊ณผ enrofloxacin์— ๋‚ด์„ฑ์ด ๊ฐ€์žฅ ๋†’์•˜๊ณ  ceftiofur์™€ clavulanic acid๊ฐ€ ์žˆ๊ฑฐ๋‚˜ ์—†๋Š” ticarcillin์— ๊ฐ์ˆ˜์„ฑ์ด ๊ฐ€์žฅ ๋†’์•˜๋‹ค๊ณ  ํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋„ S. equi ssp zooepidemicus ๊ฐ์ˆ˜์„ฑ ๊ฒฐ๊ณผ๋Š” enrofloxacin๊ณผ oxytetracycline์— ๊ฐ๊ฐ 82.8%์™€ 89.7%๊ฐ€ ๋‚ด์„ฑ์„ ๋ณด์˜€๊ณ , cefazolin (100%), cefuroxime (100%), ceftiofur (75.9%), amoxicillin-clavulanic acid (100%)์— ๋†’์€ ๋‚ด์„ฑ์„ ๋ณด์—ฌ ์œ ์‚ฌํ•œ ๊ฒฐ๊ณผ๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ๊ทธ๋Ÿฌ๋‚˜ enrofloxacin์€ ๊ตญ๋‚ด์—์„œ ๋ง์˜ ์งˆ๋ณ‘ ์น˜๋ฃŒ์— ๊ฑฐ์˜ ์‚ฌ์šฉํ•˜์ง€ ์•Š์ง€๋งŒ ๋†’์€ ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ธ ์ ์€ ํŠน์ดํ•  ๋งŒ ํ•˜์˜€์œผ๋ฉฐ ๊ทธ ์ด์œ ๋Š” ํฌ๊ฒŒ ๋‘ ๊ฐ€์ง€๋กœ ๋ณผ ์ˆ˜ ์žˆ๋‹ค. ํ•˜๋‚˜๋Š” ์ด ์•ฝ์ œ๋ฅผ ๋งŽ์ด ์‚ฌ์šฉํ•˜๋Š” ๋™๋ฌผ๋กœ๋ถ€ํ„ฐ ์•ฝ์ œ ๋‚ด์„ฑ๊ท ์ด ๋ง์—๊ฒŒ ์˜ค์—ผ๋œ ๊ฒƒ์ด๋ฉฐ ๋‹ค๋ฅธ ํ•˜๋‚˜๋Š” ์œ ์‚ฌ ์•ฝ์ œ์— ๋Œ€ํ•˜์—ฌ ๊ณตํ†ต์œผ๋กœ ๋‚ด์„ฑ์„ ๋ณด์ด๋Š” ๊ต์ฐจ๋‚ด์„ฑ์ด๋‹ค. ๊ธฐ์กด ์—ฐ๊ตฌ๋“ค์„ ํ†ตํ•ด์„œ ๋ณผ ๋•Œ ์ด์™€ ๊ฐ™์€ ๊ฒฐ๊ณผ๋Š” ํ›„์ž๊ฐ€ ๋” ์œ ๋ ฅํ•œ ์ด์œ ์ผ ์ˆ˜ ์žˆ๊ณ  ์ด ์—ฐ๊ตฌ์˜ ๊ฒฝ์šฐ ๋ถ„๋ฆฌํ•œ S. equi ssp zooepidemicus๊ฐ€ enrofloxacin๊ณผ ๊ฐ™์€ ๊ณ„์—ด์ธ ciprofloxacin์—๋„ 55.6%๊ฐ€ ๋‚ด์„ฑ์„ ๋ณด์˜€๊ณ  ๊ฐ์ˆ˜์„ฑ์ด ์žˆ๋Š” ๊ท ์ฃผ๋Š” ์ „ํ˜€ ์—†์—ˆ๊ธฐ ๋•Œ๋ฌธ์— ๊ต์ฐจ ๋‚ด์„ฑ์ด ํ˜•์„ฑ๋˜์—ˆ์„ ๊ฐ€๋Šฅ์„ฑ์ด ์žˆ์„ ๊ฒƒ์ด๋‹ค.
Clark ๋“ฑ [5]์€ 82์ฃผ์˜ E. coli์— ๋Œ€ํ•œ ๊ฐ์ˆ˜์„ฑ ๊ฒ€์‚ฌ๊ฒฐ๊ณผ, amikacin (100%), ceftiofur (94%), enrofloxacin (91%)์— ๋†’์€ ๊ฐ์ˆ˜์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๊ณ  ampicillin (62%), cephalothin (50%), neomycin (61%)์— ์ค‘๋“ฑ๋„์˜ ๊ฐ์ˆ˜์„ฑ์„ ๋‚˜ํƒ€๋‚ด์–ด ๋ณธ ์—ฐ๊ตฌ์—์„œ cephazolin (95.2%)์˜ ๊ฐ์ˆ˜์„ฑ์ด ๋†’์•˜๋˜ ๊ฒƒ์„ ์ œ์™ธํ•˜๋ฉด ๋น„์Šทํ•œ ๊ฐ์ˆ˜์„ฑ ๊ฒฐ๊ณผ๋ฅผ ๋‚˜ํƒ€๋‚ด๊ณ  ์žˆ๋‹ค. ๋˜ํ•œ 221์ฃผ์˜ S. equi ssp zooepidemicus์— ๋Œ€ํ•˜์—ฌ ๊ฐ์ˆ˜์„ฑ๊ฒ€์‚ฌ๋ฅผ ์‹ค์‹œํ•œ ๊ฒฐ๊ณผ ampicillin (92%), ceftiofur (99%), cephalothin (99%), enrofloxacin (91%), penicillin (95%), erythromycin (91%)์— ๋†’์€ ๊ฐ์ˆ˜์„ฑ์ด ๋‚˜ํƒ€๋‚ด์—ˆ๊ณ , neomycin (20%), tetracycline (59%), amikacin (5%)์— ๋‚ฎ์€ ๊ฐ์ˆ˜์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ์ด๋Š” enrofloxacin์— ๋Œ€ํ•œ ๊ฐ์ˆ˜์„ฑ ์ •๋„๋ฅผ ์ œ์™ธํ•˜๋ฉด Albihn ๋“ฑ [1]์˜ ๋ณด๊ณ ์™€ ๋น„์ˆซํ•˜์—ฌ ๋ณธ ์—ฐ๊ตฌ์—์„œ์˜ ๊ฒฐ๊ณผ์™€ ํฐ ์ฐจ์ด๋ฅผ ๋ณด์ด๊ณ  ์žˆ๋‹ค.
์ถ”์ฒœ๋˜๊ณ  ์žˆ๋Š” ๋ง ์ž๊ถ๋‚ด๋ง‰์—ผ์˜ ์น˜๋ฃŒ๋ฐฉ๋ฒ•์€ ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์ƒ๋ฆฌ์‹์—ผ์ˆ˜๋กœ ์ž๊ถ ๋‚ด ์ด๋ฌผ์ œ๊ฑฐ ๋ฐ ์„ธ์ฒ™์„ ํ•˜๊ณ , ์ž๊ถ ๋‚ด ๊ณผ๋‹คํ•œ ์ ์•ก์ด๋‚˜ ์ƒ๋ฌผ๋ง‰ (biofilms)์„ ๋…น์ผ ์ˆ˜ ์žˆ๋Š” ๋ฎค์ฝ”๋‹ค๋‹น์ฒด ๊ฐ€์ˆ˜๋ถ„ํ•ด์ฒ˜๋ฆฌ(mucolytics)๋ฅผ ํ•จ์œผ๋กœ์จ ํ•ญ์ƒ์ œ ์นจํˆฌ๋ฅผ ๋†’์ธ๋‹ค. ๊ทธ๋ฆฌ๊ณ  ์ž๊ถ์„ ์ˆ˜์ถ•์‹œํ‚ค๋Š” ๋ถ„๋งŒ์ด‰์ง„ ํ˜ธ๋ฅด๋ชฌ์„ ํˆฌ์—ฌํ•˜์—ฌ ์ž๊ถ ๋‚ด ์ด๋ฌผ์˜ ๋ฐฐ๋†์„ ์›ํ™œํ•˜๊ฒŒ ํ•œ๋‹ค. ์„ธ๊ท ์„ ์‚ฌ๋ฉธ์‹œํ‚ค๋Š” ํ•ญ์ƒ๋ฌผ์งˆ์„ ๋Œ€๊ฐœ๋Š” ๋ฐœ์ •๊ธฐ ๋™์•ˆ์— ์ž๊ถ ๋‚ด์— ํˆฌ์—ฌํ•œ๋‹ค. ์ž๊ถ๋‚ด๋ง‰์—ผ ์น˜๋ฃŒ์— ์ตœ๊ณ ๋กœ ์ ํ•ฉํ•œ ํ•ญ์ƒ์ œ๋ฅผ ์‚ฌ์šฉํ•  ์ˆ˜ ์žˆ๋Š” ์ฒด๊ณ„์ ์ธ ์‹คํ—˜์€ ๊ฑฐ์˜ ์•Œ๋ ค์ ธ ์žˆ์ง€ ์•Š์ง€๋งŒ, ํ˜„์žฅ์—์„œ ์–ป์–ด์ง„ ๊ฒฝํ—˜์„ ํ† ๋Œ€๋กœ ์น˜๋ฃŒ ํ•˜๋Š” ๊ฒŒ ์ถ”์ฒœ ๋œ๋‹ค [17]. ฮฒ-hemolytic streptococci๋Š” ์‹คํ—˜์‹ค ๋‚ด ๊ฒ€์‚ฌ์—์„œ penicillin์— ๊ฐ์ˆ˜์„ฑ์ด ์žˆ๋‹ค. E. coli๊ฐ€ ๋ฐฐ์–‘๋œ๋‹ค๋ฉด ๋ถ„๋ฆฌ๊ท ์ด ์‹คํ—˜์‹ค ๋‚ด ๊ฒ€์‚ฌ์—์„œ ๋‚ด์„ฑ์ด ์—†๋Š” ํ•œ gentamicin์ด ์„ ํƒ๋˜๋Š” ํ•ญ์ƒ์ œ์ด๋‹ค. Pseudomonas์™€ Klebsiella spp.๋Š” ํ•ญ์ƒ์ œ ๋‚ด์„ฑ์œจ์ด ๋†’์•„์„œ ์ด๋“ค์„ ์ œ๊ฑฐํ•˜๋Š”๋ฐ ์–ด๋ ค์›€์ด ์žˆ๋‹ค [17, 19]. Gentamicin์— ์ €ํ•ญ์„ฑ์ด ์žˆ๋Š” ๊ทธ๋žŒ ์Œ์„ฑ๊ท ์— ์˜ํ•œ ์ž๊ถ๋‚ด๋ง‰์—ผ์˜ ์น˜๋ฃŒ์ œ๋กœ ์ถ”์ฒœ๋˜๋Š” ํ•ญ์ƒ์ œ๋Š” amikacin sulphate, polymyxin B, neomycin sulphate, ampicillin, carbenicillin, kanamycin sulphate ๋“ฑ์ด ์žˆ๋‹ค. ๊ด‘๋ฒ”์œ„ ํ•ญ์ƒ์ œ์ธ ceftiofur ๋ฐ clavulanic acid๊ฐ€ ์žˆ๊ฑฐ๋‚˜ ์—†๋Š” ticarcillin์ด ์ผ๋ฐ˜์ ์œผ๋กœ ์•”๋ง์—์„œ ์‚ฌ์šฉ๋˜๋ฉฐ trimethoprimโ€“sulphonamide ์ œ์ œ๊ฐ€ ์ „์‹  ํˆฌ์—ฌ๋˜๋ฉฐ ๊ฒฝ๊ตฌ์šฉ์œผ๋กœ ์‚ฌ์šฉ๋˜๋Š” ์œ ์ผํ•œ ์ œ์ œ์ด๋‹ค [18]. ๊ทธ๋Ÿฌ๋‚˜ ๋ณธ ์—ฐ๊ตฌ์—์„œ ๋ถ„๋ฆฌ๋œ ฮฒ-hemolytic streptococci์ธ S. equi ssp zooepidemicus๋Š” penicillin์— ๋†’์€ ๋‚ด์„ฑ์„ ๋ณด์˜€์œผ๋ฉฐ, ceftiofur์— ๋Œ€ํ•œ ๊ฐ์ˆ˜์„ฑ์€ S. equi ssp zooepidemicus๊ฐ€ 75.9%, E. coli๋Š” 61.9%, K. pneumoniae๋Š” 50%์˜€์œผ๋ฉฐ P. aeruginosa๋Š” ๊ฐ์ˆ˜์„ฑ์ด ์žˆ๋Š” ๊ท ์ฃผ๊ฐ€ ์ „ํ˜€ ์—†์—ˆ๋‹ค. ํŠนํžˆ ๋ถ„๋ฆฌ๊ท ์ˆ˜๋Š” ๋งŽ์ง€ ์•Š์•˜์œผ๋‚˜ K. pneumoniae 6๊ท ์ฃผ์™€ P. aeruginosa 4 ๊ท ์ฃผ๋Š” ๋ชจ๋‘ sulfamethoxazoltrimethoprim์— ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด์–ด ๊ธฐ์กด ์—ฐ๊ตฌ์™€๋Š” ํฐ ์ฐจ์ด๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ์„ ์ฒœ์ ์œผ๋กœ ฮฒ-lactam ๊ณ„์—ด ํ•ญ์ƒ์ œ์— ๋‚ด์„ฑ์„ ๊ฐ€์ง€๋Š” P. aeruginosa๋Š” gentamin์— 4๊ท ์ฃผ๊ฐ€ ๋ชจ๋‘ ๋‚ด์„ฑ์„ ๋ณด์ด์ง€ ์•Š์•˜์„ ๋ฟ cefazolin, cefuroxime, florfenicol์—๋Š” ๋ชจ๋‘ ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค.
๊ฒฐ๊ณผ์ ์œผ๋กœ ์ œ์ฃผ๋„ ๋‚ด ๋ง์˜ ์ƒ์‹๊ธฐ๊ด€์—์„œ ๋ถ„๋ฆฌ๋œ ์ž ์žฌ์ ์ธ ๋ณ‘์›์„ฑ ์„ธ๊ท ์˜ ๊ฒฝ์šฐ ๋‹ค์–‘ํ•œ ํ•ญ์ƒ์ œ์— ๋‚ด์„ฑ์„ ๋‚˜ํƒ€๋‚ด๋Š” ๋น„์œจ์ด ๊ธฐ์กด์˜ ์—ฐ๊ตฌ ๋ณด๊ณ ์— ๋น„ํ•˜์—ฌ ๋†’๊ณ  ๊ทธ๋žŒ์–‘์„ฑ๊ท ์ธ S. equi ssp zooepidemicus์™€ ๊ทธ๋žŒ์Œ์„ฑ๊ท ์ธ E. coli ๋˜๋Š” K. pneumoniae๊ฐ€ ๋™์‹œ์— ๋ถ„๋ฆฌ๋˜๋Š” ๊ฒฝ์šฐ๋„ ์žˆ์–ด ๋‹จ์ผ ํ•ญ์ƒ์ œ์˜ ์‚ฌ์šฉ์œผ๋กœ ์˜ˆ๋ฐฉ ๋ฐ ์น˜๋ฃŒ๋ฅผ ์‹œ๋„ํ•˜๋Š” ๊ฒƒ๋ณด๋‹ค๋Š” ๋‘๊ฐ€์ง€ ์ด์ƒ์˜ ํ•ญ์ƒ์ œ๋ฅผ ๋ณ‘์šฉ ์ฒ˜๋ฐฉํ•  ํ•„์š”๊ฐ€ ์žˆ์„ ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋œ๋‹ค. ๋˜ํ•œ ์ž„์ƒ์ ์ธ ๊ฒฝํ—˜์ด๋‚˜ ๊ธฐ์กด ๋ฌธํ—Œ์— ์˜์กดํ•œ ์น˜๋ฃŒ์ œ ์„ ํƒ๊ณผ ๋™์‹œ์— ๋ฐ˜๋“œ์‹œ ์‹คํ—˜์‹ค ๋‚ด ๊ฒ€์‚ฌ๋ฅผ ํ†ตํ•˜์—ฌ ํšจ์œจ์ ์ธ ํ•ญ์ƒ์ œ๋ฅผ ์„ ํƒํ•จ์œผ๋กœ์จ ๊ตญ๋‚ด ํ•ญ์ƒ์ œ ๋‚ด์„ฑ๊ท ์˜ ์ถœํ˜„ ์ •๋„๋ฅผ ์ค„์—ฌ ๋‚˜๊ฐˆ ํ•„์š”๊ฐ€ ์žˆ์„ ๊ฒƒ์œผ๋กœ ๋ณด์ธ๋‹ค.
๋ณธ ์—ฐ๊ตฌ๋ฅผ ํ†ตํ•ด ์ œ์ฃผ์ง€์—ญ ๋”๋Ÿฌ๋ธŒ๋ › ์”จ์•”๋ง์—์„œ์˜ ์ƒ์‹๊ธฐ๊ฐ์—ผ์— ๊ด€์—ฌํ•˜๋Š” ์ฃผ์š” ๋ณ‘์›์„ฑ์„ธ๊ท ์˜ ๋ถ„ํฌ์™€ ํ•ญ์ƒ์ œ ๊ฐ์ˆ˜์„ฑ์„ ์กฐ์‚ฌํ•จ์œผ๋กœ์จ ํ–ฅํ›„ ๋ง ์ˆ˜์˜์‚ฌ๋“ค์ด ํ˜„์žฅ์—์„œ ์ ์ ˆํ•œ ์น˜๋ฃŒ์ œ๋ฅผ ์„ ํƒํ•˜๋Š”๋ฐ ํ™œ์šฉ๋  ๊ฒƒ์œผ๋กœ ๋ณด์ด๋ฉฐ ๋ณธ ์—ฐ๊ตฌ๊ฐ€ ๋ง ์ƒ์‹๊ธฐ ๊ด€๋ จ ์งˆ๋ณ‘์˜ ์กฐ๊ธฐ ์น˜๋ฃŒ ๋ฐ ํ•ญ์ƒ์ œ ์˜ค๋‚จ์šฉ ๋ฐฉ์ง€์— ๋„์›€์ด ๋˜๊ธฐ๋ฅผ ๊ธฐ๋Œ€ํ•œ๋‹ค.

REFERENCES

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Tableย 1.
The number of bacterial pathogens annually isolated from uterine or vagina swab samples of thoroughbred 146 mares
Year No. of mares No. of pathogens isolated No. of mares isolated
2011 18 7 6
2012 35 14 13
2013 33 15 14
2014 40 20 16
2015 29 4 4
Total 146 60 53
Tableย 2.
Isolation rates of bacterial pathogens from genital tracts of 146 thoroughbred mares
Bacteria Year 2011 2012 2013 2014 2015 Total (%)
Streptococcus equi ssp. zooepidemicus 3a) 7b) 6a) 9c), d) 4 29 (43.8)
Escherichia coli 2a) 5 6a) 8c) - 21 (35.0)
Klebsiella pneumoniae 1 1b) 1 3d) - 6 (10.0)
Pseudomonas aeruginosa 1 1 2 - - 4 (6.7)
Total 7/18e) 14/35 15/33 20/40 4/20 60/146

a) S. equi ssp. zooepidemicus and E. coli were isolated from same sample;

b) S. equi ssp. zooepidemicus and K. pneumoniae were isolated from same sample;

c) S. equi ssp. zooepidemicus and E. coli were isolated from 2 same samples;

d) S. equi ssp. zooepidemicus and K. pneumoniae were isolated from 2 same samples;

e) the number of bacterial pathogens/the number of samples.

Tableย 3.
Antimicrobial resistant rates of bacterial pathogens antimicrobial agents
Antimicrobial agents % of resistant bacteria
SEZ (n=29) Ec (n=21) Kp (n=6) Pa (n=4)
Amoxicillin-Clavulanic acid 0 5.3 0 75.0
Ampicillin 39.3 15.0 80.0 75.0
Cefazolin 0 0 16.7 100
Ceftiofur 10.3 0 0 75.0
Cefuroxime 0 0 0 100
Ciprofloxacin 55.6 0 0 0
Enrofloxacin 82.8 0 0 25.0
Erythromycin 7.1 ND ND ND
Florfenicol 0 5.6 0 100
Gentamicin 55.2 4.7 0 0
Kanamycin 100 9.5 16.7 50.0
Neomycin ND 9.5 16.7 25.0
Oxytetracyclin 89.7 60.0 33.3 50.0
Penicillin 75.0 ND ND ND
Spiramycin 60.7 ND ND ND
Streptomycin ND 19.0 16.7 25.0
Sulfamethoxazole-Trimethoprim ND 0 100 100
Tetracycline 100 23.8 16.7 75.0
Tylosin 25.0 ND ND ND

SEZ, Streptococcus equi ssp. zooepidemicus; Ec, Escherichia coli; Kp, Klebsiella pneumoniae; Pa, Pseudomonas aeruginosa; ND, not determined.

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