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작성일자 2010-09-06
제목 `슈퍼박테리아 비상'..어떻게 대처하나
작성자 플루건 Mall
(서울=연합뉴스) 정주호 기자 = 일본에서 항생제가 듣지 않는 슈퍼박테리아에 9명이 감염돼 사망한 사실이 밝혀지면서 인접한 우리나라에도 비상이 걸렸다.

보건의료계에서는 이번에 일본에서 문제가 된 아시네토박터균이 우리나라뿐 아니라 세계 곳곳에서 이미 여러차례 분리됐던 내성균으로 병원의 감염관리 정도에 따라 얼마든지 대규모의 환자 발생이 가능할 것으로 우려하고 있다.

특히 10여년전 우리나라는 세계 최고 수준의 항생제 오남용 국가였기 때문에 항생제 내성균이 활동할 토양이 마련돼 있다는 평가도 나온다.

이에 따라 보건복지부와 질병관리본부는 새로운 내성균 출현을 조기에 발견하기 위해 전국 27개 종합병원과 대학병원을 중심으로 카르바페넴 내성균을 포함한 주요 내성균을 모니터링하고 있다.

아울러 오는 12월말부터 슈퍼박테리아 감염병을 법정전염병으로 지정, 대형병원 50여곳을 중심으로 다제내성 아시네토박터균, 카르바페넴 내성 장내세균(CRE) 등 6종의 내성균 감염현황을 실시간으로 보고받는 감시체계를 가동할 계획이다.

현재까지 우리나라에서 슈퍼박테리아 분리사례는 보고되지 않고 있다.

먼저 이번 슈퍼박테리아 사태를 이해하기 위해서는 일본과 인도 사례를 구분해서 볼 필요가 있다.

일본에서 사망자가 나온 `다제내성균 아시네토박터 바우마니'와 최근 인도, 파키스탄, 영국에서 분리된 `뉴델리형 카르바페넴 내성 장내세균'은 모두 슈퍼박테리아로 불리기는 하지만 전혀 다른 내용을 갖고 있다.

슈퍼박테리아는 항생제의 잦은 사용에 병원균 스스로 저항할 수 있는 힘을 길러 내성이 점차로 강해지면서 어떤 항생제에도 저항할 수 있게 된 균을 말한다.

질병관리본부 관계자는 "인도와 일본의 사례는 완전히 다르다"며 "카르바페넴 내성균은 인도 등지 병원에서 한정돼 발견되지만, 일본에서 나타난 아시네토박터균은 전 세계에서 나타나고 있다"고 말했다.

우리나라에서도 아시네토박터균 분리사례가 여러 차례 보고됐던 것으로 알려졌다. 일본 후쿠오카대 병원에서의 아시네토박터균 감염 경로에 한국의 한 병원이 걸쳐져 있다는 점도 한국의 아시네토박터균이 확산돼 있음을 반영한다.

다만 일본의 슈퍼박테리아 사망사례는 아시네토박터균의 감염 자체가 아니라 한 병원에서 짧은 기간에 대규모 환자에게 감염토록 방치한 것이 문제였다. 한 감염내과 학자는 "병원 감염 관리 시스템이 문제가 된 것으로 보인다"고 말했다.

공기로 전염되는 인플루엔자와는 달리 슈퍼박테리아는 감염된 상처나 의료행위 등으로 옮기기 때문에 병원에서 주사를 맞고 감염될 수도 있으며 30∼40%의 치사율을 보인다.

미생물학적으로 내성균의 출현은 현대 보건의학에서 불가피한 일이기 때문에 항생제 오남용을 줄이고 항생제를 적정하게 사용토록 유도하면서 병원감염을 최소화할 수 있는 위생수칙을 마련하는 것이 더 중요하다고 할 수 있다.

의료현장에서도 기도에 관을 꽂는 등의 외과 처치가 늘어나기 때문에 내성균 확산을 막기 위한 안전관리의 필요성이 더더욱 커지고 있다.

보건당국 관계자는 "진정한 슈퍼박테리아라고 할 수 있는 카르바페넴 내성균도 부작용이 있긴 하지만 아직 항생제로 대응할 수 있는 약이 있다"며 "무조건 두려워할 만한 일은 아니고 오히려 우려되는 것이 과한 불안감"이고 말했다.

이에 따라 보건당국은 2015년까지 전체 병원감염률을 최대 30%까지 감소시킨다는 목표를 세우고 수술부위감염 감시체계에 참여하는 의료기관을 40개 종합병원으로 확대하고 감시대상 수술도 9종으로 늘릴 계획이다.

이와 함께 조만간 병원 중환자실이나 투석실, 응급실 등에서 의료 관련 감염에 대처하기 위한 지침을 마련해 배포하기로 했다.
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