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산모에서 발색배지와 중합효소연쇄반응을 이용한 B군 사슬알균의 신속한 검출

Rapid Detection of Group B Streptococcus Using ChromID STRB and PCR in the Pregnant Women

김선주|이동현|신효심
대한임상미생물학회 (Korean Society of Clinical Microbiology)|2017.12|Annals of Clinical Microbiology|제20권 제4호|pp. 103-108

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PregnancyInfectionStreptococcus agalactiaeGroup B Streptococcus

초록

배경: Group B Streptococcus (GBS) 신생아 감염은 분만 중 산모의 질을 통해 수직 전파된다. 산모에서 GBS 선별검사의 중요성이 증가함에 따라 빠르고 효율적인 검사의 필요성이 증가했다. 본 연구에서는 발색배지인 ChromID STRB (bioMérieux, France)와 중합효소연쇄반응의 성능을 표준 배양법과 비교하였다. 방법: 2016년 4월부터 2017년 3월까지 임신 35주가 지난 산모 775명에 대해 질-직장부위에서 도말검체를 채취하였다. 채취된 면봉 검체는 LIM 액체배지에서 하룻밤 배양한 후 혈액한천배지와 ChromID STRB에 접종을 하였고, atr 유전자를 이용한 중합효소연쇄반응을 시행하였다. 결과: 산모에서 GBS 보균율은 5.9% (46/775)였다. 표준 배양법과 비교했을때, ChromID STRB의 민감도는 83.8%, 특이도는 99.3%, 양성예측률은 86.1%, 음성예측률은 99.2%였다. 중합효소연쇄반응의 민감도는 89.2%, 특이도는 99.6%, 양성예측률은 91.7%, 음성예측률은 99.5%였다. 두 검사 모두 표준 배양법만 사용했을 때에 비하여, 추가적으로 6건을 양성으로 검출할 수 있었다. 결론: 발색배지인 ChromID STRB와 atr 유전자를 이용한 중합효소연쇄반응 모두 GBS 선별검사에 적용하기에 충분한 성능을 보였다. 산모에서 항생제의 효율적인 예방적 투여를 위하여 GBS 선별검사 시행 시 표준 배양 외에 선택적 발색배지나 중합효소연쇄반응과 같은 신속한 검사법의 사용이 필요하다고 판단하였다. [Ann Clin Microbiol 2017;20: 103-108]

Abstract

Background: Group B Streptococcus (GBS) can be transmitted to neonates during delivery through the birth canal. As awareness of neonatal GBS infections is increasing, more rapid and efficient screening tests are required. The aim of this study was to evaluate the performance of ChromID STRB (bioMérieux, France) and PCR compared with the standard culture method. Methods: Recto-vaginal swabs were collected from 775 pregnant women from April 2016 to March 2017. Cotton swab cultures were grown in LIM broth overnight and then subcultured onto blood agar plates and ChromID STRB. PCR was carried out to detect atr genes specific for GBS. Results: The carrier rate of GBS was 5.9% (46/775). The sensitivity, specificity, positive predictive value, and negative predictive value were 83.8%, 99.3%, 86.1%, and 99.2%, respectively, for ChromID STRB and 89.2%, 99.6%, 91.7%, and 99.5%, respectively for PCR. Both ChromID STRB and PCR detected 6 more cases compared to the standard culture. Conclusion: Chromogenic agar, ChromID STRB, and PCR using the atr gene showed excellent performance to screen for GBS. To administer prophylactic antibiotics efficiently, either selective chromogenic agar or PCR could be used in addition to the standard culture. (Ann Clin Microbiol 2017;20:-108)

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