구토독소를 분비하는 Bacillus cereus에 의한 집단 발병 1예
A Case of Emetic Toxin Producing Bacillus cereus Strains Isolated from Outbreak
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Bacillus cereus는 두 가지 형태의 증상을 유발하는 위장관계 질병을 야기한다. 이는 한 가지 구토 독소와 9개의 장독소를 생산한다. 2008년 3월, 8명의 한 가족이 생선회를 섭취 후 식중독 증상을 보였다. 복통과 구토 증상을 보이는 6명의 환자와 2명의 무증상자의 대변 검체에서 구토 독소를 생산하는 B. cereus를 분리하였다. 본 연구에서는 haemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe), B. cereus enterotoxin T (BceT), enterotoxin FM (EntFM), cytotoxin K (cytK) 등의 장독 소 유전자와 구토 독소를 PCR 방법을 사용하여 검출하였다. 또한 독소의 활성은 BCET-RPLA, Tecra ELISA kit 그리고 Hep-2 세포독성 실험을 통해 확인하였다. 분리된 병원체는 pulsed-field gel electrophoresis (PFGE) 방법으로 유전자적 근연 관계를 확인하였다. 본 연구는 구토 독소를 분비하는 B. cereus로 인한 집단발생을 확인하였기에 문헌 고찰과 함께 보고 하는 바이다.
Abstract
Bacillus cereus causes two types of gastrointestinal diseases: emesis and diarrhea. It produces one emetic toxin and nine different enterotoxins. In March 2008, eight of a family became sick after eating slices of raw fish. We isolated emetic toxin producing B. cereus from the stools of 6 patients and 2 subclincal humans. In this study, the presence of enterotoxin genes, such as those of haemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe), B. cereus enterotoxin T (BceT), enterotoxin FM (EntFM), cytotoxin K (cytK) and cereulide were assayed by polymerase chain reaction (PCR) methods. Their enterotoxin activities were assayed using the BCET- RPLA, Tecra ELISA kit and Hep-2 vacuole activity. Bacterial isolates were subtyped by pulsed-field gel electrophoresis (PFGE). This study demonstrates the emetic toxin-producing stains of B. cereus in clinical specimens, for the first time in the Republic of Korea.
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