국내에서 최초로 분리된 Shigella dysenteriae type 8에 의한 세균성 이질 환자 집단 발생
The First Outbreak of Shigellosis Caused by Shigella dysenteriae Type 8 in Korea
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배경：2004년 4월 설사증상을 보이는 금강산 여행객 36명에서 S. dysenteriae 12주가 분리됐다. 이 균주는 모두 S. dysenteriae 혈청형 8로 확인되었고 본 연구에서는 이 균주를 대상으로 생화학적, 혈청학적 등의 특성을 밝히고 집단발생주간의 유전학적 연관관계를 밝히고자 하였다. 방법：환자로부터 분리된 12주는 VITEK system과 slide 응집 방법으로 진단하였다. 또, 항균제 감수성 시험과 PFGE 시험을 통하여 각 균주들간의 유전학적 연관관계를 확인하였다. 결과：본 연구에 사용한 대상 균주는 모두 S. dysenteriae 혈청형 8에 응집을 보였고 실험에 사용한 16종 항균제 중 streptomycin, tetracycline, trimethoprim/sulfamethoxazol 항균제에만 내성이 확인되었다. PFGE 유형은 sdx1, 2로 2가지로 분류되고 주 유형은 sdx1유형으로 11주가 여기에 속했다. 확인된 두개의 유형의 유전학적 연관도는 85.01%로 분석되었다. 결론：본 연구에서 확인된 S. dysenteriae 혈청형 8은 국내에서는 처음으로 분리된 사례로, PFGE와 항균제 감수성 결과 분리된 12균주는 모두 같은 감염원을 가지고 있었다.
Abstract
Background: In May 2004, an outbreak of a diarrheal disease occurred among tourists returning from Mt. Geumgang in North Korea; Shigella dysenteriaetype 8 was isolated from 12 of the 36 patients who were suffering from diarrhea. We investigated the genetic relatedness of the isolates. Methods: The isolates were identified by VITEK system and serotyped by a slide agglutination test. Antimicrobial susceptibility was determined by the disk diffusion method and genetic relatedness was examined by pulsed-field gel electrophoresis (PFGE). Results: All 12 isolates were identified as Shigella spp., and agglutinated by S. dysenteriae type 8 antisera. All of these isolates showed the same antibiotic susceptibility pattern, and were resistant to streptomycin, tetracycline and trimethoprim/sulfamethoxazole. PFGE patterns were classified into 2 types, sdx1 and sdx2, and the relatedness between these two types was 80.5%. Eleven isolates belonged to sdx1. Conclusion: The antibiotic susceptibility pattern and genetic relatedness of the isolates strongly suggest that they were from the same origin. Because this is the first report of S. dysenteriae type 8 isolation in Korea, and all of these cases were related to foreign travel, the surveillance system and the ability of the clinical laboratory should be strengthened to prevent the entry and spread of rare and hitherto not reported infectious agents into Korea.
참고문헌 (19)
- "Contaminated produce a common source for two outbreaks of Shigella gastroenteritis", 124, pp.299~305 (1986)
- "An outbreak of diarrhoeal disease attributed to Shigella sonnei", 112, pp.235~45 (1994)
- "Guidelines for the control of Shigellosis including epidemics due to S" (2005)
- "Bacterial infections of humans", pp.487~505 (1998), Plenum medical
- "Abigail AS and Dixie DW", pp.169~79 (1994), ASM press
- "2004 Communicable diseases statistical yearbook", data, pp.data_list[DOI]
- "Communicablediseases statistical yearbook", statics, pp.contagious_years[DOI]
- "Bacillary dysentery.J Korean Med Assoc", 42, pp.637~40 (1999)
- "Temporal shifts in the dominance of Shigella dysenteriae from 1999 to 2002 in Dhaka,Bangladesh", 41, pp.5053~8 (2003)
- "National Committee for Clinical Laboratory Standards Performance standards for antimicrobial disk susceptibility testing National Committee for Clinical Laboratory Standards"
- "Rapid PFGE protocol for typing of E H7 and other gram-negative organisms in 1 day", pp.2977~80
- "Shigellosis-pathogenesis and current epidemics", 2, pp.118~24 (1999)
- "Epidemic shiga bacillus dysentery in Central Ameria Etiologic investigation in Guantemala", mejica(s ml), pp.170~80 (1969)
- "Ampicillin-resistant shiga bacilllus in Bangladesh", 1, pp.406~7 (1974)
- "Antimicrobiol Resistance of Clinically impotrant bacteria isolated from hospitals located in representative provinces of Korea", pp.29~36
- "Epidemilolgical typing and characterization of dfr genes of Shigella sonnei isolates in Korea during the last two decades", 12, pp.106~13 (2002)
- "Occurrence of extended-spectrum beta lactamases in members of the genus Shigella in the Republic of Korea", 42, pp.5264~9 (2004)
- "Korea Center for Disease Control and Prevention", 16, pp.1~5 (2005)
- "Gene cassettes:A new class of mobile element", 141, pp.3015~27 (1995)