임상검체에서 분리된 병원성 사상균의 분자생물학적 분석
Molecular Analysis of Pathogenic Molds Isolated from Clinical Specimen
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초록
임상 검체에서 분리된 65개의 사상형 진균을 대상으로 연구하였다. 이 균주들은 형태학적으로 동정이 불가능한 진균, 형태학적으로 유사하여 동정이 까다로운 균주, 종(species) 수준의동정이 요구되는 균종들이다. PCR과 염기서열분석은 ITS. DiD2, 그리고 β-tubulin 유전자를 표적 부위로 하였고, 증폭된염기서열은 상동성 분석을 위하여 GenBank 데이터베이스의알고리즘을 이용하여 분석하였다. 형태학적으로 속 수준의 동정이 가능한 진균은 61.5%이었고, 65주의 염기서열분석으로62 균주는 속과 종의 동정이 가능하였다. 형태학적 검사와 염기서열분석의 결과, 속과 종이 불일치한 경우 14주(21.5%)이었고, 형태학적으로 동정이 불가능하였던 사례는 11 균주이었다. B. dermatitidis, T. marneffei, 그리고 G. argillacea 등은 염기서열분석으로 국내에서 처음으로 확인하였다. Aspergillus 와 같이 흔히 분리되고 성장이 빠른 진균들의 경우에는 형태학적인 검사가 보고시간과 비용 면에서는 매우 유용한 방법이다. 분자유전학적인 검사 방법은 비용과 임상적 중요성 등을 고려하여야 하지만 분자유전학적 검사를 병행하여 신속하고 정확한 결과를 제공할 수 있다.
Abstract
Sixty-five molds isolated from clinical specimens were included in this study. All the isolates were molds that could be identified morphologically, strains that are difficult to identify because of morphological similarities, and strains that require species-level identification. PCR and direct sequencing were performed to target the internal transcribed spacer (ITS) region, the D1/D2 region, and the β-tubulin gene. Comparative sequence analysis using the GenBank database was performed using the basic local alignment search tool (BLAST) algorithm. The fungi identified morphologically to the genus level were 67%. Sequencing analysis was performed on 62 genera and species level of the 65 strains. Discrepancies were 14 (21.5%) of the 65 strains between the results of phenotypic and molecular identification. B. dermatitidis, T. marneffei, and G. argillacea were identified for the first time in Korea using the DNA sequencing method. Morphological identification is a very useful method in terms of the reporting time and costs in cases of frequently isolated and rapid growth, such as Aspergillus. When molecular methods are employed, the cost and clinical significance should be considered. On the other hand, the molecular identification of molds can provide fast and accurate results.
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