소아의 세균성 호흡기감염의 진단을 위한 SeeplexTM Pneumobacter Multiplex PCR 키트의 평가
Evaluation of SeeplexTM Pneumobacter Multiplex PCR Kit for the Detection of Respiratory Bacterial Pathogens in Pediatric Patients
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배경 : 급성 호흡기 감염에서 원인균의 신속한 진단은 환자의 적절한 치료를 위하여 중요하다. 저자들은 최근 소개된 SeeplexTM Pneumobacter Detection 키트(Seegene Inc., Korea) 를 이용한 다중(multiplex) PCR 검사의 진단적 유용성을 평가 하고자 하였다. 방법 : 소아 호흡기 환자 181명의 비인두흡인액 검체를 이용 하여 Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Bordetella pertussis 및 Legionella pneumophila 등의 6가 지 호흡기 감염균에 대한 다중 PCR 검사를 실시하였다. 대상군 중 112검체에 대해서는 S. pneumoniae와 H. influenzae 배양 검사를 시행하여 PCR 결과와 비교하였고, 다중 PCR 검사의 분 석특이도 검증을 위하여 교차반응성을 평가하였다. 결과 : 총 대상군 181명 중 81명(44.8%)에서 다중 PCR 결과 가 양성이었다. 중복감염을 포함한 양성 예는 S. pneumoniae 가 52명(28.7%), H. influenzae가 47명(26.0%), M. pneumoniae가 9명(5.0%), B. pertussis가 3명(1.7%), 그리고 C. pneumoniae가 1명(0.6%)이었다. 배양검사와의 일치율은 S. pneumoniae와 H. influenzae에서 각각 92.9% (kappa index=0.84, P<0.001) 및 91.1% (kappa index=0.75, P<0.001)이었다. 호 흡기 감염의 흔한 원인 바이러스와 세균에 대한 다중 PCR법의 교차반응은 관찰되지 않았다. 결론 : SeeplexTM Pneumobacter Detection 키트는 호흡기 감염균의 신속한 검출을 위한 선별검사로서 유용할 것으로 생각 된다. 이후 S. pneumoniae와 H. influenzae 양성 결과의 임상 적 해석을 위한 하기도검체를 이용하는 추가연구가 필요할 것으 로 사료된다.
Abstract
Background : Rapid identification of the causative agent among potential bacterial and viral pathogens is important for the management of acute respiratory disease. In this study, we evaluated the analytical performance and clinical usefulness of a recently-introduced multiplex PCR assay, SeeplexTM Pneumobacter detection kit (Seegene Inc., Korea) for the identification of respiratory bacterial pathogens. Methods : One hundred and eighty one nasopharyngeal aspirates were collected from pediatric patients with respiratory symptoms and analysed by multiplex PCR for the detection of Streptococcus pneumoniae (S.P), Haemophilus influenzae (H.I), Mycoplasma pneumoniae (M.P), Chlamydophila pneumoniae (C.P), Bordetella pertussis (B.P) and Legionella pneumophila (L.P). A comparison of multiplex PCR with conventional culture for the isolation of S.P and H.I was performed on 112 specimens. The cross reactivity of multiplex PCR was also evaluated. Results : Of 181 cases, 81 cases were positive by multiplex PCR (44.8%): 52 cases for S.P (28.7%), 47 cases for H.I (26.0%), 9 cases for M.P (5.0%), 3 cases for B.P (1.7%) and 1 case for C.P (0.6%) including multiple infection cases. The agreement rates between multiplex PCR and culture for S.P and H.I were 92.9% (kappa index=0.84, P<0.001) and 91.1% (kappa index=0.75, P<0.001), respectively. There was no cross reactivity with common bacterial and viral pathogens. Conclusions : SeeplexTM Pneumobacter detection kit could be a useful screening tool for the rapid detection of respiratory bacterial pathogens. Further studies with lower respiratory tract specimens would be needed for the clinical evaluation of S. pneumoniae and H. influenzae detected by multiplex PCR.
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