간경화증 환자에서 Streptococcus gallolyticus subsp. gallolyticus 균혈증 1예
A Case of Streptococcus gallolyticus subsp. gallolyticus Bacteremia in Liver Cirrhosis
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Streptococcus bovis 균혈증은 사람에서 심내막염, 대장암, 간경화증 등과 관련이 있는 것으로 알려져 있다. 2000년대 이전에는 S. bovis group의 생물형으로 아종을 분류하였으나 현재는 DNA 상동성에 따른 분류로 바뀌었다. 저자들은 간경화증 환자에서 16S rRNA 염기순서분석법을 이용하여 동정한 S. gallolyticus subsp. gallolyticus 균혈증 1예를 보고하고자 한다. 증례 환자는 간경화증의 과거력이 있는 61세 남자로 발열을 주소로 내원하였다. 혈액배양에서 그람양성알균이 자랐으며, Microscan 동정 키트(Beckman Coulter, USA)에서는 S. bovis, Vitek 2 동정 키트(bioMérieux, USA)에서는 Enterococcus saccharolyticus로 각각 동정되었다. 최종적으로 16S rRNA 염기순서분석법을 이용하여 S. gallolyticus subsp. gallolyticus로 확인하였다. 본 중례는 S. gallolyticus의 정확한 동정에 16S rRNA 염기순서분석법이 유용함을 보여주고 있다.
Abstract
Streptococcus bovis bacteremia in humans has been traditionally associated with infective endocarditis, colorectal cancer, and liver cirrhosis. S. bovis strains were previously categorized by biotype, but since the 2000s, they have been reclassified by DNA homology. We report a case of S. gallolyticus subsp. gallolyticus bacteremia, identified by 16S rRNA sequencing, in a patient diagnosed with liver cirrhosis. A 61-yr-old man with a history of liver cirrhosis presented to the hospital with a complaint of fever. Blood culture revealed the presence of gram-positive cocci, and the isolated organism was identified as S. bovis by the MicroScan identification kit (Beckman Coulter, USA), but as Enterococcus saccharolyticus by the Vitek 2 identification kit (bioMérieux, USA). The organism was finally confirmed as S. gallolyticus subsp. gallolyticus by 16S rRNA sequencing.
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