2006-2010년 단일기관 소아에서의 엔테로바이러스 감염 역학 및 임상 양상에 관한 연구
Epidemiology and Clinical Characteristics of Enterovirus Infections in Children : A Single Center Analysis from 2006 to 2010
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목 적:본 연구는 최근 5년간 엔테로바이러스의 분자유전학적 역학 및 임상 양상을 조사하고자 하였다. 방 법: 2006년부터 2010년까지 한전병원에서 엔테로바이러스 감염이 의심되는 소아 환자의 검체를 질병관리본부로 의뢰하였고, 감염이 확진된 환자를 후향적으로 분석하였다. 결 과: 277명 환자에서 386개의 검체가 분석되었고그 중 적어도 한 개 이상의 검체에서 양성을 소견을 보인환자는 총 98명(35.4%) 이었다. 98명의 환자로부터 100개의 엔테로바이러스가 확인되었고, echovirus 30형 28건(28%), enterovirus 71형 12건(12%), echovirus 25형 10건(10%), echovirus 9형 9건(9%), coxsackie-virus A6형 8건(8%) 순이었다. 연도별 분포는 2006년과 2008년에 각각 echovirus 25형 및 echovirus 30형에 의한 무균성 뇌수막염이 각각 61.5% 및 69.2%로 대부분을 차지하였다. Enterovirus 71형에 의한 합병증을동반한 환자는 없었다. 결 론:단일기관에서 최근 5년간 분리된 엔테로바이러스 감염 양상을 확인하였고 우리나라 소아에서의 최근 역학을 파악하는 데 도움이 될 것으로 사료된다.
Abstract
Purpose : This study was performed to investigate the epidemiology of enterovirus (EV) infections in children at a secondary hospital during recent 5 years. Methods : We collected the cerebrospinal fluid, stool and throat swab samples from the pediatric patients with suspected EV infections in KEPCO Medical Center, Seoul, Korea from July 2006 to September 2010. EV detection and genotype identification were performed by RT-PCR at Korea Centers for Disease Control and Prevention. Results : A total of 386 samples were collected from 277 patients during study period. Ninety-eight patients (35.4%) were diagnosed with EV infections. The RT-PCR positive rate was the highest in throat swab samples (48.3%). The median age of patient was 4.7 years (range, 0.1-12.5 years). Aseptic meningitis (50, 51.0%) was the most common clinical manifestation;herpangina (22, 22.4%) and hand-foot-mouth disease (18, 18.4%). One hundred EVs were isolated from 98 patients and 20 genotypes of EV were identified; Echovirus 30 (28 cases, 28%), Enterovirus 71 (12 cases, 12%), Echovirus 25 (10 cases,10%), Echovirus 9 (9 cases, 9%) and Coxsackievirus A6 (8 cases, 8%). Aseptic meningitis caused by Echovirus 30 was the most common manifestation in 2008. There was no complicated case caused by Enterovirus 71. Conclusion : This study showed the epidemiology of confirmed EV infection in children from 2006 to 2010. There is a need for continuous surveillance of EV infections and its clinical manifestations.
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