Pediatric Infection and Vaccine

  • 제16권1호
  • /
  • Pages.47-53
  • /
  • 2009
  • /
  • 2384-1079(pISSN)
  • /
  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
권호 표지

임신부에서 분리된 B군 연구균의 중합효소연쇄반응과 염기서열분석을 통한 혈청형 분석

Molecular Serotyping of Group B Streptococcus Isolated from the Pregnant Women by Polymerase Chain Reaction and Sequence Analysis

  • 오지은 (서울대학교 의과대학 소아과학교실) ;
  • 장현오 (별 소아청소년과) ;
  • 김남희 (인제대학교 의과대학 일산백병원 소아청소년과) ;
  • 이진아 (서울대학교 의과대학 소아과학교실) ;
  • 최은화 (서울대학교 의과대학 소아과학교실) ;
  • 이환종 (서울대학교 의과대학 소아과학교실)
  • Oh, Chi Eun (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Jang, Hyun Oh (Byul Pediatrics) ;
  • Kim, Nam Hee (Department of Pediatrics, Ilsan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Jina (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Choi, Eun Hwa (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Lee, Hoan Jong (Department of Pediatrics, College of Medicine, Seoul National University)
  • 투고 : 2009.05.12
  • 심사 : 2009.05.24
  • 발행 : 2009.06.25
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목 적: 국내 임신부의 생식기와 직장에서 분리된 B군 연구균의 혈청형 분포를 분자생물학적인 방법으로 확인하고자 하였다. 방 법: 산전 진찰을 위해 고양시 소재 4개의 산부인과병원을 방문한 임신 35주 이상 임신부의 생식기와 직장에서 분리 되어 $-70^{\circ}C$에 보관 중이던 42개의 B군 연구균에서 DNA를 추출하고 혈청형 특이 PCR 과 염기서열 분석을 이용하여 혈청형을 결정하였다. 결 과: 42개 균주 모두에서 혈청형 특이 PCR 과 염기서열 분석을 통해 혈청형을 결정할 수 있었고 빈도순으로 III형이 12균주(28.6%), V형이 11균주(26.2%), Ia형이 11균주(26.2%), VI형이 4균주(9.5%), Ib형이 2균주(4.8%), II형이 2균주(4.8%)였다. 결 론: 국내의 후기 임신부에서 흔하게 분리되는 B군 연구균의 혈청형은 III형, V형, Ia형이었고 본 연구에서 이용한 혈청형 특이 PCR과 염기서열 분석은 앞으로도 관련 연구에 유용하게 사용할 수 있을 것으로 보인다.

Purpose : This study was performed to investigate the serotype distribution of group B streptococcus (GBS) isolated from pregnant Korean women using molecular methods. Methods : The study materials included 42 GBS isolates obtained from the vagina and anorectum of pregnant women in Goyang, Korea between 2005 and 2006. Four clinical isolates with known serotypes (Ia, Ib, III, and V) were used for validation of molecular serotyping. We used serotype-specific primers for identification of the serotypes (Ia, Ib, III, V, and VI). To determine the ambiguous serotypes by serotype-specific PCR, sequence analysis of the PCR amplicons which had been amplified with GBS-common primers was used. Results : The serotypes determined by the molecular methods agreed with the previously known 4 serotypes (Ia, Ib, III, and V). The serotypes of all 42 isolates were successfully determined by molecular methods. The distribution of the GBS serotype was as follows in order of frequency: serotype III was found in 12 isolates (28.6%), serotype V was found in 11 isolates (26.2%), serotype Ia was found in 11 isolates (26.2%), serotype VI was found in 4 isolates (9.5%), serotype Ib was found in 2 isolates (4.8%), and serotype II was found in 2 isolates (4.8%). Conclusion : Serotypes III, V, and Ia were the most frequently identified serotypes in pregnant Korean women. Molecular serotyping is useful for surveillance of the serotype distribution of GBS in colonized pregnant women and GBS diseases of neonates.

키워드

참고문헌

  1. Edwards MS, Baker CJ. Streptococcus agalactiae. In : Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 3rd ed. Philadelphia : Elsevier Churchill Livingstone, 2005:2423-34.
  2. Edwards MS, Nizet V, Baker CJ. Group B streptococcal infections. In: Remington JS, Klien JO, Baker CJ, Wilson CB, editors. Infectious diseases of the fetus and newborn infant. 6th ed. Philadelphia : WB Saunders Co, 2006:1091-141.
  3. Boyer KM, Gadzala CA, Kelly PD, Burd LI, Gotoff SP. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. II. Predictive value of prenatal cultures. J Infect Dis 1983;148:802-9. https://doi.org/10.1093/infdis/148.5.802
  4. Schuchat A, Zywicki SS, Dinsmoor MJ, Mercer B, Romaguera J, O'Sullivan MJ, et al. Risk factors and opportunities for prevention of early-onset neonatal sepsis: A multicenter case-control study. Pediatrics 2000;105:21-6. https://doi.org/10.1542/peds.105.1.21
  5. Regan JA, Klebanoff MA, Nugent RP. The epidemiology of group B streptococcal colonization in pregnancy. Vaginal Infections and Prematurity Study Group. Obstet Gynecol 1991;77:604-10.
  6. Uh Y, Kwon JY, Jang IH, Yoon KJ, Kim HK. Colonization rate of group B streptococcus in pregnant women and neonates. Korean J Clin Pathol 1994;14: 447-53.
  7. Kim MW, Jang HO, Chang DY, Cho JR, Kim YA, Choi HM et al. Group B streptococcal colonization rate in Korean pregnant women. Korean J Obstet Gynecol 2006;49:337-44.
  8. Yun HK, Song PJ, Choi KC, Ju JR, Cho BS, Jung SJ. A case of neonatal meningitis by group B streptococcus. J Korean Pediatr Soc 1984;27:1011-7.
  9. Kim YK, Kwak YH, Kim YJ, Jung HS, Hong JY, Lee HJ. Clinical features of group B $\beta$-hemolytic streptococcal infection in infants and children. Korean J Pediatr Infect Dis 1999;6:194-202.
  10. Kim SH, Park HJ, Park SE, Hong YR, Lee YA, Shin JB. The etiology of neonatal bacterial meningitis in Busan, Korea. Korean J Pediatr Infect Dis 2007;14:43- 6.
  11. Harrison LH, Elliott JA, Dwyer DM, Libonati JP, Ferrieri P, Billmann L, et al. Serotype distribution of invasive group B streptococcal isolates in Maryland: implications for vaccine formulation. Maryland Emerging Infections Program. J Infect Dis 1998;177:998- 1002. https://doi.org/10.1086/515260
  12. Kong F, Gowan S, Martin D, James G, Gilbert GL. Serotype identification of group B streptococci by PCR and sequencing. J Clin Microbiol 2002;40:216-26. https://doi.org/10.1128/JCM.40.1.216-226.2002
  13. Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC. MMWR Morb Mortal Wkly Rep 2002;51(RR11):1-22.
  14. Kong F, Martin D, James G, Gilbert GL. Towards a genotyping system for Streptococcus agalactiae (group B streptococcus): use of mobile genetic elements in Australasian invasive isolates. J Med Microbiol 2003; 52:337-44. https://doi.org/10.1099/jmm.0.05067-0
  15. Arakere G, Flores AE, Ferrieri P, Frasch CE. Inhibition enzyme-linked immunosorbent assay for serotyping of group B streptococcal isolates. J Clin Microbiol 1999; 37:2564-7.
  16. Uh Y, Jang IH, Yoon KJ, Lee CH, Kwon JY, Kim MC. Colonization rates and serotypes of group B streptococci isolated from pregnant women in a Korean tertiary hospital. Eur J Clin Microbiol Infect Dis 1997;16:753- 6. https://doi.org/10.1007/BF01709259
  17. Kim HJ, Lee JW, Lee KI, Lee HS, Hong JH, Han SH, et al. Causative organisms in children with bacterial meningitis (1992-2002). J Korean Pediatr Soc 2003;46: 1085-8.
  18. Lin FY, Clemens JD, Azimi PH, Regan JA, Weisman LE, Philips JB, et al. Capsular polysaccharide types of group B streptococcal isolates from neonates with early-onset systemic infection. J Infect Dis 1998;177: 790-2. https://doi.org/10.1086/517810
  19. Davies HD, Raj S, Adair C, Robinson J, McGeer A. Population-based active surveillance for neonatal group B streptococcal infections in Alberta, Canada: implications for vaccine formulation. Pediatr Infect Dis J 2001;20:879-84. https://doi.org/10.1097/00006454-200109000-00011
  20. Zaleznik DF, Rench MA, Hillier S, Krohn MA, Platt R, Lee ML, et al. Invasive disease due to group B Streptococcus in pregnant women and neonates from diverse population groups. Clin Infect Dis 2000;30: 276-81. https://doi.org/10.1086/313665
  21. Lachenauer CS, Kasper DL, Shimada J, Ichiman Y, Ohtsuka H, Kaku M, et al. Serotypes VI and VIII predominate among group B streptococci isolated from pregnant Japanese women. J Infect Dis 1999;179: 1030-3. https://doi.org/10.1086/314666
  22. Uh Y, Kim HY, Jang IH, Hwang GY, Yoon KJ. Correlation of serotypes and genotypes of macrolide- resistant Streptococcus agalactiae. Yonsei Med J 2005;46:480-3. https://doi.org/10.3349/ymj.2005.46.4.480
  23. Ekelund K, Slotved HC, Nielsen HU, Kaltoft MS, Konradsen HB. Emergence of invasive serotype VIII group B streptococcal infections in Denmark. J Clin Microbiol 2003;41:4442-4. https://doi.org/10.1128/JCM.41.9.4442-4444.2003
  24. Schrag SJ, Zywicki S, Farley MM, Reingold AL, Harrison LH, Lefkowitz LB, et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 2000;342:15-20. https://doi.org/10.1056/NEJM200001063420103
  25. Baker CJ, Rench MA, Edwards MS, Carpenter RJ, Hays BM, Kasper DL. Immunization of pregnant women with a polysaccharide vaccine of group B streptococcus. N Engl J Med 1988;319:1180-5. https://doi.org/10.1056/NEJM198811033191802