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부산지역에서 분리된 엔테로바이러스의 유행양상 분석 및 유전자형 연구

Genetic Characterization for Human Enterovirus Isolated from Busan Region in Korea

  • 김남호 (부산광역시 보건환경연구원 역학조사과) ;
  • 민상기 (부산광역시 보건환경연구원 역학조사과) ;
  • 박은희 (부산광역시 보건환경연구원 역학조사과) ;
  • 박연경 (부산광역시 보건환경연구원 역학조사과) ;
  • 권순목 (부산광역시 보건환경연구원 역학조사과) ;
  • 진성현 (부산광역시 보건환경연구원 역학조사과)
  • Kim, Nam-Ho (Busan metropolitan City Institute of Health and Environment) ;
  • Min, Sang-Kee (Busan metropolitan City Institute of Health and Environment) ;
  • Park, Eun-Hee (Busan metropolitan City Institute of Health and Environment) ;
  • Park, Yon-Koung (Busan metropolitan City Institute of Health and Environment) ;
  • Kwan, Sun-Mok (Busan metropolitan City Institute of Health and Environment) ;
  • Jin, Seong-Hyeon (Busan metropolitan City Institute of Health and Environment)
  • 투고 : 2010.03.03
  • 심사 : 2010.03.30
  • 발행 : 2010.06.30

초록

부산지역에서 2007년부터 2009년까지 3년 동안 임상적으로 HEV 의심 환자 검체 총 2,743건(대변 1,503건, 뇌척수액 1,213건, 인후도찰물 27건)의 검체 중 240건(8.7%)에서 HEV가 검출되었다. 연도별로는 2007년에는 HEV 감염의심 환자 검체 1,001건에서 86건(8.6%)에서 HEV가 분리되었고, 2008년의 경우 979건 중 85건(8.7%), 2009년 763건 중 69건(9.0%)이 분리되었다. 본 연구에 사용된 검체 2,743건 중 1,315건이 6월부터 9월까지 4개월간 의뢰되어 전체 의뢰건수의 48.0%를 차지하였다. HEV는 5월부터 분리율이 증가하기 시작해서 6월(15.5%), 7월(15.8%), 8월(15.3%)에 높게 나타나 HEV 분리가 하절기에 집중되어 나타난 것을 확인할 수 있었다. 검사건수 별 양성률은 남자 9.5%, 여자 8.7%로 성별에 따른 분리율의 차이를 찾기는 어려웠으며, 대부분 10세 이하의 연령에서 바이러스가 분리되었다. 분리된 HEV 분리주들에 대하여 VP1 region sequencing을 통하여 HEV의 유전형을 확인하여 HEV-A와 HEV-B 두 종류의 유전자형이 부산지역에서 유행하였음을 확인하였다. HEV-A의 부산지역 분리주 31주를 이용하여 상동성 비교분석을 실시한 결과 분리주 31주 사이에 21.8~100%의 상동성을 보였으며, HEV-B의 부산지역 분리주 41주를 이용하여 상동성 비교분석을 실시한 결과 분리주 41주 사이에 56.0~100%의 상동성 보여 최근 3년간 부산지역에 분리된 HEV 혈청형들 사이에 상동성의 차이를 보이는 결과를 확인 할 수 있었으며, 이를 볼 때 부산지역에서 유행하는 HEV 내에 상당한 정도의 유전자 변이를 추정해 볼 수 있었다.

Human enteroviruses (HEV) are considered one of the major infectious causes of central nervous system infections such as aseptic encephalomeningitis in pediatrics. This study was focused on providing information related to genetic characteristics and diversities of HEV which prevailed between 2007 and 2009 in Busan, Korea. A total of 2,743 specimens were collected from children and screened for isolation of HEV by cell culture and RT-PCR. Among the specimins, 240 isolates were grouped into 21 different HEV serotypes using VP1 RT-PCR. The major etiological agents were CV-A6 and CV-B2 in 2007, E-6 and E-30 in 2008 and CV-B1 in 2009. The occurrence of HEV infections was the most frequent in the summer (May to August, 188 cases, 78.3%). Most of the isolates were identified from specimens from children under 10 years old, with the highest occurrence in the 2 to 4 year old range (15.2%). However, there were no significant differences between male and female children for the isolates. For analyzing genetic characterization, VP1 gene was amplified by RT-PCR and sequenced. The phylogenetic tree was established by Clustal W method using DNASTAR software. Using the sequence analysis of the VP1 region, it was classified into 2 groups; HEV-A and HEV-B. The HEV-A group contained 6 serotypes and sequences of 31 isolates were compared within each serotype. The HEV-B group contained 10 serotypes and the sequences of 41 isolates were compared within each serotype. Homology analysis of the VP1 region showed that the identity scores of HEV-A and B isolates were different. In conclusion, genetic divergences were observed among the isolates from children between 2007 and 2009 in Busan.

키워드

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