경기서부지역 설사 환아의 바이러스 유병율

Prevalence of Viruses with Diarrhea among Hospitalized Children West Gyeonggi Province

  • 서수영 (가톨릭대학교 부천성모병원 소아청소년과) ;
  • 정인아 (가톨릭대학교 부천성모병원 소아청소년과) ;
  • 김지훈 (가톨릭대학교 부천성모병원 소아청소년과) ;
  • 조경순 (가톨릭대학교 부천성모병원 소아청소년과) ;
  • 빈중현 (가톨릭대학교 부천성모병원 소아청소년과) ;
  • 김현희 (가톨릭대학교 부천성모병원 소아청소년과) ;
  • 이희진 (가톨릭대학교 부천성모병원 진단의학연구소) ;
  • 이원배 (가톨릭대학교 부천성모병원 소아청소년과)
  • Seo, Soo Young (Department of Pediatrics, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea) ;
  • Jung, In Ah (Department of Pediatrics, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea) ;
  • Kim, Ji Hoon (Department of Pediatrics, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea) ;
  • Cho, Kyung Soon (Department of Pediatrics, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea) ;
  • Bin, Joong Hyun (Department of Pediatrics, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea) ;
  • Kim, Hyun Hee (Department of Pediatrics, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea) ;
  • Lee, Hee Jin (Clinical Medical Research Institute, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea) ;
  • Lee, Wonbae (Department of Pediatrics, Bucheon St Mary's Hospital College of Medicine, The Catholic University of Korea)
  • 투고 : 2011.10.21
  • 심사 : 2011.10.25
  • 발행 : 2012.04.25

초록

목 적 : 이 연구는 경기서부지역의 감염성 설사의 원인 바이러스의 역학 및 지역적 유병율에 대한 정보 제공을 위해 실시되었다. 방 법 : 2009년 1월부터 12월까지 가톨릭대학교 부천성모병원에 급성 설사로 입원한 10세 미만 환아를 대상으로 흔한 세균성 병원체가 없는 310개의 대변 검체에서 rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, norovirus의 유무를 PCR과 RT-PCR을 이용하여 확인하였다. 결 과 : parechovirus (16%)가 가장 흔한 것으로 나타났으며, adenovirus (15%), astrovirus (14%), rotavirus (13%), enterovirus (5%)의 순으로 검출되었다. 단일 감염은 55.8%에서, 중복 감염은 3.2%에서 나타났다. 바이러스성 장염은 전체적으로 두 차례의 유행 시기를 보였으며, 84.6%는 2세 이하에서 발생하였다. 결 론 : parechovirus, adenovirus, astrovirus, enterovirus는 기존에 시행 중인 진단방법으로는 과소평가되어 있으나 소아 설사의 중요한 원인이다.

Purpose : This study was conducted to evaluate epidemiological data of the viral pathogens obtained from stool exams and provide information on the regional prevalence of infectious diarrheal disease west in Gyeonggi Province, Korea. Methods : We enrolled a cohort of children <10 years of age admitted for treatment of acute diarrhea at Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea. In total, 310 fecal specimens, documented to be free of common bacterial pathogens, were collected from pediatric patients during a 12-month period from January to December 2009 and were tested for the presence of rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, and norovirus using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) assay. Results : The most common virus was parechovirus (16%), followed by adenovirus (15%), astrovirus (14%), rotavirus (13%), and enterovirus (5%). Interestingly, only one of the specimens was positive for norovirus. Single infection cases were detected in 173 (55.8%) of the 310 children, whereas mixed viral infections were detected in 10 (3.2%) of the same children. Viral gastroenteritis generally showed a double peak of incidence. Parechovirus, rotavirus, and adenovirus shared a similar pattern of peak incidence with overall viruses; however, astrovirus infections occurred more frequently in the spring. Eighty-five percent of the confirmed viral gastroenteritis cases developed in under 24 months. Conclusion : The results support the importance of parechovirus, adenovirus, astrovirus, and enterovirus as causative agents of diarrhea in children, which may be underestimated by current routine diagnostic testing.

키워드

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