Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Epidemiological Study on Acute Diarrheal Disease of Children and Adolescents in the Jeju Region Using a Multiplex-PCR

Multiplex-PCR을 이용한 제주지역 소아청소년의 급성설사질환 역학조사

  • Lee, Kyu-taeg (Department of Laboratory Medicine, Cheju Halla General Hospital) ;
  • Kim, Sunmi (Department of infection Control Service Team, Cheju Halla General Hospital) ;
  • Chong, Moo Sang (Department of Clinical Pathology, Cheju Halla University)
  • 이규택 (제주한라병원 진단검사의학과) ;
  • 김선미 (제주한라병원 감염관리실) ;
  • 정무상 (제주한라대학교 임상병리과)
  • Received : 2017.05.06
  • Accepted : 2017.06.08
  • Published : 2017.06.30
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Abstract

To examine the cause of acute diarrheal disease in children and adolescents, 521 fecal samples underwent multiple-PCR for a period of two years, between March 2015 and February 20178, in the Jeju region of Korea. Based on the analysis of 179 positive samples, 102 samples were male (56.98%) and 77 were female (43.02%), and highest positive rates were shown in the age group of 3~4 years (51.96%) and 5~6 years (12.29%). When 209 cases (40.12%), including double infection were analyzed, there were 88 cases (16.89%) of norovirus-GII infection, 26 cases (4.99%) of Campylobacter spp. infection, 18 cases (3.45%) of rotavirus infection, 18 cases (3.45%) of Clostridium difficile Toxin B infection, 17 cases (3.26%) of adenovirus infection, 16 cases (3.07%) of Clostridium perfringens infection, 11 cases (2.11%) of astrovirus infection, 5 cases (0.96%) of Salmonella spp. infection, 3 cases (0.58%) of norovirus-GI, Yersinia spp. and Aeromonas spp. infections, and 1 case (0.19%) of verocytotoxin-producing E. coli infection. Based on a seasonal separation of early childhood, norovirus-GI and norovirus-GII mainly prevailed during the winter, when the temperature is low. Typical enteritis with an increased prevalence of rotavirus during the spring. Astrovirus prevailed between the months of April and October, when norovirus-GI, norovirus-GII, and rotavirus did not prevail. With increasing age, acute diarrheal disease was not only induced by a virus, but also by bacteria. Although a test for virus is an effective method when trying to identify the cause during early childhood by multiplex-PCR, it would be desirable to undergo tests for both virus and bacteria concurrently as age increases.

2015년 3월부터 2017년 2월까지 2년간 Multiplex-PCR을 이용한 소아청소년의 급성설사질환 원인규명을 위해 의뢰된 521 분변 검체를 대상으로 5종의 바이러스 검사와 10종의 세균검사를 실시한 521 분변 검체 중 바이러스나 세균이 확인된 170명 중 중복 감염이 확인된 9명의 검체를 포함하여 179개의 양성검체의 결과를 분석한 결과 남아가 102명(56.98%), 여아가 77명(43.02%)이었으며, 3~4세(51.96%), 5~6세(12.29%) 연령대에서 가장 높은 양성율을 보였다. 179건의 양성 검체 중 중복감염을 포함한 209건(209/521, 40.12%)을 분석한 결과 norovirus-GII 감염이 88건(88/521, 16.89%), Campylobacter spp. 감염이 26건(26/521, 4.99%), rotavirus 감염이 18건(18/521, 3.45%), Clostridium difficile Toxin B 감염이 18건(18/521, 3.45%), adenovirus 감염이 17건(17/521, 3.26%), Clostridium perfringens 감염은 16건(16/521, 3.07%), astrovirus 감염은 11건(11/521, 2.11%), Salmonella spp. 감염은 5건(5/521, 0.96%), norovirus-GI, Yersinia spp., Aeromonas spp. 감염은 각각 3건(3/521, 0.58%), verocytotoxin-producing E. coli 감염은 1건(1/521, 0.19%), Vibrio spp, E. coli O157:H7, Shigella spp. 감염은 나타나지 않았다. 유아기(6세 이하)의 계절별 분리 양상을 확인한 결과는 기온이 낮은 겨울(11~2월)에는 주로 norovirus-GI, norovirus-GII가 유행하였고, 기온이 상승하기 시작하는 봄(3~5월)에는 rotavirus가 유행하는 경향을 전형적인 장염바이러스의 경향을 보였다. Astrovirus 경우에는 norovirus-GI, norovirus-GII, rotavirus가 유행하는 시기가 아닌 4월~10월에 유행하는 경향을 보이고, adenovirus인 경우에는 8월~2월까지 유행하는 경향을 보였다. 연령이 높아질수록 바이러스뿐만 아니라 세균이 원인이 되어 급성설사질환을 유발하는 것으로 나타났으며, 다중 중합효소연쇄반응으로 원인을 파악하고자 할 때에는 유아기 때에는 바이러스 검사를 의뢰하는 것이 유효하지만 연령이 높아짐에 따라 바이러스와 세균을 동시에 의뢰하는 것이 바람직하다고 사료된다.

Keywords

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