• Tuberculosis and Respiratory Diseases
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• 제57권3호
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• pp.234-241
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• 2004

연구배경 : MAC는 NTM 폐질환의 가장 흔한 원인균이다. Clarithromycin과 같은 새로운 항생제의 사용에도 불구하고, 아직까지 MAC 폐질환의 내과적 치료성적은 만족스럽지 못한 실정이다. 본 연구는 MAC 폐질환 환자를 대상으로 clarithromycin이 포함된 내과적 치료의 효과를 알아보고자 하였다. 대상 및 방법 : 2000년 1월부터 2003년 12월까지 삼성서울병원 호흡기내과에서 진단된 MAC 폐질환 환자 56명 중 clarithromycin이 포함된 병합 항생제 치료를 6개월 이상 시행한 환자 15명을 대상으로 하여 후향적 조사를 시행하였다. 결 과 : 남자가 6명(40%) 여자가 9명(60%)이었고, 연령의 중앙값은 67세(범위 53-87세)였다. 원인균은 M. intracellulare가 12명(80%), M. avium이 3명(20%)이었고, 객담 도말 양성환자가 13명(87%)이었다. 5명(27%)의 환자는 upper lobe cavitary form, 그리고 10명(67%)은 nodular bronchiectatic form이었다. 모든 환자에서 clarithromycin, rifampin, ethambutol을 투여하였고, 8명(53%)의 환자는 streptomycin을 함께 사용하였다. 치료기간은 중앙값 17개월(범위 8-22개월)이었다. 6개월 이상 치료한 15명 중 8명(53%)에서 균음전에 성공하였다. 6개월 치료 후 단순흉부방사선 촬영에서 10명(67%)이 호전되었고 5명(33%)은 변화가 없었다. 균음전에 실패한 1명은 폐절제술을 시행하였다. 폐절제술을 시행한 환자를 제외하고 12개월 이상 내과적 치료를 시행한 9명 중 4명(44%)이 균음전에 성공하였다. 12개월 치료 후 단순흉부방사선촬영에서 6명(67%)이 호전을 보였다. 전체적으로 내과적 치료 후 균음전에 성공한 환자는 9명(60%)으로, 이 중 5명의 환자는 치료 시작 1-2개월 후부터 배양 음성이 유지되었다. 1명의 환자에서 위장관 장애와 시신경염으로 치료를 중단하였다. 결 론 : MAC 폐질환에서 clarithromycin을 포함한 내과적 치료 후 균음전에 성공한 환자는 60%에 불과하였다. 보다 효과적인 치료약제의 개발이 필요하며, 내과적 치료에 반응하지 않는 환자에서는 폐절제술을 고려하여야 할 것으로 사료된다.

• 대한수의학회지
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• 제29권3호
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• pp.283-289
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• 1989

In order to measure in vitro cell mediated immunity in the guinea pigs sensitized with the killed bacilli of Mycobacterium bovis ($AN_5$), M avium (serotype 2), M tuberculosis and M intracellulare (serotype 8), leukocyte adherence inhibition (LAI) test was established using the antigens of purified protein derivatives (PPD) tuberculin. By using LAI test, specificity of cell-mediated immune responses of the guinea pigs inoculated with various Mycobacterium spp was investigated, and comparison between values of LAI and skin test was also made to evaluate the specificity of the newly designed test. The results obtained throughout the experiments were summarized as follows; 1. The optimal concentration of PPD antigens for LAI test was 1 to 2mg per ml of medium. 2. When the leukocytes of guinea pigs sensitized with both M bovis($AN_5$) and M avium (serotype 2) for 2 to 8 weeks were incubated with homologous or heterologous PPD antigens, mean values of LAI test were $61.2{\pm}11.2$ and $65.6{\pm}5.1%$ in homologous PPD antigens respectively, while $30.0{\pm}3.7$ and $32.8{\pm}5.7%$ in heteNlogous PPD antigens, showing the prominently high value of LAI in the homologous syst,em (p<0.01). 3. When the leukocytes of guinea pigs sensitized with both M tuberculosis and M intracellulare (serotype 8) for 2 to 8 weeks were incubated with homologous and heterologous PPD antigens, mean values of LAI test were $67.9{\pm}2.9$ and $66.9{\pm}5.0%$ in homologous PPD antigens, while $27.4{\pm}7.4$ and $24.4{\pm}7.1%$ in heterologous PPD antigens, showing the prominently high value of LAI in the homologous system (p<0.01). 4. Comparing with the specificity of LAI and skin tests on the basis of the value obtained from the homologous system, deviation of reaction was revealed to be 49.5 to 100.2 in LAI test, and -15.9 to 52.0 in skin test.

• 대한의생명과학회지
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• 제16권1호
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• pp.10-18
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• 2010

The present study was set to develop comprehensive system for assessing the safety of drinking water using PCR-reverse blot hybridization assay (REBA). The REBA developed in this study can detect waterborne pathogens such as Shigella spp., Salmonella spp., Citrobacter spp., Enterobacter spp., Klebsiella spp., Yersinia spp., Mycobacterium spp., Listeria spp. at the genus level, and Escherichia coli, Citrobacter freundii, Klebsiella pneumoniae, Pseudomonas aeruginosa, Yersinia enterocolitica, Y. pseudotuberculosis, Mycobacterium avium complex, M. marinum, Enterococcus faecalis, and Staphylococcus aureus at the species level, and E. coli O157:H7 at the strain level.

• 미생물학회지
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• 제24권4호
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• pp.377-384
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• 1986

A study on the production of mycobacterial antogens has been made in order to improve immunological reactivity and specificity, which have long been explored for the better use of immunological diagnosis of mycobacterial infections. Instead of culture filtrate cell extract was used as a starting material for the production of antigens in this study. Cell extract was fractionated though several steps such as salting out, gel filtration and ion exchange column chromatography and reactivity and specificity of the fractions so produced were enaluated by the various serological methods. The result showed that the species-specific antigenic components distributed mostly in the fractions, Tc of M. tuberculosis, Kc of M. kansasii, Sa of M. scrofulaceum, Aa of M. avium and Fa, Fb, Fc (FF1) of M. fortuitum, which were fractionated by ion exchange column prior to concentrating by salting out and molecular sieving.

• Tuberculosis and Respiratory Diseases
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• 제79권2호
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• pp.74-84
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• 2016

Nontuberculous mycobacteria (NTM) are emerging pathogens that affect both immunocompromised and immunocompetent patients. The incidence and prevalence of NTM lung disease are increasing worldwide and rapidly becoming a major public health problem. For the diagnosis of NTM lung disease, patients suspected to have NTM lung disease are required to meet all clinical and microbiologic criteria. The development of molecular methods allows the characterization of new species and NTM identification at a subspecies level. Even after the identification of NTM species from respiratory specimens, clinicians should consider the clinical significance of such findings. Besides the limited options, treatment is lengthy and varies by species, and therefore a challenge. Treatment may be complicated by potential toxicity with discouraging outcomes. The decision to start treatment for NTM lung disease is not easy and requires careful individualized analysis of risks and benefits. Clinicians should be alert to those unique aspects of NTM lung disease concerning diagnosis with advanced molecular methods and treatment with limited options. Current recommendations and recent advances for diagnosis and treatment of NTM lung disease are summarized in this article.

• Annals of Clinical Microbiology
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• 제18권2호
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• pp.37-43
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• 2015

배경: 결핵은 전세계적으로 단일 원인균으로는 가장 높은 치사율을 가진 질병이다. 결핵의 치료에 있어서 마이코박테리아를 빠르고 정확하게 확인하는 것이 필수적이다. 본 연구에서는 임상 객담 검체의 도말 슬라이드에서 결핵균과 비결핵 항산균의 감별을 위해 Peptide Nucleic Acid (PNA) Probe를 이용한 FISH assay를 평가하고자 한다. 방법: 결핵균과 비결핵 항산균의 16s rRNA를 타겟으로 한 PNA probe를 합성하였다. 각 probe의 특이도는 표준 균주인 Mycobacterium tuberculosis ATCC 13950, M. kansasii ATCC 12479, 임상 검체에서 분리된 마이코박테리아 3종(M. abscessus, M. avium, and M. intracellulare) 그리고 호흡기계에서 흔히 분리되는 10종류의 박테리아를 이용하였다. Centers for Disease Control and Prevention (CDC)의 Acid fast bacili (AFB) 염색 기준상 trace 이상인 128개의 임상 객담 검체를 이용하여 Probe의 성능을 평가하였다. PNA FISH와 항산균 염색결과는 CDC 기준에 따라 단계를 분류하고 서로 비교하였다. 결과: 결핵균과 비결핵 항산균 특이 PNA probe는 결핵균과 M. kansasii 표준 균주 그리고 임상검체에서 분리된 3종의 마이코박테리아에 대해 특이적인 반응을 보였고 다른 박테리아와 교차반응을 보이지 않았다. 또한 89개의 결핵균 배양 양성 객담 검체와 29개의 비결핵 항산균 배양 양성 객담 검체에 각각 특이적인 반응을 보였고 CDC 기준에 따라 분류한 PNA FISH와 AFB염색 결과는 2+ 이상의 검체에서 서로 잘 일치하였다. 결론: PNA FISH 방법은 임상 객담 검체에서 결핵을 진단하고, 항산균과 비결핵 항산균을 구분하는데 있어서 민감하고 정확한 결과를 보였다.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.191-196
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• 2012

While nontuberculous mycobacterium (NTM) infections are recently on the rise, arthritis caused by NTM is hardly reported in Korea. NTM arthritis has no distinctive clinical characteristics from chronic arthritis. Tuberculosis of the joint specifically produces similar clinical and pathologic presentations to NTM arthritis, so it is not easy to distinguish between them. We report a case of Mycobacterium intracellulare in an arthritis patient after trauma and surgical repair of the injury. At the beginning, the patient was diagnosed as tuberculous tenosynovitis through pathology without microbiologic evidence. The final diagnosis was made after subsequent recurrences for several years. The misdiagnosis and delayed diagnosis led to irreversible joint destruction and functional impairment. NTM infection must be included in the differential diagnosis of chronic arthritis at the outset.

• Journal of Microbiology and Biotechnology
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• 제23권8호
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• pp.1167-1175
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• 2013

Paratuberculosis (PTB) or Johne's disease is one of the most serious chronic debilitating diseases of ruminants worldwide that is caused by Mycobacterium avium subsp. paratuberculosis (MAP). MAP is a slow-growing bacterium that has very long latent periods, resulting in difficulties in diagnosing and controlling the disease, especially regarding the diagnosis of fecal shedders of MAP without any clinical signs. Based on this situation, attempts were made to identify biomarkers that show early responses to MAP infection in a macrophage cell line, RAW 264.7. In response to the infection with the bacterium, a lot of genes were turned on and/or off in the cells. Of the altered genes, three different categories were identified based on the time-dependent gene expression patterns. Those genes were considered as possible candidates for biomarkers of MAP infection after confirmation by quantitative RT-PCR analysis. To the best of our knowledge, this is the first attempt at discovering the host transcriptomic biomarkers of PTB, although further investigation will be required to determine whether these biomarker candidates are associated within the natural host.

• 한국동물위생학회지
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• 제38권4호
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• pp.221-225
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• 2015

The bacterium causing Johne's disease (JD), Mycobacterium avium subspecies paratuberculosis (MAP), is distributed worldwide and causes progressive intestinal disease, also known as paratuberculosis, in domestic and exotic ruminants, including cattle. The subclinical form of this disease results in progressive weight loss, reduced milk production, lower slaughter value, and premature culling, with possible impacts on fertility and udder health. Eventually, infection can lead to the clinical form that manifests chronic diarrhea, emaciation, debilitation, and eventual death. JD is a major cause of economic loss in cattle industry. In this study, serological testing was conducted by ELISA to determine the prevalence of MAP in Korean native cattle of Jeju during the duration of 2010 to 2013. A total of 5,150 blood sera were collected in 111 farms and the samples were classified into four different age groups for MAP; group 1 (2 years or less), group 2 (2~4 years), group 3 (5~7 years), and group 4 (over 8 years). Overall seroprevalence of MAP was 5.2% (269/5,150), and annually from 2010 to 2013, they were 11.6% (106/915), 2.1% (10/474), 5.5% (89/1,627), and 3.0% (64/2,134), respectively. Also, the prevalence rates was determined by age groups: 48 of group 1 (17.8%), 154 of group 2 (57.3%), 48 of group 3 (17.8%), and 19 of group 4 (7.1%) were seropositive for MAP. Although seropositive samples were found in all age groups, the highest seroprevalence was found in group 2. This study showed that during the investigation the seroprevalence of MAP tended to decrease.

• 대한수의학회지
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• 제60권3호
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• pp.117-122
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• 2020

Johne's disease (JD) caused by Mycobacterium avium subspecies paratuberculosis (MAP) is a chronic, wasting infectious disease in ruminants that causes enormous economic losses to the dairy and beef cattle industries. The most effective way to eradicate JD is to detect infected individuals as early as possible and remove them from the herd. However, it is difficult to detect infected individuals early with the currently using diagnostic methods. Two serological diagnostic kits commercially used worldwide and a fecal detection test were compared using 298 serum samples and feces of cattle in this study to present an efficient diagnostic method. Although there was a high correlation between the 2 serological diagnostic kits (R² = 0.7473), kit A showed a higher serological positive rate. However, the correlation between fecal tests and serological diagnosis was very low. MAP was also detected in fecal tests in many serologically negative individuals. In the periodical diagnosis of JD, MAP was detected in the feces of only cows with the higher antibody titer to MAP. These results suggest that for effective eradication of JD, early detection of infected individuals by fecal tests together with the serological tests currently in use and by removal of infected individuals are needed.