Annals of Clinical Microbiology

The Korean Society of Clinical Microbiology (대한임상미생물학회)
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Multiplex PCR Based Epidemiological Study for the Causes of Acute Diarrheal Disease in Adults Living in Jeju Island

Multiplex PCR을 이용한 제주도 성인의 급성 설사 원인체에 관한 역학조사

  • Lee, Kyutaeg (Department of Laboratory Medicine, Cheju Halla General Hospital) ;
  • Kim, Dae Soon (Infection Control Service Team, Cheju Halla General Hospital) ;
  • Chong, Moo Sang (Department of Clinical Pathology, Cheju Halla University)
  • 이규택 (제주한라병원 진단검사의학과) ;
  • 김대순 (제주한라병원 감염관리실) ;
  • 정무상 (제주한라대학교 임상병리과)
  • Received : 2017.08.28
  • Accepted : 2017.10.27
  • Published : 2018.03.31
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Abstract

Background: We attempted to determine the characteristics of diarrheal pathogens according to species, seasonal variations, and patient age using multiplex PCR for the epidemiologic study of diarrheal disease in Jeju Island. Methods: From March 2015 to Feb 2017, stool specimens were collected from 537 diarrheal patients older than 16 years. Multiplex PCR was used to identify pathogens and found Group A Rotavirus, enteric Adenovirus, Norovirus GI/GII, Astrovirus, Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp., Clostridium difficile toxin B (CDB), Clostridium perfringens, Yersinia enterocolitica, Aeromonas spp., Escherichia coli O157:H7, and verocytotoxin-producing E. coli (VTEC). Results: Pathogens were isolated from 221 of 537 samples (41.2%); 9.3% were positive only for viral pathogens; 30.2%, only for bacterial pathogens; and 1.7%, for both viral and bacterial pathogens. Bacteria were more prevalent in spring, summer, and autumn, but viral pathogens were more prevalent in winter. Overall prevalence were Campylobacter spp. (26.7%), Clostridium perfringens (23.9%); Norovirus GII (11.4%), CDB (8.2%), Aeromonas spp. (6.3%), Group A Rotavirus (5.1%), Salmonella spp. (3.9%), Astrovirus (3.9%), Norovirus GI (3.1%), Vibrio spp (2.7%), enteric Adenovirus (1.6%), Shigella spp. (1.2%), VTEC (1.2%), and Yersinia enterocolitica (0.4%). Group A Rotavirus and Norovirus GII were more prevalent in winter and early spring. Campylobacter spp., CDB, and C. perfringens were detected frequently, without seasonal variation. Conclusion: Bacterial pathogens are more prevalent than viruses in acute diarrhea in adults living in Jeju Island, especially in spring, summer, and autumn. Viral pathogens are prevalent in winter. Campylobacter spp., CDB, and Clostridium perfringens are the major pathogens occurring without seasonal variations. These data will be helpful in identifying diarrheal pathogens and for treatments and prevention strategies.

배경: 급성 설사 원인체의 동정을 위해 다중연쇄중합효소가 유용한 방법으로 사용되고 있다. 이에 저자는 제주도 성인에서 각각의 설사 원인체, 계절, 연령에 따른 특징에 대해 조사하여 제주도 성인에서 설사 원인 유발체에 대한 역학적인 기초적인 자료를 제공하고자 하였다. 방법: 2015년 3월부터 2017년 2월까지 2년 동안 16세 이상의 성인에서 다중연쇄중합효소를 이용한 5가지 바이러스성 설사 원인체(Group A Rotavirus, enteric Adenovirus, Norovirus GI/GII, Astrovirus), 10가지 세균성 설사 원인체(Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp., Clostridium difficile toxin B (CDB), Clostridium perfringens, Yersinia enterocolitica, Aeromonas spp., Escherichia coli O157:H7, verocytotoxin-producing E. coli (VTEC)) 검사를 의뢰한 537명의 결과를 토대로 조사하였다. 결과: 설사 원인체는 537검체 중 221검체(41.2%)에서 양성을 보였고 9.3%는 바이러스에서, 30.2%는 세균에서, 1.7%는 중복감염을 보였다. 세균성 원인균은 봄, 여름, 가을에, 바이러스성 원인체는 겨울에 자주 관찰되었다. 원인체별로는 Campylobacter spp. (26.7%), C. perfringens (23.9%), Norovirus GII (11.4%), CDB (8.2%), Aeromonas spp. (6.3%), Group A Rotavirus (5.1%), Salmonella spp. (3.9%), Astrovirus (3.9%), Norovirus GI (3.1%), Vibrio spp. (2.7%), enteric Adenovirus (1.6%), Shigella spp. (1.2%), VTEC (1.2%), Y. enterocolitica (0.4%)이었고 E. coli O157:H7는 연구기간 내에 관찰되지 않았다. Rotavirus, Norovirus GII는 겨울과 봄에 자주 관찰되었고 Campylobacter, CDB, C. perfringens는 계절적인 변화는 보이지 않으며 매월 빈번히 관찰되었다. 결론: 제주도에 사는 성인에서 세균성 설사 원인균이 바이러스성 원인체보다 봄, 여름, 가을에 빈번하였다. 세균성 설사 원인체는 겨울에 빈번하였다. Campylobacter, CDB 및 C. perfringens는 계절적인 변이를 보이지 않으며 매월 빈번히 관찰되었다. 본 연구의 결과는 제주의 성인 설사 원인체에 대한 역학적인 자료로 사용되며 조기 진단, 치료 및 설사 원인체의 전파 방지에 도움이 될 것이다.

Keywords

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