2014-2016년도 국내 소아청소년에서의 폐렴구균 비인두 보균 균주 및 침습성감염 균주의 MLST 분석

GENETIC STRUCTURE OF STREPTOCOCCUS PNEUMONIAE FROM NASOPHARYNGEAL CARRIAGE AND INVASIVE DISEASES FROM 2014 TO 2016 IN KOREA

(지상발표):媛

Release Date :

Kyuyol Rhie¹, Hoan Jong Lee¹^,2, Ki Wook Yun¹^,2, Eun Hwa Choi¹^,2, Jin Han Kang³, Kyung-Hyo Kim⁴, Dong Soo Kim⁵, Yae-Jean Kim⁶, Byung Wook Eun⁷, Sung Hee Oh⁸, Hye-Kyung Cho⁹, Young Jin Hong¹⁰, Kwang Nam Kim¹¹, Nam Hee Kim¹², Yun-Kyung Kim¹³, Hyunju Lee¹⁴, Taekjin Lee¹⁵, Hwang Min Kim¹⁶, Eun Young Cho¹⁷, Chun Soo Kim¹⁸, Su Eun Park¹⁹, Chi Eun Oh²⁰, Dae Sun Jo²¹, Young Youn Choi²² , Jina Lee²³

Seoul National Univesity Children's Hospital Department of Pediatrics¹

Seoul National Univesity College of Medicine Department of Pediatrics²

Catholic University College of Medicine Department of Pediatrics³

Ewha Womans University School of Medicine Department of Pediatrics⁴

Yonsei Univeresity College of Medicine Department of Pediatrics⁵

Sungkyunkwan University School of Medicine Department of Pediatrics⁶

Eulji University Hospital Department of Pediatrics⁷

Hanyang University College of Medicine Department of Pediatrics⁸

Gachon University School of Medicine Department of Pediatrics⁹

Inha University School of Medicine Department of Pediatrics¹⁰

Hallym University Chuncheon Sacred Heart Hospital Department of Pediatrics¹¹

Inje University College of Medicine Department of Pediatrics¹²

Korea University College of Medicine Department of Pediatrics¹³

Seoul National Univesity Bundang Hospital Department of Pediatrics¹⁴

CHA University Bundang CHA Hospital Department of Pediatrics¹⁵

Yonsei Univeresity Wonju College of Medicine Department of Pediatrics¹⁶

Chungnam National University Hospital Department of Pediatrics¹⁷

Keimyung University School of Medicine Department of Pediatrics¹⁸

Pusan National University School of Medicine Department of Pediatrics¹⁹

Kosin University College of Medicine Department of Pediatrics²⁰

Chonbuk National University Medical School Department of Pediatrics²¹

Chonnam National University Medical School Department of Pediatrics²²

University of Ulsan College of Medicine Department of Pediatrics²³

이규열¹, 이환종¹^,2, 윤기욱¹^,2, 최은화¹^,2, 강진한³, 김경효⁴, 김동수⁵, 김예진⁶, 은병욱⁷, 오성희⁸, 조혜경⁹, 홍영진¹⁰, 김광남¹¹, 김남희¹², 김윤경¹³, 이현주¹⁴, 이택진¹⁵, 김황민¹⁶, 조은영¹⁷, 김천수¹⁸, 박수은¹⁹, 오지은²⁰, 조대선²¹, 최영윤²² , 이진아²³

서울대학교 어린이병원 소아청소년과¹

서울대학교 의과대학 소아청소년과²

가톨릭대학교 의과대학 소아청소년과³

이화여자대학교 의학전문대학원 소아청소년과⁴

연세대학교 의과대학 소아청소년과⁵

성균관대학교 의과대학 소아청소년과⁶

을지대학교병원 소아청소년과⁷

한양대학교 의과대학 소아청소년과⁸

가천대학교 의학전문대학원 소아청소년과⁹

인하대학교 의학전문대학원 소아청소년과¹⁰

한림대학교 춘천성심병원 소아청소년과¹¹

인제대학교 의과대학 소아청소년과¹²

고려대학교 의과대학 소아청소년과¹³

분당서울대학교병원 소아청소년과¹⁴

차 의과대학교 분당차병원 소아청소년과¹⁵

연세대학교 원주의과대학 소아청소년과¹⁶

충남대학교병원 소아청소년과¹⁷

계명대학교 의과대학 소아청소년과¹⁸

부산대학교 의학전문대학원 소아청소년과¹⁹

고신대학교 의과대학 소아청소년과²⁰

전북대학교 의학전문대학원 소아청소년과²¹

전남대학교 의과대학 소아청소년과²²

울산대학교 의과대학 소아청소년과²³

Abstract

Background and aims: This study investigated the genetic structure of isolates from pneumococcal carriage and invasive pneumococcal disease (IPD) of Korean children from 2014 to 2016. Methods: 2356 nasopharyngeal aspirates were collected from children with respiratory symptoms at the Seoul National University Children\'s Hospital. Among them, 354 aspirates were pneumococcal isolates and 78 isolates were selected as representative strains. Invasive isolates were collected from 22 hospitals throughout Korea. IPD cases were identified by isolating pneumococci from a normally sterile site. Each isolate was identified using standard microbiological techniques, Quellung reaction, and the multi-locus sequence typing. Results: 154 pneumococcal isolates were analyzed: 78 isolates were from nasopharyngeal carriage isolates and 76 from invasive isolates. The relative proportion of non-vaccine serotypes among carriage and invasive isolates were 84.6% and 80.3%, respectively. 27 STs with 3 clonal complexes (CCs) (34.5%) and 27 singletons (65.5%) were assigned for carriage isolates. 27 STs with 3 CCs (35.4%) and 21 singletons (64.6%) were assigned for invasive isolates. Of four CCs identified, CC81, CC161, and CC320 were main complexes: among carriage isolates-CC166 (20.5%), CC320 (10.2%), and CC1982 (3.8%); among invasive isolates-CC81 (13.1%), CC166 (11.8%), and CC320 (10.5%). CC166 mainly consisted of serotypes 23A, 11A, 15C, 15B in both types of isolates. CC320 consisted of 19A (75%) and 15B (25%) in carriage isolates; all serotypes constituting CC320 were 19A in invasive isolates. The CC81 in invasive isolates was mainly occupied with 15A (60.0%). ST11189 was prevalent in both carriage and invasive isolates, 6.4% (all 10A) and 13.1% (all 10A) respectively. ST6945 was prevalent in invasive isolates (13.1%, all 12F), but only one (1.3%, 12F) in carriage isolates. 9 STs (ST880, ST2758, ST3385, ST3386, ST5545, ST6945, ST7314, ST10161, and ST11189) were found among both types of isolates. 12 STs (ST63, ST180, ST189, ST191, ST386, ST393, ST439, ST855, ST1012, ST1373, ST1982, and ST10272), however, were only found among invasive isolates. Conclusions: Serotypes 11A, 15A, 15B/C, 23A, and 19A mainly occupied CCs of both types of isolates. 10A and 12F were mainly identified in singletons of invasive isolates while diverse serotypes were scattered among carriage isolates.

Keywords: Multi-locus sequence typing (MLST), Pneumococcal nasopharyngeal carriage isolates, Pneumococcal invasive isolates