인천지역 소아 입원 환자의 엔테로바이러스 역학과 혈청형에 따른 임상양상 비교

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조병욱;권성은;권문주;허명제;김경선;홍영진;김순기;권영세;김동현
Cho, Byoung Wook;Kwon, Seong Eun;Kwon, Mun Ju;Hur, Myong Je;Kim, Kyung Seon;Hong, Young Jin;Kim, Soon Ki;Kwon, Young Se;Kim, Dong Hyun

  • 투고 : 2015.09.24
  • 심사 : 2015.10.30
  • 발행 : 2016.04.25

초록

목적: 소아에서 엔테로바이러스 감염증은 무증상 감염부터 비특이적 발열성 질환, 수족구병, 수막뇌염 등 다양한 질환으로 나타날 수 있다. 본 연구는 소아 입원 환자들을 대상으로 엔테로바이러스 감염의 유전자형 별 임상양상에 대하여 알아보고자 하였다. 방법: 2014년 3월부터 2015년 3월까지 인하대병원에 입원한 환자들 중 400명을 대상으로 real-time reverse transcriptase-polymerase chain reaction (RT-PCR)로 엔테로바이러스를 검출하였으며, RT-seminested PCR로 혈청형을 분석하였다. 염기서열의 계통분석을 시행하여 neighbor-joining tree를 작성하였다. 결과: 전체 연구대상 400명 중 112명(28%)에서 엔테로바이러스 양성이 확인되었으며 엔테로바이러스 양성 환자의 평균연령은 2.66세(3일-14세), 남녀 성비는 1.73:1 이었다. 65개의 검체에서 엔테로바이러스의 혈청형을 확인할 수 있었고, coxsackievirus B5 17례(15.2%), coxsackievirus A16 13례(11.6%), enterovirus 71 10례(8.9%), coxsackievirus A2 9례(8.0%) 순이었다. 엔테로바이러스 양성 환자들 중 96명(86%)에서 비특이적 발열 증상이 있었으며, 0-11일의 다양한 발열기간을 나타냈고, 평균 발열기간은 3.13일이었다. 발진은 전체 양성환자 중 44명(39%)에서 나타났으며, 수막뇌염은 43명(38%)에서 나타났다. 염기서열에 따른 계통 분석에서 6개의 유전적 군집이 관찰되었다. 결론: 저자들은 인천지역 단일기관에 입원한 환자에서 분리된 엔테로바이러스의 혈청형과 임상양상을 확인하였다. 본 연구 결과가 앞으로 국내 엔테로바이러스 감염의 역학을 파악하는 데에 도움을 줄 것으로 생각한다.

키워드

Enterovirus;Epidemiology;Children;Genotype

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