요로 감염환자에서 혈청학적 방법을 이용한 P-pili특이혈중 항체의 조사

Serological Studies on the Specific Antibodies Against P-pili of Uropathogenic Escherichia coli

비뇨기계 병원성 대장균의 중요한 병원성 인자 중의 하나로 인정되고 있는p-fimbriae의 subtype의 분포를 확인하기 위하여 요로감염증으로 확진된 환자의 혈청을 이용하여 immunoblotting 을 실시하였고, 이와 동시에 효소면역 측정법을 실시하여 p-fimbriae특이 항체 보유를 확인하였다. Immunoblotting 결과 우리나라 요로감염증환자에서 높은 빈도로 확인되는 p-fimbriae subtype의 분포는 $F7_1$34(56.7%), $F7_2$28(46.7%), F13 30(50%)등이 높게 나타났으며, 이와 같은 결과는 효소면역측정법에서도 동일하게 나타났다. 그러나 P-pili를 순수분리하지 않고 whole cell을 이용한 효소면역 측정법은 교차반응 때문에 비뇨기 감염증의 혈청학적인 진단에 적합하지 않는 것으로 나타났다. 또 우리 나라의 요로감염 환자에서 항체 양성율이 높은 $F7_1$, $F7_2$, F13만을 혼합하여 항원으로 이용한 효소면역측정법의 특이도와 민감도가 각각 92.6%, 90%로 나타나, 이와 같은 방법을 임상진단에 응용할 수 있을 것으로 판단되었다.

Escherichia coli is one of the most common etiological agents in urinary tract infection. An important virulence factor is the adhesive capacity of E. coli to uroepithelial cell, mediated by bacterial fimbriae. The Adhesion property has been regarded as an important virulence determinant in urinary tract infections. A total of 60 patients, who were diagnosed microbiologically as urinary tract infections, were examined by immunoblotting and enzyme-linked immunosorbent assay(ELISA). Uropathogenic E. coli with recombinant plasmid were positive for mannose resistant hemagglutination (MRHA). For identification of p-fimbriae subtype in uropathogenic E. coli, In the immunoblot analysis, specific bands in the range of p-fimbriae molecular weight of 17KD-22KD were identified. For the distribution of p-fimbriae subtype in the patient sera, 34/60(56.7%) were positive for $F7_1$, 28/60(46.7%) were positive for $F7_2$, and 30/60(50%) were positive for F13 with immunoblotting method. similar trends were observed in the enzyme-linked immunosorbent assay. Relatively good specificity(92.6%) and sensitivity(90%) were found in the ELISA test system using mixed antigens of purified $F7_1$, $F7_2$, and F13 p-fimbriae, and 60 sera from patients with urinary tract infections. In conclusion The serological tests were convenient method in diagnosis of urinary tract infections. among those ELISA could be recommended in diagnosis of urinary tract infections.