Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A study of serotyping of Streptococcus pneumoniae by multibead assay

다중구슬 분석법에 의한 폐구균 혈청형 결정 연구

  • Cho, Ky Young (Department of Pediatrics, College of Medicine Ewha Woman's University) ;
  • Lee, Jung Ah (Department of Pediatrics, College of Medicine Ewha Woman's University) ;
  • Cho, Sung Eun (Department of Laboratory Medicine, College of Medicine Ewha Woman's University) ;
  • Kim, Nam Hee (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Lee, Jin A (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Hong, Ki Sook (Department of Laboratory Medicine, College of Medicine Ewha Woman's University) ;
  • Lee, Hoan Jong (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Kyung Hyo (Department of Pediatrics, College of Medicine Ewha Woman's University)
  • 조기영 (이화여자대학교 의과대학 소아과학교실) ;
  • 이정아 (이화여자대학교 의과대학 소아과학교실) ;
  • 조성은 (이화여자대학교 의과대학 진단검사의학교실) ;
  • 김남희 (서울대학교 의과대학 소아과학교실) ;
  • 이진아 (서울대학교 의과대학 소아과학교실) ;
  • 홍기숙 (이화여자대학교 의과대학 진단검사의학교실) ;
  • 이환종 (서울대학교 의과대학 소아과학교실) ;
  • 김경효 (이화여자대학교 의과대학 소아과학교실)
  • Received : 2006.08.17
  • Accepted : 2006.09.13
  • Published : 2007.02.15
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Abstract

Purpose : Streptococcus pneumoniae is a major etiologic agent for pneumonia, meningitis, otitis media, and sepsis among young children. Multi-drug resistant strains have raised great concern worldwide, thus the importance of prevention with vaccines has been emphasized. However, vaccines may force the appearance of pneumococcal infections by nonvaccine serotypes. Thus, distribution of pneumococcal serotypes should be monitored to estimate vaccine efficacy. We used a new and efficient multibead assay in determining pnemococcal serotypes. Methods : From January to February 2005, 643 children were recruited from ten day care centers to isolate pneumococci from their oropharynx. Pneumococcal serotyping was performed on 62 pneumococcal isolates from 60 children by multibead assay. This immunoassay required two sets of latex particles coated with pneumococcal polysaccharides and serotype-specific antibodies. Twenty four newly developed monoclonal antibodies specific for common serotypes and a pool of polyclonal rabbit sera for some of the less common serotypes were used. Results : The most prevalent pneumococcal serotypes were serotype 6A, 19A, 19F, 23F, and 11A/D/F which accounted more than 50 precent of all the 62 pneumococcal isolates. We found that multibead assay can be performed very rapidly and objectively. Conclusion : This multibead immunoassay was very useful in serotyping clinical isolates of S. pneumoniae because it was simple, reliable and fast.

목 적: 폐구균은 영유아와 소아에서 세균성 수막염, 중이염, 폐염 등의 주요한 원인균이다. 최근 전 세계적으로 여러 항균제 내성을 보이는 폐구균이 증가하는 추세여서 폐구균 단백 결합 백신의 도입과 함께 폐구균의 예방이 중요시되고 있다. 백신이 특이 혈청형에 대한 항체를 유도하기 때문에 백신에 해당하지 않는 혈청형의 폐구균의 감염율이 상대적으로 증가할 수 있다. 이와 같은 배경에서 폐구균 질환의 역학을 이해하기 위해서는 임상 검체나 인두에서 분리된 폐구균의 혈청형 분석이 필요하다. 이번 연구에서는 새롭게 제시되고 있는 효과적이고 정확한 다중구슬 분석법을 이용하여 폐구균 혈청형을 분석하였다. 방 법: 2005년 1-2월 동안 서울 지역의 10개 유아원에서 9세 이하 소아 643명을 대상으로 calcium alginate 면봉으로 구인두 점막을 문질러 검체를 얻고 60명의 소아에서 폐구균을 분리하였다. 이들 60명에서 다중구슬 분석법으로 혈청형을 분석하여 62균주의 혈청형을 분리하였다. 다중구슬 분석법은 폐구균 다당질과 혈청형 특이 항체로 덮혀진 두 종류의 라텍스 세트를 이용하였다. 이 두 세트는 24가지 혈청형으로 이루어져 있고, 이 혈청형들은 임상적으로 의미 있는 질환을 일으키는 폐구균 혈청형의 90% 이상을 차지하는 혈청형들이다. 결 과: 이번 연구에서 분리된 62균주에서 혈청형 6A, 19A, 19F, 23F, 11A/11D/11F이 전체의 53.2%를 차지하고 있었다. 다중구슬 분석법으로 62 균주의 혈청형을 정확하고 빠르게 연구할 수 있었다. 결 론: 다중구슬 분석법은 폐구균 혈청형 분석에 정확하고 정량적인 결과를 도출할 수 있었고 향후 폐구균 혈청형 연구을 위한 기준 방법으로 제시할 수 있다.

Keywords

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