Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Analysis of DNA fingerprints of Mycobacterium Tuberculosis Isolates from Patients Registered at Health Center in Gyeonggi Province in 2004

2004년도 경기도 보건소 결핵환자로 부터 분리된 결핵균 DNA 지문분석

  • 박영길 (대한결핵협회 결핵연구원) ;
  • 강희윤 (대한결핵협회 결핵연구원) ;
  • 임장근 (대한결핵협회 결핵연구원) ;
  • 하종식 (대한결핵협회 결핵연구원) ;
  • 조정옥 (경기도청 보건위생과) ;
  • 최향순 (경기도청 보건위생과) ;
  • 이계철 (경기도청 보건위생과) ;
  • 최영화 (아주대학교 의과대학) ;
  • 신승수 (아주대학교 의과대학) ;
  • 전기홍 (아주대학교 의과대학) ;
  • 배길한 (대한결핵협회 결핵연구원)
  • Received : 2006.01.17
  • Accepted : 2006.03.13
  • Published : 2006.03.30
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Abstract

Background : IS6110 DNA fingerprint is a very useful tool for investigating the transmission of tuberculosis. The aim of this study was to identify the epidemiological situations within a given area (one province). Methods : The 681 Mycbobacterium tuberculosis isolates from patients, who were registered at health centers in Gyeonggi Province from May to December in 2004, were subjected to IS6110 DNA fingerprinting. Patients belonging to clusters were interviewed by health-workers to determine their previous contacts or household TB history. Results : The number of IS6110 copies of the 681 isolates showed diverse fingerprint patterns from 0 to 21 of which the most prevalent copy number was 10 from 120 isolates (17.6%). Thirty-three isolates (4.8%) belonged to the K strain, and 128 isolates (18.8%) belonged to the K family. There were 180 (26.4%) isolates belonged belonging to fifty clusters, of which two clusters were within household transmission. Forty-three (23.9%) out of 180 patients resided in an area under the same health center control. The rate of clusters in those aged 60-70 was higher than in any other age group ( 95% CI of RR : 1.072 ~ 1.988). Conclusion : This is the first report of an epidemiological survey based on a whole province using a DNA fingerprinting technique for M. tuberculosis. These results will be helpful in developing a program or policies to prevent the transmission of TB.

배 경: 결핵균 DNA 지문분석은 전염경로를 파악하는데 있어 매우 유용하다. 본 연구는 결핵균 DNA 지문 조사를 통하여 우리나라에서 처음으로 일개 지역(도 단위)에서 분리된 결핵균에 대하여 역학적 상황을 파악하고자 하였다. 방 법 : 2004년 5월부터 12월 까지 경기도내 보건소에 등록되는 모든 결핵환자의 검체로부터 분리된 681개 결핵균주에 대해서 DNA 지문 검사를 실시하였다. Cluster로 나타난 환자들에 대해서는 전파경로의 파악에 도움을 얻기 위하여 설문지를 통한 역학조사를 실시하였다. 결 과 : 681균주 중에서 IS6110의 copy 수는 0개에서 21개로 다양하였고, 그 중 10개가 120균주(17.6%)로 가장 많이 분포하였다. K 균주는 33 균주(4.8%)이었고, K family에 속한 균주는 128주(18.8%)였다. 또한 681균주 중에서 180명(26.4%)의 환자들이 포함된 50 종류의 cluster를 발견하였고, 50 종류의 cluster 중에서 같은 가족 내 감염이 2건이었고, 180명 중 근접지역 감염이 43명(23.9%)이었다. 연령대별 cluster 비율은 남녀 모두 60대 이후와 20대에서 높게 나타났다. 결 론 : 본 연구를 통하여 최초로 일개 지역(도 단위)을 중심으로 한 cluster의 분포율, 근접지역의 cluster 비율, 연령대별 cluster 비율 등을 알 수 있었다. 향후 지속적이며 더 확대된 대상으로 철저한 역학조사와 더불어 수행한다면, 결핵전염관리 대책을 세우는데 매우 유용한 기초 자료를 얻을 수 있을 것으로 판단된다.

Keywords

References

  1. World Health Organization. Global tuberculosis control surveillance, planning, financing: WHO report. 2005
  2. Korea Center for Disease Control and Prevention & Korean Institute of Tuberculosis. Annual report on the Notified Tuberculosis Patients in Korea. 2005
  3. van Soolingen D, Hermans PW, de Haas PE, Soll DR, van Embden JD. Occurrence and stability of insertion sequences in Mycobacterium tuberculosis complex strains: evaluation of an insertion sequence dependent DNA polymorphism as a tool in the epidemiology of tuberculosis. J Clin Microbiol 1991;29:2578-86
  4. van Soolingen D, Hermans PW, de Haas PE, van Embden JD. Insertion element IS1081-associated restriction fragment length polymorphisms in Mycobacterium tuberculosis complex species: a reliable tool for recognizing Mycobacterium bovis BCG. J Clin Microbiol 1992;30:1772-7
  5. van Soolingen D, de Haas PE, Haagsma J, Eger T, Hermans PW, Ritacco V, et al. Use of various genetic markers in differentiation of Mycbacterium bovis strains from animals and humans and for studying epidemiology of bovine tuberculosis. J Clin Microbiol 1994;32:2425-33
  6. Park YK, Bai GH, Kim SJ. Restriction fragment length polymorphism analysis of Mycobacterium tuberculosis isolated from countries in the western pacific region. J Clin Microbiol 2000;38:191-7
  7. van Embden JD, Cave MD, Crawford JT, Dale JW, Eisenach KD, Gicquel B, et al. Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a stanard methodology. J Clim Microbiol 1993;31:406-9
  8. Herold CD, Fitzgerald RL, Herold DA. Current techniques in mycobacterial detection and speciation. Crit Rev Clin Lab Sci 1996;33:83-138 https://doi.org/10.3109/10408369609083058
  9. van Soolingen D, Borgdorff MW, de Haas PE, Sebdk MM, Veen J, Dessens M, et al. Molecular epidemiology of tuberculosis in the Netherlands: a nationwide study from 1993 through 1997. J Infect Dis 1999;180:726-36 https://doi.org/10.1086/314930
  10. Small PM, Hopewell PC, Singh SP, Paz A, Parsonnet J, Ruston DC, et al. The epidemiology of tuberculosis in San Francisco: a population-based study using conventional and molecular methods. N Engl J Med 1994;330:1703-9 https://doi.org/10.1056/NEJM199406163302402
  11. Bifani PJ, Plikaytis BB, Kapur V, Stockbauer K, Pan X, Lutfey ML, et al. Origin and interstate spread of a New York City mutidrug-resistant Mycobacterium tuberculosis clone family. JAMA 1996;275:452-7 https://doi.org/10.1001/jama.275.6.452
  12. Geng E, Kreiswirth B, Driver C, Li J, Burzynski J, DellaLatta P, et al. Changes in the transmission of tuberculosis in New York City from 1990 to 1999. N Engl J Med 2002;346:1453-8 https://doi.org/10.1056/NEJMoa012972
  13. Fujikane T, Fujiuchi S, Yamazaki Y, Matsumoto H, Takahashi M, Fujita Y, et al. Molecular epidemiology of tuberculosis in the north Hokkaido district of Japan. Int J Tuberc Lung Dis 2004;8:39-44
  14. Kim SJ, Bai GH, Lee H, Kim HJ, Lew WJ, Park YK, et al. Transmission of Mycobacterium tuberculosis among high school students in Korea. Int J Tuberc Lung Dis 2001;5:824-30