Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Distribution of Disease Severity and Group A Rotavirus Genotypes (VP7 & VP4) in Children with Acute Rotavirus Gastroenteritis

급성 로타바이러스 장염 소아에서 질환의 중증도와 로타바이러스 VP7 & VP4 유전형의 분포에 대한 연구

  • Oh, Hyun-Ju (Department of Pediatrics, Jeju National University School of Medicine) ;
  • Kang, Hyun-Sik (Department of Pediatrics, Jeju National University School of Medicine) ;
  • Kang, Ki-Soo (Department of Pediatrics, Jeju National University School of Medicine) ;
  • Kim, Youn-Woo (Department of Pediatrics, Jeju National University School of Medicine) ;
  • Hong, Jung-Yun (Department of Pediatrics, Jeju National University School of Medicine) ;
  • Shin, Kyung-Sue (Department of Pediatrics, Jeju National University School of Medicine) ;
  • Lee, Jin-Sook (Department of Pediatrics, Jeju National University School of Medicine) ;
  • Lee, Su-Hyun (Department of Microbiology, Jeju National University School of Medicine) ;
  • Lee, Keun-Hwa (Department of Microbiology, Jeju National University School of Medicine) ;
  • Cho, Moon-Je (Department of Biochemistry, Jeju National University School of Medicine) ;
  • Suh, Dong-In (Department of Pediatrics, Seoul National University College of Medicine)
  • 오현주 (제주대학교 의학전문대학원 소아과학교실) ;
  • 강현식 (제주대학교 의학전문대학원 소아과학교실) ;
  • 강기수 (제주대학교 의학전문대학원 소아과학교실) ;
  • 김연우 (제주대학교 의학전문대학원 소아과학교실) ;
  • 홍정연 (제주대학교 의학전문대학원 소아과학교실) ;
  • 신경수 (제주대학교 의학전문대학원 소아과학교실) ;
  • 이진숙 (제주대학교 의학전문대학원 소아과학교실) ;
  • 이수현 (제주대학교 의학전문대학원 미생물학교실) ;
  • 이근화 (제주대학교 의학전문대학원 미생물학교실) ;
  • 조문제 (제주대학교 의학전문대학원 생화학교실) ;
  • 서동인 (서울대학교 의과대학 소아과학교실)
  • Received : 2011.04.19
  • Accepted : 2011.05.19
  • Published : 2011.06.30
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Abstract

Purpose: We aimed to study the distribution of rotavirus genotypes (VP7 and VP4) and disease severity of rotavirus gastroenteritis prevalent in our community. Methods: Stool samples were collected from 156 children who were hospitalized with rotavirus gastroenteritis from December 2007 to June 2008. The disease severity of all patients was scored using the Vesikari scale. After extraction of ds-RNA of the rotavirus, cDNA synthesis using reverse transcription and polymerase chain reaction (RT-PCR) and multiplex PCR was performed. Following this, the final identification of genotypes was performed. Results: Of the 156 samples, VP7(G) and VP4(P) genotypes were identified in 147 (94.2%) and 140 (89.7%) samples, respectively. G1 (116 of 147 samples; 78.9%) and P[8] (137 of 140 samples; 97.9%) were the most prevalent, respectively. Of the 138 samples identified of combination types of VP7 and VP4, G1P[8] (111 samples; 80.4%) was the most prevalent. Other combination types varied with very low distribution rates. 9.4% of genotypes were not included in the new vaccines. The disease severity score was $11.8{\pm}3.3$ ($mean{\pm}2SD$). The distribution of disease severity was mild or moderate in 37.8% and severe in 62.2% of patients. Conclusion: The most prevalent genotype combination of rotavirus was G1P[8] and genotypes not included in the vaccines represented 9.4% in our community. Disease severity distribution of hospitalized children with rotavirus gastroenteritis was higher in the severe than in the mild and moderate categories.

목적: 저자들은 지역사회에서, 로타바이러스 장염에 걸린 소아들에서 질환의 중증도와 로타바이러스 VP7 유전형과 VP4 유전형의 분포에 대해 알아보고자 하였다. 방법: 2007년 12월부터 2008년 6월까지 로타바이러스 장염으로 병원에 입원한 156명의 소아들에서 대변 샘플을 수집하였다. 모든 환자들에 대한 질환 중증도는 Vesikari 점수를 이용하여 평가하였다. 로타바이러스 ds-RNA를 분리한 후, 역전사 중합효소 연쇄반응과 다중 중합효소 연쇄반응을 이용하여 cDNA를 합성하였다. 마지막으로 유전형을 확인하였다. 결과: 156명의 환자 샘플에서, VP7(G)는 147명(94.2%)에서 확인되었고 VP4(P)는 140명(89.7%)에서 확인되었다. G1 유전형(147명 중 116명; 78.9%)과 P[8] 유전형(140명 중 137명)이 각각 가장 많았다. VP7과 VP4 조합형은 138명에서 확인할 수 있었는데, G1P[8] 조합형이 111명(80.4)으로 가장 많았다. 다른 조합형들은 종류가 다양하였고 분포가 낮았다. 전체 조합형 중 9.4%가 새로운 로타바이러스 백신에 포함되지 않은 것이었다. 로타바이러스 장염의 질환 중중도는 $11.8{\pm}3.3$ ($mean{\pm}2SD$)였다. 전체 환자에서 경증 내지 중등도가 37.8%였고, 중증은 62.2%였다. 결론: 로타바이러스 유전자 조합형 중 가장 흔한 것은 G1P[8]이었다. 새로운 백신에 포함되지 않은 유전자 조합형은 9.4%였다. 로타바이러스 장염으로 입원한 소아들의 질환 중증도분포는 경증과 중등도보다 중증에서 높게 나타났다.

Keywords

References

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