소아 설사 환자에서 분리한 Salmonella, Shigella에 관하여

이복권(Bok Kwon Lee),김기상 (Ki Sang Kim),이명원(Myung Won Lee),정태화(Tae Hwoa Jung) 大韓微生物學會 1984 大韓微生物學會誌 Vol.19 No.1

장출혈성대장균 감염증의 역학적 특성 및 관리대책

이상원(Sang-Won Lee),이복권(Bok-Kwon Lee),이용제(Yang-Jae Lee),이희수(Hee-Soo Lee),정석찬(Suk-Chan Jung),곽효선(Hyo-Sun Kwak),최보율(Bo-Youl Choi) 한국역학회 2005 Epidemiology and Health Vol.27 No.1

E. coli is a bacterium that is commonly found in the gut of humans and warm-blooded animals. Most strains of E. coli are harmless. But some strains such as Enterohaemorrhagic E. coli(EHEC), can cause severe food borne disease. It is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat. There is no widely agreed definition of when a shiga-toxin producing E. coli is considered to be an EHEC. But in Korea, the word "EHEC", "STEC", "VTEC" are often used as same meaning, which refer to the E.coli those producing shiga-toxin. We suggest the term STEC refers to those E. coli produce one or more shiga-toxins(stx), and the term EHEC refers only to STEC that cause a clinical illness. EHEC infection were designated as the class 1 notifiable disease in Korea in 2000. Although EHEC/STEC cases were not common in Korea, the number of STEC infection cases reported has increased since 2001. From 2001 to 2004, the number of STEC infection cases in Korea were 11, 8, 52, 118 respectively. These cases included 17 due to E. coli O157, 136 due to E. coli, serogroup non-O157, and 15 due to E. coli that were not serogrouped. The most common serotype implicated is E. coli O91 without virulent factor and clinical symptoms. But those cases involve in one epidemic in primary school in 2004. STEC infections in Korea occur in all age groups, with the highest frequencies in children less than 5 years old. Healthy cattle are the main animal reservoir for STEC and they harbor the organism as part of the bowel flora. The proportion of STEC in E. coli in animal feces was examined by using stool samples from 283 Korean beef cattle on 27 farms, 169 milk cattle on 28 frams, 455 swine on 50 farms. As determined by culture and toxin assay, the proportion of STEC was 25.8%(16 STEC/62 E. coli) in milk cattle, 18.8%(19 STEC/lOl E.coli) in Korean beef cattle, 14.0%(25 STEC/178 E. coli) in swine. Effective surveillance of EHEC/STEC in humans is essential in order to protect the public health. EHEC infection is notifiable in many countries including USA, Japan, and Belgium. Finland, Italy, Netherlands, and the United Kingdom(UK), have sentinel systems. England, Wales, and Scotland have comprehensive national laboratory reporting schemes for STEC. And there has been an increase in the number of reported cases and outbreaks during the past decades in many countries Prevention of STEC infection requires control measures at all stages of surveillace, investigations and special pathogen tracing such as PulseNet.

한국과 일본에서 유행하는 장염비브리오의 병원성 인자와 유전자의 특성

홍석원,문지영,이복권,김영부,Hong, Seuk-Won,Moon, Ji-Young,Lee, Bok-Kwon,Kim, Yung-Bu 한국생명과학회 2007 생명과학회지 Vol.17 No.3

본 연구는 1999년에서 2001년도 걸쳐서 3년간 국내에서 분리된 환자유래 장염비브리오 18균주와 일본 후쿠오카 지역에서 2002년도에 환자에서 분리한 장염비브리오 9균주 등 총 27균주에 대하여 toxR 유전자의 검출, 혈청형별 검사, 약제내성의 양상, tdh, trh1 및 trh2 유전자의 보유상태 및 urease 생성성을 살펴보고, 혈청형 O3:K6 균주에 대하여 TDH의 생성성 검사, tdh 양성균주의 RFLP 형별, ORF 8의 분포, PFGE법과 RAPD법을 실시하였으며 결과는 다음과 같다. 1. 한국 및 일본의 환자유래 균주 대부분에서 urease음성이었으며, toxR 유전자로 확인 동정하였고 혈청형의 분포는 국내 분리 주의 O3:K6, O4:K9, O6:K46, O3:K57, O5:Kl5와 일본 분리주의 O3:K6, O1:K38, O4:K68, O4:Kl2의 혈청형으로 나타났다. 2. 항생제 감수성 시험에서는 vancomycin과 oxacillin은 27균주 (100%), penicillin은 26균주 (96.3%)로 높은 내성을 나타내었고, 14균주 (51.9%)가 4가지 이상의 항생제에 다제내성을 나타내었다. 항생제의 내성양상은 6종류로 혈청형에 관계없이 vancomycin, oxacillin, penicillin에 내성을 나타내는 V형이 15균주 (55.6%)로 가장 많이 나타났다. 3. tdh 유전자는 26균주가 PCR법과 DNA probe hybridization법의 결과에서 양성으로 나타났으며, urease양성이었던 일본 환자유래 혈청형 O3:K6 1균주만이 tdh유전자 음성, trh2 유전자 양성을 나타냈다. 혈청형 O3:K6의 TDH 생성성역가는 전 균주가 256배에서 2,048배 정도로 나타났으며, RFLP 양상은 모든 균주가 11.5 kb와 4.3 kb에 tdh 유전자를 보유하고 있었다. 또한 혈청형 O3:K6 균주들은 RAPD법과 PFGE법으로 유전자형별을 비교 검토한 결과 8형으로 거의동일한 유전자형별의 결과를 나타내었다. 4. ORF 8의 분포는 혈청형 O3:K6 전 균주에서 양성이었고, 특히 혈청형 O6:K46 4균주 모두에서 ORF 8 양성을 나타내어 새롭게 나타난 유행균주일 가능성을 시사 하였다. 따라서 ORF 8 유전자의 검출은 범세계적으로 유행하는 균주들을 동정하는데 있어 genetic marker로서 매우 유용한 것으로 사료된다. A total of 27 strains of Vibrio parahaemolyticus (18 strains isolated from Korea and 9 strains from Japan) were serotyped and examined for biochemical characteristics, antimicrobial susceptibility patterns, cytotoxicity assay, thermostable direct hemolysin (TDH) production and molecular epidemiology. Using polymerase chain reaction (PCR) method and DNA probe hybridization method, the strains were tested for toxR, tdh, trh and ORF 8 genes. The V. parahaemolyticus isolated from patients were belonged to 8 different serotypes : O3:K6, O1:K38, O3:K57, O4:K9, O4:Kl2, O4:K68, O5:Kl5 and O6:K46. Urease-positive strain possessed the trh gene, and conversely, urease-negative strains lacked the gene, indicating that urease production by V. parahemolyticus strains strongly correlates with the possession of the trh gene. Most strains showed multiple resistant to more than three antibiotics and the antibiogram could be classified into 6 group (I to VI). All of the O3:K6 strains isolated in South Korea and Japan producted TDH at high levels. The TDH titers ranged between 256 and 2.048, and the average titer was 1009. To distinguish the new and increasingly common V. parahaemolyticus strains from clinical isolates, ORF 8 is a useful genetic marker. After Southern hybridization, the HindIII restriction fragment patterns of the tdh gene were grouped one type, respectively. One type showed two bands one of which was 4.3kb and the other was 11.5kb in size. Variation between the O3:K6 serotype are minor when compared to the differences seen with the non O3:K6 strains. The migration patterns of Not I -digested of the total DNA of the O3:K6 strains were similar, and only slight variations were observed between the serotypes. By contrast, the O3:K6 strains and non O3:K6 had markedly different profiles. In conclusion, Random amplified polymorphic DNA (RAPD) profile using appropriate primers was an effective epidemiological marker.

울주군에서 발생한 장출혈성대장균 감염증의 발생 원인

이상원,양병국,이복권,박재구,황병훈,임현술,배근량,Lee, Sang-Won,Yang, Byung-Guk,Lee, Bok-Kwon,Park, Jae-Gu,Hwang, Byeong-Hun,Lim, Hyun-Sul,Bae, Geun-Ryang 대한예방의학회 2003 예방의학회지 Vol.36 No.1

Objectives : Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. Methods : We peformed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we peformed rectal swabs on the cattle raised by the household of the index patient. Results : We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. Conclusions : We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.

새로운 항균활성을 보이는 토양 분리 세균 Paenibacillus polymyxa DY1의 분류와 동정

신은석,이희무,이복권,김성훈,권순일,유관희,Shin, Eun-Seok,Lee, Hee-Moo,Lee, Bok-Kwon,Kim, Sung-Hoon,Kwon, Sun-Il,Yoo, Kwan-Hee 한국미생물학회 2007 미생물학회지 Vol.43 No.1

항생제 내성 세균의 출현으로 새로운 항생물질의 개발에 대한 필요성이 대두되고 있다. 본 연구에서는 새로운 항균활성물질을 개발하고자 강원도 대암산 용늪 토양으로부터 새로운 항균물질을 생산하는 균을 분리하였고, 이를 동정하였다. 생화학적인 시험과 16S ribosomal DNA 염기서열 분석결과 Paenibacillus polymyxa균과 가장 높은 상동성을 보여주었다. 지방산 조성의 분석에서도 이 균주는 Paenibacillus polymyxa와 가장 가까웠다. 이 균주가 생산하는 항균물질은 1군 법정 전염병을 일으키는 Samonella enterica serovar Typhi와 Shigella dysentery, enterohaemorrhagic Eschelichia coli, 그리고 Vibrio cholera등의 병원성 세균에 성장억제 효과를 나타냈으며, 다른 일반 식중독 장내세균에서도 성장억제 효과를 나타냈다. 이 균주가 생산하는 항균활성 물질은 과거에 보고된 것과 다른 새로운 것으로 보이며, 광범위한 항균활성으로 인하여 새로운 항생물질 개발 후보로 많은 잠재력을 가진 것으로 평가된다. The DY1 strain of Gram-positive, rod-shaped bacteria was isolated from the soil sample collected from Daeam mountain, Korea. The culture filtrate of DY1 strain showed a broad spectrum of antimicrobial activity on various pathogenic and food poisoning enteric bacterial species tested in vitro. It showed significant growth-inhibitory effect on Salmonella enterica sp., Shigella sp., pathogenic Escherichia coli, Vibrio cholerae, Vibrio parahemolyticus, and Yersinia enterocolitica. For the identification of the DY1 strain, morphological, biochemical and molecular phylogenetic approaches were performed. The DY1 strain was found to be a member of the genus Paenibacillus on the basis of morphological and biochemical analyses. The 16S rDNA of DY1 showed the highest pairwise identity with Paenibacillus polymyxa with 99.79% (1,413 bp/1,416 bp). The antimicrobial entity from DY1 looked different from preciously reported ones and seems to have a great potential to be further studied as a candidate of new antibiotics to control multi-drug resistant pathogens.

地球村(지구촌) 콜레라 流行(류행)의 歷史(력사) 우리날의 現況(현황)

정태화 ( Tai Wha Jung ),이복권 ( Bok Kwon Lee ),검호훈 ( Ho Hoon Kim ) 대한임상검사과학회 1995 대한임상검사과학회지(KJCLS) Vol.27 No.1

청원군 일개 면에서 산발적으로 신고한 세균성이질 집단 발병 역학조사

이용제,황의경,김종숙,김준영,이복권,구자설,강종원,Lee, Yong-Jae,Hwang, Ue-Kyoung,Kim, Jong-Suk,Kim, Jun-Young,Lee, Bok-Kwon,Koo, Ja-Seol,Kang, Jong-Won 대한예방의학회 2005 예방의학회지 Vol.38 No.2

Objectives: This study was undertaken to investigate the source of infection and mode of transmission of shigellosis, which occurred sporadically among residents and students in a subcounty of Cheongwon county, Chungbuk province, Korea, from June 4 to July 3 2003. Methods: 692 subjects completed a questionnaire and provided a swab for microbiological examinations,and 7 environmental specimens were examined for bacterial organisms. PFGE (pulsed-field gel electrophoresis) and fingerprinting were performed to find the genetic relationship among the temporally associated sporadic isolates. Results: A total of 29 patients had symptoms consistent with the case definition, with 13 confirmed and 16 suspected cases. The frequency of diarrhea was 6 times or more a day (80.8%), with a duration of 1 to 4 days (88.5%) in most cases. The most common symptoms accompanying the diarrhea were fever (80.9%) followed by abdominal pain (76.9%), headache (65.4%), chill (61.5%), vomiting (46.2%) and tenesmus (15.4%). The epidemic curve was characteristic of a person-to-person transmission. The PFGE and fingerprinting demonstrated identical or similar DNA patterns among the 3 Shigella sonnei isolates (A51, A53 and A61 types) found in this outbreak. Conclusion: A genetically identical strain of S. sonnei was estimated to be the cause of this outbreak, and the mode of transmission was most likely person-to-person.

Klebsiella pneumoniae분리균의 생화학적 특성과 항생물질 내성유형 연구

이훈구(Hun-ku Lee),김기상(Ki-Sang Kim),이복권(Bok-Kwon Lee),정태화(Tae-Hwa Chung),이형환(Hyung-Hoan Lee) 大韓微生物學會 1987 大韓微生物學會誌 Vol.22 No.4

한국에서 분리된 장내세균(Salmonella, Shigella, E. coli 균속)의 병원적 역할에 관한 연구

정태화(Tae-Hwoa Jung),이연태(Yun-Tai Lee),이명원(Myung-Won Lee),이복권(Bok-Kwon Lee),김기상(Ki-Sang Kim) 大韓微生物學會 1986 大韓微生物學會誌 Vol.21 No.1

장티푸스의 혈청학적 진단을 위한 Vi-수동혈구응집법, SD$^{(R)}$ Kit 및 Widal 시험에 대한 효용성 평가

김성훈,김석호,이덕용,이에스더,박미선,이복권,Kim, Sung-Hun,Kim, Shuk-Ho,Lee, Deog-Yong,Lee, Esther,Park, Mi-Sun,Lee, Bok-Kwon 한국미생물학회 2010 미생물학회지 Vol.46 No.2

본 연구는 장티푸스 환자에 대한 혈청학적 시험법인 Vi-PHA, $SD^{(R)}$ kit, Widal 시험(O & H)에 대하여 평가를 위해 수행하였다. 2005년부터 2006년까지 수집된 36건의 혈청검체를 대상으로 하였으며, 9건은 배양검사를 통하여 장티푸스균이 검출된 확진환자의(Typhoid fever) 검체이며, 27건은 비장티푸스성 열성환자의(Non-typhoid fever) 검체이다. 시험결과 Vi-PHA는 환자 혈청 9건 중 양성 8건으로 민감도 88.9% (P<0.001; Fisher's exact test), 비장티푸스성 열성환자 27건 중 1건이 양성을 보여 특이도 96.3%로 나타났다. $SD^{(R)}$ kit는 민감도 100% (P<0.001), 특이도 92.6%로 나타났다. Widal (O & H) 시험의 민감도는 각각 88.9% (P=0.001), 100% (P<0.001), 특이도는 77.8%, 70.4%로 나타났다. 민감도는 $SD^{(R)}$ kit와 Widal H 검사법이 가장 높은 것으로 확인되었으며, 특이도는 Vi-PHA가 가장 높게 나타났다. 장티푸스의 효과적인 혈청학적 진단을 위하여 급성 또는 유행지역에서는 특이도가 높은 Vi-PHA로 검사를 수행하고, 장티푸스 비 유행지역과 고위험군에 대하여는 민감도가 높은 Widal H와 $SD^{(R)}$ kit를 적용하는 것이 진단의 유의수준을 높일 수 있을 것으로 판단된다. In this study, we evaluated Vi-passive hemagglutination (Vi-PHA), SD Salmonella Typhi IgG/IgM ($SD^{(R)}$ kit) and Widal test for the rapid laboratory diagnosis of typhoid fever patients. A total of 36 serum samples from febrile patients in Korea from 2005 to 2006 were used. Among 36 patients, 27 were fever patients without typhoid, 9 were typhoid fever. Vi-PHA showed 8 positive results out of 9 typhoid fever patients (sensitivity 88.9%) and 1 positive and 26 negative results out of 27 febrile patients without typhoid (specificity 96.3%). The sensitivity and the specificity of $SD^{(R)}$ kit were 100% and 92.6%, respectively. However, the sensitivity and the specificity of Widal O & H tests were 88.9%, 100%, and 77.8%, 70.4%, respectively. Consequently, Widal H and $SD^{(R)}$ kit showed higher sensitivity and Vi-PHA showed higher specificity. To efficient diagnosis, Vi-PHA may be sufficient diagnosis method in acute cases and $SD^{(R)}$ kit and Widal test may be sufficient in sporadic area and high risk group.