β-용혈성 연쇄구균 B,C 및 G군의 감염에 관한 연구

Abstract

[한글]

사람에게 감염을 일으키는 연쇄구균은 대부분이 β-용혈성이고 주로 A와 D군에 속한다.

8, C 및 G군감염의 중요성이 인정된 것은 비교적 최근의 일이다. 특히 B군 세균에 의한 치명적인 신생아 감염의 보고는 점차 증가되고 있다. 그러나 B, C 및 G군 감염에 관한 우리나라에서의 보고는 소수에 불과함으로 이에 저자는 이들 세균 감염의 현황을 파악하고

저 1979년 8월부터1980년 10월 사이에 연세의료원 환자에서 분리한 β-용혈성 연쇄구균을 coagglutination법으로 혈청군을 검사하고 환자의 임상 소견을 조사하여 다음과 같은 결과를 얻었다.

1. 분리된 414균주중 A군이 79주(19.1%). B군이 26주(6.3%), C군이 47주(11.4%) 그리고 G군이 57주(13.7%)이었으며 205주(49.5%)는 혈청군을 동정할 수 없었다.

2. 검사물별 분리수는 B,C 및 G군 세균 모두가 호흡기계에서 가장 많았다. 호흡기계를 제외한 부위에서는 B군은 비뇨생식기계에서 G군은 창상부위에서 주로 분리되었다.

3. 126예의 환자중 “definite infection”으로 판단된 예는 B군이 12예 (9.5%), C군이 3예 (2.4%), G군이 27예(21.4%)이었다. 감염부위 별로는 호흡기계와 비뇨생식기계가 각 8예 (6.3%),그외의 부위가 26예 (20.6%)이었다.

4. 연령별 분리수는 9세이하군에서 50.7 %로 가장 많았고 60세 이상에서도 8.0% 로 비교적 많았다. 1명의 신생아는 패혈증이 동반된 수막염이었는데 이로 인하여 사망하였다. 성별 분리수는 남자에서 다소 많았다.

5.대부분의 환자들은 조직손상, 종양, 결핵, 당뇨병등 세균의 감염을 초래하기 쉬운 기존질환을 가지고 있었다.

이 연구의 결과로 β-용혈성 연쇄구균중 B, C 및 G군은 호흡기계에서는 감염을 일으키는 일이 적지만, 호흡기 이외의 부위에서는 감염의 원인균으로서 분리되는 일이 많고, 기존질환이 있는 환자는 감염이 되기 쉬우며 중독한 경과를 밟기도 하므로 종래의 bacitracin법에 의한 A군만의 동정으로는 불충분하며 적어도 B, C 및 G혈청군의 동정도 필요하다는 결론을 얻었다.

A study on the infection due to group B. C and G β- hemolytic streptococci

Chol Young Sook

Department of Medical Science The Graduate School Yonsei university

(Directed by Prof. Samuel Y. Lee. M.D.)

Streptococci, Pathogenic to human subjects, are mostly β-hemolytic and generally

belong to groups A and D. organisms belonging to B. C. and G have long been known

to cause infections. but their clinical importance has not been recognized until

quite recently. The incidence of fatal neonatal infections of group B has been

increasing particularly during the decade. However, there has been only a few

reports on group B, C, and G infection in Korea.

This study was made to determine serological group of clinical isolate of

β-hemolytic streptococci by coagglutination method and to clarify the B, C, and G

infection in a Korea.

β-hemolytic streptococci isolated from Yonsei Medical Center specimen during

August 1979-October 1980 were studied and the following results were obtained.

1. A total of 414 isolates were obtained and their groups were: A 19.1%, B 6.3%,

C 11.4%, and nongroupable 49.5%.

2. Groups B, C, and G were most frequently isolated from the respiratory tract

specimens. Excluding respiratory sources, group B was mainly isolated from the

urogenital tract, and group G from various wounds.

3. Among the l26 patient, who were categorized as having definite infections, 12

yieled group B, 3group C and 27 group G organisms. There were 8 cases each of the

respiratory and urogenital tract infections, on 26 infections on various other

sites.

4. From patients under 10 years of age, 50.7% of B, C, and G organisms were

isolated. 8.0% of the culture were isolated from patients 60 years and over.

There was a fatal neonatal meningitis and septicemia due to group B organism. the

organisms were isolated more frequently from male patients .

5. Majority of the patients who yielded the organisms were found to have

underlying diseases such as tissue injury neoplasm, tuberculosis and diabetes

mellitus.

It is concluded that group B, C, and G streptococci cause respiratory infection

not frequently, but they often invade other sites. patients with underlying disease

are prone to be infected by the organisms and some of them can be fatal. Therefore

it is important to identify not only group A but also B, C, and G organisms.

[영문]

Streptococci, Pathogenic to human subjects, are mostly β-hemolytic and generally belong to groups A and D. organisms belonging to B. C. and G have long been known to cause infections. but their clinical importance has not been recognized until quite recently. The incidence of fatal neonatal infections of group B has been increasing particularly during the decade. However, there has been only a few reports on group B, C, and G infection in Korea.

This study was made to determine serological group of clinical isolate of β-hemolytic streptococci by coagglutination method and to clarify the B, C, and G infection in a Korea.

β-hemolytic streptococci isolated from Yonsei Medical Center specimen during August 1979-October 1980 were studied and the following results were obtained.

1. A total of 414 isolates were obtained and their groups were: A 19.1%, B 6.3%, C 11.4%, and nongroupable 49.5%.

2. Groups B, C, and G were most frequently isolated from the respiratory tract specimens. Excluding respiratory sources, group B was mainly isolated from the urogenital tract, and group G from various wounds.

3. Among the l26 patient, who were categorized as having definite infections, 12 yieled group B, 3group C and 27 group G organisms. There were 8 cases each of the respiratory and urogenital tract infections, on 26 infections on various other

sites.

4. From patients under 10 years of age, 50.7% of B, C, and G organisms were isolated. 8.0% of the culture were isolated from patients 60 years and over.

There was a fatal neonatal meningitis and septicemia due to group B organism. the organisms were isolated more frequently from male patients .

5. Majority of the patients who yielded the organisms were found to have underlying diseases such as tissue injury neoplasm, tuberculosis and diabetes mellitus.

It is concluded that group B, C, and G streptococci cause respiratory infection not frequently, but they often invade other sites. patients with underlying disease are prone to be infected by the organisms and some of them can be fatal. Therefore

it is important to identify not only group A but also B, C, and G organisms.