Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
Ann Clin Microbiol Antimicrob. 2022 Dec 6;21(1):55. doi: 10.1186/s12941-022-00543-1.
The prevalence of Tropheryma whipplei varies depending on age, region, and underlying disease. We estimated the prevalence of T. whipplei in the stools of Korean patients with diarrhea using real-time PCR (RT-PCR) and compared three RT-PCR targets, rpoB, hsp65, and Dig15.
A total of 1404 nucleic acid samples extracted from the stools of Korean patients with diarrhea were tested using an initial RT-PCR targeting T. whipplei-specific regions of 16S-23S rRNA intergenic spacer. Subsequently, the samples positive for the initial RT-PCR were tested using the follow-up RT-PCRs targeting rpoB, hsp65, and Dig15 and analyzed by sequencing to confirm the presence of T. whipplei. We estimated the prevalence of T. whipplei and compared them according to gender and age. We also compared the performance of three targets in the follow-up RT-PCRs.
T. whipplei was detected in 1.4% of all samples (20 of 1404), and there were no differences according to gender and age. In pediatric samples (≤ 19 years), T. whipplei was detected higher in children aged 6-19 than in those aged 1-5 (2.7% vs. 0.7%, P = 0.01). Sensitivities of the rpoB, hsp65, and Dig15 RT-PCR were 50.0%, 85.0%, and 95.0%, respectively; specificities were 100.0%, 100.0%, and 84.6%, respectively.
This is the first study that estimated the prevalence of T. whipplei in the stools of Korean patients with diarrhea. This study demonstrated the presence of T. whipplei in stools of Koreans, even though the bacterium was detected low. The RT-PCRs targeting hsp65 and Dig15 showed reliable performance, and a multiplex PCR including these targets is expected to be useful for T. whipplei detection.
惠特莫尔氏疏螺旋体的流行率因年龄、地区和基础疾病而异。我们使用实时 PCR（RT-PCR）估计了韩国腹泻患者粪便中 T.whipplei 的流行率，并比较了三个 RT-PCR 靶标 rpoB、hsp65 和 Dig15。
共检测了 1404 份从韩国腹泻患者粪便中提取的核酸样本，使用针对 16S-23S rRNA 基因间区的 T.whipplei 特异性区域的初始 RT-PCR 进行检测。随后，对初始 RT-PCR 阳性的样本进行 rpoB、hsp65 和 Dig15 的后续 RT-PCR 检测，并通过测序进行分析以确认 T.whipplei 的存在。我们估计了 T.whipplei 的流行率，并根据性别和年龄进行了比较。我们还比较了三种靶标在后续 RT-PCR 中的性能。
在所有样本（1404 份）中，T.whipplei 的检出率为 1.4%（20 份），且无性别和年龄差异。在儿科样本（≤19 岁）中，6-19 岁儿童的 T.whipplei 检出率高于 1-5 岁儿童（2.7% vs. 0.7%，P=0.01）。rpoB、hsp65 和 Dig15 RT-PCR 的灵敏度分别为 50.0%、85.0%和 95.0%，特异性分别为 100.0%、100.0%和 84.6%。
这是第一项估计韩国腹泻患者粪便中 T.whipplei 流行率的研究。本研究表明，即使细菌的检出率较低，韩国人粪便中也存在 T.whipplei。针对 hsp65 和 Dig15 的 RT-PCR 表现可靠，包含这些靶标的多重 PCR 有望用于 T.whipplei 检测。
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