WO2016099076A1 - 세균 유래의 나노소포체를 이용한 세균성 감염질환 원인균 동정방법 - Google Patents
세균 유래의 나노소포체를 이용한 세균성 감염질환 원인균 동정방법 Download PDFInfo
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Definitions
- the present invention is to identify the causative agent (caused bacteria) of bacterial infectious diseases through genetic analysis contained in the nano-vesicles in clinical samples containing nano-sized extracellular vesicles, that is, nano-vesicles derived from bacteria, It relates to a method for predicting antibiotic resistance to.
- Severe bacterial infections are characterized by severe expression of bacterial infections such as pneumonia, infective endocarditis, osteomyelitis, osteoarthritis, meningitis, sepsis, etc., among bacterial infections.
- the incidence rate is increasing rapidly with the spread of multidrug-resistant bacteria due to the use of antibiotics.
- Enterococcus as a multidrug resistant bacterium that causes bacterial severe infectious diseases spp ., Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , Enterobacter spp. Etc. are known.
- Severe infection by multidrug-resistant bacteria occurs mainly in the form of in-hospital infection, and mortality due to severe infection is 5.4% for pneumonia and 29% for sepsis.
- the bacterial infection is severe, the patient's hospital stay is longer, the utility of the treatment is low compared to the investment, and in Korea, the annual cost of disease caused by multidrug-resistant bacteria has been surveyed to more than 1 trillion won.
- the recent reports of multidrug-resistant bacteria in the community as well as internal infections by multidrug-resistant bacteria are expected to be a major problem for the public health in the future.
- a method currently used for diagnosing a bacterial severe infectious disease includes a method of identifying a causative bacterium by a biochemical method by performing bacterial culture of a clinical sample such as blood in vitro.
- the conventional method based on the results of the recent metagenenomic analysis of metagenome (metagenome) can be identified only 1% of the total bacteria, and it takes at least 5 days to culture the bacteria until now, do not know the causative bacteria The situation is based on the use of antibiotics based on clinical experience.
- eukaryotic cells such as prokaryotic cells such as bacteria and host cells, such as humans, secrete vesicles out of cells, and secreted vesicles have been reported to perform various functions.
- Extracellular vesicles secreted by bacteria contain lipopolysaccharide (LPS), bacteria-derived proteins and genes, and are generally called nanovesicles because they are 20-100 nanometers (nm) in size. It has been reported that extracellular vesicles have been found in various secretions, excreta, or tissue lavage fluids of humans or animals, and the extracellular vesicles present in tissues are known to reflect the state of the tissues secreting vesicles. Has been reported.
- the present inventors found that the genes derived from bacteria exist in the bacteria-derived nano-vesicles derived from the samples separated from the body of mammals, and the cause of severe bacterial infection through the gene sequence analysis extracted from the nano-vesicles.
- the present invention has been completed by developing a method for predicting (causative bacteria).
- the present invention extracts genes present in nano-vesicles from clinical samples of mammals containing bacterial-derived endoplasmic reticulum to identify the causative bacteria of severe bacterial infection through sequencing and predict antibiotic resistance of the causative bacteria.
- the purpose is to provide.
- the present invention comprises the steps of: (A) extracting the gene in the nano-vesicles from the patient sample containing the bacteria-derived nano-vesicles; (B) performing PCR on the extracted gene using primer pairs of SEQ ID NOs: 1 and 2; And (C) provides a method for identifying bacterial bacterial infection causing bacteria, comprising the step of determining that the bacterial bacterial infection causing bacteria is present when the PCR result is increased compared to the normal person.
- the present invention (A) extracting the gene in the nano-vesicles from the patient sample containing the bacteria-derived nano-vesicles; (B) performing PCR on the extracted gene using primer pairs of SEQ ID NOs: 1 and 2; And (C) provides a method for predicting antibiotic resistance to the bacterial bacterial infectious agent causing bacterial infection when the PCR result is increased compared to the normal person, the antibiotic response to the bacterial bacterial infectious disease causative agent. .
- the patient sample is selected from the group consisting of urine, blood, oral fluid, gastric juice, feces, nasal fluid, sputum, skin cleansing fluid, pleural fluid, peritoneal fluid, joint fluid, cerebrospinal fluid, amniotic fluid and vaginal fluid It is characterized by.
- the gene in the nano-vesicles is characterized in that 16S rDNA or 16S rRNA.
- the nano-vesicles preferably have an average diameter of 10-300nm, more preferably 20-100nm.
- the bacterial serious infectious disease is characterized in that selected from the group consisting of sepsis, sinusitis, pneumonia, tuberculosis, infective endocarditis, osteoarthritis, osteomyelitis, urinary tract infections, encephalitis, meningitis and nephritis.
- the causative bacterium is characterized by being a multidrug resistant bacterium selected from the group consisting of Skermanella , Alkalibacterium , Ureaplasma , Corynebacterium , Streptococcus , Caulobacteraceae , Brevibacterium , Staphylococcus , Kocuria , Pseudomonas , Xanthomonadaceae , and Sphingobium .
- step of extracting the gene in step (A) (a) centrifuging the patient sample to obtain a supernatant, and then removing the bacteria and foreign matter by a filter; (b) centrifuging and concentrating the product obtained after the filtering; (c) ultra-centrifuging the concentrated product to obtain nano-vesicle pellets; (d) heat treating the nano-vesicle pellets; And (e) centrifuging the heat treatment product to obtain a supernatant.
- the heat treatment in step (d) is characterized in that it is carried out for 5-30 minutes at 90-110 °C.
- the method of the present invention it is possible to provide information on the causative agent of bacterial infection and to predict the causative agent of bacterial infection by analyzing the gene sequences in the nano-endoplasmic reticulum in clinical samples containing the bacterial-derived nano-ER.
- Figure 1 is an electron micrograph to confirm the shape of the nano-vesicles in the urine samples of normal and severe bacterial infection patients.
- Figure 2 is a dynamic light scattering measurement results for confirming the size of the nano-vesicles in the urine samples of normal and severe bacterial infection patients.
- 3 is a PCR result for confirming the presence of a gene derived from bacteria in the nano-vesicles isolated from the urine samples of normal people and severe bacterial infection.
- Figure 4a is a result of the meta-genomic analysis of the nano-vesicles isolated from the urine samples of normal and severe bacterial infection patients
- Figure 4b shows a list of bacteria (yellow highlighted) increased nano-vesicles in patients with severe bacterial infections compared to normal people The result is.
- 5 is a result showing the difference in the amount of DNA extraction according to the heat treatment method, DNA extraction kit, DNA extraction compound (phenol / chloroform) treatment in the urine samples of normal and severe bacterial infection patients.
- 6 is a result of performing a heat treatment by separating the nano-vesicles from the urine sample, or a direct heat treatment to the urine sample, the meta-genomic analysis at the gate level (phylum level).
- FIG. 7 is a result obtained by separating nano-vesicles from a urine sample and performing a heat treatment or direct heat treatment on a urine sample, and performing a metagenome analysis at a genus level.
- the present invention relates to a method for identifying the causative bacteria of severe bacterial infection and predicting antibiotic resistance by analyzing gene sequences in nano-vesicles in clinical samples such as urine containing bacterial-derived nano-vesicles.
- the inventors have discovered that nanovesicles secreted from bacteria are absorbed into the body and distributed through the blood into various tissues of the mammal, which are excreted in urine and feces. Therefore, the genes were extracted from the urine samples of 11 normal individuals (control) and 25 severe bacterial infections (separated from nanovesicles), followed by analyzing the sequencing of 16S rDNA or 16S rRNA specific to bacteria. It was confirmed that the causative agent of bacterial infection can be predicted.
- the present inventors conducted a metagenome analysis on DNA extracted from the nano vesicles, and found that the endoplasmic reticulum derived from 12 bacteria was significantly increased in the urine of the severely infected bacteria compared to the urine of normal people. It was.
- the gene was extracted and subjected to metagenomic analysis of the sample through heat treatment, it was confirmed that the distribution of bacteria-derived endoplasmic reticulum is similar at the phylum level and genus level. In other words, it was found that the same result was obtained even by analyzing gene sequencing by directly extracting genes in nano-vesicles without separating bacterial-derived nano-vesicles from clinical samples.
- the genome was extracted by heat treatment to the urine samples derived from urine samples of normal people, infectious endocarditis and nephritis (APN), and then amplified using 16S rDNA primers to perform metagenome analysis at the genus level.
- the urine of infective endocarditis increased more than about 60% of the endoplasmic reticulum derived from Staphylococcus , and the remarkable increase of the endoplasmic reticulum derived from Caulobacteraceae to more than 40% in urine of patients with nephritis. It was confirmed.
- bacterial infection or bacterial infectious disease refers to diseases caused by bacteria or bacterial toxins.
- bacterial or bacterial toxins penetrate through the host's defenses to cause infectious diseases.
- Representative examples include pneumonia and pulmonary tuberculosis; Osteomyelitis, osteoarthritis of the bone joints; Infective endocarditis in the heart; Encephalitis, meningitis, which occurs in the brain; Nephritis occurring in the kidneys; Systemic sepsis.
- severe bacterial infection or “severe bacterial infection” refers to a severe expression of a bacterial infection including a case in which mortality is high or difficult to treat due to bacterial infection such as pneumonia, sepsis, infective endocarditis, nephritis, osteoarthritis, etc. Means.
- 'prediction of the causative agent or causative organism' means that an appropriate antibiotic can be used by providing information on the causative causative agent of an infectious disease caused by a bacterium or a bacterial toxin, or that the course of the disease can be predicted after antibiotic use. It is meant to include.
- the term 'predicting antibiotic resistance' includes providing antibiotic resistance information on a causative agent of an infectious disease caused by a bacterium or a bacterial toxin to use an appropriate antibiotic, or predicting disease progression after using antibiotics. I mean.
- bacteria-derived endoplasmic reticulum is a nano-size endoplasmic reticulum secreted by the bacteria contained in the clinical sample, extracting the gene by separating the nano-vesicles from the clinical sample, or without separating the nano-vesicles from the clinical sample containing the nano-vesicles
- Genes contained in the nano-vesicles can be extracted by heat treatment, compound treatment, or the like.
- the 'clinical sample' containing the nano-vesicles is not particularly limited as a sample obtained from a patient, but may use blood, urine, sputum, feces, nasal fluid, oral fluid, joint fluid, pleural fluid, cerebrospinal fluid, etc. as desired. Can be.
- the method for separating the nano-vesicles from the clinical sample is not particularly limited, for example, in urine or blood, such as centrifugation, ultrafast centrifugation, filtration by filter, gel filtration chromatography, pre-flow electrophoresis, capillary electrophoresis, etc. A method, and a combination thereof. In addition, it may further include a process such as washing, centrifugation, concentration of the obtained nano-vesicles for the removal of impurities.
- the method of extracting the gene in the nano-vesicles from the clinical sample, after separating the nano-vesicles from the clinical sample, extract the genes in the nano-vesicles by physical or chemical methods, or the process of separating nano-vesicles from the clinical samples containing nano-vesicles Genes in nanovesicles can be extracted directly by physical or chemical methods such as heat treatment without going through.
- the nanovesicles separated by the above method may have an average diameter of 10 to 300 nm, but preferably 20 to 100 nm.
- 'gene' is a concept including DNA and RNA derived from bacteria, and 'gene sequencing' includes amplifying a gene using primers complementary to gene sequences.
- 'metagenome' is also referred to as 'military genome', and means a total of genomes including all viruses, bacteria, fungi, and the like in an isolated region such as soil and animal intestine, and mainly refers to a microorganism that is not cultured. It is used as a concept of genome to explain the identification of many microorganisms at once using sequencer for analysis.
- the metagenome does not refer to one genome or genome, but to a kind of mixed dielectric as the genome of all species of one environmental unit. This is a term from the point of view of defining a species in the course of the evolution of biology in terms of functional species as well as various species that interact with each other to create a complete species.
- rapid sequencing is used to analyze all DNA and RNA regardless of species, to identify all species in one environment, and to identify interactions and metabolism.
- Urine samples in 50 ml tubes were suspended by centrifugation (3,500 ⁇ g, 10 min, 4 ° C.), the supernatant was taken only, and bacteria and foreign substances were removed using a 0.22 ⁇ m filter. Subsequently, the centrifugal tube (centripreigugal filters 50 kD) was transferred to 1,500 ⁇ g, centrifuged at 4 ° C. for 15 minutes to discard materials smaller than 50 kD and concentrated to 10 ml.
- Nano-vesicle quantitative value ( ⁇ g / ml) Normal 1 6 Normal 2 114 Normal 3 8 Normal 4 10 Normal 5 2 Sepsis patients 1 2 Sepsis 2 35 Sepsis 3 2 Sepsis 4 4 Sepsis patients 5 7
- Example 2 In urine samples Nanovesicular Structure and size analysis
- the size of the nano-vesicles separated by the method of Example 1 was measured using a dynamic light scattering method (Dynamic light scattering: zetasizer nano ZS Malverk, UK). After preparing 1ml of the nano-vesicles at a concentration of 5 ⁇ g / ml, and transferred to the cuvette (ZEN0112) was placed in place and photographed three times 30 times. As a result, it was confirmed that the size of about 10 to 100 nm as shown in FIG.
- PCR was performed with the following 16s rDNA primer to confirm the presence of a gene derived from bacteria in the extracted DNA. As a result, as shown in FIG. 3, it was confirmed that the bacteria derived from sepsis 1 and 2 were present. .
- DNA was extracted from the nano vesicles by the heat treatment method of Example 3, 16S rDNA primer pair (SEQ ID NO: Sequencing was performed by PCR amplification using 1 and 2) (Roche GS FLX sequencer).
- SFF Standard Flowgram Format
- OTU operational taxonomy unit
- Figure 4a is a result of the meta-genomic analysis of the nano-vesicles isolated from the urine samples of normal and severe bacterial infection patients
- Figure 4b is a list of bacteria increased nano-vesicles in patients with severe bacterial infections (yellow highlighted) ), 12 species of Skermanella , Alkalibacterium , Ureaplasma, Corynebacterium , Streptococcus, Caulobacteraceae , Brevibacterium , Staphylococcus, Kocuria , Pseudomonas , Xanthomonadaceae , and Sphingobium increased.
- DNA was hardly extracted in the case of using the DNA extraction kit, and the amount of DNA extraction increased in the case of extraction with the phenol / chloroform compound than in the case of using the kit. It was found that the method is superior to other methods in the amount of DNA extraction.
- Example 6 Nanoendoplasmic Reticulum Derivation of bacteria with or without isolation Nanoendoplasmic Reticulum Analysis of the differences in the distribution
- DNA was extracted after heat-treatment on nano-vesicles separated from urine samples and after heat-treatment on urine samples without separate nano-vesicles.
- the metagenome analysis was performed by the method of Example 4 above.
- Example 4 For each of 10 urine samples of a normal person and an infectious endocarditis patient, PCR amplification of the genome extracted by the heat treatment method of Example 3 with 16S rDNA primer pairs (SEQ ID NOs: 1 and 2), followed by Example 4 The metagenome analysis was performed by the method of. As a result, it was confirmed that the endoplasmic reticulum derived from Staphylococcus increased 61% significantly in the urine of patients with infective endocarditis compared to normal subjects.
- Example 3 For each of 10 urine samples of normal people and nephritis (APN), the genome extracted by the heat treatment method of Example 3 was PCR amplified by 16S rDNA primer pairs (SEQ ID NOs: 1 and 2), followed by the method of Example 4 Metagenome analysis was performed. As a result, it was confirmed that 46% of the endoplasmic reticulum derived from Caulobacteraceae increased significantly in the urine of nephritis patients compared to normal people.
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Abstract
Description
샘 플 | 나노소포체 정량값 ( ㎍/ ml) |
정상인 1 | 6 |
정상인 2 | 114 |
정상인 3 | 8 |
정상인 4 | 10 |
정상인 5 | 2 |
패혈증 환자 1 | 2 |
패혈증 환자 2 | 35 |
패혈증 환자 3 | 2 |
패혈증 환자 4 | 4 |
패혈증 환자 5 | 7 |
Claims (16)
- 하기의 단계를 포함하는, 세균성 중증 감염질환 원인균의 동정방법.(A) 세균 유래 나노소포체를 함유하는 환자샘플에서 나노소포체 내의 유전자를 추출하는 단계;(B) 상기 추출된 유전자에 대하여 서열번호 1 및 2의 프라이머쌍을 이용하여 PCR을 수행하는 단계; 및(C) 상기 PCR 결과물이 정상인에 비하여 증가되어 있을 경우 세균성 중증 감염질환 원인균이 존재하는 것으로 판정하는 단계.
- 제 1 항에 있어서, 상기 환자샘플은 소변, 혈액, 구강액, 위액, 대변, 비강액, 객담, 피부세척액, 흉막액, 복막액, 관절액, 뇌척수액, 양수, 및 질세척액으로 이루어진 군에서 선택되는 것을 특징으로 하는, 동정방법.
- 제 1 항에 있어서, 상기 나노소포체 내의 유전자는 16S rDNA 또는 16S rRNA인 것을 특징으로 하는, 동정방법.
- 제 1 항에 있어서, 상기 나노소포체는 평균 직경이 10-300nm인 것을 특징으로 하는, 동정방법.
- 제 1 항에 있어서, 상기 세균성 중증 감염질환은, 패혈증, 부비동염, 폐렴, 결핵, 감염성 심내막염, 골관절염, 골수염, 요로감염, 뇌염, 뇌막염, 및 신장염으로 이루어진 군에서 선택되는 것을 특징으로 하는, 동정방법.
- 제 1 항에 있어서, 상기 원인균은 Skermanella , Alkalibacterium , Ureaplasma, Corynebacterium , Streptococcus, Caulobacteraceae , Brevibacterium , Staphylococcus, Kocuria , Pseudomonas , Xanthomonadaceae, 및 Sphingobium으로 이루어진 군에서 선택되는 다제내성균인 것을 특징으로 하는, 동정방법.
- 제 1 항에 있어서, 상기 단계 (A)에서 유전자를 추출하는 단계는, 하기의 단계를 포함하는 것을 특징으로 하는 동정방법.(a) 환자샘플을 원심분리하여 상등액을 얻은 후 필터에 의해 세균 및 이물질을 제거하는 단계;(b) 상기 필터링 후 얻은 산물을 원심분리하여 농축하는 단계;(c) 상기 농축 산물을 초고속원심분리하여 나노소포체 펠렛(pellet)을 얻는 단계;(d) 상기 나노소포체 펠렛을 열처리하는 단계; 및(e) 상기 열처리 산물을 원심분리하여 상등액을 얻는 단계.
- 제 7 항에 있어서, 상기 단계 (d)에서 열처리는 90-110℃에서 5-30분간 행하는 것을 특징으로 하는, 동정방법.
- 하기의 단계를 포함하는, 세균성 중증 감염질환 원인균에 대한 항생제 내성예측방법.(A) 세균 유래 나노소포체를 함유하는 환자샘플에서 나노소포체 내의 유전자를 추출하는 단계;(B) 상기 추출된 유전자에 대하여 서열번호 1 및 2의 프라이머쌍을 이용하여 PCR을 수행하는 단계; 및(C) 상기 PCR 결과물이 정상인에 비하여 증가되어 있을 경우 세균성 중증 감염질환 원인균에 대하여 항생제 반응성이 낮을 것으로 판단하는 단계.
- 제 9 항에 있어서, 상기 환자샘플은 소변, 혈액, 구강액, 위액, 대변, 비강액, 객담, 피부세척액, 흉막액, 복막액, 관절액, 뇌척수액, 양수, 및 질세척액으로 이루어진 군에서 선택되는 것을 특징으로 하는, 예측방법.
- 제 9 항에 있어서, 상기 나노소포체 내의 유전자는 16S rDNA 또는 16S rRNA인 것을 특징으로 하는, 예측방법.
- 제 9 항에 있어서, 상기 나노소포체는 평균 직경이 10-300nm인 것을 특징으로 하는, 예측방법.
- 제 9 항에 있어서, 상기 세균성 중증 감염질환은, 패혈증, 부비동염, 폐렴, 결핵, 감염성 심내막염, 골관절염, 골수염, 요로감염, 뇌염, 뇌막염, 및 신장염으로 이루어진 군에서 선택되는 것을 특징으로 하는, 예측방법.
- 제 9 항에 있어서, 상기 원인균은 Skermanella , Alkalibacterium , Ureaplasma, Corynebacterium , Streptococcus, Caulobacteraceae , Brevibacterium , Staphylococcus, Kocuria , Pseudomonas , Xanthomonadaceae, 및 Sphingobium으로 이루어진 군에서 선택되는 다제내성균인 것을 특징으로 하는, 예측방법.
- 제 9 항에 있어서, 상기 단계 (A)에서 유전자를 추출하는 단계는, 하기의 단계를 포함하는 것을 특징으로 하는 예측방법.(a) 환자샘플을 원심분리하여 상등액을 얻은 후 필터에 의해 세균 및 이물질을 제거하는 단계;(b) 상기 필터링 후 얻은 산물을 원심분리하여 농축하는 단계;(c) 상기 농축 산물을 초고속원심분리하여 나노소포체 펠렛(pellet)을 얻는 단계;(d) 상기 나노소포체 펠렛을 열처리하는 단계; 및(e) 상기 열처리 산물을 원심분리하여 상등액을 얻는 단계.
- 제 15 항에 있어서, 상기 단계 (d)에서 열처리는 90-110℃에서 5-30분간 행하는 것을 특징으로 하는, 예측방법.
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KR101798176B1 (ko) | 2017-11-15 |
EP3235910A1 (en) | 2017-10-25 |
US20170369930A1 (en) | 2017-12-28 |
US10351900B2 (en) | 2019-07-16 |
KR20160073157A (ko) | 2016-06-24 |
CN107429290B (zh) | 2021-04-20 |
CN107429290A (zh) | 2017-12-01 |
JP2017538421A (ja) | 2017-12-28 |
EP3235910B1 (en) | 2020-02-12 |
EP3235910A4 (en) | 2018-06-20 |
JP6430648B2 (ja) | 2018-11-28 |
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