| Project/Area Number |
21K09525
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 56040:Obstetrics and gynecology-related
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| Research Institution | Juntendo University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
竹田 純 順天堂大学, 医学部, 准教授 (60813459)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2023: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2022: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2021: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | GBS感染症 / 周産期死亡 / 新生児B群溶血性レンサ球菌感染症 / 等温核酸増幅法 |
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| Outline of Research at the Start |
本研究では、等温核酸増幅法を応用し、短時間・高精度なベッドサイドで実施可能なGBS遺伝子検出法を開発する。本法は、分娩直前の的確なタイミングで、どこの施設でも24時間実施可能で、短時間でGBSを検出し得る方法となりうる。検査確定から分娩までのタイムラグを無くすことは、検査結果未確定による不要な予防的抗生剤投与を回避して新生児腸管細菌草叢への長期的影響を最小化するものであり、その有用性は大きい。また、本法は薬剤耐性遺伝子の同時検出を構想しており、適切な抗生剤選択は増加傾向にある薬剤耐性GBS株にも対処しうる。本研究では、現行ガイドラインの弱点を補強し得る革新的なGBS予防法確立を目指す。
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| Outline of Final Research Achievements |
We aimed to reveal the clinical features to explore transmission route of LOD. Vaginal-and-anorectal specimens were collected from 530 pregnant women at the time of antepartum, delivery or postpartum. Oral/anorectal specimens were collected from their newborns at the time of birth, day3, or day30. Each sample was tested by PCR and/or culture for GBS detection. The DNA for PCR was purified directly from the buffer that the swab specimens were suspended without enrichment cultivation. The antepartum prevalence of maternal GBS was 18.6％ according to PCR, and 16.1％ according to cultures. In 9.6％ of cases, GBS results on PCR were inconsistent with antepartum and delivery. GBS was detected in 4.6％ of neonate even from GBS negative mother. GBS positive neonate with negative mother suggests horizontal infection after birth. Our method is a direct detection without an enrichment cultivation, suggesting the possibility of point of care testing.
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| Academic Significance and Societal Importance of the Research Achievements |
現行のガイドラインで予防し得る早発型GBSとは異なり、遅発型GBSは水平感染による出生後感染の可能性が示唆された。したがって本研究で確立した新規核酸検出法は、濃縮培養工程を伴わず直接検出可能であり、分娩時のポイントオブケア検査としてのみならず、発症を疑う新生児の早期診断ツールとしても有効といえ、周産期医療への貢献が期待できる。
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