{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:22:21Z","timestamp":1792790541214,"version":"4.5.0"},"reference-count":28,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,10,5]]},"abstract":"<jats:p>\n                    This study was performed to determine the nationwide antigenic diversity of\n                    <jats:italic>Orientia tsutsugamushi<\/jats:italic>\n                    in South Korea. Sequence analysis was performed around variable domains I and II of a 56-kDa protein-encoding gene. We used eschar to overcome the disadvantages of conventional serotyping. The serological passive hemagglutination assay (PHA) was assessed based on the genotyping results. We analyzed 153 isolates from scrub typhus patients in major endemic areas and found that Boryong was the major strain (68.6%). New strains were also identified: Taguchi (19.6%), Kanda\/Kawasaki (9.2%), and UAP7 (1.3%). PHA yielded significantly fewer positive results among Kawasaki strains (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001), which are not included in the PHA antigen panel. In South Korea, Boryong was still the predominant strain, but the sequence analysis identified new changes in minor strains (30.1%). This antigenic drift had a negative effect on the PHA results. Periodic surveillance of the contemporary strains using sequence analysis is needed.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.2010.09-0791","type":"journal-article","created":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T13:15:08Z","timestamp":1285938908000},"page":"930-935","source":"Crossref","is-referenced-by-count":20,"title":["Antigenic Drift of Orientia tsutsugamushi in South Korea as Identified by the Sequence Analysis of a 56-kDa Protein-Encoding Gene"],"prefix":"10.4269","volume":"83","author":[{"given":"Sang-Won","family":"Park","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Kug","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee Gyung","family":"Kwak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chisook","family":"Moon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baek-Nam","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eu Suk","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Myung","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Seop","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Clin Infect Dis","first-page":"1296","article-title":"Clinical usefulness of eschar polymerase chain reaction for the diagnosis of scrub typhus: a prospective study","volume":"43","author":"Kim","year":"2006"},{"key":"R2","series-title":"Am J Trop Med Hyg","first-page":"542","article-title":"Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study","volume":"75","author":"Kim","year":"2006"},{"key":"R3","series-title":"Am J Trop Med Hyg","first-page":"325","article-title":"Eradication of Rickettsia tsutsugamushi from patients' blood by chemotherapy as assessed by the polymerase chain reaction","volume":"52","author":"Murai","year":"1995"},{"issue":"(Suppl 3)","key":"R4","series-title":"Clin Infect Dis","first-page":"S203","article-title":"Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi","volume":"48","author":"Kelly","year":"2009"},{"key":"R5","series-title":"Infect Immun","first-page":"2076","article-title":"The 56-kilodalton major protein antigen of Rickettsia tsutsugamushi: molecular cloning and sequence analysis of the sta56 gene and precise identification of a strain-specific epitope","volume":"58","author":"Stover","year":"1990"},{"key":"R6","series-title":"J Clin Microbiol","first-page":"2628","article-title":"Specific amplification of Rickettsia tsutsugamushi DNA from clinical specimens by polymerase chain reaction","volume":"29","author":"Furuya","year":"1991"},{"key":"R7","series-title":"J Clin Microbiol","first-page":"1637","article-title":"Serotype-specific amplification of Rickettsia tsutsugamushi DNA by nested polymerase chain reaction","volume":"31","author":"Furuya","year":"1993"},{"key":"R8","series-title":"J Korean Med Assoc","first-page":"430","article-title":"Thirteen cases of rickettsial infection including 9 cases of tsutsugamushi disease first confirmed in Korea [Korean]","volume":"29","author":"Lee","year":"1986"},{"key":"R9","series-title":"Emerg Infect Dis","first-page":"1127","article-title":"Rapid increase of scrub typhus, South Korea, 2001\u20132006","volume":"15","author":"Kweon","year":"2009"},{"key":"R10","series-title":"J Biol Chem","first-page":"12728","article-title":"Diversity of immunodominant 56-kDa type-specific antigen (TSA) of Rickettsia tsutsugamushi: sequence and comparative analyses of the genes encoding TSA homologues from four antigenic variants","volume":"267","author":"Ohashi","year":"1992"},{"key":"R11","series-title":"FEMS Microbiol Lett","first-page":"163","article-title":"Phylogenetic analysis of Orientia tsutsugamushi strains based on the sequence homologies of 56-kDa type-specific antigen genes","volume":"180","author":"Enatsu","year":"1999"},{"key":"R12","series-title":"Microbiol Immunol","first-page":"439","article-title":"Epidemiological survey of Orientia tsutsugamushi distribution in field rodents in Saitama prefecture, Japan, and discovery of a new type","volume":"45","author":"Tamura","year":"2001"},{"key":"R13","series-title":"Nucleic Acids Res","first-page":"4673","article-title":"CLUSTAL W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position-specific gap penalties and weight matrix choice","volume":"22","author":"Thompson","year":"1994"},{"key":"R14","series-title":"Mol Biol Evol","first-page":"406","article-title":"The neighbor-joining method: a new method for reconstructing phylogenetic trees","volume":"4","author":"Saitou","year":"1987"},{"key":"R15","series-title":"Evolution","first-page":"783","article-title":"Confidence limits on phylogenies: an approach using the bootstrap","volume":"39","author":"Felsenstein","year":"1985"},{"key":"R16","series-title":"Gene","first-page":"119","article-title":"Cloning and sequencing of the gene (tsg56) encoding a type-specific antigen from Rickettsia tsutsugamushi","volume":"91","author":"Ohashi","year":"1990"},{"key":"R17","series-title":"J Clin Microbiol","first-page":"598","article-title":"High-level expression of a 56-kilodalton protein gene (bor56) of Rickettsia tsutsugamushi Boryong and its application to enzyme-linked immunosorbent assays","volume":"31","author":"Kim","year":"1993"},{"key":"R18","series-title":"Microbiol Immunol","first-page":"229","article-title":"Antigenic relationship among the eight prototype and new serotype strains of Orientia tsutsugamushi revealed by monoclonal antibodies","volume":"43","author":"Kang","year":"1999"},{"key":"R19","series-title":"Microbiol Immunol","first-page":"627","article-title":"Demonstration of antigenic and genotypic variation of Orientia tsutsugamushi which were isolated in Japan, and their classification into type and subtype","volume":"40","author":"Ohashi","year":"1996"},{"key":"R20","series-title":"Tsutsugamushi Disease in Korea","first-page":"25","author":"Chang","year":"1994"},{"key":"R21","series-title":"Commun Dis Monthly Rep","first-page":"245","article-title":"Current trends of scrub typhus (Korean)","volume":"15","author":"Korea Centers for Disease Control and Prevention","year":"2004"},{"key":"R22","series-title":"Am J Trop Med Hyg","first-page":"528","article-title":"Determination and geographical distribution of Orientia tsutsugamushi serotypes in Korea by nested polymerase chain reaction","volume":"65","author":"Ree","year":"2001"},{"key":"R23","series-title":"Clin Microbiol Infect","first-page":"311","article-title":"Characterisation of Orientia tsutsugamushi genotypes from wild rodents and chigger mites in Korea","volume":"15","author":"Shim","year":"2009"},{"key":"R24","series-title":"BMC Infect Dis","first-page":"82","article-title":"Clinical characteristics of the autumn-winter type scrub typhus cases in south of Shandong province, northern China","volume":"9","author":"Liu","year":"2009"},{"key":"R25","series-title":"Am J Trop Med Hyg","first-page":"162","article-title":"Scrub typhus in Japan: epidemiology and clinical features of cases reported in 1998","volume":"67","author":"Ogawa","year":"2002"},{"key":"R26","series-title":"Am J Trop Med Hyg","first-page":"542","article-title":"Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: a prospective study","volume":"75","author":"Kim","year":"2006"},{"key":"R27","series-title":"Clin Microbiol Infect","first-page":"168","article-title":"Detection of new genotypes of Orientia tsutsugamushi infecting humans in Thailand","volume":"14","author":"Fournier","year":"2008"},{"key":"R28","series-title":"Clin Infect Dis","first-page":"391","article-title":"Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion","volume":"44","author":"Blacksell","year":"2007"}],"container-title":["The American Society of Tropical Medicine and 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