Solunum yolu enfeksiyonu olan çocuklarda respiratuvar sinsityal virusun gerçek zamanlı polimeraz zincir reaksiyonu ile araştırılması

Öz

Amaç: Respiratuvar sinsityal virus (RSV), yaşamın ilk yıllarında solunum yolu enfeksiyonlarının (SYE) en sık etkenidir. Bu çalışmada SYE olan çocuklarda RSV A/B’nin multipleks polimeraz zincir reaksiyonu (PCR) ile araştırılması, yaş grupları arasında RSV dağılımı, eşlik eden koenfeksiyonlar ve mevsimsel dağılım özelliklerini değerlendirmeyi amaçladık.

Yöntemler: Bu çalışma çapraz kesitsel olarak planlanmıştır. Çalışmaya Nisan 2015 – Mart 2018 tarihleri arasında, 0-18 yaş arasında 

SYE ön tanısı ile gönderilen nazofaringeal sürüntü örnekleri dahil edildi. Örneklerden nükleik asit ekstraksiyon işlemi, EZ1 Virus Mini Kit V 2.0 (Qiagen, Almanya) ile EZ1 Advanced XL (Qiagen, Almanya) cihazında yapıldı. RSV A/B ve solunum paneline ait diğer viruslar, FTD Respiratory pathogens 21 (Fast-Track Diagnostics, Luxembourg) kiti kullanılarak multipleks real-time PCR yöntemi ile araştırıldı.

Bulgular: Yaş aralığı 0-18 olan 2707 hastanın medyan yaşı 1 idi ve %57,4’ü (1554) erkekti. RSV pozitifliği %14,4’ünde (390) tespit edildi. Kız ve erkeklerde RSV sıklığı sırasıyla %13,6 ve %15,5 idi (P=0,16). En yüksek RSV oranı <1 yaş grubunda %18,1 idi (P<0,001). Mikst etken ile enfeksiyonu %5,4’ünde saptandı. En fazla RSV ve HRV (%1,8) birlikteliği görüldü. RSV en sık Aralık (%27,9), ardından Ocak ve Şubat ayında saptandı (P<0,001). 

Sonuç: SYE olan pediatrik hastaların %14,4’ünde RSV saptadık. RSV’nin 1 yaş altında daha yaygın olduğu tespit ettik. Bu çalışmada, RSV'nin kış mevsiminde sık görülen bir patojen olduğunu belirledik. Real-time PCR ile RSV tanısının erken konulması, gereksiz antibiyotik kullanımının ve nozokomiyal enfeksiyonların önlenmesi açısından önem taşımaktadır. Ayrıca, insidansın arttığı kış mevsimi boyunca SYE’lerin önlenmesi, kontrolü ve tedavisi için etkili bir yaklaşımın uygulanmasına yardımcı olabilecektir.

Anahtar Kelimeler

• Respiratuvar sinsityal virus,Real-time PCR,Solunum yolu enfeksiyonu

Investigation of respiratory syncytial virus in children with respiratory tract infection by real-time polymerase chain reaction

Abstract

Aim: Respiratory syncytial virus (RSV) is the most common agent of respiratory tract infections (RTIs) in the early stages of life. This study aimed to investigate RSV A/B in children with RTIs by multiplex Polymerase Chain Reaction (PCR) and evaluate the distribution of RSV among age groups, concurrent co-infections, and features of its seasonal distribution. 

Methods: Zero to eighteen-year-old patients whose nasopharyngeal swab samples were analyzed with the pre-diagnosis of RTI between April 2015 - March 2018 were included in this cross-sectional study. RSV A/B and other viruses of the respiratory panel were investigated with the multiplex real-time PCR method. 

Results: Median age of 2707 patients was 1 (age range: 0-18) and 57.4% (1554) of them were male. RSV positivity was found in 14.4% (390). Prevalence of RSV in females and males were 13.6% and 15.5% respectively (P=0.16). The highest RSV rate was 18.1% in those younger than one year. Mixed infection factors were found in 5.4%, the most common ones being RSV and human rhinovirus (1.8%). RSV was mostly seen in December, followed by January and February (P<0.001). 

Conclusion: RSV was found in 14.4% of the pediatric patients with RTI. We found that RSV was more common under the age of 1. In this study, we determined that RSV was commonly seen in winter. Early diagnosis of RSV with real-time PCR plays a crucial role in the prevention of unnecessary use of antibiotics and nosocomial infections. It may also help to implement an effective approach to the prevention, control, and treatment of RTIs during winter when the incidence increases.

Keywords

• Respiratory syncytial virus,Real-time PCR,Respiratory tract infection

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